Benign ductal or glandular neoplasms of the esophagus unrelated to Barrett esophagus are extremely rare. Only 9 cases have been reported in the English language literature. We now report a case of esophageal gland duct adenoma incidentally found in a 73-year-old man. A 0.8 cm-sized, polypoid submucosal lesion in the distal esophagus was removed. Histologically, the lesion was well circumscribed and consisted of several ducts or cysts with focal papillary configurations. Interstitial lymphocytic infiltration with germinal centers was also observed. The lining cells of ducts or cysts were composed of two layers: an inner intensely eosinophilic luminal duct cell layer and an outer myoepithelial cell layer that was accentuated by alpha-smooth muscle actin. There was no significant nuclear atypia or mitosis. Mucin production was occasionally observed in a few goblet cells. To the best of our knowledge, this is the first case of benign ductal or glandular neoplasm of the esophagus among Koreans.
Actins ; Adenoma ; Aged ; Barrett Esophagus ; Eosinophils ; Esophagus ; Germinal Center ; Goblet Cells ; Humans ; Mitosis ; Mucins ; Muscles ; Neoplasms, Glandular and Epithelial ; Phenobarbital

We investigated whether there was any difference in the extent of cupping reversal after reduction of intraocular pressure(IOP) by trabeculectomy between advanced glaucoma(stage IV of Jonas classification; 6 eyes) and less advanced glaucoma(stage III or less; 5 eyes). Computer-aided morphometry was performed in 11 eyes of 10 adult patients with chronic open-angle glaucoma in whom reversal of glaucomatous cupping was apparent photographically. Mean preoperative IOP, postoperative IOP, and percent reduction of IOP respectively were 42.5+/-8.3mmHg, 12.5+/-3.8mmHg, and 69.1+/-13.2%(range, 40.6 to 81.0%) over a mean period of 22.7+/-14.6 months(range, 5 to 53 months). Mean cup area and cup to disc ratio decreased significantly(P<0.01, Wilcoxon signed rank test). The reversal of rim area/disc area ratio showed a marginally significant correlation with the percent reduction of IOP(Spearman`s correlation coefficient=0.57, P=0.07). The reversal of vertical cup to disc ratio was significaltly lower in eyes with advanced glaucoma than in eyes with less advenced glaucoma(P=0.03, Mann-Whitney U test). Although reversal of other disc parameters tended to be lower in eyes with advanced glaucoma, they were not statistically significant. In eyes with advanced glaucoma, reversal of rim area/disc area ratio was more pronounced in the nasal disc region than in the superior or inferior disc region. Our results suggest that the extent of cupping reversal after reduction of IOP may decrease in the advanced stage of glaucoma than in mild to moderate stages of glaucoma.
Adult ; Classification ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Trabeculectomy

We investigated whether there was any difference in the extent of cupping reversal after reduction of intraocular pressure(IOP) by trabeculectomy between advanced glaucoma(stage IV of Jonas classification; 6 eyes) and less advanced glaucoma(stage III or less; 5 eyes). Computer-aided morphometry was performed in 11 eyes of 10 adult patients with chronic open-angle glaucoma in whom reversal of glaucomatous cupping was apparent photographically. Mean preoperative IOP, postoperative IOP, and percent reduction of IOP respectively were 42.5+/-8.3mmHg, 12.5+/-3.8mmHg, and 69.1+/-13.2%(range, 40.6 to 81.0%) over a mean period of 22.7+/-14.6 months(range, 5 to 53 months). Mean cup area and cup to disc ratio decreased significantly(P<0.01, Wilcoxon signed rank test). The reversal of rim area/disc area ratio showed a marginally significant correlation with the percent reduction of IOP(Spearman`s correlation coefficient=0.57, P=0.07). The reversal of vertical cup to disc ratio was significaltly lower in eyes with advanced glaucoma than in eyes with less advenced glaucoma(P=0.03, Mann-Whitney U test). Although reversal of other disc parameters tended to be lower in eyes with advanced glaucoma, they were not statistically significant. In eyes with advanced glaucoma, reversal of rim area/disc area ratio was more pronounced in the nasal disc region than in the superior or inferior disc region. Our results suggest that the extent of cupping reversal after reduction of IOP may decrease in the advanced stage of glaucoma than in mild to moderate stages of glaucoma.
Adult ; Classification ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Trabeculectomy

