Authors experienced a rare adenocarcinoma arising in presacral sacrococcygeal teratoma in a adult and herein reported. The patient was a 52 year old female admitted because of lower abdominal pain for 5 to 6 months. Past and familial history were unremarkable. On rectal examination a mass was palpated 3 cm above the anal verge. The large bowel was displaced by an extrinsic mass but there was no evidence of intrinsic tumor lesion on barium enema, CT was done and showed a large presacral tumor attached to the sacrum. Clinical impression was sacrococcygeal teratoma. Resected tumor mass was a relatively well circumscribed cystic mass, measuring 11 x 11 cm and the cystic content was previously evacuated. Inner surface showed ragged appearance, and focal nodular solid area was noted. On microscopic examination, the tumor revealed the derivatives of three germ layers and main components were tissues of respiratory tract. Sections from the solid area showed a well differentiated adenocarcinoma and with stromal, capsular and perineural invasion. Borderline malignant epithelial lesions are also noted suggesting the pathogenesis and progression of this tumor. There was no recurrence for one year after surgery in the follow up.
Adult ; Male ; Female ; Humans ; Adenocarcinoma

We present an ultrastructure of an incidentally found renomedullary interstitial tumor also called as medullary fibroma in a 77 year-old female who had a metastatic adenocarcinoma of colon to the ureter. This tumor was a small and grayish white nodule in renal medulla, measuring 0.4 x 0.4 cm. Microscopically the tumor composed of spindle cells, with some vacuolation and intercellular collagen fibers. The electron microscopic observation of the spindle cells reveal that nuclei are spindle to oval shape and cytoplasm contain abundant rough endoplasmic reticulum, polyribosome without microfilaments and cisterna like structures supporting that the renomedullary interstitial cell tumor is renal interstitial cell origin than fibroblasts.
Female ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

PURPOSE: We studied the result and cilincal significance of transscleral fixation of posterior chamber lens in complete vitrectomized eyes without capsular support. METHODS: We evaluated 30 aphakic eyes of 30 patients and according to the cause of pars plana vitrectomy, there were 9 eyes for intraocular foreign body, 8 eyes for lens dislocation, 8 eyes for retinal detachment, 3 eyes for vitreous hemorrhage, 2 eyes for endophthalmitis. RESULTS: The postoperative best-corrected visual acuity group was intraocular foreign body group and the group of lens dislocation, vitreous hemorrhage, retinal detachment, and endophthalmitis were in the descending order of visual acuity. The most common postoperative early complication was temporary hypotony and the others were hyphema, and temporary increased IOP. The most common postoperative late complication was exposed scleral fixation suture and the others were vitreous hemorrhage, cystoid macular edema, subluxation of intraocular lenses, retinal detachment. CONCLUSIONS: We experienced many postoperative temporary hypotony patients, but all cases were improved in short term period. The complication related to scleral fixation in vitrectomized eyes was imposed to smaller than the scleral fixation in vitreous support. But, in fact the development of retinal detachment or vitreous incarceration complication in the vitrectomized eye was not different from the eyes having vitreous support.
Endophthalmitis ; Foreign Bodies ; Humans ; Hyphema ; Lens Subluxation ; Lenses, Intraocular* ; Macular Edema ; Postoperative Complications ; Retinal Detachment ; Sutures ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

A spinal epidural hemangioma is rare. In this case, a 51 year-old female patient had low back pain and right thigh numbness. She was initially misdiagnosed as having a ruptured disc with possible sequestration of granulation tissue formation due to the limited number of spinal epidural hemangiomas and little-known radiological findings. Because there are no effective diagnostic tools to verify the hemangioma, more effort should be put into preoperative imaging tests to avoid misdiagnosis and poor decisions).
Diagnostic Errors ; Female ; Granulation Tissue ; Hemangioma ; Humans ; Hypesthesia ; Low Back Pain ; Thigh

No abstract available.
Lutein* ; Plasma*

PURPOSE: We studied the result and clinical significance of anterior chamber lens implantation in completely vitrectomized eyes without capsular support. METHODS: We evaluated 15 aphakic eyes of 15 patients. According to the cause of pars plana vitrectomy, there were 6 eyes for lens dislocation, 5 for intraocular foreign body, and 4 for rhegmatogenous retinal detachment. RESULTS: The final available postoperative best-corrected visual acuity was 0.5 or better in 9 eyes (60%). No statistically significant difference was noted in preoperative and postoperative IOP. The average of postoperative astigmatism was 1.14 +/- 0.79D. The most common early complication was temporary increase in IOP, but we could control IOP within normal limit with transient treatment. The postoperative late complications were glaucoma, IOL decentration and cystoid macular edema, but serious postoperative complications such as bullous keratopathy and retinal detachment were not found. CONCLUSIONS: The anterior chamber IOL implantation appears to be well tolerated and represents a simple alternative to transscleral fixation of a posterior chamber IOL in completely vitrectomized aphakic eyes.
Anterior Chamber* ; Astigmatism ; Foreign Bodies ; Glaucoma ; Humans ; Lens Implantation, Intraocular* ; Lens Subluxation ; Lenses, Intraocular* ; Macular Edema ; Postoperative Complications ; Retinal Detachment ; Visual Acuity ; Vitrectomy

