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This paper assesses to what extent, and in what ways, mobile money has affected the financial inclusion of women in Nairobi. Women in Kenya have limited property rights and continue to require appr...

The aim of this research is to examine the extent to which mobile money has improved the financial inclusion of Nairobi’s urban poor. Nairobi is Kenya’s largest and most developed city, but it is a...

A mononuclear nonheme cobalt(III) iodosylbenzene complex, [CoIII (TQA)(OIPh)(OH)]2+ (1), is synthesized and characterized structurally and spectroscopically. While 1 is a sluggish oxidant in oxidation reactions, it becomes a competent oxidant in oxygen atom transfer reactions, such as olefin epoxidation, in the presence of a small amount of proton. More interestingly, 1 shows a nucleophilic reactivity in aldehyde deformylation reaction, demonstrating that 1 has an amphoteric reactivity. Another interesting observation is that 1 can be used as an oxygen atom donor in the generation of high-valent metal-oxo complexes. To our knowledge, we present the first crystal structure of a CoIII iodosylbenzene complex and the unprecedented reactivity of metal-iodosylarene adduct.

Outer-sphere electron transfer from styrene, thioanisole, and toluene derivatives to a triflic acid (HOTf)-bound nonheme Mn(IV)-oxo complex, [(N4Py)MnIV(O)]2+-(HOTf)2 (N4Py = N, N-bis(2-pyridylmethyl)- N-bis(2-pyridyl)methylamine), has been shown to be the rate-determining step of different types of redox reactions such as epoxidation, sulfoxidation, and hydroxylation of styrene, thioanisole, and toluene derivatives, respectively, by [(N4Py)MnIV(O)]2+-(HOTf)2. The rate constants of HOTf-promoted epoxidation of all styrene derivatives with [(N4Py)MnIV(O)]2+ and electron transfer from electron donors to [(N4Py)MnV(O)]2+ exhibit a remarkably unified correlation with the driving force of outer-sphere electron transfer in light of the Marcus theory of electron transfer. The same electron-transfer driving force dependence is observed in the oxygen atom transfer from [(N4Py)MnIV(O)]2+-(HOTf)2 to thioanisole derivatives as well as in the hydrogen atom transfer from toluene derivatives to [(N4Py)MnIV(O)]2+-(HOTf)2. Thus, mechanisms of oxygen atom transfer (epoxidation and sulfoxidation) reactions of styrene and thioanisole derivatives and hydrogen atom transfer (hydroxylation) reactions of toluene derivatives by [(N4Py)MnIV(O)]2+-(HOTf)2 have been unified for the first time as the same reaction pathway via outer-sphere electron transfer, followed by the fast bond-forming step, which exhibits the singly unified electron-transfer driving force dependence of the rate constants as outer-sphere electron-transfer reactions. In the case of the epoxidation of cis-stilbene by [(N4Py)MnIV(O)]2+-(HOTf)2, the isomerization of cis-stilbene radical cation to trans-stilbene radical cation occurs after outer-sphere electron transfer from cis-stilbene to [(N4Py)MnIV(O)]2+-(HOTf)2 to yield trans-stilbene oxide selectively, which is also taken as evidence for the occurrence of electron transfer in the acid-catalyzed epoxidation.

Extranodal Natural Killer/T-cell lymphoma (ENKL) is an aggressive NK or cytotoxic T-cell neoplasm. The cytological features of NK/T-cell lymphoma have been rarely described, mainly focusing on the fine needle aspiration cytology from lymph nodes or soft tissue, except for a few cases focused on body fluid. A 46-year-old man visited the hospital due to generalized weakness and weight loss. Three months prior, computed tomographic scan revealed mesenteric panniculitis and reactive lymph nodal enlargement, as well as a mildly thickened left adrenal gland, suggesting an inflammatory condition. About 100 days later, marked enlargement of both adrenal glands with pericardial effusion was noted. The pericardial effusion contained medium-sized atypical lymphocytes, suspicious for malignant lymphoma, and the left adrenal mass was histologically confirmed as ENKL on biopsied specimen. Herein, we describe the cytological features of NK/T-cell lymphoma in body fluid cytology along with a review of the literature.

