BACKGROUND: Although a laparoscopic cholecystectomy results in less pain than an open cholecystectomy, it is not a pain-free procedure. Therefore, this study was conducted to determine whether perioperative intravenous lidocaine would reduce postoperative pain after a laparoscopic cholecystectomy. METHODS: Fifty patients undergoing laparoscopic cholecystectomy were divided into two groups; a lidocaine group, in which patients were injected with a lidocaine bolus (1.5 mg/kg) and infusion (1.5 mg/kg/h); and a control group, in which patients were injected with the same volume of saline bolus and infusion. Intravenous lidocaine was initiated before anesthesia was administered and continued for 1 hour postoperatively. The intensity of abdominal and shoulder pain was then assessed 1, 6, 12 and 24 hours after surgery and recorded using a visual analog pain score (VAS) and verbal rating score (VRS). RESULTS: The abdominal pain score (VAS and VRS) was significantly lower in the lidocaine group than in the control group at all times evaluated during the first 24 hours after surgery (P < 0.05). In addition, the shoulder pain score and incidence were significantly lower in the lidocaine group than the control group at 12 hours and 24 hours after surgery (P < 0.05). In the lidocaine group, the incidences of epigastric, right flank, and back pain were lower than that of the control group, but these differences were not statistically significant. CONCLUSIONS: Perioperative intravenous lidocaine reduces shoulder and abdominal pain for 24 hours after laparoscopic cholecystectomy.
Abdominal Pain ; Anesthesia ; Back Pain ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Humans ; Incidence ; Lidocaine ; Oxalates ; Pain, Postoperative ; Shoulder ; Shoulder Pain

No abstract available.
Lymphoma* ; Pseudolymphoma*

Although the incidence and mortality for most cancers such as lung and colon are decreasing in several countries, they are increasing in several developed countries because of an unhealthy western lifestyles including smoking, physical inactivity and consumption of calorie-dense food. The incidences for lung and colon cancers in a few of these countries have already exceeded those in the United States and other western countries. Among them, lung cancer is the main cause of cancer death in worldwide. The cumulative survival rate at five years differs between 13 and 21 % in several countries. Although the most important risk factors are smoking for lung cancer, however, the increased incidence of lung cancer in never smokers(LCINS) is necessary to improve knowledge concerning other risk factors. Environmental factors and genetic susceptibility are also thought to contribute to lung cancer risk. Patients with lung adenocarcinoma who have never smoking frequently contain mutation within tyrosine kinase domain of the epidermal growth factor receptor(EGFR) gene. Also, K-ras mutations are more common in individuals with a history of smoking use and are related with resistance to EFGR-tyrosine kinase inhibitors. Recently, radon(Rn), natural and noble gas, has been recognized as second common reason of lung cancer. In this review, we aim to know whether residential radon is associated with an increased risk for developing lung cancer and regulated by several genetic polymorphisms.
Adenocarcinoma ; Colon ; Colonic Neoplasms ; Developed Countries ; Epidermal Growth Factor ; Genetic Predisposition to Disease ; Humans ; Incidence ; Life Style ; Lung Neoplasms* ; Lung* ; Mortality ; Phosphotransferases ; Polymorphism, Genetic ; Protein-Tyrosine Kinases ; Radon* ; Risk Factors ; Smoke ; Smoking ; Survival Rate ; United States

The Editorial Office of Obstet Gynecol Sci would like to correct the author list.

BACKGROUND: Intravenous injection of mesenchymal and hematopoietic stem cells (MSCs, HSCs) has the disadvantages of low delivery rate to bone marrow and sequestration of cells in the lung and liver. This study was designed to determine whether there is a relationship between the administration route and dosage of stem cells and GVHD and survival. METHODS: MSCs were retrieved from five subcultured C3H/10T1/2, cell lines from C3H/He mice. HSCs were transplanted by injecting 1 x 10(7) of bone marrow mononuclear cells and 5 x 10(6) of spleen cells from six to eight week old female C3H/He mice into six week old irradiated female BALB/c mice. The groups were divided into intravenous injection (IV) and intra-marrow (IM) injection groups. IV and IM+MSC groups consisted of mice transplanted with the same bone marrow mononuclear cells and SP, IV and IM groups, with the additional co-injection of 1 x 10(6) MSCs. RESULTS: Evaluation of all mice, in both groups, showed no difference in GVHD and survival. However, high dose injection with 1 x 10(6) MSCs led to a decreased incidence of GVHD (P<0.05) and improved survival (P<0.01) in both groups. CONCLUSION: The results of this study showed that the positive effects of MSC on GVHD and survival were primarily dependent on the number of injected cells.
Animals ; Bone Marrow ; Cell Line ; Female ; Graft vs Host Disease* ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Incidence ; Injections, Intravenous ; Liver ; Lung ; Mesenchymal Stromal Cells* ; Mice ; Spleen ; Stem Cells ; Transplants*