PURPOSE: The purpose of this study was to evaluate the effectiveness of a health promotion program utilizing action planning strategy for young adults. METHODS: A non-equivalent control group pre-post-test design was used. One hundred three university students participated in the study. Participants in the experimental group (n=51) were provided the health promotion program utilizing action planning strategy for five weeks. The program consisted of weekly sessions that included action planning and group feedback. The control group (n=52) was provided with health information every week for 5 weeks. Program outcomes, including self-efficacy, physical activity health behaviors, total exercise time per week, daily cigarette consumption, frequency of alcohol drinking per month, nutritional health behaviors, and subjective health status, were assessed at baseline and at follow-up after 5 weeks. RESULTS: The participants in the experimental group demonstrated significant increases in self-efficacy, physical activity health behaviors, weekly exercise time, and nutritional health behaviors and significant decreases in daily cigarette consumption than those in the control group. CONCLUSION: The health promotion program utilizing action planning strategy is a brief and effective intervention to promote health behaviors among young adults. Further investigation is warranted to assess the program's effectiveness among other age groups and populations at high risk for chronic illness.
Alcohol Drinking ; Chronic Disease ; Diagnostic Self Evaluation ; Follow-Up Studies ; Health Behavior ; Health Promotion ; Humans ; Motor Activity ; Self Efficacy ; Tobacco Products ; Young Adult

PURPOSE: The purpose of this study was to evaluate the effectiveness of a health promotion program utilizing action planning strategy for young adults. METHODS: A non-equivalent control group pre-post-test design was used. One hundred three university students participated in the study. Participants in the experimental group (n=51) were provided the health promotion program utilizing action planning strategy for five weeks. The program consisted of weekly sessions that included action planning and group feedback. The control group (n=52) was provided with health information every week for 5 weeks. Program outcomes, including self-efficacy, physical activity health behaviors, total exercise time per week, daily cigarette consumption, frequency of alcohol drinking per month, nutritional health behaviors, and subjective health status, were assessed at baseline and at follow-up after 5 weeks. RESULTS: The participants in the experimental group demonstrated significant increases in self-efficacy, physical activity health behaviors, weekly exercise time, and nutritional health behaviors and significant decreases in daily cigarette consumption than those in the control group. CONCLUSION The health promotion program utilizing action planning strategy is a brief and effective intervention to promote health behaviors among young adults. Further investigation is warranted to assess the program's effectiveness among other age groups and populations at high risk for chronic illness.

BACKGROUND: Perfluorocarbon (PFC) liquids have high oxygen carrying capacity and relatively low surface tension allowing them to spread evenly through the diseased lung, especially in the case of adult respiratory distress syndrome. But few studies have demonstrated the effects of PFC on a bronchoconstriction model. The aim of this study was to investigate the effects of PFC on pulmonary mechanics and gas exchange in methacholine-induced bronchoconstricted cats using a flow interruption technique. METHODS: Twenty male cats were divided into four groups; control group (group C, n = 5), PFC group (group P, PFC 5 ml/kg, n = 5), methacholine group (group M, 25 microgram/kg/min, n = 5), PFC and methacholine group (group MP, n = 5). Respiratory pressure using a flow interruption technique was measured immediately after stabilizing the heart rate and blood pressure 0, and 15, 30 and 60 min after the start of the intratracheal administration of PFC and/or methacholine infusion, depending on the group. Arterial blood gas analysis was done to compare arterial partial oxygen pressure among the groups at the time of measuring the pressure values. The pressure data was transferred to a personal computer and analyzed using ANADAT software program. Respiratory, airway and tissue viscoelastic pressure were calculated. Statistical analysis was done by ANOVA and statistical significance was defined as P <0.05. RESULTS: Group M and MP showed significantly increased airway pressures compared with group C (P <0.05), but there was no difference among the groups in terms of viscoelastic pressure. Arterial blood gas analysis showed that group P and MP had lower arterial partial oxygen pressures than group C (P <0.05). CONCLUSIONS: This study demonstrates that the intratracheal administration of PFC in a bronchoconstriction cat model increases airway pressure more than tissue viscoelastic pressure, and decreased arterial oxygen partial pressure. We conclude that the intratrachel administration of PFC is not to be recommended in bronchoconstrictive situations.
Airway Resistance ; Animals ; Blood Gas Analysis ; Blood Pressure ; Bronchoconstriction* ; Cats* ; Natural Resources ; Heart Rate ; Humans ; Liquid Ventilation ; Lung ; Male ; Mechanics ; Methacholine Chloride ; Microcomputers ; Oxygen ; Partial Pressure ; Pulmonary Gas Exchange* ; Respiratory Distress Syndrome, Adult ; Respiratory Mechanics* ; Surface Tension

