No abstract available.
Carcinoma, Hepatocellular* ; Classification*

A 69 years old, otherwise healthy male pt. was admitted and soheduled for subtotal gastrectomy under the Dx. of stornach Ca. The induction of anesthesia and beginning of Operation were smooth and unevntful. After peritoneal opening, the surgeon complained of distended stomach which was synch- ronous with ventilation. With repeating tracheogram and endoscopic examination, the authors fecund unsuspected tracheo-esophageal fistula on the low-middle esophagus. Durins convalescenee the pt, had not suffered any pulmonary complication.
Aged ; Anesthesia ; Anesthesia, General* ; Esophagus ; Fistula* ; Gastrectomy ; Humans ; Male ; Stomach ; Ventilation

No abstract available.
Antibodies, Antiphospholipid* ; Rheumatic Diseases*

PURPOSE: This study was performed to investigate the cellular characteristics of the secondary pupillary membrane. METHODS: The secondary pupillary membrane was removed from the anterior lens surface during cataract extraction from 2 patients with cataract associated with uveitis. Specimen from one patient was stained with hematoxylin-eosin with flat preparation method. Specimen from the other patient cultured for 1 and 2 weeks was observed with transmission electron microscopy. RESULTS: The flat preparation showed the neovascular membrane with pigment-laden cells. The cultured cells consisted of the well preserved vascular components which had the vascular endothelial cells and pericyte and pigment-laden cells lined by basement membrane on first week of culture. The iris pigment epithelial cell which contained the pigment granules within cytoplasm and lined by basement membrane were observed on second week of culture. CONCLUSIONS: These results suggest that the secondary pupillary membrane consists of vascular membrane and pigment epithelial cell of iris which is a major component of secondary pupillary membrane and secrets extracellular matrix.
Basement Membrane ; Cataract ; Cataract Extraction ; Cells, Cultured ; Cytoplasm ; Endothelial Cells ; Epithelial Cells ; Extracellular Matrix ; Humans ; Iris ; Membranes* ; Microscopy, Electron, Transmission ; Pericytes ; Uveitis

BACKGROUND: Fluoxetine, a widely used antidepressant drug, has been described as a selective serotonin reuptake inhibitor. In addition to its antidepressant action it has been demonstrated to be effective in alleviating pain associated with various diseases. Dorsal root ganglion (DRG) neurons are primary sensory neurons and transmit peripheral information to central nervous system. Two types of sodium channels are expressed in DRG neurons based on their sensitivity to tetrodotoxin. They are involved in the generation and conduction of nociception. The effects of fluoxetine on sodium currents in DRG neurons were examined to elucidate the analgesic mechanism of the drug. METHODS: DRG neurons wereacutely dissociated from rats (2~6 days postnatal) by enzymatic digestion. The whole-cell configuration of patch clamp technique was used to record tetrodotoxin-sensitive (TTX-S) and tetrodotoxin-resistant (TTX-R) sodium currents. RESULTS: Fluoxetine inhibited TTX-S and TTX-R sodium currents with Kd values of 60 microM and 59 microM, respectively, at the holding potential of -80 mV. For both types of sodium channels the steady-state inactivation curves were shifted in the hyperpolarizing direction and the conductance-voltage relationship curves were shifted in the depolarizing direction by fluoxetine. These effects combined together would greatly reduce the neuronal excitability. CONCLUSIONS: The blockade of sodium currents in sensory neurons is considered as a possible mechanism for the analgesic action of fluoxetine.
Animals ; Central Nervous System ; Diagnosis-Related Groups ; Digestion ; Fluoxetine* ; Ganglia, Spinal ; Neurons ; Nociception ; Rats* ; Sensory Receptor Cells* ; Serotonin ; Sodium Channels ; Sodium* ; Tetrodotoxin

Analyses and studies have been made on 34 cases of the combined ICH, showing mass effect among 305 male and female ruptured intracranial aneurysmal patients who were admitted to Kyungpook National University Hospital from Mar. 1984, through Feb. 1990. The incidence of the large ICH was 11.1% with 2.1 to 1 ratio of male to female. The highest age incidence of the hematoma was in the 40 to 60 years bracket. The most frequent site of the aneurysm combined with the large ICH was at MCA aneurysm, 38.6%, followed by at A-com artery aneurysm, 4.8%. The most frequent location of the hematoma was in temporal lobe, 88.2%. The rate of combined large ICH was 20.3% in multiple aneurysmal bleeding patients who revealed higher incidence of the hematoma than the single bleeding patients. In amount of the hematoma, 30-40ml bracket ranked top occupying 32.4% of all cases. After surgical treatment, 29.4% patient was improved to the good and fair on discharge. The rate of mortality was 61.8%, which was mainly due to direct effect of hematoma and cerebral infarction caused by vasospasm.
Aneurysm ; Arteries ; Cerebral Infarction ; Female ; Gyeongsangbuk-do ; Hematoma* ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Temporal Lobe

