In acupuncture practice of animals, preanesthetics sometimes are needed. The purpose of this study was to select the ideal chemical restraint at acupuncture for gastric motility. Nine healthy mixed breed dogs weighed 10-21 kg and aged 1-3 years old were used in this study. Two EMG surface electrodes were placed between the seromuscular and the mucosal layer of pylorus. Twenty minutes after feeding normal gastric motility was recorded for 60 minutes using physiograph (Narco-Biosystem). Then preanesthetic treated-gastric motility was observed for 30 minutes. Preanesthetics used were xylazine, diazepam, and acepromazine. Acupuncture needles were inserted to BL-21 (Wei-Yu) acupoint, and then changes of gastric motility were recorded for 60 minutes. The gastric motility following xylazine administration (1 mg/kg, IV) was markedly decreased. BL-21 (Wei-Yu) acupoints stimulation did not alter xylazine-induced depression of gastric motility. The diazepam (1 mg/kg IV) treated-gastric motility was increased mildly 20 minutes after drug administration. BL-21 (Wei-Yu) acupoint stimulation after diazepam administration enhanced gastric motility significantly. The gastric motility following acepromazine (0.3 mg/kg, IM) administration was not changed compared with normal gastric motility. Application of traditional acupuncture at BL-21 (Wei-Yu) significantly increased the gastric motility. Based on these results, acepromazine and diazepam could be acceptable chemical restraints for acupuncture therapy of gastric motility, but xylazine couldn't be.
Acepromazine ; Acupuncture/*standards ; *Acupuncture Points ; Adjuvants, Anesthesia ; Adrenergic alpha-Agonists ; Animals ; Antipsychotic Agents ; Atropine ; Diazepam ; Dogs/*physiology ; Dopamine Antagonists ; Electromyography/veterinary ; Gastrointestinal Motility/drug effects/*physiology ; Hypnotics and Sedatives ; Metoclopramide ; Parasympatholytics ; Preanesthetic Medication/standards/*veterinary ; Xylazine

No abstract available.

The authors have intended to measure intrinsic dose distribution by Farmer dosimeter in irregularly shaped fields such as L.M. and T shape models in order to determine dose in homogeneity in those models. We made 2 off-xis points in each model and measured the depth dose at 1.5, 5 and 9cm below surface. The results showed 1~3% dose discrepancy between 2 points. We also measured the depth dose by geometric approximation and computer calculation in those models, and came to the conclusion that computer calculation using Clarkson's principle is simpler and the measurements are closer to the ideal data obtained by the experiment in three models of irregularly shaped fields than those of geometric approximation method.

BACKGROUND: Pancreaticoduodenectomy is well established in the armamentarium of the surgeon treating periampullary carcinoma and benign lesion. With refinement of operative technique and more enlighting management during the postoperative period, the morbidity and mortality of this procedure have reduced significantly. Leakage of the pancreaticojejunal anastomosis has been a major complication after this procedure, frequently reported in an incidence of 5 percent to 15 percent. Therefore, authors retrospectivly reviewed about clinical experience of duct-to-mucosa anastomosis and PTBD in pancreaticoduodenectomy. OBJECTS & METHODS: The authors retrospectively reviewed the medical records of 93 patients who had undergone a pancreaticoduodenectomy with the duct-to-mucosa method between 1994 and 2000 by one surgeon. RESULTS: The male-to female ratio was 2.1:1(63:30) and mean age was 57 years old(range from 26 to 77). Thirty patients(32.6%) of 93 patients were distal common bile duct cancer, 22 patients(24%) were pancreatic head cancer, 21 patients(23%) were Ampulla of Vater cancer, 5 patients(5.4%) were chronic pancreatitis, 3 patient(3.3%) were duodenal cancer. The operative morbidity was 35.8%, and there was three perioperative mortality(3.2%). The mean operative time was 8.8 hours. A pancreatic fistula was diagnosed in 6 of the 93 patients(6.5%) and surgical intervention was done in 1 of the 6 patients. A PTBD for preoperatively biliary drainage was done 64 cases and complication related PTBD was 3 cases(4.7%, hemobilia). CONCLUSIONS: Even if this anastomotic technique requires a little more time and attention by the surgeon, we experienced that the low incidence of pancreatico-jejunal anastomosis related complication represents a validation of the method, and a motivation to adapt this anastomotic technique. But, this method is not absolute because surgeon's preference is most important factor in operation.
Ampulla of Vater ; Common Bile Duct ; Drainage ; Duodenal Neoplasms ; Female ; Head and Neck Neoplasms ; Humans ; Incidence ; Medical Records ; Mortality ; Motivation ; Operative Time ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Pancreaticojejunostomy* ; Pancreatitis, Chronic ; Postoperative Period ; Retrospective Studies