BACKGROUND: Hemodynamic changes through the histamine-induced release of atracurium are relatively common, but can be particularly dangerous in hemodynamically unstable patients. This study evaluated the effectiveness of a pretreatment with an anti-histamine agent before the administration of atracurium in the prevention of histamine-induced hemodynamic changes. METHODS: Forty-eight ASA class I and II patients were assigned to four groups. Groups 1 and 2 were assigned to receive atracurium through a bolus 0.5 mg/kg. Groups 3 and 4 were assigned to receive atracurium through a bolus 1.0 mg/kg. Group 1 and 3 were pretreated with pheniramine (H1-blocker) and ranitidine (H2-blocker) intravenously before the induction of general anesthesia. After induction, HemosonicTM 100 was installed and the following hemodynamic parameters were measured: systemic vascular resistance (SVR), cardiac index (CI), heart rate (HR) and blood pressure (BP) immediately before, 1, 2, 3, 5 and 10 min after the rapid administration of the atracurium bolus before the skin incision. RESULTS: Groups 1 and 3 showed more stable hemodynamics than groups 2 and 4. Group 2 showed more significant changes in the SVR, CI, BP, HR than group 1 (P< 0.05). Group 4 showed more significant changes in the SVR, CI, BP, HR than group 3, and some cases were significant hemodynamically (P< 0.05). Group 4 showed more significant changes in the SVR, CI, BP, HR than group 2 (P <0.05). CONCLUSIONS: Pretreatment with an anti-histamine drug prior to the administration of atracurium can be effective in attenuating the hemodynamic responses.
Anesthesia, General ; Atracurium* ; Blood Pressure ; Heart Rate ; Hemodynamics* ; Histamine ; Humans ; Pheniramine ; Ranitidine ; Skin ; Vascular Resistance

BACKGROUND: Charcot-Marie-Tooth (CMT) disease is the most common form of inherited motor and sensory neuropathy. Neurofilament light chain polypeptide (NEFL) is one of the most abundant cytoskeletal components of the neuron. The NEFL gene encoding the neurofilament light chain plays an important role in the axonal structure that includes an extensive fibrous network in the cytoplasm of the neuron. Mutations in the NEFL gene are also present in CMT2E, CMT type 1 and Dejerine-Sottas syndrome. However, there have been no reports to investigate the NEFL genes in Korean CMT patients. Therefore, we investigated to find the clinical characteristics in patients with the NEFL gene mutation. METHODS: We examined mutations of the NEFL gene in 125 Korean CMT families. Mutations were confirmed by the sequencing of both strands. Nerve conduction studies were carried out on CMT patients having each mutation. RESULTS: Three pathogenic mutations were found in 3 families, and 2 polymorphisms in 2 families. Two mutations (Leu334Pro, Pro22Arg) were determined too novel, and those were not detected in 105 healthy controls. A de novo missense mutation was found in a CMT family with the NEFL mutation. The frequency of the NEFL mutation was 2.4%, which was similar in Europeans, and lower than those found in Japanese. Pro22Arg and Glu397Lys mutations showed demyelinating neuropathy and Leu334pro mutation showed axonal neuropathy. CONCLUSIONS: We found NEFL mutations in patients with sporadic or dominantly inherited CMT. NEFL mutations should be considered in the evaluation of CMT or related neuropathies with various clinical features.
Asian Continental Ancestry Group ; Axons ; Charcot-Marie-Tooth Disease* ; Cytoplasm ; Hereditary Sensory and Motor Neuropathy ; Humans ; Mutation, Missense ; Neural Conduction ; Neurons

