The extent of excision and necessity of hepatectomy in type IVa choledochal cyst has not been clarified. We performed left lobectomy of the liver for complete excision of the cyst in a thirty-year-old male patient with type IVa choledochal cyst. Postoperative recovery was untroubled and outcome was satisfactory. Complete excision of the cyst including hepatectomy is an acceptable operative management for patients with type IVa choledochal cyst. This procedure can eliminate the possibility of subsequent cancer arising from remaining cyst.
Choledochal Cyst* ; Hepatectomy ; Humans ; Liver ; Male

No abstract available.
Lymph Nodes* ; Neoplasm Metastasis* ; Tomography, X-Ray Computed*

No abstract available.
Dizocilpine Maleate* ; Dopamine* ; Methamphetamine*

A case of myxoma of the breast was reported. A 25-year-old woman showed a lump in the left breast which was suddenly enlarged after the delivery of a baby. A tumor measuring 73.53cm was located in the upper outer quadrant of the breast. Fine needle aspiration cytology revealed scattered benign spindle shaped mesenchymal cells with abundant myxoid material. On excision, the tumor was partly solid, partly cystic and multilocular. Each nodule consisted of an abundant mucoid material with a few spindle or stellate mesenchymal cells. Pleomorphism and mitosis were absent. The mesenchymal cells showed immunoreactivities for S-100 protein, smooth muscle actin, and CD34. The myxoid stroma was positively stained with alcian blue and mucicarmine. These findings suggest that constituent cells derive from totipotential primitive mesenchymal cells.
Actins ; Adult ; Alcian Blue ; Biopsy, Fine-Needle ; Breast* ; Female ; Humans ; Mitosis ; Muscle, Smooth ; Myxoma* ; S100 Proteins

No abstract available.
Humans ; Kidney Failure, Chronic*

BACKGROUND: Endobroncheal intubation or extubation may occur accidentally when the patient's neck is flexed or extended even in the appropriate endotracheal intubation. The purpose of this study is to examine the effect of fixation or unfixation of the endotracheal tube at the teeth level on the displacement of its distal end when the patient's neck is extended or flexed. METHODS: This study was conducted in 37 patients who underwent endotracheal general anesthesia. The patients with the evidence of pathology in head, neck and chest were excluded from the study. Individual patient's displacement in endotracheal tube tip compared unfixed cases with fixed cases when the change of neck position. The moved distance was measured by fiberoptic bronchoscope. The data were statistically analyzed by Student's paired t-test. RESULTS: The endotracheal tube moved away from the carina when the patient's neck was extended, while it moved toward the carina when flexed in all cases. When the patient's neck was extended the average distance displaced 1.2 0.7 cm in fixed cases and 1.1 0.9 cm in unfixed cases. when the neck was flexed, they were 1.2 0.5 cm and 1.0 0.8 cm respectively. There were not statistically significant between the fixed and the unfixed cases. CONCLUSIONS: It is concluded that the displacement of the endotracheal tube is not related to its fixation or unfixation at the teeth level and therefore, unfixation does not provide any benefits in terms of the displacement of the distal end of the tube in adult trachea.
Adult ; Anesthesia, General ; Bronchoscopes ; Head ; Humans ; Intubation ; Intubation, Intratracheal ; Neck* ; Pathology ; Thorax ; Tooth ; Trachea

Subcutaneous emphysema is a complication of the pneumoperitoneum necessary to perform laparoscopy and will be seen more often as laparoscopic techniques are applied to a growing number of intraabdominal procedures. We report a case of subcutaneous emphysema and hypercarbia without pneumothorax or pneumomediastinum during laparoscopic cholecystectomy, which was treated by multiple puncture with 18G needle on emphysematous site. The suspected cause is inadvertent subcutaneous insufflation of carbon dioxide through the trocar sites by increased intra-abdominal pressure for the establishment of pneumoperitoneum. Immediate recognition, evaluation, and treatment of subcutaneous emphysema is necessary since this can be life-threatening complication.
Carbon Dioxide ; Cholecystectomy, Laparoscopic* ; Insufflation ; Laparoscopy ; Mediastinal Emphysema ; Needles ; Pneumoperitoneum ; Pneumothorax ; Punctures ; Subcutaneous Emphysema* ; Surgical Instruments

No abstract available.
Liver*

The present study was undertaken to measure the effects of thiopental and thiamylal on isolated thoracic aortic hlical strips in normotensive Wistar rats(NWR) and spontaneously hypertensive rats(SHR). Phenylphrine(10(-9) ~ 10(-5) M) caused a dose-dependant contraction in thoracic aortic strips contracted with 30mM KCI in NWR and SHR. The contraction induced by 30mM KCI was taken as 100% and the mean absolute values of NWR and SHR were 463+/-30 and 457+/-38mg, respectively. The ED50 of phenylphrine in thoracic aortic strips contracted with 30mM KCI in NWR and SHR was (2.3+/-1.2) X 10(-8) M and (2.1+/-1.1) X 10(-9) M, respectively. There were no significant differences in the contractile response of thoracic aorta from NWR and SHR to 30mM KCI. In helically cut strips of thoracic aorts contracted with 30mM KCI, the cumulative administration of thiopental (10(-5) ~ 10(-3) M) caused a dose related contraction in NWR and SHR. The contraction induced by 30mM KCI was taken as 100% and the mean absolute values of NWR and SHR were 496+/-31 and 541+/-69mg, respectively. There were significant differences (p<0.05 and p<0.01) in the contractile responses of thoracic aorta from NWR and SHR to thiamylal(3X10(-4) and 10(-3) M). The dose-related contraction to thiamylal was greater than that to thiopental in NWR and SHR.
Aorta, Thoracic* ; Rats, Inbred SHR* ; Thiamylal* ; Thiopental*

No abstract available.
DNA* ; Ploidies*