No abstract available.

Stage IV-S neuroblastoma, characterized by a primary tumor plus disseminated tumors in liver, skin and bone marrow, has a favorable clinical prognosis when compared to metastatic Stage IV neuroblastoma. This favorable outcome also characterized mice receiving tumor transplants to these "IV-S" sites. We report the testing of the hypothesis that enhanced anti-tumor immunity in "IV-S" site neuroblastoma recipients explains this improved survival. A million murine C1300 neuroblastoma cells were inoculated into 256 A/J mice to either "IV-S" sites of skin, liver, peritoneal cavity, or to the disseminated stage "IV" sites of subcutaneous tissue, muscle, kidney and lung. After 21 and 28 days of tumor growth, spleen cells from tumor bearing mice were harvested and analyzed by a 51 Cr release lymphocytotoxicity assay. Cytotoxic T cell activity was consistently higher at day 28 than day 21. In the liver and in the peritoneal cavity, cytotoxic T cell activity was higher than in other organs, and at day 28 these values were significantly higher than Stage "IV" sites. On the other hand, skin is not a immunologically privileged site in vivo study.
Animal ; Cytotoxicity, Immunologic ; Male ; Mice ; Mice, Inbred A ; Neoplasm Staging ; Neuroblastoma/*immunology/pathology/secondary ; Support, Non-U.S. Gov't ; T-Lymphocytes/immunology

Cosmetic lateral canthoplasty, in which the size of the eye is increased by extending the palpebral fissure and decreasing the degree of the eye slant, has become a prevalent procedure for East Asians. However, it is not uncommon for there to be complications or unfavorable results after the surgery. With this in mind, the authors have designed a surgical method to reduce complications in cosmetic lateral canthoplasty by preserving the lateral canthal angle. We discuss here the anatomy required for surgery, the surgical methods, and methods for reducing complications during cosmetic lateral canthoplasty.
Asian Continental Ancestry Group ; Humans ; Lacrimal Apparatus ; Methods

PURPOSE: The purpose of this study is to evaluate the incidence and the degree of peritumoral edema on MRI in meningioma and to correlate other MR findings with the edema. MATERIALS AND METHODS: MR images of 35 patients with histologically-confirmeal meningioma were retrospectively reviewed. We analyzed the MR findings with special attention to the presence or absence and degree of edema. The edema was graded as absent, mild (extending less than 1 cm from outer margin of mass), moderate (1 to 3cm with mild mass effect), and severe (more than 3cm with marked mass effect). We also evaluated size and margin of the tumor, heterogeneity of mass signal, enhancement pattern and dural enhancement of the masses. In 24 patients with cerebral angiography, cerebral vascularity on angiogram was correlated with MR findings. Statistic correlation analysis was done using SAS ver 6.04. RESULTS: Twenty-five of 35 cases (72%) had edema; mild in 11 cases, moderate in 10 cases, and severe in 4 cases. Heterogeneous signal intensity of mass (<0.001), heterogeneous enhancement of mass (<0.001), mass size (<0.001), location (<0.001), and vascularity on angiography (<0.05) were well correlated with edema, while mass margin (>0.05), dural enhancement (>0.05), and histologic type (>0.05) were not correlated with edema. CONCLUSION: In meningioma, moderate to severe peritumoral edema occurred in 41% (14/35). The edema was correlated with heterogeneous enhancement, size, location, heterogeneous signal intensity and vascularity of the mass on angiography.
Angiography ; Cerebral Angiography ; Edema* ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Meningioma* ; Population Characteristics ; Retrospective Studies

Angiosarcoma is the most common primary intracardiac malignancy, but many published papers have reported it to be rather rare. The prognosis of angiosarcoma is known to be very poor, and the treatment of choice has been surgery until recently, but many centers currently tend to try multimodal therapies, including chemotherapy and radiotherapy. In this report, we present a rare case in which an intracardiac angiosarcoma could have threatened the patient's life in short time by the rapid progression of the tumor, which caused right atrial rupture.
Heart Rupture ; Hemangiosarcoma ; Prognosis ; Rupture ; Sarcoma

BACKGROUND: Perioperative transfusion of red blood cell (RBC) may cause adverse effects. Bloodless-cardiac surgery has been spotlighted to avoid those problems. Off pump coronary artery bypass (OPCAB) surgery can decrease the transfusion. However, the risk factors of transfusions in OPCAB have not been investigated properly. MATERIALS AND METHODS: One hundred and thirteen patients (male:female=35:78, mean age=66.7+/-9.9 years) who received isolated OPCAB were retrospectively analyzed from March 2006 to September 2007. The threshold of RBC transfusion was 28.0% of hematocrit. Bilateral internal thoracic arteries graft were used for 99 patients (87.6%). One hundred and three (91.1%) and 35 patients (31.5%) took aspirin and clopidogrel just before surgery. RESULTS: Sixty-five patients (47.5%) received the RBC transfusion (mean 2.2+/-3.2 units). Mortality and major complications were not different between transfusion and no-transfusion group. But, ventilator support time, intensive care unit stay and hospitalization period had been reduced in no-transfusion group (p<0.05). In multivariate analysis, patients risk factors for RBC transfusion were preoperative low hematocrit (<37.5%) and clopidogrel medication. Surgical risk factors were longer graft harvesting time (>75 minutes) and total operation time (>5.5 hours, p<0.05). CONCLUSION: We performed the transfusion according to transfusion guideline; over 40% cases could conduct the OPCAB without transfusion. There were no differences in major clinical results between transfusion and non-transfusion group. In addition, when used together with accurate understanding of transfusion risk factors, it is expected to increase the proportion of patients that do not undergo transfusions.
Aspirin ; Blood Transfusion ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Erythrocyte Transfusion ; Erythrocytes ; Hematocrit ; Hospitalization ; Humans ; Intensive Care Units ; Mammary Arteries ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Ticlopidine ; Transplants ; Ventilators, Mechanical