No abstract available.
Female ; Humans ; Ovarian Cysts* ; Ovary*

Orthotopic liver transplantation has been an established medical therapy for almost any end-stage liver disease. In spite of improved survival rates following transplantation, acute or chronic allograft failure requiring hepatic retransplantation still occurs with an incidence of 9% to 22%. We experienced one case of anesthesia for liver retransplantation in 30-year-old male patient with posttransplantation hepatic arterial thrombosis. He had taken primary liver transplantation due to hepatocelluar carcinoma 15days before retransplantation. The operation was finished successfully after 10hours of anesthesia with anhepatic time of 65 minutes. Careful attention was paid to eletrolyte balance, blood coagulation function as well as cardiovascular and respiratory function. Hemodynamic value was relatively stable throughout the operation and postoperative mechanical ventilatory support was required for about 15 hours.
Adult ; Allografts ; Anesthesia ; Blood Coagulation ; Hemodynamics ; Humans ; Incidence ; Liver ; Liver Diseases ; Liver Transplantation ; Male ; Survival Rate ; Thrombosis

BACKGROUND: Gabapentin, an anticonvulsant structurally related to gamma-aminobutyric acid (GABA), was recently reported to be effective in pain associated with reflex sympathetic dystrophy and neuropathy. However, the effects of intrathecal (IT) gabapentin in postoperative pain are unclear. This study was designed to evaluate the analgesic action of IT gabapentin in a rat model of postoperative pain which was similar to human postoperative pain states. METHODS: Rats were prepared with chronic intrathecal catheter. Under halothane anesthesia, a 1 cm incision was made in the plantar aspect of the hind paw and closed. Rats were divided into 7 groups, a control group (saline 20 microliter intrathecally n = 6); a GP 30 group (gabapentin 30 microgram intrathecally, n = 6); a GP 100 group (gabapentin 100 microgram intrathecally, n = 6); a GP 300 group (gabapentin 300 microgram intrathecally, n = 6); a GP 1000 group (gabapentin 1,000 microgram intrathecally, n = 6); a NS-GP group (saline 10 microliter and gabapentin 300 microgram intrathecally, n = 6) and DS-GP group (D-serine 100 microgram and gabapentin 300 microgram intrathecally, n = 6). The rats were placed on an elevated plastic mesh floor, and withdrawal threshold was determined using calibrated von Frey filaments applied from beneath the test cage to an area adjacent to the wound. A cumulative pain score based on the weight bearing behavior of the rats, and motor deficit score, were also assessed. RESULTS: In all group, the median withdrawal threshold for punctate hyperalgesia decreased from 148.4 mN before surgery to 1.5 mN-14.5 mN 2 hours after surgery-inducing hyperalgesia and remained unchanged during the 2hr testing period. The IT administration of gabapentin (30 300 microgram) increased the median withdrawal threshold toward preincision values dose-dependently and the nonevoked pain scores were also decreased. But the effects of intrathecal gabapentin were reversed by IT D-serine. The Analgegic effects of gabapentin were observed at doses that had no significant effect on motor function or spontaneous activity. CONCLUSIONS: These observations suggest that intrathecal gabapentin can modulate the facilitation of spinal nociceptive processing by tissue injury and may offer a therapeutic agent for the treatment of postoperative pain.
Anesthesia ; Animals ; Catheters ; gamma-Aminobutyric Acid ; Halothane ; Humans ; Hyperalgesia ; Models, Animal* ; Pain, Postoperative ; Plastics ; Rats* ; Reflex Sympathetic Dystrophy ; Weight-Bearing ; Wounds and Injuries

BACKGROUND: Cell cycle deregulation plays a major role in chemical multistage carcinogenesis.Therefore, the evaluation of cell cycle proteins is important. METHODS: In order to induce carcinogenesis in the rat urinary bladder, 0.05% N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN)was administered to male Sprague-Dawley rats for 30 weeks. Expressions of cyclin D1, A, E, and B1 were examined by immunohistochemical stainings. RESULTS: Urothelial cell hyperplasia appeared at 5 weeks, followed by papilloma at 10 weeks. Superficial carcinoma was observed at 20 weeks, and invasive carcinoma developed in 40% (4/10) of the rats at 30 weeks. Expressions of cyclin D1 and A increased sequentially from normal mucosa throughhyperplasia, papilloma, and carcinoma (p<0.01). Expressions of cyclin D1, B1 and cyclin Ewere higher in invasive carcinomas than in superficial carcinomas (p<0.01). In contrast, therewas no significant difference in the expression of cyclin B1 between hyperplasia, papillomaand superficial carcinoma. CONCLUSIONS: The present results indicate the important roles of cyclin D1 and A in the development of BBN-induced urothelial carcinoma of rats. Aberrantexpression of cyclin B1 and E may contribute to the progression from superficial to invasivebladder cancer rather than tumorigenesis.
Animals ; Carcinogenesis* ; Cell Cycle ; Cell Cycle Proteins ; Cyclin B1 ; Cyclin D1 ; Cyclins* ; Humans ; Hyperplasia ; Male ; Mucous Membrane ; Papilloma ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder*