This report presents an unusual case of primary malignant melanoma in the midesophagus. The patient was a 36-year-old woman presenting with dysphagia and odynophagia. The resected esophagus and proximal stomach showed a dark purple large polypoid mass, measuring 6.0 3.3 2.0 cm, with a diffuse tan pigmentation of surrounding mucosa in the mid-esophagus and two small daughter nodules, up to 1.2 0.3 cm, in the lower esophagus near the gastro-esophageal junction. A microscopic examination revealed a malignant melanoma of epithelioid cell type confined to mucosa and submucosa with a diffuse melanosis. Cytoplasmic immunoreactivity for HMB 45 and S-100 protein were noted. An electron microscopic examination revealed large, loosely cohesive variable shaped cells with a few cytoplasmic premelanosomes.
Adult ; Cytoplasm ; Deglutition Disorders ; Epithelioid Cells ; Esophagus* ; Female ; Humans ; Melanoma* ; Melanosis ; Mucous Membrane ; Nuclear Family ; Pigmentation ; S100 Proteins ; Stomach ; Triacetoneamine-N-Oxyl

Fibroepithelial polyps of the ureter are usually acquired rather than congenital. Most polyps are hamartomatous growths which tend to arise in the proximal portion of the left ureter. Most patients exibit either hematuria or persistent flank pain secondary to partial ureteral obstruction. Because of false positivity of urine cytology, as well as intravenous pyelogram, the correct diagnosis is confused with malignancy. Herein we report four cases of ureteral fibroepithelial polyp, which are associated with stones resulting in partial obstruction of the ureter. One of the four cases is associated with nephrogenic adenoma in the lamina propria of the adjacent ureter. The following report describes clinicopathologic findings of fibroepithelial polyp with review of literatures.
Adenoma

We have studied the vasodilating effect of bolus doses of sodium nitroprusside (SNP), nitro- glycerin (NTG), and isosorbide dinitrate (ISDN) in 40 patients during cardiopulmonary bypass with a constant pump flow. Blood volume of the venous reservoir and mean arterial pressure were recorded for 10 minutes after drug administration to detect changes in venous capacitance and arteriolar resistance. SNP 500 ug decreased mean blood pressure significantly more than NTG and ISDN compared with placebo. NTG 500 ug decreased mean blood pressure transiently at 1-4 min but significantly reduced reservoir blood volume. ISDN 500 ug increased mean blood pressure after drug administration, decreased reservoir blood volume less than NTG. We could conclude that SNP was more effective arteriolar vasodilator than NTG and ISDN, but NTG and ISDN were effective as a venodilator during cardiopulmonary bypass.
Arterial Pressure ; Blood Pressure ; Blood Volume ; Cardiopulmonary Bypass* ; Glycerol ; Humans ; Isosorbide Dinitrate* ; Isosorbide* ; Nitroglycerin* ; Nitroprusside* ; Sodium* ; Vascular Access Devices

PURPOSE: To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. MATERIALS AND METHODS: Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39months. RESULTS: Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. CONCLUSION: Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study.
Catheters* ; Deglutition Disorders ; Dilatation* ; Esophageal Achalasia* ; Esophageal Perforation ; Follow-Up Studies* ; Humans ; Male ; Recurrence

Teratocarcinoma is a form of mixed germ cell tumor composed of a mixture of teratoma and embryonal carcinoma. It is rarely found in the brain, but when present it is most commonly found in the pineal region. We investigated a case of primary teratocarcinoma in the pineal region. The patient was a 10 year old boy who had suffered from a bitemporal headache for one month. Brain CT and MRI revealed a rather well defined ovoid heterogenous mass in the pineal gland region, measuring 4.3 x 3.8 x 3.0 cm in size. Microscopically the tumor contained areas of immature teratoma and embryonal carcinoma. Immunohistochemical staining revealed positive reactions for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, and alpha-fetoprotein in the embryonal carcinoma component.

A review of the literature on cancer pain revealed that many persons with cancer receive inadequate analgesia for pain control, due in part to a lack of knowledge of the control of cancer pain by both physicians and nurses. This study is composed of two parts : one is to train nurses to change their knowledge of and attitude toward the pain management of patients having cancer and to evaluate the effectiveness of this training in comparison with other non-trained group ; the other is to test the applicability of the pain management method knowledge and attitude in the levels of pain of oncology patients. General characteristics of nurses such as age, education, educational experiences of cancer pain management were not different in both groups except the clinical experience. General characteristics of cancer patients and pain-related variables such as pain, sleep, daily activities, treatment modalities, causes of pain were not different in both groups except the educational levels of patients. After an eight-hour educational program given to the experimental nurse group, the knowledge and attitude about assessment of cancer pain, pain medication, and pharmacological knowledge were significantly higher in the experimental group than in the control group, while knowledge about classification of analgesics was not significantly different. The amount of analgesics, measured by the morphine equivalent doses, used in the experimental group was significantly lower than in the control group in the first and the last days. The experimental group used more systematic ways of drug changes from non-narcotic analgesics to narcotic analgesics than the control group. This indicated that the control group used fentanyl patches more commonly than in the control group. Cancer pain scores of both group of patients were measured on an hourly bases for a week in both groups. The patients' pain scores of the first day of measurement in experimental group were not significantly higher than those of control group of patients, while those of the last day were significantly higher than those of the control group. This study supports the need for educational program for the management of cancer pain to the nurses and the doctors.
Analgesia ; Analgesics ; Analgesics, Non-Narcotic ; Classification ; Education ; Fentanyl ; Humans ; Morphine ; Narcotics ; Pain Management*

