The aim of the present study is to demonstrate the usefulness of intraoperative fine needle aspiration (FNA) of pancreatic lesions in 30 patients. A conclusive diagnosis was done in 27 patients and the diagnoses of three patients were deferred. No complications followed the procedure. Based on histologic findings of the resected specimens in 20 cases and of cell blocks in 10 cases, the final diagnoses were adenocarcinoma in 19 cases, chronic pancreatitis in nine cases and tuberculosis in two cases. The sensitivity, specificity and diagnostic accuracy were 95%, 100% and 96% resepectively and there were no false positives. The smear of aspirate was stained with toluidine blue and examined by light microscope. The presence of there-dimensional clusters of disoriented cells and the increased nuclear/cytoplasmic ratio with large prominent nucleoli were the most helpful criteria for a diagnosis of malignancy in the pancreas. The intraoperative FNA of pancreatic lesions was considered as a simple, safe, and highly specific and sensitive tool in differentiating benign from malignant lesions. The intraoperative FNA can be recommended as the first tool of choice of intraoperative diagnostic procedure in lesions of the pancreas.
Child ; Male ; Female ; Humans ; Adenocarcinoma

When operations in the field of plastic surgery are performed under local anesthesia, the degree of pain suffering the patients becomes different depending on the kind, dosage effective duration of anesthetic agent and the technique of the operator. Patients suffer from pain physically and psychologically when skin infiltration is carried out. Recently, out-patient surgery has increased in number, so the necessity of more complete analgesia for the patient undergoing surgery is required. Patients were operated under the local infiltrative anesthesia, and the supplemental intravenous anesthesia to kill pain. Patients were randomly divided into four groups differing in combinations of intravenous anesthetic agents, such as ketamine, midazolam, fentanyl that have potent analgesic sedative and amnesic effects. By random allocation patients received ketamine and midazolam(Group I), ketamine and fentanyl(Group II), midazolam and fentany l (Group III), ketamine, fentanyl arts midazolam(Group IV). The purpose of this study is to focus on the results obtained in four groups for finding out a more safe and less complicated combination of intravenous anesthetic agents and for standardization of dosage. In conclusion the group I (ketamine and midazolam) showed better results than other groups for the following reasons; no significant change in vital signs, no hypoxia no complication such as nausea, headache unpleasant dream, and hallucination, potent analgesia effects, amnesia. We have found this combination to be a highly satisfactory anesthesia and analgesia technique for outpatient plastic surgery from the standpoints of the surgeon and the patient.
Amnesia ; Analgesia ; Anesthesia ; Anesthesia and Analgesia ; Anesthesia, Intravenous* ; Anesthesia, Local* ; Anesthetics ; Anesthetics, Intravenous ; Anoxia ; Dreams ; Fentanyl ; Hallucinations ; Headache ; Humans ; Ketamine ; Midazolam ; Nausea ; Outpatients ; Random Allocation ; Skin ; Surgery, Plastic* ; Vital Signs

When operations in the field of plastic surgery are performed under local anesthesia, the degree of pain suffering the patients becomes different depending on the kind, dosage effective duration of anesthetic agent and the technique of the operator. Patients suffer from pain physically and psychologically when skin infiltration is carried out. Recently, out-patient surgery has increased in number, so the necessity of more complete analgesia for the patient undergoing surgery is required. Patients were operated under the local infiltrative anesthesia, and the supplemental intravenous anesthesia to kill pain. Patients were randomly divided into four groups differing in combinations of intravenous anesthetic agents, such as ketamine, midazolam, fentanyl that have potent analgesic sedative and amnesic effects. By random allocation patients received ketamine and midazolam(Group I), ketamine and fentanyl(Group II), midazolam and fentany l (Group III), ketamine, fentanyl arts midazolam(Group IV). The purpose of this study is to focus on the results obtained in four groups for finding out a more safe and less complicated combination of intravenous anesthetic agents and for standardization of dosage. In conclusion the group I (ketamine and midazolam) showed better results than other groups for the following reasons; no significant change in vital signs, no hypoxia no complication such as nausea, headache unpleasant dream, and hallucination, potent analgesia effects, amnesia. We have found this combination to be a highly satisfactory anesthesia and analgesia technique for outpatient plastic surgery from the standpoints of the surgeon and the patient.
Amnesia ; Analgesia ; Anesthesia ; Anesthesia and Analgesia ; Anesthesia, Intravenous* ; Anesthesia, Local* ; Anesthetics ; Anesthetics, Intravenous ; Anoxia ; Dreams ; Fentanyl ; Hallucinations ; Headache ; Humans ; Ketamine ; Midazolam ; Nausea ; Outpatients ; Random Allocation ; Skin ; Surgery, Plastic* ; Vital Signs

