OBJECTIVE: To report our experience with laparoscopically assisted vaginal hysterectomy (LAVH) and evaluate the advantages of LAVH. This is a retrospective study. METHODS: From Jan. 2001 to Aug. 2002, 204 LAVHs were performed at the Department of Obstetrics and Gynecology, Our Lady of Mercy Hospital, The Catholic University of Korea. We studied the results with regard to the age, parity, previous abdominal surgery, surgical indications, operation time, weight of uterus, change of hemoglobin, hospital stay, concomitant procedures, and complications. RESULTS: The mean age was 43.9+/-6.4 years. The mean parity was 2.1+/-1.3. Tubal ligation was most common previous abdominal surgery. As a surgical indication, leiomyoma (52.9%) and adenomyosis (33.3%) were more common indications than any other gynecological problem. The mean operation time was 85.7+/-22.4 minutes. The mean uterine weight was 206.2+/-103.7 g. The mean hemoglobin change was 1.2+/-0.7 g/dl. The mean hospital stay was 3.3+/-0.8 days. Unilateral salpingoophorectomy was most common operation as concomitant procedure. Surgical complication rate was 3.4%. CONCLUSION: LAVH is a safe and effective alternative to abdominal hysterectomy with advanced technologic development in laparoscopic instruments and skills.
Adenomyosis ; Female ; Gynecology ; Hysterectomy ; Hysterectomy, Vaginal* ; Korea ; Leiomyoma ; Length of Stay ; Obstetrics ; Parity ; Retrospective Studies ; Sterilization, Tubal ; Uterus

OBJECTIVE: The purpose of this study was to evaluate value of methotretrexate (MTX) in the treatment of tubal pregnancy. METHODS: 28 patients with unruptured tubal pregnancy were treated alternately with four doses of intramuscular MTX (1.0 mg/kg) and four doses of intramuscular citrovorum factor (0.1 mg/kg). Patients considered eligible for MTX treatment of tubal pregnancy were those with unruptured tubal pregnancy Alopecia ; Bone Marrow ; Chorionic Gonadotropin ; Dermatitis ; Diagnosis ; Diarrhea ; Female ; Fetal Heart ; Gestational Age ; Gestational Sac ; Gingivitis, Necrotizing Ulcerative ; Humans ; Leucovorin ; Methotrexate* ; Pneumonia ; Pregnancy ; Pregnancy, Tubal* ; Salpingectomy ; Ultrasonography ; Vomiting

The author measured the severity of brain damage of 36 rabbits irradiated 2.45 GHz microwave for 10 minutes, 20 minutes and 30 minutes, respectively. Electromicroscopic and light microscopic findings of just after, 1 weeks, 2 weeks and 4 weeks after irradiated brain were compared in each time. Swelling and vacualization of nerve cell and mitochondria were noted. Also these changes tend to increased severity along amount of radiation, but revealed reversible changes with time. Myelinated and unmyelinated nerve fibers were examined as same manner. These nerve fibers also revealed swelling and vascuolization, these findings also tend to increase severity with irradiation power and more prominent at unmyelinated nerve fibers. Reversability of these findings after each time period were more prominent in myelinated nerve fibers than unmyelinated nerve fibers.
Brain ; Cerebrum* ; Microwaves* ; Mitochondria ; Myelin Sheath ; Nerve Fibers ; Nerve Fibers, Myelinated ; Nerve Fibers, Unmyelinated ; Neurons ; Rabbits*

The mu opioid receptor (MOR) has been regarded as the main site of interaction with analgesics in major clinical use, particularly morphine. The repressor element-1 silencing transcription factor (REST) functions as a transcriptional repressor of neuronal genes in non-neuronal cells. However, it is expressed in certain mature neurons, suggesting that it may have complex and novel roles. In addition, the interactions between MOR and REST and their functions remain unclear. In this study, we examined the effects of morphine on the expression of REST mRNA and protein in human neuroblastoma NMB cells to investigate the roles of REST induced by MOR activation in neuronal cells. To determine the effects of morphine on REST expression, we performed RT-PCR, real-time quantitative RT-PCR, western blot analysis and radioligand binding assays in NMB cells. By RT-PCR and real-time quantitative RT-PCR, the expression of REST was found to be unchanged by either the MOR agonist morphine or the MOR specific antagonist CTOP. By western blot, morphine was shown to significantly inhibit the expression of REST, but this suppression was completely blocked by treatment with CTOP. In the radioligand binding assay, the overexpression of REST led to an increased opioid ligand binding activity of endogenous MOR in the NMB cells. These results together suggest that morphine inhibits the expression of REST in human neuroblastoma cells through a post-transcriptional regulatory mechanism mediated through MOR.
Analgesics ; Blotting, Western ; Humans ; Morphine ; Neuroblastoma ; Neurons ; Receptors, Opioid, mu ; RNA, Messenger ; Somatostatin ; Transcription Factors

Purpose: The clinical implications of tumor-infiltrating T cell subsets and their spatial distribution in biliary tract cancer (BTC) patients treated with gemcitabine plus cisplatin were investigated. Materials and Methods: A total of 52 BTC patients treated with palliative gemcitabine plus cisplatin were included. Multiplexed immunohistochemistry was performed on tumor tissues, and immune infiltrates were separately analyzed for the stroma, tumor margin, and tumor core. Results: The density of CD8+ T cells, FoxP3- CD4+ helper T cells, and FoxP3+ CD4+ regulatory T cells was significantly higher in the tumor margin than in the stroma and tumor core. The density of LAG3- or TIM3-expressing CD8+ T cell and FoxP3- CD4+ helper T cell infiltrates was also higher in the tumor margin. In extrahepatic cholangiocarcinoma, there was a higher density of T cell subsets in the tumor core and regulatory T cells in all regions. A high density of FoxP3- CD4+ helper T cells in the tumor margin showed a trend toward better progression-free survival (PFS) (p=0.092) and significantly better overall survival (OS) (p=0.012). In multivariate analyses, a high density of FoxP3- CD4+ helper T cells in the tumor margin was independently associated with favorable PFS and OS. Conclusion The tumor margin is the major site for the active infiltration of T cell subsets with higher levels of LAG3 and TIM3 expression in BTC. The density of tumor margin-infiltrating FoxP3- CD4+ helper T cells may be associated with clinical outcomes in BTC patients treated with gemcitabine plus cisplatin.

The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.