PURPOSE: Cystic neoplasms of the pancreas are rare tumors that occurs in approximately 10~15% of all cystic lesions of the pancreas. A recent trend has been to resect all cystic neoplasms, without any attempt to preoperatively determine the exact histologic subtype. METHODS: We retrospectively reviewed the clinical records of fifteen patients with cystic neoplasms and intraductal papillary mucinous neoplasms of the pancreas who were treated surgically between January, 1991 and May, 2001. RESULTS: Patient ages ranged from 14 to 69 years with a mean of 53.4. Sixty percent of patients were women. There were 4 cases of mucinous cystic neoplasms, 7 solid pseudopapillary tumors, 3 intraductal papillary mucinous neoplasms, and 1 serous cystadenoma. The most prominant symptom was an abdominal mass. Pancreaticoduodenectomy was performed in six cases, distal pancreatectomy in five cases, excision of cyst in three cases and median segmental pancreatectomy in one case. The mortality rate from surgery was 0%, and the overall perioperative complication rate was 40%. The mean follow-up was 24 months (range from 2 months to 63 months). Two patients, both displaying intraductal papillary mucinous neoplasms, died at 9 and 14 months postoperatively. CONCLUSION: We suggest that cystic neoplasms of the pancreas including intraductal papillary mucinous neoplasm should be resected because they are malignant or pre-malignant. Endoscopic retrograde cholangiopancreatography is the imaging modality of choice for the diagnosis of intraductal papillary mucinous neoplasm. We conclude that the prognosis for resected cystic neoplasms of the pancreas is good.
Cholangiopancreatography, Endoscopic Retrograde ; Cystadenoma, Serous ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Mortality ; Mucins* ; Pancreas* ; Pancreatectomy ; Pancreaticoduodenectomy ; Prognosis ; Retrospective Studies

PURPOSE: Cystic lesions of the liver are highly variable in respect to appearance and therapeutic approach. However, without cystectomy and hepatic resection, the patient is at risk for recurrent enlargement, infection, or progression of an unrecognized malignant neoplasm. The goal of this study was to discern the safest and most effective method, with special emphasis on a suitable therapeutic technique for various cystic lesions of the liver. METHODS: We reviwed the cystectomy and hepatic resection and outcome of patients with hepatic cysts from November, 1987 to April, 2000 at the Hanyang University Hospital. A retrospective study of 19 patients with various cystic lesions of the liver was performed. RESULTS: There were 8 simple cysts, 2 polycystic liver disease, 2 biliary cystadenoma, 4 biliary cystadenocarcinoma, 2 hydatid cysts, and 1 traumatic cyst. In examining the 6 cystectomies, 13 hepatic resections. (4 right lobectomies, 4 left lobectomies, 5 minor hepatic resections), there were no postoperative deaths in this series. Four patients (21.1%) developed operative complications. During the mean follow- up time of 78.2 months, symptomatic relief was complete and permanent in all of patients except the 1 biliary cystadenocarcinoma 1 of the 4 patients with biliary cystadenocarcinoma died of tumor recurrence (5.3%) approximately 27 months after hepatic resection. CONCLUSION: Cystectomy and hepatic resection is a more curative treatment for cystic lesions of the liver than other treatments. We recommend complete cystectomy and hepatic resection as the preferred therapy, particularly when the cyst is large, a malignancy cannot be ruled out, and a proper diagnosis is not confirmed.
Cystadenocarcinoma ; Cystadenoma ; Cystectomy* ; Diagnosis ; Echinococcosis ; Humans ; Liver Diseases ; Liver* ; Recurrence ; Retrospective Studies

A primary hepatic sarcoma is a rare tumor, that most frequently arises from hepatic connective tissue or vascular channels, and is usually located in the intrahepatic area. Pedunculated, or bulging, lesions have also been reported. We encountered a pedunculated primary hepatic leiomyosarcoma occurring in a 61-year-old woman. A giant exophytic hepatic mass measuring 15x10cm in size, was located in the left lateral segment of the liver, which was compressing the stomach. A left lateral segmentectomy was performed. Microscopically, the tumor was composed of spindle cells reactive to muscle specific actin. The mitotic figures were 5/10 high power fields indicating the tumor was malignant. No other primary sites were recognized from clinical studies.
Actins ; Connective Tissue ; Female ; Humans ; Leiomyosarcoma* ; Liver ; Mastectomy, Segmental ; Middle Aged ; Sarcoma ; Stomach