BACKGROUND AND OBJECTIVES: Hypercholesterolemia is a key factor in the development of atherosclerosis. We sought to evaluate the relation between hypercholesterolemia and plaque composition in patients with coronary artery disease. SUBJECTS AND METHODS: Study subjects consisted of 323 patients (mean 61.5 years, 226 males) who underwent coronary angiography and virtual histology-intravascular ultrasound examination. Patients were divided into two groups according to total cholesterol level: hypercholesterolemic group (> or =200 mg/dL, n=114) and normocholesterolemic group (<200 mg/dL, n=209). RESULTS: Hypercholesterolemic patients were younger (59.7+/-13.3 years vs. 62.6+/-11.5 years, p=0.036), than normocholesterolemic patients, whereas there were no significant differences in other demographics. Hypercholesterolemic patients had higher corrected necrotic core volume (1.23+/-0.85 mm3/mm vs. 1.02+/-0.80 mm3/mm, p=0.029) as well as percent necrotic core volume (20.5+/-8.5% vs. 18.0+/-9.2%, p=0.016) than normocholesterolemic patients. At the minimal lumen area site, percent necrotic core area (21.4+/-10.5% vs. 18.4+/-11.3%, p=0.019) and necrotic core area (1.63+/-1.09 mm2 vs. 1.40+/-1.20 mm2, p=0.088) were also higher than normocholesterolemic patients. Multivariate linear regression analysis showed that total cholesterol level was an independent factor of percent necrotic core volume in the culprit lesion after being adjusted with age, high density lipoprotein-cholesterol , hypertension, diabetes mellitus, smoking and acute coronary syndrome (beta 0.027, 95% confidence interval 0.02-0.053, p=0.037). CONCLUSION: Hypercholesterolemia was associated with increased necrotic core volume in coronary artery plaque. This study suggests that hypercholesterolemia plays a role in making plaque more complex, which is characterized by a large necrotic core, in coronary artery disease.
Acute Coronary Syndrome ; Atherosclerosis ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Demography ; Diabetes Mellitus ; Humans ; Hypercholesterolemia ; Hypertension ; Linear Models ; Smoking

PURPOSE: The aims of this study were to analyze the clinical characteristics of children with Kikuchi's disease(KD) at a medical center and to investigate the etiologic role of human herpesvirus 8(HHV 8) or Epstein-Barr virus(EBV) in children with KD. METHODS: Twenty six children who were diagnosed as KD between Jan. 1998 and Dec. 2005 were included. Medical records were reviewed on the clinical characteristics of children with KD. Follow up data were collected by chart review and telephone contact. Polymerase chain reaction(PCR) was performed in order to detect HHV 8 DNA, and in situ hybridization(ISH) was perfomed in order to detect EBV RNA from 20 lymph node tissues. RESULTS: There were 15 girls and 11 boys with a mean age of 13 years. Posterior cervical lymph nodes were involved in 72 percent(18/25) of the patients. Extracervical lymphadenopathy was associated in one patient. Fever was an associated symptom in 31 percent(8/26) of the patients. Leukopenia was observed in six (46 percent) patients. The cervical lymphadenopathy usually resolved spontaneously within 6 months. Only one patient had a recurrence of lymphadenopathy with fever during follow-up. No children with KD in our series developed systemic lupus erythematosus. HHV 8 DNA was not amplified by nested PCR in any of the cases, and all cases were negative for EBV RNA by ISH. CONCLUSION: KD should be differentiated as a cause of cervical lymphadenopathy in children. HHV 8 and EBV may not play major causative roles in KD in children.
Child* ; DNA ; Female ; Fever ; Follow-Up Studies ; Herpesvirus 4, Human* ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Humans* ; Leukopenia ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphatic Diseases ; Medical Records ; Polymerase Chain Reaction ; Recurrence ; RNA ; Telephone

Health promotion center is an area that hospitals promote and operate with priority for the early detection and prevention of disease. The quality of medical service needs to be improved by providing a quick and customized service to the patients who use the center. In the past, the examiners or hall managers took charge of the guidance and management of the patients in order, and the patients suffered from the disorder and discomfort while they are called and identified by name. In this paper, we realized automated health promotion system using PDA operation system to provide services comfortable for both patients and examiners. A comfortable and personalized system has been developed, where patients are provided with personalized guidance for the examination labs instead of being called by name and history of medical examination through the mobile terminal,
Health Promotion* ; Humans ; Medical Records Systems, Computerized

