Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic

Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic

No abstract available.
Blepharophimosis* ; Humans

Higt energy electron beam therapy is a method which is used for the treatment of superficial tumors (less than 5 cm deep) with a characteristically sharp drop-off in dose beyond the tumor. This method offers distinct advantages in dose uniformity and in minimizing the dose to deeper tissues. We report herein three cases of epithelial skin cancer treated with high energy electron beam. The first patient was a 79-year-old male who had primary basal cell carcinoma(BCC) on the right lateral canthus. The second patient was a 67-year-old male who had recurreiit BCC on the right cheek. Both of them received electron beam therapy on the lesion and there were no clinical relapse signs over 1 year. The third patient was a 46-year-old male who had squamous cells, carcinoma on the lower lip. He also received electron beam therapy on the lesion, but it recurred.
Aged ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheek ; Humans ; Lip ; Male ; Middle Aged ; Recurrence ; Skin Neoplasms* ; Skin*

It has been suggested that glucocorticoid receptors are present in inner ear tissues and may act in stress related mechanism of cochlea. The purpose of this study was to determine whether stress to auditory system could change glucocorticoid receptors(GR) in the cochlear tissues and to hypothesize the relationship between heat shock protein and glucococorticoid receptors which may involve in stress related mechanism of cochlea. Sprague-Dawley rats were exposed to intense broad band noise(110dB SPL) as a stressful condition to auditory system and immunohistochemical and western blot analyses were used to compare the expression patterns of glucocorticoid receptors between noise exposed and normal rat cochlea. In western blot analysis, immunoreactive bands of noise exposed cochlear tissues were weaker than those of normal non-noise exposed cochlear tissues. In immunohistochemistry, GR immunostaining was observed in spiral ligament, stria vascularis, and outer hair cells of both noise exposed and normal cochlear tissues. Density of immunoreactive staining was decreased after noise exposure. With these results was could hypothesize the relationship between glucocorticoid receptor and heat shock proteins under stressful condition in the cochlea. If the cochlea is exposed to stress such as noise trauma, glucocorticoid hormone would be released and enter the cell to bind to glucocorticoid receptors with dissociation of heat shock proteins from the DNA binding sites. Then the levels of glucocorticoid receptors in the cytoplasm would be decreased and resultant increased expression of heat shock proteins may occur. This study suggest that glucocorticoid receptors may participate in stress response of the cochlea alone or in conjunction with heat shock proteins.
Animals ; Binding Sites ; Blotting, Western ; Cochlea ; Cytoplasm ; DNA ; Ear, Inner ; Hair ; Heat-Shock Proteins ; Immunohistochemistry ; Noise* ; Rats* ; Rats, Sprague-Dawley ; Receptors, Glucocorticoid* ; Spiral Ligament of Cochlea ; Stria Vascularis

Bodycomposition measurement is useful in the diagnosis of pathology, assessment of disease process and response to treatement in many endoclonologic and metabolic diseases. The Techniques used currently are mostly indirect, often expensive, difficult and time-consuming. A new method for estimation of body composition, infrared interactance, is rapid, safe, noninvasive, and may be useful in research and clinical studies. Body composition was assessed in 51 children and adolescants with insulin-dependent diabetes mellitus by infrared interactance method using a Futrex 5000A body fat content analyzer. Percentage body fat of pubertal girls was 26.1+/-7.6%, significantly greater than prepubertal girls (17.9%, 0<0.01) and pubertal boys (19.9%, p<0.05). Body fat content was increased through puberty in girls. but not increased in boys. Our data do not explain why body fat of pubertal boys was not increased. There was no significant association of insulin dose and HbA1C level with percentage body fat. Thus, we had to attempt measure calorie intake, activity level and diet composition. Our data revealed that dietary carbohydrates may prompt fat deposition, but energy balance does not explain the differences between pubertal girls and boys. In conclusion, Body fat increased through puberty in girls, but the etiology of differences in pubertal girls and boys is not clear, and in view of potential adverse effect of fat depostion of long-term health, further larger case-contolled study will be necessary.
Adipose Tissue ; Adolescent* ; Body Composition* ; Child* ; Diabetes Mellitus, Type 1* ; Diagnosis ; Diet ; Dietary Carbohydrates ; Female ; Humans ; Insulin ; Metabolic Diseases ; Pathology ; Puberty

