Lobular carcinoma of the male breast is very rare, because of the absence of lobules in the normal male breast. Herein, a case of lobular carcinoma of the male breast with cellular features of signet ring cells is described. A 57-year-old man presented with a left breast mass. Histologic examination showed classic invasive lobular carcinoma with in situ component. Most infiltrating tumor cells had a prominent signet ring cell appearance. The patient was phenotypically male and had fathered children. There was no history of predisposing factors to breast lesion, such as hormone use or gynecomastia.
Breast* ; Carcinoma, Lobular* ; Causality ; Child ; Fathers ; Gynecomastia ; Humans ; Male* ; Middle Aged

Lobular carcinoma of the male breast is very rare, because of the absence of lobules in the normal male breast. Herein, a case of lobular carcinoma of the male breast with cellular features of signet ring cells is described. A 57-year-old man presented with a left breast mass. Histologic examination showed classic invasive lobular carcinoma with in situ component. Most infiltrating tumor cells had a prominent signet ring cell appearance. The patient was phenotypically male and had fathered children. There was no history of predisposing factors to breast lesion, such as hormone use or gynecomastia.
Breast* ; Carcinoma, Lobular* ; Causality ; Child ; Fathers ; Gynecomastia ; Humans ; Male* ; Middle Aged

We had two cases of hepatitis developing after surgery. Case 1. A 47 year old male underwent surgery for amputation of the lower leg under enflurance anesthesia. Preoperative liver function test were slightly abnormal. On the 25th portoperative day, serum transaminases were elevated and the A/G ratio was reversed. On the 65th postoperative day, the liver function tests returned to near normal leve. Case 2. A 37 year old male underwent the first surgery for reduction of a pateliar fracture under spinal anesthesia. Preoperative serum transaminages were elevated and other laboratory findings at normal levels. On the 20th postoperative day serum transaminases were more elevated and on the 120th postoperative day, ti became normal again. This patient underwent the second surgery for removal of a K-wire under enflurane anesthesia and afterwards hepatitis recurred. On the 60th 2nd postoperative day LEFs became nearer to normal level and he was discharged in good health. Possible causes of the hepatitis in these cases were considered to be the preoperative liver disease, blood transfusion, the stress of the surgery and anesthesia.
Adult ; Amputation ; Anesthesia ; Anesthesia, Spinal ; Blood Transfusion ; Enflurane ; Hepatitis* ; Humans ; Leg ; Liver Diseases ; Liver Function Tests ; Male ; Middle Aged ; Transaminases

BACKGROUND: Core temperature decreases rapidly after the induction of general anesthesia, because the heat is redistributed to peripheral tissues. Thermoregulatory responses of volatile anesthetics have been tested, but their effects have not been directly compared. Therefore, we evaluated the thermoregulatory responses to sevoflurane, desflurane, and isoflurane. METHODS: Sixty healthy patients scheduled for laparoscopic myomectomy or radical hysterectomy were allocated into three groups; Group S (sevoflurane, n = 20), Group D (desflurane, n = 20), and Group I (isoflurane, n = 20). Anesthesia was maintained with 1 minimum alveolar concentration (MAC) of sevoflurane, desflurane, and isoflurane in a 50/50 mixture of N2O/O2. Patients were maintained in a normovolemic and normocapnic state. The core temperature and forearm minus fingertip skin-temperature gradient (an index of peripheral vasoconstriction) were monitored after the induction of general anesthesia. RESULTS: Each of the seven patients given sevoflurane, desflurane, and isoflurane vasoconstricted at a core temperature of 35.3 +/- 0.5degrees C, 33.6 +/- 0.4degrees C, and 35.2 +/- 0.4degrees C, respectively. The vasoconstriction threshold was the lowest in patients anesthetized with desflurane. The core temperature gradient (Ti-Tf) was significantly higher in patients that were anesthetized with desflurane than in those that were anesthetized with sevoflurane or isoflurane. The core temperature of desflurane was significantly lower than that of sevoflurane or isoflurane 15 minutes after the induction of anesthesia until 180 minutes of anesthesia. CONCLUSIONS: These results indicate that the core temperature is maintained at a higher level in patients that have been anesthetized with sevoflurane or isoflurane than in those that have been anesthetized with desflurane.
Anesthesia ; Anesthesia, General ; Anesthetics ; Forearm ; Hot Temperature ; Humans ; Hysterectomy ; Isoflurane ; Laparoscopy ; Methyl Ethers ; Vasoconstriction

No abstract available.
Adenocarcinoma* ; alpha-Fetoproteins*

BACKGROUND: The insertion of a mouth gag causes acute hemodynamic changes such as hypertension and tachycardia. Several adjuvant drugs have been used to attenuate such responses. The aim of this study was to determine the effects of remifentanil in preventing the hemodynamic changes associated with the insertion of mouth gag after a remifentanil injection. METHODS: Thirty children, ASA1 or 2, who were scheduled for elective surgery, were divided randomly into two groups; group I (placebo; normal saline 0.05 ml/kg, n = 15), and group II (remifentanil 0.05microg/kg, n = 15). After inducing general anesthesia with thiopental sodium (5 mg/kg) and rocuronium (0.06 mg/kg), anesthesia was maintained by the inhalation of sevoflurane 2 vol% in N2O/O2 (50/50) via an endotracheal tube. The patients in group I and II received normal saline 0.05 ml/kg, and remifentanil 0.05microg/kg 1 minute before inserting the mouth gag, respectively. The patients' blood pressure heart rate were measured before and after inserting mouth gag. RESULTS: The hemodynamic changes in group I were minimal after inserting the mouth gag compared with group II. CONCLUSIONS: Remifentanil is effective in attenuating the increase in blood pressure and heart rate after inserting a mouth gag.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Child ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Inhalation ; Mouth* ; Tachycardia ; Thiopental ; Tonsillectomy*

