Continuous arteriovenous hemofiltration(CAVH) is used to treat hemodynamically unstable patients with renal failure, refractory ascites and edema, sepsis, or ARDS patients. Patients received CAVH during a 3-year-period from March 1994 to February 1997. Their clinical findings were analyzed retrospectively, and the results were as follows; They were 6 men and 3 women from 28 to 62 years. 3 patients had ARDS, 2 patients had CHF. The remainder had SLE, liver cirrhosis, septic shock with cholangitis, diabetic ketoacidosis with pulmonary edema. The duration of treatment ranged from 30 to 50 hours, with a mean of 41.6+/-6.9 hours. The total fluid repalcement was 22.4+/-1.7L and the mean fluid loss was 3.9+/-2.6L. Changes in serum BUN, creatinine, sodium, potasium before and after treatment were not significantly diffrent. The complication of CAVH is clotting of hemofilter, hypotension, bleeding, and mild thrombocytopenia. 2 of 3 ARDS patients expired during CAVH, liver cirrhosis patient expired later due to hepatic encephalopathy, and, finally 6 patients discharged with improved conditions. In conclusion, CAVH, a safe and effective therapy in hemodynamically unstable patients with renal failure, refractory ascites and edema, sepsis, or ARDS patients.
Ascites ; Cholangitis ; Creatinine ; Diabetic Ketoacidosis ; Edema ; Female ; Hemofiltration* ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Hypotension ; Liver Cirrhosis ; Male ; Pulmonary Edema ; Renal Insufficiency ; Retrospective Studies ; Sepsis ; Shock, Septic ; Sodium ; Thrombocytopenia

In order to establish the predicted normal values of the systolic time intervals the duration of the systolic time intervals measured from simultaneous recordings of the electrocardiogram, the phonocardiogram and the carotid pulse tracing. The subjects studied were 160 healthy males and 160 females. The mean ages of males and females were 29 and 31 years old, respectively. The transformation period was not closely related to heart rate, and its mean values for males and females were 58 and 56 msec., respectively, and the mean for males and females combined was 57 msec. The remainder of the systolic time intervals, however, showed a significant linear and inverse relation to heart rate. Thus, based upon these data regression equations for the prediction of the normal values of electromechanical systole, left ventricular ejection time, mechinical systole, precjection period andisovolumiccontraction time for males, females, and males and females combined were obtained.
Adult ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Reference Values* ; Systole*

BACKGROUND AND OBJECTIVES: Glottic incompetence from the unilateral vocal cord paralysis can be improved by medialization of the paralyzed vocal cord. There are many medialization techniques. Among them, medialization thyroplasty and injection laryngoplasty are frequently used techniques. We compared the vocal outcomes of fat injection and medialization thyroplasty in unilateral vocal cord paralysis. The aim of this study is to find out which modalities are more preferable as initial treatment of unilateral vocal cord paralysis. MATERIALS AND METHOD: From 2004 January to 2008 September, medialization thyroplasty was performed in 13 patients and fat injection in 14 patients for unilateral vocal cord paralysis. We analyzed the voice quality by several subjective and objective parameters. The parameters are visual analog scale, GRBAS scale, acoustic analysis (fundamental frequency, jitter, shimmer, noise to harmonic ratio), and aerodynamic analysis (maximum phonation time, mean flow rate, subglottic pressure). RESULTS: Visual analog scale, jitter, shimmer and maximum phonation time are improved after both medialization thyroplsty and fat injection. In GRBAS scale, fat injection showed statistically significant improvement compared with medialization thyroplasty. The mean flow rate was also significantly decreased in fat injection. CONCLUSION: Both medialization thyroplasty and fat injection improved voice quality. But injection laryngoplasty with fat may be superior to silastic medialization in short-term voice outcome.
Acoustics ; Dimethylpolysiloxanes ; Humans ; Laryngoplasty ; Noise ; Phonation ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