No abstract available.
Heparin ; Parenteral Nutrition ; Thrombocytopenia

PURPOSE: To report the initial clinical experience with single-incision laparoscopic gastric wedge resection for submucosal tumors. MATERIALS AND METHODS: The medical records of 10 patients who underwent single-incision laparoscopic gastric wedge resection between July 2009 and March 2011 were reviewed retrospectively. The demographic data, clinicopathologic and surgical outcomes were assessed. RESULTS: The mean tumor size was 2.5 cm (range, 1.2~5.0 cm), and the tumors were mostly located on the anterior wall (4/10) or along the greater curvature (4/10), of the stomach. Nine of ten procedures were performed successfully, without the use of additional trocars, or conversion to laparotomy. One patient underwent conversion to multiport laparoscopic surgery, to get simultaneous cholecystectomy safely. The mean operating time was 66.5 minutes (range, 24~132 minutes), and the mean postoperative hospital stay was 5 days (range, 4~7 days). No serious perioperative complications were observed. Of the 10 submucosal tumors, the final pathologic report revealed 5 gastrointestinal stromal tumors, 4 schwannomas, and 1 heterotopic pancreas. CONCLUSIONS: Single-incision laparoscopic gastric wedge resection for gastric submucosal tumors is feasible and safe, when performed by experienced laparoscopic surgeons. This technique provides favorable cosmetic results, and also short hospital stay and low morbidity, in carefully selected candidates.
Cholecystectomy ; Cosmetics ; Gastrectomy ; Gastrointestinal Stromal Tumors ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Medical Records ; Neurilemmoma ; Retrospective Studies ; Stomach ; Stomach Neoplasms ; Surgical Instruments ; Surgical Procedures, Minimally Invasive

Brugada syndrome is characterized by an ECG pattern of right bundle branch block and ST segment elevation in right precordial leads (V1 to V3), without structural heart disease. However, these ECG manifestations transiently normalize in up to 40% of cases. Brugada syndrome is responsible for up to one half of all sudden cardiac deaths in young adults and they may be worsened by beta blockers. We present the anesthetic management of a patient with Brugada syndrome without the characteristic ECG pattern.
Anesthesia* ; Brugada Syndrome* ; Bundle-Branch Block ; Death, Sudden ; Death, Sudden, Cardiac ; Electrocardiography* ; Heart Diseases ; Humans ; Young Adult

BACKGROUND: Inducible nitric oxide synthase (iNOS) is expressed during the late stage of ischemia and may play an important role in the delayed progression of ischemic brain injury. This study was conducted to investigate the effect of N-(3-[aminomethyl] benzyl] acetamidine (1,400 W), a selective inhibitor of iNOS on hypoxic ischemic injury in a neonatal rat model. METHODS: Seven-day old Sprague-Dawley rats were used. The right common carotid artery was ligated under halothane anesthesia. Three 3 hours after recovery, animals were exposed to 8% oxygen in 92% nitrogen. The treatment group (n = 14) received 7 intraperitoneal injection of 20 mg/kg of 1,400 W. The first dose was given 18 hours after the injury and interval between injections was 8 hours. The control group (n = 13) did not receive 1,400 W. The degree of ischemic damage and apoptosis were evaluated 3 days after injury by 1H magnetic resonance spectroscopy (MRS) and terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end-labeling (TUNEL) staining. The authors obtained Lipid/N-acetyl aspartate (Lip/NAA) and lipid/ creatine (Lip/Cr) ratios as apoptotic markers via 1H MRS, and counted the apoptotic cell number by TUNEL staining in the right hemisphere. Data were analyzed using the unpaired t-test. RESULTS: There were no significant differences in the Lip/NAA or Lip/Cr ratios of the 2 groups, and no significant differences were found in terms of the number of TUNEL positive cells between 2 groups, either. CONCLUSIONS: The iNOS inhibitor investigated did not show protective effects against delayed neuronal damage and apoptosis after the hypoxic-ischemic injury in newborn rats, at least during the 3 days following injury. Our results suggest that NO has different roles in cerebral hypoxia-ischemia according to the stage of neonatal cerebral development.
Anesthesia ; Animals ; Apoptosis* ; Aspartic Acid ; Brain Injuries ; Brain* ; Carotid Artery, Common ; Cell Count ; Creatine ; Halothane ; Humans ; Hypoxia-Ischemia, Brain ; In Situ Nick-End Labeling ; Infant, Newborn ; Injections, Intraperitoneal ; Ischemia ; Magnetic Resonance Spectroscopy* ; Models, Animal ; Neurons ; Nitric Oxide Synthase Type II* ; Nitrogen ; Oxygen ; Rats* ; Rats, Sprague-Dawley