Solid pseudopapillary tumor of the pancreas is a rare tumor that affects young females with low malignant potential and good prognosis with more than 90% survival at 5 years. Metastasis is very rare. We report the case of a 74-year-old female who had pancreatic solid-pseudopapillary tumor and synchronous hepatic metastasis.
Aged ; Female ; Humans ; Neoplasm Metastasis ; Pancreas ; Pancreatic Neoplasms ; Prognosis

Introduction: we measured the hemodynamic changes by the thoracic electrical bioimpedance (TEB) device during induction of anesthesia, endotracheal intubation or insertion of layngeal mask airway (LMA). This TEB device is safe, reliable and estimate continuously and invasively hemodynamic variables. METHODS: We measured the cardiovascular response of endotracheal intubation or that of LMA insertion in thirty ASA class I patients. General anesthesia was induced with injection of fentany 1 microgram/kg, thiopetal sodium 5 mg/kg and vecuronium 1 mg/kg intravenously. Controlled ventilation was for 3 minutes with inhalation of 50% nitrous oxide and 1.5 vol% of enflurane before tracheal intubation or LMA insertion in all patients. The patient was randomly assinged to either tracheal intubation group (ET group) or laryngeal mask airway group (LMA group). Heart rate (HR), mean arterial pressure (MAP), systemic vascular resistance (SVR), stroke index (SI) and cardic index (CI) were measured to pre-induction, pre-intubation, 1 minute after intubation, 2 minute, 3 minute, 5 minute, 7 minute. RESULTS: MAP and SVR were decreased effectively LMA group than ET group during 1 minute after intubation, 2 minute, 3 minute, 5 minute, 7 minute (p<0.05). HR was decreased effectively LMA group than ET group between pre-induction and 1 minute after intubation, between 1 minute after intubation and 2 minute after intubation (p<0.05). But, SI and CI were no difference between ET group and LMA group during induction of anesthesia and intubation (p<0.05). CONCLUSION: The insertion of LMA is beneficial for certain patients than endotracheal tube to avoid harmful cardiovascular response in the management of airway during anesthesia.
Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Enflurane ; Heart Rate ; Hemodynamics* ; Humans ; Inhalation ; Intubation ; Intubation, Intratracheal* ; Laryngeal Masks* ; Masks ; Nitrous Oxide ; Sodium ; Stroke ; Vascular Resistance ; Vecuronium Bromide ; Ventilation

OBJECTIVETo evaluate the effects of Artesunate on tumor necrosis factor alpha (TNF-alpha), monocyte chemoattractant protein (MCP-1), and on reduced activation normal T cell expressed and secreted (RANTES) in the serum and the synoviocyte culture supernate of collagen-induced arthritis (CIA) rats.

METHODSEighty male Wistar rats were selected to establish the CIA rat model. On the 6th day after modeling, 60 rats with the sum of arthritis index of right metapedes and two propodium > or = 6 were selected, and randomly divided into 6 groups (n = 10), i.e., the blank control group, the CIA model control group (treated with normal saline, abbreviated as the CIA group), the MTX positive control group (abbreviated as the MTX group), the large dose Artesunate group (at the daily dose of 20 mg/kg), the moderate dose Artesunate group (at the daily dose of 10 mg/ kg), and the small dose of Artesunate group (at the daily dose of 2.5 mg/kg). Mice were sacrificed 7 days of immune injection and their venous blood was collected to obtain the serum. Meanwhile, the synovial tissues of the knee joint were taken by aseptic techniques and primary cultured for 48 h. The supernate was collected by centrifuge. The changes of MCP-1, RANTES, and TNF-alpha in the serum and the synoviocyte culture supernate were observed in each group before and after treatment using ELISA.

RESULTSArtesunate significantly decreased the expressions of TNF-alpha in the serum and the synoviocyte culture supernate, showing significant difference when compared with the model control groups (P < 0.05). There was no statistical difference in the large dose Artesunate group and the moderate dose Artesunate group when compared with the MTX group (P > 0.05). But statistical difference existed in the large dose Artesunate group, the moderate dose Artesunate group, and the MTX group when compared with the small dose Artesunate group (P < 0.05). Artesunate could significantly decrease the expressions of MCP-1 and RANTES in the serum and the synoviocyte culture supernate, showing statistical difference when compared with the model control group (P < 0.05). But no statistical difference existed when compared with the MTX group (P > 0.05).

