No abstract available.
Intestinal Atresia*

We report 2 cases of unusual ureteral tumor. A case appeared as bladder tumor causing ureteral obstruction by outgrowing of the tumor of terminal ureter into the bladder wall. The surface of bladder mucosa was intact. The other one presented as a large retroperitoneal mass causing obstruction of the external iliac vein such as an ovarian tumor. The literature is reviewed briefly.
Iliac Vein ; Mucous Membrane ; Ureter* ; Ureteral Obstruction ; Urinary Bladder ; Urinary Bladder Neoplasms

Administration of succinylcholine for intratracheal intubation may cause untoward reactions such as elevation of intraocular and intrabdominal pressure, increased plasma potassium level, and development of postoperative muscle pain, ets. The fasciculation of muscle fibers caused by nondepolarizing activity of succinylcholine may be responsible for those reactions, although this is not clearly defined. Several attempts ehterfore, have been made to minimize the development of muscle fasciculation following administration of succinylcholine. Of thest, self-taming of succinylcholine, pretreatment wit small doses of non-depolarizing neuromuscular blockers, or the use of hexafluorenium are examples. The authors observed the effects of succinylcholine on intraocular pressure and the degree of muscle fasciculation after self taming of succinylcholine. pretreating the patients with d-tubocurarine and pancuronlum before administration of succinylcholine was also studied. All three techniques showed significant decreases in the degree of muscle fasciculation. And small doses of d-tubocurarine and pancuronium did not seem to affect intraocular pressure, although a taming dose of succinylcholine itself caused significant increases in intraocular pressures.
Fasciculation ; Humans ; Intraocular Pressure ; Intubation, Intratracheal ; Myalgia ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pancuronium ; Plasma ; Potassium ; Succinylcholine* ; Tubocurarine

Abdominal pregnancy is a rare variation of ectopic pregnancy, which has been classified as primary or secondary. The clinical characteristics of abdominal pregnancy are extremely variable, so early diagnosis is very difficult. Because of high maternal morbidity and mortality, the prompt surgical intervention is required. Omental pregnancy is a very rare form of abdominal pregnancy, which is hard to detect early. The diagnosis of omental pregnancy is hardly ever made prior to laparotomy. We have experienced a case of omental pregnancy in a 36-year-old woman and report this case with brief review of literature.
Adult ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Laparotomy ; Mortality ; Pregnancy* ; Pregnancy, Abdominal ; Pregnancy, Ectopic

A morphological study on the ultrastructures of the alimentary tract and the excretory system of Clonorchis sinensis was conducted. The liver flukes were collected from rabbit liver six months after the experimental infection The worms were washed with 0.85 percent saline solution and immediately moved to cold 2.5 percent glutaraldehyde in 0.1 M phosphate buffer pH 7.4. The materials were dissected and fixed for two hours. The blocks were post-fixed in 1 percent osmium tetroxide. The blocks were embedded in Epon 812. Ultra thin sections were cut with Sovall MT-2 ultramicrotome and stained with uranyl acetate and lead citrate. Sections were then observed with Hitachi HS-7S electron microscope. The following results were obtained in a series of observations. The walls of oral cavity and esophagus comprised tegumental syncytium, basement membrane, loose connective tissue, muscular layer and parenchymal cells. The apical surface and the base of the syncytium were covered with a protoplasmic membrane for each forming numerous invaginations. Granular endoplasmic reticulum was developed in the epithelium of the oesophagus. The gastrodermis of Clonorchis sinensis comprised two types of cells in general. The first cell type was numerous one forming a single continuous layer of epithelial cells. Each of the cells had outfolded cytoplasm into the caecal lumen and lamellae along the cell surface. Among the above epithelial cells, no considerable differences in structure reflecting their functional states were identified. The second cell type was less differentiated in nature and lay within the gastrodermis above the basement membrane but not in contact with the caecal lumen, being overlapped by neighboring gastrodermal cells of the type described above. At this portion the gastrodermis seemed to be a pseudostratified epithelium. There were well-developed lamellae along the surface of epithelia of all canals or duct concerning evacuation. The excretory pore was 7.5 micrometer in diameter and dorso-terminally opended. The epithelium of the excretory pore, a syncytial layer, contained many microtubules unlike the other part of tegumental layer of this worm. The epithelium thickness of the excretory pore was very irregular(1.3-5.5 micrometer).
parasitology-helminth-trematoda ; Clonorchis sinensis ; electron microscopy ; alimentary tract ; liver ; rabbit