A 74-year-old woman presented with a month-long nausea and vomiting, then she could not take a meal. She had found an asymptomatic 4th ventricular mass 6 year ago as a preoperative work-up for ovarian cancer. And during the yearly follow-up, the mass had grown continuously over 6 years, and caused symptoms in the seventh year. MRI revealed a large ovoid extra-axial mass in the fourth ventricle compressing adjacent medulla and cerebellum. Surgery achieved near total resection since the tumor tightly adhered to the brain stem of 4th ventricle floor. The histological diagnosis was ependymoma (WHO grade II). She transferred rehabilitation facility for mild gait disturbance, hoarseness and swallowing difficulty. Fourth ventricle ependymoma in the elderly is extremely rare and the growth rate has not been reported. Here, we present a rare care of 4th ventricle ependymoma found asymptomatic at elderly but continuously grow to cause local pressure symptoms.
Aged ; Brain Stem ; Cerebellum ; Deglutition ; Diagnosis ; Ependymoma ; Female ; Follow-Up Studies ; Fourth Ventricle ; Gait ; Hoarseness ; Humans ; Magnetic Resonance Imaging ; Meals ; Nausea ; Ovarian Neoplasms ; Rehabilitation ; Vomiting

Endoscopic polypectomy was firstly introduced by Tsuneoka in 1969, and till now this method has been widely used for the treatment of benign and malignant polyps with the advent of technical improvement. This method is a very important modality as secondary prevention of malignancy because polyps in gastraintestinal tract are now being considered as precancerous lesion. Polypectomy with snare and electrocautery is mainly used for pedunclated polyps (eg. Yamada Class III, IV), but sessile polyps pose technical difficulty and occasionally cause serious gastrointestinal hemorrhage when resection margin adjacent polyp base. We performed polypectomy with "O"-ring used in endocopic variceal ligation (EVL) to make sessile polyp as semipedunclated form, and also to control bleeding, and then successfully remove it with conventional snare polypectomy. We report these 5 cases with the review of the literature.
Electrocoagulation ; Gastrointestinal Hemorrhage ; Hemorrhage ; Ligation* ; Polyps ; Secondary Prevention ; SNARE Proteins

No abstract available.
Humans

BACKGROUND: 15,16-dihydrotanshinone I (DHTS) is a natural abietane diterpenoid that is mainly found in the roots of Salvia miltiorrhiza Bunge (Labiatae). DHTS exhibits a potential anti-proliferative effect in various human cancer cells. However, the mechanisms of action of DHTS as an anti-cancer agent have not been fully elucidated. Therefore, the present study investigated the anti-cancer effect of DHTS in terms of cell cycle regulation and the regulation of the AMP-activated protein kinase (AMPK)/Akt/mTOR signaling pathway in SK-HEP-1 human hepatocellular carcinoma cells. METHODS: The anti-proliferative effects of DHTS were evaluated by the sulforhodamine B assay in SK-HEP-1 cells. Cell cycle distribution was analyzed by flow cytometry. The elucidation of mechanisms of action such as the AMPK/AKT/mTOR and mitogen-activated protein kinase (MAPK) pathway was assessed by Western blot analysis. RESULTS: DHTS showed a significant anti-proliferative activity against SK-HEP-1 cells. DHTS induced cell cycle arrest in the G0/G1 phase, which was mediated by downregulation of cyclin D1, cyclin A, cyclin E, CDK4, CDK2, c-Myc and p-Rb expression and with increased expression of the CDK inhibitor p21. DHTS also activated the AMPK signaling. In addition, DHTS downregulated the Akt/mTOR and MAPK signaling pathways. CONCLUSIONS: Our results suggest that the anti-proliferative activity of DHTS might be associated with the induction of G0/G1 phase cell cycle arrest and regulation of AMPK/Akt/mTOR and MAPK signaling pathways in SK-HEP-1 cells.
AMP-Activated Protein Kinases ; Blotting, Western ; Carcinoma, Hepatocellular ; Cell Cycle Checkpoints ; Cell Cycle ; Cyclin A ; Cyclin D1 ; Cyclin E ; Cyclins ; Down-Regulation ; Flow Cytometry ; Humans ; Protein Kinases ; Salvia miltiorrhiza

