Novel surgical use of electrosurgical tip cleaners in subdermal excision for axillary osmidrosis

Background@#Axillary osmidrosis is a disease characterized by axillary malodor. The conventional treatment method of subdermal excision uses Metzenbaum scissors. Recently, subdermal excision using the Versajet system was introduced. However, it is an expensive surgical tool, and a recent study demonstrated a higher frequency of axillary skin necrosis with the Versajet. We propose a novel, cost-effective, and safe subdermal excision method that utilizes an electrosurgical tip cleaner (ETC). @*Methods@#Our retrospective cohort study included 27 patients who underwent subdermal excision from June 2012 to November 2021. The patients were classified into three groups according to the surgical method: Metzenbaum scissors, Versajet, and ETC. The operation time, hospitalization cost, and postoperative complications were investigated. @*Results@#The number of patients in the Metzenbaum scissors, Versajet, and ETC groups was seven, eleven, and nine, respectively. The mean operation time and hospitalization cost were significantly different among the three groups (P<0.05). The longest mean operation time was observed in the Metzenbaum scissors group (112.9±23.6 minutes), followed by the ETC and Versajet groups (76.4±27.1 and 64.2±24.8 minutes, respectively). The most expensive method was the Versajet ($2,346.1±517.7), followed by the ETC and Metzenbaum scissors ($1,391.8±317.7 and $1,279.6±287.5, respectively). No postoperative complications were observed. @*Conclusions@#The ETC is a novel method of subdermal excision, comparable to Metzenbaum scissors or Versajet. Therefore, it is recommended for situations where it is necessary to consider both the time and cost of surgery.

The Role of Artificial Intelligence in Gastric Cancer: Surgical and Therapeutic Perspectives:A Comprehensive Review

Stomach cancer has a high annual mortality rate worldwide necessitating early detection and accurate treatment. Even experienced specialists can make erroneous judgments based on several factors. Artificial intelligence (AI) technologies are being developed rapidly to assist in this field. Here, we aimed to determine how AI technology is used in gastric cancer diagnosis and analyze how it helps patients and surgeons. Early detection and correct treatment of early gastric cancer (EGC) can greatly increase survival rates. To determine this, it is important to accurately determine the diagnosis and depth of the lesion and the presence or absence of metastasis to the lymph nodes, and suggest an appropriate treatment method. The deep learning algorithm, which has learned gastric lesion endoscopyimages, morphological characteristics, and patient clinical information, detects gastric lesions with high accuracy, sensitivity, and specificity, and predicts morphological characteristics. Through this, AI assists the judgment of specialists to help select the correct treatment method among endoscopic procedures and radical resections and helps to predict the resection margins of lesions.Additionally, AI technology has increased the diagnostic rate of both relatively inexperienced and skilled endoscopic diagnosticians. However, there were limitations in the data used for learning, such as the amount of quantitatively insufficient data, retrospective study design, single-center design, and cases of non-various lesions. Nevertheless, this assisted endoscopic diagnosis technology that incorporates deep learning technology is sufficiently practical and future-oriented and can play an important role in suggesting accurate treatment plans to surgeons for resection of lesions in the treatment of EGC.

Effects of hypercarbia on arterial oxygenation during one-lung ventilation: prospective randomized crossover study / 대한마취과학회지

