No abstract available.
Transplants*

BACKGROUND: Mechanisms of secondary injury (post-ischemic injury) in the central nervous system have cently reported in a vast of amount of experiments. Among many factors which give rise to post-ischemic neuronal damage, glial deterioration probably mediated by calcium paradox, could be another of the aggravating deleterious factars to the already ischemic neurophil. METHODS: Here we have designed experiment to investigate calcium paradox in astroglial cell line, humsn asttocytoma U1242MG. Intracellular calcium alterations in experimental cells were monitored by using calcium indicating dye fura-2 and epifluorescent photometry system. RESULTS: Intracellular free calcium changes during reperfusion phase after exposure to low calcium led to a prampt increase in intracellular calcium level after 10 and 30 minutes. The way of calcium entry during the reperfusion phase was mediated by the revase mode of Na+/Ca(2+) exchanger. Cells that had a reduction of reperfusate calcium to 10 uM increased cell viability. Also we observed an inverse relationship between major enzymatic activity in the astrocytoma cells (i.e., glutamine synthetase activity) and the duration of reperfusion in the the same protocols. CONCLUSIONS: A relatively small amount of intracellular calcium increase by the reverse mode of Na+/Ca(2+) exchanger during the reperfusion period is related to a limitation of enzyme activity and viability 24 hours later.
Anesthesia* ; Astrocytoma ; Brain ; Calcium ; Capnography* ; Cell Line ; Cell Survival ; Central Nervous System ; Fura-2 ; Glutamate-Ammonia Ligase ; Ions ; Neuroglia ; Neurons ; Photometry ; Reperfusion

Adult intussusception is rare, and the majority of cases has an underlying cause that requires surgical resection. We report a case of a 39 yr-old man with ileo-ileo-colic intussusception caused by ileal lipoma that was successfully managed by a laparoscopic-assisted surgical maneuver. Using a three-cannula technique, ileo-colic intussusception was reduced laparoscopically. Then, through a 4-cm transverse incision in the right lower quadrant abdomen, ileo-ileal intussusception was reduced manually, and a resection of the tumor-bearing ileal segment and end-to-end anastomosis was performed extracorporeally. Although the role of laparoscopy in managing intussusception is not clearly defined, laparoscopy may be an alternative approach to the surgical treatment of adult intussusception in selected cases.
Adult ; Case Report ; Human ; Ileal Diseases/surgery* ; Ileal Neoplasms/surgery* ; Intussusception/surgery* ; Laparoscopy ; Lipoma/surgery* ; Male

The purpose of this study was to determine the efficacy of the CO2-laser energy in the operation of cleft palate and pharyngeal fiap compared with the traditional scalpel surgery. This investigation involved a series of 34 patients who underwent CO2-laser assisted palatoplasty and pharyngeal flap between 1995 and 1997. The 19 males and 15 females ranged from 13 months to 36 years in age (mean age of 5.6 years) at the time of surgery. The postoperative clinical follow-up ranged from 6 to 24 months (mean 12 months). The CO??-laser provided the surgeon with bloodless operative field with reduction in blood loss giving greater visibility. It also offered an advantage in deep surgical cavity in Ro-pharynx through an operative arm, reaching areas that would otherwise have been difficult to access by traditional means. There was less bleeding during the surgery using, and therefore, complication. associated with bleeding was minimalized. There were no significant differences in their wound healing between the traditional scapel method and the laser method. The mean hospitalization in the group using the laser was approximately one day less than the group using the scapel. Preliminary findings suggest that the laser assisted palatoplasty and pharyngeal flap has a definitive advantage in providing the surgeon with bloodless operative field, reduction of blood loss, early recovery. Disadvantages of the laser surgery is a learning curve, the expenses of equipment, and safety precaution.
Arm ; Cleft Palate ; Female ; Follow-Up Studies ; Hemorrhage ; Hospitalization ; Humans ; Laser Therapy ; Learning Curve ; Male ; Wound Healing