BACKGROUND AND OBJECTIVES: The advent of magnetic resonance imaging has enabled surgeons to detect small intracanalicular tumors. Therefore, many patients with acoustic tumors can be candidates for hearing preservation. This study was designed to analyze hearing results following acoustic tumor removal through the extended middle cranial fossa approach (EMCFA) and to determine the prognostic factors associated with successful hearing preservation. MATERIALS & METHODS: We retrospectively reviewed 11 patients whose tumor was removed via EMCFA (10:acoustic tumor, 1:lymphangioma). RESULTS: In 9 patients, the tumors were completely removed with EMCFA and in one patient, the suboccipital approach was combined with EMCFA. However, the approach was transformed to the translabyrinthine approach in one patient, because the tumor adhered to the cochlear nerve. The overall success rate of hearing preservation was 60% (6 of 10). In 20% of patients, the hearing was worse and other 20% of patients lost their hearing. Preoperative hearing level, location of tumor and origin of tumor affect the postoperative hearing. But tumor size did not relate to hearing preservation. CONCLUSION: In most cases, we could preserve the patient's hearing with EMCFA. However, the patients with poor preoperative hearing and tumor originated from the superior vestibular nerve were at risk for hearing loss.
Cochlear Nerve ; Cranial Fossa, Middle* ; Hearing Loss ; Hearing* ; Humans ; Magnetic Resonance Imaging ; Neuroma, Acoustic ; Retrospective Studies ; Vestibular Nerve

Lung cancer is one of the most common causative cancers worldwide. Particularly, non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases. NSCLC is a serious form of lung cancer that requires prompt diagnosis, and the 5-year survival rate for patients with this disease is only 24%. Gibbosic acid H (GaH), a natural lanostanoid obtained from the Ganoderma species (Ganodermataceae), has antiproliferative activities against colon and lung cancer cells. The aim of the present study was to evaluate the antiproliferative activity of GaH in NSCLC cells and to elucidate the underlying molecular mechanisms.GaH was found to induce G0/G1 cell cycle arrest and autophagy by activating adenosine monophosphate-activated protein kinase in A549 and H1299 cells. The induction of this cell cycle arrest was associated with the downregulation of cyclin E1 and CDK2.Additionally, the induction of autophagy by GaH was correlated with the upregulation of LC3B, beclin-1, and p53 expression. GaH also induced apoptosis by upregulating cleaved caspase-3 and Bax in the lung cancer cells. These findings suggest that GaH has a potential in the growth inhibition of human lung cancer cells.

The nephrotic syndrome that occurs in the absence of renal vein thrombosis, amyloidosis, neoplastic infiltration of the kidneys is an unusual but a well recognized paraneoplastic syndrome. The most frequently reported neoplasms associated with nephrotic syndrome are Hodgkin's disease and various carcinomas. The most common renal lesions are membranous glomerulonephritis(MGN) associated with carcinomas and minimal change lesions associated with Hodgkin's disease. Approximately 40% to 45% of patients clinically manifest the MGN symptoms prior to the diagnosis of the tumor, 40% simultaneously with the tumor and the remaining 15% to 20% following the tumor. Therefore, evaluating the underlying malignancy in patients with MGN is important. Here we report a patient with squamous cell lung cancer, which was detected 12 months after a MGN had been diagnosed, with a review of the relevant literature.
Amyloidosis ; Diagnosis ; Glomerulonephritis, Membranous* ; Hodgkin Disease ; Humans ; Kidney ; Lung Neoplasms* ; Lung* ; Nephrotic Syndrome ; Paraneoplastic Syndromes ; Renal Veins ; Thrombosis