No abstract available.
Animals ; Cardioplegic Solutions* ; Oxygen* ; Rats*

BACKGROUND: In this randomized, double-blinded study, we evaluated the efficacy of ramosetron and ondansetron for preventing postoperative nausea and vomiting (PONV) after middle ear surgery. METHODS: Seventy patients of either sex, ASA 1-2, scheduled middle ear surgery (mastoidectomy and tympanoplasty) under general anesthesia with sevoflurane and remifentanil were included. Patients were randomly divided into two groups and received IV ramosetron 0.3 mg (group R) or ondansetron 4 mg (group O) before the end of operation (n = 35 each). The incidence and severity of PONV, pain score (VAS), rescue antiemetic, rescue analgesic and side effects were assessed following 6 hr, 24 hr and 48 hr after surgery. RESULTS: The incidence of PONV showed no significant difference between groups at each time points after surgery. There were no difference in the severity of nausea, pain score, rescue antiemetic, analgesic drug usage and side effects between groups. CONCLUSIONS: Prophylactic therapy with ramosetron is as effective and safe as conventional prophylactic therapy with ondansetron for preventing PONV in patients undergoing general anesthesia for middle ear surgery.
Anesthesia, General ; Benzimidazoles ; Ear, Middle ; Humans ; Incidence ; Methyl Ethers ; Nausea ; Ondansetron ; Piperidines ; Postoperative Nausea and Vomiting ; Vomiting

BACKGROUND: Verrucous hemangioma (VH) and angiokeratoma (AK) are vascular birthmarks of an unclear nosology and these birthmarks commonly show a superficial hyperkeratotic vascular component. There are both similarilities and differences between VH and AK with some confusion concerning their overlapping features. OBJECTIVE: This study was undertaken to review the clinicopathological features of VHs and AKs and to determine the similarilities and differences between them. METHODS:We retrospectively reviewed 11 VHs and 7 AKs at the Vascular Anomaly Clinic of our hospital over the past 10 years. They were evaluated from the clinicopathologic point of view for factors such as the age of onset, location, size, symptoms, the histopathological epithelial change and involvement of deeper tissue. RESULTS: These birthmarks share common clinical features with the exception of gender and lesion size. Histopathologically, hyperkeratosis, acanthosis and capillary dilatation in the upper dermis were commonly seen. Yet lobular proliferation and dilatation of blood vessels in the deep dermis, or more importantly, the subcutis were detected in VH only. Furthermore there was a case of VH that showed diffusely scattered increased blood vessels in the subcutis, suggesting an evolving stage of VH and there was another case of VH that was erroneously diagnosed as AK via the initial biopsy, and the final diagnosis was changed according to the excised lesion. CONCLUSION:The two diseases share most of their clinicopathological features, but small parts of features like gender, the clinical size and the histological deep dermis/subcutis involvement were differences. Making the correct differential diagnosis between VH and AK through a deep biopsy with appropriate timing and long-term follow-up and/or radiological examination is helpful to avoid erroneous management.
Age of Onset ; Angiokeratoma ; Biopsy ; Blood Vessels ; Capillaries ; Dermis ; Diagnosis, Differential ; Dilatation ; Follow-Up Studies ; Hemangioma ; Retrospective Studies

BACKGROUND: Hemangioma of infancy (HOI) is one of the most common tumors in childhood. Their clinical features can on occasion look like those of other vascular tumors and malformations, so the correct differentiation of HOI may not always be easy. OBJECTIVE: The purpose of this study was to review the clinicopathological features of HOIs and to particularlyexamine the usefulness of glucose transporter protein isoform-1 (GLUT-1) immunohistochemical stain (IHS) as a specific marker of HOI. METHODS: This study was conducted at the Vascular Anomaly Clinic of Kyungpook National University Hospital during 11 years (1998~2008). Sixty-two cases were selected in addition to selecting other tumors and malformation as a control group. We then reviewed their clinical features and the results of H&E and GLUT-1 IHS for making the differential diagnosis. RESULTS: The male to female ratio was 1 : 2.88. The head and neck were the most commonly involved sites. The complications included ulceration and/or bleeding (12.9%), scarring (9.7%), infection (4.8%), ocular complications (4.8%) like visual axis occlusion, and pain (1.6%). Three phases of proliferating, involuting and involuted of a HOI comprised 11.3%, 37.1% and 51.6% of the lesions, respectively, from the clinical view point and 11.3%, 48.4% and 40.3% of the lesions, respectively, from the pathological point of view. GLUT-1 was positively expressed on almost all of the HOIs (47/57, 82.5%), except for 10 HOIs of the involuted phase and the other controls. CONCLUSION: The clinicopathological findings of this study were similar with those of the previous reports. The expression of GLUT-1 by a HOI can be helpful to make the correct diagnosis from other vascular tumors and malformations.
Axis, Cervical Vertebra ; Cicatrix ; Female ; Glucose Transport Proteins, Facilitative ; Head ; Hemangioma ; Hemorrhage ; Humans ; Iodine Compounds ; Male ; Neck ; Ulcer