OBJECTIVES: After the investigation of one worker with occupational asthma, we surveyed the prevalence of occupational asthma and the exposure level of pharmaceutical dust of 32 workers in a pharmaceutical company. METHODS: Thirty-two of the 90 employees participated in the survey which consisted of questionnaire, blood sampling, spirometry and skin prick tests with 8 common allergens as well as 9 antibiotics and 2 enzymes. Various indices of the working environment were also measured. Subjects who had a symptom suggestive of work-related asthma or positive skin prick test were further investigated by PC20 methacholine. Nine subjects who had a PC20 result of 16 mg/ml or less (n=7) or had work-related symptoms and positive skin prick test (n=2) were referred to undergo a specific bronchial provocation test to pharmaceutical dust in an academic allergic disease center. RESULTS: Eleven of 32 workers (34.4%) had a work-related symptom suggestive of occupational asthma. Ten (31.2%) showed positive skin prick test. 8 (25.0%) had a PC20 result of 16 mg/ml or less (indicative of significant bronchial hyperresponsiveness), and 5 (15.6%) had a positive result on the specific bronchial provocation test. Exposure levels of stuffing, input of raw materials and screening process were relatively high. CONCLUSIONS: This survey showed that pharmaceutical workers have an increased risk of occupational asthma. Although pharmaceutical factories maintain a relatively good working environment, careful control of respiratory tract exposures, especially during stuffing, input of raw materials and screening process, is important to prevent occupational asthma. Pharmaceutical workers need to undergo regular skin prick and methacholine bronchial provocation tests, as well as asthmatic symptom survey, to ensure the early detection and prevention of occupational asthma.
Allergens ; Anti-Bacterial Agents ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Dust* ; Mass Screening ; Methacholine Chloride ; Prevalence* ; Questionnaires ; Respiratory System ; Skin ; Spirometry

The endoscopic diagnosis of gastric carcinoid has been considered difficult. Reported cases of this tumor diagnosed by endoscopic examination are rare. And the gastric carcinoid with massive upper gastrointestinal bleeding is a rare disease entity. We experienced a case of gastric carcinoid admitted to the hospital because of hematemesis, melena and syncope. And it was diagnosed by endoscopic biopsy, although it resembled type IIa+IIc early gastric cancer at endoscopic examination. To our knowledge, this is the first case report of gastric carcinoid tumor mimicking early gastric cancer. So we report this case with a review of relevant literatures.
Biopsy ; Carcinoid Tumor* ; Diagnosis ; Hematemesis ; Hemorrhage ; Melena ; Rare Diseases ; Stomach Neoplasms* ; Syncope

The prevalence of colon cancer is increasing in Korea and the principal strategy of its management is early detection and surgical resection. For the early detection of colon cancer, endoscopic evaluation is important and the ability to find out early stage small lesion is needed for the endoscopist. To find out encloscopic features of early colon cancer, we reviewed 17 cases of early colon cancer who have admitted to Seoul National University Hospital from January 1982 to December 1993. 1)59% of the lesions were located in rectum and the size ranged from 0.7cm to 9cm, all of the 17 cases showed polypoid mass contour and the surface of them had erosion, hyperemia, ulceration and easy touch bleeding tendency. 2) Colon cancer was diagnosed by endoscopic gross findings in 41% and endoscopic biopsy could confirm colon cancer in 70%. However, barium enema could diagnose only 41% of early colon cancer. 3) Five cases were operated under the diagnosis of colonic adenoma which were large(>3 cm) villous type or contained severe dysplasia 4) Submucosal tumor infiltration was found in 10 cases and 65% had associated adenoma 5) Lymph node involvement was none and there was no recurrence in 47 month follow up period after various surgical treatments.
Adenoma ; Barium ; Biopsy ; Colon* ; Colonic Neoplasms* ; Diagnosis ; Endoscopy ; Enema ; Follow-Up Studies ; Hemorrhage ; Hyperemia ; Korea ; Lymph Nodes ; Prevalence ; Rectum ; Recurrence ; Seoul ; Ulcer

BACKGROUND: To evaluate the efficacy and safety of gemcitabine and cisplatin chemotherapy in advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Forty patients (21 men, 19 women ; age range, 37 to 73 years; median, 63 years) with unresectable stage IIIB to IV NSCLC were evaluated. Patients received cisplatin 60mg/m2 (Day 1), gemcitabine 1200mg/m2 (Day 1 and 8) every 21 days. Eighteen patients had stage IIIB disease and 22 had stage IV. There were 28 patients of adenocarcinoma (70.0%), 11 of squamous cell carcinoma (27.5%), and one of large cell carcinoma (2.5%). RESULTS: Of 40 patients, no patients showed complete response while 15(37.5%) showed partial response, 7(17.5%) had stable diseases, 18(45%) had progressive diseases. During a total of 195 courses of chemotherapy, grade 3 or more granulocytopenia and thrombocytopenia occured in 12.5% and 2.5% of patients respectively. Non-hematologic toxicity was mild and easily controlled. There was one case of treatment-related death by pneumomia. The median survival was 55 weeks (95% CI, 34~75weeks), and the time to progression was 19 weeks (95% CI, 16~23weeks). One year survival rate was 55% and 2 year survival rate was 10%. CONCLUSION: The efficacy of cisplatin and gemcitabine combination chemotherapy was acceptable in the treatment of advanced NSCLC.
Adenocarcinoma ; Agranulocytosis ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Male ; Survival Rate ; Thrombocytopenia