No abstract available.
Acromegaly* ; Osteoarthropathy, Primary Hypertrophic*

The synovium is lined by a layer of intimal cells which have been classified on ultrastructural criteria into type A and B synoviocytes. The functionally important lining cells of the synovium(type A and B synoviocytes) are the subjects of many study but have presented problems with their characterization and microscopical identification. Synovial sarcoma is a distinct and generally recognized soft tissue tumor that its origin still raises controversy. In this study, 12 cases of nonspecifically proliferative and resting human synoviocytes have been obtained from the synovium of knee and hip joints, and 3 cases of synovial sarcoma which have arisen in the left thigh, left buttock and right inguinal region were examined with light microscopy, immunohistochemical observation, and electron microscopy. In light microscopic level, it was difficult to differentiate the type A synoviocytes from type B synoviocytes morphologically. The reactive type B synoviocytes were positive for the protein of cytoskeleton such as pancytokeratin, CK1, CK8, CEA, and vimentin. The resting type B synoviocytes showed positive reactions for pancytokeratin, CK1, and CK8. The markers for the monocytes/histiocytes(CD15, CD68, lysozyme, Al-AT, Al-ACT) were reactive in resting and reactive type A synoviocytes. Also, MHC class II antigen was reactive in type A synoviocytes. Three cases of primary synovial sarcoma were 2 fibrous monophasic and 1 biphasic. Spindle-shaped cell in fibrous monophasic synovial sarcoma showed reactivity for CK7 and pancytokeratin, and epithelial cells (lining the glands) in biphasic synovial sarcoma were reactive for CK 7, pancytokeratin, EMA, and focally CEA, but only spindle cells reactive for vimentin, By electron microscopy, fibrous monophasic synovial sarcoma showed pseudogland formation with intercellular junctions of paired subplasmalemmal density and discontinuous basal lamina. These results suggest that the reactive type B synoviocytes and synovial sarcoma show an aberrant expression of the vimentin and CEA. The expression of CK on the resting and reactive type B synoviocytes and fibrous monophasic and biphasic synovial sarcomas are different. Type A synoviocytes expressing the MHC class II molecule and monocyte/histiocyte markers suggest a member of the mononuclear phagocytic system. The reasons of the aberrant expression of the intermediate filament, vimentin and oncofetal antigen, and CEA in reactively proliferative type B synoviocytes and synovial sarcoma and the different expression of cytokeratin on the resting, reactive type B synoviocyte and synovial sarcoma should be further evaluated.
Basement Membrane ; Buttocks ; Cytoskeleton ; Epithelial Cells ; Hip Joint ; Histocompatibility Antigens Class II ; Humans* ; Immunohistochemistry ; Intercellular Junctions ; Intermediate Filaments ; Keratins ; Knee ; Microscopy ; Microscopy, Electron ; Muramidase ; Sarcoma, Synovial* ; Synovial Membrane ; Thigh ; Vimentin

Placement of an endoprosthesis for palliative decompression of biliary obstruction has been advocated as an effective alternative for interanl-external drainage catheters, of which the care and psychological impact of the external segment protruded through the skin has been a difficult problem. (continue...)
Catheters ; Decompression ; Drainage* ; Skin

BACKGROUND AND OBJECTIVES: The myocardial protective effect of ischemic preconditioning is well known. However, the mechanism is remains unclear. The purpose of this study is to determine the role of adenosine, protein kinase C, KATP channel and the change of monophasic action potential duration on cardioprotective effect of ischemic preconditioning in cat. Materials AND METHODS: In this experiment, 66 cats were allocated into 7 groups:control (n=10), ischemic preconditioning (n=10), adenosine pre-treated (n=10), SPT (8-p-sulfophenyl theophylline) pre-treated (n=9), polymyxin B pre-treated (n=9), glibenclamide pre-treated (n=9) and nicorandil pre-treated (n=9) groups. Ischemic preconditioning was performed in ischemic preconditioning, SPT pre-treated, polymyxin B pre-treated and glibenclamide pre-treated groups by 3 episodes of 5 minutes ischemia and 10 minutes reperfusion. All animals were subjected to 40 minutes of ischemia and 40 minutes reperfusion. Monophasic action potential duration at 50% repolarization (MAP50) was measured in the ischemic and non-ischemic area respectively by epicardial probe throughout the experiment. The effect of ischemic preconditioning was determined by infarct size (% area at risk). RESULTS: Ischemic preconditioning, adenosine pre-treatment and nicorandil pre-treatment groups demonstrated a significant reduction in infarct size (26+/-4%, 25+/-4% and 34+/-8% infarction of the risk zone, respectively, p<0.01, p<0.01 and p<0.05 vs. control) with respect to control (41+/-8% infarction of the risk zone). However, pretreatment with SPT, polymyxin B or glibenclamide abolished the effect of ischemic preconditioning. Ischemic preconditioning group exhibited a significant reduction of MAP50 duration in the ischemic area during preconditioning;at the first preconditioning 128+/-11 msec vs. 144+/-10 msec control, at the second preconditioning 110+/-10 msec vs.147+/-10 msec control (p<0.01), at the third preconditioning 114+/-10 msec vs. 145+/-11 msec control (p<0.05). But, pretreatment with SPT, polymyxin B and glibenclamide prevented the reduction of MAP50 in the ischemic area during ischemic preconditioning. During 40 minutes ischemia, the shortening of MAP50 was more pronounced in the preconditioned group than in control group;at 5 minutes 112+/-13 msec vs. 124+/-10 msec control, at 10 minutes 89+/-12 msec vs. 133+/-11 msec control (p<0.05 ), at 20 minutes 93+/-12 msec vs. 136+/-11 msec control (p<0.05), and at 30 minutes 107+/-19 msec vs. 144+/-14 msec control (p<0.05). In adenosine pre-treated group, the MAP50 was significantly shortened than control group throughout 40 minutes occlusion period;at 5 minutes 90+/-8 msec (p<0.05), at 10 minutes 77+/-9 msec (p<0.05), at 20 minutes 92+/-8 msec (p<0.05), and at 30 minutes 103+/-8 msec (p<0.05). Nicorandil pretreatment pronounced the ischemic shortening of MAP50 in ischemic area and the effect was significant during early ischemic period;at 10 minutes 98+/-22 msec (p<0.05 vs. control). In pretreatment groups with SPT, polymyxin B or glibenclamide, the ischemic preconditioning of MAP50 measured in non-ischemic area was not significantly different compared with control group. MAP50 measured in ischemic area during reperfusion was not significantly different between groups. CONCLUSION: Based on this study, adenosine receptor-protein kinase C-KATP channel activation and monophasic action potential duration shortening during ischemia play an important role in myocardial protection during ischemic injury.
Action Potentials* ; Adenosine* ; Animals ; Cats* ; Glyburide ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Nicorandil ; Phosphotransferases ; Polymyxin B ; Protein Kinase C* ; Protein Kinases* ; Receptors, Purinergic P1* ; Reperfusion