Airway Management ; Aorta ; Drainage ; Edema ; Esophagus ; Heart ; Lung ; Mediastinitis ; Mediastinum ; Neck ; Thorax ; Tongue ; Vagus Nerve

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients* ; Pharynx*

The decision of surgical treatment for pancreatic cystic lesions may mainly depend on the malignant potential of each lesion. Surgical excision is the most optimal treatment for the mucinous cystic neoplasm due to its high malignant potential. On the other hand, intraductal papillary mucinous neoplasm (IPMN) is divided into main duct type and branch-duct type. Main duct IPMN has high risk of malignant transformation. Therefore, surgical resection has been recommended for all main duct IPMN. Branch duct IPMN has relatively low malignant potential, and usually shows slow progression. A branch duct IPMN that is asymptomatic, less than 3 cm in size and without mural nodules may be followed-up without resection. Serous cystic neoplasm is usually benign in nature. Surgical treatment for serous cystic neoplasm should be considered when definitive diagnosis being uncertain, larger than 4 cm in size, or presence of symptoms. Solid pseudopapillary neoplasm also has low malignant potential which needs surgical excision. Surgical treatment for pancreatic pseudocyst is considered in limited cases with complication, such as infection or bleeding, and which is not controlled with non-surgical treatment. Management strategy for pancreatic cystic lesions should be individualized, and the decision to resect or follow-up a lesion should be based on factors such as the presence or absence of symptoms, patient age, cyst size, grading of malignant potential, location of the lesion, and the surgical risk of the patient.
Follow-Up Studies ; Hand ; Hemorrhage ; Humans ; Mucins ; Pancreas ; Pancreatic Cyst ; Pancreatic Pseudocyst

The objective of this investigation was to evaluate the influence of gestational age at exposure on the prenatal effects of gamma-radiation. Pregnant ICR mice were exposed to a single dose of 2.0 Gy gamma-radiation at a gestational 2.5 to 15.5 days post-coitus (p.c.). The animals were sacrificed on day 18 of gestation and the fetuses were examined for mortality, growth retardation, change in head size and any other morphological abnormalities. The only demonstrable effect of irradiation during the preimplantation period was an increase in prenatal mortality. Resorptions were maximal on post-exposure day 2.5 after conception. The pre-implantation irradiated embryos which survived did not show any major fetal abnormalities. Small head, growth retardation, cleft palate, dilatation of the cerebral ventricle, dilatation of the renal pelvis and abnormalities of the extremities and tail were prominent after exposure during the organogenesis period, especially on day 11.5 of gestation. Our results indicate that the late period of organogenesis in the mouse is a particularly sensitive phase in terms of the development of the brain, skull and extremities.
Abnormalities, Radiation-Induced/*pathology ; Animals ; Bone and Bones/abnormalities/radiation effects ; Female ; Fetal Death ; *Gamma Rays ; *Gestational Age ; Mice ; Mice, Inbred ICR ; Pregnancy ; Pregnancy, Animal/*radiation effects ; Prenatal Exposure Delayed Effects

From May 1, 1993 to May 31 1995, the authers studied retrospectively 211 patients who underwent cardiovascular operation with cardiopulmonary bypass (CPB). Because we were interested in new development of ARF (prevalence, mortality rate, and main risk factors), we performed a multivariate statistical analysis about data of patients with preoperative serum creatinine values of less than 1.5 mg/dL. Normal renal function before operation (serum creatinine level less than 1.5 mg/dL) was registered in 198 (74%) patients. Of these, 27 (14%) patients showed postoperative renal complication, including 20 (10%) patients classified as renal dysfunction (serum creatinine level between 1.5 and 2.5 mg/dL) and 7 (4%) patients as acute renal failure (serum creatinine level higher than 2.5 mg/dL). The mortality rate was 5.8% in normal patients, 5% in patients with renal dysfunction, and 43% when acute renal failure developed (p=0.036). Indeed, the renal impairment proved to be an independent predictor of mortality (odd ratio 2.52~11.25), along with cardiovascular (odd ratio 4.20) and respiratory (odd ratio 2.18) complications. Multivariate analysis identified the following variables as independent risk factors for postoperative renal impairment : advanced age (odd ratio 1), need for emergency operation (odd ratio 3.78), low-output syndrome (odd ratio 3.66), respiratory complication (odd ratio 1.30), need for deep hypothermic circulatory arrest (odd ratio 1.4). The 13 patients (7%) with preoperative renal failure showed a significantly higher morbidity and mortality rate than those without renal complications before operation. We concluded that the likelihood of severe renal complications is resonably low in the patients undergoing cardiac operation without preexisting renal dysfunction, but associated mortality remains high. A prominant role of hemodynamic factor in the development of postoperative acute renal failure must be recognized during preoperative, intraoperative, and postoperative periods.
Acute Kidney Injury* ; Cardiopulmonary Bypass ; Circulatory Arrest, Deep Hypothermia Induced ; Creatinine ; Emergencies ; Hemodynamics ; Humans ; Mortality ; Multivariate Analysis ; Postoperative Period ; Renal Insufficiency ; Retrospective Studies ; Risk Factors

Patient management is considered an important factor in dental field. The aim of this review is to analyze the efficacy of hypnosis to treat fear, anxiety, pain, stress of dental patients, and see how it can be adopted in dentistry for improving patient satisfaction. Medline research was carried out to find the use of hypnosis in dentistry and other aspects of hypnosis in medical area. It can help patient more comfortable, relax, and accordingly reduce patient's negative feelings such as fear, anxiety, pain, stress during dental treatment. Also, it affects patient recovery after surgery by accelerating healing speed and reinforce immune system. When hypnosis is used with other anesthetic method, it can reduce the use of main medication, leading to reduce possibility of side effect. Therefore, using Hypnosis can give patients more comfortable dental experience, both mentally and physically, ultimately making patients more satisfied with the dental treatment.
Anxiety ; Dentistry* ; Humans ; Hypnosis* ; Immune System ; Methods ; Patient Satisfaction*

