Microadenocarcinoma of the pancreas is a very rare tumor, and we report one case of this malignancy.Sonography revealed a bulky mass with massive internal necrosis, while CT demonstrated a heterogeneously enhancedtumor with massive and irregularly marginated necrosis.
Necrosis ; Pancreas*

Nodular regenerative hyperplasia (NRH) of the liver is not common, and no MR imaging of this condition has been reported. We describe a case of NRH with findings of US, CT, MR and angiography. US showed hypoechoic nodules; spiral CT showed enhancing nodules during the arterial phase; MR showed no detectable masses on T1 and T2-weighted images, and angiography showed hypervascular masses on arterial phases.
Angiography ; Hyperplasia* ; Liver* ; Magnetic Resonance Imaging ; Tomography, Spiral Computed

No abstract available.
Child* ; Glomerulonephritis, Membranoproliferative* ; Humans

Pyruvate dehydrogenase complex deficiency (PDCD) is one of the most common neurodegenerative disorders associated with abnormal mitochondrial metabolism. Pyruvate dehydrogenase complex plays an important role in glucose metabolism and generation of energy from carbohydrates. Potential therapies for PDCD, include thiamine and ketogenic diet (KD), have been used with varying degrees of success. However, the KD is too restrictive, and its serious complications, particularly in early age of neonate or infancy are important drawbacks. Recently, the modified Atkins diet (MAD) for intractable epilepsy has provided balanced nutrients. The complications can be expected to be less frequent and well controlled. In this report, we describe an infant with PDCD confirmed by PDHA1 gene mutation through high-throughput sequencing technique of whole exome sequencing, who failed to continue the KD, but made good progress on MAD.

Due to rapid evolution and technological advancements, medical personnel now require special training outside of their safe zones. Anesthesiologists face challenges in practicing in locations beyond the operating room. New locations, inadequate monitoring devices, poor assisting staff, unfamiliarity of procedures, insufficient knowledge of basic standards, and lack of experience compromise the quality of patient care. Therefore, anesthesiologists must recognize possible risk factors during anesthesia in nonoperating rooms and familiarize themselves with standards to improve safe practice. This review article emphasizes the need for standardizing hospitals and facilities requiring nonoperating room anesthesia, and encourages anesthesiologists to take the lead in applying these practice guidelines to improve patient outcomes and reduce adverse events.
Anesthesia* ; Deep Sedation ; Humans ; Monitoring, Intraoperative ; Operating Rooms* ; Patient Care ; Risk Factors

BACKGROUND: Patients undergoing laparoscopic gynecological surgery have a remarkably high incidence of postoperative nausea and vomiting (PONV). The purpose of this study was to evaluate the effect of the timing of ramosetron administration on its antiemetic efficacy in patients undergoing laparoscopic gynecological surgery. METHODS: One hundred and twenty patients undergoing laparoscopic gynecological surgery under general anesthesia were randomized to receive 0.3 mg of ramosetron intravenously either immediately after induction (group I, n = 60) or at the completion of surgery (group II, n = 60). Occurrences of nausea and vomiting, the need for rescue antiemetics and analgesics, pain score, as well as adverse events associated with study medications, were recorded for 48 hrs after the operation. RESULTS: The incidence of postoperative nausea and vomiting in the I and II groups were 46.7%, 41.7% respectively. There was no significant difference between the groups in the incidences of PONV, the need for rescue antiemetics and analgesics, pain score and adverse events associated with study medications (P > 0.05). CONCLUSIONS: The effect of ramosetron administered either immediately after induction or at the completion of surgery was similar to each other on its efficacy as a prophylactic antiemetic in patients undergoing laparoscopic gynecological surgery.
Analgesics ; Anesthesia, General ; Antiemetics ; Benzimidazoles ; Female ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Nausea ; Postoperative Nausea and Vomiting ; Vomiting

