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.
Ascites*

An adult beagle dog was presented with a cervical mass detected by palpation and computed tomography. Fine needle aspirates revealed numerous epithelial cells with plasmacytoid appearance and frequent naked nuclei. Histologically, the mass consists of multiple packets of neoplastic cells and extensive areas of necrosis and fibrosis. Neoplastic cells were also found in submandibular lymph nodes. Immunohistochemistry showed that neoplastic cells were positive for calcitonin and negative for thyroglobulin. Based on these findings, the cervical mass was diagnosed as thyroid C-cell carcinoma. Almost one year after the surgical excision, the dog remains healthy without any symptom of recurrence or metastasis.
Adult ; Animals ; Calcitonin ; Dogs* ; Epithelial Cells ; Fibrosis ; Humans ; Immunohistochemistry ; Lymph Nodes ; Necrosis ; Needles ; Neoplasm Metastasis ; Palpation ; Recurrence ; Thyroglobulin ; Thyroid Gland*

OBJECTIVE: To investigate whether polymorphism of gene encoding COMT is associated with the risk of endometriosis in Korean women. METHODS: We investigated 136 patients with histopathologically confirmed endometriosis rAFS stage III/IV and 251 control group women who were surgically proven to have no endometriosis. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) of PCR products were done to determine each participant's COMT genotype. RESULTS: The distribution according to NIaIII genetic polymorphisms of COMT were as follows. COMT HH, COMT HL, and COMT LL genotypes were 56.6% (77 women), 34.6% (47 women) and 8.8% (12 women) in the study group and 50.6% (127 women), 39.4% (99 women) and 10.0% (25 women) in the control group. There was no significant difference between the study group and the control group. CONCLUSION: The results suggest that COMT genetic polymorphism may not be associated with the development of endometriosis in Korean women.
Endometriosis* ; Female ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

Innervation anomalies are well-known sources of erroneous interpretation in motor nerve conduction studies. The extensor digitorum brevis (EDB) muscle is supplied by the deep peroneal nerve and is commonly used as recording point in peroneal motor conduction study. If the compound muscle action potentials (CMAPs) are not evoked with EDB muscle recording without any symptoms or signs of peroneal neuropathy, we should lead one to consider either technical pitfall or anomalous innervation. We experienced an anomalous innervation in a woman in whom the bilateral EDB muscles were innervated exclusively by the tibial nerve. This was proved using a monopolar needle electrode for recording in extensor digitorum brevis (EDB) and flexor digitorum brevis (FDB) muscles, which encoded acceptable shape of CMAPs on tibial nerve stimulation. To avoid erroneous interpretation of electromyographic and nerve conduction studies, one should be aware of this possible innervation anomaly ("all tibial foot").
Action Potentials ; Electrodes ; Female ; Humans ; Muscles ; Needles ; Neural Conduction ; Peroneal Nerve ; Peroneal Neuropathies ; Tibial Nerve*

PURPOSE: Adhesion after flexor tendon injury is a result of fibrosis between tendon and tendon sheath. This, finally interfere with gliding mechanism of tendon and results in functional problem of hands. Therefore, there have been many trials to reduce adhesion around the tendon. However, there is no standard procedure clinically practiced in hospitals. Mitomycin-C is an antineoplastic alkylating agent that decrease fibroblast proliferation and scar formation. It is commonly used in many surgery to reduce postoperative adhesion. This study was designed to observe the effect of Mitomycin-C on preventing adhesion in injured flexor tendon. METHODS: The deep flexor tendon of digit 2 and 4 in the left forepaw of 15 New Zealand White rabbits were subjected to partial tenotomy. In study group, injury site was exposed to a single 5-minute application of Mitomycin-C, and in control group was left untreated. Digit 2 and 4 in the right forepaw of each rabbit were considered as non-adhesion control group. After 2 weeks, the animals were sacrificed and digits were amputated for biomechanical test and histological study. RESULTS: In biomechanical study to measure yield point, mean yield point of non-adhesion control was 17.43+/-2.33 and 25.07+/-4.03 for adhesion control, which proves increase of adhesion in adhesion control group(p<0.05) in 95% confidence. In Mitomycin-C group, mean yield point was 12.71+/-4.97. Compared with adhesion control, there was decrease in adhesiveness in Mitomycin-C group(p<0.05) in 95% confidence. In histological study, the result of adhesion control revealed massive adhesions of bony structure, fibrotic tissue and tendon structure with ablation of the border. However in Mitomycin-C group, we could find increased fibrotic tissue, but adhesion is much lesser than adhesion group and borders between structures remain intact. CONCLUSION: This study suggests that Mitomycin-C can significantly reduce adhesion of injured flexor tendon in rabbit model.
Adhesiveness ; Animals ; Cicatrix ; Fibroblasts ; Fibrosis ; Hand ; Mitomycin ; Rabbits ; Tendon Injuries ; Tendons ; Tenotomy

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

OBJECTIVE: The aim of this study was to evaluate the detection rate of the chromosomal abnormalities by screening of maternal serum alpha-FP, free beta-hCG in midtrimester and to evaluate the association of elevated free beta-hCG with neonatal & pregnancy outcome. METHODS: From October 1995 to December 1999, We studied 8,304 pregnant women who delivered in Asan Medical Center. We measured the levels of serum alpha-FP and free beta-hCG in the midtrimester. We reviewed high Down risk group, high NTD risk group and numerous cases of chromosomal abnormalities, retrospectively. To evaluate the association of elevated free beta-hCG with neonatal & pregnancy outcome, we reviewed birth weight, apgar score, gestational age at delivery, presence of PIH or fetal growth restriction. RESULTS: Two hundred ninety eight (3.6%) women were screened as high Down risk pregnancy, 61 (0.7%) women were screened as high NTD risk pregnancy. In the high risk group of chromosomal abnormalities, there were 13 cases of various chromosomal abnormalites, including of six Down syndrome baby. In the low risk group, there were two (0.02%) Down syndrome baby and 8 cases of other chromosomal abnormality. By using maternal serum alpha-FP, free beta-hCG in mid-trimester, 68% of the detection rate of chromosomal abnormalites and 4.1% of false positive rate was reported. The detection rate of Down syndrome is 75% (6/8) and 3.5% of false positive rate, 0.02% of false negative rate were reported. In the aspect of pregnancy outcome, when the free beta-hCG more than 2.5MOM, there were more numerous preterm delivery (8.2% vs 3.8%), IUGR (4.6% vs 1.7%), lower 1 min apgar score than 7 (6.4% vs 2.7%). CONCLUSION: Maternal serum alpha-FP, free beta-hCG is at least useful method as Double markers screening method for fetal chromosomal abnormalites and maybe elevated free beta-hCG level can be useful marker of poor pregnancy outcome such as PIH, low birth weight or preterm delivery.
Apgar Score ; Birth Weight ; Chromosome Aberrations ; Chungcheongnam-do ; Down Syndrome ; Female ; Fetal Development ; Fetal Growth Retardation ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Mass Screening ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second* ; Pregnant Women ; Retrospective Studies

No abstract available.
Animals ; Mice* ; Premature Birth*

No abstract available.
Amnion* ; Cyclooxygenase 2*