No abstract available.
Prostate* ; Testis*

PURPOSE: Many diagnostic modalities have been used for diagnosis of gastroesophageal reflux disease (GERD). Feeding materials during esophageal pH monitoring may interfere the result of examination and esophageal pH monitoring can not diagnose GER in case of alkaline reflux. The purpose of our study is to evaluate whether scintigraphy can substitiute 24 hr pH monitoring in children with GERD. METHODS: From March 2002 to June 2003, 23 patients (12 boys and 11 girls, mean age 27 months) who have been admitted to Hanyang University Hospital presented with GER symptoms (recurrent vomiting, cough, chest pain, irritability) were included in the study. Scintigraphy and 24 hr pH monitoring were performed in all patients. RESULTS: Six out of the 23 patients (26.1%) had evidence of GER on 24 hr pH monitoring, whereas nine of 23 patients (39.2%) exhibited GER by scintigraphy. Two out of the 23 patients could not be tested because of irritability. Three (14.3%) patients had evidence of GER on both 24 hr pH monitoring and scintigraphy, three (14.3%) patients on only 24 hr pH monitoring, six (28.6%) patients on only scintigraphy, and nine (42.9%) patients had no evidence of GER on both methods. No correlation was observed between 24 hr pH monitoring and scintigraphic results by Fisher's exact test (p=0.523) or Kendal's tau (t=0.678). CONCLUSION: The results of this study demonstrated that there was no correlation between 24 hr pH monitoring and scintigraphy. Therefore these modalities could be used as complementary tests to diagnose GERD.
Chest Pain ; Child* ; Cough ; Diagnosis ; Esophageal pH Monitoring ; Female ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration* ; Radionuclide Imaging ; Vomiting

A ‘collision’ tumor refers to the existence of two different neoplasms within the same tumor. Sometimes, the term ‘biphasic tumor’ is also used. However, a ‘collision’ tumor is defined as the occurrence of two neoplasms within proximity of each other yet maintaining distinctly defined, separate boundaries. In contrast, a ‘biphasic’ tumor demonstrates two or more phenotypically distinct neoplastic cell populations merging within the same space. Here, we report a case of collision tumor associated with sarcomatoid eccrine porocarcinoma and basal cell carcinoma arising in a 57-year-old male patient.
Carcinoma, Basal Cell* ; Eccrine Porocarcinoma* ; Humans ; Male ; Middle Aged

PURPOSE: Human acellular dermal matrix(ADM) is widely used in the treatment of congenital anomalies and soft tissue deficiencies. But it is rapidly degraded in the body and does not provide satisfactory results. There is a need to improve collagen fiber stability through various methods and ultimately regulate the speed of degradation. METHODS: The ADMs were added with various cross- linking agents called glutaraldehyde, dimethyl 3,3'-dithiobispropionimidate to produce cross-linked acellular dermal matrices. 1,4-butanediol diglycidyl ether solution was applied with a pH of 4.5 and 9.0, respectively. The stability of cross-linked dermal matrix was observed by measuring the shrinkage temperature and the degradation rates. The cross- and non-cross linked dermis were placed in the rat abdomen and obtained after 8, 12 and 16 weeks. RESULTS: The shrinkage temperature significantly increased and the degradation rate significantly decreased, compared to the control(p<0.05). All of cross- linked dermises were observed grossly in 16 weeks, but most of non-cross linked dermis were absorbed in 8 weeks. Histologically, the control group ADM was found to have been infiltrated with fibroblasts and most of dermal stroma were transformed into the host collagen fibers. However, infiltration of fibroblasts in the experiment was insignificant and the original collagen structure was intact. CONCLUSION: Collagen cross-linking increases the structural stability and decreases degradation of acellular dermis. Therefore, decrease in body absorption and increase in duration can be expected.
Abdomen ; Absorption ; Acellular Dermis ; Animals ; Butylene Glycols ; Collagen ; Dermis ; Ether, Ethyl ; Fibroblasts ; Glutaral ; Humans ; Hydrogen-Ion Concentration ; Imidoesters ; Rats