In the rat hippocampal formation, the time-course and dose-response of the expression of enkephalin and dynorphin gene were examined after kainate (KA) treatment with in situ hybridization histochemistry. The KA induced enkephalin and dynorphin mRNA expression in hippocampus occurred mainly in the dentate gyrus. The enkephalin mRNA expression appeared at 3hour after KA injection, increased dramatically at 6hour, and then decreses. At 24hour after KA injection, the expression of enkephalin mRNA disappeared. The dynorphin mRNA expression appeared at once after injection and increased dramatically at 3hour. Unexpectedly at 6hour after injection, the expression was decreased, and then increased less than the 3hour expression. The increased pattern persisted to 24hour after injection. Unexpected result was also encounted in the experiment of KA dose-response of enkephalin mRNA and dynorphin mRNA. In the hippocampal formation, in contrast with other areas, low dosage (8mg/kg) of KA induced more significant expression of both genes than high dosage (16mg/kg) of KA.
Animals ; Dentate Gyrus ; Dynorphins ; Enkephalins ; Gene Expression* ; Hippocampus* ; In Situ Hybridization ; Kainic Acid ; Opioid Peptides* ; Rats* ; RNA, Messenger ; Seizures*

No Abstract Available.
Female ; Hormone Replacement Therapy* ; Humans ; Life Style* ; Osteoporosis*

Uterine scar dehiscence following laparoscopic myomectomy rarely occurs but can compromise both maternal and fetal well-being in subsequent pregnancy. We here present two cases of pregnancy complicated by preterm birth that resulted from uterine scar dehiscence following laparoscopic myomectomy. First case was a nulligravida who had scar dehiscence at 26 weeks of gestation after having a laparoscopic myomectomy 3 months prior to conception. Two weeks later, we observed her fetal leg protruding through the defect. The other case was a primigravida with a history of prior cesarean delivery, whose sonography revealed myomectomy scar dehiscence at 31 weeks of gestation. Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect. In both cases, babies were born by emergency cesarean section. Conservative management can be one of treatment options for myomectomy scar dehiscence in preterm pregnancy. However, clinicians should always be aware of the possibility of obstetric emergencies.
Abdominal Pain ; Cesarean Section ; Cicatrix* ; Emergencies ; Female ; Fertilization ; Humans ; Leg ; Pregnancy* ; Premature Birth ; Uterine Myomectomy ; Uterine Rupture

BACKGROUND: Immunoglobulin (Ig) gene rearrangement analysis is a useful additional tool to detect clonality of B-lymphoproliferative disease and the method to detect immunoglobulin gene rearrangement is required the high sensitivity and specificity. BIOMED-2 multiplex PCR was designed for the evaluation of molecular clonality of lymphoid lesions. We evaluated the usefulness of the BIOMED-2 multiplex PCR by comparing it with conventional nested PCR. METHODS: Sixteen patients with malignant lymphoma and 5 with reactive lymph nodes were examined to assess the sensitivity, specificity, and accuracy between conventional nested PCR and BIOMED-2. All 3 tests performed using the BIOMED-2 kit for immunoglobulin (Ig) heavy chain (IGH) gene, Igkappa light chain (IGK) gene, and Iglambda light chain (IGL) gene, were used to analyze clonality. RESULTS: Both the methods showed 100% specificity (95% confidence interval, 56.6-100.0). The combination of IGH and IGK BIOMED-2 tests with or without IGL revealed the highest sensitivity (87.5%; range, 64.0-96.5%) and accuracy (90%; range, 0.70-0.97). Compared to the conventional method, the BIOMED-2 test for IGH showed a higher sensitivity (62.5%; range, 38.6-81.5%) and accuracy (71%, 0.50-0.86). CONCLUSIONS: These results suggest that, compared to the conventional method, BIOMED-2 has higher sensitivity and allows for easier interpretation while evaluating the clonality of B-lymphoproliferative disease.
Gene Rearrangement ; Genes, Immunoglobulin ; Hematologic Neoplasms ; Humans ; Immunoglobulins ; Light ; Lymph Nodes ; Lymphoma ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Sensitivity and Specificity