PURPOSE: Surgical resection is still considered as the gold standard in patients with hepatic metastases from colorectal cancer. The impact of the number of hepatic metastases is a controversial issue. We aimed to evaluate the outcomes and the prognostic factors after hepatic resection in multiple hepatic metastases from colorectal cancer. METHODS: Between June 1989 and October 2005, 42 patients underwent hepatic resections for three or more hepatic metastases from colorectal cancer. Disease-free survival analyses were performed on patients grouped as a function of the following factors: age, sex, preoperative serum CEA level, primary tumor site, nodal status, intrahepatic distribution, diameter of the liver lesion, their number, and the resection margin. RESULTS: Of the 42 patients, 29 (69.0%) developed recurrence (16 in the liver alone, 5 in the liver and another distant site, 8 in a distant site alone) during a median follow-up of 24 months. The overall 1-, 2-, and 5-year survival rates were 89.1%, 58.6%, and 31.8%, respectively. The 1-year and 2-year disease-free survival rates were 38.1 and 29.4%, respectively. There was no postoperative mortality and the morbidity rate was 11.9%. The disease-free survival rate was independently associated with the resection margin of the metastatic tumor (P=0.017). The 1-year disease- free survival rates in patients with more than a 5-mm resection margin and with less than a 5-mm resection margin were 72.7%, and 25.8%, respectively. CONCLUSIONS: If technically feasible, an aggressive hepatic resection should be performed for the treatment of multiple hepatic metastases from colorectal cancer. The surgical resection margin may govern the outcomes in patients with surgically curable hepatic metastases from colorectal cancer.
Colorectal Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Liver ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Survival Rate

PURPOSE: Recent studies have showed a 7~15% lymph node metastasis rate in T1 rectal cancer. Surgical options for T1 rectal cancer are radical resections, local excisions, and local excisions with adjuvant radiotherapy. Outcomes according to the type of surgery are variable. The present study was performed to assess outcomes of T1 rectal cancer according to therapeutic modalities and to provide guidelines for appropriate treatment of T1 rectal cancer. METHODS: A retrospective study of 117 patients with T1 rectal cancer who underwent surgery between June 1989 and December 2002 at Asan Medical Center was conducted. Radical resections, local excisions, and local excisions with adjuvant radiotherapy were performed as therapeutic modalities. Adjuvant radiotherapy after local excision was performed in patients with sm2 or sm3 cancers, lympho-vascular invasion (+), poorly differentiated cancer, and resection margin (+) or because of a patient's refusal to undergo a radical resection. RESULTS: Twenty-five (21.3%) patients were treated by local excision, 14 (12.0%) by adjuvant radiotherapy after local excision, and 78 (66.7%) by radical resection. The distance from the anal verge was significantly longer in the radical resection group than in the local excision group (7.8+/-3.4 vs. 4.9+/-2.1 cm; P<0.001). There was no significant difference by age, sex, or pathologic findings between the three groups. There was one local recurrence in the local excision group, one distant metastasis in the local excision with adjuvant radiotherapy group, and two distant metastases in the radical resection group. The 5-year cancer-specific survival and disease-free survival rates were as follows; local excision group, 94.1 and 95.8%, respectively; local excision with adjuvant radiotherapy group, 100 and 92.8%, respectively; radical resection group, 98.3 and 98.6%, respectively. There were no significant differences in survival between the groups. CONCLUSIONS: Oncological outcomes of T1 rectal cancer patients were comparable among the surgical options. Adjuvant radiotherapy is recommended after local excision in patients with risk factors, such as sm2 or sm3 cancer, poorly differentiated cancer, and positive lympho-vascular invasion.
Chungcheongnam-do ; Disease-Free Survival ; Disulfiram ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies ; Risk Factors

BACKGROUND: Postoperative sore throat (POST) is a relatively common complication after endotracheal intubation, and various methods has been proposed to prevent it. In the present study, we assessed the effectiveness of ketamine gargling for reducing POST. METHODS: This study was conducted in a prospective, randomized, placebo-controlled, and single-blinded manner. The study populations consisted of 40 patients between 20 and 60 years old who were classified as American Society of Anesthesiologists physical status I-II and were scheduled for elective laparoscopic cholecystectomy. Patients in group K received ketamine (1 ml, 50 mg) in normal saline (29 ml), and they gargled with the given solution for 30 s before induction. Patients in group C received normal saline (30 ml) and gargled it for 30 s before induction. All patients were interviewed 1, 6, and 24 h after the operation. The visual analog scale (VAS) score of POST was checked. RESULTS: The VAS scores of POST were significantly lower in group K than in group C at 1 and 6 h after the operation. However, there were no significant differences in VAS scores at 24 h after the operation. CONCLUSIONS: Preoperative ketamine gargling temporarily reduced POST in patients that underwent laparoscopic cholecystectomy.
Cholecystectomy, Laparoscopic ; Humans ; Intubation, Intratracheal* ; Ketamine* ; Pharyngitis* ; Prospective Studies ; Visual Analog Scale