No abstract available.
Antioxidants* ; Glutathione* ; Humans

PURPOSE: We evaluated the correlation between the carcinogenesis of gallbladder and the expression of lysozyme, p53, c-erbB2 and CEA in gallbladder lesions. MATERIALS AND METHODS: Thirty cases of gallbladder lesions (containing 17 cases of GB carcinoma) were examined. We analyzed the clinicopathologic findings of the early (stage I & II) and advanced carcinoma (stage III, IV & V) and those of carcinoma with or without metaplasia in the tumor. We performed p53, c-erbB2 and CEA immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. We also performed lysozyme immunohistochemical staining and compared its finding with metaplastic and non-metaplastic lesions. RESULTS: There are two distinct genetic pathways in gallbladder cacinogenesis and metaplastic carcinoma was more frequent than non-metaplastic carcinoma. Metaplasia of gallbladder did not reveal any difference of the clinicopathologic findings and depth of invasion (Nevin stage). Lysozyme expression was found in all metaplastic lesions but non-expression did not indicate non-metaplastic lesions. p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively. The correlation of p53 and c-erbB2 expressions was found but which did not indicate that the co-expression was needed in the carcinogenesis. CEA immunohistochemical staining may be helpful in the differential diagnosis of benign lesions and precancerous and cancerous lesions of the gallbladder. CONCLUSION: These results suggest that p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively.
Carcinogenesis ; Diagnosis, Differential ; Gallbladder* ; Metaplasia* ; Mucous Membrane ; Muramidase

Congenital absence of nails usually occur as a rare isolated anomaly or combined with other ectodermal defects. This anomaly is regarded as an inherited disorder either dominantly or recessively but quite a few cases were reported as sporadically developed. The patient was a 2-month-old girl who had no nails on both her 2nd, 3rd toes but had rudimentary nails on her left big toe and both 4th toes at birth. We could not find any other congenital deformity, any family history of inherited diseases related to anonychia. Radiological findings revealed no visualization of both 4th distal phalanges, only. We report this case as congenital anonychia of a sporadic type which may have developed independently from an underlying bone abnormality. We also review other reported cases in the literature.
Congenital Abnormalities ; Ectoderm ; Female ; Hallux ; Humans ; Infant ; Parturition ; Toes*

The plica is remaining synovial septa in adult life which developed in early fetal life. The suprapatellar plica separates the suprapatellar pouch from the knee joint which sometimes has chnical significance according to its shape, but it has been occasionally overlooked and also pathophysiology of symptomatic plicae may be hard to explain. The authors experienced 7 cases of suprapatellar plica syndrome which mimic soft tissue tumor in 7 patients who had complained of vague pain and ill defined mass around the knee and by arthroscopy found the imperforated suprapatellar plica in which increased hydraulic pressure cavity evokes the clinical symptoms and signs exarnination from 1992 to 1997. We suggest that the suprapatellar plica with complete septum might be clinically significant in patients who are in active life.
Adult ; Arthroscopy ; Humans ; Knee ; Knee Joint

To maintain an adequate airway in a patient with tracheobronchial narrowing coming from various causes, prosthetic tracheobronchial stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. After insertion, precious reported complications were granuloma formation, dysphagia, suction catheter entrapment and fatal massive hemoptysis. We report a case of complication associated with expandible metallic scent with endobronchial stenosis due to tuberculosis.
Catheters ; Constriction, Pathologic* ; Deglutition Disorders ; Granuloma ; Hemoptysis ; Humans ; Palliative Care ; Stents* ; Suction ; Tuberculosis

