We present a case of pulmonary artery catheter (PAC) placement through the right internal jugular vein, bridging vein and coronary sinus in a patient with previously unrecognized persistent left superior vena cava (LSVC) and diminutive right superior vena cava. A 61-year-old male patient was scheduled for mitral valve repair for regurgitation. Preoperative transthoracic echocardiography revealed dilated coronary sinus, but no further evaluations were performed. During advancement of the PAC, right ventricular and pulmonary arterial pressure tracing was observed at 50 and 60 cm, respectively. Transesophageal echocardiography ruled out intracardiac knotting and revealed the presence of the PAC in the LSVC, entering the right ventricle from the coronary sinus. Diminutive right superior vena cava was observed after sternotomy. The PAC was left in place for 2 days postoperatively without any complications. This case emphasizes that the possibility of LSVC and associated anomalies should always be ruled out in patients with dilated coronary sinus.
Arterial Pressure ; Catheterization, Swan-Ganz* ; Catheters ; Coronary Sinus ; Echocardiography ; Echocardiography, Transesophageal ; Heart Ventricles ; Humans ; Jugular Veins ; Male ; Middle Aged ; Mitral Valve ; Pulmonary Artery ; Sternotomy ; Vascular Malformations ; Veins ; Vena Cava, Superior*

Ganglia of the cruciate ligament are quite rare. About 60 cases were reported previously in the world and 6 cases were reported at two articles in korea. It's symptoms may be similar to those of internal derangement of knee, especially meniscal lesion. We report a case of isolated ganglion of posterior cruciate ligament with brief of literatures.
Ganglia ; Ganglion Cysts* ; Knee ; Korea ; Ligaments ; Posterior Cruciate Ligament*

Fibrovascular polyp of the esophagus is a rare and benign pedunculated intraluminal tumor. The tumor consists of varying amount of vascular fibrous and adipose tissue that arises in the submucosa and is covered by squamous epithelium. We report the typical radiographic, CTand MR findings of a case of giant fibrovascular polyp of the esophagus.
Adipose Tissue ; Epithelium ; Esophagus* ; Polyps*

OBJECTIVE: To evaluate the changes of maximum fibrillation potential amplitude and root- mean-square (RMS) value of denervation potential after nerve injury using power spectrum analysis. METHODS: The sciatic nerve was transected in 8 rats, and was compressed in 6 rats. Denervation potentials were collected in gastrocnemius using monopolar needle weekly after nerve injury. The change of RMS value of 1 second epoch of denervation potentials with time was evaluated and compared with the change of maximun fibrillation potential amplitude. RESULTS: In nerve-transected rat, the RMS value declined linearly with time after injury. On the contrary, the amplitude of fibrillation potentials declined much rapidly during first 3 weeks. In nerve-compressed rat, both the RMS value and amplitude of fibrillation potential increased for 2 weeks after injury, and declined thereafter. As the result of simple regression analysis, the changes of RMS value correlated better than changes of fibrillation amplitude in all 8 nerve-transected rat. CONCLUSION: The RMS value of denervation potentials correlated well with time after nerve injury in animal experiments. Measurement of the RMS value might be helpful to evaluate the time after peripheral nerve injury, but long-term human data should be essential for clinical application.
Animal Experimentation ; Animals ; Denervation* ; Evaluation Studies as Topic* ; Humans ; Needles ; Peripheral Nerve Injuries ; Rats* ; Sciatic Nerve ; Spectrum Analysis*

PURPOSE: To investigate the change of the Beta adrenergic system in the rat visual cortex and superior colliculus after visual deprivation during a critical period of postnatal development. METHODS: The changes of beta 1 and beta 2 adrenergic receptor mRNA were investigated by using northern blot analysis in the rat visual cortex and superior colliculus. The right eyelid of visually deprived rat was sutured at the 10th postnatal days. After visual deprivation for 4 weeks, the rat were sacrificed and the visual cortex and superior colliculus tissues were removed for analysis. RESULTS: Beta 1 and beta 2 adrenergic receptor mRNA expression was decreased in the contralateral visual cortex to the deprived eye. In the superior colliculus, beta 2 adrenergic receptor mRNA expression increased in both sides, but a much greater increase was shown in the ipsilateral superior colliculus than the contralateral side. CONCLUSIONS: These results suggests that visual deprivation during a critical period of postnatal development influences the beta adrenergic system in the rat visual cortex and superior colliculus.
Animals ; Blotting, Northern ; Critical Period (Psychology) ; Eyelids ; Rats* ; Receptors, Adrenergic ; RNA, Messenger* ; Superior Colliculi* ; Visual Cortex*