Until several years ago it was generally agreed that anihypertensive medication should be stopped a few weeks before anesthesia and surgery in order to regain the compensatory function of cardiovascular system during anesthesia and surgical stress. However the present concept is that the better the hypertension is controled the more the patient's chances of surving anesthesia and it is recommended that antihypertensive medication should be continued to the time of anesthesia. The authors have experienced cases of hypertensive patients undergoing various kinds of operation and have-analyzed these cases according to the degree of hypertension, sex, department, anesthetic agent and technique, previous anesthetic medication, abnormal ECG finding and arterial blood pressure changes after anesthesia, at Jeonbug National University Hospital from January 1977 to June 1979. The results were as follows: 1) The number of hypertensive cases was 326 (12. 3%) out of 2664 total patient who received various surgical operations. 2) Only a few patients(16cases, 0. 5%) received antihypertensive medication before surgery. 3) The degree of hypertension was mostly class 1 or 2(274 patients, 78%) according to the severity index of Elwood 4) Most of the patients (253 cases, 74%) revealed elevated blood pressure after induction of anesthesia.
Anesthesia* ; Arterial Pressure ; Blood Pressure ; Cardiovascular System ; Electrocardiography ; Humans ; Hypertension ; Jeollabuk-do

Spermatogenesis in liver flukes, C. sinensis, was investigated by using light and electron microscopes. The epithelium of the testis was composed of a basement membrane, numerous lamellae protuded from the membrance and large number of spermatogonia supported by the lamellae. The lumen of the testis was filled with numerous 8, 16 and 32-cell groups representing primary spermatocytes, secondary spermatocytes and spermatids respectively. None of cell groups with over 32 or under 8 cells was noticed. The process of spermatogenesis is presumably as follows; A cell group of 8 spermatogonia, attached together by a cytophore, is separated from the testis epithelium during the growth period, thus becoming primary spermatocytes. The primary spermatocytes divide to form a cell group of 16 secondary spermatocytes giving rise to a cell group of 32 spermatids through meiotic germ cell division. The spermatids begin to undergo a spermiogenesis. The newly formed sperms remain attached together in the lumen for a while before migrating through the vasa efferentia.
parasitology-helminth-trematoda ; Clonorchis sinensis ; spermatogenesis ; morphology ; electronmicroscopy

BACKGROUND: This study was designed to determine whether etomidate-based induction can provide better hemodynamics than a standard thiopental sodium-based anesthetic induction in elderly patients. METHODS: Sixty ASA physical status 1 or 2 elderly patients scheduled for elective surgery were randomly allocated into one of three groups (Group 1; thiopental sodium, Group 2; etomidate, Group 3; pre-treatment with 0.02 mg/kg of midazolam and etomidate). We measured and compared hemodynamic changes (mean arterial pressure, heart rate), the doses of thiopental sodium and etomidate for loss of consciousness, the incidence and grade of myoclonus, and the bispectral index during induction of anesthesia. RESULTS: There were no significant differences in mean arterial pressure and heart rate among the three groups. Myoclonus occurred in 45% of patients receiving etomidate, 40% of patients receiving midazolam pre-treatment and etomidate. Pre-treatment of midazolam reduced the dose of etomidate for loss of consciousness by 20% in Group 3. The values of BIS decreased significantly from 1 minute after infusion of thiopental and etomidate, and reached 56.9 +/- 12.3 in group 1, 41.8 +/- 9.1 in group 2, and 45.8 +/- 8.5 in group 3 just before endotracheal intubation. CONCLUSIONS: These results indicate that there is no significant difference between etomidate and thiopental sodium as anesthetic induction agents in elderly patients. Pre-treatment with a small dose of midazolam reduced the dose of etomidate for loss of consciousness, but did not affect the incidence of myoclonus and hemodynamic changes during induction of anesthesia with etomidate.
Aged* ; Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Etomidate* ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Intubation, Intratracheal ; Midazolam ; Myoclonus ; Thiopental* ; Unconsciousness

