This case was an acquired aplastic anemia patient who required a major operation for excision of a mediastinal mass. The authors previewed that the coagulation abnormalities would be developed due to major operation. Thus we decided to monitoring the coagulation function using the thromboelastography during the perioperative period and checked the complete blood count, concommitantly. The total blood volume lost during operation was 1800 ml, so we gave him a transfusion of 10 U's of platelet concentrate, 10 U's of pheretic platelet rich plasma and 5 U's of whole blood. The thromboelastography was a good guide that helped us to avoid excessive treatment of the coagulation abnormalities. We concluded that the thromboelastograhy was a reliable and effective monitoring system at the intraoperative coagulation management.
Anemia, Aplastic* ; Anesthesia, General ; Blood Cell Count ; Blood Platelets ; Blood Volume ; Humans ; Perioperative Period ; Platelet-Rich Plasma ; Thrombelastography

The cell cycle is composed of G1, S, G2 and M phase. The transitions between different phases are regulated at checkpoint such as Start(restriction), S phase and mitotic checkpoint. These checkpoints are regulated by specific cyclins and Cdks(cyclin-dependent kinases). Especially, Start checkpoint in late G1 is though to be very important in control of cell cycle. In this study, it was shown various CDKN2(p16ink4A) alteration, including deletions, mutations, down regulations, and performed differential expression of p53, Cdk4, PCNA and pRb in stomach cancer tissues. 1. The frequency of CDKN2 mutations was not observed in the 19 primary stomach cancer tissues. In contrast to the mutations of CDKN2, mRNA levels was showed by Northern blot analysis that expression of CDKN2 was absent or decreased in 10 of the 19(53%) primary stomach adenocarcinoma. Western blot analysis was performed to determine the differential expression of p53, Cdk4, PCNA related to Start checkpoint. Overexpression of p53 was shown 38%, Cdk4 was expressed in all each specimens, and expression of PCNA was not shown. 2. As the other method to determine the differential expression of p53, Cdk4, PCNA and pRb, immunohistochemical analyses were performed on each 14 formalin-fixed and paraffin embedded tumor tissues of stomach adenocarcinoma. p53 overexpression was showed to clear nuclear staining only in tumor cells not in nonneoplastic cells. In staining for cdk4, the tumor was considered to be cdk4 positive if there was nuclear staining in tumor cells, regardless of cytoplasmic staining. PCNA staining for carcinoma tissues showed more intense nuclear staining in tumor cells than in nonneoplastic cells. pRb overexpression was show in tumor cells. Significant differences were observed in the expression of the proteins among the cancers from different anatomic site. Overexpression of adenocarcinomas had high rate of p53(57.1%) and pRb(71.4% ), and low late of cdk4(7.1% ) and PCNA(14.3% ), As these results, deletion of CDKN2 gene in human stomach cancer was not observed but mRNA expression was down regulated in restriction checkpoint, G1 phase. Inactivation of the CDKN2 gene due to hypermethylation may play an important role in development of cancer. And one of the abnormalities in p53, Cdk4, PCNA or pRb function occurs very common in various cancers, especially oral adenocarcinoma, osteosarcoma and squemous cell carcinoma, suggest that components in restriction checkpoint also play an critical role in the carcinogenesis and progression of cancers.
Adenocarcinoma ; Blotting, Northern ; Blotting, Western ; Carcinogenesis* ; Cell Cycle ; Cell Division ; Cyclins ; Cytoplasm ; G1 Phase Cell Cycle Checkpoints ; Genes, p16 ; Humans ; M Phase Cell Cycle Checkpoints ; Osteosarcoma ; Paraffin ; Proliferating Cell Nuclear Antigen ; RNA, Messenger ; S Phase ; Social Control, Formal ; Stomach ; Stomach Neoplasms

