No abstract available.
Humans ; Laparotomy* ; Nephrectomy* ; Tissue Donors*

No abstract available.

No abstract available.

Paraneoplastic pemphigus is a distinct and rare autoimmune disease characterized by extensive and painful mucosal ulcerations and polymorphic desquamated skin lesions in the setting of an underlying neoplasm, typically of lymphoreticular origin. Thus difficulties in the management of anesthesia can be expected. A 66-years-old man was scheduled for removal of intraabdominal sarcoma associated with paraneoplastic pemphigus. Physical examination showed multiple erythematous bullae, crusts, plaques and target-like lesions on the whole body and desquamated erythematous skin lesions on the back and extremities. In the operating room, his right femoral artery was cannulated with a 20 G, 12.7 cm CVP catheter and left femoral and subclavian veins with 14 G, 20 cm CVP catheters, respectively. After application of 4 % lidocaine spray, his oropharynx and supraglottic area were evaluated under direct laryngoscopy and revealed multiple ulcerations on oral mucosa, but no distinct lesion on supraglottic area. Anesthesia was induced by rapid-sequence method with fentanyl, thiopental sodium and succinylcholine followed by endotracheal intubation. The endotracheal tube was held by a roll gauze around the neck and its cuff was minimally inflated to avoid overpressure against his tracheal wall. After the end of surgery, his oral cavity was suctioned with no remarkable bleeding, and tracheal wall including cuff-contacted area was evaluated under fiberoptic bronchoscopy, revealed intact wall without any bulla or ulceration. The patient was transferred to intensive care unit for proper postoperative management after extubation of endotracheal tube.
Anesthesia ; Autoimmune Diseases ; Bronchoscopy ; Catheters ; Extremities ; Femoral Artery ; Fentanyl ; Hemorrhage ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Laryngoscopy ; Lidocaine ; Mouth ; Mouth Mucosa ; Neck ; Operating Rooms ; Oropharynx ; Pemphigus* ; Physical Examination ; Sarcoma ; Skin ; Subclavian Vein ; Succinylcholine ; Suction ; Thiopental ; Ulcer

No abstract available.
Microsurgery*

We live in a world where daily exposure to environmental chemicals is inevitable. Many studies point to environmental chemicals a major cause of neurological diseases. Properly intervening in and managing the exposure requires up-to-date information about neurotoxic chemicals that may lead to neurological disorders. The recent literature on the neurotoxic effects of environmental chemicals was reviewed, including both animal and human studies. Parkinson's disease, Alzheimer's disease and autism are closely associated with environmental chemicals such as polychlorinated biphenys (PCBs), dioxins, polybrominated biphenyl ethers (PBDE), and perfluoroalkyls. There is strong evidence linking environmental chemical exposure to neurodevelopmental and neurodegenerative diseases. In particular, it is important to pay close attention to a high risk-age group where the window of exposure is critical to causing neurological disease.
Alzheimer Disease ; Animals ; Autistic Disorder ; Dioxins ; Endocrine Disruptors ; Ether ; Ethers ; Humans ; Nervous System Diseases ; Neurodegenerative Diseases ; Parkinson Disease

PURPOSE: The aim of study was to review the results of open surgical repair (OSR) of chronic juxtarenal aortic occlusion (JRAO). MATERIALS AND METHODS: We retrospectively reviewed the results of OSR performed in 47 patients (male, 92%; mean age, 59.9+/-9.3 years [range, 44-79]) with chronic JRAO during the past 21 years. In order to reduce intraoperative renal ischemic time (RIT), we excised a portion of the occluded segment of the infrarenal aorta without proximal aortic clamping. We then performed suprarenal aortic clamping with both renal arteries clamped, removed the proximal aortic thrombus cap, confirmed both renal artery orifices, and moved the suprarenal aortic clamp to the infrarenal aorta to allow renal perfusion and standard aortoiliac reconstruction. We investigated early (<30 days) postoperative surgical morbidity (particularly renal function), operative mortality, and longterm patient survival. We conducted risk factor analysis for postoperative renal insufficiency. RESULTS: The mean intraoperative RIT was 10.7+/-5.5 minutes (range, 3-25), including 6 patients who underwent concomitant pararenal aortic thromboendarterectomy. Postoperatively, five (11%) patients had transient renal insufficiency, one had pneumonia, and one patient had an acute myocardial infarction. However, there was no operative mortality or newly developed dialysis-dependent renal failure. Postoperative follow up was available in 36 (77%) patients for a mean period of 6.3 years (range, 1 month-17 years). Kaplan Meier calculations of patient survival at 5 and 10 years after surgery were 91.2% and 83.6%, respectively. CONCLUSION: We have experienced short RIT, acceptable early postoperative results and long-term survival after OSR of chronic JRAO.
Aorta ; Constriction ; Endarterectomy ; Follow-Up Studies ; Humans ; Mortality ; Myocardial Infarction ; Perfusion ; Pneumonia ; Renal Artery ; Renal Insufficiency ; Retrospective Studies ; Risk Factors ; Thrombosis

No abstract available.
Female ; Follicle Stimulating Hormone* ; Injections, Subcutaneous* ; Ovulation* ; Polycystic Ovary Syndrome*

Hydatidiform moles are generally separated into two clasifications. Complete hydatidiform moles are characterized by cystic swlling of all villi, often pronounced trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin(androgenesis), and a major risk for persistent trophoblastic tumor. Partial hydatidiform moles appear to be a milder version of complete moles with both normal and cystic villi, focal trophoblastic hyperplasia, a fetus or indications of previous fetal existence, 69 chromosomes with a maternal contribution, and a malignant potential less than described for complete moles. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies. The rarity of live-born, surviving children may in part be due to termination of pregnancies, when molar parts are observed and without access to current advanced diagnostic procedures. Progress in techniques for first trimester prenatal diagnosis and improved surveillance of first trimester pregnancies through prenatal chromosomal analysis, ultrasound scan, maternal serum-hCG and serum- AFP screening has created complex situation, allowing confirmation of hydatidiform mole with coexisitng fetus. We recently experienced one case of unusual pregnancy with complete hydatidiform mole and coexisiting live fetus.
Child ; Female ; Fetus* ; Humans ; Hydatidiform Mole* ; Hyperplasia ; Incidence ; Mass Screening ; Molar ; Pregnancy ; Pregnancy Trimester, First ; Prenatal Diagnosis ; Trophoblastic Neoplasms ; Trophoblasts ; Ultrasonography

No abstract available.
Niemann-Pick Disease, Type A*