No abstract available.
Animals ; Embryonic Development* ; Female ; Mice* ; Oviducts* ; Pregnancy

This phase II study aimed to assess the clinical activity and toxicity of ifosfamide based regimen in patients with epithelial ovarian cancer, relapsed or refractory to cisplatin-containing combination chemotherapy. From July 1991 to June 1993, 18 patients with epithelial ovarian cancer, relapsed or refractory to cisplatin were treated as follows. Relapsed cases were treated with IP(ifosfamide 4,0g/m2 intravenously and cisplatin 60mg/m2 intravenously on day 1) regimen every 3-4 weeks. The regimen used in refractory cases was Et-I(etoposide 100mg/m2 intravenously on days 1 to 3 and ifosfamide 1.0g/m2 intravenously on days 1 to 5) regimen every 3 or 4 weeks. The uroprotectant mesna was concomitantly used. Responses and toxicities were evaluated according to the WHO Criteria. The overall response rate was 27.8%(5/18), including 2 complete response and 3 partial response. There were four episodes(22.2%) of grade 3, 4 myelosuppression, but no other grade 3, 4 non-hematologic toxicity. Salvage therapy with ifosfamide based regimen is a useful and well tolerated treatment strategy in selected patients with relapsed ovarian cancer.
Cisplatin ; Drug Therapy, Combination ; Humans ; Ifosfamide ; Mesna ; Ovarian Neoplasms* ; Recurrence ; Salvage Therapy

BACKGROUND: Low values of lung compliance have been reported in patients with increased pulmonary blood flow due to intracardiac left to right(L-R) shunt. The compliance had returned to within normal limits 4 to 6 weeks after surgical correction of the shunt. We investigated whether lung compliance was improved immediately after surgical correction of the shunt. METHODS: Fifty four pediatric patients who were undergoing repair of intracardiac L-R shunt were evaluated. Lung compliance, arterial oxygen tension(PaO2) and arterial to end-tidal carbon dioxide tension difference(Pa-ETCO2) were measured after induction of anesthesia and at the completion of surgery. Left atrial pressure(LAP) was monitored. Lung compliance and end-tidal carbon dioxide tension were measured by monitoring system built in Cato anesthetic ventilator system. RESULTS: Lung compliance was significantly lower after surgery(6.57+/-6.46 ml/mbar) than after induction of anesthesia(7.71+/-7.18 ml/mbar). After surgery, PaO2 was significantly decreased and Pa-ETCO2 significantly increased than after induction of anesthesia. The decrease in lung compliance after surgery significantly correlated with a decrease in PaO2(r=0.43) and an increase in Pa-ETCO2 (r=0.47) but not correlated with LAP. CONCLUSIONS: Although surgical correction of intracardiac L-R shunt reduces pulmonary blood flow, the lung compliance decreases in immediate postoperative period. Therefore a deterioration of postoperative lung compliance may need judicious management for pulmonary and hemodynamic instability.
Anesthesia ; Carbon Dioxide ; Compliance ; Hemodynamics ; Humans ; Lung Compliance* ; Lung* ; Oxygen ; Postoperative Period ; Ventilators, Mechanical

BACKGROUND: Dobutamine and amrinone, phosphodiesterase-III inhibitor, are known to have both inotropic and vasodilatory properties. We evaluated the effects of both drugs on systemic and pulmonary hemodynamics in patients with pulmonary hypertension (PH). METHODS: With Institutional Review Board approval, 45 patients whose mean pulmonary arterial pressure was greater than 30 mmHg were studied. After sternotomy under the steady state of anesthesia and controlled ventilation (30 mmHg < PaCO2 < 40 mmHg), patients recieved one of following drugs for 30minutes (min); dobutamine 5.0ug/kg/min (Group I), low dose amrinone (loading dose 1.0 mg/kg, followed by infusion 7.5 g/kg/min, Group II) or high dose amrinone (loading dose 2.0 mg/kg, followed by infusion 10 g/kg/min, Group III). Hemodynamic variables were measured at 10 min and 30 min after start of infusion. RESULTS: Dobutamine didn't decrease pulmonary arterial pressure (PAP) and cause no hemodynamic change while low and high dose amrinone reduced PAP and especcially decrease of PAP in low dose amrinone group was statistically significnat. High dose amrinone increased cardiac index (CI) and decreased both systemic vascular resistance index (SVRI) and central venous pressure (CVP) more significantly than control value. CONCLUSIONS: In patients with chronic right ventricular failure associated with PH, amrinone may decrease the PAP and improve cardiac performance more effectively than dobutamin does. Increment of dosage of amrinone may not result in significant reduction of PAP.
Amrinone* ; Anesthesia ; Arterial Pressure ; Central Venous Pressure ; Dobutamine* ; Ethics Committees, Research ; Hemodynamics* ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary* ; Sternotomy ; Vascular Resistance ; Ventilation

No abstract available.
Dysgerminoma*

OBJECTIVE: To evaluate the prevalence and genotype of high risk HPV infection with oligonucleotide microarray based DNA chip in cervical cancer. METHODS: The presence of HPV and its type were tested with oligonucleotide microarray based DNA chip in 84 specimen from cervical cancer (squamous cell carcinoma; 58, adenocarcinoma; 22, adenosquamous carcinoma and small cell carcinoma; 4). RESULTS: The overall detection rate of high risk HPV infection was 84.5% (71/84). In squamous cell carcinoma and adenocarcinoma, the detection rate were 79.3% (46/58) and 100% (22/22) respectively. The distribution of HPV types in squamous cell carcinoma and adenocarcinoma was as follows; HPV 16 (60.3%, 59.1%), HPV 18 (1.7%, 27.3%). CONCLUSION: The most common type of high risk HPV detected in squamous cell carcinoma and adenocarcinoma of cervix was HPV 16 followed by HPV 18. In contrast with squamous cell carcinoma, HPV 18 was more frequently detected than HPV 16 in adenocarcinoma. HPV DNA chip seems to be effective in the detection and typing of HPV in tissues from cervical cancer.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Genotype ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; Oligonucleotide Array Sequence Analysis ; Prevalence* ; Uterine Cervical Neoplasms*