Capillary aneurysm is classically described as a suddenly growing dark papule, and is also known as thrombosed capillary or vein. It is clinically significant that the clinical features of capillary aneurysm are closely similar to those of malignant melanoma or dysplastic nevus. The histopathological finding of capillary aneurysm reveals dilated thin-walled venule(s) just beneath the hyperplastic epidermis, lined by a single layer of endothelium and a thrombus in the lumen. This abstract focuses on four patients who presented with a dark black-colored dome-shaped nodule and clinical impression included malignant melanoma, dysplastic nevus, angiokeratoma and lymphangioma circumscriptum. We herein report four cases histologically diagnosed as capillary aneurysm, which should be considered for differential diagnosis.
Aneurysm* ; Angiokeratoma ; Capillaries* ; Diagnosis, Differential* ; Dysplastic Nevus Syndrome ; Endothelium ; Epidermis ; Humans ; Lymphangioma ; Melanoma* ; Thrombosis ; Veins

Previously reported series suggested that the morbidity rate of internal surgical drainage procedure alone was about 15% and the mortality rate was less than 5% in patients with pancreatic pseudocysts. Recently, ultrasonography or CT-guided percutaneous drainage and endoscopic drainage techniques have created a new dimension of invasive, non-surgical treatment options for these patients. In the absence of prospective, randomized, controlled studies comparing outcomes of different pseudocysts drainage techniques, the decision as to which method should be employed often lies with local expertise and enthusiasm. In our experience, radiologic percutaneous drainage with subsequent transpapillary endosopic drainage had a high success rate and was relatively less difficult which resulted in rapid clinical improvement. We report three cases of pancreatic pseudocysts treated with percutaneous drainage as a first-line treatment followed by endoscopic treatment.
Aged ; *Cholangiopancreatography, Endoscopic Retrograde ; *Drainage/instrumentation ; Female ; Hemostasis, Surgical ; Humans ; Male ; Middle Aged ; Pancreatic Ducts/radiography ; Pancreatic Pseudocyst/*radiography/*therapy ; Tomography, X-Ray Computed

A complete surgical resection is the only proven therapeutic modality that prolongs the survival in patients with leiomyosarcoma of the inferior vena cava (IVC). Reconstruction of the IVC is not always necessary but is often required to facilitate venous drainage of the kidney for the tumors at the pararenal area of the IVC. Controversy exists in postoperative adjuvant therapy. Recently, we experienced four cases of pararenal leiomyosarcoma of the IVC, of which treatment consisted of a complete resection of the tumor, ringed polytetrafluoroethylene (PTFE) graft interposition, and bilateral renal vein reconstructions in all patients. Postoperative radiation therapy was instituted in 3 of 4 patients. One patient who did not receive the postoperative radiation therapy was treated with adjuvant chemotherapy. The kidneys were preserved in all patients and no deep vein thrombosis (DVT) or venous insufficiency of the lower extremity veins developed. Distant metastasis to the lung was noted in one patient at 18 months after surgery, who was not received the postoperative radiation therapy but chemotherapy. In conclusion, a complete resection of the tumor, IVC reconstruction, and bilateral renal vein reconstruction followed by adjuvant radiation therapy is recommended for the treatment of pararenal leiomyosarcoma of the IVC.
Adult ; Combined Modality Therapy ; Female ; Human ; Leiomyosarcoma/radiography/*radiotherapy/*surgery ; Middle Aged ; Neoplasm Recurrence, Local/radiography/radiotherapy/surgery ; Retroperitoneal Neoplasms/radiography/radiotherapy/surgery ; Retrospective Studies ; Treatment Outcome ; Vascular Neoplasms/radiography/*radiotherapy/*surgery ; *Vena Cava, Inferior

