No abstract available.
Nortriptyline* ; Pharmacokinetics*

PURPOSE: To evaluate the extrahepatic spread of peripheral cholangiocarcinoma with CT. MATERIALS AND METHODS: We retrospectively reviewed CT findings of extrahepatic spread in thirty-six patients with peripheral cholangiocarcinoma confirmed adenocarcinoma at surgery(n=5) or percutaneous biopsy(n--31) without primary leion in other organs, and analysed the frequency and distribution of enlarged lymph nodes, direct invasion of adjacent solid organs, and thrombosis of major vessels. RESULTS: Among the 36 cases, enlarged metastatic lymph node was noted in twenty-four(66.7%), direct invasion into adjacent organs in six(16.7%), portal and inferior vena caval thrombosis in five(13.9%). Enlarged lymph nodes were seen in hepatic nodes(n=16, 44.4%), portocaval nodes(n=15, 41.7%), interaortocaval nodes (n=10, 27.8) and celiac nodes in two(5.6%). Direct invasion was detected in the greater omentum(n=6), gallbladder(n:3) and stomach(n=2). Portal vein thrombosis(n:5) and thrombosis of inferior vena cava(n=2) were noted. CONCLUSION: Lymph node metastasis was seen in 67% in patients with peripheral cholangiocarcinoma. Direct invasion to adjacent organs and thrombosis in portal vein or inferior vena cava were occasionally associated.
Adenocarcinoma ; Cholangiocarcinoma* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Portal Vein ; Retrospective Studies ; Thrombosis ; Vena Cava, Inferior

BACKGROUND: Dandruff is a common complaint, and is suffered by up to 50% of the population at some time. Malassezia yeasts, which comprise part of the normal skin flora, might be a critical factor in this disease, as they have been found in higher proportions in patients with seborrheic dermatitis or dandruff, its milder form. OBJECTIVE: The aim of this study was to evaluate the clinical efficacy of 4 weeks of treatment with 1% zinc pyrithione (ZP) shampoo. METHODS: A randomized, double-blind, 4-week treatment period was preceded by a 1-week run-in period. A total of 30 patients were enrolled in this study. Assessments included the patient's subjective score (PSS) and the investigator's assessment score (IAS), images of the affected scalp area, the severity of sebum production, and the erythema and moisturizing effect of the shampoo. RESULTS: 1% ZP shampoo significantly reduced the extent and severity of scaling, as measured by folliscope imaging on visit 2 (p=0.0391) and visit 3 (p=0.0381), as well as pruritus related to the disease as measured by the grading systems, PSS (p=0.0352) and IAS (p=0.0142). Additionally, the results of this study show that a treatment regimen with 1% ZP shampoo significantly reduced scalp sebum production as measured by a sebumeter. Erythema measured by the chromameter was not as meaningful. The corneometric values were slightly increased in the group treated with 1% ZP shampoo but not in the group treated with ZP-free shampoo. Side effects of the ZP shampoo were quite mild and tolerable, and were observed only in a small group of patients. CONCLUSION: 1% ZP shampoo appears to be both effective and well-tolerated when used for the treatment of dandruff.
Dermatitis, Seborrheic ; Erythema ; Humans ; Malassezia ; Organometallic Compounds ; Pruritus ; Pyridines ; Scalp ; Sebum ; Skin ; Yeasts ; Zinc

The incidence of multiple primary cancers is low than that of single primary cancer. In gastric cancer, incidence of occurrence of multiple primary cancer is 3 to 11.3%. Because stomach and lung are unrelated organs, the combination of gastric cancer and lung cancer is rare. Its estimated incidence is about 10% of all multiple primary cancers. The histologic types of secondary lung cancer in one series, squamous cell carcinomas were 49%; adenocarcinomas were 28%; large cell carcinomas were 14%; small cell carcinomas were 9%; others were 6%. This patient had been diagnosed as early gastric cancer 3 years ago, but he refused operation for cancer and wasnt followed up. After 3 years, he revisited us for dry coughing and diagnosed as small cell lung cancer. At this time, previous gastric cancer was remained as well differentiated, early gastric adenocarcinoma. For its rarity, we report this case with review of literatures.
Adenocarcinoma ; Carcinoma, Large Cell ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Cough ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Small Cell Lung Carcinoma* ; Stomach ; Stomach Neoplasms*