Central pontine myelinolysis (CPM) is a neurologic disorder that is usually related to rapid correction of hyponatremia and chronic alcoholism. CPM involves concentrated, symmetric, noninflammatory demyelination within the central pons; this pathology also occurs in extrapontine regions. Frequently observed clinical manifestations are sudden weakness, dysphagia, dysarthria, loss of consciousness, and locked-in syndrome. We describe herein a case of CPM predominated by cerebellar signs without typical symptoms, but with involvement of the cerebellum or cerebellar peduncle.
Alcoholism ; Cerebellar Ataxia ; Cerebellum ; Deglutition Disorders ; Demyelinating Diseases ; Dysarthria ; Hyponatremia ; Myelinolysis, Central Pontine ; Nervous System Diseases ; Quadriplegia ; Unconsciousness

PURPOSE: To evaluate the efficacy of acetic acid as a sclerosing agent by observation of histologic change in urinary bladder epithelium after the instillation of acetic acid. MATERIALS AND METHODS: Urinary bladder of the rabbit was catheterized with a Foley catheter, and acetic acid of 10%, 20%, 30%, 40% and 50% concentration was instilled for 5 minutes. After evacuation of the acid, the bladder was irrigated three times with normal saline. After two days, gross and histologic examinations of the bladder were performed. RESULTS: A bladder into which10% acetic acid had been instilled revealed a nearly normal epithelium without denudation. In two cases, 20% acetic acid was instilled; one revealed partial denudation of the epithelium and the other revealed complete denudation. Mild to moderate interstitial edema and vascular congestion of the bladder wall were evident in all cases in which acid at a concentration of 30% or more had been instilled. In all cases in which the concentration of acid was greater than 30%, the epithelium was completely denuded. CONCLUSION: An acetic acid concentration of 40% or more is sufficient to completely destroy the epithelium of rabbit urinary bladder, and may be effective as a new sclerosing agent in cases of renal or hepatic cyst.
Acetic Acid* ; Animals ; Catheters ; Edema ; Epithelium ; Estrogens, Conjugated (USP) ; Urinary Bladder

PURPOSE: To evaluate the hemostatic effect of N-butyl 2-cyanoacrylate(NBCA) injection and RF electrocauterization of the tract after fine needle biopsy of the liver, and the histopathologic changes of the liver. MATERIALS AND METHODS: Three lobes of rabbit liver were selected and separately punctured four times with 21 gauge biopsy needles. According to the hemostatic procedure on fine needle biopsy, three groups (1, 2, 3) were formed : group 1, in which there was no maneuver for bleeding control, was the control group ; group 2, in which NBCA was injected into the puncture tract while slowly removing the needle ; group 3, in which RF electrocauterization of the tract was carried out. After completely removing the needle, each group was evaluated for amount of bleeding and histologic change. RESULTS: The amount of bleeding was 0.407gm+/-0.245 in group 1,0.028gm+/-0.036 in group 2 and 0.035gm+/-0.028 in group 3. As compared with the control group(group 1), injecting NBCA into the biopsy tract(P=0.0002) and RF electrocauterization of the tract(P=0.0003) significantly reduced the amount of bleeding after liver biopsy. The amount of bleeding was not statistically different between group 2 and 3, however (P=0.58). In Group 1, the tract was fully filled with blood. Group 2 showed NBCA embolized in the biopsy tract, adhering to hepatocytes and mixed with blood; small vessels adjacent to the puncture tract were filled with NBCA. Group 3 showed tissue degeneration, including necrosis of hepatocytes, vacuolation and neutrophil infiltration. CONCLUSION: Injection of NBCA and RF electrocauterization of the tract after puncture of the liver for biopsy efficiently controlled bleeding. In particular, the efficiency of NBCA injection was due to its effect of plugging the tract and causing the embolization of adjacent small vessels. With regard to procedural handling, RF electrocauterization of the tract is superior to injection of NBCA.
Animals ; Biopsy* ; Biopsy, Fine-Needle ; Hemorrhage* ; Hepatocytes ; Liver* ; Necrosis ; Needles ; Neutrophil Infiltration ; Punctures

A 70-year-old man was transferred to our center due to severe epigastric and back pain with the impression of a ruptured thoracic aortic aneurysm. Six months previously, he had undergone insertion of stent graft into the descending thoracic aorta at another hospital. The findings of the computed tomographic scan suggested a rapidly growing malignant mediastinal tumor rather than a ruptured aneurysm. Exploratory thoracotomy confirmed the diagnosis and the tumor was resected along with the portion of the aorta contained in it. This exemplary case should raise the concern against overzealous application of endovascular aortic repair.
Aged ; Aneurysm ; Aneurysm, Ruptured ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Back Pain ; Diagnostic Errors ; Humans ; Sarcoma ; Stents ; Thoracotomy ; Transplants