Primary bronchial neoplasms in children, especially malignant lesions, are extremely rare. We report a case of a 10-year old boy with intermediate-grade mucoepidermoid carcinoma of the right intermediate bronchus, presenting as collapse and bronchiectasis after pneumonia. He was diagnosed by bronchoscopic biopsy. The lobectomy was performed. The patient is in good condition 1 year after operation. All reported cases of bronchial mucoepidermoid tumors in children had histologically low or intermediate grade(well differentiated) variety with a benign clinical course. The optimal surgical therapy for bronchial mucoepidermoid tumors is identical. There must be total removal of either mass with the sacrifice of as little normal lung as possible.
Biopsy ; Bronchi* ; Bronchiectasis ; Carcinoma, Mucoepidermoid* ; Child ; Humans ; Lung ; Male ; Mucoepidermoid Tumor ; Pneumonia

This study was performed to evaluate the effect of freeze-dried bone graft on space-making capacity and bone formation in the procedure of guided bone regeneration with titanium reinforced ePTFE membrane. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with titanium reinforced ePTFE membrane filled with human FDBA(Rocky Mountain Tissue Bank, Aurora Co., USA). Decortication was performed to induce the effect of bone forming factor from bone marrow. The animals were sacrificed at 2 weeks, 4 weeks, 8 weeks and 12 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. The results of this study were as follows: 1. Titanium reinforced-ePTFE membrane was biocompatable and capable of maintaining the space-making. 2. FDBA particle was surrounded with connective tissues but there was no evidence on new bone formation. 3. FDBA particle resorbed continuously but it remained until 12weeks after the surgery. Within the above results, TR-ePTFE membrane could be used effectively for Guided bone regeneration but It was assumed that FDBA does not appear to contribute to bone formation.
Animals ; Bone Marrow ; Bone Regeneration ; Connective Tissue ; Humans ; Membranes ; Osteogenesis ; Rabbits ; Skull ; Tissue Banks ; Titanium ; Transplants*

Anesthesia for the patients with mediastinal mass may be associated with significant respiratory and cardiovaacular complications due to compression of traeheobronchial trees, the pulmonary artery, heart and superior vena cava The authors present a case of a 6-year-old girl with a large mediastinal tumor located in anterior and superior mediaetinum. Preoperatively, the patient was asymptomatic and anesthesia was induced and maintained uneventfully. Operative finding was that 8 X 14 cm sized hemangioma was extended superiorly over thoracic outlet, posteriorly aorta and SVC, medially pericardium and right hilum and inferiorly right upper lung and pleura. Because difficulties in removal of the hemangioma were expected, exploratory thoracotomy was discontinued. On emergence, as soon as the patient was extubated due to irritability, the patient became cyanotic and was noticed bulging mass on right supraclavicular area, Intubation was attempted and during direct laryngoscopy, anesthesiologist also noticed a bulging mass in right oral cavity. Postoperatively, the patients airway was kept with endotracheal tube, but cyanosis appeared on the face and skin over the chest, but not below the abdomen. Bulging mass on right supraclavicular area, distension of neck vein and conjunctival edema were noticed only when the patient was crying or suctioned. Symptoms improved by deep sedation. We assumed that enlargement of hemangioma due to increased central blood volume occasionally compressed tracheobronchial tree and sup. vena cava when patient was irritable, crying and coughing. On 11th postoperative day, patient was transferred to the another hospital for the better treatment with endotracheal intubation.
Abdomen ; Airway Obstruction* ; Anesthesia ; Aorta ; Blood Volume ; Child ; Cough ; Crying ; Cyanosis ; Deep Sedation ; Edema ; Female ; Heart ; Hemangioma ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Lung ; Mouth ; Neck ; Pericardium ; Pleura ; Pulmonary Artery ; Skin ; Suction ; Thoracotomy ; Thorax ; Veins ; Vena Cava, Superior

No Abstract available.
Infection Control*

Oral allergy syndrome (OAS) is a subtype of food allergy composing of itching sense and edema in the oral cavity, lips, throat, pharynx, and larynx following ingestion of some fresh fruits or vegetables. Although the major pathogenic mechanism of OAS is known to be IgE-mediated response, here we experienced a case of OAS due to crown daisy (CD) and sesame leaf (SL) mediated by a non-IgE antibody mediated mechanism. A 33-year-old female visited our clinic to evaluate numbness of the tongue and gingiva after eating fresh CD and SL for 2 years. The patient had suffered from allergic rhinitis and atopic dermatitis for 20 years and took medications intermittently. There had been a history of food allergy to crab and shrimp. The serum total IgE level was elevated (404 kU/mL). The skin prick test showed strong positive reactions to tree and weed pollens, but not to CD and SL extracts. Enzyme-linked immunosorbant assay for detecting serum specific IgE to crude extracts of CD and SL showed negative results. The basophil activation test performed with crude extracts of CD or SL showed significant up-regulation of CD63-positive basophils by both CD and SL. In conclusion, we report a case of OAS due to CD and SL, not associated with pollen allergy, which is shown to be mediated by a non-IgE mediated mechanism.
Adult ; Basophils ; Complex Mixtures ; Crowns* ; Dermatitis, Atopic ; Eating ; Edema ; Female ; Food Hypersensitivity ; Fruit ; Gingiva ; Humans ; Hypersensitivity* ; Hypesthesia ; Immunoglobulin E ; Larynx ; Lip ; Mouth ; Pharynx ; Pollen ; Pruritus ; Rhinitis ; Rhinitis, Allergic, Seasonal ; Sesamum* ; Skin ; Tongue ; Up-Regulation ; Vegetables