Adenosquamous carcinoma in the duodenum is extremely rare disease entity and only 6 cases were reported all over the world so far. Recently we encountered a 62 year-old female patient with duodenal adenosquamous carcinoma. The patient subsequently underwent Whipple's operation. Histopathologic examination revealed two pathologic components composed of adenocarcinoma and squamous cell carcinoma. The metastatic foci of lymph nodes were composed of pure squamous cell carcinoma. For differential diagnosis, we performed several special stains including high molecular weight cytokeratin(HMWCK), low molecular weight cytokeratin(LMWCK), carcinoembryogenic antigen( CEA), mucicarmine, periodic acid-Schiff(PAS). Immunohistochemical stains demonstrated LMWCK, CEA, mucicarmine positivity for glandular component and HMWCK for squamous component. Weak positivity for squamous component was observed with PAS stain. The pathogenesis of adenosquamous carcinoma is controversial issue and not resolved yet, so we discussed the histogenesis of adenosquamous carcinoma.
Adenocarcinoma ; Carcinoma, Adenosquamous* ; Carcinoma, Squamous Cell ; Coloring Agents ; Diagnosis, Differential ; Duodenum ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Molecular Weight ; Rare Diseases

This paper reports our experiences in laparoscopically assisted surgical staging (LASS) to manage the patients with early-stage endometrial cancer. From March 1996 to March 1999, we performed LASS in 6 patients with clincal stage I adenocarcinoma of the endometrium. We performed laparoscopic-assisted vaginal hysterectomy (LAVH) with bilateral salpingo-oophorectomy (BSO) and intraoperative frozen-section (IFS) diagnosis. The depth of myometrial invasion, tumor differentiation, histologic types, cervical invasion, and adnexal involvement were determined by IFS diagnosis. Laparoscopic pelvic and/or para-aortic lymphadenectomies were performed based on the grade of the tumor and depth of myometrial invasion. One patient was discovered to have tumor metastases in pelvic peritoneum and uterosacral ligaments, and underwent only para-aortic lymphadenectomy for determining field of radiation therapy. 2 out of 5 patients only underwent LAVH with BSO and peroitoneal washing cytology. Three other patients underwent LAVH with BSO, peritoneal washing cytology and pelvic lymphadenectomy because they were identified by IFS diagnosis as intermediate risk group for nodal metastasis. The mean age of the patients was 46.4 years. Total length of the operation time ranged from 100 minutes to 305 minutes and the mean was 187.5 minutes. The mean hemoglobin decrement after the surgery was 0.9 gm/dl. No one recieved blood transfusion. The average number of pelvic and para-aortic lymph nodes removed were 16.7 and 18, respectively. After the surgery, the patients passed gas after an average of 2.0 days and urinated urine after an average of 3.8 days. No one had complication after LASS. Based on our experiences, LASS might be an alternative to the traditional surgical approach in patients with early-stage endometrial carcinoma.
Adenocarcinoma ; Blood Transfusion ; Diagnosis ; Endometrial Neoplasms* ; Endometrium ; Female ; Humans ; Hysterectomy, Vaginal ; Ligaments ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Peritoneum

PURPOSE: To report one case of neurilemoma of the bulbar conjunctiva with a review of the relevant literature. CASE SUMMARY: A 15-year-old girl presented with a bulbar conjunctival mass in the right eye. There were no other medical or ophthalmologic problems. The patient wanted to remove the mass for cosmetic reasons. We performed an excisional biopsy and simple wound closure. The mass was composed of bipolar spindle shaped cells that were arranged in bundles and fascicles in dense fibrous tissue. Immunohistochemical staining for the S-100 protein was positive. Two months after mass excision, there was no evidence of recurrence. CONCLUSIONS: We successfully treated a case of bulbar conjunctival neuriliemoma by simple excision.
Adolescent ; Biopsy ; Conjunctiva ; Cosmetics ; Eye ; Humans ; Neurilemmoma ; Recurrence ; S100 Proteins

