No abstract available.
Fallopian Tubes* ; Female ; Pregnancy*

PURPOSE: The purpose of this study was to evaluate the utility of two-phase dynamic CT, early and equilibrium pahse, in the preoperative staging of rectal cancers. MATERIALS AND METHODS: We performed incremental dynamic CT after rectal infusion of water in 34 patients with pathologically proved rectal cancers. Two-phase dynamic CT findings were prospectively analyzed and correlated with surgical and histopathologic findings. A total of 150ml of nonionic contrast medium was intravenously administered with a power injector at a flow rate of 5ml/sec for 30 sec, and two-phase images were obtained at 30 sec(early phase) and 2 min (equilibrium phase) after bolus injection. Local tumor staging and regional lymph node were classified by TNM staging. RESULTS: All 34 rectal cancers showed a moderate to marked enhancement in the early phase and a homogeneous and prolonged enhancement of the entire lesion in the equilibrium phase. T-staging of primary tumors were 85.3%(29/34) in early phase and 70.6%(24/34) in equilibrium phase. The accuracy in determining the perirectal fat invasion of rectal cancer was 92%(23/25) in early phase, and 72%(18/25) in equilibrium phase. The sensitivity & specificity of the regional lymph node metastasis were 63.6% and 79.1% in early phase, and 54.5% and 65.2% in equilibrium phase, respectively. CONCLUSION: Early phase dynamic CT was more accurate for the preoperative staging of rectal cancer than that at equilibrium phase.
Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms* ; Sensitivity and Specificity ; Water

No abstract available.
Antigens, Surface* ; Oncogenes*

No abstract available.
Calcitriol* ; Dehydroepiandrosterone* ; Gene Expression* ; Tumor Necrosis Factor-alpha*

No abstract available.
Calcitriol* ; Dehydroepiandrosterone* ; Gene Expression* ; Tumor Necrosis Factor-alpha*

No abstract available.
Antifungal Agents* ; Chemotaxis* ; Humans* ; Neutrophils* ; Phagocytosis*

The serotonin 6(5-HT6) receptor gene is a candidate gene for influencing the clinical response to treatment with antidepressants. The purpose of this study was to determine the relationship between the C267T polymorphism in the 5-HT6 receptor gene and the treatment response to citalopram in a Korean population with major depressive disorder(MDD). METHODS: Citalopram was administered for 8 weeks to the 90 patients who completed study. 21-item Hamilton depression rating scale(HAMD-21) was used as a outcome measure. RESULTS: We found that the genotype, allele, and allele-carrier distributions did not differ significantly between MDD patients and normal controls. A main effect of an interaction of genotype with time on the decrease in the HAMD-21 score during the 8 weeks study period was not found. ANOVA revealed no significant effects of the C825T polymorphism on the decrease in the HAMD-21 score at each time period. CONCLUSIONS: These results suggest that the C267T polymorphism in the 5-HT6 receptor gene is not associated with the treatment response to citalopram.
Alleles ; Antidepressive Agents ; Citalopram* ; Depression ; Depressive Disorder, Major* ; Genotype ; Humans ; Outcome Assessment (Health Care) ; Serotonin

BACKGROUND/AIMS: Combined computed tomography during arterial portography(CfAP) and computed tomography during hepatic arteriography(CBiA) are more sensitive methods compared to conventional spiral CT in detecting small hepatocellular carcinoma. However, there are few data available on the influence of combined CTAP and CTHA on decision making for treatment of hepatocellular carcinoma. We aimed to evaluate the usefulness of CTAP and CfHA as a preoperative study of hepatocellular carcinoma for surgical treatment. METHODS: Eighty-two patients with histologically proven hepatocellular carcinoma who were considered to be surgical candidates on spiral CT and angiography were included. CfAP and CTHA were performed as the routine protocol. The findings of CTAP and CTHA were analyzed and compared to conventianal spiral Cl and angiography. ReESULTS: 1) 105 nodules were found on spiral Cf plus angiography, whereas, 138 nodules found on combined CIAP and CTHA: 33 additional nodules were found in 23 cases(28%). 2) The treatment plan changed from surgery to nonsurgical treatment in 10(12%) cases: 9 cases(10%) with bilobar involvement, and 1 case (1%) with more than three nodules. 3) The larger the tumor nodules on the spiral CT, the more additional tumor nodules were found on CTAP and CTHA: combined CTAP and CTHA were able to find more nodules in 21% of tumor < 3cm, 27% of tumor with 3 - 10cm, and 71% of tumor >10cm on spiral CI' (p=0.03). CONCLUSION: Compared to spiral CT plus angiography, CI'AP and CfHA may be useful in avoiding unnecessary operation of hepatocellular carcinoma, especially in large tumors.
Angiography ; Carcinoma, Hepatocellular* ; Decision Making ; Humans ; Tomography, Spiral Computed

BACKGROUND: We evaluated whether the unilateral spinal anesthesia using a 26-gauge Quincke needle provides more adequate or hemodynamically stable spinal anesthesia than the conventional spinal anesthesia in orthopedic patients. METHODS: Fifty-eight ASA 1 or 2 patients aged from 18 to 65 years undergoing unilateral lower limb surgery were included. All patients were placed in the lateral position with the side to be operated on dependent and received a 8 mg 0.5% hyperbaric bupivacaine through a 26-gauge Quincke spinal needle for 80 seconds. Local anesthetic was injected with the needle orifice turned toward the dependent side, then the immediate supine position (conventional group, n = 34), or the lateral position (unilateral group, n = 24) was maintained for 15 minutes. Hemodynamic variables, as well as loss of cold, pinprick sensation and motor block on both sides were recorded. RESULTS: All the 23 patients in the unilateral group had adequate spinal anesthesia, whereas 6 out of 34 patients of the conventional group (17.6%) had inadequate to failed spinal anesthesia (P < 0.05). There were significant differences in the degree of motor block on the dependent side of lower extremities between the two groups. Motor block of grade 0 to 1 on the dependent side were 23.5% and 0% in the conventional and unilateral group, respectively (P < 0.05). Unilateral sympathetic or sensory block were not observed in the unilateral group. No differences in blood pressure, heart rate changes were observed between the two groups. CONCLUSIONS: The present study does demonstrate clinically relevant advantages of a lateral position for 15 minutes, either in terms of adequacy of spinal anesthesia or differential motor block using a 26-gauge Quincke spinal needle in orthopedic patients.
Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine ; Heart Rate ; Hemodynamics ; Humans ; Lower Extremity ; Needles* ; Orthopedics ; Sensation ; Supine Position

BACKGROUND: Postoperative urinary retention is defined as the inability to void with a full bladder during the postoperative period. It affects both sexes in all ages following all types of operation, including patients who previously had no micturition problems. We investigated the incidence and risk factors of urinary retention following long spinal anesthesia for total knee replacement. METHODS: We retrospectively studied a number of factors that may be associated with urinary retention in 98 women. The outcome variable of logistic regression models are urinary retention and severe urinary retention. The potential explanatory variables are age, height, weight, history of hypertension, DM and abnormal urology, heavy bupivacaine dose, types of patient-controlled analgesia, time to regression of spinal block to sacral segments (Tregression), amount of fluid and duration of surgery. We constructed a multiple linear regression model of the time from subarachnoid injection to spontaneous voiding (Tvoiding) in relation to above variables. RESULTS: The overall rate of urinary retention and severe retention were 57.1% and 30.6%. Tregression was identified as significant explanator of an increased probability for urinary retention (P = 0.002), Tregression and DM for severe urinary retention (P <0.001, P = 0.054). In the multiple linear regression model, three variables - Tregression, age, abnormal urological history were identified to have significant t-values (3.902, 3.107, 2.284) with Tvoiding (P <0.001, P = 0.003, P = 0.025). CONCLUSION: Old age, DM, abnormal urological history, delayed recovery of spinal anesthesia are risk factors to urinary retention or delayed spontaneous voiding.
Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Arthroplasty, Replacement, Knee* ; Bupivacaine ; Female* ; Humans ; Hypertension ; Incidence ; Linear Models ; Logistic Models ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Urinary Bladder ; Urinary Retention* ; Urination ; Urology