BACKGROUND: The effects of remifentanl on bispectral index (BIS) and sedation are controversial. The aim of this study was to evaluate the effects of continuous remifentanil infusion (0.03microgram/min/kg) on sedation by using BIS and the modified Observer's Assessment of the Alertness/Sedation Scale (OAA/S) during midazolam induced sedation after achieving pain free state by brachial plexus block. METHODS: In this study 40 ASA physical status 1 or 2 adult patients scheduled to undergo upper extremity surgery under brachial plexus anaesthesia were included. After obtaining adequate brachial plexus block, patients were randomly allocated to two groups. All patents received a single dose of midazolam 2 mg intravenously and continuous infusion (2 mg/h). At 15 minutes after midazolam injection, Group C received saline infusion and Group R received additional remifentanil (0.4microgram/kg bolus plus continuous infusion (0.03microgram/kg/min)). The mean arterial blood pressure (MAP), heart rate (HR), SpO2, respiration rate (RR), and BIS were recorded every 5 min after injection of midazolam. The patient's level of sedation was assessed using the modified OAA/S and BIS immediately after MAP, HR, SpO2, and RR measurements. RESULTS: There are no significant differences in MAP, HR, BIS, and the modified OAA/S between two groups but RR was significant reduced in Group R compared with Group C after remifentanil infusion. CONCLUSIONS: The remifentanil showed no effect on BIS and the modified OAA/S during midazolam induced sedation under pain free state.
Adult ; Arterial Pressure ; Brachial Plexus ; Heart Rate ; Humans ; Midazolam ; Piperidines ; Respiratory Rate ; Upper Extremity

PURPOSE: Most terminally ill cancer patients die from cancer anorexia-cachexia syndrome. This study evaluated a prognostic role of plasma leptin levels in terminally ill cancer patients. METHODS: This study enrolled 69 terminally ill cancer patients who were aged above 20 years old from July 2009 to July 2010. For univariate analysis, an association between leptin levels and patient's characteristics or other variables was examined using Spearman's correlation analysis, Wilcoxon's rank-sum test or Kruskal-Wallis test, as appropriately. For multivariable analysis, Cox's proportional hazard regression model was used to evaluate a clinical significance of plasma leptin levels as a prognostic factor and to determine factors which affect the risk of death in terminally ill cancer patients. RESULTS: A statistically significant positive correlation between plasma leptin levels and survival time was found. Univariate Cox's proportional hazard regression analyses also showed a moderately significant association between plasma leptin levels and survival time. However, after adjusting variables for sex, white blood cell counts, total bilirubin, AST, ALT, albumin and CRP levels, plasma leptin levels were not significantly associated with survival time. CONCLUSION: No significant association was found between plasma leptin levels and survival time in terminally ill cancer patients. However, this study suggested a prognostic value of plasma leptin levels in gastrointestinal cancer patients.
Aged ; Bilirubin ; Gastrointestinal Neoplasms ; Hospice Care ; Humans ; Leptin ; Leukocyte Count ; Life Expectancy ; Plasma ; Survival Rate ; Terminally Ill

No abstract available.
Catheters* ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Fetal Therapies* ; Lung*

PURPOSE: This study was designed to explore the association of diet with menopausal symptoms in Korean women. METHOD: For this cross-sectional survey, 276 women aged between 45-55 years visiting two branches of K-university hospital located in Seoul and Ansan of Kyunggi province were recruited from April to July, 2002. A menopause-specific quality-of-life questionnaire and a food frequency questionnaire were used to measure menopause-related symptoms and the intake of 28 types of foods. RESULT: No differences were found in the levels of bothersome total menopausal symptoms, physical symptoms, psychosocial symptoms, and sexual symptoms according to the intake of each food. Only higher intake of fishes, seaweeds, and vegetable oils were inversely associated with bothersome levels of vasomotor symptoms. Women with higher intake of yellow-green vegetables and lower intake of coffee, confectionery, and processed foods reported lower hot flush rate. CONCLUSION: The results suggest that higher intake of yellow-green vegetables and lower intake of coffee, confectionery and processed foods may relieve hot flushes. Further study needs to be pursued to study the relationship with nutrients of these foods and hot flushes.

BACKGROUND: Both remifentanil and sevoflurane are known for their rapid recovery characteristics, and the bispectral index (BIS) has been used as an indicator of the sedative state during anesthesia. Therefore, it is expected that if they are used together, the anesthetic-sparing effect of remifentanil and titration of the sevoflurane concentration using the BIS monitor will contribute to a faster recovery. This study examined the effect of a remifentanil infusion on the hemodynamics, the decrease in the sevoflurane concentration, and the recovery from BIS-guided sevoflurane anesthesia. METHODS: Thirty patients undergoing laparoscopic gynecologic surgery were assigned to receive a remifentanil (0.1microng/kg/min)(Group I) or saline infusion (Group II) with sevoflurane. The sevoflurane concentration was adjusted to maintain a BIS value between 40 and 60. The mean arterial pressure, heart rate, BIS, and end-tidal sevoflurane concentration were recorded during anesthesia. The eye opening time and the incidence of postoperative nausea, vomiting and shivering were checked. RESULTS: During anesthesia, the hemodynamics were more stable in Group I than in Group II with the reduced use of cardiovascular drugs. The BIS value was lower and the end tidal sevoflurane concentration was higher in group II than in group I. Group I had a shorter eye opening time and there was a similar incidence of postoperative nausea, vomiting and shivering in both groups. CONCLUSIONS: A remifentanil infusion with BIS-guided sevoflurane anesthesia produces more stable hemodynamics, reduced sevoflurane concentration, and a more rapid recovery without side effects than in BIS-guided sevoflurane anesthesia alone.
Anesthesia* ; Arterial Pressure ; Cardiovascular Agents ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Postoperative Nausea and Vomiting ; Shivering ; Vomiting