Electron microscopy (EM) can provide a valuable contribution to light microscopy (LM) in the interpretation of fine needle aspiration cytology (FNAC) specimen, especially in the diagnosis of the tumor. However, considerable care in processing the specimen is mandatory to recover the cells and avoid altering the fine structures. We experienced a case of malignant melanoma in 33-yrs-old female, diagnosed by EM study of FNAC specimen from the axillary mass, who was initially thought as dissem- inated carcinomatosis on LM study. The technique of EM study on FNAC specimen consisted of washing the needle and syringe in 2.5% glutaraldehyde after a rapid stain (Diff-Quik), which was used to obtain a preliminary diagnostic impression and to assure the adequacy of the EM specimen. After centrifugation in the steps of fixation and dehydration, the sediment was made into an epon block and examined. The whole processing time of EM study can be shortened within 7 or 8 hours, and results can be available within 48 to 72 hours. Our experience suggests the EM study on FNAC can be a useful diagnostic method in the diagnosis of difficult FNAC cases.
Behcet Syndrome* ; Biopsy, Fine-Needle ; Carcinoma ; Centrifugation ; Dehydration ; Diagnosis ; Female ; Glutaral ; Histiocytoma, Malignant Fibrous ; Humans ; Lung ; Melanoma ; Microscopy ; Microscopy, Electron ; Needles ; Nephrotic Syndrome* ; Syringes

No abstract available.
Stomach Neoplasms* ; Stomach*

In open wounds of the hand that have exposed bone or tendons, management may be difficult. Compared with conventional cutaneous pedicle flaps, the fascial radial flap transfer has several advantages : (1) one operation is required by one operating team reliably and easy to perform, (2) the appearance is not bulky, (3) the donor area is closed primarily, and (4) the hand is free for early motion of the shoulder and the elbow. One potential disadvantage is the permanent loss of the contribution of the radial artery to the circulation of the hand. One case of the fascial radial flap transfer was performed at the Department of Orthopaedic Surgery of Hanyang University Hospital, and satisfactory result was obtained.
Elbow ; Hand ; Humans ; Radial Artery ; Shoulder ; Tendons ; Tissue Donors ; Wounds and Injuries

BACKGROUND: Many factors determine the distribution of local anesthetics in the subarachnoid space. These major factors are dosage of local anesthetics, baricity of local anesthetics, position of patient, contour of vertebral column. The temperature of local anesthetics alters the baricity of local anesthetics. At 20oC, the density of 0.5% plain bupivacaine is 1.0003 and generally act as isobaric solution in the CSF. As its temperature lowers, its baricity increases. METHODS: Forty patients (A.S.A I and II) scheduled for lower extremity operation under spinal anesthesia were randomized into four groups; group I (37oC 0.5% bupivacaine, sitting position), group II (37oC 0.5% bupivacaine, 15o head-down position), group III (4oC 0.5% bupivacaine, sitting position), group IV (4oC 0.5% bupivacaine, 15o head-down position). The patients were placed in the sitting position (Group I, III) or lateral decubitus (Group II, IV) and dural puncture was performed at the L3-4 interspace using a midline approach (25-gauge Quincke spinal needle). A free flow of clear cerebrospinal fluid was obtained before administration of drug (37oC 0.5% bupivacaine in Group I, II and 4oC 0.5% bupivacaine in Group III, IV). Patients remained in the sitting position or 15o head-down position for 3 minutes after injection. Patients in each group received a solution that had been previously equilibrated in a stove to 37oC and in a refrigerator to 4oC for more than 1 day. Syringes used to administer the bupivacaine solution were also equilibrated to 37oC and 4oC, respectively. We checked sensory block level using pin-prick test at every 5 minutes. RESULTS: There was statistic significance in sensory block level between Group I, IV and Group II, III. The maximum sensory block level and the time to maximum cephalad spread of analgesia was the T4 level and 9.6 minutes in Group I, the T5 level and 13.5 minutes in Group IV compared to the T9 level and 21 minutes in Group II, the T10 level and 18 minutes in Group III. CONCLUSIONS: The temperature of 0.5% plain bupivacaine affects sensory block level and time to block. It is concluded that the temperature of the injected solution plays an important role in the sensory spread of 0.5% plain bupivacaine.
Analgesia ; Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine* ; Cerebrospinal Fluid ; Humans ; Lower Extremity ; Posture* ; Punctures ; Spine ; Subarachnoid Space ; Syringes

