BACKGROUND: Stellate ganglion block, which is one of the effective therapeutic tools for treating herpes zoster has been advocated by many investigators. However its efficacy is controversial at present. OBJECTIVE: This study was conducted to examine the role of stellate ganglion block in the prevention of postherpetic neuralgia and relationships between the time of this treatment and the outbreak of postherpetic neuralgia. METHODS: Twenty patients over the age of fifty with herpes zoster were included in this study. Before treatment, we randomly divided patients into two groups, A and B. Group A was treated with stellate ganglion block and acyclovir and group B was treated with acyclovir alone. Also we subdivided each group by starting treatment time into group 1 and 2. Group 1 was defined as the patients who began treatment within 2 weeks of the onset of the skin lesion. We observed the severity of pain and the incidence of postherpetic neuralgia according to each group.
Acyclovir ; Herpes Zoster* ; Humans ; Incidence ; Neuralgia, Postherpetic ; Research Personnel ; Skin ; Stellate Ganglion*

No abstract available.
Carcinoma, Renal Cell*

OBJECTIVE: Abnormal uterine bleeding is one of the most common disorder in gynecologic department. Organic causes of abnormal uterine bleeding are chronic cervicitis, submucosal myoma, endometrial polyp, endometrial malignancy. To find the exact cause of uterine bleeding and rule out the organic uterine disorder in the patients who considered dysfunctional uterine bleeding, hysteroscopic examination and endometrial biopsy were used. METHODS: Study group were 106 patients, who received hysteroscopic endometrial biopsy from 2. 2000 to 8. 2001.with abnormal uterine bleeding, negative in urine pregnancy test, normal in cervix cytology, and without organic lesion causing uterine bleeding in pelvic exam and ultrasonography. Age, parity, hysteroscopic biopsy result were analyzed retrospectively. RESULTS: Mean age of the study group was 43 and mean parity was 2.6. When final hysteroscopic biopsy histology were analysed, proliferative phase was most common (28.3%). Next were secretory phase (17.9%), simple hyperplasia (13.2%), endometrial polyp (10.6%), chronic endocervicitis (4.7%). Submucosal myoma, endometrial cancer, complex hyperplasia were detected in 3.8% each one. Of 106 patients, who considered dysfunctional uterine bleeding, only 63 (59.4%) patients were proved true DUB on hysteroscopic biopsy. Remainder had organic disorder (40.6%). CONCLUSION: When patients visited the hospital with abnormal uterine bleeding, doctors should be suspicious of endometrial organic disease and treat the patients with exact diagnosis. In these patients, hysteroscopic examination and biopsy were very useful and safe method to determine exact diagnosis and treatment plan.
Biopsy ; Cervix Uteri ; Diagnosis ; Endometrial Neoplasms ; Female ; Gynecological Examination ; Humans ; Hyperplasia ; Hysteroscopy ; Metrorrhagia ; Myoma ; Parity ; Polyps ; Pregnancy ; Pregnancy Tests ; Retrospective Studies ; Ultrasonography ; Uterine Cervicitis ; Uterine Hemorrhage

PURPOSE: The role of [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) in renal cell carcinoma remains to be clearly defined. The sensitivity, specificity and accuracy of FDG-PET to detect renal cell carcinomas and a distant metastatic disease were compared with other established imaging modalities, including computerized tomography (CT), chest PA and bone scan. MATERIALS AND METHODS: FDG-PET and conventional imaging techniques, including CT, chest PA and bone scan, were performed in 43 patients with primary renal tumors and/or metastatic diseases. Radical nephrectomy and metastatectomy were then performed. The results of FDG-PET were compared with the conventional imaging techniques and postoperative histopathological diagnoses. RESULTS: The postoperative histopathological diagnoses of the 43 patients were renal cell carcinomas in 41 and benign renal tumors in 2. The results of FDG-PET were true positive, equivocal and false negative in 26, 8 and 9 of the 41 patients with renal cell carcinomas, respectively. The results of the CT were true positive in all patients. The results of FDG-PET were true negative in 2 patients, but those of CT were false positive in 2 patients with benign renal leiomyoma and angiomyolipoma. Therefore, FDG-PET was less sensitive, but more specific and accurate, than CT for the evaluation of primary renal tumors. CT was false positive for retroperitoneal lymph node metastasis and at the ascending colon in each of 1 patient, but FDG-PET was true negative. FDG-PET detected unsuspected pulmonary metastatic diseases that were not detected on chest PA in 4 patients. FDG-PET was more sensitive, specific and accurate than CT in the evaluation of metastasis. CONCLUSIONS: FDG-PET was complementary to conventional imaging in the initial staging of renal cell carcinomas, but superior in evaluating the metastasis.
Angiomyolipoma ; Carcinoma, Renal Cell ; Colon, Ascending ; Diagnosis* ; Electrons* ; Fluorodeoxyglucose F18 ; Humans ; Leiomyoma ; Lymph Nodes ; Neoplasm Metastasis ; Nephrectomy ; Positron-Emission Tomography* ; Sensitivity and Specificity ; Thorax

