Since in 1963 Waters first described the techniques of guiede blind tracheal intubation to solve the problem of difficult in airway maintenance in patients who have deformity of the upper jaw, several methods are recommended to overcome a difficult intubation. We experienced successful retrograde endotracheal intubation without significant complications as follows. Using loca anethesia, 16G Tuohy needle was passed through the anterior wall of the trachea 1.5 to 2.0 cm below the cricoid cartilage in the midline. The needle was directd upward foward the larynx and the epidural catheter was insertedc through it and advanced retrograde between the vocal cords and into mouth or nose. The endotracheal tube was threaded over the catheter and the proximal end of the catheter was clamps by kelly forceps. By keeping the catheter taut and coincidently pulling back, the tube was adnvanced in to trachea.
Catheters* ; Congenital Abnormalities ; Cricoid Cartilage ; Humans ; Intubation ; Intubation, Intratracheal* ; Jaw ; Larynx ; Mouth ; Needles ; Nose ; Surgical Instruments ; Trachea ; Vocal Cords

Since in 1963 Waters first described the techniques of guiede blind tracheal intubation to solve the problem of difficult in airway maintenance in patients who have deformity of the upper jaw, several methods are recommended to overcome a difficult intubation. We experienced successful retrograde endotracheal intubation without significant complications as follows. Using loca anethesia, 16G Tuohy needle was passed through the anterior wall of the trachea 1.5 to 2.0 cm below the cricoid cartilage in the midline. The needle was directd upward foward the larynx and the epidural catheter was insertedc through it and advanced retrograde between the vocal cords and into mouth or nose. The endotracheal tube was threaded over the catheter and the proximal end of the catheter was clamps by kelly forceps. By keeping the catheter taut and coincidently pulling back, the tube was adnvanced in to trachea.
Catheters* ; Congenital Abnormalities ; Cricoid Cartilage ; Humans ; Intubation ; Intubation, Intratracheal* ; Jaw ; Larynx ; Mouth ; Needles ; Nose ; Surgical Instruments ; Trachea ; Vocal Cords

No abstract available.
Child* ; Humans ; Infant* ; Intussusception*

In the present study, immunohistochemical detection of p53 oncoprotein was performed to determine whether the grade of differentiation and the histologic type of gastric adenocarcinoma, and the degree of atypia accompanied with adenoma can be related to p53 mutation. Paraffin sections of 22 gastric adenomas and 56 gastric adenocarcinomas were examined for the overexpression of p53 oncoprotein with the avidin-biotin peroxidase complex staining procedure. The obtained results were as follows; 1. All the 22 cases of adenomas and 16 cases of well differentated adenocarcinomas showed uniformly negative staining. 2.Seven of 18 cases of moderately differentiated adenocarcinomas(39%), and five of 30 cases of poorly differentiated adenocarcinomas(17%) exhibited p53 protein expression. 3. Three of 29 cases of diffuse type (10%) and 9 of 19 cases of intestinal type(47%) exhibited p53 protein expression. These results suggest that p53 mutation is important in carcinogenesis of the intestinal type of gastric adenocarcinoma, and there is no correlation between the differentiation of gastric adenocarcinoma and the degree of p53 oncoprotein overexpression.
Adenocarcinoma ; Adenoma

