No abstract available.
Sleep Initiation and Maintenance Disorders*

PURPOSE: In the treatment of symptomatic renal cysts, sclerotherapy has high recurrence rate. Laparoacopic cyst excision has high success rate but has some limitations concerning expensive devices, CO2 use and requiring trained laparoscopist. We conceived less invasive surgical technique for renal cyst excision. MATERIALS AND METHODS: The method is as follows. 1) Minimal skin incision of camera port size at PCN site nearest to the cyst. 2) Access to retroperitoneum by Kelly clamp and finger dilatation. 3) Finger dissection with or without ballooning. 4) Aspiration of cystic fluid. 5) Drawing the redundant cyst wall out of the incision. 6) Excision of the redundant cyst wall by open surgical method. RESULTS: Clinical trials of 5 patients have been performed since March 1999, with a mean age for the patients of 60 years old (range, 56-66), cyst size of 8.3cm (7.7-9.8), wound length of 2.4cm (2.1-3), operation time of 28 minutes (20-35) and blood loss of 1.6 Hb (0.5-3). There was no drain insertion except in one case, and no use of narcotics post op 2 days. Patients were discharged post op 3 days (2-5). There is no evidence of recurrence in short term follow up (mean 8 months, range 3-15). CONCLUSIONS: Though limited trials, we think expected merits over conventional laparoscopic surgery are better or comparative cosmetic results, no CO2 use, short operation time, less technical expertise and additionally economical advantages. If necessary, conversion to laparoscopic surgery, using the initial incision as camera port is possible during the procedures. So we suggest trial of this method before conventional laparoscopic renal cyst excision.
Dilatation ; Fingers ; Follow-Up Studies ; Humans ; Laparoscopy ; Middle Aged ; Narcotics ; Pregnenolone Carbonitrile ; Professional Competence ; Recurrence ; Sclerotherapy ; Skin ; Wounds and Injuries

Any compound which disrupts the integrity of psychological aspects of performance, in particular, cognitive ability and psychomotor function analogous to the psychological behaviors of routine life, is known to be behaviorally toxic. A significant level of behavioral toxicity will interfere with patient safety and quality of life, and also may be counter-therapeutic by exacerbating the condition that the drug was prescribed for. Now, behavioral toxicity of psychotropic drugs has become one of the main growth areas of psychopharmacological research. Evaluation of the potential of drug-induced behavioral toxicity is important not only to the experimental researcher involved in human psychopharmacology, but also to the clinical practitioner treating psychiatric patients. This article attempts to describe behavioral toxicity of the three classes of psychotropic drugs-benzodiazepines, antidepressants and neuroleptics. After a brief discussion of some methodological issues arising in the investigation of behavioral toxicity, each of these drug classes is reviewed in the context of practical importance rather than purely scientific concern. The last session summarizes some suggestions for future studies on drug-induced behavioral toxicity.
Antidepressive Agents ; Antipsychotic Agents ; Humans ; Patient Safety ; Psychopharmacology ; Psychotropic Drugs* ; Quality of Life

Colonic sarcomatoid carcinomas are known to be extremely rare tumors, with only 22 cases reported either as sarcomatoid carcinomas or carcinosarcomas in the literature. The known characteristics are rapid growth, a high recurrence rate, and an extremely poor prognosis. Herein we report a case of a patient who had a sarcomatoid carcinoma of the sigmoid colon and died only 22 days after surgery due to rapid tumor growth.
Carcinosarcoma ; Colon ; Colon, Sigmoid ; Humans ; Prognosis ; Recurrence

Urachal carcinoma is an uncommon neoplasm associated with a poor prognosis. We have encountered two another cases of urachal adenocarcinoma recently 5 years after our first report. The common sign of urachal cancer was painless hematuria. We diagnosed the specific site of origin preoperatively by means of computerized tomography. One patient was performed partial cystectomy and another was total cystectomy with double barrel ureterocutaneostomy. A brief review of the literature of urachal adenocarcinoma was also made.
Adenocarcinoma* ; Cystectomy ; Hematuria ; Humans ; Prognosis

A case of torsion of the right cryptorchid testis was herein reported. The patient was 6-year-old boy who was rolled on a staircase and traumatized his right inguinal area. There after painful and tender swelling developed on the area, and it spent 4 days prior to visit our department The involved cryptorchid testis showed dark reddish discoloration and external rotation of 360 degrees and was removed because of no re-establishment of blood supply in spite of detorsion for 30 minutes.
Child ; Humans ; Male ; Testis*

