No abstract available.

A 6-year old female, who was operated on for tracheoesophageal fistula at the time of birth, was diagnosed with recurrent TEF, and it was decided to undergo endoscopic management, using cyanoacrylate under general anesthesia. After cuffing, the endotracheal tube was located at the level of the fistula, and endoscopic management was undertaken through the esophagus, using cyanoacrylate. The peak inspiratory pressure was shown to have increased from 18 to 28 cmH2O. We observed partial obstruction of the endotracheal tube end, and partial attachment of the cyanoacrylate to the tracheal wall. The patient's symptoms gradually improved, and no other particular finding was observed during the following two months. We suppose that the cyanoacrylate has been ventilated, and gradually excreted. In manipulation that may cause changes in the tube position, it is recommended to check ventilation via the fistula, and to recheck the tube position.
Anesthesia, General ; Cyanoacrylates ; Esophagus ; Female ; Fistula ; Humans ; Parturition ; Tracheoesophageal Fistula ; Ventilation

Hajdu-Cheney syndrome (HCS) is a rare skeletal dysplasia that is characterized by acroosteolysis of the distal phalanges, distinctive craniofacial and skull changes, dental abnormalities and generalized osteoporosis. The clinical and radiologic characteristics are variable and these characteristics progress with age. This syndrome shows autosomal dominant inheritance with sporadic cases. The genetic defects or molecular pathogenesis of HCS are still unknown. We experienced a case of Hajdu-Cheney syndrome in a 20-year-old man who had generalized osteoporosis with multiple non-traumatic spine compression fractures. He had acroosteolysis of the hands and feet, wormian bones in the skull, facial dysmorphism (mid-facial flattening, micrognathia and bushy eyebrows), a high arched palate, malocclusion and short dental alveolar processes. HCS was diagnosed based on the clinical and radiologic evidence. For the differential diagnosis, we excluded the other possible causes of the acroosteolysis and wormian bones, including hyperparathyroidism, osteogenesis imperfecta, hypophosphatemia and mandibuloacral dysplasia. The specific treatment of HCS is unknown, but case reports with bisphosphonate treatment have been reported.
Acro-Osteolysis ; Alveolar Process ; Diagnosis, Differential ; Foot ; Fractures, Compression ; Hajdu-Cheney Syndrome ; Hand ; Humans ; Hyperparathyroidism ; Hypophosphatemia ; Malocclusion ; Osteogenesis Imperfecta ; Osteoporosis ; Palate ; Skull ; Spine ; Wills ; Young Adult

BACKGROUND: Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stage III non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it huts at most only a modest effect on survival. Recently, cisplatin(cia-diamminedichloroplatinum ) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and METHOD: Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given 10 times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 timed in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. RESULTS: There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p<0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p<0.05). In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. CONCLUSION: There was. no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cause of Death ; Chemoradiotherapy* ; Cisplatin ; Combined Modality Therapy ; Compliance ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Radiation Pneumonitis ; Radiotherapy*

Eucommiae Cortex (EC), bark of Eucommia ulmoides, has been known as a traditional medicine to regulate hypertension and immune system. Because silk of gum in the EC blocks the release of active ingredients, EC generally has been utilized after processing with carbonization or salt-water to breakdown it. This study aimed to investigate the differences of non-processed EC and processed EC on antioxidant and anticancer properties. Antioxidant capacity was assessed by measuring the content of total polyphenols, reducing power, and ABTS radical scavenging effect. And anticancer effects were examined by evaluating the viability of pancreatic cancer cells and wound healing ability. The results demonstrated that processed EC contained more content of polyphenols and exhibited more potent reducing power and radical scavenging effect than non-processed EC. In addition, processed EC more efficiently inhibited proliferation and migration of pancreatic cancer cells. These results suggest that processing of medicinal plants can improve the biological properties such as antioxidant or anticancer activity, which may lead to the development of herbal medicine treatment technology.
Carbon ; Cell Proliferation ; Eucommiaceae ; Gingiva ; Herbal Medicine ; Hypertension ; Immune System ; Medicine, Traditional ; Pancreatic Neoplasms ; Plants, Medicinal ; Polyphenols ; Silk ; Wound Healing

