This study was undertaken to observe the effects of centrally administred antihistamines on the blood pressure. Diphenhydramine(DPH), a H1-receptor antagonist, and ranitidine(RAN), a H2-receptor antagonist were administered intracerebroventricularly(icv) on urethane-anesthetized rabbits. 1) Both DPH and RAN administered intraccebroventricularly increased blood pressure, however the intravenous(iv) adminstration of them did not affect blood pressure. The pressor response to icv DPH was dose-dependent, but that to icv RAN was not. 2) The pressor response to icv DPH(1mg) was either markedly attenuated or reversed to depressor response by the pretreatment with icv phentolamine(250,500ug), and iv chlorisondamine(0.1, 1mg/Kg) and iv phenoxybenzamine(1mg/Kg). In cord-sectioned rabbtis, icv RAN) 1mg) did not produce pressor response. 3) The pressor responsr to icv RAN(1mg) was not affected by the pretreatment with icv phentolamine(500ug), iv chlorisondamin(1mg/Kg) and iv phenoxybenzamine(1mg/Kg), and iv phenoxybenzamine(1mg/Kg). RAN also producted pressor response in cordsectioned rabbits. These results suggest that the pressor response to icv DPH is elecited by increasing peripheral sympathetic tone via the stimulation of central alpha-adrenoreceptors and the pressor response to icv RAN is produced by releasing some humoral facotr which can increase blood pressure.
Blood Pressure ; Diphenhydramine* ; Histamine Antagonists ; Rabbits* ; Ranitidine*

No abstract available.
Bile Duct Neoplasms* ; Bile Ducts* ; Bile*

The authors represented an analysis on 10 patients with traumatic epidural hematomas of the posterior fossa who had treated successfully from January 1984 to October 1985. The result were summarized as follows ; 1) Age incidence comprised ranging from 4 to 62 years and 6 were males and 4 were females. 2) Site of hematoma was related with fracture site closely and bleeding source confirmed during operation was transverse sinus in 4 cases, occipital sinus in 1 case, fracture site in 3 cases and unknown in 2 cases and it had close relationship between fracture site and large venous sinus. 3) Outcome was good in most cases except death in 1 and moderate disability in 1 case. Factors contributing to outcome were early detection and adequate treatment and also associated supratentorial injury.
Female ; Hematoma* ; Hemorrhage ; Humans ; Incidence ; Male ; Skull Fractures

PURPOSE: Recurrent gastric cancer has a very poor prognosis due to its diagnostic difficulties, variant recurrence patterns and no effective treatment modalities. In this study, we retrospectively analyzed treatment results of the recurrent gastric cancer. MATERIALS AND METHODS: We reviewed 1,286 patients who had taken radical surgery for primary gastric cancers and were diagnosed to have recurrences of their primary diseases. According to the medical records, we retrospectively analyzed the gross features, histologic types and TNM stages of primary gastric cancers. The symptoms, diagnostic modalities, durations, recurrence patterns, treatments and prognoses of recurrent diseases were also reviewed. RESULTS: The median survival time of total recurrent gastric cancer patients was 6.8 months. Ldegrees Co-regional and distant recurrences had better results than peritoneal and mixed recurrences (p<0.01). Curative resection of recurrent cancer was done in only 1.6% (18 cases in ldegrees Co-regional recurrence and 4 cases in distant recurrence), but in these cases, significant survival gain (5 year survival rate: 30.5%) was found compared to other treatment modalities (p<0.01). In multivariate analysis, the type of first operation, TNM stage, duration till recurrence, recurrence pattern, and treatment modality of recurrence were meaningful for the survival time after recurrence. CONCLUSION: In selective cases, recurrent gastric cancer had an effective treatment modality and was expected to have prolonged survival. Therefore, a careful diagnosis and an active treatment of the patients who have the recurrent gastric cancers should be done, especially for the ldegrees Co-regional recurrence.
Diagnosis ; Humans ; Medical Records ; Multivariate Analysis ; Prognosis ; Recurrence ; Retrospective Studies* ; Stomach Neoplasms* ; Survival Rate

Gastric duplication is an extremely rare disease that is commonly encountered during the first and the second decades. It is usually located in the greater curvature and forms a complete cystic structure. It usually presents non-specific post-prandial abdominal discomfort or is free of symptoms. Its significance is that it is associated with gastric malignancy or gastric ulcer and is difficult to differentiate from gastric submucosal tumor. We recently encountered an unusual case of gastric duplication, which developed in a 29-year-old man whose chief complaint was chronic abdominal discomfort. With a preoperative impression of gastric submucosal tumor, we explored his abdomen and found the gastric duplication located in the greater curvature side and performed a wedge resection. He was uneventfully discharged on the 12th postoperative day.
Abdomen ; Adult ; Humans ; Rare Diseases ; Stomach ; Stomach Ulcer