BACKGROUND: Fine needle aspiration cytology is an effective and important diagnostic procedure to distinguish benign from malignant thyroid nodule. The purpose of this study is to compare the results of thyroid fine needle aspiration cytology performed by the residents of family medicine and internal medicine. METHODS: Among patients who underwent fine needle aspiration cytology for differential diagnosis of thyroid nodule at the department of family medicine, Pusan National University Hospital from July 1996 to June 1998, we randomly selected 96 patients. We also selected 96 control patients at the department of internal medicine. We assessed the patients age, sex, accompanying symptoms, diagnostic procedures, pathologic results of fine needle aspiration cytology from the medical records and biopsy records. For statistical analysis, we used t-test and Chi-square test. RESULTS: Mean age of 96 patients of family medicine was 44.4 years. Females were 89(92.7%) and males 7(7.3%). Age and sex distributions were not significantly different from that of internal medicine patients(p>0.05). Patients with thyroid nodule had underwent fine needle aspiration cytology(100.0%), thyroid function test(76.0%), thyroid scan(49.0%), and thyroid ultrasond(35.4%). There were more thyroid scans performed in the intemal medicine department, as there were more ultrasonograms done in the family medicine department(p<0.05). Pathology results of 96 cases showed benign in 51 cases(53.1%), malignant in 8(8.3%), indeterminate in 16(16.7%), and insufficient in 21(21.9%). Among the 51 benign cases, there were cystic nodule(27.1%), adenomatous hyperplasia(22.9%), and thyroiditis(3.1%). All 8 malignant cases were papillary carcinoma. The frequency of malignancy thyroid nodules and insufficient specimens were not significantly different between the two departments(p>0.05). Complications of aspiration were rare and not significantly different between the two departments(p>0.05). CONCLUSIONS: Pathology results and complications of fine needle aspiration cytology performed by residents of family medicine and internal medicine were not significantly different.
Biopsy ; Biopsy, Fine-Needle* ; Busan ; Carcinoma, Papillary ; Diagnosis, Differential ; Female ; Humans ; Internal Medicine* ; Male ; Medical Records ; Pathology ; Sex Distribution ; Thyroid Gland* ; Thyroid Nodule ; Ultrasonography

BACKGROUND: The increasing number of outpatient surgery which requiring the rapid, smooth induction of anesthesia with rapid recovery may lead to the use propofol or sevoflurane. Our objective was to compare the hemodynamic responses and recovery profiles obtained by sevoflurane inhalation with propofol infusion using a laryngeal mask airway (LMA) in an ambulatory setting. METHODS: Forty patients undergoing knee arthroscopic surgery were randomized into two groups. The laryngeal mask airway insertion was accomplished by using the voluntary maximal vital capacity breathing method (VCB) with sevoflurane 7% in nitrous oxide 50% (sevoflurane group) or by the infusion of propofol (target: 7microgram/ml) (propofol group). Under BIS monitoring (40-60), anesthesia was maintained by sevoflurane (2-3%) or propofol (range of 3.7-4.2microgram/ml) with spontaneous respiration. Time to loss of consciousness (LOC) and LMA insertion from induction of anesthesia, hemodynamic responses, end tidal CO2, and recovery profiles were evaluated. RESULTS: The mean time to LOC and to successful LMA insertion were similar in the groups. Hemodynamic responses in the sevoflurane group were not significantly different from those of the propofol group. However, in both groups, systolic and diastolic blood pressure were lower at the time of loss of consciousness and 5 min of after LMA insertion versus preinduction and LMA insertion values (P<0.05). Heart rate was significantly lower in the propofol group (P<0.05). After cessation of anesthesia, hemodynamic responses and to the time for LMA removal or to the time for responding to a verbal command were similar in both groups. CONCLUSIONS: Sevoflurane inhalation and propofol infusion anesthesia with spontaneous respiration provided comparable conditions for outpatient surgery.
Ambulatory Surgical Procedures ; Anesthesia ; Arthroscopy* ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Inhalation ; Knee* ; Laryngeal Masks* ; Nitrous Oxide ; Outpatients* ; Propofol ; Respiration ; Unconsciousness ; Vital Capacity

