No abstract available.
Hyperparathyroidism*

No abstract available.
Brain* ; Schizophrenia ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Myasthenia Gravis ; Thyroid Gland ; Thyroiditis ; Vitiligo

A Radical gastrectomy can affect the dumping syndrome, reflux gastritis, injury of the autonomic nervous system and the small capacity syndrome and can cause some problems in the quality of life for post-gastrectomy patients. To minimize these complications in the treatment of early gastric cancer (EGC), various gastric-reduced operations have been discussed by gastric surgeons. A pylorus preserving gastrectomy (PPG) is a kind of reduced-gastric operation which preserves the distal portion (1.5 cm) of the gastric antrum and reduces postoperative complications such as the dumping syndrome and reflux esophagitis. However, a limitation of this operation is that complete lymph node dissection of the suprapyloric lymph node is undesirable for preservation of the pyloric branch of the vagus nerve. Nowadays, some reports state that this operation may be applicable in EGC confined to the mucosa and located at the gastric mid-body. (Purpose) This study was designed to evaluate the gastric function after PPG by using solid foods to obtain the gastric emptying time. (Materials and Method) From June 1995 to December 1995, we performed PPGs on 7 patients (4 patients with mucosal cancer, 2 patients with gastric ulcer and 1 patient with a leiomyoma) and Billroth I reconstruction in 7 patients (5 patients with mucosal cancer, 1 patient with advanced gastric cancer and 1 patient with gastric ulcer). To compare the gastric function between these two subgroups, we analyzed the lag time, T1/2 and the residual food after 100 min using 99mTc-tin-colloid-steamed eggs to obtain the gastric emptying time for the PPG group (n=7), the Billroth I reconstruction group (n=7), and the normal control group (n=7). A statistical analysis was done by using the Kruskal-Wallis test (Chi-square approximation). (Results) There were no differences in the amount of transfusion, the hospital stay, the operation time, and the body weight loss after operation between the PPG group and the Billroth I reconstruction group. The severe dumping syndrome and reflux esophagitis were found in one of the patients after Billroth I reconstruction, but were not found in PPG group. Statistically, there was no difference in T1/2 between the Billroth I reconstruction group and the PPG group; however, both lag times were longer than that of the normal control group. We also found that the residual food 100 min after oral intake was greater in both the Billroth I reconstruction and the PPG groups than in the normal control group. (Conclusion) Though both PPG and Billroth I reconstruction showed delayed gastric emptying, we found that PPG is superior to Billroth I reconstruction in lag time and in the amount of residual food after 100 min. We conclude that PPG is superior to Billroth I reconstruction in gastric motility, and if this operation is applied in indicated gastric cancer patients, post-operative complications, such as the dumping syndrome and reflux esophagitis can be reduced and the quality of life in post-gastrectomy patients can be increased.
Autonomic Nervous System ; Body Weight ; Dumping Syndrome ; Eggs ; Esophagitis, Peptic ; Gastrectomy ; Gastric Emptying ; Gastritis ; Gastroenterostomy ; Humans ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Mucous Membrane ; Ovum ; Postgastrectomy Syndromes* ; Postoperative Complications ; Pyloric Antrum ; Pylorus ; Quality of Life ; Stomach Neoplasms ; Stomach Ulcer ; Vagus Nerve

Diabetes is a common medical condition in hospitalized patients and is associated with increased requirement for operation and increased postoperative morbidity and mortality. The stress of surgery induces catabolic changes that alter glucose and lipid levels, as well as protein metabolism. Persistent hyperglycemia can lead to ketoacidosis in type I diabetic patients or hyperosmolar syndrome in type 2 diabetic patients. Also, hyperglycemia is a risk factor for endothelial dysfunction, impaired immunity, wound healing and embolism. The ultimate goal in the management of diabetic patients is to optimize glucose control through monitoring, fluid replacement and use of insulin.
Diabetes Mellitus ; Embolism ; Glucose ; Humans ; Hyperglycemia ; Insulin ; Ketosis ; Risk Factors ; Wound Healing

PURPOSE: Prophylactic central compartment node dissection is gaining acceptance in the treatment of papillary thyroid carcinoma (PTC). However, its benefits remain controversial. The aim of study was to evaluate the effects of prophylactic central compartment node dissection on the complication rate and the short-term disease-free survival rate. METHODS: Our treatment strategy for PTC without clinical evidence of lymph node metastasis has been changed from total thyroidectomy alone (group I) to total thyroidectomy with prophylactic central compartment node dissection (group II) since January 2007. Before and after 2007, 70 consecutive patients were selected in each group. RESULTS: The average age of patients was 46.3±11.8 years. Average follow-up period was 51.9±10.9 months. The average size of maximum diameters of the tumors was 1.3±0.8 cm. Lymph node metastasis was identified in 22.9% of patients in group II. Recurrent laryngeal nerve injury occurred in one patient in each group. Temporary and permanent hypoparathyroidism occurred in 32.9% and 2.9% in group I, 40.0% and 7.1% in group II respectively (P=0.483 and P=0.441, respectively). Locoregional recurrences developed in seven patients in group I. Fifty month disease-free survival rate was 90.0% and 100% in group I and group II, respectively (P=0.0078). CONCLUSION: Prophylactic central compartment node dissection did not seem to increase the risk of recurrent laryngeal nerve injury, but may increase the risk of temporary and permanent hypoparathyroidism. Prophylactic central compartment node dissection decreased the risk of locoregional recurrences, especially in central compartment. However, the size of metastatic lymph nodes in central compartment in the present study was relatively small and their clinical implication remains to be evaluated.
Disease-Free Survival ; Follow-Up Studies ; Humans ; Hypoparathyroidism ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Recurrent Laryngeal Nerve Injuries ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

