No abstract available.
Diskectomy ; Ear Cartilage ; Temporomandibular Joint ; Transplants

The authors experienced an anesthesia for surgical removal of insulinoma of pancreas in 66 year old woman. The patient showed symptoms of Whipples triad (hypoglycemia, low circulating glucose level and prompt relief of symptoms after glucose administration). On the abdominal CT scanning, round distal pancreatic tumor mass was detected. The patient was premedicated with Robinul 0.2 mg, diazepam 10 mg. On arrival in operating theater, the patients blood glucose level was 38 mg/dl (measured with Glucometer), despite of the low blood glucose level, she was free without any apparent symptoms. But we infused 50% D/W 50 ml rapidly and subsequently dropped 5%D/W solution and the blood gucose level was increased to 162 mg/dl before induction of anesthesia. Anesthesia was induced with thiopental sodium 250 mg IV, followed by succinylcholine 50 mg IV for endotracheal intubation and maintained with enflurane-N2O-O2, pancuronium 4 mg was administered intravenously for muslce relaxant. The blood glucose level was measured with Glucometer every 15 minute. No hypoglycemic episode was observed during anesthesia.
Aged ; Anesthesia* ; Blood Glucose ; Diazepam ; Enflurane ; Female ; Glucose ; Humans ; Insulinoma* ; Intubation, Intratracheal ; Pancreas ; Pancuronium ; Succinylcholine ; Thiopental ; Tomography, X-Ray Computed

BACKGROUND: Up to now, lobectomy, bilobectomy and pneumonectomy combined with extensive lymph node dissection have been regarded as the standard procedures for non-small cell lung cancer (NSCLC). In high-risk patients, however, limited resection (LR) has been attempted as a salvage procedure, and, recently, indication for LR has been extended to selected cases with early-stage NSCLC. MATERIAL AND METHODS: Among the 773 patients who underwent surgical procedures for NSCLC in Seoul National University Bundang Hospital from May 2003 to December 2008, 43 patients received LR. Medical records of these patients were retrospectively reviewed. RESULTS: Mean age at operation was 66.0+/-12.4 years, and there were 30 males. Twenty-five patients underwent conservative limited resection (CLR) and 18 underwent intentional limited resection (ILR). Indications for CLR were multiple primary lung cancer in 9 (9/25, 36%) and severe concomitant diseases in 5 (5/25, 20%). Of these, 6 patients underwent segmentectomy and 19 received wedge resection. During the follow-up period of 28.0+/-17.8 months, 15 patient developed recurrent lung cancer. ILR was selectively performed in lesions almost purely composed of ground glass opacity (> or =95%), or in small solid lesions (< or =2 cm). Of these, 11 patients underwent segmentectomy and 7 underwent wedge resection. During the follow-up period of 31.7+/-11.6 months, no patient developed recurrence. CONCLUSION: Intermediate-term outcome of LR for early-stage lung cancer is comparable to that of standard operation. For the delineation of the indications and appropriate surgical techniques for LR, prospective randomized multi-institutional study may be expedient.
Carcinoma, Non-Small-Cell Lung ; Follow-Up Studies ; Glass ; Humans ; Lung ; Lung Neoplasms ; Lymph Node Excision ; Male ; Mastectomy, Segmental ; Medical Records ; Pneumonectomy ; Retrospective Studies

Relapsing polychondritis (RP) is a rare autoimmune connective tissue disease of unclear pathogenesis and may present with the multisystem involvements and varied presentations, courses and responses to the therapy. The respiratory complaints or history such as dyspnea or snoring deserve to be in consideration, especially in the cases of no specific causes and must be ruled out the rare autoimmune airway diseases such as relapsing polychondritis, Wegener's granulomatosis, rhinoscleroma, or amyloidosis resulting in serious airway obstruction without adequate management. In this report we described a case of 15-year-old young male with the delayed diagnosis of relapsing polychondritis with intractable subglottic stenosis during the course of the management for several months despite of tonsillectomy for the relief of the airway obstruction.
Adolescent ; Airway Obstruction ; Amyloidosis ; Connective Tissue Diseases ; Constriction, Pathologic ; Delayed Diagnosis ; Dyspnea ; Humans ; Male ; Polychondritis, Relapsing ; Rhinoscleroma ; Snoring ; Tonsillectomy ; Wegener Granulomatosis