CONCLUSIONThe mechanism of anti-inflammatory action and immune regulation of Artesunate might be correlated with the inhibition of inflammatory factor TNF-alpha and chemotactic factors MCP-1 and RANTES.

Animals ; Artemisinins ; pharmacology ; Arthritis, Experimental ; blood ; metabolism ; Cells, Cultured ; Chemokine CCL2 ; blood ; metabolism ; Chemokine CCL5 ; blood ; metabolism ; Disease Models, Animal ; Male ; Rats ; Rats, Wistar ; Synovial Fluid ; cytology ; metabolism ; Tumor Necrosis Factor-alpha ; blood ; metabolism

Objective: Aspiration is a major concern for children with dysphagia because aspiration has been known as the primary etiology leading to recurrent pneumonia, and severe impairment of lung function in pediatric populations.This study aimed to examine the differences in each temporal measure between children with and without aspiration and investigate the effect of bolus consistency on the temporal measures. Methods: Forty-two children ranging in age from 1 year to 3 years and 11 months were included in this study. A referral for a videofluoroscopic swallowing study (VFSS) was made. They were divided into two groups according to the presence or absence of aspiration. Sixteen children were aspirators, and twenty-six children were non-aspirators.Oropharyngeal temporal measures were analyzed using frame-by-frame analysis. Results: The delayed initiation of pharyngeal swallowing, delayed laryngeal closure, and poor bolus transition in the pharyngeal stage were associated with the risk of aspiration in children with dysphagia. The bolus consistency did not affect the oropharyngeal temporal measures. Conclusion The objective temporal data in this study, including the durations and onset of physiological events in relation to bolus movement, can be used for future research to compare the swallowing functions between groups of children with various etiologies and age ranges.

Objective: Aspiration is a major concern for children with dysphagia because aspiration has been known as the primary etiology leading to recurrent pneumonia, and severe impairment of lung function in pediatric populations.This study aimed to examine the differences in each temporal measure between children with and without aspiration and investigate the effect of bolus consistency on the temporal measures. Methods: Forty-two children ranging in age from 1 year to 3 years and 11 months were included in this study. A referral for a videofluoroscopic swallowing study (VFSS) was made. They were divided into two groups according to the presence or absence of aspiration. Sixteen children were aspirators, and twenty-six children were non-aspirators.Oropharyngeal temporal measures were analyzed using frame-by-frame analysis. Results: The delayed initiation of pharyngeal swallowing, delayed laryngeal closure, and poor bolus transition in the pharyngeal stage were associated with the risk of aspiration in children with dysphagia. The bolus consistency did not affect the oropharyngeal temporal measures. Conclusion The objective temporal data in this study, including the durations and onset of physiological events in relation to bolus movement, can be used for future research to compare the swallowing functions between groups of children with various etiologies and age ranges.

Objective: Aspiration is a major concern for children with dysphagia because aspiration has been known as the primary etiology leading to recurrent pneumonia, and severe impairment of lung function in pediatric populations.This study aimed to examine the differences in each temporal measure between children with and without aspiration and investigate the effect of bolus consistency on the temporal measures. Methods: Forty-two children ranging in age from 1 year to 3 years and 11 months were included in this study. A referral for a videofluoroscopic swallowing study (VFSS) was made. They were divided into two groups according to the presence or absence of aspiration. Sixteen children were aspirators, and twenty-six children were non-aspirators.Oropharyngeal temporal measures were analyzed using frame-by-frame analysis. Results: The delayed initiation of pharyngeal swallowing, delayed laryngeal closure, and poor bolus transition in the pharyngeal stage were associated with the risk of aspiration in children with dysphagia. The bolus consistency did not affect the oropharyngeal temporal measures. Conclusion The objective temporal data in this study, including the durations and onset of physiological events in relation to bolus movement, can be used for future research to compare the swallowing functions between groups of children with various etiologies and age ranges.