This study examined the relationships among smartphone addiction, parenting attitudes and resilience to identify the relevant factors affecting smartphone addiction. Data were collected from a total of 220 middle school students responding to questionnaires in G city and analyzed using descriptive statistics, independent t-test, ANOVA, Scheff? test, Pearson coefficient correlation, and multiple regression. The results showed that the parenting attitude and resilience were negatively correlated with smartphone addiction. The significant factors affecting smartphone addiction were gender, the time of smartphone usage, parenting attitudes, and resilience. These variables explained 21.9% of smartphone addiction and the highest factor was the parenting attitudes, followed by gender, time of smartphone usage, and resilience. This study indicated that it is important to develop a program to ensure adolescents positively perceive parenting attitudes and increase their resilience to decrease the incidence of smartphone addiction.

Background & Aim Background: The Src family kinases (SFK) are non-receptor tyrosine kinases that have been implicated in a variety of process, including proliferation, survival, differentiation and migration. Recent studies showed that inhibition of SFKs resulted in enhancement of retinoic acid-induced myeloid differentiation. In this study, we investigated whether SFK inhibitor PP2 and FDA approved dual Src/ABL inhibitor (bosutinib or dasatinib) could enhance the differentiation of NB4 leukemia cells when combined with all-trans-retinoic acid (ATRA) or arsenic trioxide (ATO). Methods, Results & Conclusion Methods: We demonstrated the SFK inhibitor PP2 enhanced the differentiation of NB4 cells when combined with ATRA or ATO. Subsequently, we investigated whether bosutinib and dasatinib could enhance the differentiation of NB4 cells when combined with ATRA or ATO. The cells were analyzed for myeloid differentiation marker CD11b expression using flow cytometry. These results were confirmed in morphologic analysis by Wright stain and NBT reduction assay. In addition, we attempted to determine the difference in retinoic acid-induced gene expression. Results Our data showed that SFK inhibitor PP2 enhanced myeloid differentiation when combined with ATRA or ATO. The synergistic effect was significantly stronger when PP2 was combined with ATRA and ATO (triple treatment) than when PP2 was combined with ATRA or ATO (dual treatment). The similar results were obtained when bosutinib and dasatinib were applied instead of PP2. Co-treatment with bosutinib plus ATRA or ATO, and dasatinib plus ATRA or ATO resulted in significant enhancement of CD11b-positive cells when compared to the each treatment group in bosutinib, dasatinib, ATRA, or ATO. Also, the synergistic effects of bosutinib and dasatinib in combination with ATRA were greater than in combination with ATO. Conclusions SFK inhibitor PP2 and dual Src/ABL inhibitor (bosutinib or dasatinib) can enhances the differentiation of NB4 leukemia cells when combined ATRA and/or ATO. These findings suggest that ATRA or ATO combinated with dual Src/ABL inhibitors may have therapeutic beneficial for the treatment of APL patients.

Epstein-Barr virus (EBV) infection has been associated with a number of lymphoid malignancies, including endemic Burkitt’s lymphoma, some classical Hodgkin’s lymphoma, diffuse large B-cell lymphoma, extranodal NK/T cell lymphoma, and angioimmunoblastic T-cell lymphoma. A 59-year-old woman underwent an excisional biopsy for a left axillary mass under suspicion of malignant lymphoma. A preoperative radiological study revealed multiple enlarged lymph nodes at the left axilla, mesentery, and the left external iliac chain with hypermetabolism on a positron emission tomography-computed tomography scan. She was histologically diagnosed with EBV-positive follicular lymphoma (FL, grade 3a) and received the R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, prednisone) chemotherapy regimen. Herein, we report a rare case of EBV associated FL of lymph node with its review of literature.