Leiomyoma is a benign tumor, which usually occur at the smooth muscle of the gastrointestinal tract and uterus but rarely occurs on the corpus cavernosum of the penis. We experienced a patient with leiomyomas on the bilateral corpus cavernosa of the penis accompanied with impotence in a 60-year-old man. The patient was treated with complete local excision and has remained well without recurrence for l year, So we report this case with review of literatures.
Erectile Dysfunction ; Gastrointestinal Tract ; Humans ; Leiomyoma* ; Male ; Middle Aged ; Muscle, Smooth ; Penis* ; Recurrence ; Uterus

Although fungal infections involving the genitourinary system are increasing in case, those involving the prostate are uncommon and fungal prostatic abscesses are especially rare. There are a few sporadic reports in the literature of fungal prostatic abscess. We thought that a high index of suspicion for fungal prostatic infection must be maintained especially in high risk patients. We report a case of candidal prostatic abscess in a 37-year old man with diabetes. The diagnosis and management are discussed, and the literature is reviewed.
Abscess* ; Adult ; Candida albicans ; Diagnosis ; Humans ; Prostate ; Urogenital System

PURPOSE: Thrombopoietin (TPO) has been currently used for ex vivo expansion of hematopoietic stem cells. Previously, we have reported that TPO induces apoptosis during ex vivo expansion of cord blood CD34 cells. In this study, we have investigated the stem cell factor (SCF) to determine whether it affects the TPO-induced apoptosis. METHPDS: CD34+ cells, purified from four separate human cord bloods by magnetic bead selection, were expanded in Iscoves modified Dulbeccos medium with several cytokines. Apoptosis has been confirmed by several ways; 7-amino-actinomycin D (7-AAD) or annexin V staining, and morphologic analysis with light and electron microscopic examinations. And cell maturation was also analysed with DNA staining. RESULTS: Apoptosis was reached peak (67.8+/-5.24% of total cells) at day 9 in the cultures with TPO alone. Morphological examination of Giemsa-stained cytospin preparations revealed many immature cells with cytoplasmic blebbing and eccentric nuclei. However, multilobed nuclei were rarely observed while bilobed nuclei were frequently observed. These results suggest that premature senescence occurs in the megakaryocytic cells before full polyploidization. SCF was affective for the TPO-induced apoptosis; the peak apoptotic fraction was significantly decreased to 37.2+/-3.31% at day 9. In the cultures with SCF, the fractions of CD41+ cells were also decreased in parallel with decrease in apoptosis. Notwithstanding reduction of differentiation into megakaryocytic lineage, polyploidization(> 6N) in CD41 cell faction was significantly increased in the cultures with SCF at day 9 and day 11, respectively (P<0.05). CONCLUSION: These results suggest that SCF inhibits premature senescence of the differentiating cells of megakaryocytic lineage during ex vivo expansion using TPO.
Aging* ; Annexin A5 ; Apoptosis ; Blister ; Cytokines ; Cytoplasm ; DNA ; Fetal Blood* ; Hematopoietic Stem Cells ; Humans* ; Megakaryocytes* ; Polyploidy ; Stem Cell Factor* ; Stem Cells* ; Thrombopoietin*

The best treatment modality for spontaneous intracerebral hemorrhage is still controversial. But stereotactic surgery can minimize the brain damage and can be performed safely and simply under local anesthesia. The purpose of this study was to analyse and evaluate the therapeutic result of stereotactic aspiration of hematoma and urokinase irrigation in patients with spontaneous intracerebral hemorrhage. Consecutively, 33 cases of spontaneous intracerebral hemorrhage admitted to Chung Buk National University Hospital from May, 1991 to January, 1995 and underwent stereotactic aspiration and urokinase irrigation were analysed and evaluated by factors believed to affect the final results. The results of this analysis suggest that stereotactic aspiration and urokinase irrigation is safe and efficient in treating spontaneous intracerebral hemorrhage with similar outcome but lower mortality compared with traditional craniotomy ; and we can substitute traditional open craniotomy or conservative treatment for stereotactic aspiration combined with urokinase irrigation.
Anesthesia, Local ; Brain ; Cerebral Hemorrhage* ; Chungcheongbuk-do ; Craniotomy ; Hematoma ; Humans ; Mortality ; Urokinase-Type Plasminogen Activator