No abstract available.
Female ; Obstetric Labor, Premature* ; Pregnancy ; Ritodrine*

No abstract available.
Neuroectodermal Tumor, Melanotic

The limitation so direct or indirect laryngoscopy and laryngogram in detemining the exact site and anatomiclocation of laryngeal carcinoma were well documented by many authors. As compared with laryngoscopy and laryngogram, CT study for laryngeal cancer is more exact and accurate method demonstrating anatomic sites of involvement, invasion into deep soft tissue spaces of endolarynx, destruction of laryngeal cartilages and cervical metastasis. Fourteen laryngeal cancer patients proven by laryngoscopic biopsy were further examined by computed tomography for staging. The authors compared laryngoscopic findings with those of computed tomography, and their clinical, surgical and computed tomographic findings were analysed. The results were as follows; 1. All patients were proved as squamous cell carcinoma. They were 12 males and 2 females aged over 50 yrs. 2. Common clinical symptoms were hoarseness, dysphagia and swallowing difficulty. The pirmary anatomic sites determined by CT were 8 transglottic, 2 glottic, 2 supraglottic and 1 pyriform sinus respectively. They were 2 T1. 7 T2, 1 T3, 3 T4 by TNM systems, respectivly. (One case was difficult to evaluate exactly). 3. Invasion into deep soft tissue spaces of endolarynx, cartilage destruction, and neck metastasis were relatively predominant in transglottic caracinomas. 4.CT was superior in evaluating tumor invasion, especially into deep soft tissue spaces of endolarynx, laryngeal cartilages and metastasis ot soft tissue and lymph nodes of neck. However CT had some limitation in determining primary site of laryngeal cancer.
Biopsy ; Carcinoma, Squamous Cell ; Cartilage ; Deglutition ; Deglutition Disorders ; Female ; Hoarseness ; Humans ; Laryngeal Cartilages ; Laryngeal Neoplasms ; Laryngoscopy ; Lymph Nodes ; Male ; Methods ; Neck ; Neoplasm Metastasis ; Pyriform Sinus

Thoracoscopic esophagectomy can be performed in esophageal diseases to reduce the postoperative complications. Recently, We encountered a case of esophageal cancer and successfully treated it by thoracoscopic esophagectomy with gastric pull-up. A 59-year-old male was presented with swallowing difficulty and an esophagogram, esophagoscopy, and chest CT showed an ulcerating tumor on the lower esophagus. The operation was performed in three stages: mobilization of the esophagus by thoracoscopic surgery, construction of a gastric tube through a laparotomy, and cervical anastomosis between the esophagus and the gastric pull-through. Hoarseness developed postoperatively, and the postoperative esophagogram showed leakage at the esophagogastric anastomotic site. The anastomotic leakage was healed following surgical drainage and the patient was discharged in good health. Hoarseness subsided spontaneously two months after surgery.
Anastomotic Leak ; Deglutition ; Drainage ; Esophageal Diseases ; Esophageal Neoplasms* ; Esophagectomy* ; Esophagoscopy ; Esophagus ; Hoarseness ; Humans ; Laparotomy ; Male ; Middle Aged ; Postoperative Complications ; Thoracoscopy ; Tomography, X-Ray Computed ; Ulcer

STUDY DESIGN: Case report OBJECTIVES: We report a case of relatively rare multiple bilateral perineural cysts. SUMMARY OF LITERATURE REVIEW: Tarlov cysts, also known as perineural cysts are most often found in the sacral region, but there are a few cases reported in the thoracic region. In particular, there are very few cases of multiple bilateral thoracic perineural cysts. MATERIALS AND METHODS: A woman aged 65 years with perineural cysts in the bilateral T10-T11 and T11-12 neural foramens, underwent a T10-11-12 decompressive laminectomy and resection of the cyst. RESULTS: Satisfactory results were obtained for the patient after surgery. CONCLUSIONS: For more detailed and definitive treatment of thoracic perineural cysts, additional cases are required.
Aged ; Female ; Humans ; Laminectomy ; Sacrococcygeal Region ; Tarlov Cysts

We present a case of inadvertent arterial insertion of a central venous catheter, identified during a pericardiectomy procedure after observing abrupt changes in pressure waveform and confirmed via arterial blood gas analysis and transesophageal echocardiography. Central venous pressure measurement was initially 20 mmHg in supine, and then elevated to 30-40 mmHg in right lateral decubitus, presumably resulting from constrictive physiology of pericarditis. The pressure waveforms, however, abruptly changed from a venous to an arterial waveform during surgery. When visual discrimination between arterial and venous blood regurgitation is unreliable, anesthesiologists should confirm that using all the available methods one has on the scene, especially after at least two unsuccessful attempts or in patients with advanced age or clinical conditions resulting in jugular venous dilation. To prevent arterial catheterization, one should limit the leftward rotation of the head by <40degrees and consider using ultrasound-guided method after more than two unsuccessful attempts.
Blood Gas Analysis ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Central Venous Pressure ; Discrimination (Psychology) ; Echocardiography, Transesophageal ; Head ; Humans ; Intraoperative Complications ; Pericardiectomy ; Pericarditis