Sparganosis is a tissue-invading disease caused hy plerocercoid of Spirometra mansoni91. Usually, uncooked snakes or flogs and infected water are primary sources of sparganosis. Sparganosis found in the lower extremities, abdominal wall, breast, inguinal region and scrotum. Simple radiographs show linear or elongated calcification. Serodiagnostic tests have also heen used widely. Confirmative diagnosis of sparganosis is made by surgical removal of the worm. We experienced a case of sparganosis in a 48-year old male in the calf. We report a case and review related articles hriefly.
Abdominal Wall ; Breast ; Diagnosis ; Humans ; Lower Extremity ; Male ; Middle Aged ; Scrotum ; Snakes ; Sparganosis* ; Spirometra

We report a rescently experienced case with atypical radiologic manifestation of solid and papillary epithelial neoplasm of the pancreas in a 37 years old female patient. The tumor had heavy calcification on its capsule wall and septa. Instead of the usual encapsulated lesion with partly solid and partly cystic-hemorrhagic components, the lesion consisted of numerous fine cavitations containing air without fluid component except focal abscess fluid.
Abscess ; Female ; Humans ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancrelipase*

BACKGROUND: Alcohol has much effect on our lives as a taste food that people in almost all of the world generally have had. The effects of alcohol cause social problems as well as physical and psychological problems. Recently, interest about drinkirg increasingly rises as the rate of drinking accident increases in Korea. For this, our study examined the amount of alcohol consumption and early at-risk alcohol intake. METHODS: The prepared questionnaire was presented to subjects who were employees in Inchon . The anonymous, self-administered questionnaire was composed of questionnaire concerning alcohol consumption, early at-risk alcohol intake and doctor's role in drinking behaviour. RESULTS: Among 305 subjects, there were 189 (62%) men, 116 (38%) women whose mean age was 37. 9years. 87(28.5%)subjects were classified as high alcohol group and 218(71.5%) low alcohol group. High alcohol group was defined as early at-risk alcohol intake for men who were consuming 135g of alcohol per day, 630 per week and for women 90g per day, 270g per week. Low alcohol group was defined as early at-risk alcohol intake for men whose consumption was 90g per day, 450 per week and for women 45g per day, 270g per week . Mean alcohol consumption of drinker was 158.9g per week. 3 days per week people should not drink in order to avoid risk Although 54% of respondents thought doctors should ask about their drinkirg habits, only 16.4% of respondents reported ever being asked about alcohol intake on the subject. CONCLUSION: Early at-risk drinking subject in the study was much more than those suggested by NIH(National Institutes of Health). We conclude that primary care physicians should take more interest in screening, treating and preventing alcohol related problems and advise and educate patients to cut down or quit drinking.
Academies and Institutes ; Alcohol Drinking ; Anonyms and Pseudonyms ; Surveys and Questionnaires ; Drinking ; Female ; Humans ; Incheon ; Korea ; Male ; Mass Screening ; Physicians, Primary Care ; Social Problems

Adenomyosis is a common disease of middle-aged women and adenomyoma is a variety of adenomyosis that formed localized tumor. Cystic degeneration of an adenomyoma is a rare clinical manifestation. A 30-year-old parous woman suffered from severe dysmenorrhea and menorrhagia for about 5 months, was operated under the impression of endometriosis of the pelvis. Following the operation, cystic degeneration of an adenomyoma was found incidentally. The authors experienced a case of adenomyosis that formed cystic tumor of uterus and presented with a pertinent literatures.
Adenomyoma ; Adenomyosis* ; Adult ; Dysmenorrhea ; Endometriosis ; Female ; Humans ; Menorrhagia ; Pelvis ; Uterus

Acute fatty liver is rare but life threatening complication and usually manifests late in pregnancy. The mean gestational age onset of symptoms has been reported 35-37 weeks of gestation. Recently, several reports revealed acute fatty liver can develops in the second trimester of pregnancy. Recent reports suggest that early diagnosis and delivery decreased the mortality of fetus and mother. We have experienced a case of the second trimester onset acute fatty liver, in pregnancy so we report the case with brief review.
Early Diagnosis ; Fatty Liver* ; Female ; Fetus ; Gestational Age ; Humans ; Mortality ; Mothers ; Pregnancy ; Pregnancy Trimester, Second*

