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

BACKGROUND: Among 5 subfamilies of dopamine receptors (DAR), D3 and D5 DAR are expressed on peripheral blood mononuclear cells (PBMC). Recently, those DARs have been reported to change in Parkinson's disease (PD). METHODS: We measured the DAR mRNA expression in PBMC from 15 PD patients who had never taken antiparkinson medication, and 16 age-matched healthy people by reverse transcription and quantitative competitive polymerase chain reaction. The beta-actin mRNA expression was also measured to evaluate the relative expression of DAR mRNA. RESULTS: The D3 and D5 DAR mRNA expression was not different between patients and controls. In patients, no significant cor-relation was found between DAR mRNA expression in PBMC and clinical variables such as severity and duration of symptoms, and patients' age. CONCLUSIONS: We confirmed the presence of D3 and D5 DAR in PBMC. However, their mRNA expressions were not influenced by the disease process of PD.
Actins ; Dopamine* ; Humans ; Parkinson Disease* ; Polymerase Chain Reaction ; Receptors, Dopamine* ; Reverse Transcription ; RNA, Messenger*

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

BACKGROUND: An appropriate level of sedation and pharmacological assist are essential during percutaneous transluminal balloon angioplasty (PTA). Ketamine provides good analgesia while preserving airway patency, ventilation, and cardiovascular stability with an opioid sparing effect suggesting that it would be ideal in combination with remifentanil and midazolam in spontaneously breathing patients. We evaluated the effect of a small dose of ketamine added to midazolam and remifentanil on analgesia/sedation for PTA procedures. METHODS: Sixty-four patients receiving PTA were enrolled. The Control group received midazolam 1.0 mg i.v. and continuous infusion of remifentanil 0.05 microg/kg/min. The Ketamine group received, in addition, an intravenous bolus of 0.5 mg/kg ketamine. Patients' haemodynamic data were monitored before remifentanil infusion, 5 min after remifentanil infusion, at 1, 3, 5, 30 min after incision, and at admission to the recovery room. Verbal numerical rating scales (VNRS) and sedation [OAA/S (Observer's Assessment of Alertness/Sedation)] scores were also recorded. RESULTS: The VNRS values at 1, 3, and 5 min after incision and OAA/S scores at 5 min after remifentanil infusion, and 1, 3, and 5 min after incision were lower in the Ketamine group than in the Control group. In the Control group, the VNRS value at 1 min after incision significantly increased and OAA/S values at 3, 5, and 30 min after incision significantly decreased compared to baseline values, while there were no significant changes in the ketamine group. CONCLUSIONS: A small dose of ketamine as an adjunct sedative to the combination of midazolam and remifentanil produced a better quality of sedation and analgesia than without ketamine and provided stable respiration without cardiopulmonary deterioration.
Analgesia ; Angioplasty, Balloon ; Humans ; Ketamine ; Midazolam ; Piperidines ; Recovery Room ; Respiration ; Ventilation ; Weights and Measures

PURPOSE: The incidence of abdominal trauma with intra-abdominal organ injury or bowel rupture is increasing. Articles on the diagnosis, symptoms and treatment of small bowel perforation due to blunt trauma have been reported, but reports on the relationship of mortality and morbidity to clinical factors for prognosis are minimal. The purposes of this study are to evaluate the morbidity and mortality of patients with small bowel perforation after blunt abdominal trauma on the basis of clinical examinationand to analyze factors associated with the prognosisfor blunt abdominal trauma with small bowel perforation. METHODS: The clinical data on patients with small bowel perforation due to blunt trauma who underwent emergency surgery from January 1994 to December 2009 were retrospectively analyzed. The correlation of each prognostic factor to morbidity and mortality, and the relationship among prognostic factors were analyzed. RESULTS: A total of 83 patients met the inclusion criteria: The malewas 81.9% .The mean age was 45.6 years.The mean APACHE II score was 5.75.The mean time interval between injury and surgery was 395.9 minutes.The mean surgery time was 111.1 minutes. Forty seven patients had surgery for ileal perforations, and primary closure was done for 51patients. The mean admission period was 15.3 days, and the mean fasting time was 4.5 days. There were 6 deaths (7.2%), and 25 patientssuffered from complications. CONCLUSION: The patient's age and the APACHE II score on admission were important prognostic factors that effecteda patient's progress. Especially, this study shows that the APACHE II score had effect on the operation time, admission period, the treatment period, the fasting time, the mortality rate, and the complication rate.
APACHE ; Emergencies ; Fasting ; Humans ; Incidence ; Prognosis ; Retrospective Studies ; Rupture

A 62-year-old man with left flank pain and hematuria was shown to have a staghorn stone in left renal pelvis. Grossly, renal pelvis and calyces were markedly dilated with cystic and hemorrhagic degeneration and renal parenchyma was atrophied. A tumor-like mass was located in a hemorrhagic cyst of the renal upper pole. This mass consisted of giant cells and stromal cells mimicking a giant cell tumor of bone. This giant cell tumor-like proliferation may represent a response to hemorrhage into a cystic cavity. Recognition of this finding is important to avoid the over-diagnosis of neoplastic lesions.
Calculi ; Cell Proliferation ; Flank Pain ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Hematuria ; Hemorrhage ; Humans ; Kidney ; Kidney Pelvis ; Middle Aged ; Stromal Cells

BACKGROUND: We have experienced sporadic cases of nosocomial bacteremia/sepsis due to contaminated rubber caps of intravenous (IV) fluid bottles from May through August in 1996. We investigated the possible sources of the infections, and developed the measures to control this type of nosocomial infections. METHODS: During initial investigation of an outbreak of sporadic nosocomial bacteremia we could not found possible sources of infections from medical care providers. However, some rubber caps of IV fluid bottles showed water drops on top of them, and were suspected as possible sources of the infection. A total of 95 caps including 50 wet caps and 45 dry caps, were randomly selected from nursing stations and pharmacy receiving area for culture. We also investigated if routine disinfection methods were effective to sterilize the contaminated caps as follows; twenty of 50 wet caps were randomly selected and were divided into 2 groups. Caps of one group were disinfected with 70% isopropanol alcohol wipes and the other with 70% isopropanol alcohol wipes plus Betadine. All caps were subjected to culture before and after disinfections. Cultures were performed on blood agar plate after inoculating by using swab. RESULTS: The result of culture showed that 128 of 50(56%) wet caps were contaminated by Burkholderia picketti, Pseudomonas species, glucose-nonfermenting bacilli, Acinetobacter lowffii and Alkaligenes species. One of 45 (2.2%) dry caps grew Burkholderia picketti and Pseudomonas species. Both 70% isopropanol alcohol and 70% isopropanol alcohol plus povidone-iodine (Betadine) wipes terilized contaminated caps effectively when they were used for disinfecting caps. CONCLUSION: It is concluded that wet caps of IV fluid bottles are indicative of possible contamination by microorganisms. And use of alcohol wipe and/or Betadine to disinfect ontaminated caps at time preparing for infusion of IV fluids can be one of effective sterilization methods.
2-Propanol ; Acinetobacter ; Agar ; Bacteremia* ; Burkholderia ; Cross Infection ; Disinfection ; Nursing Stations ; Pharmacy ; Povidone-Iodine ; Pseudomonas ; Rubber* ; Sterilization ; Water