Purpose: A primary adenosquamous carcinoma of the stomach is relatively rare, accounting for only about 0.5% of all gastric cancers. However, its histopathologic characteristics are still unclear, and the most appropriate form of therapy has not been established yet. Materials and Methods: We retrospectively reviewed the clinicopathologic features of 8 patients with pathologically confirmed primary adenosquamous carcinomas out of 8,268 patients who underwent gastric cancer surgery at Samsung Medical Center between September 1994 and December 2004. Results: The median age of the 8 patients was 49 ($41{\sim}69$) years, and the male : female ratio was 5 : 3. In 3 patients, the tumor was located at the mid body of the stomach, and in 5 patients, at the lower body or antrum. The tumor sizes were $2.5{\sim}8cm$. Seven patients showed metastases to the regional lymph nodes. The UICC stage distribution were: 5 stage II, 2 stage III, and 1 stage IV. In the stage IV patient, a palliative gastrojejunostomy was performed, and he died 5 months after surgery. Of the 7 patients who underwent a radical gastrectomy and adjuvant chemotheratpy, the median survival was 34 ($12{\sim}66$) months, 2 patients died of cancer recurrence, and 4 patients are being followed up without evidence of recurrence. Conclusion: As for an adenocarcinoma of the stomach, a radical gastrectomy including regional lymph node dissection and postoperative adjuvant therapy should be performed for appropriate treatment of an adenosquamous carcinoma of the stomach.
The genioglossus muscle plays an important role in maintaining upper airway patency during inspiration; if this muscle does not contract normally, breathing disorders occur due to closing of the upper airway. These occur because of disorders of synaptic input to the genioglossus motoneurons, however, little is known about it. In this study, the distribution of GABA-, glycine-, and glutamate-like immunoreactivity in axon terminals on dendrites of the rat genioglossus motoneurons, stained intracellularly with horseradish peroxidase (HRP), was examined by using postembedding immunogold histochemistry in serial ultrathin sections. The motoneurons were divided into four compartments: the soma, and primary (Pd), intermediate (Id), and distal dendrites (Dd). Quantitative analysis of 157, 188, 181, and 96 boutons synapsing on 3 soma, 14 Pd, 35 Id, and 28 Dd, respectively, was performed. 71.9% of the total number of studied boutons had immunoreactivity for at least one of the three amino acids. 32.8% of the total number of studied boutons were immunopositive for GABA and/or glycine and 39.1% for glutamate. Among the former, 14.2% showed glycine immunoreactivity only and 13.3% were immunoreactive to both glycine and GABA. The remainder (5.3%) showed immunoreactivity for GABA only. Most boutons immunoreactive to inhibitory amino acids contained a mixture of flattened, oval, and round synaptic vesicles. Most boutons immunoreactive to excitatory amino acids contained clear and spherical synaptic vesicles with a few dense-cored vesicles. When comparisons of the inhibitory and excitatory boutons were made between the soma and three dendritic segments, the proportion of the inhibitory to the excitatory boutons was high in the Dd (23.9% vs. 43.8%) but somewhat low in the soma (35.7% vs. 38.2%), Pd (34.6% vs. 37.8%) and Id (33.1% vs. 38.7%). The percentage of synaptic covering of the inhibitory synaptic boutons decreased in the order of soma, Pd, Id, and Dd, but this trend was not applicable to the excitatory boutons. The present study provides possible evidence that the spatial distribution patterns of inhibitory and excitatory synapses are different in the soma and dendritic tree of the rat genioglussus motoneurons.