PURPOSE: We compared the safety of the double-stapling method with that of the hand-sewn method when performing a Billroth I anastomosis (BI) after a radical subtotal gastrectomy. METHODS: Fifty-three (53) patients who received a BI with stapler from February 1998 to April 1999 were compared with 24 patients who received a BI with the hand-sewn method from January 1996 to December 1998. All the patients were divided into three groups according to the type of reconstruction: Group 1 (n=42), double- stapling method, Group 2 (n=11), anastomosis through posterior gastric wall, and Group 3 (n=24), hand- sewn method. The length of the greater curvature, lesser curvature, and proximal margin and the number of resected lymph nodes were compared for radicality, and the incidence of complications was reviewed. ANOVA and the chi-square test were used for the statistical analysis. RESULTS: The mean ages were 55.2+/-10.8, 59.8+/-9.7, and 54.7+/-11.9 years for groups 1, 2, and 3, respectively. The sex ratios were 2.2:1, 1.2:1, and 1.4:1. The lengths (cm) of the greater curvature were 17.2+/-2.5, 18.4+/-2.5, and 18.6+/-3.3, and the lengths of the lesser curvature were 10.4+/-1.5, 10.9+/-1.6, and 10.7+/-2.1; however, the differences were not statistically significant (p>0.05). The lengths of the proximal resection margin were 5.4+/-2.5, 8.2+/-3.3, and 6.0+/-3.2 (p<0.05), and the numbers of resected lymph nodes were 25.3+/-8.3, 19.1+/-5.8, and 32.+/- 13.7 (p<0.01). We experienced no complication in any group, except one case of leakage in the hand-sewn group. CONCLUSION: The double-stapling technique is a safe operative method in BI after a radical subtotal gastrectomy with its very low complication rate. Especially, the so- called Tornado method is a more useful method since it doesn't need a gastrotomy in the remnant stomach.
Gastrectomy* ; Gastric Stump ; Gastroenterostomy* ; Humans ; Incidence ; Lymph Nodes ; Sex Ratio ; Stomach Neoplasms ; Tornadoes

PURPOSE: We compared the safety of the double-stapling method with that of the hand-sewn method when performing a Billroth I anastomosis (BI) after a radical subtotal gastrectomy. METHODS: Fifty-three (53) patients who received a BI with stapler from February 1998 to April 1999 were compared with 24 patients who received a BI with the hand-sewn method from January 1996 to December 1998. All the patients were divided into three groups according to the type of reconstruction: Group 1 (n=42), double- stapling method, Group 2 (n=11), anastomosis through posterior gastric wall, and Group 3 (n=24), hand- sewn method. The length of the greater curvature, lesser curvature, and proximal margin and the number of resected lymph nodes were compared for radicality, and the incidence of complications was reviewed. ANOVA and the chi-square test were used for the statistical analysis. RESULTS: The mean ages were 55.2+/-10.8, 59.8+/-9.7, and 54.7+/-11.9 years for groups 1, 2, and 3, respectively. The sex ratios were 2.2:1, 1.2:1, and 1.4:1. The lengths (cm) of the greater curvature were 17.2+/-2.5, 18.4+/-2.5, and 18.6+/-3.3, and the lengths of the lesser curvature were 10.4+/-1.5, 10.9+/-1.6, and 10.7+/-2.1; however, the differences were not statistically significant (p>0.05). The lengths of the proximal resection margin were 5.4+/-2.5, 8.2+/-3.3, and 6.0+/-3.2 (p<0.05), and the numbers of resected lymph nodes were 25.3+/-8.3, 19.1+/-5.8, and 32.+/- 13.7 (p<0.01). We experienced no complication in any group, except one case of leakage in the hand-sewn group. CONCLUSION: The double-stapling technique is a safe operative method in BI after a radical subtotal gastrectomy with its very low complication rate. Especially, the so- called Tornado method is a more useful method since it doesn't need a gastrotomy in the remnant stomach.
Gastrectomy* ; Gastric Stump ; Gastroenterostomy* ; Humans ; Incidence ; Lymph Nodes ; Sex Ratio ; Stomach Neoplasms ; Tornadoes