BACKGROUND: Patients with chest pain are common among outpatients. Several researches shows that chest pain patients can suffer from psychiatric illnesses such as hypochondriasis, depression, anxiety, somatization, panic disorder and so on. This study aims to examine the pschogenic symptoms in patients with noncardiac chest pain METHODS: In this study, the 98 people who have undergone treadmill test for chest pain during the three months from June 1st to September 30 of 1998 were selected, and the 98 patients were asked to respond to the prepared questionnaire and SCL-MPD(symptom check list-minor psychiatric disorders) before they underwent treadmill test. And then, they were classified into two groups. One group consisted of patients with noncardiac chest,pain, and the other group of patients with cardiac chest pain. These two groups were compared in 10 measures, and the compared results were analyzed by t-test. RESULTS: Among the 25 patients with cardiac chest pain, 15 patients were males and 10 patients (38%) were females, and among the 44 patients with noncardiac chest pain, 31 patients (70%) were males, 13 patients (30%) were females. The average age was 47 years old. The average age in patients with noncardiac chest pain was 48, and the 46 for those patients with cardiac chest pain . In the statistical analysis between the patients with cardiac chest pain and those with noncardiac chest pain, significant difference(p<0.005) was shown in the measures such as somatization, depression, phobic anxiety, obsessive-compulsive, neurasthenic, hypochondriacal, anxiety, anger-hostility, interpersonal sensitivity. CONCLUSIONS: As in the analysis the patients with noncardiac chest pain showed significant difference in the symptom check list-minor psychiatric disorder compared to those with cardiac chest pain. We conclude that primary care physician should take more interest in evaluating psychiatric symptoms in patients with noncardiac chest pain.
Anxiety ; Chest Pain* ; Depression ; Exercise Test ; Female ; Humans ; Hypochondriasis ; Male ; Middle Aged ; Outpatients ; Panic Disorder ; Physicians, Primary Care ; Thorax* ; Surveys and Questionnaires

In general, the long head of the biceps brachii originates from the superior glenoid labrum and the supraglenoid tubercle, crosses the rotator cuff interval, and extends into the bicipital groove. However, rare anatomic variations of the origins of the long head have been reported in the past. In this report, we review the clinical history, radiologic findings, and arthroscopic identifications of 3 anatomic variants of the biceps tendon long head. As the detection of long head of biceps tendon pathology during preoperative radiologic assessment can be difficult without prior knowledge, surgeons should be aware of such possible anatomic variations.
Anatomic Variation ; Head* ; Pathology ; Rotator Cuff ; Shoulder ; Tendons

Under the postulation that double Ruiz procedure could increase the effect of radial keratotomy(RK), RK combined with horizontal and vertical Ruiz procedure was performed in three groups of 22 rabbit eyes. In the group A of six eyes, RK with vertical Ruiz procedure was performed, and eight weeks later the horizontal Ruiz procedure was added. In the group B of eight eyes, RK with horizontal Ruiz procedure was performed, and four weeks later the vertical Ruiz procedure was added. In the group C of eight eyes, RK with horizontal and vertical Ruiz procedure were performed simultaneously. As a control, in the group D of eight eyes, RK without Ruiz procedure was performed. Changes in keratometry for four weeks and eight weeks postoperatively were analyzed. The results were as follows: 1. At eight weeks postoperatively, mean changes in keratometry were 6.434D, 3.663D, 4.030D and 1.585D in groups A,B,C and D, respectively. 2. Mean changes in keratometry of groups A,B and C were significantly higher than that of group D. 3. Mean change in keratometry of 6.434D in group A was significantly the highest of the three groups in which the double Ruiz procedure was performed. From the above results, it was concluded that the double Ruiz procedure increased the effect of RK and that the procedure was more effective when secondary Ruiz procedure was added eight weeks later.
Rabbits ; Animals