• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.559-562
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• 2012

Serum alpha-fetoprotein (AFP) is a significant marker for clinical diagnosis and prognosis evaluation in hepatocellular carcinoma (HCC) patients. However, some proportion of liver cancer patients are AFP-negative (AFP ${\leq}$20ng/ml). In order to study the differences between clinicopathological factors and prognosis of alpha-fetoprotein negative and positive patients, a total of 114 cases (41 AFP-negative and 73 AFP-positive) were selected for our research. By systematically statistical analysis, the results demonstrated that compared with AFP-negative patients, AFP-positive examples were more likely to feature cirrhosis nodules, non-complete neoplasm capsules, and a poor Edmondson-steiner grade. Furthermore, AFP-negative patients demonstrated a favorable long-term prognosis. By univariate analysis and multivariate analysis with Cox's proportional hazards model, multiple tumors were found to be independent risk factors for worse survival of AFP negative patients; however, less tumor-free margins, multiple tumors and Edmondson-steiner grades III/IV, proved to be independent risk factors leading to a poor prognosis of AFP positive cases. Finally, we can infer that high levels of AFP signify a highly malignant tumor and unfavorable prognosis.

• Journal of Gastric Cancer
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• v.9 no.2
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• pp.63-67
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• 2009

Splenic marginal zone lymphoma (SMZL) is a rare type of non-Hodgkin's lymphoma (NHL). We report here on a patient who displayed the synchronous occurrence of SMZL and early gastric cancer (EGC). The patient was a 74 year-old male with liver cirrhosis. An EGC in the gastric antrum was diagnosed and the preoperative abdomen computed tomography scan revealed splenomegaly and intra-abdominal lymphadenopathy. We performed subtotal gastrectomy and the postoperative pathologic examination revealed adenocarcinoma limited to the gastric mucosa and SMZL in the lymph nodes. The patient recovered from the surgery without complications and is now awaiting chemotherapy. SMZL has an indolent clinical course with good long-term survival and so there is the possibility of the occurrence of a second primary malignancy. Rare cases of a second primary malignancy being diagnosed along with SMZL have been described in the literature. Patients with SMZL should be carefully followed after treatment to detect the possible occurance of a second primary malignancy.

• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.31-46
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• 1988

In order to designate a present status necessary for establishment of preventive measures and guidelines of health education against hepatitis B in the course of secondary school education, knowledge and practice toward hepatitis B virus infection was surveyed by a questionnare method on total of 4,855 college entrants in the academic year of 1987 and analyzed the data collected using IBM PC(Trigem 88-II) with SAS package program. About two per cent of college entrants had past history of HBV infections not showing any difference between both sexes and geographical regions. About one third(33.7%) of total students had tested hepatitis B surface antigen(HBsAg), only 4% had tested hepatitis B surface antibody(HBsAb) and vaccination rate amounted to 24.6%, one fourth of total subjects. Both serological tests and vaccination were most commonly performed during adolescence, showing higher rates in female students than in male students. The rates also seemed to be higher in those from urban cities than those from rural cities. Students who had acquired correct knowledge that hepatitis B was infected by virus were amounted to 78.5% of college entrants, and remaining 21.5% had misunderstood that rickettsia, bacteria, fungi or parasites were causal agents. Female students were better aware of the causal agents than male students but there was no difference between places of growth. As for mode of transmission of HBV, 51.5% of male students and 47.7% of female students had correct knowledge. A very few student had known that fact that HBV was transmitted by body fluids such as tear(6.9%), nasal discharge(10.1%) and semen or vaginal secretion(19.2%) and majority(75%) of students had misunderstood that hepatitis B virus would be transmitted per os through food ingestion. Approximately one half(48.9%) of college entrants had knew correctly whom to be vaccinated. Approximately one half of the students knew that hepatr;ma(57.8%) and liver cirrhosis(57.4%) might complicate with hepatitis B virus infection, whereas 12.0% of the students responded that bronchitis was one of the complications of hepatitis B infection. In summary of the above results, we highly recommend that health education program for eradication of hepatitis B virus infection should be introduced in curricula of secondary school education in this country.

• Journal of Trauma and Injury
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• v.24 no.1
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• pp.12-17
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• 2011

Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.193-199
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• 1986

Body fluid Lactate dehydrogenase and its isoenzyme measurement was performed in 132 patients: 8 cases with peritonitis, 21 cases with malignant ascites, 43 cases with liver cirrhosis, 48 cases with tuberculous pleuritis, 12 cases with malignant pleural effusion respectively. Body fluid protein and glucose contents, red blood cell counts, white blood cell counts, cytologic examination were also performed as a comparative study. The results were as follows: 1. Measurement of total LD and protein amount could differentiate between transudate and exudate in the ascitic fluids. 2. In the malignant exudate of ascites and pleural fluid, the activity of LD2 isoenzyme was statistically increased compared with that of inflammatory exudate and the activity of LD4 isoenzyme was also increased compared with that of serum(P<0.05). 3. The inflammatory exudate of pleural fluid and ascites demonstrated the increase of LD5 isoenzyme activity stastistically compared with that of serum and malignant exudate(P<0.05). 4. A difference of total LD activity between malignant ascites and inflammatory ascites was significant statistically, while this was not observed in the pleural exudate. 5. Total LD and LD5 isoenzyme activity didn't correlated with the number of white blood cells in the exudate.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.8
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• pp.107-114
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• 2020

