Despite current advances in multimodality therapies, such as surgery, radiotherapy, and chemotherapy, the outcome for patients with high-grade glioma remains fatal. Understanding how glioma cells resist various therapies may provide opportunities for developing new therapies. Accumulating evidence suggests that the main obstacle for successfully treating high-grade glioma is the existence of brain tumor stem cells (BTSCs), which share a number of cellular properties with adult stem cells, such as self-renewal and multipotent differentiation capabilities. Owing to their resistance to standard therapy coupled with their infiltrative nature, BTSCs are a primary cause of tumor recurrence post-therapy. Therefore, BTSCs are thought to be the main glioma cells representing a novel therapeutic target and should be eliminated to obtain successful treatment outcomes.
Adult Stem Cells ; Brain Neoplasms* ; Brain* ; Drug Therapy ; Glioma ; Humans ; Radiotherapy ; Recurrence ; Stem Cells*

Pseudomyxoma peritonei may result from implantation of benign or malignant tumor in peritoneal cavity and is filled with gelatinous material (termed "Jelly Belly") in abdominal cavity. Its origin is usually an appendiceal or ovarian mucinous adenoma or cystadenocarcinoma, but other primary origin such as uterus, intestine, pancreas and stomach umor have been reported. Generally, pseudomyxoma peritonei is slowly progressive and has low grade malignant potential. This report presents a unusual long term survival after evacuation of 15,000 cc of gelatinous material from abdominal cavity which was the low grade mucinous adenocarcinoma and a review of the current literature, management and new its concept. The origin of pseudomyxoma peritonei of this case was most likely from appendiceal mvcinous adenocarcinoma.
Abdominal Cavity ; Adenocarcinoma ; Adenocarcinoma, Mucinous ; Adenoma ; Cystadenocarcinoma ; Gelatin ; Intestines ; Mucins ; Pancreas ; Peritoneal Cavity ; Pseudomyxoma Peritonei* ; Stomach ; Uterus

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

No abstract available.
Anisakiasis*

OBJECTIVE: Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. METHODS: Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. RESULTS: The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. CONCLUSION: The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications.
Cadaver ; Femoral Artery ; Ligaments ; Obturator Nerve* ; Spine

Ischemia-reperfusion injury is related with oxygen free radicals; a reason which has been suggested for this is the conversion of xanthine dehydrogenase (XDH) into xanthine oxidase (XO). In the present study, metabolic control of the enzymic conversion by modulating the cellular redox potential was attempted. An amino acid, aspartate, was tested as a possible candidate on the assumption that as a participant in the malate/aspartate shuttle, it might modify the cellular NADH/NAD+ balance. Its effect was studied by measuring the level of lipid peroxidation as a thiobarbituric acid-reactive substance (TEARS) and the conversion ratio of XDH to XO in the perfused-rat livers. The experimental animals, male Sprague Dawley rats were divided into three groups: control, ischemia and ischemia/reoxygenation. To each group, aspartate was infused at 2 mM level. ischemia alone did not affect the level of TEARS or the conversion ratio of the enzyme, regardless of aspartate infusion. In contrast, reoxygenation of previously ischemia liver significantly elevated the level of TEARS and decreased the ratio of XDH to XO; both this level and this ratio were ameliorated by aspartate. The protective role of aspartate against oxidative stress induced by ischemia/reoxygenation can be explained by the fact that aspartate may correct the increased NADH/NAD ratio by facilitating NAD regeneration from NADH through the coupled aspartate aminotransferase/malate dehydrogenase reaction and the malate-aspartate shuttle. Aspartate application may thus contribute to the development of a preventive strategy against ischemia/reperfusion-induced oxidative damages.
Animals ; Aspartic Acid* ; Free Radicals ; Humans ; Ischemia ; Lipid Peroxidation ; Liver* ; Male ; NAD ; Oxidation-Reduction ; Oxidative Stress* ; Oxidoreductases ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Reperfusion Injury ; Xanthine Dehydrogenase ; Xanthine Oxidase

