Perioperative surgical stress makes various metabolic and endocrinologic changes that may influence the postoperative outcome. These changes, so-called, "surgical stress responses" ar hyperglycemia, lipolysis, negative nitrogen balance due to proteolysis, and changes in the hormonal secretion, e.g. increased release of ACTH, prolactin, cortisol, catecholamine, and so on. To prevent these stress responses, many studies reported some kinds of effective methods. In these study we used general anesthesia combined with epidural blockade with local anesthetic(bupivacaine) and narcotic(fentanyl) mixture via epidural catheter for the total abdominal hysterectomy and the postoperative pain control(group II). We measured serum prolactin and cortisol concentrations by time-resolved fluoroimmunoassay and glucose concentrations by routine glucose oxidase method and scored the degree of postoperative pain and compared the results with those of group I, given general anesthesia during surgery and nalbuphine intramuscular injection for postoperative pain control. The results were as follows. 1) Serum prolactin concentrations were increased during the operation in both groups. 2) Serum cortisol concentrations were increased during and after the operation in both groups but were normalized sooner in group II. 3) Serum glucose concentrations were increased during and after the operation but were normalized sooner in group IL 4) The three measurements showed significant differences between the two groups during and on the first postoperative day. 5) The pain scores were significantly lower in group II untill the third postoperative day. According to the results, we concluded that serum prolactin concentration could be as much valuable index to surgical stress response as serum cortisol concentration and that the method of epidural blockade combined with general anesthesia for the surgery and postoperative pain control via epidural route could prevent or alleviate the stress response more effectively.
Adrenocorticotropic Hormone ; Anesthesia, Epidural* ; Anesthesia, General* ; Blood Glucose* ; Catheters ; Fentanyl* ; Fluoroimmunoassay ; Glucose ; Glucose Oxidase ; Hydrocortisone* ; Hyperglycemia ; Hysterectomy ; Injections, Intramuscular ; Lipolysis ; Nalbuphine ; Nitrogen ; Pain, Postoperative ; Prolactin* ; Proteolysis

No abstract available.
Endometrial Neoplasms* ; Female ; Ovary*

No abstract available.
Neuroectodermal Tumors, Primitive*

No abstract available.
Talus*

PURPOSE: To demonstrate and evaluate the value of MRI findings of the TSH(Thyroid-Stimulating Hormone, TSH, Thyrotropin)-secreting pituitary adenoma. MATERIALS AND METHODS: The authors reviewed retrospectively the MR images of 4 patients with TSH-secreting pituiatary adenoma. Evaluation of the anatomical location, signal characteristics, enhancement patterns, size, shape and circunferential changes were made. RESULTS: No characteristic common MR findings in size, shape, signal intensity, and circumferential changes of TSH-secreting pituiatary adenoma waere observed among 4 cases(size; 5x7 mm to 10x11 mm, shape;ovoid to round, signal intensity;high in 1 case on T1 and T2WI, isosignal intensity in the other 3 cases, circumferential change; stalk deviation in 1 case, no stalk deviation in 3 cases). But, the tumors were centrally located at the anterior pituitary gland and showed relatively homogeneous signal intensity on MR images of all 4 patients. CONCLUSION: We conclude that centrally-located mass at the anterior pituitary gland with homogeneous signal intensity on MR image may be suggestive of the TSH-secreting pituitary adenoma, although the MR findings are not specific for the disease.
Adenoma ; Humans ; Magnetic Resonance Imaging* ; Pituitary Gland, Anterior ; Pituitary Neoplasms* ; Retrospective Studies

No abstract available.
Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Leiomyoma*

No abstract available.
Arteriovenous Malformations* ; Hysterectomy* ; Uterus*

The standard methods of treatment in oral and maxillofacial cencer are surgery, radiotherapy and chemotherapy. But all of them can induce significant morbidities, surgery in this area can cause remarkable junctional and esthetic problems. The applications of photodynamic therapy(PDT) has been studying and trying in these days to minimize post-treatment complications. It can almost directly affect tumor cells except surrounding normal tissues, so we are able to reduce post-operative complications. But there can be a couple of complications after PDT, as like skin photosensitivity, so therapists must attend to its use and completely understand their mechanism before doing it. In our clinic, PDT was tried in an early tongue cancer patient using topically applied delta-aminolaevulinic acid (delta-ALA). The 64-year-old man was gargled with 5% delta-ALA 4 hours before irradiation. The previous punched biopsy was reported as well differentiated squamous cell carcinoma(T1N0M0). Light of 635nm wave-length from argon-pumper dye laser was used. Total 150J/cm2 was applied. After 10 days, PDT was applied again in a small suspicious area, 10 days after then, small area was excised and examined histologically. It was revealed as cancer free. Now, the patient was periodically checked up. Conclusively, PDT can be thought to be a acceptable alternative and promising method in treating of early oral and maxillofacial cancer.
Biopsy ; Drug Therapy ; Humans ; Lasers, Dye ; Middle Aged ; Photochemotherapy* ; Radiotherapy ; Skin ; Tongue Neoplasms* ; Tongue*

OBJECTIVE: Hyponatremia (Na<135 mEq/L) is associated with cerebral ischemia after subarachnoid hemorrhage (SAH) and the incidence was reported as 9-34% of treated cases of SAH. This study was undertaken to clarify the clinical factors of hyponatremia in ruptured intracranial aneurysms. METHODS: Total 170 consecutive patients with ruptured intracranial aneurysms were included in this study and the incidence and timing of hyponatremia were analyzed retrospectively. Clinical severity quantified by the Hunt and Hess grade and Fisher's grade at admission, location of ruptured aneurysm, presence of vasospasm, onset of hyponatremia, development of hydrocephalus and Glasgow Outcome Scale (GOS) were analyzed in patients with hyponatremia. RESULTS: Hyponatremia occurred in 32 (40.5%) of 79 patients with anterior cerebral artery (ACA) aneurysm group, in 18 (40.0%) of 45 patients with internal cerebral artery (ICA) aneurysm group and in nine (22.5%) of 40 patients with middle cerebral artery (MCA) aneurysm group. Hyponatremia occurred significantly more often in cases with vasospasm and hyrocephalus (p<0.05). Among vasospasm cases, hyponatremia was not associated with the location of aneurysm or hydrocepalus. Respective days of onset for symptomatic vasospasm and for hyponatremia were day 7.2+/-3.3 and day 9.9+/-5.5 following SAH (p<0.05). CONCLUSION: Hyponatremia occurred more frequently in patients with vasospasm and hydrocephalus. The onset of hyponatremia was delayed by 3 days following symptomatic vasospasm. Since careful observation for hyponatremia is required during therapy in patients with vasospasm.
Aneurysm ; Aneurysm, Ruptured ; Anterior Cerebral Artery ; Brain Ischemia ; Cerebral Arteries ; Glasgow Outcome Scale ; Humans ; Hydrocephalus ; Hyponatremia* ; Incidence ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Retrospective Studies ; Subarachnoid Hemorrhage

Software modules for interactive display, manipulation and retrieval of medical images have been designed for a Picture Archiving and Communications System (PACS). The target of these modules is not for a high-end diagnostic workstation for radiologists, but for a PC-based low cost clinical workstation for a referring physician. This software is constructed based on a concept of an object-oriented language which is designed to be modular and expandable. It consists of several functional modules: (a) a communication module for image retrieval, (b) a standard module for the interpretation of the DICOM images, (c) a user interface module for the non-computer oriented clinicians and (d) a tool module for viewing and manipulating images as well as editing the annotation.
Image Processing, Computer-Assisted/instrumentation* ; Radiology Information Systems* ; Software*