We present a case of acquired tracheoesophageal fistula (TEF) which was found during induction of general anesthesia for clipping of aneurysm. The patient had been intubated with endotracheal tube for 10 days and then done tracheotomy for 45 days. Thereafter, TEF was confirmed by MRI and treated with fistula repair and tracheal fenestration. Acquired TEF can occur under the condition of prolonged tracheal intubation with high cuff pressure (>30 mmHg) and can also result from intratracheal neoplasm, mediastinitis, and other tracheal or esophageal damages. If unrecognized during anesthetic induction, TEF can cause gastric dilatation and rupture, pulmonary aspiration and respiratory failure. So early diagnosis and proper management is very important whenever TEF is suspected during anesthetic induction.
Anesthesia, General ; Aneurysm ; Early Diagnosis ; Fistula ; Gastric Dilatation ; Humans ; Intubation ; Magnetic Resonance Imaging ; Mediastinitis ; Respiratory Insufficiency ; Rupture ; Tracheoesophageal Fistula* ; Tracheotomy

A clinical and histopathological study was performed on ninety-four patients with nephrotic syndrome (91 idiopathic and 3 secondary) who were admitted to Department of Internal Medicine, Yeungnam University Hospital during the period of nine years, from January 1985 to May 1994. The results were as following. 1. the ratio of male to female was 1.76:1. In young age group, minimal change was the most predominant type. In old age group, membranous glomerulonephritis and focal glomerulosclerosis were predominant types. 2.- The primary nephrotic syndromes were 96.8% and secondary nephrotic syndromes were 3.2%. Histopathologic findings of 94 renal biopsy tissue were classified into minimal change (43.6%) mesangial proliferative glomerulonephritis (29.8%), membranous glomerulonephritis (12.8%), Typel membranous proliferative glomerulonephritis (4.3%), focal glomerulosclerosis (3.2%) .and others (6.4%). 3. The response of eighty-six patients treated with steroid showed complete remission in 51.2%, partial remission in 20.9%, steroid dependent in 2.3%, and no effect in 25.6% of cases respectively. The response to steroid therapy was most effective in the patients with minimal change lesion. 4. In the patient with membranous proliferative glomerulonephlitis, long-term angiotensin converting enzyme inhibitor treatment showed less deterioration of renal function.
Biopsy* ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Internal Medicine ; Male ; Nephrotic Syndrome ; Peptidyl-Dipeptidase A

No abstract available.
Prostate* ; Testis*

The effects of oral chloral hydrate as the premedicant were evaluated in 87 children, scheduled for elective operations. They were all in ASA class 1 and were divided into 3 groups: group I for 10 mg/ kg, group II for 20 mg/kg and group III for 30 mg/kg of chloral hydrate syrup, respectively. The drug was adminsitered 1 hour before induction of anesthesia at the ward. On arrival at the operating room, anxiety levels, vital signs and side effects were evaluated by one observer. Their attitudes were observed just before induction of anesthesia. Hemodynamic variables such as blood pressure and heart rate were increased, probably due to increased sympathetic levels in spite of premedication. Respiratory rate was not changed in each group. The satisfactory anxiety levels checked by anxiety level 0 were 38%, 26% and 70% in group I, II and III, respectively. The attitudes at the operating rooms just before induction of anesthesia were satisfactory in 59%, 65% and 81% of group I, II and III, respectively. Side effects were about 10% in group II and III, but not in group I. We can conclude that adequate oral premedicant dose of chloral hydrate (Pocral) symp in children should be at least 30 mg/kg, one hour before induction of anesthesia.
Anesthesia ; Anxiety ; Blood Pressure ; Child* ; Chloral Hydrate* ; Heart Rate ; Hemodynamics ; Humans ; Operating Rooms ; Premedication ; Respiratory Rate ; Vital Signs