Neuroblastoma is the most common extracranial solid tumor of childhood which presents various clinical symptoms depending on the primary and metastatic sites. However, it has been rarely reported that sudden onset of blindness was the chief complaint of neuroblastoma. A four years old boy was admitted to the Yeungnam University Hospital with the chief complaint of a sudden onset of blindness due to a distant metastasis of abdominal neuroblastoma to the sphenoid sinus. On admission, both side pupils were dilated without light reflex, fundoscopy showed pale optic disk, electroretinogram was subnormal and visual evoked potential showed no response. The liver was palpable in 3 ½ finger breadth from the right costal margin and adult fist sized mass was palpable in the right flank. Skull X-ray showed destructed sphenoid bone and clinoid process and brain CT scan showed tumor mass in the sphenoid sinus and left orbit. Ultrasonogram and CT scan of the abdomen showed large tumor masses around the right kidney and para-aortic and retropancreatic lymph node. IVP showed displaced right calyceal system with preserved contour. Left supraclavicular lymph node which appeared after admission was biopsied and it showed poorly differentiated neuroblasts. He was treated according to the multiagent chemotherapy schedule for stage IV neuroblastoma patient of children's cancer study group. Abdominal tumor masses and sphenoid sinus mass were markedly reduced after 2 courses of the combination chemotherapy of cyclophosphamide, vincristine, DTIC, adriamycin and VM-26. Eventhough the blindness was not improved, the patient has been in good clinical codition.
Abdomen ; Adult ; Appointments and Schedules ; Blindness* ; Brain ; Cyclophosphamide ; Dacarbazine ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Evoked Potentials, Visual ; Fingers ; Humans ; Kidney ; Liver ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Neuroblastoma* ; Optic Disk ; Orbit ; Pupil ; Reflex ; Skull ; Sphenoid Bone ; Sphenoid Sinus ; Teniposide ; Tomography, X-Ray Computed ; Ultrasonography ; Vincristine

We retrospectively reviewed 100 consecutive patients who were ruptured intracranial aneurysm and were operated on in the department of neurosurgery of Wallace Memorial Baptist Hospital from August 1984 to August 1988. The patients who were operated upon within the first 3 days of their most recent subarachnoid hemorrhage formed the early group, the patients operated upon with 4-7 days formed the intermediate group, after 8 days were considered as the delayed group. Early operation was performed in 30 patients, intermediate operation in 20 patients, and delayed operation in 50 patients. On the base of their clinical outcome, the patients were allocated to one of 4 outcome categories(good, fair, poor, death) at the time of their hospital discharge. The 80% favorable outcome estimated from early operation and 85% from intermediate operation and 90% from delayed operation. The mortality was estimated 13% from early operation and 0% from intermediate operation and 8% from the delayed operation. Each 4 cases of early, intermediate and delayed operation was needed shunt operation for hydrocephalus. In operative result, after 1987 was better than before 1987. In hypertensive patients, there was a tendency to observe poor prognosis than normotensive patients, especially with vasospasm.
Aneurysm* ; Humans ; Hydrocephalus ; Hypertension ; Intracranial Aneurysm ; Mortality ; Neurosurgery ; Prognosis ; Protestantism ; Retrospective Studies ; Subarachnoid Hemorrhage

Purpose: Reduced port laparoscopic distal gastrectomy (RPLDG) using 3 ports is less invasive than conventional laparoscopic distal gastrectomy (CLDG) using 5 ports. Although RPLDG performed by expert surgeons is safe and feasible, novice surgeons have difficulty performing this procedure. This study evaluated the surgical outcomes and feasibility of RPLDG performed by a novice surgeon. Materials and Methods: The records of 136 patients who underwent laparoscopic distal gastrectomy for gastric cancer performed by a single novice surgeon between May 2016 and December 2018 were retrospectively reviewed. Among these 136 patients, 52 underwent RPLDG and 84 underwent CLDG. The clinicopathological characteristics, operative outcomes, and short-term postoperative outcomes of the 2 groups were compared. Results: The percentage of women was significantly higher in the RPLDG group than in the CLDG group (48.1% vs. 31%; P=0.045), but other baseline characteristics did not differ significantly between the groups. Billroth II anastomosis was performed significantly more frequent (90.4% vs. 73.8%, P=0.015) and operation time was significantly shorter (207.1±43.3 min vs. 225.5±44.6 min, P=0.020) in the RPLDG group than in the CLDG group. The time to first flatus, postoperative pain score, length of postoperative hospital stay, and incidence and severity of complications did not differ significantly between the groups. Analysis of the learning curve based on the operation time showed that performing RPLDG on 20–30 patients was required to achieve technical proficiency. Conclusions RPLDG is a safe and feasible surgical procedure for the treatment of gastric cancer, even when performed by a novice surgeon.