Kim, Yang-Ho;Choi, Jung-Keun;Park, Jung-Sun;Moon, Young-Han;Kim, Kyoo-Sang
Journal of Preventive Medicine and Public Health
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v.32
no.1
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pp.30-39
/
1999
Objectives. This study was carried out to evaluate hearing impairment judgement and to investigate the differences in various diagnostic criteria for noise-induced hearing loss (NIHL) among workers who required for close observation (C). Methods. Out of 731,029 workers who had taken the specific periodic health examination in 1994, we used the audiometric data on 37,999 workers (C) eliminating the employees who had previous otologic problems. Many investigators have being using different criteria for the evaluation of hearing impairment. In this study, we used the criteria of early (1989-1994), current, compensation for NIHL in Korea, 2-, 3-, 4-divided classification and hearing loss at 4,000 Hz and compared the evaluation results. Results. The prevalences of C and workers who had occupational disease $(D_1)$ diagnosed for NIHL were 11.1 % and 0.44 %. There were significant difference in the prevalences of C and $D_1$, depending on different province of Korea. Pure tone averages (PTAs) were not appropriately applied in their evaluation 97% of workers whom we studied on were below the level of mild hearing loss judged by ISO standard. However, there were wide variations in the prevalence rate of mild hearing loss by diagnostic criteria. Thus, there were different judgements in determining the degree of NIHL depending on which diagnostic criteria were utilized. PTAs were found 20.54 (Rt) and 20.74 (Lt) when the method of 3-divided classification was applied for audiometric data. The degree of hearing impairment of the left ear was more severe than that of right ear. The prevalence of normal hearing threshold below 20 dB was 75.4% and the range of difference in both ear was below 10 dB. Right sided hearing threshold levels were 21.08 dB (500 Hz), 18.44 dB (1,000 Hz), 22.09 (2,000 Hz) and 52.36 dB (4,000 Hz). There was typical high frequency loss (C5-dip at 4,000 Hz) above 30 - 40 dB in normal hearing level. The increasing trend in hearing threshold level was gradually decreased by the increase of PTAs. The difference between PTAs and threshold at 4,000 Hz was about 10 dB. Conclusions. We could found that PTAs in the previous examination were not appropriately evaluated. This study revealed that they did not use unique criteria for managing the workers of NIHL. For the prevention of NIHL, it was found that the quality control on diagnosis and comprehensive management program were required, especially for those of hearing loss (C).
Journal of Korean Academy of Nursing Administration
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v.1
no.2
/
pp.338-348
/
1995
We need to continuously evaluate for nursing quality and the outcome to reflect nursing, to repair and improve of nursing. The first problem for nursing quality improvement is development of evaluation tool for the quality of nursing care. We need a system for quality assurance evaluation that is, development and framework of evaluation tool for nursing care quality. The purpose of this study was attempted to develop an evaluation tool for the quality of nursing care in musculoskeletal disorder patients. The approach method of nursing quality for the development of the tool in this study was process evaluation framework. The study were devided dvelopment process and reliability, validity verification process. The subjects of development process of this tool are three nursing export groups, and the subject of reliability, validity verification process are 20 samples of two university hospital in seoul, who were within discharge 3 months after admission treatment in musculo-skeletal disorder. Data for this study was collected from March 10 to April 13, 1995. The development process of the tool were as follows : 1. Make preliminary list of the tool by focal group were constituted 12 clinical nurses. 2. Modify and add preliminary list by 4 nursing expert panel. 3. Calculate content validity of the tool by 25 nursing expert panel of judge. 4. Verify reliability and validity of the tool. 5. Finalize an evaluation tool for the quality of the nursing care in musculo-skeletal disorder. The results of this study were as follows : 1) Development an evaluation tool for the quality of nursing care in musculo-skeletal disorder. (1) The evalution tool of this study was developed 5 standards, 33 criterias and 133 indicators. (2) 5 standards were divided according to Nursing Process. from standard 1 to standard 5, involved criterias were each 6(18%), 3(9%), 3(9%), 15(46%), 6(18%). 2) Verify reliability and validity of the tool. (1) Score of adequate degree for content validity of 33 criterias and 133 indicators were every average 2.82. (2) Inter-rater reliabilities(consentaneity score) of the tool by pearson correlation coefficient between three raters were : r=.7506, r=.8934, r=.6695. and Inter-rater reliabilities by single-facet crossed design were : r=.7464. (3) The alpha coefficient relating to internal consistency was .8524 over all 30 items of 33 criterias of developed tool. (4) Score of the quality of nursing care following to generaal characteristics of this study subjects were stastically significant differences according to educational level (F=2.93, p=.029)and diagnosing classification (F=2.50, p=.042). Through this study, I'm sure that the developed tool for the quality of patient care in musculo-skeletal disorder will show the way of more improvement of the quality of nursing care and effective nursing interventions.