Objective: Aspiration is a major concern for children with dysphagia because aspiration has been known as the primary etiology leading to recurrent pneumonia, and severe impairment of lung function in pediatric populations.This study aimed to examine the differences in each temporal measure between children with and without aspiration and investigate the effect of bolus consistency on the temporal measures. Methods: Forty-two children ranging in age from 1 year to 3 years and 11 months were included in this study. A referral for a videofluoroscopic swallowing study (VFSS) was made. They were divided into two groups according to the presence or absence of aspiration. Sixteen children were aspirators, and twenty-six children were non-aspirators.Oropharyngeal temporal measures were analyzed using frame-by-frame analysis. Results: The delayed initiation of pharyngeal swallowing, delayed laryngeal closure, and poor bolus transition in the pharyngeal stage were associated with the risk of aspiration in children with dysphagia. The bolus consistency did not affect the oropharyngeal temporal measures. Conclusion The objective temporal data in this study, including the durations and onset of physiological events in relation to bolus movement, can be used for future research to compare the swallowing functions between groups of children with various etiologies and age ranges.

PURPOSE: The purpose of this study is to investigate the usefulness of ultrasound-guided femorosciatic nerve block by orthopaedist to operate the fracture around ankle. MATERIALS AND METHODS: Twenty-two patients, who had an operation for fracture around the ankle under a ultrasound-guided femorosciatic nerve block from January to April 2010, were the targets of this study. We measured the time spent for the ultrasound-guided femorosciatic nerve block, the time taken to start the operation after the nerve block, the time taken to deflate the tourniquet because of a tourniquet pain, the time passed until feeling a postoperative pain after the operation, etc. We also studied the complications and satisfaction of the anesthesia. RESULTS: It took 6.2 (3 to 12) minutes for the nerve block, 46.1 (28 to 75) minutes to start the operation, 52.5 (22 to 78) minutes until feeling a tourniquet pain and 11.5 (7.5 to 19) hours until starting to feeing a postoperative pain. There was no complication by anesthesia and 21 people (95.5%) were satisfied with anesthesia by ultrasound-guided femorosciatic nerve block. CONCLUSION: Ultrasound-guided femorosciatic nerve block by orthopaedist in the fracture around ankle reduces anesthetic and nerve injury complication, and leads to high anesthetic success rate. Also it is considered as an effective method to alleviate postoperative pain.
Anesthesia ; Animals ; Ankle ; Fees and Charges ; Femoral Nerve ; Humans ; Nerve Block ; Pain, Postoperative ; Sciatic Nerve ; Tourniquets

No abstract available.
Korea* ; Lung*

BACKGROUND/AIMS: Small-caliber esophagogastroduodenoscopy (scEGD) was developed to facilitate unsedated EGD, and has many advantages over sedated EGD in terms of costs and complications. This study compared the feasibility and tolerance of scEGD with unsedated conventional EGD (cEGD), and examined the effect of the endoscopic diameter on the patients' tolerance. METHODS: A total of 114 patients who were referred for a diagnostic EGD was randomly allocated to undergo either scEGD (GIF XP260, Olympus, diameter 6.5 mm; n=57) or cEGD (GIF XQ240, Olympus, diameter 9.0 mm; n=57). After EGD, the patients and endoscopists completed questionnaires on the level of discomfort, satisfaction and acceptance of the examination. RESULTS: Patients in the scEGD group reported significantly less discomfort (choking, pain and nausea) and more overall satisfaction than those in the cEGD group. Patients in the scEGD group were more willing to choose the same procedure again if medically indicated. According to multivariate analysis, the ultrathin endoscopic diameter itself was positively associated with the increased patients' satisfaction (odds ratio 3.07, p=0.003). CONCLUSIONS: scEGD has comparable feasibility and accuracy but is more tolerable than cEGD. scEGD may have a role in clinical practice by minimizing the level of discomfort during unsedated EGD.
Endoscopy, Digestive System ; Humans ; Multivariate Analysis