Purpose: This study was conducted to analyze the annual trends and characteristics of work-related mental disorders including suicide among Korean workers. Methods: Employing the Industrial Accident Compensation Insurance (IACI) data collected by the Korea Worker’s Compensation & Welfare Service, we analyzed total work-related mental disorders and suicide cases (n = 455) claimed to IACI from 2008 to 2012. We paid a special attention to workers’ socioeconomic status and occupational characteristics. Results: The number of injured workers and industrial accident rate decreased during the study period, whereas the case of work-related mental disorders showed significant increase. Mental disorders cases were more prevalent in workers who were male, aged the 40s, and engaged in finance, as well as with 1-5 years of working duration than their respective counterparts. Increasing trend of suicide cases was statistically significant by the Cochran-Mantel-Haenszel test (p = .002). Conclusion: This study suggests that work-related mental disorder management strategy and system should be established.

This study explores the optimal spatial allocation of initial attack resources for firefighting in the Republic of Korea. To improve the effectiveness of Korean initial attack resources with a range of policy goals, we create a scenario optimization model that minimizes the expected number of fires not receiving a predefined response. In this study, the predefined response indicates the number of firefighting resources that must arrive at a fire before the fire escapes and becomes a large fire. We use spatially explicit GIS-based information on the ecology, fire behavior, and economic characterizations important in Korea. The data include historical fire events in the Republic of Korea from 1991 to 2007, suppression costs, and spatial information on forest fire extent. Interviews with forest managers inform the range of objective functions and policy goals we address in the decision model. Based on the geographic data, we conduct a sensitivity analysis by varying the parameters systematically. Information on the relative importance of the components of the settings helps us to identify “rules of thumb” for initial attack resource allocations in particular ecological and policy settings.

Purpose: This study was conducted to analyze the characteristics of work-related musculoskeletal diseases (MSD) and the factors for approving MSD by the parts of the body. Methods: The analysis was done using the data which were drawn from the Industrial Accident Compensation Insurance that is operated by the Korea Worker's Compensation & Welfare Service. The data were composed of total cases related to the work-related diseases from 2006 to 2009. In addition, MSD data input by an investigator were collected. The factors associated with MSD were analyzed using x2 and multiple logistic regression. Results: MSD approved cases have increased since 2006 and the proportion of the approved work-related MSD cases in the workers with work-related diseases in 2009 were 33.4%. Spinal approved cases were the highest percentage and upper and lower extremities cases gradually increased. The factors for approving upper extremity were found to be age, company size, type of industry, working duration, and in the case of spine to be company size and heavy lifting. Conclusion: Work-related MSD have increased and the factors that affected MSD by the parts of the body varied. Management strategy must be established to prevent MSD by the parts of the body.

The surface modification of fluorine-doped tin oxide (FTO) transparent electrodes was carried out by lithography and inductively coupled plasma etching to improve the conversion efficiency of dye-sensitized solar cells (DSSCs). The concentration of Cl 2 gas and dc-bias voltage to the substrate were varied as the main etch parameters. The transmittance and sheet resistance of the FTO electrodes were compared before and after etching. The DSSCs fabricated on the patterned FTO electrodes showed higher conversion efficiency than those fabricated on the ordinary FTO electrodes without patterns. Scanning electron microscopy showed that more TiO 2 particles could be involved in the DSSCs with patterned FTO electrodes, and that the contact between the TiO 2 layer and electrode were improved by patterning the FTO electrode. The current–voltage curves and incident photon to current efficiency spectra showed that a significantly higher photocurrent was produced in the DSSCs fabricated on the patterned FTO.