Background@#This study aimed to evaluate the effects of hypercarbia on arterial oxygenation during one-lung ventilation (OLV). @*Methods@#Fifty adult patients undergoing elective video-assisted thoracoscopic lobectomy or pneumonectomy were enrolled. Group I patients (n = 25) were first maintained at normocarbia (PaCO2: 38‒42 mmHg) for 30 min and then at hypercarbia (45‒50 mmHg). In Group II patients (n = 25), PaCO2 was maintained in the reverse order. Arterial oxygen partial pressure (PaO2), respiratory variables, hemodynamic variables, and hemoglobin concentration were compared during normocarbia and hypercarbia. Arterial O2 content and O2 delivery were calculated. @*Results@#PaO2 values during normocarbia and hypercarbia were 66.5 ± 10.6 and 79.7 ± 17.3 mmHg, respectively (mean difference: 13.2 mmHg, 95% CI for difference of means: 17.0 to 9.3, P < 0.001). SaO2 values during normocarbia and hypercarbia were 92.5 ± 4.8% and 94.3 ± 3.1% (P = 0.009), respectively. Static compliance of the lung (33.0 ± 5.4 vs. 30.4 ± 5.3 ml/cmH2O, P < 0.001), arterial O2 content (15.4 ± 1.4 vs. 14.9 ± 1.5 ml/dl, P < 0.001) and O2 delivery (69.9 ± 18.4 vs. 65.1 ± 18.1 ml/min, P < 0.001) were significantly higher during hypercarbia than during normocarbia. @*Conclusions@#Hypercarbia increases PaO2 and O2 carrying capacity and improves pulmonary mechanics during OLV, suggesting that it may help manage oxygenation during OLV. Therefore, permissive hypercarbia may be a simple and valuable modality to manage arterial oxygenation during OLV.

Performance of the PSS, APACHE II, and SOFA score as in-hospital prognostic tool in glufosinate-poisoned patients in the intensive care unit

Objective@#Glufosinate-containing herbicide is being used increasingly in agriculture. Its poisoning is a worldwide concern. This study assessed the ability of the Poison Severity Score (PSS), Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring systems, and Sequential Organ Failure Assessment (SOFA) score to predict mortality in intensive care unit patients poisoned with glufosinate. @*Methods@#This was a retrospective cohort study conducted from January 2001 to January 2019. The demographic factors, hemodynamic variables, and laboratory variables were compared in survivors and non-survivors. Using multivariate logistic analysis, the data for the total population were analyzed retrospectively to determine the factors associated with mortality. Significant predictive variables, PSS, APACHE II scoring system, and SOFA score were compared by analyzing the receiver operating characteristic curves. @*Results@#Two hundred seventy-six patients (mean age, 56 years) were enrolled in this study. Of the 276 patients, 240 (87.0%) survived, and 36 (13.0%) died. The factors associated with mortality were a decreased mean arterial blood pressure, Glasgow Coma Scale, partial pressure of arterial oxygen/fraction of inspired oxygen, HCO3-, pH, and HCO3-, and an increased lactate, ammonia, C-reactive protein, PSS, SOFA score, and APACHE II score. Dyspnea, use of vasopressors, and application of mechanical ventilation were associated with mortality. In multivariate analysis, Glasgow Coma Scale5.2 mmol/L, use of vasopressors, and application of mechanical ventilation were predictive of mortality. The areas under the curve and 95% confidence intervals for these indicators were 0.920 (0.834-0.981), 0.865 (0.792-0.923), and 0.824 (0.752-0.897) for the PSS, APACHE II, and SOFA, respectively. @*Conclusion@#The PSS can be used to predict in-hospital mortality and stratify the risk among glufosinate-poisoned patients.

Effects of hypercarbia on arterial oxygenation during one-lung ventilation: prospective randomized crossover study / 대한마취과학회지