No abstract available.
Para-Aortic Bodies* ; Paraganglioma*

OBJECTIVES: The present study was performed to investigate whether estrogen and progesterone induce the change of vascular tone in endothelium-denuded human uterine artery and vascular reactivity may be mediated by intracelluar calcium modulation through receptor- and voltage-dependent calcium channels. METHODS: The uterine arteries were obtained at the time of hysterectomy from 28 women followed by denudation of endothelium. After confirmation of functional integrity of endothelium-denuded uterine artery, vascular reactivity was measured by using isometric force transducer and recorded by physiograph. Contraction was induced by 10-6 M norepinephrine and 35mM high concentrated potassium chloride solution which activated receptor-dependent calcium channel and voltage-dependent calcium channel, respectively.Thereafter estradiol of 4 different concentrations from 3x10-11M to 3x10-8M was administered. Progesterone was also administered to endothelium-denuded uterine artery which was contracted by 10-6M norepinephrine and high potassium chloride solution. To evaluate the effect of additional progesterone on vascular smooth muscle relaxation effect of estrogen,4 different progesterones in concentrations from 3x10-8M to 3x10-5M were given to vascular smooth muscle which was initially pretreated with norepinephrine followed by relaxation of estradiol. RESULTS: Estradiols from 3x10-11M to 3x10-8M showed in significant dose-dependent vascular relaxation. Progesterones result in significant decrease in vascular contraction in concentration dependent manner. Additional progesterone on estrogenic effects also results in significant decrease in vascular contraction. CONCLUSION: Estradiol may have endothelium independent vasorelaxation effect in human uterine artery. These vasorelaxant effects may be mediated through antagonistic action for receptor-and voltage-dependent calcium channels in vascular smooth muscle. Progesterone also bring about vasorelaxation by same action in endothelium-denuded vascular smooth muscle. On estrogen induced vascular relaxation, progesterone results in additional vasorelaxation.
Calcium ; Calcium Channels ; Endothelium ; Estradiol ; Estrogens* ; Female ; Humans* ; Hysterectomy ; Muscle, Smooth, Vascular ; Norepinephrine ; Potassium Chloride ; Progesterone* ; Relaxation ; Transducers ; Uterine Artery* ; Vasodilation

Video-assisted thoracic surgery (VATS) is emerging as a viable alternative to thoracotomy when surgical treatment of spontaneous pneumothorax is required. 20 patients with spontaneous pneumothorax underwent bullectomy between July 1995 and May 1996. The patients were divided into two groups : Control group ; the patients who received with mid-axillary approach (n=10), Experimental group ; the patients who received with VATS (n=10). The results were as follows ; 1. The total sex distribution was male predominance (male:female=17:3). Mean age of control group was 29.6+/-9.8 years and experimental group was 27.2+/-11.9 years. 2. The mean period of postoperative chest tube indwelling duration and hospital stay were 3.3+/-0.8 days and 7.9+/-1.2 days in control group and 2.1+/-0.9 days and 5.2+/-3.1 days in experimental group (p=0.005 and p=0.02). 3. The mean time of operation, vital signs and arterial blood gas analysis did not showed any statistical differences between the groups. 4. Percent recovery of tidal volume and forced vital capacity were significantly improved in experimental group comparing with control group (p<0.05). 5. The patients undergoing VATS experienced significantly less postoperative pain and limitation of motion. In conclusion, VATS is safe and offers the potential benefits of shorter postoperative hospital stays and less pain with cosmetic benefits.
Blood Gas Analysis ; Chest Tubes ; Humans ; Length of Stay ; Male ; Pain, Postoperative ; Pneumothorax* ; Sex Distribution ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Thoracotomy ; Tidal Volume ; Vital Capacity ; Vital Signs

At OPD follow-up in December 1998, chest x-ray of a 42-year-old female showed a solit ary pulmonary nodule at a superior basal segment in the right lower lobe. After percut aneous transthoracic needle aspiration failure, wedge resection of the superior basal segment of lower lobe in right lung was performed for diagnosis and therapy. Three years ago, she had received surgery to remove a mass in the left buttock. The mass was pathologically diagnosed as malignant fibrous histiocytoma. She subsequently received 4500 rad radiotherapy for 35 days. Pathology confirmed metastatic malignant fibrous histiocytoma of the lung.
Adult ; Buttocks ; Diagnosis ; Female ; Follow-Up Studies ; Histiocytoma, Malignant Fibrous* ; Humans ; Lung Neoplasms ; Lung* ; Needles ; Pathology ; Radiotherapy ; Thorax

OBJECTIVES: This study was designed to investigate the prevalence of anxiety and to identify demographic variables and clinical characteristics impacting on anxiety and quality of life in the elderly. METHODS: We analyzed data of 300 patients. Generalized anxiety disorder-7 (GAD-7), World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF), Rosenberg Self-Esteem Scale, Scale of Social Support (SSS), Brief Encounter Psychosocial instrument (BEPSI-K) were used to evaluate. Patients were divided into anxiety and non-anxiety group according to the GAD-7 score. We compared stress and quality of life between two groups and analyzed multiple linear regression with anxiety and quality of life as criterion variables. RESULTS: The prevalence of anxiety in elderly was 27% (n=81). Compared to the non-anxiety, anxiety people appeared significantly lower mean scores all of subscales in WHOQOL-BREF : General Health (t=-6.782, p<0.001), Physical Health (t=-6.935, p<0.001), Psychological Health (t=-8.816, p<0.001), Social Relationship (t=-5.409, p<0.001) and Environmental Health (t=-5.667, p<0.001). Stress, social support, education, sleep were significant explanation variables for anxiety and anxiety, stress, self-esteem were significant explanation variables for quality of life. CONCLUSION: These results show that the most important variable influencing on anxiety was stress and influencing on quality of life was anxiety.
Aged* ; Anxiety* ; Education ; Environmental Health ; Humans ; Linear Models ; Prevalence ; Quality of Life* ; World Health Organization

No abstract available.
Calcitriol* ; Dehydroepiandrosterone* ; Gene Expression* ; Tumor Necrosis Factor-alpha*