BACKGROUND: Although vitamin D analogs have been used in the topical treatment of psoriasis, their mechanisms of action are not well understand. Calcitriol, the hormonally active vitamin D3 metabolite, has been demonstrated to exert immunomodulatory effects in the skin by down-regulating the expression of Toll-like receptors (TLRs) and proinflammatory cytokines. OBJECTIVE: We investigated the effects of calcitriol on the expression of TLR2, TLR4, antimicrobial peptide LL-37, and proinflammatory cytokines in cultured human keratinocytes. METHODS: The mRNA expression levels of TLR2, TLR4, tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-1beta and LL-37 in cultured human keratinocytes were measured by real-time polymerase chain reaction (PCR) and reverse transcription (RT). Furthermore, we measured supernatant TNF-alpha levels by an enzyme-linked immunosorbent assay (ELISA) to confirm the effects of calcitriol on TLR2 and TLR4. RESULTS: As measured by RT-PCR and real-time PCR, calcitriol was found to suppress the lipopolysaccharide- and ultraviolet B radiation-mediated induction of expression of TLRs, LL-37 and proinflammatory cytokines such as TNF-alpha and IL-1beta in normal human keratinocytes. The supernatant TNF-alpha levels measured by ELISA were also suppressed after treatment with calcitriol. CONCLUSION: Calcitriol may down-regulate inflammatory stated over-expression of LL-37 and proinflammatory cytokines.
Calcitriol* ; Cholecalciferol ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukins ; Keratinocytes* ; Psoriasis ; Real-Time Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger* ; Skin ; Toll-Like Receptors ; Tumor Necrosis Factor-alpha ; Vitamin D

BACKGROUND: A rapid increase in isoflurane concentration induces tachycardia and hypertension and increases plasma catecholamine concentration. The current study examined the effects of the rate of increase in inhaled isoflurane concentration on the circulatory responses. METHODS: Unpremedicated sixty three ASA physical status 1 patients, aged 20-40 years, scheduled for elective surgery under general anesthesia were randomly allocated into one of three groups. In each group, the inspired concentration of isoflurane via mask was increased up to 5 vol% at the rate different from other groups. The inspired concentration of isoflurane via mask was increased to 5.0 vol% abruptly (group 1), for 100 seconds (group 2), or 200 seconds (group 3). The target was to produce an end-tidal concentration of isoflurane (ETisof) of 2.6 vol% which was maintained until the end of the study by adjusting the vaporizer setting, when necessary. Heart rate (HR), mean arterial pressure (MAP), ETisof, end-tidal concentration of carbon dioxide, and peripheral oxygen saturation were measured at baseline and every 30 seconds for 5 minutes after inhalation of isoflurane and for 2 minutes after intubation. RESULTS: HR and MAP were significantly increased in all three groups compared with baseline, but significant differences in maximum values were not observed in three groups. There were significant differences among the groups in time from the onset of isoflurane inhalation to the maximal effect on HR and MAP. However, there were no significant differences among the groups of the ETisof at the maximal HR and MAP were seen. CONCLUSIONS: The high concentration of isoflurane transiently increase HR and MAP during inhaled anesthesia induction. However, the rate of increase in inhaled isoflurane concentration does not affect the circulatory responses.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Carbon Dioxide ; Heart Rate ; Humans ; Hypertension ; Inhalation ; Intubation ; Isoflurane* ; Masks ; Nebulizers and Vaporizers ; Oxygen ; Plasma ; Tachycardia