No abstract available.
Lung Neoplasms* ; Lung*

The end-stage dilated cardiomyopathy is usually treated with cardiac transplantation although some limited success have also been obtained in selected patients using dynamic cardiomyoplasty or medical assist devices. Recently, a new surgical alternatives, called partial left ventriculectomy (PLV) was introduced by Randas J. V Batista in 1995. A 40-year-old man who had end-stage dilated cardiomyopathy refractory to optimal doses of medicines underwent partial left ventriculectomy (Batista's operation), which reduces ventricular volume to improve left ventricular function. The left ventricular ejection fraction increased from 20 % to 58 % at 4 month after operation.
Adult ; Cardiomyopathy, Dilated* ; Cardiomyoplasty ; Heart Transplantation ; Humans ; Stroke Volume ; Ventricular Function, Left

PURPOSE: The aim of this study is to compare the characteristics of tumor and prognosis, depending on the status of resection margin involvement, on the frozen section diagnosis in gastric cancer. MATERIALS AND METHODS: This study was conducted retrospectively, in 83 margin-positive patients on the frozen section diagnosis, who underwent gastrectomy from July 1995 to September 2006. The control group was selected by matching the age, gender, TNM stage and status of adjuvant chemoradiotherapy, among those who had shown clear resection margins. The characteristics of tumor and patient survival are investigated, and they were analyzed between the two groups. RESULTS: The tumor size was significantly larger in the study group than that of the control group (P=0.037). There was significant difference between the two groups in location of the tumors (P=0.003). Multivariate analysis indicated that only the location and Lauren's classification are independent factors, which affected the resection margin involvement. Median survival was 41.0+/-11.5 months in the study group and 93.0+/-30.3 months in the control group (P=0.049). In the survival analysis, it was investigated that TNM stage and the resection margin involvement of the frozen section diagnosis were the critical variables. CONCLUSIONS: When the tumor is located at the middle or the upper third, or the Lauren's indeterminate type, they are highly likely to show the resection margin involvement on the frozen section diagnosis, and it can, therefore, have negative effects on the prognosis. It is considered as good to perform more extensive resection as possible, during the initial resection.
Chemoradiotherapy, Adjuvant ; Frozen Sections ; Gastrectomy ; Humans ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms

PURPOSE: Fluoropyrimidine-based combination chemotherapy, in combination with either oxaliplatin or irinotecan, has demonstrated efficacy and tolerability in treatment of advanced colorectal cancer (ACC). MATERIALS AND METHODS: Between January 2006 and December 2007, a total of 478 ACC patients were treated with combination chemotherapy in first-line settings. Combination therapies included: 5-fluorouracil, folinic acid plus oxaliplatin (FOLFOX, n=172), 5-fluorouracil, folinic acid plus irinotecan (FOLFIRI, n=95), capecitabine plus oxaliplatin (XELOX, n=155), and capecitabine plus irinotecan (XELIRI, n=56). FOLFOX and FOLFIRI were repeated every 2 weeks, whereas XELOX and XELIRI were repeated every 3 weeks until occurrence of disease progression or unacceptable toxicity, or until a patient chose to discontinue treatment. RESULTS: The median age was 58 years (range, 19 to 84 years) and the median chemotherapy durations for FOLFOX, FOLFIRI, XELOX, and XELIRI were 4.9, 4.5, 5.7, and 5.4 months, respectively. Combination chemotherapy regimens were generally well tolerated. The estimated median progression-free-survival (PFS) for all patients was 6.8 months (95% confidence interval, 6.3 to 7.3 months). No statistically significant difference in PFS was found among regimens used as first-line chemotherapy. Sixty percent (n=290) of patients received second or further lines of therapy after failure. CONCLUSION: Fluoropyrimidine-based combination chemotherapy regimens appear to be equally active and tolerable as first-line therapy for ACC.
Antineoplastic Combined Chemotherapy Protocols ; Camptothecin ; Colonic Neoplasms ; Colorectal Neoplasms ; Deoxycytidine ; Disease Progression ; Drug Therapy, Combination ; Fluorouracil ; Humans ; Leucovorin ; Organoplatinum Compounds ; Retrospective Studies