PURPOSE: It has been suggested that the pineal hormone melatonin(MEL) protects neurons in vitro from excitotoxicity mediated by kainate-sensitive glutamate receptors and from oxidative stress-induced DNA damage and apoptosis. The present study evaluated the antioxidatives and anti-inflammatory effect of melatonin on kainic acid(KA)-induced neuronal injury in the hippocampus in vivo. METHODS: 30 adult male Sprague-Dawley rats were divided into two equal groups. Control group was treated with KA only and test group was treated with KA and MEL. We injected 10 mg/kg KA intraperitoneal into rats. This results in selective neuronal injury accompanied by intense microglial activation and triggers DNA damage in the hippocampus. We tested the in vivo efficacy of MEL in preventing KA-induced neuronal injury and neuroinflammation in the hippocampus. MEL(2.5 mg/kg) was injected i.p. four times : 20 min before KA, immidiately after, and 1 and 2 h after the KA. Rats were sacrificed 72 h later and their hippocampi were examined for evidence of DNA damage (in situ dUTP-end-labeling, i.e. TUNEL staining), cell viability(H&E staining), microglial (isolectin-B4 histochemistry), astroglial responses(glial fibrillary acidic protein, GFAP immunohistochemistry), and lipid peroxidation(4-hydroxynonenal immunohistochemistry). RESULTS: The cumulative dose of 10 mg/kg MEL attenuates KA-induced neuronal death as well as microglial activation and lessens DNA breaks. CONCLUSION: A possible mechanism of MEL-provided neuroprotection lies in its antioxidant and anti-inflammatory action. Present data suggest that MEL holds potential for the treatment of acute brain pathologies such as epilepsy-associated brain damage, stroke, and brain trauma.
Adult ; Animals ; Apoptosis ; Brain ; Brain Injuries ; DNA Breaks ; DNA Damage ; Epilepsy ; Hippocampus ; Humans ; In Situ Nick-End Labeling ; Kainic Acid ; Male ; Melatonin* ; Neurons* ; Pathology ; Rats ; Rats, Sprague-Dawley ; Receptors, Glutamate ; Stroke

PURPOSE: CTAP(CT during arterial portography) has been shown to be the most sensitive technique available for the detection of hepatic mass. But because of many false positive lesions, it is important to interpretate the findings correctly. So we tried to analyse the false positive findings in CTAP. MATERIALS AND METHODS: Materials were 47 patients that had (;TAP for the detection of hepatic lesions. After performing superior roesenteric artery (SMA) arterial portography for the detection of vascular variation, CT^P was done. 100 to 150 cc of 50% diluted nonionic contrast media was injected at 2--3ml/sec rate. Spiral CT was used with 8mm slice thickness and 8mm/sec table speed. We compared the findings of CTAP with CTHA(CT during hepatic arteriography), enhanced (;T, anglogram, US, Lipiodol CT and biopsy. RESULTS: Twenty nine false positive lesions were found. There were 11 peritumoral defects, 7 straight line signs, 5 perihilar defects, 2 periligamentous defects, 3 subcapsular defects and 1 defect by cirrhosis. CONCLUSION: When CTAP is used for the evaluation of hepatic lesion(esp, preoperative evaluation), understanding of the false positive findings and the characterization of the lesion through multi-modality approaches are needed for the correct diagnosis and the proper treatment.
Arteries ; Biopsy ; Contrast Media ; Diagnosis ; Ethiodized Oil ; Fibrosis ; Humans ; Portography ; Tomography, Spiral Computed*

Liposarcoma in esophagus is rare, moreover the pedunculated form is very rare. We experienced a case of liposarcoma in a 36-year-old man who had intermittent swallowing difficulty for 7 months. Endoscopy and esophagography revealed that a smooth longitudinal tumor mass occupied the esophageal lumen. Esophagotomy and surgical excision was done. The tumor was 4 cm in length and 3 cm in average diameter with an obvious stalk measuring 3.5 cm in length and 1.5 cm in diameter. Microscopic examination disclosed a lipoma with focal ulceration and liposarcomatous change infiltrating into interstitial fibrous tissue at its distal end.
Adult ; Deglutition ; Endoscopy ; Esophagus* ; Humans ; Intestines* ; Lipoma ; Liposarcoma* ; Stomach* ; Ulcer