BACKGROUND AND OBJECTIVES: To determine the anatomic position of the inferior alveolar nerve (IAN) canal in patients with mandibular prognathism using the cone-beam CT (CBCT). MATERIALS AND METHODS: Fifty rami from 25 patients were evaluated. The images were taken by i-CAT and reconstructed 3-dimensionally using the Simplant 11 program. The linear distances between the IAN canal to the buccal cortex (a, a* and a**), from the IAN canal to the alveolar crest (b and b*) and the anterior margin (b**) and finally the buccal cortical thickness (c, c* and c**) were measured at three reference planes (VP, OP and HP). RESULTS: On the left side, the average distance of a, b and c were 7.12, 15.96 and 3.60 mm on the VP plane, respectively. On the OP, the distance of a*, b* and c* was 6.11, 8.83 and 2.63 mm. For the HP, the distance of a**, b** and c** was 4.84, 10.11 and 2.30 mm. On the right side, the distance of a, b and c, on the VP, was 7.10, 16.13 and 3.42 mm, respectively. On the OP, the distance of a*, b* and c* was 4.77, 8.75 and 2.68 mm. On the HP, the distance of a*, b* and c** was 4.55, 9.84 and 2.38 mm. Regarding the difference between genders, the distance in male's was longer than female's on the VP (p=0.019), and was thicker in males than females on the HP (p=0.002). CONCLUSION: The CBCT data provided accurate information about the location and course of the IAN.
Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Mandibular Nerve ; Prognathism

BACKGROUND AND OBJECTIVES: To determine the anatomic position of the inferior alveolar nerve (IAN) canal in patients with mandibular prognathism using the cone-beam CT (CBCT). MATERIALS AND METHODS: Fifty rami from 25 patients were evaluated. The images were taken by i-CAT and reconstructed 3-dimensionally using the Simplant 11 program. The linear distances between the IAN canal to the buccal cortex (a, a* and a**), from the IAN canal to the alveolar crest (b and b*) and the anterior margin (b**) and finally the buccal cortical thickness (c, c* and c**) were measured at three reference planes (VP, OP and HP). RESULTS: On the left side, the average distance of a, b and c were 7.12, 15.96 and 3.60 mm on the VP plane, respectively. On the OP, the distance of a*, b* and c* was 6.11, 8.83 and 2.63 mm. For the HP, the distance of a**, b** and c** was 4.84, 10.11 and 2.30 mm. On the right side, the distance of a, b and c, on the VP, was 7.10, 16.13 and 3.42 mm, respectively. On the OP, the distance of a*, b* and c* was 4.77, 8.75 and 2.68 mm. On the HP, the distance of a*, b* and c** was 4.55, 9.84 and 2.38 mm. Regarding the difference between genders, the distance in male's was longer than female's on the VP (p=0.019), and was thicker in males than females on the HP (p=0.002). CONCLUSION: The CBCT data provided accurate information about the location and course of the IAN.
Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Mandibular Nerve ; Prognathism

Basaloid squamous cell carcinoma (BSCC) is uncommon and distinct variant of squamous cell carcinoma that arises mostly in the upper aerodigestive tract and aggressive, high grade tumor with an increased tendency to be deeply invasive, multifocal, and metastatic even at the initial presentation. The typical microscopic features of carcinoma with a basaloid pattern in intimate association with a squamous component helps in diagnosis of this tumour. Since Wain's report in 1986, BSCC of oral cavity, the palate, floor of the mouth, nasopharynx, oropharynx and mastoid region have been reported. However, BSCC in the nasal cavity or in the paranasal sinuses is rare and there are few reports in the Korean literature. We had experienced a case of basaloid squamous cell carcinoma that occurred in the left maxillary sinus of 72-year-old woman and reported with review of the clinical and pathologic features from the literature.
Aged ; Carcinoma, Squamous Cell* ; Diagnosis ; Female ; Humans ; Mastoid ; Maxillary Sinus* ; Mouth ; Nasal Cavity ; Nasopharynx ; Oropharynx ; Palate ; Paranasal Sinuses