Bartha strain of pseudorabies virus[PRV-Ba] was utilized as a tracer to identify the neuronal axis of rat tongue muscles ; intrinsic muscles and extrinsic muscles, styloglossus, genioglossus, and hyoglossus muscle. After injection of 10 microliter of PRV-Ba into tongue muscles and 48-96 hours survivals, rats were perfused with 4% paraformaldehyde lysine periodate and brains were removed. PRV-Ba were localized in neural circuits by immunohistochemistry employing rabbit anti PRV-Ba as a primary antibody and ABC method. Injection of PRV-Ba into the tongue muscles resulted in uptake and retrograde transport of PRV-Ba in the rat brain. The result showed a circuit specific connection of many nerve cell groups along the time sequence : PRV-Ba immunoreactive cells appeared in hypoglossal nucleus and motor trigeminal nucleus ipsilaterally as seen with conventional tracers. Raphe nucleus, prepositus hypoglossal nucleus, spinal trigeminal nucleus, Al, A5 and facial nucleus of rhombencephalon showed immunoreactivity bilaterally. There were positive neurons in parabrachial nucleus, locus ceruleus, mesencephalic trigeminal nucleus, periaqueductal gray and A7 of mesencephalon and paraventricular nucleus, suprachiasmatic nucleus, organum vasculosum of lamina terminalis of diencephalon. Also positive reactions were showed in amygdala, insular cortex, frontal cortex and subfornical organ in telencephalon. Early immunoreactivity was appeared in hypoglossal nucleus and motor trigeminal nucleus, and there were positive neurons in the nuclei of the medulla oblongate, midbrain, pons, hypothalamus, cerebellum and medial preoptic area at middle stage. Subsequently the viral antigens were found in forebrain cell groups, paraventricular nuclei, suprachiasmatic nucleus, lateral hypothalamic area and primary motor cortex in frontal lobe bilaterally at 80-90hrs postinjection. These data demonstrate that the PRV-Ba can across synapses in the central nervous system with projection specific pattern, and this virus defines many elements of the neural network governing tongue. Therefore PRV-Ba are proved as a excellent neurotracer in the tract-tracing researches.
Amygdala ; Animals ; Antigens, Viral ; Axis, Cervical Vertebra ; Brain ; Central Nervous System ; Cerebellum ; Diencephalon ; Frontal Lobe ; Hypothalamic Area, Lateral ; Hypothalamus ; Immunohistochemistry ; Locus Coeruleus ; Lysine ; Mesencephalon ; Motor Cortex ; Muscles ; Neural Pathways* ; Neurons ; Paraventricular Hypothalamic Nucleus ; Periaqueductal Gray ; Pons ; Preoptic Area ; Prosencephalon ; Pseudorabies ; Raphe Nuclei ; Rats* ; Rhombencephalon ; Subfornical Organ ; Suprachiasmatic Nucleus ; Synapses ; Telencephalon ; Tongue* ; Trigeminal Nuclei ; Trigeminal Nucleus, Spinal

Acidosis ; Administration, Intravenous ; Anesthesia ; Anesthetics ; Blood Pressure ; Dantrolene ; Diagnosis ; Early Diagnosis ; Emergency Treatment ; Fever ; Humans ; Incidence ; Male ; Malignant Hyperthermia ; Muscle Rigidity ; Orthognathic Surgery ; Succinylcholine ; Tachycardia ; Young Adult

BACKGROUND: Anatomic correction of transposition of the great arteries by means of the arterial switch operation is now accepted as the therapeutic method of choice. This retrospective study attempts to assess the results of the neonatal arterial switch operation for transposition of the great arteries performed by our newly established institution. MATERIALS AND METHODS: 33 consecutive neonates underwent the arterial switch operation between October 1991 to November 1997. There were 27 neonates with transposition and intact ventricular septum, 3 with ventricular septal defect, and 3 with Taussig-Bing anomaly. The mean age was 10.9+/-7.9 days and mean body weight was 3.29+/-0.44kg. RESULTS: Overall postoperative hospital mortality was 30.3% (10 patients). The mortality has improved with time; 75% (6 patients) among first 8 consecutive patients before 1994, 20% (2 patients) among 10 patients in 1994 and 1995, and 13.3% (2 patients) among 15 patients since 1996. Univariated analysis of risk factors revealed that earlier date of the operations and one of preoperative events were determinants for operative death. There were two late deaths. A mean follow-up of 17.4+/-16.5 months was achieved in all 21 survivors. All were in New York Heart Association functional class I. One patient had mild pulmonary stenosis and two had mild aortic valve regurgitation on their echocardiography. CONCLUSIONS: We concluded that we should continue to perform arterial switch operation for neonates with transposition of the great arteries because the mortality of the operation has been improved and the operative survivors have good functional results with low incidence of late complications.
Aortic Valve ; Arteries ; Body Weight ; Double Outlet Right Ventricle ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Septal Defects, Ventricular ; Hospital Mortality ; Humans ; Incidence ; Infant, Newborn* ; Mortality ; Pulmonary Valve Stenosis ; Retrospective Studies ; Risk Factors ; Survivors ; Transposition of Great Vessels ; Ventricular Septum

No abstract available.
Cushing Syndrome* ; Hyperplasia*