OBJECTIVE: The aim of this study was to evaluate the concentration of IL-8 and VEGF in serum and cervicovaginal washing fluid and to investigate whether local production of IL-8 and VEGF could be found. METHODS: Cervicovaginal washing fluid and sera were obtained from 14 patients with invasive cervical cancer and 19 patients with other benign disease who showed normal Pap smear result. The level of IL-8 and VEGF was determined by ELISA (PharMingenTM, San Diego, CA, USA). RESULTS: The mean concentration of cervicovaginal washing fluid IL-8 was 2181.7 pg/ml (+/-2235.7) in case group and 899.0 pg/ml (+/-1192.0) in control group, and the mean concentration of serum IL-8 was 230.6 pg/ml (+/-214.1) and 103.5 pg/ml (+/-138.5) respectively. With VEGF, the mean concentraiton of cervicovaginal washing fluid was 216.9 pg/ml (+/-125.4) in case group and 102.9 pg/ml (+/-138.1) in control group and of serum was 31.2 pg/ml (+/-15.6) and 17.7 pg/ml (+/-17.3) respectively. There was a significant correlation between IL-8 and VEGF in control group (spearman P=0.001 (0.858), 0.001 (0.839). 95% CI, cervicovaginal washing fluid, serum) as well as in case group (spearman P=0.001 (0.905), 0.041 (0.462). 95% CI). CONCLUSION: The concentration of IL-8 and VEGF from both serum and cervicovaginal washing fluid was significantly increased in case group than in control group. There seems to be a local production of IL-8 and VEGF in cervicovaginal tissue from the results of a significant correlation between IL-8 and VEGF in control group as well as in case group and a significant increase of the median concentration of IL-8 and VEGF in cervicovaginal washing fluid than in serum.
Case-Control Studies* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-8* ; Uterine Cervical Neoplasms* ; Vascular Endothelial Growth Factor A*

Carbon dioxide (CO2) poisoning is rare, but its clinical features of acute exposure include cardiovascular, respiratory, neurologic and metabolic aspects. CO2 can also have a direct toxicological effect. At very high concentrations (>9%), CO2 induces respiratory depression and narcotic-like effects on the central nervous system. Especially, acute poisoning from dry ice is caused by CO2 gas inhalation and asphyxiation, and may impose excess load on the myocardium. This case was an acute CO2 poisoning from dry ice gas inhalation. In spite of an initial severe status, the male patient rapidly improved with no complications following the application of highly concentrated oxygen and fluid therapy.
Carbon ; Carbon Dioxide ; Central Nervous System ; Dry Ice ; Fluid Therapy ; Humans ; Inhalation ; Male ; Myocardium ; Oxygen ; Respiratory Insufficiency

Various invasive and non-invasive imaging techniques have been used for the diagnosis of cardiac disease. The recently introduced multidetector row CT (MDCT) shows rapid scan speed, high temporal resolution and large volume coverage in a single breath-hold. MDCT opens a new horizon for cardiac imaging because noninvasive coronary artery imaging has become feasible using MDCT. In this article, we illustrate the technical aspects of coronary CT angiography using MDCT.
Angiography ; Coronary Angiography* ; Coronary Vessels ; Diagnosis ; Heart Diseases ; Multidetector Computed Tomography*

PURPOSE: The recent advances in microsurgical techniques and their refinement over the past decade have greatly expanded the indications for digital replantations and have enabled us to salvage severed fingers more often. Many studies have reported greater than 80% viability rates in replantation surgery with functional results. However, replantation of multi-level amputations still remain a challenging problem and the decision of whether or not to replant an amputated part is difficult even for an experienced reconstructive surgeon because the ultimate functional result is unpredictable. METHODS: Between January of 2002 and May of 2008, we treated 10 multi-level amputated digits of 7 patients. After brachial plexus block, meticulous replantation procedure was performed under microscopic magnification. Postoperatively, hand elevation, heat lamp, drug therapy and hyperbaric oxygen therapy were applied with careful observation of digital circulation. Early rehabilitation protocol was performed for functional improvement. RESULTS: Among the 19 amputated segments of 10 digits, 16 segments survived completely without any complications. Overall survival rate was 84%. Complete necrosis of one finger tip segment and partial necrosis of two distal amputated segments developed and subsequent surgical interventions such as groin flap, local advancement flap and skin graft were performed. The overall result was functionally and aesthetically satisfactory. CONCLUSION: We experienced successful replantations of multi-level amputated digits. When we encounter a multi-level amputation, the key question is whether or not it is a contraindication to replantation. Despite the demand for skillful microsurgical technique and longer operative time, the authors' results prove it is worth attempting replantations in multi-level amputation because of the superiority in aesthetic and functional results.
Amputation ; Brachial Plexus ; Fingers ; Groin ; Hand ; Hot Temperature ; Humans ; Hyperbaric Oxygenation ; Necrosis ; Operative Time ; Replantation ; Skin ; Survival Rate ; Transplants