No abstract available.
Complementary Therapies*

No abstract available.
Oncogenes* ; Thyroid Gland*

No abstract available.
Female ; Humans ; Osteoporosis* ; Prevalence* ; Risk Factors*

No abstract available.
Embryonic Development* ; Embryonic Structures* ; Female ; Ovulation* ; Pregnancy

Hepatoid adenocarcinoma of the stomach has been designated to a primary gastric adenocarcinoma with minimum criteria of elevated serum alpha-fetoprotein and its histological resemblance to neoplastic liver cells. Of the 1,500 consecutive cases of surgically resected gastric carcinomas during a period of 4 years, we retrieved 14 cases of adenocarcinoma which met the histologic features of hepatoid growth and compared them histologically with 400 consecutive cases of non-hepatoid gastric adenocarcinomas. The patient's age ragned from 32 to 80 years(non-hepatoid group: 25 to 81 years) and their male to female ratio was 3.7 : 1(non-hepatoid group: 1.8 : 1). Grossly, five case were Borrmann type II and another five cases type III. All three cases of early gastric carcinomas were the submucosal type IIc. The remaining one was an advanced gastric carcinoma mimicking early gastric carcinoma. Microscopically, the hepatoid portions varied in growing patterns and arranged in either compact, trabecular or pseudoglandular pattern and gave an immunoreactivity to alpha-fetoprotein and alpha-1-antichymotrypsin. Regardless of the tumor stage, the hepatoid areas were located in the deeper portion of the tumor mass and grew in an expanding/nodular pattern. The associated adenocarcinomatous areas were mostly papillotubular, moderately to well differentiated, and frequently revealed clear PAS-negative cytoplasm reminiscent of the differentiated embryonal carcinoma. Tumor emboli and nodal metastasis were the frequent associations. We assume that the hepatoid adenocarcinoma may develop from gastric'adenocarcinoma through embryonal carcinomatous growth.
Female ; Male ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

PURPOSE: Laparoscopic nephrectomy has become accepted as a method of simple nephrectomy replacing with open nephrectomy in patients in whom a kidney requires removal for benign disease. Laparoscopic nephrecto my is widely performed and extends its indications. We evaluated our experience with the laparoscopic nephrectomy to assess the clinical efficacy. MATERIALS AND METHODS: Between April 1996 and September 1999, 23 patients (7 men and 16 women, mean age 44.1 years old) underwent laparoscopic nephrectomy, 16 by women, mean age 44.1 years old) underwent laparoscopic nephrectomy, 16 by the transperitoneal approach and 7 by the retroperitoneal approach. Operative and clinical records were reviewed. The underlying pathological conditions included 20 cases of non-functioning kidney, 2 cases of hypoplastic kidney with complete duplication and ectopic ureter, and 1 case of ureter tumor. Four ports (21 cases, two 12mm ports and two 5mm ports) or 5 posts ( 2 cases, two 12mm ports and three 5mm ports) were used. RESULTS: The laparoscopic procedure were successful in 20 cases (87%). Three patients had open conversion due to unclear anatomy, severe adhesion, and adrenal bleeding. In successful cases, mean operative time was 253+/-83 minutes (range 140-545), mean hospital stay was postoperative 5.2 days. Intraoperative and perioperative complications were noted in 6 patients, including bleeding requiring transfusion in 3, wound infection in 1, severe subcutaneous emphysema in 1, diarrhea in 1. CONCLUSIONS: Laparoscopic simple nephrectomy is feasible, effective, and safe treatment option. It is a less invasive alternative to open surgery providing a more rapid recuperation and superior cosmetic effect.
Diarrhea ; Female ; Hemorrhage ; Humans ; Kidney ; Laparoscopy ; Length of Stay ; Male ; Nephrectomy* ; Operative Time ; Subcutaneous Emphysema ; Ureter ; Wound Infection

No abstract available.
Bilirubin* ; Fetal Blood* ; Hyperbilirubinemia, Neonatal*

Diffuse alveolar hemorrhage (DAH) is an uncommon complication in patients with systemic lupus erythematosus (SLE), and mortality remains high. In recent years, cases of DAH due to SLE treated with extracorporeal membrane oxygenation (ECMO) have rarely been reported. The authors present a case of a 43-year-old woman with SLE who had rapidly aggravating dyspnea and hemoptysis. She was diagnosed as having DAH with refractory respiratory failure and was successfully managed with veno-venous ECMO. We propose ECMO as a useful salvage therapy in patients with alveolar hemorrhage secondary to SLE who are failing conventional ventilatory support.
Adult ; Dyspnea ; Extracorporeal Membrane Oxygenation* ; Female ; Hemoptysis ; Hemorrhage* ; Humans ; Lupus Erythematosus, Systemic* ; Mortality ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Salvage Therapy

Aspiration pneumonia rarely occurs during general anesthesia; however, it can result in fatal pulmonary complications. To reduce aspiration pneumonia, a preoperative fasting time of 8 hours is recommended. A 4-year-old boy with ankyloglossia was scheduled for frenotomy. He completed preoperative fasting time and had no digestive symptoms. Pulmonary aspiration due to unexpected massive vomiting occurred during anesthesia induction. The patient's airway was immediately secured by endotracheal tube. The vomitus in the airway tract was removed by fiberoptic bronchoscopy. Abdomen radiograph taken after this event showed paralytic ileus which can cause aspiration of gastric contents. We describe a case of pneumonia caused by aspiration of gastric contents in a pediatric patient who followed fasting instructions and who was scheduled for outpatient surgery.
Abdomen ; Ambulatory Surgical Procedures ; Anesthesia ; Anesthesia, General* ; Bronchoscopy ; Child, Preschool ; Fasting* ; Humans ; Intestinal Pseudo-Obstruction ; Male ; Pneumonia ; Pneumonia, Aspiration* ; Vomiting

It has been well known that liver cirrhosis, regardless of its etiology, is an important predisposing factor in hepatocarcinogenesis. However, the type of cirrhosis in hepatocellular carcinoma(HCC)-bearing liver varies not only by geographic areas but also with the cirteria applied for morphological classification of cirrhosis. To elucidate the relationship between the nodule size of HCC-bearing cirrhotic liver and clinicopathologic features, we measured cirrhotic nodule areas of 49 surgically resected HCC cases using image analyzer. The morphological type of cirrhosis was predominantly macronodular(49%), and followed by mixed(37%) and micronodular(14%). Seventy percent of the cases showed seropositivity for HBsAg. The average area of cirrhotic nodules was significantly larger in HBsAg-positive cases(mean: 6.14 mm2) than that of HBsAg-negative cases(mean: 2.5 mm2)(p<0.05), and their size was bigger in cases with grossly expansile pattern of HCC than those cases with infiltrative ones(p<0.05). Based on the above findings, we assume that seropositivity of HBsAg may influence on the regenerative activity of cirrhotic nodules and also subsequent increase of risk for further development of HCC. The presence of cirrhohsis and nodule size seem to be the important contributing factors to determine the growing patterns of HCC.
Carcinoma, Hepatocellular