PURPOSE: Thrombocytosis is reported in patients with various tumors, including stomach, colon, ovarian, lung and pancreatic cancers. Some clinical reports have shown thrombocytosis to be a poor prognostic factor in cancer patients. However, in hepatocellular carcinoma patients, the incidence and clinical significance of thrombocytosis have not been clearly verified. In this study, the clinical significance of platelet counts was investigated in patients with hepatocellular carcinomas. METHODS: 212 patients with surgically proven hepatocellular carcinomas were enrolled in this study. The incidence, relationship with other clinicopathological factors, and the prognostic value of thrombocytosis were retrospectively evaluated. RESULTS: The incidence of thrombocytosis (> or =400, 000/ul) was 2.8% (6/212). The platelet counts were elevated in patients with a large sized tumor (p< 0.001), advanced TNM stage (p=0.009) and gross tumor thrombi in the portal vein (p=0.009). There was no difference in the survival between patients with low and high platelet counts. CONCLUSION: The incidence of thrombocytosis in hepatocellular carcinoma patients was very low. The platelet counts were elevated in patients with advanced hepatocellular carcinomas, but no prognostic significance was shown in this study.
Blood Platelets* ; Carcinoma, Hepatocellular* ; Colon ; Humans ; Incidence ; Lung ; Pancreatic Neoplasms ; Platelet Count* ; Portal Vein ; Retrospective Studies ; Stomach ; Thrombocytosis

Purpose: We present a case of central anticholinergic syndrome following the administration of atropine eye drops.Case summary: A 60-year-old male presented with decreased visual acuity in his left eye and was diagnosed with intraocular lens dislocation. Preoperatively, Isopto atropine® eye drops (1 drop at 15-minutes intervals) were used for pupil dilation. Within an hour of the first instillation, the patient exhibited drowsiness, disorientation, agitation, and urinary retention. Laboratory tests and computed tomography of the brain were unremarkable. Considering the recent administration of atropine eye drops, a diagnosis of central anticholinergic syndrome was made. The surgery was postponed and the patient recovered fully after 3 hours of observation. He remained asymptomatic during an additional day of hospitalization. Conclusions A small dose of atropine eye drops even at a therapeutic dose can induce central anticholinergic syndrome. Therefore, ophthalmologists should be aware of this rare and severe complication.

Purpose: We present a case of central anticholinergic syndrome following the administration of atropine eye drops.Case summary: A 60-year-old male presented with decreased visual acuity in his left eye and was diagnosed with intraocular lens dislocation. Preoperatively, Isopto atropine® eye drops (1 drop at 15-minutes intervals) were used for pupil dilation. Within an hour of the first instillation, the patient exhibited drowsiness, disorientation, agitation, and urinary retention. Laboratory tests and computed tomography of the brain were unremarkable. Considering the recent administration of atropine eye drops, a diagnosis of central anticholinergic syndrome was made. The surgery was postponed and the patient recovered fully after 3 hours of observation. He remained asymptomatic during an additional day of hospitalization. Conclusions A small dose of atropine eye drops even at a therapeutic dose can induce central anticholinergic syndrome. Therefore, ophthalmologists should be aware of this rare and severe complication.

Purpose: We present a case of central anticholinergic syndrome following the administration of atropine eye drops.Case summary: A 60-year-old male presented with decreased visual acuity in his left eye and was diagnosed with intraocular lens dislocation. Preoperatively, Isopto atropine® eye drops (1 drop at 15-minutes intervals) were used for pupil dilation. Within an hour of the first instillation, the patient exhibited drowsiness, disorientation, agitation, and urinary retention. Laboratory tests and computed tomography of the brain were unremarkable. Considering the recent administration of atropine eye drops, a diagnosis of central anticholinergic syndrome was made. The surgery was postponed and the patient recovered fully after 3 hours of observation. He remained asymptomatic during an additional day of hospitalization. Conclusions A small dose of atropine eye drops even at a therapeutic dose can induce central anticholinergic syndrome. Therefore, ophthalmologists should be aware of this rare and severe complication.

Gangliogliomas are rare benign tumors of the central nervous system consisting of neoplastic ganglion and low grade glial cells. The purpose of our investigation was to evaluate the clinical, radiological, surgical, and pathological features and outcome of ten patients with intracranial ganglioglioma who underwent surgery between June 1989 and December 1996. The mean follow-up period was about 24 months(range, 6-66 months) after their initial operation. The series consisted of six males and four females, and their mean age was 29.7 years. The mean length of symptoms was 9.1 years. Seizure was the most common presenting symptom and occurred in eight of ten patients. MRI findings were variable, and showed no characteristic patterns. The temporal lobe was the most common site of involvement(6/10). During surgery, a sharp demarcation between tumor and normal brain tissue was seen in seven of ten cases. Five of ten cases were solid, and the remaining cases were cystic in two, cystic with mural nodule in two, and soft, suckable in one. Total resection was possible in seven of ten patients. Diagnosis was established by identifying a mixture of abnormal astrocytic and neuronal components. Two patients showed astrocytic predominance; four, a neuronal predominance; and four, an equal admixture of cell types. All cases were benign. Other histopathological findings included microcystic change, desmoplasia, eosinophilic granular body, microcalcification, and lymphocytic infiltration. At the time of writing, all seven patients who underwent total resection were alive without recurrence; of the three who underwent subtotal resection, two were alive and in a stable condition, while in the other, the tumor had progressed within 12 months of surgery and adjuvant radiation therapy had thus been required. The patients was, though, still alive. In seven of eight patients, the frequency of seizure had markedly decreased. Our study confirms that this tumor is a distinct clinical and histological entity with a predilection for the temporal lobe. Although the number of patients and follow-up period are limited, this study also shows that epilepsy is extremely well controlled and that survival after surgical resection is good.
Brain ; Central Nervous System ; Diagnosis ; Eosinophils ; Epilepsy ; Female ; Follow-Up Studies ; Ganglioglioma* ; Ganglion Cysts ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroglia ; Neurons ; Recurrence ; Seizures ; Temporal Lobe ; Writing

Chylothorax is a debilitating condition to the point of threatening life. Diagnosis and subsequent management present significant problems for the clinician and the adverse effects of chyle loss on nutrition status and immune function result in devastating consequences for the patient. prompt diagnosis is essential to institute an effective therapeutic regimen. we reported a patient of idiopathic bilateral chylothorax treated by conservative approach with review of literatures.
Chyle ; Chylothorax* ; Diagnosis ; Humans ; Nutritional Status

A folk prescription consisting of Alnus hirsuta, Rosa davurica, Acanthopanax senticosus and Panax schinseng has been used in the treatment of diabetes mellitus. The aim of the present investigation was to evaluate the antidiabetic effects of the herb formula extract (HFE) composed of Alnus hirsuta, Rosa davurica, Acanthopanax senticosus and Panax schinseng in the streptozotocin (STZ)-induced diabetic rats. The HFE was mixed in the food supply of the healthy and STZ-induced diabetic male Sprague-Dawley rats, and its effects on the body weight, water and food intake, hyperglycemia, hypolipidemic and islet structure were studied. The treatment of the rats with STZ for 6 weeks resulted in marasmus, polydipsia, polyphagia, hyperglycemia and hypoinsulinemia. In addition, the diabetic rats showed an apparent decrease in the insulin immunoreactivity and the number of beta-cells in the pancreas. The addition of the HFE to the rats' food supply significantly lowered the serum glucose and the serum triglycerides level and preserved the normal histological appearance of the pancreatic islets. These results indicate that the HEF have a strong antidiabetic potential along with the significant hypoglycemic and hypolipidemic effects, which may be applicable in the pharmaceutical industry.
Eleutherococcus ; Alnus ; Animals ; Body Weight ; Diabetes Mellitus ; Drinking ; Drug Industry ; Eating ; Food Supply ; Glucose ; Humans ; Hyperglycemia ; Immunohistochemistry ; Insulin ; Islets of Langerhans ; Male ; Panax ; Pancreas ; Polydipsia ; Prescriptions ; Protein-Energy Malnutrition ; Rats ; Rats, Sprague-Dawley ; Rosa ; Streptozocin ; Triglycerides

BACKGROUND: Spinal zaprinast, phospodiesterase inhibitor, has been shown to have an antinociception through an increase of cGMP. The aim of this study was to examine the role of spinal adrenergic and cholinergic receptors on the antinociceptive action of intrathecal zaprinast. METHODS: Rats were implanted with lumbar intrathecal catheters. After formalin injection, formalin-induced nociceptive behavior (flinching response) was observed for 60 min. After observing the effect of intrathecal zaprinast, antagonism of intrathecal prazosin, yohimbine, atropine and mecamylamine for the effect of zaprinast were evaluated. RESULTS: Intrathecal zaprinast produced a dose-dependent suppression of formalin-induced flinches in both phases of the formalin test. Intrathecal prazosin reversed the antinociception of zaprinast in phase 2, but not phase 1. Intrathecal yohimbine reversed the antinociception of zaprinast in both phases. Neither atropine nor mecamylamine reversed the antinocicetive action of zaprinast. CONCLUSIONS: Intrathecal zaprinast is against the nociceptive state evoked by formalin stimulus. Alpha 2 or alpha 1 adrenergic receptor, but not cholinergic receptors, may be related to the action of zaprinast in the spinal cord.
Animals ; Atropine ; Catheters ; Formaldehyde* ; Mecamylamine ; Pain Measurement* ; Prazosin ; Rats* ; Receptors, Adrenergic, alpha-1 ; Receptors, Cholinergic* ; Spinal Cord ; Yohimbine

PURPOSE: This study tried to find the most significant factors predicting implant prognosis using machine learning methods. MATERIALS AND METHODS: The data used in this study was based on a systematic search of chart files at Seoul National University Bundang Hospital for one year. In this period, oral and maxillofacial surgeons inserted 667 implants in 198 patients after consultation with a prosthodontist. The traditional statistical methods were inappropriate in this study, which analyzed the data of a small sample size to find a factor affecting the prognosis. The machine learning methods were used in this study, since these methods have analyzing power for a small sample size and are able to find a new factor that has been unknown to have an effect on the result. A decision tree model and a support vector machine were used for the analysis. RESULTS: The results identified mesio-distal position of the inserted implant as the most significant factor determining its prognosis. Both of the machine learning methods, the decision tree model and support vector machine, yielded the similar results. CONCLUSION: Dental clinicians should be careful in locating implants in the patient's mouths, especially mesio-distally, to minimize the negative complications against implant survival.
Decision Trees ; Dental Implants ; Dentists ; Humans ; Machine Learning ; Methods ; Mouth ; Oral and Maxillofacial Surgeons ; Pilot Projects ; Prognosis ; Sample Size ; Seoul ; Support Vector Machine

Tuberculosis of the cystic duct lymph node is very rare. Only four cases have been reported in the literature. This paper presents the case of a young male patient with a tuberculous cystic duct lymph node and chronic cholecystitis, who was diagnosed with cystic duct stones and a gall bladder polyp preoperatively.