PURPOSE: The prognostic value of p53 remains controversial in transitional cell carcinomas of the bladder. Survivin, an inhibitor of apoptosis, is expressed in many human cancers. Recent studies have reported increased expression of survivin in superficial transitional cell carcinomas of the bladder. We investigated the expression of survivin and p53 and the clinical implications of this expression in superficial transitional cell carcinomas of the bladder. MATERIALS AND METHODS: Immunohistochemical staining of paraffin sections using a monoclonal antibody for survivin and p53 was performed in 82 cases of superficial transitional cell carcinomas of the bladder. Correlations between the expression of survivin and p53 and clinicopathological features, such as age, multiplicity of tumor, size, recurrence, and progression, were examined. RESULTS: Among 82 cases, positive survivin expression (greater than 20%) was observed in 59 cases. Positive p53 expression (greater than 20%) was observed in 46 cases. There were no significant differences in age, gender, multiplicity, tumor size, tumor grade, pT stage, recurrence, or progression-free survival between p53-positive and p53-negative groups (p>0.05). Also, there were no significant differences in age, gender, multiplicity, tumor size, tumor grade, or pT stage between survivin-positive and survivin-negative groups (p>0.05). However, recurrent-free and progression-free survivals were significantly lower in the survivin-positive group than in the survivin-negative group (p<0.05). CONCLUSIONS: The expression of survivin can be recommended as a useful marker for predicting disease recurrence and progression. Survivin may be superior to p53 as a prognostic factor in superficial transitional cell carcinoma of bladder.
Apoptosis ; Carcinoma, Transitional Cell ; Disease-Free Survival ; Genes, p53 ; Humans ; Paraffin ; Recurrence ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: Acute or chronic prostatic inflammation exists to varying degrees in surgical specimens of prostates, extirpated for the treatment of benign prostatic hyperplasia(BPH). We investigated the relationship between acute urinary retention(AUR) and intraprostatic inflammation. MATERIALS AND METHODS: Between January 1997 and December 2006, 221 patients underwent transurethral resection of the prostate(TURP) for the treatment of BPH. The patients were divided into 2 groups based on the indication for surgery; an AUR group and a lower urinary tract symptoms (LUTS) group. The area of acute inflammation, the extent, and the aggressiveness of chronic inflammation were classified into four grades. The grades of inflammation, prostate volume, age, serum prostate-specific antigen(PSA), and prior medical treatment were compared between the two groups. All specimens were reviewed by one pathologist. RESULTS: The AUR group consisted of 106(47.9%) patients, and the LUTS group consisted of 115(52.1%) patients. There were no statistical differences between the two groups with respect to the mean values of the age, prostate size, and severity of chronic inflammation. There was a significant relationship between AUR and the areas of acute inflammation, and the extent of chronic inflammation(p=0.014 and p=0.003, respectively). The aggressiveness of chronic inflammation had no relationship with AUR (p=0.062). The serum PSA level was higher in the AUR group than the LUTS group(11.5 vs. 5.3ng/ml, respectively). CONCLUSIONS: The association for AUR with acute and chronic inflammation was stronger than that which existed with prostate size. Thus intraprostatic inflammation is an important risk factor in AUR.
Humans ; Inflammation ; Lower Urinary Tract Symptoms ; Prostate ; Prostatic Hyperplasia ; Prostatitis ; Risk Factors ; Urinary Retention

Facial hyperhidrosis has a symptom of excessive sweating on the face with or without underlying disease. It can be surgically treated by video-assisted thoracic surgery (VATS). We encountered three cases of facial hyperhidrosis which we treated by VATS, which was performed by resection of the lower third of stellate ganglion and T2-T3 sympathetic ganglia with chains. Postoperative symptom was improved in all cases. There were no postoperative complications such as Horner's syndrome or postsympathectomy neuralgia.
Ganglia, Sympathetic ; Horner Syndrome ; Hyperhidrosis* ; Neuralgia ; Postoperative Complications ; Stellate Ganglion ; Sweat ; Sweating ; Sympathectomy* ; Sympathetic Nervous System ; Thoracic Surgery, Video-Assisted

BACKGROUND: Propofol is a widely-used intravenous anesthetic with a rapid onset, short duration of action and rapid elimination but the molecular mechanisms of action are not completely understood. Not only neurons but astrocytes are potential substrates for anesthetics, specifically for propofol. Intracellular calcium ion ([Ca2 ]i) is known to play a key role in the transduction and propagation of various chemical signals in astrocytes. METHODS: In the present study, the effects of propofol on the intracellular calcium concentration of astrocytoma cells by using a fura-2 fluorescence spectroscopy was investigated. RESULTS: In an isotonic standard solution, propofol (50 and 500microM) produced a transient increase in [Ca2 ]i while the intralipid did not change [Ca2 ]i. In several cells (20%), a transient increase in [Ca2 ]i was followed by sustained elevation which was sensitive to depletion of external calcium. A propofol-induced increase in [Ca2 ]i was not altered by an L-type calcium channel blocker (nifedipine 2microM). In cells bathed in a Ca2 -free external solution, a transient increase in [Ca2 ]i was observed. After the pretreatment of cyclopiazonic acid (CPA), an endoplasmic reticulum Ca2 -ATPase blocker, propofol 500microM did not produce any significant increase in [Ca2 ]i. Carbachol, which is known to release calcium from the inositol 1,4,5-triphosphate (IP3)-induced calcium release (IICR) stores, prevented the [Ca2 ]i increase by propofol and vice versa. High concentrations of caffeine (10 mM), which release calcium from the calcium-induced calcium release (CICR) stores, had no effect on [Ca2 ]i. CONCLUSIONS: From the above results, it is suggested that an increase in [Ca2 ]i by propofol in astrocytoma cells is mainly due to calcium release from the IICR stores.
Anesthetics ; Astrocytes ; Astrocytoma* ; Baths ; Caffeine ; Calcium Channels, L-Type ; Calcium* ; Carbachol ; Cytosol* ; Endoplasmic Reticulum ; Fura-2 ; Inositol 1,4,5-Trisphosphate ; Neurons ; Propofol* ; Spectrometry, Fluorescence