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.

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

5-Fluorouracil (5-FU) is a commonly used chemotherapeutic agent. However, its neurotoxicity is rare and not well recognized. We report a case of 5-FU neurotoxicity with organic brain syndrome and progression to multifocal leukoencephalopathy in a 44-year-old male patient having malignant gast- rointestinal stromal tumor. 5-FU-induced neurotoxicity should, therefore, be considered as an important differential diagnosis in cancer patients with neurological abnormality and history of chemotherapy.
Adult ; Brain/*pathology ; Case Report ; Electroencephalography ; Fluorouracil/*adverse effects/therapeutic use ; Gastrointestinal Neoplasms/drug therapy ; Human ; Leukoencephalopathy, Progressive Multifocal/diagnosis/etiology ; Magnetic Resonance Imaging ; Male ; Neurotoxicity Syndromes/diagnosis/*etiology

BACKGROUND: The basic treatment of malignant tumors is surgery, radiotherapy, chemotherapy. Even though, the object of these treatments is to kill cancer cells, they have limitations. So, in future studies of treatment of cancer, we should look into increasing human immune response using gene therapy in order to induce damage to tumor cells. OBJECTIVE: The cell growth inhibitory effect of cervical cancer cells was investigated by direct transfection using liposome(pRcCMVp53/lipofectin). and by indirect transfection using Adenovirus(AdCMVp53). METHODS: The cervical cancer cell lines we used in this study were HPV16 positive, having inhibitory gene, wild p53 gene, CaSki, SiHa, HPV18 positive HeLa, HeLaS3 and HPV negative C33A, HT3, LacZ gene was used as the marker gene for the transfection efficacy. Direct transfection was done by using lipofectin (pRcCMVp53/lipofectin) and indirect transfection was done by using virus, AdCMVp53. The effect of tumor cell growth inhibition was measured by cell counting assay. RESULT: Inhibition of growth of cervical cancer cells in cell counts of direct transfection was CaSki(88.5%), SiHa(59.1%), HeLa(86.0%), HeLaS3(78.0%), C33A(91.3%) and HT3(74.0%). Inhibition of growth of cervical cancer cells in cell counts of indirect transfection was CaSki(97.4%), SiHa(91.6%), HeLa(95.8%), HeLaS3(99.7%), C33A(97.3%) and HT3(87.4%). CONCLUSION: The inhibition of cell growth of cervical cancer cells by direct and indirect transfection was significantly reduced, and showed little differences depending on the type of cells. These results will have a great meaning in treating cervical cancer patients using gene therapy by direct or indirect transfection
Adenoviridae* ; Cell Count ; Cell Line ; Drug Therapy ; Genes, p53 ; Genetic Therapy* ; Humans ; Lac Operon ; Plasmids* ; Radiotherapy ; Transfection ; Uterine Cervical Neoplasms*

OBJECTIVE: The transfection efficiencies of gynecologic cancer cell lines were investigated by different mediated transfection methods using recombinant LacZ plasmid (pRcCMVLacZ and pAAVCMVLacZ). METHODS: In this study, the gynecologic cancer cell lines were used CaSki, SiHa (cervical, HPV16+, wild type p53 gene), HeLa, HeLa S3 (cervical, HPV18+, wild type p53 gene), C33A, HT3 (cervical, HPV-, p53 mutant), HckE6/E7 (cervical, HPV16 immortalized keratocyte), PA-1 (ovary, wild type p53), SKOV-3, A2774 (ovary, p53del) and OVCAR-3 (ovary, p53 mutant). The pRcCMVLacZ and pAAVCMVLacZ plasmid transfection were performed by using liposome system such as Ca2+-phosphate, Fugen6(TM), Lipofection(TM), Lipogen(TM) and N-stearyl lactobionamide (N-SLBA) with X-gal staining. The LacZ gene was used the reporter gene for the transfection efficiencies evaluation. RESULTS: Each of cell lines were showed different transfection efficiencies by Ca2+-phosphate, Fugen6(TM), Lipofectin(TM), Lipogen(TM) and N-SLBA. Each of cell were revealed that HeLa S3, HT3 and A2774 were high transfection efficiency using the pRcCMVLacZ by the Lipogen(TM), SiHa, HeLa, QGU, OVCAR-3 and PA-1 were high efficiency using the pAAVCMVLacZ by Lipofectin(TM), CaSki was high efficiency using the pRcCMVLacZ by the Lipogen(TM), A2774 and Cx16.2 were high efficiency using the pRcCMVLacZ by the Lipofectin(TM), SKOV-3 and HkcE6/E7 were high efficiency using pAAVCMVLacZ by the Lipogen(TM). CONCLUSION: As a result, We proved that each of cell lines differed trasnfection efficiencies according to mediated transfection and recombinant LacZ plasmid style. Above all, Lipofectin(TM) mediated transfection was showed high efficiency at the most of cell lines.
Cell Line* ; Genes, Reporter ; Humans* ; Lac Operon* ; Liposomes ; Plasmids* ; Transfection*