The aim of this study was to develop a new starter for fermented milk. The approach started with 103 acid-producing isolates from Kimchi, a type of spiced, fermented cabbage and then PCR screening was used to identify 72 Lactobacillus strains. The ability to inhibit the growth of food-borne human pathogens (Escherichia coli, Salmonella enteritidis, Staphylococcus aureus) of these strains were measured, using the paper disk method. Among them, one bacterium (LHB55) that showed a strong antibacterial activity against food-borne human pathogens was identified and further characterized, using 16S rDNA sequencing and API 50CHL system. Because this isolate was identified as L. plantarum, it was named as L. plantarum LHB55. The yogurt produced using commercial LAB with L. plantarum LHB55 did not display properties that are microbially or physico-chemically different from the control group, which suggests that L. plantarum LHB55 can be used as a useful starter for yogurt containing high antibacterial activity. We think that identifying effective starter strains enabling further development of fermented milk that can deliver better health benefits such as antimicrobial properties is of high significance, and thus our effort in this type of approach will continue.
Seo, Young Kyung;You, Dong Keun;Kim, Hwan;Kim, Siyeon;Lee, Go eun;Kim, Sang-Ho;Kang, Hyung-Won;Jung, In Chul
Journal of Oriental Neuropsychiatry
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v.28
no.3
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pp.263-274
/
2017
Objectives: To identify the current status of Korean medical practice pattern, diagnosis and treatment of dementia through recognition survey, and to use it as a preliminary data for various dementia research. Methods: Questionnaires were developed through expert meetings. The disease was defined as dementia and mild cognitive impairment, and areas were designated to practice pattern, diagnosis and treatment. From December 18, 2016-January 18, 2017, 221 respondents, including 36 neuropsychiatrists of Korean Medicine and 185 general physicians (including other medical specialists) were included. Results: 1. In both groups, the most commonly used KCD (Korean standard classification of disease and cause of death) were in the order of Unspecified Alzheimer's Dementia (F00.9), Mild Cognitive Impairment (F06.7), and Unspecified Dementia (F03). 2. The most commonly used pattern identification were zang-fu and qi-blood-yin-yang in both groups. 3. Diagnostic evaluation tools were mainly conducted by MMSE, radiologic examination, K-DRS, GDS and CDR in both groups. 4. Both groups reported using acupuncture and herbal medicine mainly. 5. In both groups, the acupuncture method was used extensively in the order of Body, Scalp, and Sa-Am. 6. Neuropsychiatrists used a variety of herbal medicines such as Wonjiseokchangpo-san (Yuanzhushichangpu-san), Yukmijihwang-tang (Liuweidihuang-tang), Palmijihwang-won (Baweidihuang-won), Sunghyangjungki-san (Xingxiang Zhengqi-san) and Ondam-tanggami (Wendan-tangjiawei). General physicians used a variety of herbal medicines such as Ondam-tanggami (Wendan-tangjiawei), Bojungikgi-tang (Buzhongyiqi-tang), Yukmijihwang-tang (Liuweidihuang-tang). 7. Neuropsychiatrists used a variety of Korean herbal preparation products (benefit and non-benefit) such as Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Yukmijihwang-tang (Liuweidihuang-tang), Jodeung-san (houteng-san), Palmijihwang-won (Baweidihuang-won). General physicians used a variety of Korean herbal preparation products such as Bojungikgi-tang (Buzhongyiqi-tang), Banhabaegchulcheonma-tang (banxiabaizhutianma-tang), Yukmijihwang-tang (Liuweidihuang-tang), Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Palmijihwang-won (Baweidihuang-won). Conclusions: By confirming awareness of Korean medical doctors treating dementia in clinical fields and understanding differences between neuropsychiatrists of Korean medicine and general physicians, it can be used to understand guideline users' needs and confirm clinical questions during development of future clinical practice guidelines for dementia.
