BACKGROUND: Patients with locally advanced non-small cell lung cancer are often treated with radiation alone or in combination with chemotherapy. Both modalities have a potentially damaging effect on pulmonary function. In order to examine changes in the cardiopulmonary exercise function of patients with locally advanced non-small cell lung cancer before and after conventional radiotherapy, we conducted a prospective study involving patients with such cancer, that had received radiation therapy. METHODS: Resting pulmonary function test, thoracic radiographic finding and cardiopulmonary exercise test(CPET) were assessed prior to and 4 weeks following radiation therapy in 11 male patients with locally advanced non-small cell lung cancer. Patient with endobronchial mass were excluded. RESULTS: The forces vital capacity(FVC), forced expiratory volume in 1 second(FEV1)and maximal voluntary ventilation(MVV) did not decreased between before and 4 weeks after radiation but the diffusing capacity(DLCO) had decreased by 11% 4 weeks after radiation, which was not statistically significant. No changes in maximal oxygen consumption(VO2max), carbon dioxide production(VCO2), exercise time and work load were attributed to radiation therapy. Follow up cardiopulmonary exercise testing revealed unchanged cardiovascular function, ventilatory function and gas exchange. No difference in cardiopulmonary exercise test performance was observed between pre- and post-radiation. CONCLUSION: Cardiopulmonary exercise function did not decrease within the short-term after the radiation of patients with locally advanced non-small cell lung cancer.
Carbon Dioxide ; Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Exercise Test ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Lung Neoplasms ; Male ; Oxygen ; Prospective Studies ; Radiotherapy ; Respiratory Function Tests

The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.
Hamartoma ; Lung ; Prevalence ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary

The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.
Hamartoma ; Lung ; Prevalence ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary

We report an autopsy case of the brain stem glioma that extended extensively in the brain stem itself and cephalad. This 18-year-old boy first presented with dizziness, vomiting and left side weakness with left facial palsy. Brain MRI revealed a diffusely infiltrative tumor involving whole medulla, pons and lower midbrain. A total of 4000 R was given with some alleviation of respiratory difficulty. He died one year after the onset. Autopsy revealed the tumor involving pons, a portion of medulla oblongata, and cerebellum. The tumor showed diffusely infiltrative pattern and extended along the periventricular area to the thalamus and corpus callosum. The cut surface was grayish white and solid. It also showed areas of myxoid degeneration and necrosis probably related to radiation therapy. Microscopically the tumor was a cellular and pleomorphic glioma that showed some astrocytic differentiation. It was diffuse without geographic necrosis.

Lesch-Nyhan syndrome is an inborn error of purine metabolism resulting from hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) deficiency and leading to excess purine production and uric acid over-production. It is a very rare X-linked recessive disorder, characterized by movement disorder, cognitive deficits, and self-injurious behavior. However, because of the high incidence of calculi, patients may present for surgery of urinary tract, and have increased risk of difficult intubation, aspiration pneumonia, renal insufficiency or sudden death. We report the case of a 5-year-old boy with Lesch-Nyhan syndrome who underwent successive extracorporeal shockwave lithotripsy under general anesthesia.
Anesthesia, General ; Calculi ; Child ; Death, Sudden ; Humans ; Incidence ; Intubation ; Lesch-Nyhan Syndrome ; Lithotripsy ; Movement Disorders ; Pneumonia, Aspiration ; Preschool Child ; Purines ; Renal Insufficiency ; Self-Injurious Behavior ; Uric Acid ; Urinary Tract

Sex typing may become the start point in investigations that are usually performed through amelogenin typing. In cases involving genotype-phenotype discrepancy, amelogenin typing could yield misleading results. The rare XX male syndrome is characterized by a phenotypic male with a 46, XX female karyotype. In this point, this case report would help understand the importance of genotype-phenotype discrepancy.
Amelogenin ; Female ; Genes, sry ; Humans ; Karyotype ; Klinefelter Syndrome ; Male ; Y Chromosome

PURPOSE: Alveolar bone develops with tooth eruption and is absorbed following tooth extraction. Various ridge preservation techniques have sought to prevent ridge atrophy, with no superior technique evident. Collagen has a long history as a biocompatible material. Its usefulness and safety have been amply verified. The related compound, atelocollagen, is also safe and displays reduced antigenicity since telopeptides are not present. MATERIALS AND METHODS: The current study evaluated whether the Rapiderm® atelocollagen plug (Dalim Tissen, Seoul, Korea) improves tissue healing of extraction sockets and assessed the sequential pattern of bone regeneration using histology and microcomputed tomography in six beagle dogs. To assess the change of extraction socket, hard tissues were examined 2, 4, 6, and 8 weeks after tooth extraction. RESULT: The experimental groups showed better bone fill with slow remodeling process compared to the control groups although there was no statistical difference between groups. CONCLUSION: The atelocollagen seems to have a tendency to slow bone remodeling in the early phase of healing period and maintain remodeling capacity until late phase of remodeling. Also, use of atelocollagen increased the bone-to-tissue ratio compared to healing of untreated extraction socket.
Animals ; Atrophy ; Bone Regeneration* ; Bone Remodeling ; Collagen ; Dogs* ; Seoul ; Tooth Eruption ; Tooth Extraction ; X-Ray Microtomography

