No abstract available.
Bile Ducts* ; Bile*

No abstract available.
Gastrectomy*

The authors studied the early morphologic changes of peripheral nerve, which is known as relatively radioresistant tissue to the X-ray irradiation, but recently clamied by several clinician through development of neuropathies after radiotherapy of the malignacy. Rabbits were received 1,000 or 2,000 cGy of X-ray on the knee joint areas. Sciatic nerves were extracted out 30 minutes, 1, 2, 4, 24 hours, and 3 and 7 days after irradiation. The morphologic changes were observed by light and electron microscopes. The results were summarized as follows: Light microscopically, only mild edema is noted. Electron microscopically, irregular separation and folding of myelin sheath with spherical body formation are noted. Above features were more prominent at later stages and aggregated nests of fragmented myelin were scattered 16 hours after irradiation. Schwann cell necrosis is noted after 24 hours. But above degenerative changes were scarcely present 7 days after irradiation. There is no remarkable axonal changes. The interstitial tissue revealed swelling and irregularity of surface of endothelial cells, and edema. On the basis of the results, it may be concluded that the peripheral nerve is injured by irradiation in early stages, and the main target of irradiation injury is thought to be myelin sheath and Schwann cells, which would be reversible and could be recovered promptly.
Rabbits ; Animals

OBJECTIVE: The objective of this study is to evaluate the expressions, microvessel counts and angiogenic pathway of VEGF and PD-ECGF and proliferative activity of Ki-67 according to clinicopathologic feature of cervical tumor. METHODS: Two hundred three cervical specimens were evaluated; among these 20 were designated normal epithelium, 36 mild dysplasia, 28 moderate dysplasia, 36 severe dysplasia, 28 carcinoma in situ, 17 microinvasive carcinoma and 38 invasive cervical carcinoma (21 squamous cell carcinoma and 17 adenocarcinoma). Microvessel count was determined by immunohistochemical staining using anti-factor VIII-related monoclonal antibody. The expression of VEGF (vascular endothelial growth factor) and PD-ECGF (platelet-derived endothelial cell growth factor) were evaluated by immunohistochemical staining with anti-human VEGF monoclonal antibody and anti-dThdPase monoclonal antibody. The proliferative activity was examined using a Ki-67 equivalent monoclonal antibody (MIBl). RESULT: There was no statistical significance on microvessel count except invasive cancer comparing with mild dysplasia including normal tissue, but there was a little increase in microvessel counts according to severity of tumor. The intensity of VEGF and PD-ECGF expression was significantly correlated with severity of cervical tumor. And the microvessel density was significantly higher in the positive expression of VEGF and PD-ECGF than in the negative expression. The intensity of PD-ECGF expression in invasive adenocarcinoma was significantly lower in comparison with VEGF expression. The intensity of Ki-67 expression had no correlation with severity of cervical tumor and was significantly higher in moderate and severe dysplasia than in microinvasive and invasive carcinoma. Ki-67 expression had no statistical correlation with VEGF and PD-ECGF. CONCLUSION: The VEGF and PD-ECGF are important angiogenic factors and associated with progression of cervical tumor. The VEGF may be involved in the progressions of squamous cell carcinoma and adenocarcinoma, but the PD-ECGF may not be involved or be minimally involved in the progression of adenocareinoma. There seems to be a different angiogenic pathway pertaining to the histologic difference of cervical cancer. There was no difference of Ki-67 expression according to severity of cervical tumor.
Adenocarcinoma ; Angiogenesis Inducing Agents ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Endothelial Cells ; Epithelium ; Microvessels ; Thymidine Phosphorylase* ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