OBJECTIVE: To investigate the clinical characteristics and associated risk factors for emergency peripartum hysterectomy classified by the amounts of blood loss. MATERIAL AND METHODS: We reviewed the medical records of 159 cases of peripartum hysterectomy among 46,666 deliveries, from Jan. 1995 to Dec. 2005 at the Dept. of Ob. & Gy. of Graduate School of Medicine, Gachon University of Medicine and Science. We divided the 159 cases into three groups based on the amounts of blood loss, which were group A as less than 2,000 mL of blood loss, group B as 2,000 to 4,000 mL of blood loss, and group C as more than 4,000 mL. The incidence, the type of delivery, the amounts of transfusion, the operative indication and the complications of peripartum hysterectomy were evaluated. RESULTS: The incidence of peripartum hysterectomy was 0.34% (159/46,666) and 0.47% in cases of cesarean section and 0.19% in vaginal delivery, respectively. There was no meaningful correlation between maternal age, parity, gestational age, hospital stay and amount of blood loss. The increments of blood loss correlated to the frequency of peripartum hysterectomy after cesarean section (p<0.05). The most common operative indication in group A was uterine atony (47.19%), and those in group B and C were adherent placentation (48.08%, 50.00%). Intraoperative and postoperative complications according to excessive bleeding were increased, and DIC, pulmonary infection, urethral and bladder injury were observed more frequently in group C than in group A. CONCLUSION: The emergency peripartum hysterectomy was related to adherent placentation and was accompanied with increased blood loss.
Cesarean Section ; Dacarbazine ; Emergencies ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Length of Stay ; Maternal Age ; Medical Records ; Parity ; Peripartum Period ; Placentation ; Postoperative Complications ; Pregnancy ; Risk Factors ; Urinary Bladder ; Uterine Inertia

BACKGROUND: The sodium concentration in the central nervous system may play an important role in cardiovascular function and body fluid regulation. The purpose of this investigation was to examine the effects of intracerebroventricular (ICV) infusion of hypertonic NaCl solutions on the cardiovascular responses in normotensive and 2-kidney, 1 clip (2K1C) renal hypertensive rats. METHODS: 2K1C hypertension was made by clipping the left renal artery and were used 4 weeks later. Age-matched control rats received a sham treatment. Under thiopental (50 mg/kg, IP) anesthesia, both isotonic and hypertonic NaCl solutions (0.15 M, 0.6 M and 1.2 M) were ICV applied, while blood pressure and heart rate (HR) responses were continuously monitored. RESULTS: Central administration of hypertonic NaCl solution caused an elevation in mean arterial pressure (MAP) and HR in both normotensive and 2K1C hypertensive rats. The response magnitude in the blood pressure was positively correlated to the NaCl concentration in normotensive rats, while the pressor responses to hypertonic NaCl were comparable regardless of the concentration of NaCl in hypertensive rats. Despite of the HR responses were similar in between two groups, the magnitude of the MAP increases were more elevated in hypertensive than in normotensive control rats. Isotonic NaCl solution, when centrally applied, caused an elevation in blood pressure only in hypertensive rats. CONCLUSION: These results indicate that the central sensitivity to sodium chloride is altered in 2K1C renal hypertensive rats.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure ; Body Fluids ; Central Nervous System ; Heart Rate ; Hypertension ; Hypertension, Renal ; Infusions, Intraventricular* ; Placebos ; Rats* ; Renal Artery ; Sodium ; Sodium Chloride ; Thiopental

13 cases of intracranial Aneurysm were obliterated intracranially with Heifetz clip under Halothane /O2 Deliberate Hypotensive anesthesia. Deliberate hypotension in the surgery of intracranial aneurysm is used to diminish bleeding and render an aneurysmal sac slack to make clipping easy. Herein is presented a review of clinical experience of deliberate hypotension in conjunction with postural drainage. Clinical investigation has shown that this method offers a wider margin of safety. All factors stressed again the needs for careful, adequate and ideal clippage of the neck of aneurysm preferably with the use of Heifetz clip. Deliberate hypotension and adequate clippage of the neck of aneurysm subsequently allowed a favorable clinical result with an operative mortality by 7.7%.
Anesthesia* ; Aneurysm ; Drainage, Postural ; Halothane ; Hemorrhage ; Hypotension ; Intracranial Aneurysm* ; Mortality ; Neck