OBJECTIVE: The purpose of this study is to investigate the incidence and types of skin lesions occurring in the patients with a spinal cord injury(SCI), traumatic brain injury(TBI), cerebrovascular accident(CVA), and an amputation. METHOD: Five hundred and eighty-nine charts from 1991 to 1997 were retrospectively reviewed. During the hospitalization, the skin lesions were examined by the dermatologists upon consultations. The patients were divided by their diagnosis of the SCI, TBI, CVA, and amputation. The incidence of the skin lesions were analysed. RESULTS: The number of patients was as follows; SCI 228, TBI 181, CVA 143, and amputation 37. The skin lesions occurred in 72 cases(12.9%) of which 30 cases(13.2%) occured in SCI, 21 cases(11.6%) in TBI, 15 cases(9.8%) in CVA and 7 cases(18.9%) in amputation. These include dermatophytosis 23 cases(23.9%), seborrheic dermatitis 21 cases(21.8%), pilosebaceous disorder 17 cases(17.7%) such as folliculitis, acne, and acneiform eruption, eczema 11 cases(11.4%), drug eruption 9 cases(9.4%), candidiasis 6 cases(6.3%), and others 9 cases(9.4%) such as steatocytoma multiplex, epidermal cyst, intertrigo, alopecia areata, and etc. The incidence of ANS related skin lesion such as seborrheic dermatitis and pilosebaceous disorder in SCI was significantly higher than in TBI and stoke, which the defect is in the brain(p<0.05). However, the incidence in other lesions such as dermatophytosis, eczema, and candidiasis was not significantly different between these two groups(p>0.05). The number of cases of ANS related skin lesions was 21(52.5%) and 3(42.9%) in SCI patients whose level of injury was from C1 to T6(in 40) and at or below T7(in 7) respectively. In contrast, the number of cases of other skin lesions such as dermatophytosis, eczema, and candidiasis was 15(37.5%) of C1 to T6 level and 4(57.1%) of at or below T7 level in the same SCI patients groups. CONCLUSION: This study illustrates that the incidence of skin lesion in rehabilitation unit is 72 cases of 589 patients(12.9%). The incidence of ANS related skin lesion is higher in the patients with spinal cord injury than brain lesion. And the level of injury is higher in SCI, the more skin lesions occur.
Acne Vulgaris ; Acneiform Eruptions ; Alopecia Areata ; Amputation ; Autonomic Nervous System ; Brain ; Candidiasis ; Dermatitis, Seborrheic ; Diagnosis ; Drug Eruptions ; Eczema ; Epidermal Cyst ; Folliculitis ; Hospitalization ; Humans ; Incidence ; Intertrigo ; Pressure Ulcer* ; Referral and Consultation ; Rehabilitation* ; Retrospective Studies ; Skin* ; Spinal Cord ; Spinal Cord Injuries ; Tinea

Airway smooth muscle (ASM) hyperplasia and angiogenesis are important features associated with airway remodeling. We investigated the effect of IL-4 and amphiregulin, an epidermal growth factor family member, on the proliferation of human ASM cells and on the release of vascular endothelial growth factor (VEGF) and monocyte chemotactic protein (MCP)-1 from human ASM cells. Human ASM cells were growth-arrested for 48 hr and incubated with platelet-derived growth factor (PDGF)- BB, interleukin (IL)-4, amphiregulin, and VEGF to evaluate cell proliferation. The cells were treated with PDGF, IL-4 and amphiregulin to evaluate the release of VEGF, MCP-1. IL-4 suppressed unstimulated and PDGF-stimulated ASM cell proliferation. Amphiregulin stimulated ASM cell proliferation in a dose-dependent manner. VEGF did not have any influence on ASM cell proliferation. IL-4 stimulated VEGF secretion by the ASM cells in a dose-dependent manner and showed added stimulatory effects when co-incubated with PDGF. Amphiregulin did not promote VEGF secretion. IL-4 and amphiregulin showed no stimulatory effects on MCP-1 secretion. The results of this study showed that IL-4 had bifunctional effects on airway remodeling, one was the suppression of the proliferation of the ASM cells and the other was the promotion of VEGF release by the ASM cells, and amphiregulin can promote human ASM cell proliferation.
Bronchi/metabolism ; Cell Proliferation ; Cells, Cultured ; Chemokine CCL2/metabolism ; Chemokine CCL3/metabolism ; Cytokines/metabolism ; *Gene Expression Regulation ; Glycoproteins/*physiology ; Humans ; Intercellular Signaling Peptides and Proteins/*physiology ; Interleukin-4/metabolism/*physiology ; Models, Biological ; Myocytes, Smooth Muscle/*metabolism ; Vascular Endothelial Growth Factor A/metabolism