No abstract available.
Cesarean Section* ; Female ; Pregnancy

No abstract available.
Cesarean Section* ; Female ; Pregnancy

BACKGROUND: The optimal depth of subclavian catheterization is not clearly and simply defined in the pediatric population. The aim of this study is to examine the relationship between the depth of the subclavian catheter and easily measured body-size variables, such as weight and height, and then to formulate a guide for the optimal depth of subclavian catheterization in the pediatric population. METHODS: We cannulated eighty-five pediatric cardiac patients via the left or right subclavian approach. The position of the catheter tip was determined by postoperative AP chest x-ray, and the length from the skin to the point of the border of superior vena cava and the right atrium (SK-SVCRA) was measured. RESULTS: Significant correlations with SK-SVCRA were found for weight and height. For the right approach, SK-SVCRA is calculated as 0.28xweight (kg) + 4.86 or 0.07 x height (cm)+1.70. For the left approach, SK-SVCRA is calculated as 0.22xweight (kg)+6.51 or 0.06xheight (cm)+3.94. CONCLUSIONS: Simple equations for the placement of the catheter tip at the border of the superior vena cava and right atrium as a function of patients' weight and height were formulated. These data may provide a useful guide to determine how deeply the subclavian catheter should be located.
Catheterization* ; Catheters* ; Heart Atria ; Humans ; Skin ; Thorax ; Vena Cava, Superior

BACKGROUND: Most surgical patients experience preoperative anxiety. This anxiety can effect the amount of preanesthetic medication and anesthetic agents needed, and contribute to postoperative pain. Music has been recognized as a way to reduce anxiety and fear. The effect of hymn and sutra-chanting on the preanesthetic patient's anxiety in the operating room were studied. METHODS: 98 patients were divided into two groups according to the religionist or atheism. Group I(n=50, religionist) and Group II(n=48, atheism) listened to hymn or sutra-chanting according to the patient's religion and choice. At ward, hemodynamic variables including systolic and diastolic blood pressure and pulse rate were measured as control values. Hemodynamic variables and measurements of anxiety score with Hamilton anxiety rating scale were made at pre-music and post-music in the operating room. Also, patient's response to the music was measured on the postoperative 5-6th day. RESULTS: There were no difference between ward, pre-music, and post-music in terms of systolic pressure, diastolic pressure and pulse rate except the systolic pressure at pre-music that is grater than that of controls in both groups. Both group, anxiety score at post-music was significantly lower than that of pre-music (10.2+/-3.4 vs 4.4+/-2.9, 11.0+/-3.2 vs 5.7+/-3.1). At post-music, anxiety score in Group I showed significant reduced compaired with Group II (p<0.05). Patients showed relatively good satisfaction with music in both groups. CONCLUSION: The results suggest that music with hymn and Sutra-chanting were effective to reduce preanesthetic anxiety in both religionist group and atheism group.
Anesthesia ; Anesthetics ; Anxiety* ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Music ; Operating Rooms* ; Pain, Postoperative ; Preanesthetic Medication ; Premedication

PURPOSE: To evaluate the therapeutic effect of the combined treatment of excision of the papillae and a supratarsal injection of triamcinolone on refractory vernal keratoconjunctivitis (VKC). METHODS: Twenty-three eyes of 14 patients with refractory vernal keratoconjunctivitis were included. Patients were treated with the combined excision of papillae and supratarsal injection of triamcinolone. Best corrected visual acuity (BCVA), intraocular pressure, symptoms of itching, tearing, discomfort, secretion and epiphora, and signs including limbal hypertrophy, hyperemia, papilla size, keratitis, corneal neovascularization and blepharitis were evaluated before and two weeks, four weeks, and eight weeks after treatment. The CCL11 level in the tears of each eye were analyzed before and two weeks after treatment. RESULTS: The mean scores of subjective symptoms and objective signs as well as BCVA were significantly improved two weeks after treatment. CCL11 levels in the tears were 389.5+/-474.9 pg/ml before treatment and were undetectable two weeks after treatment. Improvement of symptom and sign parameters was maintained up to eight weeks after treatment. However, seven eyes (30.4%) recurred within two weeks after treatment. CONCLUSIONS: Combined excision of the papillae and a supratarsal injection of triamcinolone may be effective in the treatment of refractory VKC.
Blepharitis ; Conjunctivitis, Allergic ; Corneal Neovascularization ; Eye ; Humans ; Hyperemia ; Hypertrophy ; Intraocular Pressure ; Keratitis ; Lacrimal Apparatus Diseases ; Pruritus ; Tears ; Triamcinolone ; Visual Acuity