The anesthetic properties on blockade of tourniquet pain of hyperbaric tetracaine (T-caine) and bupivacaine (marcaine) with or without epinephrine administered intrathecally were compaired in randomized study involving fourty healthy surgical patients. This investigation employed solutions of the two agents with or without epinephrine that contained equal dose (13 mg), concentration (0.5%), and volume (3ml). No statistically significant difference in height, anesthetic time, tourniquet time, tourniquet pressure, and sensory blockade level were observed between the four groups. Tourniquet pain or inadequate anesthesia did not occur in epinephrine-mix groups, But occurred in 20% of the patients in the tetracaine (t-caine) group & bupivacaine (marcaine) group each other. The results suggest that equal concentrations and dosages of hyperbaric tetracaine (T-caine) and bupivacaine (Marcaine) possessed similar anesthetic qualities on blockade of tourniquet pain following subarachnoid administration.
Anesthesia ; Bupivacaine* ; Epinephrine ; Humans ; Tetracaine* ; Tourniquets*

Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.
Autografts ; Blood Vessels ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Diffusion ; Femur ; Humans ; Knee Joint ; Osteoarthritis ; Platelet-Derived Growth Factor* ; Rabbits* ; Regeneration* ; Transplants*

Inflammatory myofibroblastic tumor (IMT) is a space occupying lesion which is composed of myofibroblasts, plasma cells, and lymphocytes. IMT of the maxillary sinus is rare and its etiology is unknown. We present a case of inflammatory myofibroblastic tumor occurring in the right maxillary sinus of a 57-year-old woman. Radiologically, this tumor was interpreted as malignant neoplasm. On histologic examination, bundles of spindle cells were admixed with inflammatory cells including mature plasma cells and lymphocytes. On the basis of the immunohistochemical findings and ultrastructural features, we recognized that the intervening spindle cells were myofibroblasts. We discussed etiology and prognostic factors of this tumor.
Female ; Humans ; Lymphocytes ; Maxillary Sinus* ; Middle Aged ; Myofibroblasts* ; Plasma Cells

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment.
Angiokeratoma* ; Capillaries ; Dermis ; Epidermis ; Female ; Humans ; Lasers, Dye* ; Middle Aged ; Papilloma ; Parturition ; Skin Diseases

PURPOSE: The objective of this study was to determine the factors affecting the time to recurrence after radical nephrectomy for localized renal cell carcinoma. MATERIALS AND METHODS: We retrospectively evaluated 321 patients who received radical nephrectomies for localized renal cell carcinoma (pT1a-pT2b N0M0). Of 29 patients with disease recurrence, 9 had recurrence more than 5 years after radical nephrectomy. We evaluated the clinicopathological factors, with the use of a retrospective study design. RESULTS: Tumor necrosis was statistically different between the late recurrence group and the recurrence free group (Fisher exact test, p=0.046). Hematuria at diagnosis (chi-square test, p=0.045) was statistically significant in early recurrence. In the univariate logistic regression analysis, tumor necrosis (odds ratio [OR], 4.629; 95% confidence interval [CI], 1.106 to 19.379; p=0.036) and pT stage>1 (OR, 7.232; 95% CI, 1.727 to 30.280; p=0.007) were risk factors of late recurrence. In the multivariable logistic regression analysis, pT stage>1 (OR, 7.143; 5% CI 1.706 to 29.912, p=0.007) was associated with late recurrence. Regarding early recurrence, initial symptoms at diagnosis and pathologic T stage>1 were statistically significant in both univariate and multivariable logistic regression analysis. In terms of recurrence site, patients with late recurrence tended to have unusual metastasis sites other than lung, liver or bone (chi-square test, p=0.012). CONCLUSIONS: These data suggest that tumor necrosis may affect late disease recurrence. Patients with initial symptoms and hematuria at diagnosis are vulnerable to recurrence in a shorter period after nephrectomy. Patients with late recurrence showed a tendency to have unusual metastasis site other than lung, liver or bone.
Carcinoma, Renal Cell* ; Disease-Free Survival ; Hematuria ; Humans ; Liver ; Logistic Models ; Lung ; Necrosis ; Neoplasm Metastasis ; Nephrectomy* ; Recurrence* ; Retrospective Studies ; Risk Factors

OBJECTIVES: This study was designed to investigate the association between 5-HT 2A receptor gene promoter -1438A/G polymorphism and schizophrenia in a Korean population. METHOD: 5-HT 2A receptor gene promoter -1438A/G polymorphism was typed with Polymerase Chain Reaction in 132 patients with schizophrenia and 138 healthy normal controls. RESULT: There was no difference in allelic frequency of -1438A/G polymorphism between patients with schizophrenia and controls(K 2=2.261, df=1, p=0.133). A difference was found in genotype distribution(K 2=6.157, df=2, p=0.046), but this difference was being given by the increased A/A in th controls and A/G in the patients. The genotype frequency, which is the sum of homozygosity and heterozygosity for the -1438 G allele, was significantly higher in the patients(K 2=5.880, df=1, p=0.015). However, there was no difference between the patients with schizophrenia and conrols in the frequency of homozygosity for the -1438 G allele. CONCLULSION: These results suggest that -1438A/G polymorphism of the 5-HT 2A receptor gene promoter is not causally related to the development of schizophrenia in a Korean population.
Alleles ; Genotype ; Humans ; Polymerase Chain Reaction ; Schizophrenia* ; Serotonin*