PURPOSE: To determine the impact of interstitial laser coagulation (ILC) on the quality of life and sexual function in patients with a benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Eighty-nine patients treated with ILC were prospectively evaluated. The treatment outcome was evaluated 1, 3, 6 months and 1 year after the ILC with the international prostate symptom score (IPSS), the prostate volume, the peak urinary flow rate (Q-max), the post-void residual urine (PVR), and the quality of life assessment score. In addition, a self-reporting questionnaire including the International Index of Erectile Function (IIEF) were completed before and 3 months after treatment to determine the impact on sexual function. RESULTS: ILC showed significant improvement in the clinical and voiding parameters (IPSS, Q-max, PVR, prostate size). After ILC, 76% of patients were satisfied with the treatment and the quality of life score improved significantly after 3 months. There was no significant difference between the mean scores of the pretreatment and post-treatment erectile function, orgasmic function, sexual desire and intercourse satisfaction. However, the overall satisfaction score decreased from the pre-operative value of 3.05 to a post-operative value of 2.27 (p<0.05). An ejaculation loss or severe decrease in ejaculate volume was reported in 11 (23%) of the 46 patients followed up after ILC. Interestingly, only 5 (45%) of the 11 patients with a loss of ejaculation or severe decrease in ejaculate reported a deterioration of their sex life, while only 1 (4%) of the 23 without any change in ejaculate volume reported such deterioration. CONCLUSIONS: There were no significant changes in sexual desire, erectile function, orgasmic function, and intercourse satisfaction with ILC. However, the overall satisfaction decreased after ILC. Post-treatment sexual dysfunction appears to be mainly related to the impaired ejaculatory function.
Ejaculation ; Humans ; Laser Coagulation* ; Male ; Orgasm ; Prospective Studies ; Prostate ; Prostatic Hyperplasia* ; Quality of Life* ; Surveys and Questionnaires ; Treatment Outcome

A 38-year-old female patient had bradycardia in the preoperative electrocardiogram (ECG), and she showed severe bradycardia, with the heart rate (HR) under 40 beats per minute (bpm) even after arrival in the operating room. Immediately after endotracheal intubation, ventricular tachycardia with HR over 200 bpm occurred, but it disappeared voluntarily. The surgery was postponed for additional cardiac evaluation because of the persistent severe bradycardia. On postanesthesia day 2, complete atrioventricular (AV) block appeared. We expected spontaneous recovery over 2 weeks, but the complete AV block persisted. A permanent pacemaker was eventually inserted, and the patient was discharged without other complications on day 4 after insertion of the pacemaker. We report this case because complete AV block has commonly occurred in patients with risk factors such as first AV block, secondary AV block, or bundle branch block, but complete AV block has occurred despite the absence of arrhythmia in this patient.
Adult ; Anesthesia, General ; Arrhythmias, Cardiac ; Atrioventricular Block ; Bradycardia ; Bundle-Branch Block ; Electrocardiography ; Female ; Heart Rate ; Humans ; Intubation, Intratracheal ; Operating Rooms ; Risk Factors ; Tachycardia, Ventricular