Diamond-like carbon (DLC) films have been deposited by radio frequency plasma enhanced chemical vapour deposition (rf-PECVD) with different Ar-CH4 mixtures. Nanocrystalline diamond films have been deposited by microwave plasma-enhanced chemical vapour deposition (MPCVD), using Ar-H2-CH4 mixtures. X-ray photoelectron spectroscopy (XPS) and nanotribological investigation (by scanning force microscopy) have been used to compare the mechanical properties and structures of these films. Highly orientated and non-orientated microcrystalline diamond films and MPCVD-produced amorphous carbon have also been studied by way of comparison. The diamond films exhibit a linear relationship between roughness and the coefficient of friction. The DLC and amorphous carbon have higher friction coefficients than the best performing diamond film, but may more easily be deposited as smooth coating. Possible applications for these various carbon-based films include microelectromechanical components, for which smooth, hard coatings are required.

Since the hexavalent chromium used in chromium electroplating was found to cause cancer in human body, alternative deposition techniques have been widely investigated. Sputter deposition of chromium (Cr) as a deposition technique for replacing electroplating was studied. Effects of RF-power, substrate temperature on the deposition rate, corrosion-resistance, hardness and adhesion strength were investigated. X-ray diffraction (XRD) analysis was performed to determine the structure and the compositions of the films. The hardnesses of the films were measured by using a nanoindenter. The microstructures of the films were observed using scanning electron microscopy. The deposition rate and hardness of the sputter-deposited Cr film tend to increase with the increasing RF-power and substrate temperature of the sputtering process. Both the hardness and adhesion strength of the sputter-deposited chromium film was found to be higher than those of the electroplated chromium film.

DNA gyrase is a type II topoisomerase that is essential for chromosome segregation and cell division owing to its ability to modify the topological forms of bacterial DNA. In this study, the N-terminal fragment of the GyrB subunit of DNA gyrase from Xanthomonas oryzae pv. oryzae was overexpressed in Escherichia coli, purified and crystallized. Diffraction data were collected to 2.10 A resolution using a synchrotron-radiation source. The crystal belonged to space group I4(1), with unit-cell parameters a = b = 110.27, c = 70.75 A. The asymmetric unit contained one molecule, with a V(M) of 2.57 A(3) Da(-1) and a solvent content of 50.2%.

DNA gyrase is a type II topoisomerase that is essential for chromosome segregation and cell division owing to its ability to modify the topological forms of bacterial DNA. In this study, the N-terminal breakage-reunion domain of the GyrA subunit of DNA gyrase from Colwellia psychrerythraea 34H was overexpressed in Escherichia coli, purified and crystallized. Diffraction data were collected to 2.60 A resolution using a synchrotron-radiation source. The crystal belonged to space group P2(1)2(1)2(1), with unit-cell parameters a = 98.98, b = 101.56, c = 141.83 A. The asymmetric unit contained two molecules, with a corresponding V(M) of 3.18 A(3) Da(-1) and a solvent content of 59.9%.

Burkitt lymphoma (BL) is a rare subtype of adult non-Hodgkin lymphoma, so studies on the outcome of adult BL, especially in Asian patients, are scarce. We report our results using the LMB protocol on Korean adult BL patients. Thirty-eight newly diagnosed BL patients were treated with the LMB protocol; 29 males and nine females with a median age of 47 years (range 18-70) were analyzed, and 14 (36.8%) patients had central nervous system or bone marrow involvement. After the induction phase, 28 patients achieved complete response (CR, 73.7%) and five showed partial response (PR, 13.2%). Among those achieving CR, only four showed relapse. All of the non-CR patients died, including five PR and one with progressive disease. The other four patients died because of infection after the first course of induction. The progression-free and overall estimated survival at 5 years was 74.99% and 68.10%, respectively. Of the 12 patients who died, the median survival was 4.43 months (95% confidence interval 1.43-7.43 months). Thus, most deaths occurred shortly after diagnosis, and four patients older than 58 years died after the first induction cycle. Most early deaths were caused by treatment-related morbidity and failure to achieve complete response. B symptoms, advanced age, bone marrow involvement, and St. Jude/Murphy stage IV classification were significantly associated with poor overall survival. In conclusion, the LMB protocol was effective for Korean adult BL patients. However, considering the high incidence of treatment-related deaths and the poor outcome of non-CR patients, risk-adapted modification of the induction phase is warranted.