Traumatic optic neuropathy is a challenging emergency; controversies involving definition, natural history, pathomechanisms, and treatment modalities make its management problematic. Surgical decompression does not always yield favorable results; if this approach is considered, however, a careful evaluation of the necessary extent of invasion, the patient's condition(including a compromised brain) and the surgeon's familiarity with the procedure must all be carefully considered. We managed two traumatic optic neuropathy patients whose vision had been lost after fracture of the medial orbital wall. Using a nasal endoscope, the endonasal approach was employed, and endoscopic optic nerve decompression was performed; visual acuity was partly recovered. This precedure can be used in patients with decreased visual acuity due to traumatic optic neuropathy involving fractures of the optic canal. It is considered minimally invasive, has no specific contraindication, and can be used in patients whose brain condition is compromised.
Brain ; Decompression* ; Decompression, Surgical ; Emergencies ; Endoscopes ; Humans ; Natural History ; Optic Nerve Injuries* ; Optic Nerve* ; Orbit ; Recognition (Psychology) ; Visual Acuity

Diagnosis and therapeutic monitoring of human brain infarcts are dependent on imaging techniques such as computed axial tomography and magnetic resonance imaging. Yet, the radiological findings, especially contrast enhancement(CE), are not well correlated with the histopathological findings of the infarcts. By imaging techniques, CE is observed along the cortical margin of the infarcts, delayed in time after the initial attack. Explanation of the CE in terms of histopathological changes is the purpose of this study. Brain infarction was evoked by injection of homologous blood clots into the right common carotid artery of the rats. Three weeks after the injection, infarcts were examined light and electron microscopically. To confirm the possible increased permeability of vessels, horseradish peroxidase was injected intravenously before sacrifice of some rats. Unaffected brain tissue contralateral to the infarcts was examined for control. The results were as follows. Capillaries of the normal brain showed endothelial cells connected with tight junctions and approximated intimately to basement membrance on which cytoplasmic processes of the astrocytes rest. Pinocytotic vesicles in the endothelial cells were rarely observed. Horseradish peroxidase was confined almost to the capillary lumens. In contrast, regenerated capillaries in the infarcts showed endothedial cells with thin cytoplasmic processes protruded into the lumens and many pinocytotic vesicles. Toght junction and basement membrance were well formed, but astrocytes were not observed. Horseradish peroxidase was noted in the pinocytotic vesicles and around the capillaries. The regenerated capillaries were noted almost exclusively along the cortical margin of the infarcts. From the above results, CE of human brain infarcts along the cortical margin may be explained by the permeable capillaries regenerated at the cortical periphery of the infarcts.
Animals ; Astrocytes ; Brain Infarction ; Brain* ; Capillaries ; Capillary Permeability* ; Carotid Artery, Common ; Cytoplasm ; Diagnosis ; Endothelial Cells ; Horseradish Peroxidase ; Humans ; Magnetic Resonance Imaging ; Permeability ; Rats* ; Tight Junctions

PURPOSE: Adenomatous polyps in the stomach are rather uncommon, however are related to a malignant transformation. So, in such cases it is important to predict cancer risk and to select an appropriate surgical method. The aim of this study is to examine clinicopathologic factor for predicting malignancy and determine appropriate surgical management of gastric adenomatous polyps. METHODS: A total 41 patients who underwent surgery from 1996 to 1999 for gastric adenomatous polyps at the Department of Surgery, Seoul National University Hospital were included this study. All patients had undergone preoperative endoscopic biopsy and histology was confirmed. Authors analyzed the clinicopathologic factors associated with malignancy and the outcome of surgical treatment. RESULTS: Of the 41 patients, 17 patients had an adenomatous polyp alone, 24 patients had an adenomatous polyp associated with malignancy. The location, number, size and morphology of the polyp were not associated with malignancy. Only cellular atypism in the preoperative biopsy was significantly associated with malignancy. 31 patients underwent subtotal gastrectomy whereas 10 patients wedge resection. All lymph nodes resected in patients with adenocarcinoma were negative. Recurrence of polyp or adenocarcinoma had not occurred in any patients after follow-up of mean 22 months. CONCLUSION: Cellular atypism detected in preoperative histology was associated with malignancy in gastric adenomatous polyp. Lymph node metastasis was negative in patients with malignancy. Our findings support the wedge resection withsafe margin as being appropriate in surgical management of gastric adenomatous polyps.
Adenocarcinoma ; Adenomatous Polyps* ; Biopsy ; Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Polyps ; Recurrence ; Seoul ; Stomach