This study was conducted to examine the effects of simulation-based education on the clinical reasoning competence, clinical competence, and satisfaction with simulation experience (SSE). The research design was one group pretest-posttest. Study participants were 89 third-year nursing students from C University in G city, who were engaged the simulation-based education for eight weeks from August to October 2019. Learning scenario titles were blood transfusion reaction patient care with postoperative total hip replacement, hypoglycemia patient care with diabetes mellitus, and hyperkalemia patient care with liver cirrhosis. The data were analyzed by paired t-test using SPSS Win 23.0 program. After applying simulation-based education, nursing students' clinical reasoning competence (t=-17.082, p<.001) and clinical competence(t=-18.40, p<.001) improved significantly. SSE score was 4.65 out of 5 points. The results indicate that the simulation-based education in this study gave the students the experience of providing qualified and secure nursing care under conditions similar to those in the real clinical field. To improve the clinical reasoning competence and clinical competence of nursing students, various cases scenarios are developed and simulation-based education should be applied to more subjects in the nursing curriculum.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.332-340
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• 2011

Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.

• Tuberculosis and Respiratory Diseases
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• v.51 no.1
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• pp.17-24
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• 2001

Background : Community-acquired pneumonia(CAP) remains a leading cause of morbidity and mortality worldwide. Recently, the evolution of drug-resistant microorganisms has become a serious problem in CAP management. Specific antimicrobial therapy is the cornerstone of CAP management. However, obtaining an accurate etiologic diagnosis clinically is not easy and empirical antimicrobial treatment is usually administered prior to the correct microbiologic diagnosis. In this study, the clinical usefulness of empirical CAP treatment was investigated. Methods : A total 35 cases were studied prospectively over a 16-month period in Mokpo Catholic Hospital from Dec. 1995 to Mar. 1997. The microbiologic diagnosis was made by sputum, blood culture, a specific serum antibody test and an immunologic study. Results : The causative organisms were isolated in 10 (30%) out of 33 cases: 8 cases and 1 case on the sputum culture and blood culture respectively, and 1 case by an indirect hemagglutinin test. 12 cases had underlying diseases: pulmonary tuberculosis 4, alcoholism 4, diabetes mellitus 3, and liver cirrhosis 1. Antimicrobial treatment was given empirically and all cases recovered. Conclusion : A definite microbiologic diagnosis before commencing the appropriate treatment in CAP is not straightforward. Empirical therapy according to a clinical assessment is important and helpful. However, every effort to make the correct etiologic diagnosis should be taken.

• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.337-343
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• 2020

An enlarged spleen can be caused by infections, cirrhosis and other liver diseases, blood diseases characterized by abnormal blood cells, problems with the lymph system, immune diseases, or other conditions. Therefore, knowing the normal size of the spleen is helpful for the diagnosis of spleen and may be useful for follow-up. Ultrasonographic examination may be considered normal size if the maximum length is less than 12 cm and less than 5 cm in thickness, but may vary depending on sex and race. We aimed to present the normal range of spleen size by measuring the spleen size by ultrasonography in 20's normal adult Korean. The length of the male spleen was 10.95±1.07 cm and the width was 4.48±0.61 cm. The female length was 9.20±1.30 cm and the width was 3.55±0.44 cm. There was a significant difference (p<0.001). The spleen length increased with increasing height (r=.57) and there was a significant positive linear relationship with increasing spleen length as body weight increased(r=.63). In normal adults, 5 men and 2 women had a spleen length of more than 12 cm and 2 men with a size exceeding 13 cm.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.106-115
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• 1995

Reactive humsn mesothelial cells were examined by immunocytochemical stain with intermediate filaments (cytokeratin [CK1, CK7, CK8, CK18, CD19), vimentin, desmin, actin), epithelial membrane antigen, carcinoembryonic antigen (CEA), MHC class II antigen (HLA-DR), LeuM-1 (CD15), $\alpha1-antitrypsin$(ACT), $\alpha1-antichymotrypsin$ (ACHT), CD68(KP-1) and FcyRIII(CD16). The mesothelial cells were isolated from patients with liver cirrhosis and pleural effusion, and short-term cultured in RPMI 1640 media containing 10% heat inactivated fetal calf serum and 1% identical supernatant fluid of the patients' transudates. The results obtained are as follows 1. The cultured-reactive mesothelial cells were positive for the protein of cytoskeleton such as cytokeratin and vimentin, but negative for desmin and actin. The resting mesothelial cells showed positive reactions for cylokeratin, but negative for vimentin, desmin and actin. 2. The primary antibodies to the cytokeratin were strongly reactive for CK1, CK8 and CK18 but negative for CK7 and CK19 in both reactive and resting mesothelial cells. 3. Resting mesothelial cells showed negative reactions for CEA, but strong positive reactions in cultured-reactive mesothelial cells. 4. The markers for the monocytes/histiocytes(CD11b, CD14, CD16, CD68, Iysozyme and $\alpha1-antitrypsin$ and $\alpha1-antichymotrypsin$) were nonreactive in resting mesothelial cells, but lysozyme and $\alpha1-antitrypsin$ were weakly reactive in reactive and proliferative mesothelial cells. 5. MHC Class II molecule(HLA-DR antigen) was negative in both resting and reactive mesothelial cells. These results suggest that the short-term cultured, reactive mesothelial cells show a newly aberrant expression of the vimentin and calcine-embryonic antigen. The reason of the aberrant expression of the intermediate filament and oncofetal antigen in reactive and proliferative mesothelial cells should be further evaluated.