PURPOSE: To evaluate safe access route and success rate of percutaneous drainage of pelvic fluid collection. MATERIALS AND METHODS: The 35 percutaneous drainages of pelvic fluid collection under the CT and fiuorosocpic guidance were done in 32 patients. The anterior transabdominal approach was done in 20 patients, while the nine patients used the transgluteal approach through greater sciatic foramen. Three patients , who had septated or noncommunicating abscesses, underwent drainage using both approaches. The catheter was removed when the patient's symptom and laboratory data were improved or the amount of drainage and the size of fluid collection were markedly reduced. Success, partial success and failure were classified. RESULT: The causes of fluid collection were complication of intraabdominal operation in 27 patient. The diagnosis after drainage included abscess(21), Ioculated ascites(6), and hematoma(4). The 27 cases(30 procedure) were treated successfully and the mean duration of catheter insertion was 10 days. The partial successes were two cases(2 procedures), which had palliative purpose. Three cases(3 procedures) were failed, which were multiple Ioculated ascites of pancreatic origin(2) and recurrent abscess(I). The significant complication during the procedure or drainage was not noted. CONCLUSION: The percutaneous drainage .under CT and fluoroscopy was effective technique for the management of pelvic. fluid collection, using anterior transperitoneal and transgluteal route through greater sciatic foramen.
Abscess ; Ascites ; Catheters ; Diagnosis ; Drainage* ; Fluoroscopy ; Humans

A method for exact evaluation of ligament integrity of the knee joint would be of clinical importance from the diagnostic point of view as well as from the desire to introduce objective measurement of stability either pre-and postoperatively, or before and after conservative treatment. Assessment of the posterior cruciate injury has been considered by numerous authors over the past decades. Even stress machine, such as Gonylaxometer, knee ligament arthrometer(KT-l000) and Genucome, have many problems such as soft tissue error, expansiveness and low popularity. Generally, orthopedic surgeons use passive tests, in which the displacing force is applied externally, to evaluate the integrity of the ligaments of the knee. Posterior tibial displacement of knee was measured at quadriceps neutral angle using a specially designed frame which minimized the rotational error to negate the quadriceps pulling effect. Posterior displacement of both sides of knee was measured in 15 patients who had posterior cruciate ligament injury and 40 adults who had normal knee. The following results were obtained. l. In the normal knee, the mean score of posterior tibial displacement was 3.0875mm in left, 2.8125mm in right each other and there was a mean of 1.05mm posterior displacement of tibia compared to the contralateral knee(range: 0–2.5mm). 2. More than 6mm displacement of lateral femoral condyle compared to the uninjured knee suggested posterior cruciate ligament injury. 3. This radiological measurement seems very efficient in detecting the posterior cruciate ligament instability of knee because of its simplicity, inexpensiveness and easy reproducibility with minimal error.
Adult ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Orthopedics ; Posterior Cruciate Ligament ; Surgeons ; Tibia

No abstract available.
Craniocerebral Trauma* ; Head* ; Prognosis*

Necleolar organizer regions(NORs) ARE LOOPS OF DNA which transcribe to ribosomal RNA by RNA polymerase I. Since NOR-associated proteins are argyrophilic, silver staining method has been used for demonstration of AgNORs. The numbers and/or configurations of NORs may reflect the activities of cells in hyperplastic and neoplastic conditions. To evaluated the applicability of AgNORs in the diagnosis of hepatocellular carcinoma, the author had performed silver staining on the routinely processed, formalin-fixed, paraffin-embedded sections of 14 cases of normal liver(control), 23 cirrhotic liver, and 21 hepatocellular carcinoma. The results are summarized as follows: 1) The mean number of AgNORs per nucleus(mAgNOR) of normal liver, cirrhotic liver and hepatocellular carcinoma was 1.45+/-0.07, 2.53+/-0.38 and 5.52+/-1.63, respectively. The difference of mAgNOR between normal and cirrhotic liver, and between cirrhotic liver and hepatocellular carcinoma was statistically significant, respectively(p<0.01). 2) The percentage of nuclei showing five or more AgNORs per nucleus(pAgNOR) was 0.07% in normal liver, 7.59% in cirrhotic liver, and 60.49% in hepatocellular carcinoma. 3) AgNORs in hepatocellular carcinoma were large, pleomorphic and irregularly clumped, in addition to increase of mAgNOR and high pAgNOR. In conclusion, the increase of mAgNOR, high pAgNOR and large, irregular AgNORs are regarded as an additional helpful finding for the histopathological diagnosis of hepatocellular carcinoma.
Carcinoma, Hepatocellular

9,10-Dimethyl-1,2-benzanthracene ; Animals ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cricetinae ; Cytoplasm ; Epigenomics ; Epithelium ; Islands ; Mineral Oil ; Mouth Neoplasms ; Mucous Membrane ; Prognosis ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors

No abstract available.
Humans ; Male ; Prostate* ; Prostate-Specific Antigen*

No abstract available.
Humans ; Male ; Prostate* ; Prostate-Specific Antigen*

PURPOSE: With the process of neoangiogenesis being linked to the growth and metastasis of various tumors, anticancer therapeutics with a basis in the suppression of neoangiogenesis has recently been receiving attention. In this study, we tried to clarify the immunoreactivities of vascular endothelial growth factor (VEGF), major angiogenic inducer and thrombospondin-1 (TSP-1), major angiogenic inhibitor in human Wilms' tumor and its clinicopathological significance. MATERAILS AND METHODS: Utilizing immunohistochemical staining, we assessed the immunoreactivities of VEGF and TSP-1 in archival tissues of 29 Wilms' tumors and 25 normal kidneys. Also, we assessed the relationship between expression of each factor and clinicopathological parameters in 29 cases of Wilms' tumors. RESULTS: Immunoreactivities of VEGF and TSP-1 were detected mainly in the cytoplasm of the tubular cells in normal kidneys. In Wilms' tumors, whereas VEGF was detected in the cytoplasm of the tumor cells and peritumoral stromal tissues, but TSP-1 only in the peritumoral stromal tissues. Immunohistochemical expression patterns of each factor were divided into two groups according to the area of immunoreactivity (negative:<10%, positive: > OR =10%). VEGF immunoreactivity was detected in 25 (100%) normal kidneys and in 20 (69%) Wilms' tumors. However, TSP-1 immunoreactivity was detected in 24 (97%) normal kidneys and in 3 (10%) Wilms' tumors. Therefore, although no significant difference was observed between the expressions of VEGF and TSP-1 in normal kidney, the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors. A relatively higher rate of positive expression of TSP-1 was observed in the patients with no demonstrable lymph node metastasis. Also, as for the VEGF, maximal diameter of the tumor was larger in the positive expression group. However, it proved otherwise for TSP-1 as the negative expression group demonstrated tumors with larger maximal diameters. CONCLUSIONS: Our study demonstrated that the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors, and disease progression has a tendency to be found in the VEGF-positive cases and TSP-1 negative cases. We suggest that the growth and metastasis of Wilms' tumor may be influenced mainly by TSP-1 decrease rather than VEGF increase.
Cytoplasm ; Disease Progression ; Humans ; Kidney ; Lymph Nodes ; Neoplasm Metastasis ; Thrombospondin 1 ; Vascular Endothelial Growth Factor A* ; Wilms Tumor*

BACKGROUND: The aim of this study was to compare the efficacy of ketorolac, paracetamol, and paracetamol plus morphine on pain relief after thyroidectomy. METHODS: Eighty patients were randomly allocated to one of the 4 groups: normal saline (group C), ketorolac 30 mg (group K), paracetamol 1 g (group P), and paracetamol 700 mg plus morphine 3 mg (group PM). Each regimen was administered intravenously (IV) 30 min. before the end of surgery. If pain was not relieved, patients received an IV bolus of pethidine hydrochloride 25 mg. Pain intensity using a visual analogue scale (VAS) was recorded at 0.5, 1, 2, 4, and 6 hr after the end of surgery. RESULTS: VAS at 0.5 and 1 hr after the end of surgery were significantly lower in group K, group P, and group PM than in group C (P < 0.05). The number of patients receiving pethidine hydrochloride at 0.5 and 1 hr after the end of surgery was significantly lower in group K, group P, and group PM than in group C (P < 0.05). There was no significant difference among the groups in the incidences of adverse events associated with study medications and patient satisfaction (P > 0.05). CONCLUSIONS: Paracetamol 1 g IV possesses a similar analgesic efficacy to ketorolac 30 mg IV after thyroidectomy. Paracetamol may represent an alternative to ketorolac for pain prevention after mildly to moderately painful surgery in situations where the use of NSAIDs is unsuitable.
Acetaminophen ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal ; Humans ; Incidence ; Ketorolac ; Meperidine ; Morphine ; Patient Satisfaction ; Thyroidectomy

BACKGROUND: It has been demonstrated that patients with atopic dermatitis(AD) show an impaired capacity of their T cells to release of interleukin-2(IL-2) in vitro and elevated serum levels of soluble IL-2 receptor(sIL-2R). Both immunosuppressive agents, cyclosporin A(CsA) and FK-506 can block early events in T lymphocyte activation and FK-506 is 10- to 100-fold more potent in the inhibition of IL-2 and other lymphokines production. OBJECTIVE: We compared the effects of CsA and FK-506 on PHA-induced lymphokine and sIL-2R production and compared the effects of CsA and FK-506 on PHA-induced IL-4 production in a high IgE group and a low IgE group in patients with AD. METHODS: A total of 32 peripheral blood samples from 17 patients with AD and 15 control groups were tested. Lymphocytes were isolated from blood samples and were cultured with PHA(positive control), PHA and CsA(10 ng/ml), PHA and FK-506 (1 ng/ml), and without stimulation (negative control). The amount of cytokines such as IL-2, IL-3, IL-4 and sIL-2R were measured using an enzyme-linked immunosorbent assay(ELISA). RESULTS: CsA and FK-506 inhibited significantly the production of IL-2, IL-3, IL-4 in PHA-stimulated lymphocytes of both the AD patients and the control groups. FK-506(1 ng/ml) inhibited cytokines production more significantly than CsA(10 ng/ml). However, CsA and FK-506 did not significantly inhibit the production of sIL-2R. There were no significant differences in the inhibitory effect of CsA and FK-506 on IL-4 production upon PHA-stimulation between AD patients with a high IgE level and with a low IgE level. CONCLUSION: Both FK-506 and CsA inhibit lymphokine production, but not the production of sIL-2R. FK-506 inhibited more significantly lymphokine production at a 10-fold lower concentration than CsA. Our data suggest that FK-506 could be more effective in the treatment of severe AD than CsA, and both these agents show their immunosuppressive activity through the suppression of lymphokine production, not via the suppression of sIL-2R production in AD.
Cyclosporine* ; Cytokines ; Dermatitis, Atopic* ; Humans ; Immunoglobulin E ; Immunosuppressive Agents ; In Vitro Techniques ; Interleukin-2 ; Interleukin-3 ; Interleukin-4 ; Lymphocyte Activation ; Lymphocytes* ; Lymphokines ; T-Lymphocytes ; Tacrolimus*