Background@#This study aimed to evaluate the effects of hypercarbia on arterial oxygenation during one-lung ventilation (OLV). @*Methods@#Fifty adult patients undergoing elective video-assisted thoracoscopic lobectomy or pneumonectomy were enrolled. Group I patients (n = 25) were first maintained at normocarbia (PaCO2: 38‒42 mmHg) for 30 min and then at hypercarbia (45‒50 mmHg). In Group II patients (n = 25), PaCO2 was maintained in the reverse order. Arterial oxygen partial pressure (PaO2), respiratory variables, hemodynamic variables, and hemoglobin concentration were compared during normocarbia and hypercarbia. Arterial O2 content and O2 delivery were calculated. @*Results@#PaO2 values during normocarbia and hypercarbia were 66.5 ± 10.6 and 79.7 ± 17.3 mmHg, respectively (mean difference: 13.2 mmHg, 95% CI for difference of means: 17.0 to 9.3, P < 0.001). SaO2 values during normocarbia and hypercarbia were 92.5 ± 4.8% and 94.3 ± 3.1% (P = 0.009), respectively. Static compliance of the lung (33.0 ± 5.4 vs. 30.4 ± 5.3 ml/cmH2O, P < 0.001), arterial O2 content (15.4 ± 1.4 vs. 14.9 ± 1.5 ml/dl, P < 0.001) and O2 delivery (69.9 ± 18.4 vs. 65.1 ± 18.1 ml/min, P < 0.001) were significantly higher during hypercarbia than during normocarbia. @*Conclusions@#Hypercarbia increases PaO2 and O2 carrying capacity and improves pulmonary mechanics during OLV, suggesting that it may help manage oxygenation during OLV. Therefore, permissive hypercarbia may be a simple and valuable modality to manage arterial oxygenation during OLV.

Performance of the PSS, APACHE II, and SOFA score as in-hospital prognostic tool in glufosinate-poisoned patients in the intensive care unit

Objective@#Glufosinate-containing herbicide is being used increasingly in agriculture. Its poisoning is a worldwide concern. This study assessed the ability of the Poison Severity Score (PSS), Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring systems, and Sequential Organ Failure Assessment (SOFA) score to predict mortality in intensive care unit patients poisoned with glufosinate. @*Methods@#This was a retrospective cohort study conducted from January 2001 to January 2019. The demographic factors, hemodynamic variables, and laboratory variables were compared in survivors and non-survivors. Using multivariate logistic analysis, the data for the total population were analyzed retrospectively to determine the factors associated with mortality. Significant predictive variables, PSS, APACHE II scoring system, and SOFA score were compared by analyzing the receiver operating characteristic curves. @*Results@#Two hundred seventy-six patients (mean age, 56 years) were enrolled in this study. Of the 276 patients, 240 (87.0%) survived, and 36 (13.0%) died. The factors associated with mortality were a decreased mean arterial blood pressure, Glasgow Coma Scale, partial pressure of arterial oxygen/fraction of inspired oxygen, HCO3-, pH, and HCO3-, and an increased lactate, ammonia, C-reactive protein, PSS, SOFA score, and APACHE II score. Dyspnea, use of vasopressors, and application of mechanical ventilation were associated with mortality. In multivariate analysis, Glasgow Coma Scale5.2 mmol/L, use of vasopressors, and application of mechanical ventilation were predictive of mortality. The areas under the curve and 95% confidence intervals for these indicators were 0.920 (0.834-0.981), 0.865 (0.792-0.923), and 0.824 (0.752-0.897) for the PSS, APACHE II, and SOFA, respectively. @*Conclusion@#The PSS can be used to predict in-hospital mortality and stratify the risk among glufosinate-poisoned patients.

The Efficacy of Midline Barbed Absorbable Sutures in Progressive Tension Closure of Abdominal Flap Donor Sites

BACKGROUND: The donor site of abdominal flaps for breast reconstruction consists of a wide suprafascial cavity that poses a risk of seroma formation. The authors evaluated the efficacy of continuous progressive tension sutures (PTS) using unidirectional barbed absorbable sutures for decreasing the volume of fluid collection and the risk of seroma at the abdominal donor site. METHODS: Between March 2013 and February 2015, 37 consecutive patients underwent breast reconstruction using a deep inferior epigastric artery perforator flap. Two patients who underwent salvage operations were excluded. Ten patients underwent standard abdominal flap donor site closure without PTS. Seven received donor site closure with interrupted Vicryl PTS between the abdominal flap and abdominal muscle fascia. Eighteen patients underwent closure with continuous PTS using unilateral barbed absorbable sutures. Body mass index, the approximate flap area, the duration of drain maintenance, the total drained volume, and the incidence of seroma were compared across these 3 groups. The operative time and subjective difficulty perceived by the surgeon was compared between the 2 PTS groups. RESULTS: The total drained volume was lower and the duration of drain maintenance was shorter in both PTS groups than in the standard closure group. There were no cases of seroma in the PTS groups, and 2 that resolved with conservative care in the standard closure group. More time was required and the subjective difficulty score was significantly higher for interrupted PTS than for continuous PTS. CONCLUSIONS: Continuous PTS effectively reduced the duration of drain insertion, the total volume of drained fluid, and was swifter and easier to perform than interrupted PTS.