The purpose of this study was to investigate the characteristics or the potassium channels existing in the rat urinary bladders. Smooth muscle strips of rat detrusor urinae were examined by isometric myography. Relaxation responses of detrusor muscle strips to the three potassium channel openers pinacidil, a cyanoguanidine derivative, BRL 38227, a benzopyran derivative and RP 52891, a tertrahydrothiopyran derivative were examined. The potassium channel openers reduced the basal tone, and the rank order of potency was RP 52891>pincidil>BRL 38227. Procaine, an inhibitor of the voltage-sensitive potassium channel tended to increase the basal tone, but it did not affect the relaxant effects of the calcium-activated potassium channel opener did not antagonize the relaxant effects, but it reduced the Emax of RP 52891 and BRL 38227. Glibenclamide, an inhibitor of the ATP-sensitive potassium channel, antagonized the relaxant effects of pinacidil, RP 52891 and BRL 38227 reducing the Emax of RP 52891 and BRl 38227. Galanin which inhibits secretion of insulin through opening the ATP-sensitive potassium channels in pancreatic β-cells rather increased the basal tone of the isolated detrusor strips. These results suggest that the urinary bladder of the rat has mainly the ATP-sensitive, glibenclamide sensitive potassium channel, which is a different type from that in the pancreatic β-islet cells.
Animals ; Cromakalim ; Galanin ; Glyburide ; Insulin ; KATP Channels ; Muscle, Smooth ; Myography ; Pinacidil ; Potassium Channels* ; Potassium Channels, Calcium-Activated ; Potassium* ; Procaine ; Rats* ; Relaxation ; Urinary Bladder

This study aimed to investigate the existence of GABA receptor and the mechanisms of action of GABA and diazepam of the trachealis muscle isolated from dog. Horizontal muscle strips of 2mm×15mm were prepared from canine trachea, and isometric myography in isolated muscle chamber bubbled with 95/5%-O₂/CO₂ at 36℃, at the pH of 7.4 was performed. Muscle strips contracted responding to the electrical field stimulation (ESP) by 2~20 Hz, 20 msec, monophasic square wave of 60 VDC. GABA and diazepam suppressed the EFS-induced contractions to the similar extent, significantly. (p<0.05). Bicuculline, a GABA(A) receptor antagonist blocked both GABA- and diazepam-inhibitions; but DAVA, a GABA(B) receptor antagoinst did not affect either of them. These results suggest than in the canine trachealis muscle, there may be only GABA(A) receptor, and GABA and diazepam inhibit the contractility via GABA(A) receptor.
Animals ; Bicuculline ; Diazepam ; Dogs ; gamma-Aminobutyric Acid* ; Hydrogen-Ion Concentration ; Myography ; Receptors, GABA ; Receptors, GABA-A ; Trachea

PURPOSE: To describe the emergence of the North Texas Korean American Nurses Society (NTKANS) and to examine its sociocultural contributions to Korean immigrant societies in the U.S. for the last half century. METHODS: The study used retrospective historical analysis to explore the first North Texas Korean immigrant nurses' footsteps. Using Christy's historical research methodology, this study explored themes found in the NTKANS Minutes, the directories, and newspapers, and compared them with historical nursing contexts found in documents, immigrant nurse's pictures, and letters. Interviews with twenty first immigrant Korean nurses, the members, were also used as main data. RESULTS: Since its emergence in 1969, the NTKANS have contributed to local Korean societies through community medical services, financial supports to local Korean associations, local publications, and opening Korean school. In addition, the society has contributed to the other Korean immigrant nursing societies in the U.S. CONCLUSION: The sociocultural contributions NTKANS had made to Korean immigrant societies were not possible without its members' enormous efforts, personal struggles, and altruistic dedications. The trials and tribulations these immigrant nurses have overcome and the achievements they made for last half century would greatly inspire students and nurses in Korea who may seek international leadership and scholarship.
Achievement ; Anniversaries and Special Events ; Asian Americans ; Emigrants and Immigrants ; Fellowships and Scholarships ; Financial Support ; Humans ; Korea ; Leadership ; Periodicals ; Research Design ; Retrospective Studies ; Societies, Nursing ; Texas

No abstract available.
Depression*