Recently, laser treatment of benign prostatic hyperplasia (BPH) is considered as a promising alternative to traditional transurethral resection of the prostate (TURP). To evaluate the effectiveness and safety of laser therapy on BPH, we compared the results of transurethral balloon laser thermotherapy (TUBALT, n=13) and Hybrid laser prostatectomy (HLP, n=21) with those of TURP (n=25) in 58 patients with mild and moderate BPH. Following data were evaluated at postoperative 1, 3 and 6 months : AUA symptom score (SS), maximal flow rate (Qmax), subjective symptom improvement (SI), postoperative complications. All 3 groups show significant improvement after treatment in the Qmax values. Among 3 groups, the Qmax value was lower in TUBALT group (12.9+/-3.3 ml/sec) than those in HLP group (15.5+/-5.2 ml/sec) and TURP group (18.7+/-5.3 ml/sec) on postoperative 6 months. The Qmax values were not significantly different between HLP and TURP groups. In the SS values, all 3 groups show significant improvement after treatment and, TUBALT (9.9+/-9.7) and HLP (10.3+/-9.4) group were comparable to TURP group (5.2+/-4.2) on postoperative 6 months. In global assessment of SI, both HLP (87.5%) and TUBALT (75%) group were also comparable to TURP (90%) group on postoperative 3 months. but TUBALT group showed delayed symptom improvement compared to TURP group. Postoperative complications were minimal both in HLP and TUBALT groups, compared to TURP group. These results suggest that both HLP and TUBALT are effective in mild and moderate BPH, Further more, HLP treatment could be considered a promising alternative to TURP.
Humans ; Hyperthermia, Induced* ; Laser Therapy ; Postoperative Complications ; Prostate ; Prostatectomy* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate

Histamine type 2 (H2) receptor antagonists are widely used for stress ulcer prophylaxis in critical and postoperative care. Though ranitidine is one of the most commonly used H2 receptor antagonists, with a low incidence of adverse reactions, a few anaphylactic reactions associated with ranitidine have been reported. This report describes 2 additional cases of anaphylaxis induced by ranitidine used for stress ulcer prophylaxis.
Anaphylaxis ; Histamine ; Incidence ; Postoperative Care ; Ranitidine ; Ulcer

BACKGROUND: Manual manipulation under anesthesia in primary frozen shoulder is recommended for restoring range of motion and improving function. Usually, manipulation is performed briefly under general anesthesia, which accompanies some anesthesia- related risks for outpatients. METHODS: 12 patients suffered from primary frozen shoulder were received manipulation under monitored anesthesia care (MAC) with propofol (1 mg/kg) and remifentanil (25microgram) as an initial dose. And then we injected additional bolus dose (propofol 20 mg, remifentanil 10microgram) in case of inadequate sedation. After manipulation, sodium hyaluronate 20 mg, 0.75% ropivacaine 22.5 mg and ketorolac 30 mg were injected into the glenohumeral joint. Clinical data were gathered at baseline and at 4 weeks after manipulation. RESULTS: The procedure was carried out successfully under MAC. Clinical results including improvements of visual analogue scale of pain and range of motion were comparable to previous studies. 2 patients who received relatively large doses of anesthetics have required triple airway maneuver and manual mask ventilation for 1 to 2 minutes respectively because of desaturation below 90%. There are not any serious adverse effects. CONCLUSIONS: MAC with propofol and remifentanil makes it possible to get adequate level of sedation for shoulder manipulation and to reduce recovery time from anesthesia at the same time. MAC, therefore, is the adequate outpatient anesthetic method for shoulder manipulation.
Amides ; Anesthesia ; Anesthesia, General ; Anesthetics ; Bursitis ; Humans ; Hyaluronic Acid ; Ketorolac ; Masks ; Outpatients ; Piperidines ; Propofol ; Range of Motion, Articular ; Shoulder ; Shoulder Joint ; Ventilation