The immediate early gene, cyr61, is transcriptionally activated within minutes by serum and serum growth factors. The encoded Cyr61 protein is secreted into the extracellular matrix and promotes cell adhesion and migration. In this study, we sought to examine the expression profile of cyr61 gene during neuronal cell death induced by various toxic stimuli and the mechanisms involved. Our data show that toxic stimuli, such as etoposide, significantly increased cyr61 mRNA levels in immortalized hippocampal progenitor (H19-7) cells. Cyr61 transcriptional activation was corroborated at the protein level as well. To identify the upstream signaling cascades involved in cyr61 gene induction, the blocking effect of either JNK or p38 kinase-signaling pathway on cyr61 induction in response to etoposide was tested. Transfection of the cells with a kinase-deficient mutant MEKK, an upstream activator of JNK, significantly decreased the cyr61 expression induced by etoposide. In contrast, cyr61 mRNA levels did not change after pretreatment with SB203580, the p38 kinase inhibitor. When the induction of cyr61 was tested by using several of its deleted promoters driving the expression of reporter gene, the promoter activation occurred primarily within the region containing an SRE-like CArG box. In addition, the SRF, which binds to the CArG site, was directly phosphorylated by active JNK. Furthermore, the blockade of cyr61 gene expression using an antisense encoding cyr61 sequence significantly inhibited the cell death induced by etoposide. Overall, these results suggest that the induction of the immediate early gene, cyr61, is important for neuronal cell death in the central nervous system hippocampal progenitor cells, and JNK activation, but not of p38, as well as the subsequent SRF phosphorylation are involved in cyr61 gene induction.

목적: 만성골수성백혈병의 진단 및 치료를 위한 한국 치료 가이드라인은 한국 실정에 맞춘 내용을 통해 국내 치료방침 및 연구 기준을 표준화하기 위하여 제정되었다. 방법: 국내 만성골수성백혈병 전문가들을 대상으로 한 설문 조사와 자문 미팅을 거쳐 본 가이드라인을 작성하였다. 결과: 본 가이드라인에는 만성골수성백혈병의 진단 및 초기 검사, 예후인자, 만성기에서의 초치료 및 치료 중 확인 사항과 반응 평가, 이차 약제 변경 및 이후의 치료 반응 평가, 가속기 및 급성기에서의 치료와 반응 평가, 동종 조혈모세포이식, 독성 평가 및 관리 등 만성골수성백혈병의 전반에 대한 국내 전문가들의 의견을 종합한 권고안을 제시하고 있다. 결론: 만성골수성백혈병의 치료는 최근 많은 발전이 있었으며 향후 예후 평가에 대한 연구 및 약제의 중단 가능성 평가 연구 등 다양한 연구들을 통해 더욱 더 많은 향상이 있을 것으로 기대된다.

We investigated subcellular distribution of ERK2 in osteoblast-like UMR-106 cell and explored to determine if its activities are regulated by insulin. 23%, 34% and 43% of total ERK2 were distributed in membrane, cytosol and nucleus, respectively. Insulin caused 40% increase of ERK2 content in membrane in 10 min whereas it induced approximately 50% decrease of ERK2 in cytosol in 10 min. In terms of kinase activity, insulin stimulated phosphorylation of the membrane-associated ERK2 by 2-fold and 1.8-fold in 1 min and 10 min and cytosolic ERK2 by 2.7-fold and 2.3-fold in 1 min and 10 min, respectively. In contrast, the phosphorylation of nuclear ERK2 was stimulated by insulin in time-dependent manner with maximal (3-fold) activity observed at 30 min. Insulin also increased the content of MEK2 in membrane by 2.2- to 2.6-fold in 10 min. MEK2 translocated into membrane in response to insulin may play a role in the activation of the membrane-associated ERK2 via phosphorylation.