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of photoselective vaporization of the prostate (PVP) for treatment of benign prostatic hyperplasia (BPH) in men with a prostate volume greater than 60 cc. MATERIALS AND METHODS: The clinical data of 249 men with symptomatic BPH who underwent PVP between January 2006 and June 2008 were retrospectively analyzed. All patients were classified into two groups according to their prostate volume (group A, <60 cc; group B, > or =60 cc). The preoperative evaluation included a digital rectal exam, urinalysis, prostate-specific antigen levels, International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximal flow rate (Qmax), postvoid residual urine volume (PVR), and transrectal ultrasonography. The total operative time, used energy (kJ), urethral Foley catheter indwelling period, and the number of hospital days were recorded afterward. The IPSS, QoL score, Qmax, and PVR were evaluated at 1, 3, 6, and 12 months postoperatively. RESULTS: In both groups, significant improvements in the subjective and objective voiding parameters were achieved and these improvements were sustainable for at least 1 year with minimal complications. During the follow-up period, the PVR in group B significantly increased. Retrograde ejaculation and urethral stricture were the common complications in both groups. There was no significant difference in the incidence rate. CONCLUSIONS: PVP is safe and efficacious, with durable results for men with symptomatic BPH and large prostate volumes.
Catheters ; Ejaculation ; Follow-Up Studies ; Humans ; Incidence ; Laser Therapy ; Male ; Operative Time ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quality of Life ; Retrospective Studies ; Urethral Stricture ; Urinalysis ; Volatilization

A 51-year-old Korean woman presented with a non-tender, well-demarcated, reddish, edematous patch on the right anterior chest where a previous mastectomy and radiation therapy had been performed. She had been diagnosed as having infiltrating ductal carcinoma of the right breast about 1 year ago. Histopathological findings of the skin lesions were consistent with inflammatory metastatic carcinoma of the breast. Inflammatory carcinoma or carcinoma erysipeloides is a well-established entity most frequently associated with carcinoma of the breast. It is characterized by dermal lymphatic invasion by malignancy and clinically should be distinguished from erysipelas or cellulitis. We describe a case of inflammatory metastatic carcinoma derived from an infiltrating ductal carcinoma of the breast which can be clinically confused with radiation dermatitis.
Breast* ; Carcinoma, Ductal ; Cellulitis ; Dermatitis ; Erysipelas ; Erysipeloid ; Female ; Humans ; Mastectomy ; Middle Aged ; Skin ; Thorax

Common radiographic appearances of ossifying fibroma (OF) are well demarcated margin, radiolucent or mixed lesion. Lesions for the radiographic differential diagnosis with OF include fibrous dysplasia, focal cemento-osseous dysplasia. Other confusing lesions might be the mixed lesions such as calcifying odontogenic cyst, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, and benign cementoblastoma. We reported three cases of OF in posterior mandible. These cases showed a little distinguished radiographic features of OF and diagnosed from a combination of clinical, radiographic, and histopathologic information. We need to further refine radiographic and histopathological features of OF and other confusing lesions with literatures review because some cases of these lesions are not easily differentiated radiographically and histopathologically.
Ameloblastoma ; Diagnosis, Differential ; Fibroma, Ossifying ; Mandible ; Odontogenic Cyst, Calcifying ; Odontogenic Tumors ; Skin Neoplasms

Favre-Racouchot syndrome is a disease of senile or actinic processes and another name is nodular elastosis with cysts and comedones. Clinically, facial skin shows, especially lateral to the eyes, multiple open and cystically dilatated comedones and can be defined as cutaneous disturbances characterized by a degenerative process of the dermis associated with cysts and comedones. Sunlight is a strong causative factor and dermal degenerative processes result in this condition. We report the case of a 78-year-old man who showed multiple yellowish papules on both sides of cheeks, the periorbital and, malar areas. He had had this condition for 25-years. His job used to involve physical labor and much exposure to sunlight. An excisional biopsy specimen from the facial malar lesion showed cystically dilated comedones with basophilically degenerated dermal tissue. We performed a therapeutic excision on the two large nodular lesions on both malar areas and applied topical tretinoin. The Patients clinical appearance was much improved 2 months later.
Actins ; Aged ; Basophils ; Biopsy ; Cheek ; Dermis ; Facial Dermatoses* ; Humans ; Skin ; Sunlight ; Tretinoin*