A 76-years old man with a ruptured abdominal aortic aneurysm underwent an emergency abdominal aortic replacement with artificial graft. The patient developed abdominal compartment syndrome at the day of the operation and he received secondary decompression operation the next day. At 45 hours after the second operation the patient was returned to operation room to close the abdominal fascia, and sigmoid colon necrosis was found so we performed sigmoid colectomy with colostomy. After 22 days from the last operation, the abdominal wound was closed completely and the patient was discharged at the 42nd postoperative day with a colostomy state. We report here on this complex case together with a review of the recent articles.
Aged ; Aortic Aneurysm, Abdominal* ; Colectomy ; Colon* ; Colon, Sigmoid ; Colostomy ; Compartment Syndromes ; Decompression ; Emergencies ; Fascia ; Humans ; Intra-Abdominal Hypertension* ; Ischemia* ; Necrosis ; Transplants ; Wounds and Injuries

No abstract available.
Drainage* ; Humans ; Jaundice, Obstructive*

No abstract available.
Cervix Uteri* ; Female ; Lymph Nodes* ; Neoplasm Metastasis* ; Risk Factors*

No abstract available.
Colorectal Neoplasms* ; Humans

BACKGROUND: Surgical resection remains the mainstay of treatment for esophageal cancer. Despite recent advances in surgical therapy, i.e. en bloc resection and extended lymphadenectomy, the overall long-term prognosis of patients with esophageal carcinoma has not, however, improved during the last decades. One of the major reasons in its relatively high recurrence rate. MATERIAL AND METHOD: A retrospective review of recurrent patterns of cancer in 42 patients who underwent curative surgery for primary esophageal cancer was performed clinically and histo-phthologically. RESULT: Nineteen patients had developed recurrece during the 18 to 52 months(mean 34.2 nonths), 8 had local recurrences, 1 had both, and 11 had systemic recurrences. Twelve patients(63%) had developed recurrence within 1 year, 5 patients(26%) between 1 year to 2 patients(11%) after 2 years. The recurrence rate according to growth pattern of tumor or presence of microinvasive findings was not statistically significant, but it increased significantly in clinical tumor stage III than stage IIA, B and in patients with the number of metastatic lymph node over ten. CONCLUSION: Post-operative recurrences of esophageal cancer appear as a high rate even though curative wide resection was done. Several clinical and histo-pathological factors correlate with the recurrence.
Esophageal Neoplasms* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Prognosis ; Recurrence* ; Retrospective Studies

There have been controversies on the rationale, surgicl indication, technique and results of meniscus repair.. Authors comparatively studied 100 cases of meniscus injury in 88 patients (arthroscopic total menisectomy: 16 cases, arthroscopic partial menisectomy: 68 cases, arthroscopic meniscus suturing: 16 cases) from February 1985 to March 1992. The results were as follows: 1. Male (61.4%) was much more affected than female. 2. The third decade group was most commonly affected and the most common causes was sports injury (43.2%) 3. The lateral meniscus was more injured (71%), than the medial (29%) 4. In arthroscopic finding, longitudinal tear (37%) was the most common. 5. According to the Tapper and Hoover's criteria, satisfactory result was 56.3% in arthroscopic meniscus repair group.
Athletic Injuries ; Female ; Humans ; Knee ; Male ; Menisci, Tibial ; Tears

No abstract available.
Glycogen Storage Disease Type I*

Hepatoblastoma (HB) is a rare embryonic malignant tumor of the liver. Most morphological studies on HB have limited to the histological characteristics and only 3 cases of HB have been described in the cytology literature. We present 2 cases of HB occurring in children aged 1 year and 3 years, respectively. The distinctive cytologic features of fine needle aspiration of HB were clusters of tumor cells showing acinar and trabecular pattern, smaller tumor cells with a high nuclear-cytopalsmic ratio and hyperchromatic nuclei having prominent nucleoli, and the presence of extramedullary hematopoiesis and osteoid material. These features were also found in the cell block and the biopsy specimen, and appeared very useful in the differentiation of HB from hepatocellular carcinoma.
Acute Kidney Injury* ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Child* ; Hematopoiesis, Extramedullary ; Hepatoblastoma ; Humans ; Liver ; Nephrosis, Lipoid*

OBJECTIVES: Nitric oxide(NO)plays an important role in pathophysiology of stroke and various neurodegenerative diseases. This study is designed to elucidate the mechanisms by which signaling pathway of LPS-stimulated NO generation in rat prmary astrocytes may be mediated by MAP kinase cascades and transcriptional activation of NF-kB. METHOD: The generation of NO from primary rat neonatal astrocytes was measured by using Greese's reagents and Western blot analysis with including Erk, JNK1 and p38 was assessed by in vitro immunecomplex kinase assay. Activation of transcriptional activator, NF-kB, was determined by using electrophoretic mobility shift assay. RESULTS: Treatment of cultured rat primary neonatal astorcytes with LPS results in the generation of NO as well as increase in the expression of inducible nitric oxide synthase(iNOS) LPS-induced NO generation is inhibited by the addition of inhibitors of MEK and JNK1/SPAK, PD 98059 and curcumin. LPS also imcreases the phosphotransferase activity of Erk as well as JNK1 and increases the phosphorylation of p38. Inhibition of Ras results in decrease of LPS-inudced NO generation. cAMP decreases the LPS-induced NO generation via inhibition of JNK1. Furthermore LPS activates transcriptional activator, NF-kB which is inhibited by the addition of inhibitors of MEK and JNK. CONCLUSION: These data suggest that MAP kinases, especially Erk and JNK1, may mediate the signaling cascade of LPS-induced NO generation in rat primary astrocytes via activation of transcriptional factor, NF-kB.
Animals ; Astrocytes ; Blotting, Western ; Curcumin ; Electrophoretic Mobility Shift Assay ; Indicators and Reagents ; MAP Kinase Signaling System ; Neurodegenerative Diseases ; NF-kappa B ; Nitric Oxide* ; Phosphorylation ; Phosphotransferases ; Rats* ; Stroke ; Transcriptional Activation

Ventilation during general anesthesia for bronchoscopy has recently been greatly improved by application of the Venturi principle. Ever since 1967 when Sanders published a paper describing the Venturi principle for ventilatory bronchoscopy, this technique has become increasingly popular. Many papers have been published promoting the use of the Venturi principle which in most cases entails a 16-gauge needle aimed distally down the proximal end of a bronchoscope through which a jet of oxygen is intermittently injected to produced positive pressure ventilation in the lungs. In our study, ten patients undergoing bronchoscopy were ventilated with the Venturi stsytem and the patients were bronchoscoped with a Karl Stors bronchoscope lined with a Venturi oxygen injecttimer, Freiberg 8585T, to which oxygen was supplied from an adjustable pressure reducing valve connected to pipeline oxygen at 55 psi. The following results were obtained: 1) Ten patients verying in age from 2 to 53 years were bronchoscoped becaeuse of subglotticedema, granuloma, emphysems, and tracheal stenosis. 2) The internal diameter of the bronchoscopes varied from 3.0mm to 6.5mm and the inflation pressure varies also from 0.4bar to 1.0bar. The inspiration to expiration time ratio was 1:2 and 1:3. 3) The average PaO2 was well maintained during bronchoscopy and in the postanesthetic stage, but the PaCO2 was slightly increased over the preoperative values. The explanation for this result is that the bronchoscope fitted too tightly to the trachea, so that exhalation was incomplete, and the process of exchange inhibited the elimination of CO2 from the lungs. The results obtained from this study suggest that this technic and device, when used properly, should provide adequate ventilation and an improved visual isation of the operative field.
Anesthesia, General ; Bronchoscopes ; Bronchoscopy* ; Exhalation ; Granuloma ; Humans ; Inflation, Economic ; Lung ; Needles ; Oxygen* ; Positive-Pressure Respiration ; Pulmonary Ventilation* ; Trachea ; Tracheal Stenosis ; Ventilation