Objective : The study was designed to evaluate the possibility of treatment of stroke patients with dysarthia by the sa-am acupuncture. Methods: From March 1st 2003 to June 30th 2003, the clinical comparison studies were carried out 20 cases of stroke patients with dysarthria treated by Sa-Am acupuncture(Group I) & general acupuncture(Group II), who had been treated in Dept. of acupuncture and Moxibustion, Dae-jeon Oriental Medical Hospital, Dae-jeon University. Results : The results obtained as follows; 1. The Articuration of Group I and Group II was improved significantly. Group I is more effective than Group II significantly(p<0.05). 2. The Vowel of Group I and Group II was improved but there was no signification(p>0.05). 3. The Alternation of Group I and Group II was improved significantly. Group I is more effective than Group II significantly(p<0.05). 4. The Speed of reading the sentence of Group I and Group II was improved but only Group I was improved significantly(p<0.05). Conclusions: This result suggest that sa-am acupuncture was effective treatment of stroke patients with dysarthria. So further research is needed continuously.
The purpose of this double-blind study was to evaluate clinical effects of botulinum toxin type A (BTX-A) injection on myofascial pain syndrome (MPS) involving upper trapezius and compare with those of lidocaine injection. 21 patients presenting with active TrP1 and/or TrP2 in the upper trapezius over 6 months were selected for this study. The subjects were randomly divided into two groups; one group injected with BTX-A (15 unit of $Botox^{(R)}$ / 0.3 ml per trigger point (TrP)) and the other group injected with 0.5% lidocaine (0.3 ml /TrP). The clinical effects were evaluated by VAS and PPT at baseline, 2, 4, 6 and 8 weeks after treatment. BTX-A group showed persistent decrease of VAS values and increase of PPT values following treatment. While there was no significant difference in VAS values between BTX-A and lidocaine groups (p=0.347), there was significant difference in PPT values after treatment between two groups (p=0.000). The subjects received BTX-A showed noticeable improvement in PPT values after treatment, suggesting more reliable effect of BTX-A injection compared with lidocaine injection. The results of this study support that the direct injection of BTX-A to a TrP is an effective and safe treatment for MPS involving upper trapezius.
The Journal of the Korean bone and joint tumor society
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v.6
no.2
/
pp.82-87
/
2000
Tumoral calcinosis is a disease of unclear etiology which presents with periarticular and intramuscular calcification without the disorder of calcium and phosphorus metabolism. The incidence is very rare but the rate is higher among the blacks than whites. There has been no report on the recurrent occurrence on the asian race. We report a case that recurred several times with tumoral calcinosis of both knee and thigh. A 21-year-old woman visited to our department with masses in both right thigh and knee. She had a history of local excisions and biopsies(4 times at other hospital) and showed prompt recurrences. The complete marginal excision was performed for the treatment. The histological examination showed the findings that are compatible with tumoral calcinosis. There has been a free of recurrence over the past two years.
The Journal of the Korean bone and joint tumor society
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v.6
no.1
/
pp.41-46
/
2000
We experienced the case of familiar hypercholesterolemia with multiple xanthomas which was treated by combined surgical and medical therapy. He was 26-year-old male patient of familiar hypercholesterolemia with multiple xanthomas in 22 sites on whole body, and was treated by 17 surgical excisions of the xanthomas and by medical therapy of the hypercholesterolemia. There was a normal healing process of the surgical wounds. Continual postoperative medical therapy of the hypercholesterolemia was done. There was no recurrence of the symptoms during more than 13 months of follow-up. But the serum level of the cholesterol was not lowered significantly, so we are treating him with drug therapy. Familial hypercholesterolemia is caused by a specific disorder of lipid metabolism, and is characterized by increased LDL cholesterol, tendon xanthomas, coronary disease associated with autosomal dominant transmission. Xanthomas usually appear in the second decade of life with familiar hypercholesterolemia which may have high risk for premature coronary atherosclerosis, which might be prevented with early diagnosis and medical treatment. So, orthopedic surgeons do not only excise the xanthomatosis surgically but also can diagnose the underlying hypercholesterolemia.
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