Twenty three consecutive patients admitted to our department with the suspicion of juxtasellar tumor were subjected to computed tomographic examinations. The diagnostic accuracy of CT scan was compared to that of plain skull x-ray, carotid angiography, and pneumoencephalography. The characteristic CT findings of pituitary tumors, carniopharyngiomas and parasellar meningiomas were observed, including their contrast enhancement patterns. In pituitary adenomas, the author evaluated the enlargement of the sella turcica by calculating the sella turcica size index with the use of measured interclinoid distance on CT Polaroid pictures. The results were as following: 1) CT gave the highest accuracy of various diagnostic tools, indicating that CT has become the screening method of choice in the detection of juxtasellar masses along with its another advantage of noninvasiveness. 2) Pituitary adenomas showed significant enlargement of the sella turcica according to the author's sella turcica size index. Size index above 2.5 was thought to have to be interpreted as an abnormally enlaged sella turcica. 3) Suprasellar cistern was visualized in 87% of 23 normal CT scans as a pentagone(48%) or a hexagone(43%) or a tetragone(9%), but it was identified only in 51% of supratentorial mass lesions. 4) Pituitary adenomas invariably showed positive contrast enhancement(100%), but rarely contained calcification(10%) or dilatation of ventricles(8%). 5) Craniopharyngiomas generally contained large dense calcifications or partly calcified peripheral ring(83%) and cyst formation(83%). Contrast enhancement(67%) and hydrocephalus(50%) were often found, but enlargement of the sella turcica was unusual(3%). 6) As compared to the tendency of anterolateral growth in pituitary adenomas, craniopharyngiomas were often found to extend posterosuperiorly. 7) It was advantageous to perform the operation at the side of predominant location of the tumor in suprasellar cistern or at the side of the cystic portion of the tumor. 8) A case of hypothalamic glioma was operatively verified that appeared as an isodense suprasellar mass, showing marked contrast enhancement.
Angiography ; Craniopharyngioma ; Dilatation ; Glioma ; Humans ; Mass Screening ; Meningioma ; Pituitary Neoplasms ; Pneumoencephalography ; Sella Turcica ; Skull ; Tomography, X-Ray Computed

Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is a rare tumor with 0.7% of all primary cervical malignancies. It may grossly range from no visible cervical lesion to a large exophytic cervical mass and histologically similar neoplasms occur in the nasopharynx. It has been classified as a subtype of squamous cell carcinoma. But, after reviewing the literature, this tumor is a distinct carcinoma of the cervix that differs from squamous cell carcinoma. LELC is composed of undifferentiated cells surrounded by a marked inflammatory infiltrate, characterized by plasma cells and lymphocytes in the stroma. It may represent a better prognostic group than the more common squamous cell carcinoma of the cervix because of lack of lymph node metastasis. Typically affects a younger population of women, is more prevalent in noncaucasian population (especially, those of Asian descent). However, it is not clearly understood, Epstein-Barr virus play in the pathogenesis of cervical LELC while humam papilloma virus (HPV) is a risk factor for squamous cell carcinoma. The prognosis is good only by surgical treatment. Radiation therapy also appears to be effective in eradicating localized, low-stage disease (radiosensitive). The authors have experienced one case of LELC of the uterine cervix. We report a case with a brief review.
Asian Continental Ancestry Group ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Female ; Herpesvirus 4, Human ; Humans ; Lymph Nodes ; Lymphocytes ; Nasopharynx ; Neoplasm Metastasis ; Papilloma ; Plasma Cells ; Prognosis ; Risk Factors

BACKGROUND: Anesthetic agents used for general anesthesia are emerging possible influential factors for surgical site infection (SSI). In this retrospective study, we evaluated the incidence of SSI after colorectal surgery according to the main anesthetic agents: volatile anesthetics vs. propofol. METHODS: A total 1,934 adult patients, who underwent elective colorectal surgery under general anesthesia between January 2011 and December 2013, were surveyed to evaluate the incidence of SSI: 1,519 using volatile anesthetics and 415 using propofol for main anesthetic agents. Patient, surgery, and anesthesia-related factors were investigated from all patients. Propensity-score matching was performed to reduce the risk of confounding and produced 390 patients in each group. RESULTS: Within the propensity-score matched groups, the incidence of SSI was higher in the volatile group compared with the propofol group (10 [2.6%] vs. 2 [0.5%], OR = 5.0 [95% CI = 1.1-2.8]). C-reactive protein was higher in the volatile group than in the propofol group (8.4 ± 5.6 vs. 7.1 ± 5.3 mg/dl, P = 0.001), and postoperative white blood cells count was higher in the volatile group than in the propofol group (9.2 ± 3.2 × 10³/µl vs. 8.6 ± 3.4 × 10³/µl, P = 0.041). CONCLUSIONS: The results of this study suggest that intravenous anesthesia may have beneficial effects for reducing SSI in colorectal surgery compared to volatile anesthesia.
Adult ; Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Anesthetics* ; C-Reactive Protein ; Colorectal Surgery* ; Humans ; Incidence ; Leukocytes ; Propofol* ; Research Design ; Retrospective Studies* ; Surgical Wound Infection*

BACKGROUND: Patients with acute myocardial infarction (AMI) have worse clinical outcomes than those with stable coronary artery disease despite revascularization. Non-culprit lesions of AMI also involve more adverse cardiovascular events. This study aimed to investigate the influence of AMI on endothelial function, neointimal progression, and inflammation in target and non-target vessels. METHODS: In castrated male pigs, AMI was induced by balloon occlusion and reperfusion into the left anterior descending artery (LAD). Everolimus-eluting stents (EES) were implanted in the LAD and left circumflex (LCX) artery 2 days after AMI induction. In the control group, EES were implanted in the LAD and LCX in a similar fashion without AMI induction. Endothelial function was assessed using acetylcholine infusion before enrollment, after the AMI or sham operation, and at 1 month follow-up. A histological examination was conducted 1 month after stenting. RESULTS: A total of 10 pigs implanted with 20 EES in the LAD and LCX were included. Significant paradoxical vasoconstriction was assessed after acetylcholine challenge in the AMI group compared with the control group. In the histologic analysis, the AMI group showed a larger neointimal area and larger area of stenosis than the control group after EES implantation. Peri-strut inflammation and fibrin formation were significant in the AMI group without differences in injury score. The non-target vessel of the AMI also showed similar findings to the target vessel compared with the control group. CONCLUSION: In the pig model, AMI events induced endothelial dysfunction, inflammation, and neointimal progression in the target and non-target vessels.
Acetylcholine ; Arteries ; Balloon Occlusion ; Constriction, Pathologic ; Coronary Artery Disease ; Drug-Eluting Stents ; Endothelium ; Fibrin ; Follow-Up Studies ; Humans ; Inflammation ; Male ; Myocardial Infarction ; Reperfusion ; Stents ; Swine ; Vasoconstriction