No abstract available.
Stomach Neoplasms* ; Stomach*

BACKGROUND: Many factors determine the distribution of local anesthetics in the subarachnoid space. These major factors are dosage of local anesthetics, baricity of local anesthetics, position of patient, contour of vertebral column. The temperature of local anesthetics alters the baricity of local anesthetics. At 20oC, the density of 0.5% plain bupivacaine is 1.0003 and generally act as isobaric solution in the CSF. As its temperature lowers, its baricity increases. METHODS: Forty patients (A.S.A I and II) scheduled for lower extremity operation under spinal anesthesia were randomized into four groups; group I (37oC 0.5% bupivacaine, sitting position), group II (37oC 0.5% bupivacaine, 15o head-down position), group III (4oC 0.5% bupivacaine, sitting position), group IV (4oC 0.5% bupivacaine, 15o head-down position). The patients were placed in the sitting position (Group I, III) or lateral decubitus (Group II, IV) and dural puncture was performed at the L3-4 interspace using a midline approach (25-gauge Quincke spinal needle). A free flow of clear cerebrospinal fluid was obtained before administration of drug (37oC 0.5% bupivacaine in Group I, II and 4oC 0.5% bupivacaine in Group III, IV). Patients remained in the sitting position or 15o head-down position for 3 minutes after injection. Patients in each group received a solution that had been previously equilibrated in a stove to 37oC and in a refrigerator to 4oC for more than 1 day. Syringes used to administer the bupivacaine solution were also equilibrated to 37oC and 4oC, respectively. We checked sensory block level using pin-prick test at every 5 minutes. RESULTS: There was statistic significance in sensory block level between Group I, IV and Group II, III. The maximum sensory block level and the time to maximum cephalad spread of analgesia was the T4 level and 9.6 minutes in Group I, the T5 level and 13.5 minutes in Group IV compared to the T9 level and 21 minutes in Group II, the T10 level and 18 minutes in Group III. CONCLUSIONS: The temperature of 0.5% plain bupivacaine affects sensory block level and time to block. It is concluded that the temperature of the injected solution plays an important role in the sensory spread of 0.5% plain bupivacaine.
Analgesia ; Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine* ; Cerebrospinal Fluid ; Humans ; Lower Extremity ; Posture* ; Punctures ; Spine ; Subarachnoid Space ; Syringes

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

Transcatheter arterial chemoembolization(TACE) is an imperative method for the managment of inoperable hepatocellular carcinoma(HCC). It is well known that primary HCC frequently invades the portal venous system and forms a tumor thrombus obstructing the portal blood flow which makes unfavorable prognosis of patiebt. We retrospetively reviewed 58 patients who reveived TACE(minimum 3 times) of HCC invading into portal venous system. Group 1(n=29) which showed peripheral portal vein invasion had better clinical and laboratory response. Group 2(n=17) which showed first order portal branch invasion had similar response to Group 3(n=12), which had main portal invasion. Group 1 showed no difference in survival time between TAC and TACE, but, in Group 2 and 3, emboliation with chemotherapy made longer survival than chemotherapy only. Clinical level of AFP was meaningful in Group 1 and 2 as decreasing value. Our results provides that careful selection of TACE and case by case Coil/Gelfoam embolization can improve the mean survival and clinical response when HCC evidently invades portal venous system.
Carcinoma, Hepatocellular* ; Drug Therapy ; Humans ; Methods ; Portal Vein* ; Prognosis ; Thrombosis

Transcatheter arterial chemoembolization(TACE) is an imperative method for the managment of inoperable hepatocellular carcinoma(HCC). It is well known that primary HCC frequently invades the portal venous system and forms a tumor thrombus obstructing the portal blood flow which makes unfavorable prognosis of patiebt. We retrospetively reviewed 58 patients who reveived TACE(minimum 3 times) of HCC invading into portal venous system. Group 1(n=29) which showed peripheral portal vein invasion had better clinical and laboratory response. Group 2(n=17) which showed first order portal branch invasion had similar response to Group 3(n=12), which had main portal invasion. Group 1 showed no difference in survival time between TAC and TACE, but, in Group 2 and 3, emboliation with chemotherapy made longer survival than chemotherapy only. Clinical level of AFP was meaningful in Group 1 and 2 as decreasing value. Our results provides that careful selection of TACE and case by case Coil/Gelfoam embolization can improve the mean survival and clinical response when HCC evidently invades portal venous system.
Carcinoma, Hepatocellular* ; Drug Therapy ; Humans ; Methods ; Portal Vein* ; Prognosis ; Thrombosis

No abstract available.
Holoprosencephaly*

Thallium-201 brain SPECT is utilized in the diagnosis of brain tumor especially in cases where CT or MRI findings alone cannot differentiate malignant lesion from benign. Recently we came across two cases of positive T1-201 brain SPECT in clinically suspected brain tumor patients that turned out to be hemorrhagic cerebral infarction instead on biopsy. The findings in these cases demonstrate that thallium-201 accumulation may occur by the breakdown of the blood-brain barrier and phagocytic cell infiltration in the liquefaction stage of infarction.
Biopsy ; Blood-Brain Barrier ; Brain ; Brain Neoplasms ; Cerebral Infarction* ; Diagnosis ; Humans ; Infarction ; Magnetic Resonance Imaging ; Phagocytes ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Colon, Descending* ; Leiomyosarcoma*

No abstract available.
Para-Aortic Bodies* ; Paraganglioma*