Activation of K+ channel by 1-EBIO rescues the head and neck squamous cell carcinoma cells from Ca2+ ionophore-induced cell death

Ion channels in carcinoma and their roles in cell proliferation are drawing attention. Intracellular Ca2+ ([Ca2+]i)-dependent signaling affects the fate of cancer cells. Here we investigate the role of Ca(2+)-activated K+ channel (SK4) in head and neck squamous cell carcinoma cells (HNSCCs) of different cell lines; SNU-1076, OSC-19 and HN5. Treatment with 1 microM ionomycin induced cell death in all the three cell lines. Whole-cell patch clamp study suggested common expressions of Ca(2+)-activated Cl- channels (Ano-1) and Ca(2+)-activated nonselective cation channels (CAN). 1-EBIO, an activator of SK4, induced outward K+ current (ISK4) in SNU-1076 and OSC-19. In HN5, ISK4 was not observed or negligible. The 1-EBIO-induced current was abolished by TRAM-34, a selective SK4 blocker. Interestingly, the ionomycin-induced cell death was effectively prevented by 1-EBIO in SNU-1076 and OSC-19, and the rescue effect was annihilated by combined TRAM-34. Consistent with the lower level of ISK4, the rescue by 1-EBIO was least effective in HN5. The results newly demonstrate the role of SK4 in the fate of HNSCCs under the Ca2+ overloaded condition. Pharmacological modulation of SK4 might provide an intriguing novel tool for the anti-cancer strategy in HNSCC.

Feasibility of Translaminar Screw Placement in Korean Population: Morphometric Analysis of Cervical Spine

PURPOSE: To analyze the feasibility of unilateral and bilateral translaminar screw placement in Koran population, and compare the acceptance rate using previously reported data in American population. MATERIALS AND METHODS: The translaminar lengths, thickness, heights, and sagittal-diagonal measurements were performed. The feasibility analysis was performed using unilateral and bilateral 3.5 mm cervical screw placement on the CT scans within 0.5 mm of safety margin. We also performed radiographic analysis of the morphometric dimensions and the feasibility of unilateral and bilateral translaminar screw placement at C3-C7. RESULTS: Korean population had similar or significantly shorter translaminar lengths and thickness (lengths and thickness in C7 among males; lengths in C6-C7 and thickness in C4 among females) than American population, but had similar or significantly longer translaminar heights and sagittal-diagonal measurements (heights in C3-C7 and sagittal-diagonal measurements in C3-C6 among males; heights in C7 and sagittal-diagonal measurements in C3-C7 among females). Unilaterally, translaminar screw acceptance rates in C3-C7 were similar between Korean and American male population, but the rates in C4-C6 were significantly smaller between Korean and American female population. Bilaterally, translaminar screw acceptance rates in C3 and C5-C6 were significantly larger between Korean and American male population, but the rates in C3-C7 were similar between Korean and American female population. CONCLUSION: The feasibility of unilateral and bilateral translaminar screw placement is different depending on different ethnics. Subaxial cervical unilateral translaminar screw placement among Korean male population and bilateral placement at C4-C7 among Korean female population are more acceptable than American population.

Kirschner Wire Fixation for the Treatment of Comminuted Zygomatic Fractures

BACKGROUND: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. METHODS: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, Kwire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). RESULTS: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. CONCLUSION: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.

