There are various reports referring to the clinical siignificances and removal of postgastrectomy bezoar. In this case, suture thread were thought to he the important factor of the bezoar formation, This bezoar was removed intaetly uaing fiber-optic endoscope in patinet who had postgastrectomy bezoar, by cutting the thread by biopsy forceps.
Bezoars* ; Biopsy ; Endoscopes ; Surgical Instruments ; Sutures*

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

BACKGROUND: Propofol and ketamine had been used for anesthesia induction and for total intravenous anesthesia. The nature of any hypnotic interactions occurring between propofol and ketamine are unknown. A comparison of maternal and neonatal effects among propofol-ketamine combination, ketamine and propofol were studied when used for anesthesia induction in Cesarean section. METHODS: Forty five patients in ASA class I or II scheduled for Cesarean section randomly assigned to either propofol 2 mg/kg (n=15), ketamine 1 mg/kg (n=15) or propofol 1 mg/kg - ketamine 0.5 mg/kg combination group (n=15) as an induction agent. Maternal systolic and diastolic blood pressure, heart rate, Apgar score and umbilical blood gas analysis were measured. RESULTS: Before intubation, systolic and diastolic pressure were decreased in propofol group but increased in ketamine and propofol-ketamine combination group. Heart rate were increased in all three groups. But there were no significant differences among three groups (p<0.05). After intubation, there were significant increase in systolic, diastolic pressure and heart rate in three groups but no significant differences among three groups (p<0.05). And there was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. CONCLUSIONS: Propofol-ketamine combination was found to be similar to propofol or ketamine only in the effects on the mother and neonate. But propofol-ketamine gained more stable hemodynamic change than propofol or ketamine before intubation. Therefore propofol-ketamine appears to be a suitable alternatives to propofol or ketamine as an induction agent for anesthesia in Cesarean section.
Anesthesia ; Anesthesia, Intravenous ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Depression ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Ketamine* ; Mothers ; Pregnancy ; Propofol*

No abstract available.
Keratins*

No abstract available.
Biopsy, Fine-Needle* ; Pancreas*

A case of metastatic alveolar soft part sarcoma is presented with clincal, pathological and radiological features. Alveolar soft part sarcoma is a rare soft-tissue neoplasm that is malignant and invariably fatal. It was first described and named by Christopherson, et al. in 1952. Since 1952 numerous examples of this tumor have been reported and have been studied with the electron microscope, but there is still considerable uncertainty as to the exact histogenesis of the tumor. Most cases occur in young females involving the lower extrimities especially in the right side. The most initial presenting symptom is a slowgrowing painless mass and the principal metastatic sites are the lungs, followed by the brain and skeleton. Cerebral metastasis, in fact, may be the first manifestation of the disease. Treatment is radical surgical excision but radiotherapy and chemotherapy are less effective. We present the reported case of metastatic alveolar soft pat sarcoma with electron microscopic findings.
Brain ; Drug Therapy ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Radiotherapy ; Sarcoma ; Sarcoma, Alveolar Soft Part* ; Skeleton ; Uncertainty

PURPOSE: The aim of this study was to evaluate the effect of overexpression of heat shock protein 70 (HSP70) on the expression of inducible nitric oxide synthase and on the concentration of nitric oxide and to determine the mechanism for the relationship between HSP70 and inducible nitric oxide synthase (iNOS) in sepsis. METHODS: Experiments were performed on male Sprague-Dawley rats, and sepsis was induced by using cecal ligation and puncture (CLP). Glutamine (GLN) or saline was administered 1 h after initiation of sepsis. We acquired serum and lung tissues from the rats 12 h or 24 h after initiation of sepsis. We analyzed the concentration of nitric oxide, the expression of HSP70 in the lung, and the gene expression of iNOS in the lung. RESULTS: In CLP+GLN, glutamine given after initiation of sepsis enhanced the expression of HSP70 in the lung at 12 h (CLP+GLN vs. CLP:: 47.19 +/- 10.04 vs. 33.22 +/- 8.28, p = 0.025) and 24 h (CLP+GLN vs. CLP: 47.06 +/- 10.60 vs. 31.90 +/- 4.83, p = 0.004). In CLP+GLN, glutamine attenuated the expression of iNOS mRNA in the lung at 12 h (CLP+GLN vs. CLP: 4167.17 +/- 951.59 vs. 5513.73 +/- 1051.60, p = 0.025) and 24 h (CLP+GLN vs. CLP: 9,437.65 +/- 2,521.07 vs. 18,740.27 +/- 8,241.20, p = 0.016) and reduced the concentration of nitric oxide in serum at 12 h (CLP+GLN vs. CLP: 0.86 +/- 0.48 vs. 3.82 +/- 2.53 micromol/L, p = 0.016) and 24 h (CLP+GLN vs. CLP: 0.39 +/- 0.25 vs. 1.85 +/- 1.70 micromol/L, p = 0.025). CONCLUSION: The overexpression of HSP70 induced by the administration of glutamine in sepsis attenuated the gene expression of iNOS and reduced the concentration of nitric oxide.
Animals ; Gene Expression ; Glutamine ; Heat-Shock Proteins ; Hot Temperature ; HSP70 Heat-Shock Proteins ; Humans ; Ligation ; Lung ; Male ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Punctures ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Sepsis

Since 1949, lithium has been widely used for treatment of manic depressive disorder. It has also been used for agranulocytosis after anticaneer chemotherapy and partially for hyperthyroidism. But it is well known that the long term administration of this drug is associated wih various antithyroid effects such as hypothyroidism, simple goiter, nodules and even thyrotoxicosis. Although the exact mechanism for leading hypothyroidism or goiter is still unknown, the incidence of lithium-induced hypothyroidism is 1-37% during lithium atment. We had an experience of newly developing goiter with or without hypothyroidism during lithium treatment in 4 MDP patients. Among our patients, the duration of lithium administration was from 0.7 months to 11 years, and the development of thyroid abnormality was impossible to predict. They were treated with thyroxine while lithium was discontinued causing favorable outcome. We suggest that routine thyroid function test include thyroid autoimmune antibody screening in patients planning to undergo lithium treatment.
Agranulocytosis ; Antithyroid Agents ; Depressive Disorder ; Drug Therapy ; Goiter* ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Lithium Carbonate* ; Lithium* ; Mass Screening ; Thyroid Function Tests ; Thyroid Gland ; Thyrotoxicosis ; Thyroxine

STATEMENT OF PROBLEM: Clinically, maxillary first premolar has a high risk of fracture. This is thought to be caused by the susceptible figure which the maxillary first premolar has. In other words, sharp cusp angles of the premolar is thought to influence this situation. PURPOSE: This study was to know stress distribution of all-ceramic crown according to the cusp angle. MATERIAL AND METHOD: It was manufactured a three dimensional finite element model simplified maxillary first premolar, and then analyzed stress distribution when cusp angle was each 80 degrees, 90 degrees, 100 degrees, 110 degrees and 120 degrees. RESULTS AND CONCLUSION: 1. The von Misses stress showed that stress decreases as cusp angle increases in the central groove of the occlusal surface. 2. It showed that maximum principal stress was centered at the region of the central groove of the occlusal surface and a region which the force was inflicted. And also it appeared high on the lingual and buccal side of finish line. 3. The X axis of normal stress was focused in the central groove of the occlusal surface. The Y axis normal stress appeared high in the central groove of the occlusal surface, buccal and lingual side. 4. The Stress near the finish line showed a low value compared with stress in the region of the central groove of the occlusal surface. 5. It shows that the most dangerous angle for tooth fracture was on 80 degrees of the cusp angle and low on 120 degrees of its.
Axis, Cervical Vertebra ; Bicuspid* ; Ceramics* ; Crowns* ; Tooth Fractures

Down syndrome is perhaps the most common genetic condition associated with mental retardation. In cytogenetic examination, trisomy 21 is in 95% of Down syndrome, and the others are mosaicism, translocation or deletion. There are many associated diseases with Down syndrome such as, thyroid function abnormality, congenital heart disease, intestinal blockage, and so on. Hypothyroidism appeared in 15% before adolescent in Down syndrome patients. In Korea, there were several reports of Down syndrome with hypothyroidism in childhood but not in adulthood. And we had three cases of hypothyroidism with Down syndrome in adulthood. Cytogenetic examination revealed trisomy 21 in the 2 cases and 1 case of mosaicism. Antithyroid antibody was positive in one case. None of these cases was admitted due to symptoms of hypothyroidism. It is very difficult to make the diagnosis of hypothyroidism in Down syndrome because of similarity in symptoms between Down syndrome and hypothyroidism. Thus, periodic thyroid function test should be made in Down syndrome, and this could be a part of improving quality of life in Down syndrome.
Adolescent ; Adult* ; Congenital Abnormalities ; Cytogenetics ; Diagnosis ; Down Syndrome* ; Heart Diseases ; Humans ; Hypothyroidism* ; Intellectual Disability ; Korea ; Mosaicism ; Quality of Life ; Thyroid Function Tests ; Thyroid Gland