목적 본 연구는 소득계층별 산과 진료실적 추이, 주요 다빈도 질환 및 의료기관 이용양상을 비교분석하기 위해 시도하였다. 연구방법 2004-2008년 지난 5년간 건강보험청구자료 중 산과코드(O00-O99) 전체를 발췌하여 분석하였다. 대상자의 건강보험 자격자료를 이용해 대상자의 일반적 특성을 구분하였고, 건강보험료 부과수준에 따라 소득분위를 5분위로 구분하여 분석하였다. 통계분석은 SAS 프로그램을 이용하였다. 결과 소득1분위 집단은 입원진료실적은 가장 낮은 비율을 차지하는 반면, 외래진료 실적은 최근 2년간 증가추세를 보이는 가운데 가장 높은 비율을 차지하는 것으로 나타났다. 소득1분위는 유산, 전자간증, 자간증의 진료 비율이 높고, 분만은 적은 비율을 차지하였으며, 소득5분위는 고령임부, 다태임신 비율이 높은 것으로 나타났다. 또한 소득수준이 높아질수록 대형병원의 입원 및 외래 이용률이 높은 것으로 나타났다. 결론 본 연구결과, 소득계층별로 다빈도 산과질환 및 의료기관 이용이 차이를 보이는 것으로 확인되었다. 향후 대상자의 소득수준별 특성에 맞는 산전관리프로그램이 필요하며, 특히 저소득층 임신부를 위한 제도적 지원 강화 방안 모색이 필요하다.

Purpose Appendicitis is the most common condition leading to an intra-abdominal operation for a non-obstetric problem in pregnancy. The aim of this study was to examine our experience and to analyze the clinical characteristics and the pregnancy outcomes for appendicitis during pregnancy that was reported in Korea. Methods We reported 25 cases of appendicitis during pregnancy that were treated at Good Moonhwa Hospital from January 2004 to March 2010. We also analyzed appendicitis during pregnancy reported in Korea between 1970 and 2008 by a review of journals. Results The incidence of acute appendicitis during pregnancy was one per 568 deliveries. The mean age was 27.92 years old, the gestational stage at the onset of symptoms was the first trimester in 10 patients (40%), the second trimester in 14 patients (56%), and the third trimester in 1 patient (4%). Among the 25 cases, 21 were treated with an open appendectomy and 4 with laparoscopic appendectomies. The postoperative complications were 2 wound infections and 1 spontaneous abortion. Conclusion Our experience demonstrated that appendectomies on pregnant patients can be successfully performed at secondary hospitals.

have been reported on. We assessed the effectiveness of a single course of high dose dexamethasone as first-line treatment for adult patients with ITP. Methods: The subjects of the study were previously untreated adult patients with newly diagnosed ITP and who had a platelet count of less than 20,000/ μL or a platelet count less than 50,000/μL. High-dose dexamethasone at a dose of 40mg/day for four consecutive days was given orally. A response was defined as an increase in the platelet count of at least 30,000/μL and a platelet count of more than 50,000/μL by day 10 after the initial treatment. A sustained response was defined as a platelet count of more than 50,000/μL that was maintained for six months after the initial treatment. Results: Twenty two patients were eligible. The median platelet count before treatment was 19,000/μL. Seventeen patients (77%) among the 22 patients achieved an initial response by day 10: the mean platelet count 10 days after the initial treatment was 144,000/μL (range: 51,000 to 428,000/μL). Among the patients with a response, 4 (23.5%) had a sustained response, and the other 13 (76.5%) relapsed within six months. All the patients well tolerated the high-dose dexamethasone treatment. Conclusion: A single course of high-dose dexamethasone is effective as an initial treatment for adults ITP patients, although the response duration is short. To maintain the response, repeated high-dose dex- amethasone treatment may be needed or other alternative therapies can be considered. (Korean J Hematol 2009;44:22-27.)