Angiomyolipoma is a benign renal tumor composed of thick- walled blood vessels, smooth muscle cells, and adipose tissue. Despite the aggressive biological and histological features associated with angiomyolipoma, the lack of distant metastasis led us to conclude that angiomyolipoma is a benign neoplasm. Epithelioid angiomyolipoma is a recently described variant type of angiomyolipoma of the kidney. Diagnosis is usually made by histological method and immunohistochemical staining with HMB-45. Several reports suggested the presence of malignant epithelioid angiomyolipomas showing multiple metastases and local aggressiveness. We report a case of epithelioid angiomyolipoma with multiple metastases. Local recurrence and liver, bone and lung metastases developed 11 months after radical nephrectomy. Right hepatectomy and wedge resection of left lobe of the liver with radiation therapy were done.
Adipose Tissue ; Angiomyolipoma* ; Blood Vessels ; Diagnosis ; Hepatectomy ; Kidney ; Liver ; Lung ; Myocytes, Smooth Muscle ; Neoplasm Metastasis* ; Nephrectomy ; Recurrence

Mucoepidermoid carcinoma of the liver is a rare variant of cholangiocarcinoma which contains both mucus-secreting glandular cells and squamous cells mixed in nests. We diagnosed a case of mucoepidermoid carcinoma of the liver in a 69-year-old woman who visited hospital because of fever, chill, right flank pain for one week. On admission, she was not jaundiced. Under a provisional diagnosis of liver abscess, a pigtail catheter was inserted to the abscess cavity. One month after the admission, despite conservative treatment, the abscess cavity remained. For a curative treatment and possible hiden malignancy, right hepatectomy of the liver and excision of partial diaphragm were done. Microscopically, the tumor mass composed of solid and invasive nests of epidermoid and mucin-producing cells with desmoplastic stroma. Alcian blue, Periodic-Acid Schiff (PAS) stainings confirmed the presence of mucin in the cytoplasm of mucus-secreting cells. Electron micrographs showed the presence of tonofilaments and confirmed the squamous nature of the tumor cells. The tumor cells, intrahepatic bile ducts and ductules were consistently reactive with cytokeratin 7. Adjacent nonneoplastic liver cells were negative to cytokeratin 7. In the present case, the tumor was diagnosed as mucoepidermoid carcinoma, which was arisen from the intrahepatic bile duct.
Abscess ; Aged ; Alcian Blue ; Bile Ducts, Intrahepatic ; Carcinoma, Mucoepidermoid* ; Catheters ; Cholangiocarcinoma ; Cytoplasm ; Diagnosis ; Diaphragm ; Female ; Fever ; Flank Pain ; Hepatectomy ; Humans ; Intermediate Filaments ; Keratin-7 ; Liver Abscess* ; Liver* ; Mucins

BACKGROUND/AIMS: The diagnosis and treatment of benign hepatic lesions remain controversal. The widespread availability of ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI), and their frequent application in evaluating abdominal pain, has resulted in more frequent discovery of incidental benign hepatic lesions. To address these points, the clinical data of patients with benign hepatic lesions treated with surgical resections at our hospital were reviewed retrospectively. METHODS: We reviewed the clinical records of thirty nine patients with benign hepatic lesions who had undergone hepatic resection from January, 1985 to August, 2002 at Hanyang University Hospital. RESULTS: There were 39 patients, whose mean age was 47.0 years. The ages ranged from 24~74 years. There were 14 male patients and 25 female patients. The ratio of male and female was 1:1.8. Major symptoms were right upper quadrant pain, mass, epigastric pain, and non-specific GI symptoms. 22 cases of anatomical resections (10 right lobectomy, 5 left lobectomy, 7 left lateral segmentectomy) and 17 non anatomical resections were done. There were no postoperative deaths in this series. Fourteen patients (35.9%) developed operative complications. All of them were minor complications. During the mean follow up time, symptomatic relief was achieved in patients out of patients who we could contact with opd follow up or telephone interview. Three patients died of massive pleural effusion 4 years after operation, myocardial infarction 14 months after operation, alcoholic liver cirrhosis and diabetes mellitus 33 months after operation. CONCLUSION: Hepatic resection in patients who had benign hepatic lesions in the liver was safe and effective treatment modality if patients were selected with suitable indications.
Abdominal Pain ; Diabetes Mellitus ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Interviews as Topic ; Liver ; Liver Cirrhosis, Alcoholic ; Magnetic Resonance Imaging ; Male ; Myocardial Infarction ; Pleural Effusion ; Retrospective Studies ; Ultrasonography