BACKGROUND: The injection of rocuronium causes pain and withdrawal responses. This study was designed to determine an appropriate dose of remifentanil to prevent the withdrawal responses associated with injection of rocuronium in children. METHODS: Fourty five ASA physical status I and II pediatric patients were randomly allocated into three groups; Group I (placebo; normal saline 3 ml, n = 15), Group II (remifentanil 0.3microg/kg, n = 15), Group III (remifentanil 0.5microg/kg, n = 15). After the induction of anesthesia with 5 mg/kg of thiopental sodium, patients in groups I, II, and III received normal saline 3 ml, remifentanil 0.3microg/kg, and remifentanil 0.5microg/kg, respectively. After one minute, rocuronium 0.6 mg/kg was injected over 10 seconds. The patient's response after injection was graded using a four-point scale. The patient's heart rate (HR), mean arterial pressure (MAP) were measured at pre-anesthesia (T0), 1 minute after injection of thiopental sodium (T1), test drug (T2), and rocuronium (T3). RESULTS: The incidence of withdrawal responses was 100%, 66.7%, and 20% in groups I, II, and III, respectively. In addition, the severity of withdrawal responses was lowest in group III. CONCLUSIONS: Remifentanil 0.5microg/kg was an appropriate dose to prevent the withdrawal responses on injecting rocuronium.
Androstanols ; Anesthesia ; Arterial Pressure ; Child ; Heart Rate ; Humans ; Incidence ; Piperidines ; Thiopental

No abstract available.
Humans ; Hypersensitivity* ; Phenytoin*

A route of colorectal cancer development other than the adenoma-carcinoma sequence has recently become an issue due to the discovery of depressed-type early colorectal cancers. Moreover, the fact that some polyp-like cancers actually originate from depressed-type lesions has become obvious. Despite the protruding shapes of depressed-type early colorectal cancers, they probably have biological characteristics, which are different from those of the usual polyp lesions. We undertook this study to evaluate the clinical significance of depressed-type colorectal neoplasms. The authors recently experienced 87 cases of depressed-type colorectal neoplasms. Using Kudo's classification, we classified these 87 cases into three types based on their growth patterns, type IIc, type IIa + IIc, and type Is + IIc, and then analyzed these types on the basis of size, type, and submucosal invasion rate. The submucosal invasion rate of cancers of type IIa + IIc was significantly higher than that of type IIc (p < 0.05), and the rate for cancers of types IIa + IIc and Is + IIc together was significantly higher than that of type IIc (p < 0.05). However, no significant difference was found between the rates of types IIa + IIc and Is + IIc. In conclusion, the IIa + IIc and Is + IIc sub-types of depressed-type colorectal neoplasms, individually and together, have higher rates of submucosal invasion than type IIc lesions. Accordingly, type IIa + IIc and type Is + IIc must be differentiated from the usual polyps and should be managed cautiously, despite their protruding shapes.
Colorectal Neoplasms/*pathology ; Disease Progression ; Female ; Human ; Male ; Middle Age ; Neoplasm Invasiveness

OBJECTIVES: This study was conducted to investigate the association between job stress and occupational injury among Korean employees. METHODS: The data was obtained from a work-stress survey that was administered to employees of small and medium-sized companies in Incheon, Korea. A four-month prospective follow-up study was conducted (the baseline study was conducted from September 2006 to October 2006, and the follow-up study was done from March 2007 to April 2007). A total of 1,241 participants (774 males and 467 females) were included in the analysis. A structured self-reported questionnaire was used to assess each respondent's sociodemographics, work related factors, job stress, and occupational injury. Job stress was measured using 24 items (7 sub-scales) of the Short Form of the Korean Occupational Stress Scale (KOSS-SF). Occupational injuries were assessed by self-report during the follow-up period. We estimated the relation of job stress to occupational injury using logistic regression analyses. RESULTS: A total of 199 employees (16.0%) had suffered at least one occupational injury during the previous 4-months. After adjustment for confounding variables, the logistic regression analyses indicated that the groups with high stress as related to 'Job demand' (OR=2.23, 95% CI=1.61-3.08), 'Organizational system' (OR=1.63, 95% CI=1.19-2.23), 'Lack of reward' (OR=1.42, 95% CI=1.03-1.95) and 'Occupational climate' (OR=1.55, 95% CI=1.13-2.13) were more likely to experience occupational injury than the other groups. CONCLUSIONS: Our results tend to suggest that job stress is associated with occupational injury. The importance of job stress should be acknowledged and stress management programs need to be started to minimize the occupational injury caused by job stress.
Confounding Factors (Epidemiology) ; Follow-Up Studies ; Humans ; Korea ; Logistic Models ; Male ; Occupational Injuries ; Prospective Studies ; Questionnaires ; Risk Factors