Objective: To determine the association of macrocalcification and rim calcification with malignancy and to stratify the malignancy risk of thyroid nodules with macrocalcification and rim calcification based on ultrasound (US) patterns. Materials and Methods: The study included a total of 3603 consecutive nodules (≥ 1 cm) with final diagnoses. The associations of macrocalcification and rim calcification with malignancy and malignancy risk of the nodules were assessed overall and in subgroups based on the US patterns of the nodules. The malignancy risk of the thyroid nodules was categorized as high (> 50%), intermediate (upper-intermediate: > 30%, ≤ 50%; lower-intermediate: > 10%, ≤ 30%), and low (≤ 10%). Results: Macrocalcification was independently associated with malignancy in all nodules and solid hypoechoic (SH) nodules (p < 0.001). Rim calcification was not associated with malignancy in all nodules (p = 0.802); however, it was independently associated with malignancy in partially cystic or isoechoic and hyperechoic (PCIH) nodules (p = 0.010). The malignancy risks of nodules with macrocalcification were classified as upper-intermediate and high in SH nodules, and as low and lowerintermediate in PCIH nodules based on suspicious US features. The malignancy risks of nodules with rim calcification were stratified as low and lower-intermediate based on suspicious US features. Conclusion Macrocalcification increased the malignancy risk in all and SH nodules with or without suspicious US features, with low to high malignancy risks depending on the US patterns. Rim calcification increased the malignancy risk in PCIH nodules, with low and lower-intermediate malignancy risks based on suspicious US features. However, the role of rim calcification in risk stratification of thyroid nodules remains uncertain.

BACKGROUND AND OBJECTIVES: Adduct spasmodic dysphonia (ADSD) is a neurogenic and focal laryngeal dystonia resulting in a strained voice quality with spastic voice breaks. While muscle tension dysphonia (MTD) is caused by functional voice disorders, its symptoms are similar to those of ADSD. Because the approaches of treatment for ADSD and MTD are radically different, accurate evaluations are necessary for precise diagnosis. A spectrogram analysis for differentiating ADSD from MTD provides differentiations on four spectral findings (abrupt voice breaks, irregular wide-spaced vertical striations, well-defined formants and high-frequency spectral noise). The aim of this study was to evaluate if the spectrogram could provide detailed information on the visual characteristics that distinguish ADSD and MTD. SUBJECTS AND METHOD: 11 female patients of ADSD and 13 female patients of MTD who were diagnosed by laryngoscope and stroboscope from 2009 through 2012 were selected for this study. The speech samples of subjects were obtained using Computerized Speech Lab. The two speech therapists evaluated a wide-band (300 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings. RESULTS: Abrupt voice breaks and irregular wide-spaced vertical striations of ADSD were significantly higher than those of MTD. Well-defined formants and high-frequency spectral noise were not found significantly different between two groups. CONCLUSION: The spectrograms provided visual perceptual information needed to differentiate ADSD from MTD. Voice therapy to reduce hypertension could be considered for patients of ADSD with excessive formants and noise. If spectrogram analysis were used along with other assessments, it would be more useful in distinguishing ADSD from MTD.
Diagnosis ; Dysphonia* ; Dystonia ; Female ; Humans ; Hypertension ; Laryngoscopes ; Muscle Spasticity ; Muscle Tonus* ; Noise ; Voice ; Voice Disorders ; Voice Quality ; Weights and Measures

Objective: To determine the association of macrocalcification and rim calcification with malignancy and to stratify the malignancy risk of thyroid nodules with macrocalcification and rim calcification based on ultrasound (US) patterns. Materials and Methods: The study included a total of 3603 consecutive nodules (≥ 1 cm) with final diagnoses. The associations of macrocalcification and rim calcification with malignancy and malignancy risk of the nodules were assessed overall and in subgroups based on the US patterns of the nodules. The malignancy risk of the thyroid nodules was categorized as high (> 50%), intermediate (upper-intermediate: > 30%, ≤ 50%; lower-intermediate: > 10%, ≤ 30%), and low (≤ 10%). Results: Macrocalcification was independently associated with malignancy in all nodules and solid hypoechoic (SH) nodules (p < 0.001). Rim calcification was not associated with malignancy in all nodules (p = 0.802); however, it was independently associated with malignancy in partially cystic or isoechoic and hyperechoic (PCIH) nodules (p = 0.010). The malignancy risks of nodules with macrocalcification were classified as upper-intermediate and high in SH nodules, and as low and lowerintermediate in PCIH nodules based on suspicious US features. The malignancy risks of nodules with rim calcification were stratified as low and lower-intermediate based on suspicious US features. Conclusion Macrocalcification increased the malignancy risk in all and SH nodules with or without suspicious US features, with low to high malignancy risks depending on the US patterns. Rim calcification increased the malignancy risk in PCIH nodules, with low and lower-intermediate malignancy risks based on suspicious US features. However, the role of rim calcification in risk stratification of thyroid nodules remains uncertain.