14599 Background: We prospectively conducted a phase II trial to test the efficacy and safety of irinotecan, 5-fluorouracil and leucovorin (FOLFIRI) regimens for the first-line treatment of previously untreated patients with recurrent or metastatic advanced CRC. Methods: Thirty-four previously untreated patients with advanced CRC were enrolled in this study from June 2001 to December 2006. Eligible patients had histologically confirmed adenocarcinoma, no prior systemic therapy in palliative setting, ECOG PS = 2, adequate organ function, written informed consent and at least one measurable disease. The patients received either irinotecan 180 mg/m2 on day 1 with a LV bolus of 200 mg/m2 and a FU bolus of 400 mg/m2, and this was followed by a FU continuous infusion of 600 mg/m2 on day 1 and day 2 (the classic FOLFIRI regimen), or they were treated with a LV bolus of 400 mg/m2 and a FU bolus of 400 mg/m2 followed by a FU continuous infusion of 2,400 mg/m2 for 46 hours (the simplified FOLFIRI regimen), and these treatments were repeated every 2 weeks until disease progression. Results: There were 13 females and 21 males with median age of 54 years (range: 41–79). The most common metastatic sites were lung and liver. A total of 262 cycles were administrated with median 6 cycles per patient (range: 1–22). All pts were evaluable for toxicity, and 30 pts for response to the treatment. The objective response rate was 26.4% with 2 complete responses respectively. Sixteen (47%) pts had stable disease and 7 (20.5%) had a progression. The tumor control rate was 73.4%. The median TTP was 5.3 months, and the overall survival was 10.1 months. The prognostic factor for longer TTP and survival was the ECOG performance status (PS). The type of regimens was not affected on response rate, TTP and survival. The chemotherapy was generally well tolerated and the most common grade 3–4 toxicities were neutropenia, diarrhea. The non- hematological toxicities were similar for both treatment groups, with more frequent grade =3 neutropenia being noted for the simplified FOLFIRI regimen. Conclusions: The FOLFIRI regimen was demonstrated to have a moderate antitumor activity with acceptable toxicity profiles, and tend to show more favorable outcome for patients with good ECOG PS. No significant financial relationships to disclose.

Purpose: An anastomotic leak after resection of rectal cancer is a omnious complication. The diverting stoma is performed to avoid this serious complication. However, a diverting stoma and a stoma reversal are associated with significant morbidity and a small mortality. As stoma-related complications are associated with a delay of adjuvant therapy for advanced rectal cancer, minimal stoma-related morbidity is mandatory for rectal cancer patients. A safe and simple dissection of the stoma is known to be associated with less morbidity at stoma closure. Since in a loop colostomy of a not everted fashion, it is easy to construct and dissect the peristomal site at colostomy reversal, this study evaluated the usefulness of a protective loop colostomy of a not everted fashion in rectal cancer. Methods: We reviewed the clinical records of 71 cases of loop colostomy closure for rectal cancer between January 1996 and December 2004. The clinical data, including indications for the stoma, the clinicopathologic features of the patients and their general conditions, the data for patients receivingadjuvant therapy, stoma-relatedmorbidity, stoma-closure-related morbidity, and perioperative data were examined. Results: Indications for stomacreation are the discretion of the surgeon (n=22), poor bowel preparation (n= 21), unstable anastomosis (n= 16), bowel obstruction (n= 6), and anastomotic leakage (n= 6). The stoma-related morbidity rate for a non-eversion colostomy was 5.6%. Morbidity events were peristomal erythema (n= 2), prolapse (n= 1), and parastomal hernia (n= 1) requiring surgery. The stoma-closure-related morbidity rates was 9.9%. In the 45 patients undergoing adjuvant therapy, colostomy closure was performed during adjuvant therapy in 39 patients. Major complications, such as anastomotic leakage or abscess following reversal of the non-eversion colostomy, occurred in 1 of the 71 patients (1.4%). The average operating time and the blood loss for clostomy closure were 89.5 minutes and 202.3 ml, respectively. A simple closure of the loop colostomy was performed in 51 patients (71.8%). Conclusions: Based on our results, a non-eversion colostomy may be considered due to the ease of construction and reversal if a temporary divertingstoma for rectal cancer is indicated. JKorean Soc Coloproctol 2007;23:28-33