Fat containing masses, except mediastinal lipomatosis, of the thorax are uncommon. In spite of uncommonoccurences, as CT can detect not only the fat content but also the presence and character of the non-fattycomponent of the mass, accurate preoperative diagnosis can usually be made in most cases of fat containingmediastinal masses. Authors report 6 cases of fat containing mediastinal masses, that were diagnosedpreoperatively by CT scan, comprising 2 cases of limpoma(combined with plexiform neurofibroma in a case), 1liposarcoma, 1 thymolipoma, and 2 cases of omental hernia through Morgagni foramen.
Diagnosis ; Hernia ; Lipomatosis ; Neurofibroma, Plexiform ; Thorax ; Tomography, X-Ray Computed

OBJECTIVE: The study of 467 cases of amniocentesis have been done at the department of Genetics, Taegu Cheil Hospital from Oct. 1997 to May 1999 for the purpose of analysis of abnormal karyotype according to the indication and age distribution, METHODS: We collected amniotic fluid using 22G spinal needle and measured amniotic alphafetoprotein and acetylcholine esterase in supematant and performed cytogenetic analysis. RESULTS: Positive Down screeing(positive triple test) was the most common indication of amniocentesis (61.5%) and abnormal karyotypes were 24 cases(5.1%) in 467 cases. Among 24 abnormal cases, 10 cases(2.1%) of 21 trisomy were observed. Abnormal karyotypes were most common in the group of abnormal ultrasonogram finding and the gmup of maternal age between 31 to 35 years old, which consists of 25% and 7.7% respectively. CONCLUSION: More attention for the abnormal karyotype should be paid to the group of abnormal ultrasonogram finding and the group of maternal age between 31 to 35 years old as well as above 35 years old.
Abnormal Karyotype ; Acetylcholine ; Adult ; Age Distribution ; Amniocentesis ; Amniotic Fluid ; Cytogenetic Analysis* ; Cytogenetics* ; Daegu ; Female ; Genetics ; Humans ; Karyotype ; Maternal Age ; Needles ; Trisomy ; Ultrasonography

Although uterine arterovenous malformation(AVM) is a rare cause of menorrhagia or postmenopausal bleeding, it is important to consider that curettage may precipitate life-threatening hemorrhage and therefore it is contraindicated when AVM is suspected. Special investigations such as hysteroscopy, Doppler flow ultrasound and angiography are important diagnostic tools, and transarterial embolization(TAE) has replaced hysterectomy as the treatment of choice in women who wish to retain their fertility. But due to the high incidence of collateral vessels, recurrence of the vascular malformation after TAE is common. We have experienced two cases of AVM, one of which was managed by TAE in combination with surgical arterial ligation.
Angiography ; Arteriovenous Malformations* ; Curettage ; Female ; Fertility ; Hemorrhage ; Humans ; Hysterectomy ; Hysteroscopy ; Incidence ; Ligation* ; Menorrhagia ; Recurrence ; Ultrasonography ; Vascular Malformations

PURPOSE: To report the radiographic and clinical results of 6.5 mm cancellous full threaded buttress screw or Steinmann pin fixation to maintain a reduction of calcaneal posterior facet depression fracture. MATERIALS AND METHODS: From June 2009 to June 2012, 50 consecutive cases with calcaneal joint depression fracture that underwent open reduction and screw or pin fixation were enrolled in this study. A 6.5 mm cancellous full threaded screw was inserted from the posteroinferior aspect of the calcaneal tuberosity to the posterior facet (group A) or Steinman pin was inserted from the posterosuperior aspect of the calcaneal tuberosity to the calcaneocuboidal joint (group B). Both preoperative and postoperative Bohler and Gissane angles were measured radiographically, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale on the final follow-up were assessed. RESULTS: The mean age of patients was 44.1 years, and the mean follow-up period was 27.2 months. According to the Sanders classification, 28 cases were type II and 22 cases were type III. In Sanders type II, Bohler and Gissane angles improved significantly from 10.1degrees and 126.2degrees preoperatively to 27.2degrees and 117.1degrees, respectively, in the immediate postoperative radiograph, and at the final follow-up, 26.6degrees and 118.6degrees, respectively. In Sanders type III, Bohler and Gissane angles improved significantly from 5.0degrees and 129.8degrees to 29.9degrees and 119.3degrees, respectively, in the immediate postoperative radiograph, and 26.9degrees and 120.2degrees at the final follow-up. All cases achieved bony union, and the average period until complete union was 13.3 weeks. AOFAS ankle-hindfoot scale was 82.6 in Sanders type II and 77.3 in Sanders type III at the final follow-up. CONCLUSION: A 6.5 mm cancellous full threaded buttress screw or Steinman pin fixation is a noninvasive treatment method with a merit of being able to maintain the bearing capacity of the posterior facet comparable to plate fixation.
Ankle ; Calcaneus ; Classification ; Depression* ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Joints*