Commentary to "Survival rate of Astra Tech implants with maxiilary sinus lift"

No abstract available.

Comparison of autogenous tooth bone graft and synthetic bone graft materials used for bone resorption around implants after crestal approach sinus lifting: a retrospective study

PURPOSE: This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements. METHODS: In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed. RESULTS: The bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference. CONCLUSIONS: Based on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.

Alveolar ridge preservation of an extraction socket using autogenous tooth bone graft material for implant site development: prospective case series

This case series evaluated the clinical efficacy of autogenous tooth bone graft material (AutoBT) in alveolar ridge preservation of an extraction socket. Thirteen patients who received extraction socket graft using AutoBT followed by delayed implant placements from Nov. 2008 to Aug. 2010 were evaluated. A total of fifteen implants were placed. The primary and secondary stability of the placed implants were an average of 58 ISQ and 77.9 ISQ, respectively. The average amount of crestal bone loss around the implant was 0.05 mm during an average of 22.5 months (from 12 to 34 months) of functional loading. Newly formed tissues were evident from the 3-month specimen. Within the limitations of this case, autogenous tooth bone graft material can be a favorable bone substitute for extraction socket graft due to its good bone remodeling and osteoconductivity.

Slip Reduction Rate between Minimal Invasive and Conventional Unilateral Transforaminal Interbody Fusion in Patients with Low-Grade Isthmic Spondylolisthesis

OBJECTIVE: To compare the slip reduction rate and clinical outcomes between unilateral conventional transforaminal lumbar interbody fusion (conventional TLIF) and unilateral minimal invasive TLIF (minimal TLIF) with pedicle screw fixation for treatment of one level low-grade symptomatic isthmic spondylolisthesis. METHODS: Between February 2008 and April 2012, 25 patients with low-grade isthmic spondylolisthesis underwent conventional TLIF (12 patients) and minimal TLIF (13 patients) in single university hospital by a single surgeon. Lateral radiographs of lumbar spine were taken 12 months after surgery to analyze the degree of slip reduction and the clinical outcome. All measurements were performed by a single observer. RESULTS: The demographic data between conventional TLIF and minimal TLIF were not different. Slip percentage was reduced from 15.00% to 8.33% in conventional TLIF, and from 14.15% to 9.62% in minimal TLIF. In both groups, slip percentage was significantly improved postoperatively (p=0.002), but no significant intergroup differences of slip percentage in preoperative and postoperative were found. The reduction rate also not different between conventional TLIF (45.41+/-28.80%) and minimal TLIF (32.91+/-32.12%, p=0.318). CONCLUSION: Conventional TLIF and minimal TLIF with pedicle screw fixation showed good slip reduction in patients with one level low-grade symptomatic isthmic spondylolisthesis. The slip percentage and reduction rate were similar in the conventional TLIF and minimal TLIF.

Analysis of Organic Components and Osteoinductivity in Autogenous Tooth Bone Graft Material

Tooth-derived bone graft material

With successful extraction of growth factors and bone morphogenic proteins (BMPs) from mammalian teeth, many researchers have supported development of a bone substitute using tooth-derived substances. Some studies have also expanded the potential use of teeth as a carrier for growth factors and stem cells. A broad overview of the published findings with regard to tooth-derived regenerative tissue engineering technique is outlined. Considering more than 100 published papers, our team has developed the protocols and techniques for processing of bone graft material using extracted teeth. Based on current studies and studies that will be needed in the future, we can anticipate development of scaffolds, homogenous and xenogenous tooth bone grafts, and dental restorative materials using extracted teeth.

Single-Stage Reconstruction of Extensive Defects after Fournier's Gangrene with an Exposed Iliac Crest and Testes

No abstract available.

