No abstract available.
Gastrointestinal Stromal Tumors* ; Hemorrhage*

No abstract available.

It has long been an accepted policy to employ radiation therapy as initial treatement of choice for most casesof invasive carcinoma of cervix uteri. But, complications following radiotherapy were troublesome problem fot thepatients cured by radiation therapy. The aim of the present study is to present the types and rate of complicationsand to evalute the contributing facors induced the radiation complications. The aim of the present study is topresent the types and rate of complications and to evalute the contributing factors induced the radiationcomplications. 957 cases of invasive carcinoma of cervix uteri receiving radiation therapy were analyzed. Theconclusions are as follows; 1. Bowel complications developed in 96 cases (10.03%). 2. 86% of all bowelcomplications appeared during the first 18 months and most frequently seen after 6 to 12 months(40.03%). 3. Thefrequency of complicaiton was higher in older age and larger irradiation dose, but there is no apparentcorrelation between stage and the occurrence of complications. 4. Portal combination was also a contributingfactor. Highest frequency was noted in AP & PA parallel opposing portals followed by 4 oblique portals and boxtechnique.
Cervix Uteri ; Female ; Radiotherapy

The Marfan syndrome is classified as a heritable disorder of connective tissue with clinical and pathological alterations involving supporting elements. In its classic form, the Marfan syndrome is associated with abnormalities of the eye(ectopia lentis), aorta(aortic dilatation and aortic regurgitation) and skeleton(dolichostenomelia, arachnodactyly and pectus deformity). The authers have experienced a case of marfan syndrome recently. The patient was 30-years-old male complaining of anterior chest pain radiating to upper back. Physical examination showed tall status, increased length of the limbs as compared with the trunk and arachnodactyly. On auscultation, heart sound was normal without murmur. He wore glasses because of moderate myopia. Roentgenogram of the chest P-A revealed normal cardiac and aortic contours and lung fields. Left lateral view of chest X-ray revealed concave depression of sternum showing mild pectus excavatum, fusiform dilatation of aorta from aortic root to mid portion of thoracic aorta and resulting in obliteration of retrosternal clear space. Echocardiogram demonstrated moderate dilatation of aortic root A-P diameter(4.5cm) without aortic or mitral valvular abnormalities and normal size of left ventricular cavity(EDD:5.3cm). These data coupled with a distinct family history could permit the diagnosis of Marfan syndrome.
Aorta ; Aorta, Thoracic ; Arachnodactyly ; Chest Pain ; Connective Tissue ; Depression ; Diagnosis ; Dilatation ; Extremities ; Eyeglasses ; Funnel Chest ; Glass ; Heart Auscultation ; Humans ; Lung ; Male ; Marfan Syndrome* ; Myopia ; Physical Examination ; Sternum ; Thorax

Narcotic analgesics may be added to spinal anesthetics solution to improve the quality of sensorimotor blockade and to produce postoperative pain relief. The opioid-related side effects of respiratory depression, pruritus, nausea, and urinary retension also occur with intrathecal administration and the effects are dose-related. It is difficult to select morphine with spinal anesthetic solution due to fatal side-effect, respiratory depression. Intrathecal morphine dose used for our study was less than 1mg, thereby the risk of respiratory depression was decreased. There was no report that the addition of morphine affected the motor block produced by the local anesthetics in spinal anesthesia. But in our study, we found that 0.9 mg of intrathecal morphine produced prolongation of optimal condition for operation(more than 3 hours duration), and sufficient postoperative pain relief(for about 20 hours) without respiratory depression in 28 out of 30 spinal anesthesia cases. On the other hand, 0.5 mg or 0.7 mg of intrathecal morphine produced sufficient postoperative pain relief without respiratory depression(for about 20 hours), but insufficient prolongation of optimal condition for operation in each 30 cases of spinal anesthesia.
Anesthesia, Spinal* ; Anesthetics ; Anesthetics, Local ; Hand ; Morphine* ; Narcotics ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Tetracaine*

BACKGROUND: Recent studies suggest the hypothesis that blockade of nociceptive input with local anesthetics before surgery can decrease pain beyond the immediate postoperative period. The purpose of this study was to determine if the preincisional infiltration with local anesthetics affected postoperative pain relief. METHOD: Among 30 patients having tonsillectomy, 15 patients(group 1) given peritonsillar infiltration using lidocaine with epinephrine(1 : 200,000) were compared with 15 patients(group 2)given peritonsillar infiltration using saline with epinephrine(1 : 200,000). Following general anesthesia with a mixture of O2-N2O(50%) and enflurane(1-2vol.%), peritonsillar infiltration were performed 5 minutes before surgery. Constant incisional pain and pain on swallowing were assessed using a visual analogue scale at 4 hour, 1, 2, 3 and 4 days postoperatively. The time to emergence and behaviour of patient at 0.5, 1 and 4 hour were recorded postoperatively. RESULT: Preincisional infiltration with lidocaine resulted in a significant decrease in postoperative pain during 4 days after surgery and smoother emergence. CONCLUSION: There were significant difference in pain scores between lidocaine group and saline group during 4 days after surgery. Preincisional lidocaine infiltration seemed to have analgesic activity beyond the residual anesthetic period. The results of this study support the theory of pre-emptive analgesia.
Analgesia ; Anesthesia, General ; Anesthetics ; Anesthetics, Local ; Child* ; Deglutition ; Humans ; Lidocaine* ; Pain, Postoperative ; Postoperative Period ; Tonsillectomy