Case 1 was a 55-year-old housewife with the 1-year history of mild recurrent gross hematuria and recent history of massive hematuria following radiation treatment for uterine cancer 7 years ago. Various conservative treatments showed no effect but complete hemostasis was obtained immediately after instillation of 100 ml of 4% formalin solution for 30 minutes under sedation. And to date, there has been no recurrence of hematuria or significant complications for 5 months after the treatment. Case 2 was a 45-year-old housewife with the 3-month history of symptomless gross hematuria following irradiation for a gynecologic malignancy 8 years ago. Complete hemostasis was obtained one day after instillation of 100 ml of 4% formalin solution for 30 minutes under sedation. and to date, there has been no recurrence of hematuria or any complications for 2 months after the treatment. Postradiation vesical bleeding is a very difficult condition to control and may result in total cystectomy and urinary diversion. The treatment by intravesical instillation of formalin solution for the intractable vesical bleeding is simple to perform, shows excellent effect and no significant complications, and is a highly recommendable mode of treatment for massive, uncontrollable vesical bleeding before total cystectomy and urinary diversion.
Administration, Intravesical* ; Cystectomy ; Formaldehyde* ; Hematuria ; Hemorrhage* ; Hemostasis ; Humans ; Middle Aged ; Recurrence ; Urinary Diversion ; Uterine Neoplasms

Vaccinia virus is the prototype orthopoxvirus that has been used as a vaccine strain for small pox. This virus has been used to express a variety of cellular and viral genes in mammalian cells at high levels. Interleukin-4 (IL-4) has been found to stimulate the proliferation of T cells and enhance the cytolytic activity of cytotoxic T lymphocytes. To test the immunotherapeutic potential of IL-4 delivered in vivo by poxvirus, a recombinant vaccinia virus expressing the murine IL-4 gene (RVVmIL-4) was constructed. A high level of IL-4 production was confirmed by infecting HeLa cells and measuring IL-4 in cell culture supernatant by ELISA. As a tumor model, two cell lines were used: the murine T leukemic line P388 and the murine breast cancer line TS/A. CDF1 mice were intraperitoneally inoculated with 1 x 105 cells of P388. Mice were injected at the same site with 5 x 105 PFU of recombinant vaccinia virus; first, 3 days after the injection of tumor cells and thereafter once every week for 3 weeks. Intraperitoneal injections of RVVmIL-4 significantly prolonged the survival time of mice inoculated with tumor cells. All mice injected with RVVmIL-4 remained alive for 30 days after the postinoculation of tumor cells, while 100% and 70% of the animals injected with saline or wild type vaccinia virus died, respectively. In another tumor model using TS/A, tumor was established by subcutaneously inoculating 2 x 105 tumor cells to BALB/c mice. After tumor formation was confirmed on day 4 in all mice, 5 x 106 PFU of RVVmIL-4 was inoculated subcutaneously three times, once every week for 3 weeks. The TS/A tumor was eradicated in two of the nine mice. Seven of the nine mice treated with RVVmIL-4 developed a tumor, but tumor growth was significantly delayed compared to those treated with saline or wild type vaccinia virus. These results indicate that recombinant vaccinia viruses may be used as a convenient tool for delivering immunomodulator genes to a variety of tumors.
Animals ; Breast Neoplasms ; Cell Culture Techniques ; Cell Line ; Enzyme-Linked Immunosorbent Assay ; Genes, Viral ; HeLa Cells ; Humans ; Injections, Intraperitoneal ; Interleukin-4* ; Interleukins* ; Mice ; Orthopoxvirus ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic ; Vaccinia virus* ; Vaccinia*

BACKGROUND: Bilirubin has been suggested as a antioxidant which protect oxidation of lipids and lipoproteins. Given that oxidized lipids and lipoproteins are known to be atherogenic, low serum concentrations of bilirubin could be associated with the high risk of coronary artery disease (CAD). But few studies have been performed for confirmation of this hypothesis. In this study, we evaluated the relationship between serum concentrations of billrubln and the angiographically documented CAD. METHODS: Eighty five CAD patients and 56 non-CAD patients, classified according to the maximum stenosis of coronary artery at angiography, were enrolled in this study. The degree of the coronary arterial stenosis were subclassified into <10% (non-CAD), 10-49% (mildly stenotic CAD) and > or =50% (severely stenotic CAD). We retro-spectively reviewed serum concentrations of total and direct bilrubin at the time of angiography, compared tine mean concentrations of bilirubin between two groups and evaluated it in relation to the severity of CAD by statistical analysis. RESULTS: The mean concentration of total bilrubin was significant1y lower in CAD group 4han non-CAD group (12.8 micromol/L vs. 15.2 micromol/L, p value=0.04) The mean concentration of direct bilirubin was lower in CAD group than non-CAD group but not statistically significant (3.3 micromol/L vs. 4.2 micromol/L, p value=0.07). Although not significant, the concentration of total bilirubin in severely stenotic group (12.8 CAD group 12.8+/-4.3 micromol/L) was lower than mildly stenotic group (13.5+/-3.8 micromol/L) and non CAD group (15.2+/-7.4 micromol/L ) (p=0.07). CONCLUSIONS: This study showed that low serum concentrations of total bilirubin were associated with the high risk of CAD and supports the hypothesis that serum bilirubin could act as an antiatherosclerotic factor. Further prospective studies are required to confirm the relationship between bilirubin and CAD and to elucidate the most associated fraction of bilirubin and pathogenic mechanism.
Angiography ; Bilirubin* ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Lipoproteins

No abstract available.
Diagnosis*