BACKGROUND: Phospholipase C (PLC) plays an important role in cellular signal transduction and is thought to be critical in cellular growth, differentiation and transformation of certain malignancies. Two second messengers produced from the enzymatic action of PLC are diacylglycerol(DAG) and lnositol 1, 4, 5-trisphosphate(IP3). These two second messengers are important in down stream signal activation of protein kinase C and intracelluar calcium elevation. In addition, functional domains of the PLC isozymes, such as Src homology 2(SH2) domain, Src homology 3(SH3) domain, and pleckstrin homology(PH) domain play crucial roles in protein translocation, lipid membrane modification and intracellular memrane trafficking which occur during various mitogenic processes. We have previously reported the presence of PLC-γ1, γ2, β1, β3, and δ1 isozymes in normal human lung tissue and tyrosine-kinase-independent activation of phospholipase C-γisozymes by tau protein and AHNAK. We had also found that the expression of AHNAK protein was markedly increased in various histologic types of lung cancer tissues as compared to the normal lungs. However, the report concerning expression of various PLC isozymes in lung cancers and other lung diseases is lacking. Therefore, in this study we examined the expression of PLC isozymes in the paired surgical specimens taken from lung cancer patients. METHODS: Surgically resected lung cancer tissue samples taken from thirty seven patients and their paired normal control lungs from the same patients. The expression of various PLC isozymes were studied. Western bolt analysis of the tissue extracts for the PLC isozymes and immunohistochemistry was performed on typical samples for localization of the isozyme. RESULTS: In 16 of 18 squamous cell carcinomas, the expression of PLC-γ1 was increased. PLC-γ1 was also found to be increased in all of 15 adenocarcinoma patients. In most of the non-small cell lung cancer tissues we had examined, expression of PLC-δ1 was decreased. However, the expression of PLC-δ1 was markedly increased in 3 adenocarcinomas and 3 squamous carcinomas. Although the numbers were small, in all 4 cases of small cell lung cancer tissues, the expression of PLC-δ1 was nearly absent. CONCLUSION: We found increased expression of PLC-γ1 isozyme in lung cancer tissues. Results of this study, taken together with our earlier findings of AHNAK protein-a putative PLD-γ, activator-over-expression, and the changes observed in PLC-δ1 in primary human lung cancers may provide a possible insight into the derranged calcium-inositol signaling pathways leading to the lung malignancies.
Adenocarcinoma ; Calcium ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans* ; Immunohistochemistry ; Isoenzymes* ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Membranes ; Phospholipases ; Protein Kinase C ; Protein Transport ; Rivers ; Second Messenger Systems ; Signal Transduction ; Small Cell Lung Carcinoma ; tau Proteins ; Tissue Extracts ; Type C Phospholipases

BACKGROUND: Spinal zaprinast, phospodiesterase inhibitor, has been shown to have an antinociception through an increase of cGMP. The aim of this study was to examine the role of spinal adrenergic and cholinergic receptors on the antinociceptive action of intrathecal zaprinast. METHODS: Rats were implanted with lumbar intrathecal catheters. After formalin injection, formalin-induced nociceptive behavior (flinching response) was observed for 60 min. After observing the effect of intrathecal zaprinast, antagonism of intrathecal prazosin, yohimbine, atropine and mecamylamine for the effect of zaprinast were evaluated. RESULTS: Intrathecal zaprinast produced a dose-dependent suppression of formalin-induced flinches in both phases of the formalin test. Intrathecal prazosin reversed the antinociception of zaprinast in phase 2, but not phase 1. Intrathecal yohimbine reversed the antinociception of zaprinast in both phases. Neither atropine nor mecamylamine reversed the antinocicetive action of zaprinast. CONCLUSIONS: Intrathecal zaprinast is against the nociceptive state evoked by formalin stimulus. Alpha 2 or alpha 1 adrenergic receptor, but not cholinergic receptors, may be related to the action of zaprinast in the spinal cord.
Animals ; Atropine ; Catheters ; Formaldehyde* ; Mecamylamine ; Pain Measurement* ; Prazosin ; Rats* ; Receptors, Adrenergic, alpha-1 ; Receptors, Cholinergic* ; Spinal Cord ; Yohimbine