Purpose: Palliative chemotherapy for patients with recurrent or metastatic gastric cancer has been shown to have a survival benefit. Docetaxel monotherapy has achieved appreciable results for treating gastric cancer. We investigated the clinical efficacy and feasibility of a docetaxel and cisplatin combination regimen for patients suffering with recurrent or metastatic gastric cancer. Materials and Methods: Patients with histologically proven, bidimensionally measurable lesions of recurrent or metastatic gastric cancer, and they had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 and no prior palliative chemotherapy were eligible for this study. The combination chemotherapy regimen consisted of docetaxel 75 mg/m2 plus cisplatin 75 mg/m2 on day 1, and this was repeated every 3 weeks until disease progression. Results: 32 patients were enrolled from 2002 to 2005. The objective response rate was 31.3% (95% confidence interval (CI): 14.2～48.2%) with no CR. The disease control rate was 59.4%. At a median follow up of 38.9 months, the median overall survival was 7.4 months (95% CI: 6.3～8.5). The median time to progression was 4.7 months (95% CI: 3.1～6.3). During a total of 106 cycles, grade 3 or 4 hematological toxicities were observed as follows: neutropenia (39 of 106 cycles) and anemia (3 of 106 cycles). The grade 3 or 4 non-hematological toxicities included anorexia (18.9%) and nausea/vomiting (21.7%). Conclusion: Docetaxel and cisplatin combination chemotherapy showed promising anti-tumor activity and this was well tolerated as a first-line treatment for patients with recurrent or metastatic gastric cancer. Further large, randomized phase III studies are warranted. (Cancer Res Treat. 2007;39:49-53) Purpose: Palliative chemotherapy for patients with recurrent or metastatic gastric cancer has been shown to have a survival benefit. Docetaxel monotherapy has achieved appreciable results for treating gastric cancer. We investigated the clinical efficacy and feasibility of a docetaxel and cisplatin combination regimen for patients suffering with recurrent or metastatic gastric cancer. Materials and Methods: Patients with histologically proven, bidimensionally measurable lesions of recurrent or metastatic gastric cancer, and they had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 and no prior palliative chemotherapy were eligible for this study. The combination chemotherapy regimen consisted of docetaxel 75 mg/m2 plus cisplatin 75 mg/m2 on day 1, and this was repeated every 3 weeks until disease progression. Results: 32 patients were enrolled from 2002 to 2005. The objective response rate was 31.3% (95% confidence interval (CI): 14.2～48.2%) with no CR. The disease control rate was 59.4%. At a median follow up of 38.9 months, the median overall survival was 7.4 months (95% CI: 6.3～8.5). The median time to progression was 4.7 months (95% CI: 3.1～6.3). During a total of 106 cycles, grade 3 or 4 hematological toxicities were observed as follows: neutropenia (39 of 106 cycles) and anemia (3 of 106 cycles). The grade 3 or 4 non-hematological toxicities included anorexia (18.9%) and nausea/vomiting (21.7%). Conclusion: Docetaxel and cisplatin combination chemotherapy showed promising anti-tumor activity and this was well tolerated as a first-line treatment for patients with recurrent or metastatic gastric cancer. Further large, randomized phase III studies are warranted. (Cancer Res Treat. 2007;39:49-53)