Modifications of T-Scores by Quantitative Ultrasonography for the Diagnosis of Osteoporosis in Koreans

To identify a proper T-score threshold for the diagnosis of osteoporosis in Koreans using quantitative ultrasonography (QUS), normative data from 240 females and 238 males (ages 20-29 yr) were newly generated. Then, the osteoporosis prevalence estimate for men and women over 50 yr of age was analyzed using previous World Health Organization (WHO) methods and heel QUS. T-scores were calculated from the normative data. There were definite negative correlations between age and all of the QUS parameters, such as speed of sound (SOS), broadband ultrasound attenuation (BUA), and estimated heel bone mineral density (BMD) (p<0.0001). After applying the recently determined prevalence of incident vertebral fracture in Koreans over 50 yr of age (11.6% and 9.1%, female vs male, respectively) to the diagnosis of osteoporosis by T-scores from heel BMD as measured by QUS, it was revealed that applicable T-scores for women and men were -2.25 and -1.85, respectively. These data suggest that simply using a T-score of -2.5, the classical WHO threshold for osteoporosis, underestimates the true prevalence when using peripheral QUS. Further prospective study of the power of QUS in predicting the absolute risk of fracture is needed.

Clinical characteristics of thyroid microcarcinomas with special reference to the prognostic factors / 대한내과학회지

BACKGROUND: The incidence of thyroid microcarcinoma is increasing due to the more frequent use and improvement of ultrasonography and fine-needle aspiration biopsy. There are several prognostic factors for thyroid carcinomas. The patient's sex, age at diagnosis, muliplicity or bilaterality of tumor masses, extrathyroidal extensions, lymph node metastasis, and presence of distant metastases are considered the most important. Since the recent update of the TNM (Tumor, Node, Metastasis) staging system, the importance of lymph node metastasis is increased. There are, however, a paucity of studies on thyroid microcarcinomas in the Korean population. METHODS: We reviewed and analyzed the records of 302 patients diagnosed with, and treated for, thyroid microcarcinomas from January through December 2004. RESULTS: 302 (50.2%) out of the 601 cases of thyroid cancers were microcarcinomas. Women comprised 275 (91.1%) of these cases. Eighty cases (26.5%) contained multiple tumor masses (> 2), and 50 (16.6%) cases exhibited bilaterality. Evaluation of the histology revealed that nearly all of the cases (300 of 302) were of the papillary type. There was only one case each of the follicular and medullary histological type. There were 85 (28.1%) cases of extrathyroidal extensions, and 91 cases (30.1%) of lymph node metastasis, but no cases of distant metastases. CONCLUSIONS: Thyroid microcarcinomas have bad prognostic factors and appear to exist at relatively higher cancer stages. Therefore, it is important to treat them as early and as vigorously as possible with extensive surgery, radioactive iodine therapy, and thyroxine suppression.

Prognostic Significance of DNA Content and S-Phase Fraction in Gastric Carcinomas

PURPOSE: DNA flow cytometry is a simple and easy method to assess the DNA content and the cell-cycle distribution of a tumor cell. The prognostic significance of the DNA content and the S-phase fraction in a gastric carcinoma has been controversial. The purpose of this study was to evaluate the prognostic significance of the nuclear DNA content and the S-phase fraction in patients with a gastric carcinoma. METHODS: Between May 1995 and March 1996, 94 patients who were underwent a gastric resection for a gastric carcinoma were evaluated with DNA flow cytometry. Of them, 88 patients underwent a gastric resection with curative intent. The relationship of variable clinicopathological factors and of recurrence pattern to survival and nuclear DNA content were assessed. RESULTS: The mean age was 55 years. 55 patients (58.5%) exbitied diploidy and 39 patients (41.5%) aneuploidy. There was no relationship between the clinicopathological factors and either the ploidy pattern or the S-phase fraction. Though the recurrence and its pattern were not different between the two ploidy group (p=0.860, 0.137), diploidy tended to recur locoregionally and aneuploidy hematogenously. CONCLUSION: The ploidy pattern was a significant prognostic factor in gastric carcinomas, but should be interpreted carefully.