BACKGROUND: Evidence has accumulated that neostigmine can produce potent antinociceptive effects by interacting with muscarinic receptors in peripheral tissues. This study assesses the analgesia and side effects of intraarticular neostigmine alone and the combination of neostigmine and bupivacaine. METHODS: In a double-blind, randomized manner, sixty ASA class 1 or 2 patients were selected for arthroscopic knee surgery under general anesthesia. In the control group (Group 1, n = 15), the patients received 30 ml of intraarticular normal saline. In Group 2 (n = 15), the patients received a combination of intraarticular 500 microgram neostigmine and 30 ml normal saline. In Group 3 (n = 15), 500 microgram neostigmine diluted in 0.125% bupivacaine 30 ml was injected into the knee joint. In Group 4 (n = 15), 750 microgram neostigmine diluted in 30 ml of normal saline was injected into the knee joint. Postoperative pain was assessed using the visual analogue scale (VAS) score at 1, 2, 4, 6, 12, and 24 hours after the intraarticular injection, and the side effects of the four groups were evaluated. RESULTS: Groups 2, 3 and 4 resulted in significantly low VAS scores up to 6 hr after injection compared with Group 1 (P < 0.05). The difference was not significant between Groups 2 and 3, nor between Groups 2 and 4. Side effects such as nausea, vomiting, and urinary retention were observed. However, the intensity of side effect was mild. CONCLUSIONS: The results suggest that intraarticular injection of the acetylcholinesterase inhibitor neostigmine produces a significant analgesic effect following knee arthroscopy. (Korean J Anesthesiol 2000; 39: 212-217)
Acetylcholinesterase ; Analgesia ; Anesthesia, General ; Arthroscopy* ; Bupivacaine* ; Humans ; Injections, Intra-Articular ; Knee Joint ; Knee* ; Nausea ; Neostigmine* ; Pain, Postoperative ; Receptors, Muscarinic ; Urinary Retention ; Vomiting

Psoriasis is a relatively common disorder that affects at least 1-2% of the population, however, the pathogenesis is not fully understood yet. Histopathologically, psoriatic lesion is characterized by hyperplasia of keratinocyte, intraepidermal neutrophil accumulation and activated T lymphocyte infiltration in the dermis. Among many cytokines, IL-8 is known to play a role for the activation and migration for neutrophil and T lymphocyte and for the proliferation of keratinocyte. We performed immunohistochemical staining with anti-IL-8 monoclonal antibody for the active lesion, stable lesion and normal-looking skin of ten psoriatic patients and ten healthy controls. Strong expression of IL-8 in the epidermis and dermis was noted from the active as well as stable psoriatic skins. In the normal-looking skin of the psoriatic patients, only faint expression which is not different from healthy control skin, was noted. These observations indicate that the expression of IL-8 is increased in psoriatic lesion, and IL-S is important for the initiation and maintenance of psoriasis.
Cytokines ; Dermis ; Epidermis ; Humans ; Hyperplasia ; Interleukin-8* ; Keratinocytes ; Lymphocytes ; Neutrophils ; Psoriasis ; Skin*

Peripheral nerve blocks are commonly used for surgical anesthesia, postoperative analgesia, and to reduce opioid requirements. Although these blocks have traditionally been carried out using local anesthetics, single-injection techniques can be short-lived and limited by the relatively brief duration of action of currently available local anesthetics. Increasing the dose or concentration of local anesthetics may prolong the duration of analgesia, but may also increase the risk such as unwanted motor weakness or systemic toxicity of local anesthetics. Numerous adjuvant medications have been added to local anesthetics to prolong the durations of anesthesia and analgesia achieved by peripheral nerve blocks, and currently, a number of different adjuvants are used to improve quality of the block. This article will review the several nerve block adjuvants used in combination with local anesthetics to provide blockade of peripheral nerves in clinical practice, describing the rationale for their use in peripheral nerve blocks, and the evidence for their effectiveness.
Analgesia ; Anesthesia ; Anesthesia and Analgesia ; Anesthetics, Local* ; Nerve Block* ; Peripheral Nerves