OBJECTIVES: The purpose of this study was to evaluate abrasion of Icon(R) infiltrated, sound bovine enamel by using confocal laser scanning microscopy (CLSM) after toothbrush abrasion tests. METHODS: Sound bovine enamel specimens whose Vickers Hardness Number ranged from 280 to 320 were prepared. To measure abrasion, specimens were allocated to groups on the basis of tooth brushing stroke frequencies. Tooth brushing stroke frequencies were categorized into 5 groups: 1,800, 5,400, 10,800, 21,600 and 43,200 strokes. Both infiltration depth of Icon(R) and the abrasion depth were measured by CLSM. RESULTS: Mean infiltration depth of Icon(R) for sound bovine enamel was 98.6 microm. There was no statistically significant difference in enamel abrasion depth between groups with 5,400 strokes and 10,800 strokes, but the abrasion depth increased with further increase in tooth brushing stroke frequencies (P<0.001). The mean abrasion depth of resin infiltrated bovine enamel after 43,200 tooth brushing strokes was 17.45 microm. CONCLUSIONS: The magnitude of abrasion after 43,200 tooth brushing strokes, which corresponds to brushing 3 times a day for 4 years, was less than 20 microm. This result suggests that abrasion by tooth brushing would not be a clinical problem for resin infiltrated enamel.
Dental Caries ; Dental Enamel ; Hardness ; Microscopy, Confocal ; Stroke ; Tooth

No abstract available.
Neurilemmoma* ; Ulnar Nerve*

No abstract available.
Neurilemmoma* ; Ulnar Nerve*

No abstract available.
Amino Acid Transport System X-AG* ; Anesthetics* ; Glutamic Acid*

Purpose: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastrointestinal neoplasms. However, this is a time-consuming procedure requiring various devices. This study aimed to evaluate the efficacy and safety of the ClearCut™ Knife H-type, which is an integrated needle-tipped and insulated-tipped (IT) knife. Materials and Methods: Between July 2020 and September 2021, 99 patients with gastric epithelial neoplasms scheduled for ESD at three tertiary care hospitals were randomly assigned to H-knife (ClearCut™ Knife H-type) or IT-knife (conventional IT knife) groups.Procedure times, therapeutic outcomes, and adverse events were analyzed. Results: A total of 98 patients (50 in the H-knife group and 48 in the IT-knife group) were analyzed. The median total procedure time was 11.9 minutes (range, 4.4–47.2 minutes) in the H-knife group and 12.7 minutes (range, 5.2–137.7 minutes) in the IT-knife group (P=0.209).Unlike the IT-knife group, which required additional devices in all cases, no additional devices were used in the H-knife group (P<0.001). En-bloc resection was performed for all lesions in both groups. The incidence of adverse events was not significantly different between groups (4.0% in the H-knife group vs. 8.3% in the IT-knife group; P=0.431). Conclusions The newly developed hybrid device, the ClearCut™ Knife H-type, had comparable efficacy to the conventional IT knife for gastric ESD.

IL-12 is a secretory heterodimeric cytokine composed of p35 and p40 subunits. IL-12 p35 and p40 subunits are sometimes produced as monomers or homodimers. IL-12 is also produced as a membrane-bound form in some cases. In this study, we hypothesized that the membrane-bound form of IL-12 subunits may function as a costimulatory signal for selective activation of TAA-specific CTL through direct priming without involving antigen presenting cells and helper T cells. MethA fibrosarcoma cells were transfected with expression vectors of membrane-bound form of IL-12p35 (mbIL-12p35) or IL-12p40 subunit (mbIL-12p40) and were selected under G418-containing medium. The tumor cell clones were analyzed for the expression of mbIL-12p35 or p40 subunit and for their stimulatory effects on macrophages. The responsible T-cell subpopulation for antitumor activity of mbIL-12p35 expressing tumor clone was also analyzed in T cell subset-depleted mice. Expression of transfected membrane-bound form of IL-12 subunits was stable during more than 3 months of in vitro culture, and the chimeric molecules were not released into culture supernatants. Neither the mbIL-12p35-expressing tumor clones nor mbIL-12p40-expressing tumor clones activated macrophages to secrete TNF-alpha. Growth of mbIL-12p35-expressing tumor clones was more accelerated in the CD8+ T cell-depleted mice than in CD4+ T cell-depleted or normal mice. These results suggest that CD8+ T cells could be responsible for the rejection of mbIL-12p35-expressing tumor clone, which may bypass activation of antigen presenting cells and CD4+ helper T cells.
Animals ; Antigen-Presenting Cells ; Clone Cells ; Corynebacterium ; Fibrosarcoma ; Interleukin-12 ; Interleukin-12 Subunit p35 ; Interleukin-12 Subunit p40 ; Macrophages ; Mice ; Rejection (Psychology) ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; Tumor Necrosis Factor-alpha