No abstract available.
Laser Therapy*

A case of primary non-clear-cell adenocarcinoma of the vagina is reported occurring in a 65-year-old woman without exposure to diethylstilbestrol (DES) in utero. The adenocarcinoma did not appear to be associated with vaginal adenosis. It lacked clear cell component and interestingly composed of columnar epithelial cells of endocervical-type. Cytologically round to oval nuclei revealed one or more small nucleoli and fine granular chromatin pattern. Cytoplasm was plump, faintly basophilic and homogeneously stained. Histologically well differentiated columnar epithelial cells were arranged in trabecular pattern mainly, and also occasional glandular lumina and small solid sheets were found. Mitoses were hardly found.
Adenocarcinoma ; Aged ; Basophils ; Cellular Structures ; Chromatin ; Cytoplasm ; Diethylstilbestrol ; Epithelial Cells ; Female ; Glomerulonephritis* ; Humans ; Mitosis ; Purpura, Schoenlein-Henoch* ; Vagina

Between Jan. 1983 and Dec. 1990, 17 Patients with distal anterior cerebral artery(DACA) aneurysms were admitted to our institute and underwent microsurgical neck clipping of their aneurysms. This group comprised 3.7% of the 437 aneurysms managed surgically during this period. There were 11 females and 6 males. The mean age was 48.5 years. Most of DACA aneurysms were located at the genu portion of the anterior cerebral artery. Three cases were at the proximal protion of A2 close to the anterior communicating artery. Two cases were at the dista pericallosal artery and distal callosomarginal artery. Eight patients had additional vascular anomalies documented by angiography such as multiple aneurysms, azygos DACA and duplication of DACA. Direct neck clipping was possible in all cases through the interhemispheric approach or the frontotemporal approach according to the location. For the interhemispheric apporach preoperative evaluation of the exact location and direction of the aneurysms on the angiogram was important for operative planning. The surgical outcome was good or excellent without any neurological deficits in 17 of the cases. Operative management, clinical features and incidence of vascular anomalies associated with DACA aneurysms are discussed.
Aneurysm ; Angiography ; Anterior Cerebral Artery* ; Arteries ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Neck

No abstract available.
Basilar Artery* ; Rabbits* ; Vasoconstrictor Agents* ; Vasodilator Agents*

Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

BACKGROUND: The length of postoperative drug therapy remains controversial in pulmonary tuberculosis. We analyzed our experiences to determine the postoperative duration of chemotherapy after resection. METHODS: A retrospective review was performed in 66 of 95 patients that underwent pulmonary resection for pulmonary tuberculosis between January 1993 and December 1998. We compared the relapse rates according to the length of postoperative chemotherapy in each group, classified by the results of sputum AFB culture before the surgery, the number of resistant durgs, the number of prior treatment and the division of anti-TB drugs used postoperatively. RESULTS: Fifty three of 66(80.3%) were men and 13(19.7%) were women with a median age of 33.5 years(range, 16 to 63). The mean lengths of the pre-and post-operative chemotherapies were 4.9 months, and 12.9 months respectively. Five of 66 patients(7.6%) relapsed during the mean period of follow up(39.7 months). In the group less than three times of the prior treatment, there were two relapses(20%) in Ed-the highlight above-rephrase 10 patients that were medicated for 6 months or less, and one relapse in 43 patients(2.3%) that took medicine for more than 6 months(p=0.03). In the group using second-line drugs postoperatively, there was one relapse(25%) in four patients that were medicated for 12 months or less. No patient in a total of 17 that received medicine for more than 12 months relapsed(p=0.03). CONCLUSION: We recommend that patients with the prior treatment less than three times should be treated for more than 6 months after resection and patients using the second-line drugs postoperatively should be medicated for more than 12 months.
Drug Therapy ; Female ; Humans ; Male ; Recurrence ; Retrospective Studies ; Sputum ; Tuberculosis, Pulmonary*

Fifty-one consecutive 186 patients with aneurysmal subarachnoid hemorrhage were treated from the day of admission with nimodipine which was given first as an IV infusion at 30ug/kg/hr for 1 week and then orally in a dose of 360mg/day for 2 weeks and compared with 135 patients which were treated without nimodipine for the past 2 years. A comparision based on clinical and radiological variables influencing both the coruse and the outcome of the disease showed no significant difference between the nimodipine treated group and the control group except the delayed timing of surgery in the control group. There was no significant difference in the outcome between the nimodipine treated patients and the patients treated without nimodipine, however in Hung & Hess grade IV patients nimodipine treatment was associated with a significantly better outcome. Nimodipine treatment reduced the occurrence of delayed ischemic deficts(DID) in grade III, IV patients. Significant improvement in the outcome occurred in the nimodipine treated patients with subarachnoid hemorrhage of large amount(Fisher classification III).
Aneurysm* ; Classification ; Humans ; Intracranial Aneurysm ; Nimodipine* ; Subarachnoid Hemorrhage*

Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of CO2 gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. PaCO₂, pH, buffer base and PaO2 were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean PaCO₂ level was 12.1±7.8 mmHg in the priming solution. However, 15 minutes after extracorporeal circulation, the PaCO₂ level was maintained at 35.7±5.7 mmHg. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean 7.45±0.29), but after 15 minutes it was ranged from 7.28 to 7.42 (mean 7.35±0.05). 3) Mean buffer base level in the priming solution was 7.9±3.5 mmol/l. but after 15 minutes, it was 19.6±1.2 mmol/l. 4) Mean PaO₂ level in the priming solution was 667.1±45.6 mmHg, but after 15 minutes, it was 280.7±131.7 mmHg.
Extracorporeal Circulation* ; Heart* ; Heart-Lung Machine ; Humans ; Hydrogen-Ion Concentration ; Oxygen ; Oxygenators ; Thoracic Surgery*

This study included 38 children patients of less than 4 years old and 18 kg body weight. After 8 hours of starvation, the children were divided into 2 groups: Group I received Hartmann's solution and Group II received Hartmann's dextrose solution. In both groups, the rates of infusion were 10 ml/kg/hr before and during operation and blood samples were collected just before and 1 hr after induction of anesthesia, respectively. The results were as follows; 1) In the Group I, blood glucose concentration just before induction was decreased than control values that was checked at ward, and 1 hr value after induction was significantly increased then control values. 2) In the Group II, blood glucose concentration was increased just before and 1hr after induction than control values significantly respectively. 3) In the blood glucose concentration 1 hr after induction, difference between Group I and Group II was not significant. 4) In children, duration of starvation about 8 hrs did not significant influence on blood glucose concentration although dextrose was not administered.
Anesthesia* ; Blood Glucose* ; Body Weight ; Child* ; Fluid Therapy* ; Glucose ; Humans ; Starvation*