No abstract available.
Embryonic Structures* ; Fluorescence* ; Humans* ; In Situ Hybridization* ; Preimplantation Diagnosis*

BACKGROUND: It is well known that intravenous patient controlled analgesia (IV-PCA) is an effective method to reduce the magnitude of postoperative pain. However, we do not know the appropriate time to start the IV-PCA. To determine the appropriate time to minimalize the sympathetic stimulation and shorten the awakening time after general anesthesia, experiments to indicate whether starting an infusion of the IV-PCA before the end of an operation has a minimal hemodynamic change and similar recovery index compared with the control group were done. METHODS: Seventy-eight patients scheduled for a total abdominal hysterectomy were randomly allocated to two groups. In the IV-PCA group (n = 37), we started the infusion of the IV-PCA before the end of the operation and in the control group (n = 41) which received no IV-PCA, we did not use the IV-PCA as a postoperative pain control method. We measured heart rate, blood pressure, postanesthesia recovery score every 10 minutes for 60 minutes and awakening time at the post-anesthesia care unit. RESULTS: The postanesthesia recovery scores on arrival, 10, 20, 30, 40 and 50 minute after arrival at the post-anesthesia care unit were lower in the IV-PCA group than in the control group. In addition the awakening time after vaporizer-off and at the post-anesthesia care unit was longer in the IV-PCA group than in the control group. CONCLUSIONS: We conclude that starting the infusion of the IV-PCA before the end of the operation is not effective in early recovery and awakening.
Analgesia, Patient-Controlled ; Anesthesia, General ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Hysterectomy ; Pain, Postoperative

An esophageal schwannoma originating in a schwann cell of a neuron presents as a type of submucosal tumor. An esophageal schwannoma is extremely rare, with only 30 reported cases. It is usually a benign tumor. However, three cases with malignant findings and one case with local recurrence have been reported. Reviews of previous reports indicate that benign schwannomas are usually located in the upper esophagus and occur in middle aged-women. An esophageal schwannoma is usually asymptomatic but sometimes causes dysphagia as an initial symptom and dyspnea by trachea compression. The differentiation of a schwannoma from the other submucosal tumors is very difficult on a preoperative examination with the use of esophagoscopy, endoscopic ultrasound and computed tomography. A definite diagnosis of the tumor requires a histological examination and immunohistochemical staining. Positive immunostaining for s-100 protein supports the schwann cell origin of the tumor. We report a case of an esophageal schwannoma with intense FDG uptake as detected on PET-CT.
Deglutition Disorders ; Dyspnea ; Esophagoscopy ; Esophagus ; Neurilemmoma ; Neurons ; Recurrence ; S100 Proteins ; Trachea

OBJECTIVE: To compare the clinical outcomes between Day 2 and Day 3 embryo transfer(ET) groups in in vitro fertilization and embryo transfer(IVF-ET) with intracytoplasmic sperm injection(ICSI). METHODS: From May, 1997 to December, 1998, 174 cycles of IVF-ET with ICSI were performed and classified into two groups: Day 2 ET group(n=134) and Day 3 ET group (n=40). In Day 3 ET group, embryos fertilized after ICSI were cultured in vitro for further 24 hours in M3 media. RESULTS: There were no significant differences in the age and BMI of patients, basal serum FSH level, protocol of controlled ovarian hyperstimulation(COH), indication of ICSI, and source of sperm for ICSI between two groups. Only the number of the previous failed IVF-ET cycles was significantly higher in Day 3 ET group(p<0.05). Serum E2 level on hCG day, the numbers of oocytes retrieved after COH, oocytes fertilized after ICSI, and embryos transferred, and the rates of fertilization, cleavage, and implantation showed no significant differences. However, cumulative embryo score(CES) was significantly higher in Day 3 ET group(p<0.05). Although there were no significant differences in the rates of pregnancy per ET, spontaneous abortion, and live birth, the rates of biochemical and multiple pregnancy were significantly higher in Day 3 ET group(p<0.05). CONCLUSIONS: In IVF-ET with ICSI, the relatively higher CES may contribute to the higher risk of multiple pregnancy in Day 3 ET group, compared with the conventional Day 2 ET group.
Abortion, Spontaneous ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Humans ; Live Birth ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

BACKGROUND/AIMS: Dieulafoy lesions are an important cause of upper gastrointestinal bleeding. The purpose of this study was to assess the efficacy of endoscopic treatment for these lesions and to identify the possible predictive factors for rebleeding associated with clinical and endoscopic characteristics. METHODS: Records from 44 patients admitted with Dieulafoy bleeding between January 2006 and December 2007 were reviewed. We retrospectively analyzed the clinical and endoscopic findings and then correlated the rebleeding risk factors with Dieulafoy lesions. RESULTS: Primary hemostasis was achieved by endoscopic treatment in 39 patients (88.6%). There were no significant differences between the rebleeding and non-rebleeding groups with respect to age, gender, initial hemoglobin levels, presence of shock, concurrent disease, location of bleeding, or initial hemostatic treatment methods. However, the use of non-steroidal anti-inflammatory drugs or anticoagulants (p=0.02) and active stages in the Forrest classification (p<0.01) were risk factors for rebleeding after endoscopic therapy. CONCLUSIONS: Endoscopic therapy is effective and safe for treating Dieulafoy lesions, and it has both short- and long-term benefits. Early identification of risk factors such as the use of non-steroidal anti-inflammatory drugs or anticoagulants and the Forrest classification of bleeding predict the outcome of Dieulafoy lesions.
Adult ; Aged ; Arteriovenous Malformations/complications/*therapy ; Female ; Gastrointestinal Hemorrhage/etiology/*therapy ; Hemostasis, Endoscopic/*methods ; Humans ; Male ; Middle Aged ; Recurrence ; Risk Factors