BACKGROUND: Expression of CXCR4 chemokine receptor, initially described to be involved in the homing of lymphocytes in inflammatory tissue, on breast cancer cell lines is associated with the development of lung metastases. In the present study, we evaluated CXCR4 expression in patients with non-small cell lung cancer (NSCLC). METHODS: Tissue microarray blocks were constructed from 408 formalin-fixed, paraffin-embedded NSCLC samples and analyzed via immunohistochemical staining. RESULTS: We observed CXCR4 expression in 214 (66.3%) of the 323 tumors with cytoplasmic or nuclear staining patterns. These tumors were then divided into 109 negative, 166 weak-positive and 48 strong-positive expression groups. Strong expression of CXCR4 correlated with NSCLC recurrence (p=0.047) and distant metastasis (p=0.035). However, lymph node metastasis (p=0.683) and locoregional recurrence (p=0.856) were not associated with CXCR4 expression. Interestingly, the median overall survival times relative to CXCR4 expression were 71 months in the CXCR4-negative group, 43 months in the weakly positive CXCR4 group and 23 months in the strongly positive CXCR4 group. Strongly positive CXCR4 staining was associated with significantly worse outcomes (p=0.005, log-rank test). CONCLUSIONS: Expression of CXCR4 was associated with distant NSCLC metastases and shorter survival times.
Neoplasm Metastasis ; Breast Neoplasms ; Lung Neoplasms

We experienced a rare case of trachea diverticula combined with the sequela of tuberculosis and a fungus ball. The patient had complained of coughing and hemoptysis for a long time after experiencing tuberculosis. He was admitted due to hemoptysis and the aggravation of coughing. The CT scan showed a variable sized trachea diverticula combined with tuberculosis sequela and a fungus ball in the right lung fields. The diagnosis was made by bronchoscopy and a CT scan. After bronchial artery embolization and conservative treatment, the patient's symptoms improved and the patient was discharged.
Bronchial Arteries ; Bronchoscopy ; Cough ; Diagnosis ; Diverticulum* ; Fungi* ; Hemoptysis* ; Humans ; Lung ; Tomography, X-Ray Computed ; Trachea ; Tuberculosis*

Local control is the important prognostic factor in cancer treatment because local control decrease the relative risk of metastatic spread and increse distant metastasis free survival. IORT is the modality which could increase local control without incressing complication, combined with curative operation. Eventhough we could achieve significant deacreased local failure by IORT and curative resection, it should not be committed as a main treatment modality without proving acceptable complications. Therapeutic Radiology Department of Yeungnam University Medical Center have tried 58 IORT from June 15, 1988, and performed 53 IORT in patients with gastric cancer. No local failure has been reporte? by regular follow up so far. Nine cases(17%) of treatment related complifaiton were reported including intestinal obstrution, hemorrhage, sepsis, and bone marrow depression. These complications could be comparable to Jo's 25.2% (chemotherapy + operation), Kim's 18% (chemotherapy only in inoperable patients), because our treatment regimen is consisted of IORT (1500 cGy), external irradiation(--4500 cGy) and extensive chemotherapy (FAM, 5FU+MMC, BACOP). Our data encouraged us to re-inforce further IORT in stomach cancer treatment.
Academic Medical Centers ; Bone Marrow ; Depression ; Drug Therapy ; Follow-Up Studies ; Hemorrhage ; Humans ; Neoplasm Metastasis ; Radiation Oncology ; Sepsis ; Stomach Neoplasms*

OBJECTIVE: To investigate the effectiveness of radiographic parameters on segmental instability in the lumbar spine using Kinetic magnetic resonance imaging (MRI). METHODS: Segmental motion, defined as excessive (more than 3 mm) translational motion from flexion to extension, was investigated in 309 subjects (927 segments) using Kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration (DD), facet joint osteoarthritis (FJO), and ligament flavum hypertrophy (LFH). These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. RESULTS: The overall incidence of segmental instability was 10.5% at L3-L4, 16.5% at L4-L5, and 7.3% at L5-S1. DD and LFH at L3-L4 and FJO and LFH at L4-L5 were individually associated with segmental instability (p<0.05). At L4-L5, the following combinations had a higher incidence of segmental instability (p<0.05) when compared to other segments : (1) Grade IV DD with grade 3 FJO, (2) Grade 2 or 3 FJO with the presence of LFH, and (3) Grade IV DD with the presence of LFH. At L5-S1, the group with Grade III disc and Grade 3 FJO had a higher incidence of segmental instability than the group with Grade I or II DD and Grade 1 FJO. CONCLUSION: This study showed that the presences of either Grade IV DD or grade 3 FJO with LFH at L4-L5 were good indicators for segmental instability. Therefore, using these parameters simultaneously in patients with segmental instability would be useful for determining candidacy for surgical treatment.
Humans ; Hypertrophy ; Incidence ; Intervertebral Disc Degeneration ; Ligaments ; Magnetic Resonance Imaging ; Osteoarthritis ; Spine ; Zygapophyseal Joint