Latent transforming growth factor (TGF)-beta-binding protein (LTBP) is required for the assembly, secretion, matrix association, and activation of latent TGF-beta complex. To elucidate the cell specific expression of the genes of LTBP-1 and their splice variants and the factors that regulate the gene expression, we cultured primary human glomerular endothelial cells (HGEC) under different conditions. Basal expression of LTBP-1 mRNA was suppressed in HGEC compared to WI-38 human embryonic lung fibroblasts. High glucose, H2O2, and TGF-beta1 upregulated and vascular endothelial growth factor (VEGF) further downregulated LTBP-1 mRNA in HGEC. RT-PCR with a primer set for LTBP-1S produced many clones but no clone was gained with a primer set for LTBP-1L. Of 12 clones selected randomly, Sca I mapping and DNA sequencing revealed that only one was LTBP-1S and all the others were LTBP-1S delta 53. TGF-beta1, but not high glucose, H2O2 or VEGF, tended to increase LTBP-1S delta 53 mRNA. In conclusion, HGEC express LTBP-1 mRNA which is suppressed at basal state but upregulated by high glucose, H2O2, and TGF-beta1 and downregulated by VEGF. Major splice variant of LTBP-1 in HGEC was LTBP-1S delta 53. Modification of LTBP-1S delta 53 gene in HGEC may abrogate fibrotic action of TGF-beta1 but this requires confirmation.
*Alternative Splicing ; Amino Acid Sequence ; Cell Line ; Cells, Cultured ; Cloning, Molecular ; Comparative Study ; Endothelial Cells/drug effects/*metabolism ; *Gene Expression Regulation ; Glucose/pharmacology ; Humans ; Hydrogen Peroxide/pharmacology ; Intracellular Signaling Peptides and Proteins/*genetics ; Kidney Glomerulus/cytology ; Protein Isoforms/genetics ; RNA, Messenger/genetics/metabolism ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; *Transcription, Genetic ; Transfection ; Transforming Growth Factor beta/pharmacology ; Vascular Endothelial Growth Factor A/pharmacology

A 45 year-old man who suffered with palpitation and dyspnea for 3 years visited our hospital. He was dianosed as mitral insufficieny due to isolated cleft mitral valve in anterior mitral leaflet on the basis of transthoracic echocardiogram In our case edges of the cleft were relatively thin and smooth. The entire length of the cleft was sutured with 5-0 Prolene(R) interrupted sutures. We report a case of direct suture repair in a patient with isolated cleft in anterior mitral valve leaflet.
Dyspnea ; Humans ; Middle Aged ; Mitral Valve Insufficiency* ; Mitral Valve* ; Sutures

Allergic asthma is associated with persistent functional and structural changes in the airways and involves many different cell types. Many proteins involved in allergic asthma have been identified individually, but complete protein profiles (proteome) have not yet been reported. Here we have used a differential proteome mapping strategy to identify tissue proteins that are differentially expressed in mice with allergic asthma and in normal mice. Mouse lung tissue proteins were separated using two-dimensional gel electrophoresis over a pH range between 4 and 7, digested, and then analyzed by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MS). The proteins were identified using automated MS data acquisition. The resulting data were searched against a protein database using an internal Mascot search routine. This approach identified 15 proteins that were differentially expressed in the lungs of mice with allergic asthma and normal mice. All 15 proteins were identified by MS, and 9 could be linked to asthma-related symptoms, oxidation, or tissue remodeling. Our data suggest that these proteins may prove useful as surrogate biomarkers for quantitatively monitoring disease state progression or response to therapy.
Animals ; Asthma/genetics/immunology/*metabolism ; Comparative Study ; Disease Models, Animal ; Electrophoresis, Gel, Two-Dimensional ; Gene Expression/immunology ; Gene Expression Profiling ; Lung/immunology/metabolism/pathology ; Male ; Mice ; Mice, Inbred BALB C ; Ovalbumin/immunology ; Proteome/*analysis/genetics/immunology ; Proteomics/methods ; RNA, Messenger/genetics/metabolism ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization