No abstract available.

No abstract available.
Brain* ; Hemangioendothelioma* ; Lung* ; Mediastinum*

BACKGROUND: beta-Catenin has dual functions: adhesive molucule and transcriptional activator. Subcellular accumulation of beta-catenin and subsequent formation of beta-catenin- Tcf/Lef-1 complexes, as well as c-myc and cyclin D1 genes which were recently defined as target genes of beta-catenin- Tcf/Lef-1, has been shown to be important in the development of colorectal and breast carcinomas. The author investigated the rate of subcellular accumulation of beta-catenin and overexpression of c-myc and cyclin D1, and also investigated the association between them in the pulmonary adenocarcinomas. METHODS: Fifty-one surgically resected primary adenocarcinomas of the lung, including 11 bronchioloalveolar carcinomas, were investigated by immunohistochemical analysis with monoclonal antibodies specific for beta-catenin, c-myc and cyclin D1. Clinico-pathological information were collected from the patient charts and surgical pathology reports. RESULTS: Accumulation of beta-catenin in the nucleus and/or cytoplasm and overexpression of c-myc and cyclin D1 were observed to be 20%, 37%, 16%, respectively. Ten cases showing accumulated patterns of beta-catenin revealed alternative overexpressions of c-myc (7 cases) and cyclin D1 (3 cases). In nonmucinous tumors, 9 cases showing overexpression of c-myc or cyclin D1 revealed accumulations of beta-catenin. The accumulation of beta-catenin was not statistically related to clinico-pathological parameters. The association between c-myc overexpression and histological subtype of tumors was observed. CONCLUSIONS:It is suggested that the accumulation of beta-catenin is closely associated with tumorigenesis in a minor subset (20%) of peripheral adenocarcinomas of the lung. It is also suggested that transactivation of beta-catenin may closely be associated with the overexpression of c-myc or cyclin D1 in the nonmucinous adenocarcinoma.
Adenocarcinoma* ; Adenocarcinoma, Bronchiolo-Alveolar ; Adhesives ; Antibodies, Monoclonal ; beta Catenin* ; Breast Neoplasms ; Carcinogenesis ; Cyclin D1* ; Cyclins* ; Cytoplasm ; Genes, bcl-1 ; Humans ; Lung ; Pathology, Surgical ; Transcriptional Activation

Accurate placernent of double-lumen endobronchial tube is essential for successful one lung anesthesia We studied 58 adult patients (38 males and 20 females) undergoing thoracic surgery under one lung anesthesia. We used the fiberoptic bronchoscope as an "introducer" over which the double lumen tube was advanced under direct vision. Correct position of the left side double-lumen endobronchial tube at supine position was determined by direct vision of cephalad surface of the bright blue bronchial cuff immediately below the carina. Correct position of the right side double lumen endobronchial tube at supine position was determined by direct vision of the right upper lobe bronchial orifice through the right upper labe ventilation slot. After the patient was repositioned, the position of the double lumen endobronchial tube was rechecked by fiberoptic bronchoscope. The results were as follows; 1) There was a significant correlation of correct depth of left and right double lumen endobronchial tube at supine position with height for both male and female patients. 2) Left side double lumen endobronchial tube: 58% of total cases (20 Case of 38 Case) were displaced by turning of the patient from supine to the lateral decubitus position. 3) Right side double lumen endobronchial tube: 65% of total cases (13 Case of 20 Case) were displaced by turning of the patient from supine to the lateral decubitus position.
Adult ; Anesthesia ; Bronchoscopes ; Female ; Humans ; Lung ; Male ; Supine Position ; Thoracic Surgery ; Ventilation

Epidermolysis bullosa (EB) is a rare inherited disease characterized by vesiculobullous lesion that arise in response to minimal trauma or shearing force to the skin. Epiderrnolysis bullosa herpetiformis-Dowling Meara, a variant of EB, has its onset at birth and can be a life threatening disease as it was in this case. We report a case of epidermolysis bullosa herpetiformis in a newborn with a generalized intraepidermal blisters noted at birth whose diagnosis was confirmed by electron microscope. A brief review of the literature is included.
Blister ; Diagnosis ; Epidermolysis Bullosa* ; Humans ; Infant, Newborn ; Parturition ; Skin

The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Anoxia* ; Flail Chest ; High-Frequency Jet Ventilation ; Humans ; Male ; Middle Aged ; Oxygen ; Respiration, Artificial* ; Respiratory Insufficiency ; Ventilation

The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Anoxia* ; Flail Chest ; High-Frequency Jet Ventilation ; Humans ; Male ; Middle Aged ; Oxygen ; Respiration, Artificial* ; Respiratory Insufficiency ; Ventilation

INTRODUCTION: Accurate placement of double-lumen endobronchial tube (DLT) is essential for optimal gas exchange and collapse of nondependent lung during one-lung anesthesia. The goal of this study was to determine if measurement of tracheal length from the preoperative chest X-ray can be used for the prediction of adequate length of left-sided DLT insertion. METHODS: 25 patients scheduled for elective thoracotomy under one-lung anesthesia were studied. After measurement of tracheal length from preoperative chest X-ray and of length from incisor to vocal cord during intubation, the patient was intubated with left-sided DLT to the depth of predetermined length from incisor to carina. The tube position was evaluated with fiberoptic bronchocsope. RESULTS: In 22 patients (88%) the DLTs were positioned satisfactorily, and in three patients it was required to reposition DLT. CONCLUSIONS: This technique may be useful for accurate placement of DLT for the one-lung anesthesia.
Anesthesia ; Humans ; Incisor ; Intubation ; Lung ; Thoracotomy ; Thorax* ; Vocal Cords

Prostate cancer commonly manifests with bony metastases. Visceral metastasis can also occur in the lungs and liver. However, stomach metastasis related to prostate cancer is rare. Here, we report a case of prostate cancer metastatic to the stomach. A 66-year-old male was diagnosed with prostate adenocarcinoma. He was noted as having abdominal discomfort, nausea, and vomiting 18 months after the diagnosis. A histopathologic examination and an esophagogastroduodenoscopic gastric biopsy revealed stomach-metastatic adenocarcinoma. He was also noted as having cerebellar metastatic lesions, which were identified by using a brain magnetic resonance imaging (MRI) scan. The patient died of cardiovascular complications 5 months after the diagnosis of stomach metastasis.
Adenocarcinoma ; Aged ; Biopsy ; Brain ; Humans ; Liver ; Lung ; Magnetic Resonance Imaging ; Male ; Nausea ; Neoplasm Metastasis ; Prostate ; Prostatic Neoplasms ; Stomach ; Vomiting

Orthopedic surgical procedures are associated with a variety of complications due to em- bolic phenomena. Fat embolism syndrome is associated with multiple trauma injuries and surgery involving longbone fractures. The pathogenesis of syndrome is not clear and treatment remains supportive. We experienced a case of pulmonary embolism associated with total hip replacement. We suspected embolism on pulmonary perfusion scan and diagnosed fat embolism with criteria for diagnosis of fat embolism syndrome by Gurd.
Arthroplasty, Replacement, Hip* ; Diagnosis ; Embolism ; Embolism, Fat ; Femur Neck* ; Femur* ; Multiple Trauma ; Orthopedic Procedures ; Perfusion ; Pulmonary Embolism*