Myristoylated alanine-rich C kinase substrate (MARCKS) is a widely distributed protein kinase C (PKC) substrate and has been implicated in actin cytoskeletal rearrangement in response to extracellular stimuli. Although MARCKS was extensively examined in various cell culture systems, the physiological function of MARCKS in the central nervous system has not been clearly understood. We investigated alterations of cellular distribution and phosphorylation of MARCKS in the hippocampus following kainic acid (KA)-induced seizures. KA (25 mg/kg, i.p.) was administered to eight to nine week-old C57BL/6 mice. Behavioral seizure activity was observed for 2 h after the onset of seizures and was terminated with diazepam (8 mg/kg, i.p.). The animals were sacrificed and analyzed at various points in time after the initiation of seizure activity. Using double-labeling immunofluorescence analysis, we demonstrated that the expression and phosphorylation of MARCKS was dramatically upregulated specifically in microglial cells after KA-induced seizures, but not in other types of glial cells. PKC alpha, beta I, beta II and delta, from various PKC isoforms examined, also were markedly upregulated, specifically in microglial cells. Moreover, immunoreactivities of phosphorylated MARCKS were co-localized in the activated microglia with those of the above isoforms of PKC. Taken together, our in vivo data suggest that MARCKS is closely linked to microglial activation processes, which are important in pathological conditions, such as neuroinflammation and neurodegeneration.
Up-Regulation/drug effects ; Time Factors ; Seizures/chemically induced/*metabolism ; Protein Kinase C-delta/analysis ; Protein Kinase C-alpha/analysis ; Protein Kinase C/*analysis ; Protein Biosynthesis/drug effects ; Phosphorylation/drug effects ; Microscopy, Confocal ; Microglia/cytology/drug effects/*metabolism ; Mice, Inbred C57BL ; Mice ; Membrane Proteins/*analysis/metabolism ; Kainic Acid/*toxicity ; Isoenzymes/analysis ; Intracellular Signaling Peptides and Proteins/*analysis/metabolism ; Immunohistochemistry ; Animals

We have experienced a case of idiopathic erythrocytosis developed in a patient with end stage renal disease who had switched to CAPD from hemodialysis. Hemoglobin levels gradually increased from 8 to 19.0 mg/dl, resulting in various symptoms from hyperviscosity during the first 2 months after the initiation of CAPD. There were no other possible causes of secondary erythrocytosis, such as hypoxia, erythropoietin -producing tumor or acquired cyst. Serum level of IGF-1 was above the normal range in contrast with low serum levels in CAPD patients with anemia. Increased IGF-1 levels may possibly influence on the development of erythrocytosis in this case.
Anemia ; Anoxia ; Erythropoietin ; Humans ; Insulin-Like Growth Factor I ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Polycythemia* ; Reference Values ; Renal Dialysis

BACKGROUND: Minimum alveolar concentration (MAC) is decreased during pregnancy, but there are no data regarding the requirements for intravenous agents. Recently only one study showed that the requirement for thiopental in pregnant women of 7-13 weeks' gestation was less than the requirement obtained in nonpregnant women. Thus we wanted to determine whether pregnant patients needed less propofol for hypnosis and anesthesia than nonpregnant patients. METHODS: One hundred nonpregnant women having gynecologic surgery and 100 pregnant women of 5-13 weeks' gestation undergoing elective abortions were recruited. They were randomly allocated 10 groups according to the doses of propofol and each group had 10 patients. During a period of 30 seconds, one of the doses of propofol 1.0, 1.25, 1.5, 1.75, 2.0, 2.25, 2.5, 2.75, 3.0 or 3.25 mg/kg was administered. Two minutes later, patients were asked to open their eyes as a test for hypnosis. Patients who did not open their eyes were given a 10 seconds, 50-Hz, 80-mA transcutaneous tetanic electrical stimulus to the ulnar nerve as a test for anesthesia. Estimates of ED50 and ED95 for hypnosis and anesthesia were obtained by logistic regression. RESULTS: In the pregnant women, the median effective doses (ED50) (95% confidence interval) for hypnosis and anesthesia were 1.25 (1.13-1.35) mg/kg and 2.71 (2.49-3.04) mg/kg, the ED95 (95% CI) were 1.51 (1.16-1.87) mg/kg and 3.04 (2.80-3.58) mg/kg respectively. Whereas in the nonpregnant women, the ED50 for hypnosis and anesthesia were 1.27 (1.39-1.90) mg/kg and 4.12 (3.50-6.01) mg/kg, the ED95 were 1.53 (1.41-1.93) mg/kg and 4.35 (3.66-7.26) mg/kg respectively. CONCLUSIONS: In early pregnant women, the doses of propofol for hypnosis and anesthesia were 1.6% and 34.2% less compared with those in nonpregnant women.
Anesthesia ; Female ; Gynecologic Surgical Procedures ; Humans ; Hypnosis ; Logistic Models ; Pregnancy* ; Pregnant Women ; Propofol* ; Thiopental ; Ulnar Nerve