PURPOSE: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). MATERIALS AND METHODS: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: 49.1+/-10.8). RESULTS: Eighteen lesions of primary HPT consisted of 13 adenomas and 5 hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). CONCLUSION: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.
Adenoma ; Diagnosis ; Humans ; Hyperparathyroidism, Primary ; Hyperparathyroidism, Secondary* ; Hyperplasia ; Parathyroid Glands ; Radionuclide Imaging* ; Retrospective Studies ; Sensitivity and Specificity

covered with liguid nitrozen and pulverized with a pestle. To the powered tissue 5ml of 3.3M formic acid/0.5% Tween 20 was added and centrifuged at 40,000*g for 10 min. An aliquot of supernate was put into C18 sepak minicolumn to eliminates IGF-BPs. Measurement of IGF-I in rat tissues was done by RIA with anti-hIGF-I antibody and hIGF-I(PSIII) standard which was prepared by Drs. L. E. Underwood and J. J. Van Wyk UNC at Chapel Hill, NC, USA and distributed through the National Hormone and Pituitary Distribution Program. Distribution of IGF-I in rat tissue was seen by SDS-PAGE and ligand blotting method. A cDNA library in lambda gt11 of rat liver was used to isolate the cDNA of IGF-I. Phage containing inserts encoding rat IGF-I were identified by hybridization with biotin labeled synthesized oligomer which was the sequence from 1 to 8 aminoacids of known rat IGF-I. The EcoRI inserts were subcloned into PBluescript SK. The nucleotide sequence of both strands was determined by the dideoxy chain termination method. RESULTS: 1)IGF-BPs in tissue extract which could compete with antibody for IGF-I in measureing the IGF-I were eluted at 50Kdalton molecular weight marker using Protein-pak 300SW column. Using C18-sepak minicolumn, IGF-BPs were completely eliminated from tissue extract as much as possible, using Protein-pak 300SW column. 2)The amount of IGF-I in tissues was as folows: liver 575+/-41.6ng/g, lung 552.0+/-40.8ng/g. kidney 503+/-30.8ng/g, heart 449.0+/-30.4ng/g, testis 225+/-18.8ng/g, spleen 146+/-26.4ng/g, muscle 92+/-7.6ng/g and brain 49.0+/-5.8ng/g. The amount of IGF-I in blood was 1403+/-60.8ng/ml. 3)Banding patterns of IGF-BPs in rat tissues extract were obtained using ligand blotting. IGF-BP3 bands at 50 Kdalton molecular weight marker were strongly shown in testis, heart, and lung extracts but not in brain and muscle. IGF-BP1 and 2 band at 30Kdalton molecular weight marker was strongly shown in liver, kidney, spleen, testis, heart and lung. IGF-BP4 band at 21 Kdalton molecular weight marker was weakly shown only in spleen and muscle. 4) The nucleotide sequence of cloned cDNA of rat IGF-I is as follows. 5 10 15 5'----- CC CTT TGC GGG GCT GAG CTG GTG GAC GCT CTT CAG TTC GTG TGT 20 25 30 -GGA CCA AGG GGC TTT TAC TTC AAC AAG CCC ACA GGC TAT GGC- 35 40 45 -TCC AGC ATT CGG AGG GCA CCA CAG ACG GGC ATT GTG GAT GAG------3 CONCLUSION: This study suggests that tissue extraction method for IGF-I from tissues and elimination of IGF-BPs using C18 sepak minicolumn is suitable for measuring in large numbers of samples. Expression of IGF-I and IGF-BPs in multiple tissues suggests some phsiologic function at each tissue level. Subcloning of cDNA of exon 3 and 4 of IGF-I was useful for studying regulation of IGF-IA and IB mRNA in rat tissue.
Animals ; Bacteriophages ; Base Sequence ; Biotin ; Brain ; Carrier Proteins* ; Clone Cells ; DNA, Complementary ; Electrophoresis, Polyacrylamide Gel ; Exons ; Gene Library ; Heart ; Insulin-Like Growth Factor I* ; Kidney ; Liver ; Lung ; Molecular Weight ; Polysorbates ; Rats* ; RNA, Messenger ; Spleen ; Testis

No abstract available.
Humans ; Hypoplastic Left Heart Syndrome* ; Survivors*

No abstract available.