An esophageal schwannoma originating in a schwann cell of a neuron presents as a type of submucosal tumor. An esophageal schwannoma is extremely rare, with only 30 reported cases. It is usually a benign tumor. However, three cases with malignant findings and one case with local recurrence have been reported. Reviews of previous reports indicate that benign schwannomas are usually located in the upper esophagus and occur in middle aged-women. An esophageal schwannoma is usually asymptomatic but sometimes causes dysphagia as an initial symptom and dyspnea by trachea compression. The differentiation of a schwannoma from the other submucosal tumors is very difficult on a preoperative examination with the use of esophagoscopy, endoscopic ultrasound and computed tomography. A definite diagnosis of the tumor requires a histological examination and immunohistochemical staining. Positive immunostaining for s-100 protein supports the schwann cell origin of the tumor. We report a case of an esophageal schwannoma with intense FDG uptake as detected on PET-CT.
Deglutition Disorders ; Dyspnea ; Esophagoscopy ; Esophagus ; Neurilemmoma ; Neurons ; Recurrence ; S100 Proteins ; Trachea

Background : diabetic neuropathy is one of the serious complication of diabetes mellitus and it can cause serious foot problems. These foot problems could be preventable if early detection method of diabetic neuropathy is established. Therefore, essential diagnostic tool is needed. The changes on electrophysiologic studies(EPS) may to be necessarily correlated with clinical neuropathy. Theater has attempted to confirm the thermography as an useful tool for detecting diabetic peripheral neuropathy. Methods : Author has studied 20 patients with diabetes visiting to department of family medicine of Korea University Hospital between December 1, 1998 and June, 30, 1999. All cases were evaluated on clinical criteria. Furthermore, the EPS and thermography have been taken. The author investigated the results of thermograpy and the relation of the clinical diagnosis and EPS. Results : among 20 cases, 12(60.0%) cases have shown abnormality on EPS and 6(30.0%) cases of them was also abnormal on clinical criteria, the other 8(40.0%) cases were normal on EPS. Results of EPS were moderately related to clinical diagnosis. 10(50.0%) cases have shown abnormality on thermography and 6(30.0%) cases of them were also abnormal on clinical criteria, the other 10(50.0%) cases were normal on thermography. Results of thermography were related to clinical diagnosis. Among 12(60.0%) cases were abnormal on EPS, 9(45%) cases also have shown abnormality on thermography. Among 8(40.0%) cases were normal on EPS, 7(35.0%) cases were also normal on thermography. Results of thermography were highly related to EPS. Conclusion : Thermography is a useful diagnostic tool in diabetic peripheral neuropathy.
Diabetes Mellitus ; Diabetic Neuropathies* ; Diagnosis ; Foot ; Humans ; Korea ; Peripheral Nervous System Diseases ; Thermography*

Cutaneous squamous cell carcinoma (SCC) is the second most common skin cancer and the majority of such patients can be easily treated with a relatively low risk of recurrence and metastasis. However, there are subgroups of SCC that are at a higher risk, depending on patient's or tumor's characteristics. A greater part of the metastases from these high-risked SCCs spread towards the regional lymph nodes, whereas distant metastases are relatively uncommon. Early identification of nodal metastasis can allow the selective and timely inclusion of possible high-risked SCC patients into more aggressive treatments and meticulous follow-up protocols for achieving potential survival benefit. Therefore, sentinel lymph node biopsy (SLNB) is popular in the management of malignant melanoma, and it may also be useful to detect regional metastasis of high-risked SCCs. This procedure could also spare node-negative patients the morbidity of unnecessary additional therapy, like elective lymph node dissection. We report herein on a case of SCC with regional nodal metastasis, which is confirmed by SLNB.
Carcinoma, Squamous Cell ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis ; Nitriles ; Pyrethrins ; Recurrence ; Sentinel Lymph Node Biopsy ; Skin Neoplasms