PURPOSE: CYP2D6 and N-acetyltransferase (NAT2) are polymorphic enzymes which are expressed in the hepatocyte in a genotype-determined manner. They are known to be involved in the inactivation and activation of various mutagens and carcinogens, respectively. The activities of the two enzyme systems are associated with the genetic susceptibility of many human cancers. METHODS: This study was performed to determine the genotype frequencies of the two enzyme systems in primary hepatocellular carcinoma patients and healthy controls. One hundred healthy controls and 55 liver cancer patients were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: In the healthy controls, the CYP2D6 wild type allele frequency was 0.985 and the CYP2D6*4 frequency was 0.015. No CYP2D6 poor-metabolizer was detected. No significant differences were found in the hepatocellular carcinoma patients group. Among the controls, the frequencies of F, S1, S2 and S3 alleles of the NAT2 system were 0.725, 0.01, 0.14 and 0.125, respectively. The genotype frequencies were found to be 0.91 for the rapid acetylator and 0.09 for the slow acetylator. No significant differences were found in the hepatocellular carcinoma group. CONCLUSION: The distribution of CYP2D6 and NAT2 polymorphism is very unique in the Korean population, as characterized by the extremely low frequency of CYP2D6 poor-metabolizer and NAT2 slow acetylator. CYP2D6 and NAT2 polymorphisms did not seem to play an important role in the hepatic carcinogenesis in the Korean population.
Alleles ; Carcinogenesis ; Carcinogens ; Carcinoma, Hepatocellular* ; Cytochrome P-450 CYP2D6* ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Hepatitis B ; Hepatocytes ; Humans ; Korea* ; Liver Neoplasms ; Mutagens

PURPOSE: Detrusor instability is common in men with benign prostatic hypertroplasia(B.P.H.) and known to be reversed in about two thirds of patients after operation. We evaluated the fate of detrusor instability in B.P.H patients after operation. MATERIALS AND METHODS: In 11 patients with urgency or urge incontinence combined with B.P.H., cystometries were performed at baseline and 3 months after operation. RESULTS: Detrusor instability associated with B.P.H was reversed postoperatively in 7 patients (63.6%). CONCLUSIONS: Detrusor instability with urgency or urge incontinence can be managed by operation for B.P.H. This will improve the quality of life for B.P.H. patients.
Humans ; Male ; Prostatectomy* ; Prostatic Hyperplasia* ; Quality of Life ; Urinary Incontinence, Urge

PURPOSE: In preliminary studies, it was found that mammalian cells can be infected by recombinant baculovirus in vitro. Therefore, the potential use of recombinant baculovirus(BacG-cytonegalovirus(CMV)-P53) for the bladder gene therapy was investigated. MATERIALS AND METHODS: The recombinant Baculovirus(BV) pseudotyped was developed with the vesicular stomatitis virus(VSV) G protein. The presence of the VSV-G protein in purified BV preparations was confirmed by Western blotting analysis. The bladder cancer cells of human(HT-1376) were infected with various multiplicity of infection(MOI) of the BV, and the percentage of apoptotic cells determined by methyl thiazolyl tetrazolium(MTT) assay. RESULTS: The suppression effect of the recombinant BV with a P53 insertion in human bladder cancer cells(HT-1376) increased as the MOI of the recombinant BV increased; 100% cell survival in the group with PBS, and 81.6+/-4.3, 52.0+/-5.6 and 39.8+/-3.7% at 1, 10 and 100 MOI, respectively (p<0.05). CONCLUSIONS: Significant growth suppression was observed following infection with BacG-CMV-P53 in a human bladder cancer cell line. This observation suggests that BacG-CMV-P53 may be a potentially effective agent to prevent recurrence for P53 mutated bladder cancer. Bladder gene therapy using recombinant baculovirus could be a safe and effective treatment of bladder cancer.
Baculoviridae* ; Blotting, Western ; Cell Line* ; Cell Survival ; Genetic Therapy* ; GTP-Binding Proteins ; Humans ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vesicular Stomatitis