Delayed hypoxic encephalopathy is one of the most important neurologic sequelae in carbon monoxide (CO) poisoning. Regional cerebral blood flow (CBF) of cerebral cortices were measured in five patients with delayed CO encephalo'pathy confirmed by clinical features and magnetic resonance imaging (MRI) and five normal persons using "'Tc-HMPAO SPECT (technetium 99m hexamethylpropylene amine oxide single photon emission computed tomography). For the quantitative analysis, six pairs of region of interest in cerebral cortices and cerebellar hemispheres were determined. Among five regions to cerebellar ratios, those of superior and inferior frontal, parietal, and temporal cortices were significantly reduced (p<005). The degree of reduction in CBF was marked especially in frontal and temporal cortices and similar in both hemispheres. Early scan failed to predict delayed neurologic sequelae in one patient, but follow-up scan was well correlated with clinical improvement in another patient. Diffuse reduction of CBF in cerebral cortices was different from the anatomical MR findings. We think that reduced CBF in cerebral cortices is associated with clinical features of delayed carbon monoxide encephalopathy. Transient vascular mechan' ism or re duced cortical energy metabolism might be the cause of reduced CBF in cerebral cortices.
Carbon Monoxide* ; Carbon* ; Cerebral Cortex ; Energy Metabolism ; Follow-Up Studies ; Humans ; Hypoxia, Brain ; Magnetic Resonance Imaging ; Poisoning ; Rabeprazole ; Tomography, Emission-Computed, Single-Photon

Gastrointestinal duplication is a rare congenital disorder that can occur anywhere along the gastrointestinal tract. The most frequent site of duplication is the mesenteric border of the small intestine. Retroperitoneal duplication cysts are extremely rare. Most duplications are diagnosed in neonates or infants, but rarely preoperatively. By the complete excision of a retroperitoneal duplication cyst, a 26 year old male patient, who had suffered from intermittent severe abdominal pain all his life, was successfully treated. Herein, a case of retroperitoneal duplication cyst is reported, with a review of literature.
Abdominal Pain ; Adult ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Gastrointestinal Tract ; Humans ; Infant ; Infant, Newborn ; Intestine, Small ; Male

OBJECTIVE: Embryonic stem (ES) cells could be differentiated into the specific cell types by alternation of culture condition and modification of gene expression. This study was performed to evaluate the differentiation protocol for mouse and human ES cells to insulin secreting cells. METHODS: Undifferentiated mouse (JH-1) and human (Miz-hES1) ES cells were cultured on STO feeder layer, and embryoid bodies (EBs) were formed by suspension culture. For the differentiation, EBs were cultured by sequential system with three stage protocol. The differentiating ES cells were collected and marker gene expressions were analyzed by semi-quantitative RT-PCR in each stage. Amount of secreted insulin levels in culture media of human ES cells were measured by human insulin specific RIA kit. RESULTS: During the differentiation process of human ES cells, GATA-4, alpha-fetoprotein, glucose transporter-2 and Ngn-3 expression were increased whereas Oct-4 was decreased progressively. Insulin and albumin mRNAs were expressed from stage II in mouse ES cells and from stage III in human ES cells. We detected 3.0~7.9 microU/ml secretion of insulin from differentiated human ES cells by in vitro culture for 36 days. CONCLUSION: The sequential culture system could induce the differentiation of mouse and human ES cells into insulin secreting cells. This is the first report of differentiation of human ES cells into insulin secreting cells by in vitro culture with serum and insulin free medium.
alpha-Fetoproteins ; Animals ; Culture Media ; Embryoid Bodies ; Embryonic Stem Cells* ; Feeder Cells ; Gene Expression ; Glucose ; Humans ; Insulin* ; Insulin-Secreting Cells* ; Mice ; RNA, Messenger

A 45-year-old male visited our clinic due to right palmar anhidrosis and contralateral hyperhidrosis. Chest computed tomography (CT) showed a solitary pulmonary nodule with mediastinal lymph node enlargement, but a cause for atypical palmar anhidrosis was not identified. Subsequent fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed (PET/CT) revealed a localized pleural metastasis at the right apex with direct invasion of the paravertebral sympathetic chain. The pleural metastasis, which was not seen on chest CT, evoked ipsilateral anhidrosis independent of a mass effect or direct invasion by the primary lung tumor. 18F-FDG PET/CT can be helpful in identifying the cause of atypical symptoms in patient with small sized lung cancer.
Adenocarcinoma ; Electrons ; Fluorodeoxyglucose F18 ; Humans ; Hyperhidrosis ; Hypohidrosis ; Lung Neoplasms ; Lung ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Solitary Pulmonary Nodule ; Thorax ; Tomography, X-Ray Computed