The incidence of multiple primary cancers is low than that of single primary cancer. In gastric cancer, incidence of occurrence of multiple primary cancer is 3 to 11.3%. Because stomach and lung are unrelated organs, the combination of gastric cancer and lung cancer is rare. Its estimated incidence is about 10% of all multiple primary cancers. The histologic types of secondary lung cancer in one series, squamous cell carcinomas were 49%; adenocarcinomas were 28%; large cell carcinomas were 14%; small cell carcinomas were 9%; others were 6%. This patient had been diagnosed as early gastric cancer 3 years ago, but he refused operation for cancer and wasnt followed up. After 3 years, he revisited us for dry coughing and diagnosed as small cell lung cancer. At this time, previous gastric cancer was remained as well differentiated, early gastric adenocarcinoma. For its rarity, we report this case with review of literatures.
Adenocarcinoma ; Carcinoma, Large Cell ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Cough ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Small Cell Lung Carcinoma* ; Stomach ; Stomach Neoplasms*

BACKGROUND: Propofol can produce a dose-dependent reduction in blood pressure by providing titratable sedation and rapid recovery. It has been reported that a combination of midazolam and propofol resulted in the significant reduction in the total dose of propofol needed. It was hypothesized that the addition of low-dose midazolam to propofol may provide sufficient sedation without compromising the hemodynamic stability. METHODS: A total of 40 consecutive patients were randomly assigned to one of two groups (n = 20 each). Group M-P received a bolus of 0.02 mg/kg of midazolam, followed by a propofol infusion with a fixed target concentration of 1.0microgram/ml. Group P received only a propofol infusion with an initial target plasma concentration of 2.5microgram/ml. Subsequent titration of the infusion rates in Group P or the additional midazolam boluses in Group M-P were made in order to maintain a predetermined sedation level. RESULTS: In Group P, a mean dose of 5.4 +/- 0.7 mg/kg/h propofol was used compared with 2.7 +/- 0.5 mg/kg/h in Group M-P (P<0.0001, plus additional 2.96 +/- 1.8 mg of midazolam). Ephedrine was administered to 15 patients in Group M-P and 17 patients in Group P. Recovery was significantly fast (Group P, 6.8 +/- 2.9 min vs. Group M-P, 9.8 +/- 4.4 min, P<0.05). CONCLUSIONS: Sedation with propofol plus midazolam requires a lower total dose of propofol compared with propofol alone but has no superior hemodynamic stability. A further study using younger patients and combinations of different doses of each drug will be needed.
Anesthesia, Spinal* ; Blood Pressure ; Ephedrine ; Hemodynamics ; Humans ; Hypotension ; Midazolam ; Plasma ; Propofol* ; Prospective Studies*

Visual disturbances are common among women with pre-eclampsia. The obstetricians should have an understanding of the various conditions associated with visual impairments. We report a case of Purtscher-like retinopathy developed after pre-eclampsia combined with acute pancreatitis. A 33-year-old primigravida with twin pregnancy was admitted to the department of obstetrics and gynecology for preterm labor and pre-eclampsia at 36+4 weeks gestation. After a cesarean section, she complained of abdominal pain and visual acuity loss. She was diagnosed with Purtscher-like retinopathy combined with acute pancreatitis after ophthalmologic examination and an abdominal computed tomography scan. Purtscher-like retinopathy, most often observed after trauma, is very rare in pre-eclampsia. In addition, while visual disturbances from other conditions are transient, it can result in persistent visual impairments. Thus, when a patient with pre-eclampsia complains of visual problems for a long period of time, obstetricians should consider an ophthalmologic evaluation and treatments during the earliest stage of the disease.
Abdominal Pain ; Cesarean Section ; Female ; Gynecology ; Humans ; Obstetric Labor, Premature ; Obstetrics ; Pancreatitis ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Twin ; Retinal Diseases ; Vision Disorders ; Visual Acuity