PURPOSE: We investigated reproducibility of the quantification of left ventricular volume and ejection fraction, and grading of myocardial wall motion and systolic thickening when we used gated myocardial SPECT and Cedars quantification software. MATERIALS AND METHODS: We performed gated myocardial SPECT in 33 consecutive patients twice in the same position after Tc-99m-MIBI SPECT. We used 16 frames per cycle for the gatingof sequential Tc-99m-MTBI SPECT. After reconstruction, we used Cedars quantitative gated SPECT and calculated ventricular volume and ejection fraction (EF), Wall motion was graded using 5 point score. Wall thickening was graded using 4 point score. Coefficient of variation for re-examination of volume and fraction were calculated. Kappa values (k-value) for assessing reproducibility of wall motion or wall thickening were calculated. RESULTS: Enddiastolic volumes (EDV) ranged from 58 mi to 248 ml (122 ml +/- 42 ml), endsystolic volumes (ESV) from 20 mi to 174 mi (65 ml +1- 39 ml), and EF from 20% to 68% (51% +/- 14%). Geometric mean of standard deviations of 33 patients was 5.0 ml for EDV, 3.9 ml for ESV and 1.9% for EF. Their average differences were not different from zero (p>0.05). k-value for wall motion using 2 consecutive images was 0.76 (confidence interval: 0.71-0.81). k-value was 0.87 (confidence interval:0.83-0.90) for assessment of wall thickening. CONCLUSION: We concluded that quantification of functional indices, assessment of wall motion and wall thickening using gated Tc-99m-MIBI SPECT was reproducible and we could use this method for the evaluation of short-acting drug effect.
Heart ; Humans ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: The nature of operation alters the volume of distribution at steady state (Vdss) of drug. The hepatic extraction ratio of midazolam (0.3~0.7) could be influenced by hepatic blood flow (HBF), and hepatic enzyme activity. The pharmacokinetics of intravenous midazolam were determined in patients undergoing lung surgery. METHODS: Midazolam, 0.2 mg/kg, was administered to five patients undergoing lung surgery at 30 minutes after induction of anesthesia. Anesthesia was maintained with O2-enflurane for one lung ventilation. Blood samples from artery were drawn at increasing intervals for 12 h. Plasma midazolam concentrations were measured by gas chromatography. Computer simulations of the times required for 20%, 50%, and 80% decreases in midazolam concentrations were performed. RESULTS: A three compartment model best described the concentration versus time data. The volume of the central compartment (Vc) and volume of distribution at steady state (Vdss) were 4.3 2.8 l and 59.9 20.1 l, respectively. The elimination half-life was 3.4 2.2 h. Simulations indicate that under all the situations, the concentrations would decrease more rapidly in our patients in spite of similar Vdss and elimination half-life of patients undergoing minor gynecological surgery. CONCLUSION: The elimination half-life was in the range of previously reported values. The shorter recovery time is apparently due to relatively faster redistrubution, and relatively greater capacity for redistribution.
Anesthesia ; Arteries ; Chromatography, Gas ; Computer Simulation ; Female ; Gynecologic Surgical Procedures ; Half-Life ; Humans ; Lung* ; Midazolam* ; One-Lung Ventilation ; Pharmacokinetics* ; Plasma