No Abstract Available.
Calmodulin* ; Cell Death* ; Humans* ; Retinoblastoma*

No abstract available.
Bronchopulmonary Sequestration*

Pure primary hepatic rhabdomyosarcoma in adult is very uncommon. There have been only five previous case of primary rhabdomyosarcoma of the adult liver. A case of hepatic ihabdomyosarcoma was diagnosed in a 52 year-old female. She was admitted to the hospital due to the epigastric pain and weight loss. A CT scan of the abdomen showed a large hypodense mass with focal calcification occupies most of the both lobes of the liver. The liver biopsy showed massive liver tumor composed entirely of oval shaped cells showing light microscopic and immunohistochemical evidence of rhabdomyoblastic differentiation. We report a case of hepatic rhabdomyosarcoma with review of literature.
Abdomen ; Adult ; Biopsy ; Female ; Humans ; Liver* ; Rhabdomyosarcoma* ; Tomography, X-Ray Computed ; Weight Loss

Majority of .hepatocellular carcinoma is evolved from a well differentiated cancerous condition such as hypetptastic lesions eg; adenomatous hyperplasia in cirrhotic liver or de no vo carcinogenesis and prolifenation along with dedifferentiation. Adenomatous hyperplasia is may be seen in severe acute hepatic injury, like svhmassive hepatic necrosis, or in chronic liver diseases, particularly liver cirrhosis and it has recently attracted much interest from both clinicians and pathologists because it is regarded as a precursor lesion of hepatocObdar carcinoma. Hepatic. denomatous hyperplasia resembling focal nodular hyperplasia might have developed from localized vascular changes associated with chronic liver disease, pre-existing arterial malformation and early stage of angiogenesis in hepatocarcinogenesis. .fie present a patient who developed hepatocellular carcinoma after hepatic artery ligation.
Carcinogenesis ; Carcinoma, Hepatocellular* ; Focal Nodular Hyperplasia ; Hepatic Artery* ; Humans ; Hyperplasia ; Ligation* ; Liver ; Liver Cirrhosis ; Liver Diseases ; Necrosis

BACKGROUND: Electrical breathing pacing has many advantages over mechanical ventilation. However, clinically permanent diaphragmatic pacing has been applied to limited patients and few temporary pacing has been reported. Our purpose is to investigate the feasibility of temporary electrical diaphragm pacing in explothoracotomy canine cases. METHODS: Five dogs were studied under the general anesthesia. Left 5th intercostal space was opened. Self designed temporary pacing leads were placed around the left phrenic nerve and connected to the myostimulator. Chest wall was closed after tube insertion with underwater drainage. Millar catheter was introduced to the aorta and right atrium. Swan-Ganz catheter was introduced to the pulmonary artery. When the self respiration was shallow with deep anesthesia, hemodynamic and tidal volume were measured with the stimulator on. RESULTS: Tidal volume increased from 143.3 +/- 51.3 ml to 272.3 +/- 87.4 ml(p=0.004). Right atrial diastolic pressure decreased from 0.7 +/- 4.0 mmHg to -10.5 +/- 4.7 mmHg(p=0.005). Pulmonary arterial diastolic pressure decreased from 6.1 +/- 2.5 mmHg to 1.2 +/- 4.8 mmHg(p<0.001). The height of water level in chest tube to show intrathoracic pressure change was from 10.3 +/- 6.7cmH2O to 20.0 +/- 5.3 cmH2O. CONCLUSION: Temporary electrical diaphragmatic pacing is a simple method to assist respiration in explothoracotomy canine cases. Self designed pacing lead is implantable and removable. Negative pressure ventilation has favorable effects on the circulatory system. Therefore, clinical application of temporary breathing pacing is feasible in thoracotomy patients to assist cardiorespiratory function.
Anesthesia ; Anesthesia, General ; Animals ; Aorta ; Blood Pressure ; Catheters ; Chest Tubes ; Diaphragm ; Dogs ; Drainage ; Heart Atria ; Hemodynamics ; Humans ; Phrenic Nerve ; Pulmonary Artery ; Respiration ; Respiration, Artificial ; Thoracic Wall ; Thoracotomy ; Tidal Volume ; Ventilation ; Water

The ratio of acetoacetate to 8-hydroxybutyrate (ketone body ratio) in the blood may reflects the mitochondrial free NAD+/NADH ratio in the liver. Also arterial ketone body ratio will reflects the energy status of the hepatocytes, because mitochondrial free NAD+/NADH ratio is closely related to oxidative phosphorylation. Arterial ketone body ratio and osmolal gap, the difference between measured osmolality and calculated osmolality, were measured 30 min after the induction of hemorrhagic shock with mean arterial blood pressure at 40 mmHg in ten rabbits. Arterial ketone body ratios decreased significantly (p<0.05) from 0.74+/-0.17 to 0.38+/-0.09 and osmolal gap increased significantly (p<0.05) from 17.7+/-5.9 mOsm/Kg to 32.8+/-12.3 mOsm/Kg at 30 min after the induction of hemorrhagic shock. These results suggest that in hemorrhagic shock, decreased arterial ketone body ratio which reflects the inhibition of the TCA cycle is associated with increase of osmolal gap.
Arterial Pressure ; Hepatocytes ; Liver ; Osmolar Concentration ; Oxidative Phosphorylation ; Rabbits ; Shock, Hemorrhagic*

BACKGROUND: In postmenopausal women, progestogen should be added to protect the endometrium from hyperplasia or carcinoma induced by the unopposed estrogen. However, the effects of progestogen on bone mineral densities and serum lipodproteins have not been precisely evaluated in Korean postmenopausal women. METHODS: To evaluate the effects of progestogen on bane mineral densities and serum lipoprotein in estrogen rephcement therapy, we canducted a 2-year trial of long conjugated equine estrogen(conjugated estrogen 0.625mg/day) with or without cyclic progestogen(MPA 5mg/day for 12 days) in 120 postmenopausal women. In all subjects, bone mineral density was measured in lumbar vertebra(L2-L4) and femur neck using dual energy X-ray absorptiometry(DEXA) and serum lipoprotein was measured from the beginning of the treatment, 12 manths, and 24 manths later, respectively. RESULTS: BMD of femur neck in both groups increased but not significantly compared to basal level at 12 months and/or 24 months of treatment. As for BMD of lumbar spine, it increased significantly in both groups. Both groups showed a significant decrease in the levels LDL cholesterol, but there was no statistical significance in serum triglycerids. Conjugated estrogen plus MPA group in constrast to conjugated estrogen only group showed a significant decrease in total cholesterol levels. CONCLUSIONS: These results suggest that the addition of MPA of the daily of 5mg for 12 days cyclically in estrogen replacement treatment appear to be effective in postmenopausal women with protection on bone mineral density and maintenance of long-term favorable effects on serum lipoprotein.
Bone Density* ; Cholesterol ; Cholesterol, LDL ; Endometrium ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Femur Neck ; Humans ; Hyperplasia ; Lipid Metabolism* ; Lipoproteins ; Postmenopause ; Spine

Mucormycosis is a rare but invasive opportunistic fungal infection with increased frequency during chemotherapy-induced neutropenia. The clinical infections due to Mucor include rhinocerebral, pulmonary, cutaneous, gastrointestinal and disseminated diseases. The first two are the most common diseases and all entities are associated with a high mortality rate. Still hepatic involvement of Mucor is rarely reported. We experienced a case of hepatic and small bowel mucormycosis in a 56-year-old woman after induction chemotherapy for B-cell acute lymphocytic leukemia. Initial symptoms were a high fever unresponsive to broad spectrum antibiotics and pain in the left lower abdominal quadrant. It was followed by septic shock, deterioration of icterus and progressively elevated transaminase. An abdominal CT demonstrated multiple hypodense lesions with distinct margins in both lobes of liver and pericolic infiltration at small bowel and ascending colon. Diagnosis was confirmed by biopsy of the liver. The histopathology of the liver showed hyphae with the right-angle branching, typical of mucormycosis. The patient was managed with amphotericin B and operative correction of the perforated part of the small bowel was performed. However, the patient expired due to progressive hepatic failure despite corrective surgery and long-term amphotericin B therapy.
Case Report ; Female ; Human ; Intestinal Diseases/therapy ; Intestinal Diseases/radiography ; Intestinal Diseases/pathology* ; Intestinal Diseases/microbiology ; Intestine, Small/radiography ; Intestine, Small/pathology ; Liver Diseases/therapy ; Liver Diseases/radiography ; Liver Diseases/pathology* ; Liver Diseases/microbiology ; Middle Age ; Mucormycosis/therapy ; Mucormycosis/radiography ; Mucormycosis/pathology* ; Mucormycosis/microbiology ; Tomography Scanners, X-Ray Computed

Prognosis of placental abruption depends on gestational age and the status of the mother and the fetus, and perinatal mortality was almost entirely attributable to prematurity. A midtrimester women with placental abruption was successfully treated by expectant management including fetal surveillance, serial ultrasonography and maternal hematologic examination, and delivered a healthy baby 11 weeks later. We suggest that expectant management may be considered as a good treatment option until fetal lung maturation is documented in preterm pregnancy with placental abruption if there is no maternal or fetal compromise.
Abruptio Placentae* ; Female ; Fetus ; Gestational Age ; Humans ; Live Birth* ; Lung ; Mothers ; Perinatal Mortality ; Pregnancy ; Pregnancy Trimester, Second* ; Prognosis ; Ultrasonography

For applying the quality assurance (QA) of volumetric modulated arc therapy (VMAT) introduced in Eulji Hospital, we classify it into three different QA steps, treatment planning QA, pretreatment delivering QA, and treatment verifying QA. These steps are based on the existing intensity modulated radiation therapy (IMRT) QA that is currently used in our hospital. In each QA step, the evaluated items that are from QA program are configured and documented. In this study, QA program is not only applied to actual patient treatment, but also evaluated to establish a reference of clinical acceptance in pretreatment delivering QA. As a result, the confidence limits (CLs) in the measurements for the high-dose and low-dose regions are similar to the conventional IMRT level, and the clinical acceptance references in our hospital are determined to be 3 to 5% for the high-dose and the low-dose regions, respectively. Due to the characteristics of VMAT, evaluation of the intensity map was carried out using an ArcCheck device that was able to measure the intensity map in all directions, 360degrees. With a couple of dosimetric devices, the gamma index was evaluated and analyzed. The results were similar to the result of individual intensity maps in IMRT. Mapcheck, which is a 2-dimensional (2D) array device, was used to display the isodose distributions and gave very excellent local CL results. Thus, in our hospital, the acceptance references used in practical clinical application for the intensity maps of 360degrees directions and the coronal isodose distributions were determined to be 93% and 95%, respectively. To reduce arbitrary uncertainties and system errors, we had to evaluate the local CLs by using a phantom and to cooperate with multiple organizations to participate in this evaluation. In addition, we had to evaluate the local CLs by dividing them into different sections about the patient treatment points in practical clinics.
Humans ; Radiotherapy, Intensity-Modulated