No abstract available.
Twins, Conjoined*

No abstract available.
Bile Ducts* ; Bile* ; Cholecystectomy*

BACKGROUND: Various combinations of treatment modalities have been reported in stage III non-small cell lung cancer (NSCLC), however, the standard treatment modality has not established yet. Recently, the efficacy of concurrent chemotherapy and radiation therapy has been reported in locally advanced lung cancer. We evaluate the response rate, toxicity, arid survival of concurrent chemotherapy with etoposide and cisplatin(EP) arid radiation therapy for unresectable stage III NSCLC. METHODS: Between October 1995 and December 1996, 32 patients with histologically proven unresectable stage III NSCLC without, malignant pleural effusion were entered into this study. Twenty-nine patients were eligible for the response, survival, and toxicity analysis. Induction was two cycles of chemotherapy with etoposide arid cisplatin plus concurrent chest RT to 4500cGy. Resection was attempted if the clinical response offered surgical resectability. Boost radiation therapy upto 5940cGy and one cycle of EP were performed if the disease were stable or responsive but still unresectable. RESULTS: Of 29 eligible patients, 22(75.9%) showed partial response(PR). The progression free interval was 6.3months(range 1.1 to 19.5months). Surgical resection was performed in one patient The median survival was l2.1months and one-year survival rate was 50.6%. The major toxicity was leukopenia(> or = grade 3,46%) Thrombocytopenia over grade 3 was found in 1%. Radiation pneumonitis occurred in 13 patients(46%). CONCLUSION: Concurrent chemotherapy(EP) pins radiotherapy was effective and tolerable in the treatment of unresectable stage III NSCLC.
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy* ; Etoposide* ; Humans ; Lung Neoplasms ; Pleural Effusion, Malignant ; Radiation Pneumonitis ; Radiotherapy ; Survival Rate ; Thorax ; Thrombocytopenia

PURPOSE: The purpose of this study is to evaluate the surgical outcomes of the clavicle lateral end fracture fixed with an oblique T locking compression plate (LCP). MATERIALS AND METHODS: Fourteen clavicle lateral end fractures were fixed with the oblique T-LCP and followed up for at least 1 year after the surgery. Thirteen cases were unstable Neer type II fractures and one case was nonunion of the Neer type I fracture. The mean age was 46 years of age (range, 26~70). In ten cases, augmenting sutures with the absorbable suture material were placed in the coraco-clavicular ligament and around the plate and the clavicle to improve the stability of fracture fixation. Autogenous iliac bone graft was done in four cases. The clinical outcomes were evaluated by using UCLA scoring system and KSS (Korean Shoulder Score). RESULTS: The mean UCLA score was 33.5 and the mean KSS was 94.9. Average time of bone union was 11.9 weeks (range, 6~28), including 1 case with a delayed union. There was no complication such as loss of fixation or nonunion. CONCLUSION: Fixation with the oblique T-LCP is a good option providing reliable functional results in clavicle lateral end fractures.
Clavicle ; Fracture Fixation ; Ligaments ; Shoulder ; Sutures ; Transplants

No abstract available.
Small Cell Lung Carcinoma*

OBJECTIVE: To compare the clinical outcomes of patients with vitrified-thawed embryos transferred using either the 0.25 mL straw method and the pull and cut straw (PNC) method. To evaluate the clinical outcomes of patients with transferred embryos that underwent assisted hatching at the cleaved embryo (day 3) or the blastocyst (day 5) stage. METHODS: The study population consisted of women who underwent vitrified-warmed embryo transfer between May 2000 and December 2011 and assisted hatching was performed after warming of embryos. Cycles of thawing between assisted hatching treated and non treated groups were compared for survival and pregnancy rates. RESULTS: The PNC vitrification method improved survival and pregnancy rates in partial lysed embryos. While assisted hatching did not affect the developmental and clinical pregnancy rates of the vitrified-warmed blastocyst group, it did increase the pregnancy rate of poor quality vitrified-warmed cleaved embryos. CONCLUSION: These results suggest that PNC may increase the number of clinical pregnancies via the vitrification of both cleaved embryos and blastocysts. In addition, selective assisted hatching treatment of embryos that show a poor prognosis after warming may increase the rate of clinical pregnancy.
Blastocyst ; Embryo Transfer ; Embryonic Structures ; Female ; Humans ; Pregnancy ; Pregnancy Rate ; Prognosis ; Vitrification

Placement of the self-expandable metallic stents for palliative treatment of malignant esophagogastric strictures has been thought to be easy, fast and effective method than conventional methods (bypass procedures, radiation therapy, laser treatment, esophageal intubation, etc.). The expandable metallic stent tubes were found to overcome some of the limitations of nonexpandable conventional tubes. Their implantation is better tolerated and safer than that of nonexpandable tubes, because the risks of migration and perforation are lower.On our knowledge, there has been no report of pyloric obstruction after this metallic stent insertion.We hereby report a case of pyloric obstruction caused by a migrated self-expandable metallic stent for palliative treatment of malignant esophageal stricture.
Constriction, Pathologic ; Deglutition Disorders* ; Esophageal Neoplasms ; Esophageal Stenosis ; Intubation ; Laser Therapy ; Palliative Care ; Stents*

A reninoma is an uncommon, benign, renin-secreting juxtaglomerular cell tumor that causes secondary hypertension in young patients. This hypertension is treated by tumor resection. Except for increased levels of plasma renin and angiotensin I and II, the other physical and laboratory examinations and electrocardiographs were within normal limits upon admission of a 19-year-old woman with a reninoma. For percutaneous computed tomography-guided radiofrequency ablation, general anesthesia was induced by thiopental sodium and rocuronium bromide and maintained with servoflurane (2-4 vol%) and oxygen. The operation ended uneventfully in hemodynamic stability. However, the patient complained of dizziness while sitting 5 hours after the operation, and hypotension was diagnosed. After aggressive normal saline (1 L) infusion over 30 min, the hypotension was corrected and the patient recovered without any other surgical complications. Here, we report the anesthetic management of a patient who underwent percutaneous computed tomography-guided radiofrequency ablation for reninoma destruction, particularly focusing on postoperative hypotension.
Anesthesia, General ; Angiotensin I ; Catheter Ablation* ; Dizziness ; Electrocardiography ; Female ; Hemodynamics ; Humans ; Hypertension ; Hypotension ; Oxygen ; Plasma ; Renin ; Thiopental ; Young Adult

Acromegaly is a chronic, debilitating condition caused by excessive secretion of growth hormone (GH). Impaired glucose tolerance is present in about 20-40% of acromegaly, with diabetes mellitus developing in about 10~15% of patients, but diabetic ketoacidosis is a rare association. Herein is reported a case of diabetic ketoacidosis in a 33 year-old female, with a 4 year history of typical acromegaly features. She presented with severe hyperglycemia and ketoacidosis, but with no other cause for this metabolic derangement. She had elevated plasma GH (50 ng/mL) and IGF-1 (1533 ng/mL) levels, and a pituitary macroadenoma. About 200 units of insulin per day were required for her glycemic control. However, the serum IGF-1 level and daily insulin requirement were significantly tapered after a transsphenoidal adenomectomy and long acting somatostatin analogue treatment. There was a good correlation with the daily insulin requirement and plasma IGF-1 level. This case demonstrates that severe GH excess can cause diabetic ketoacidosis, and that its successful treatment improves glucose metabolism.
Acromegaly* ; Adult ; Diabetes Mellitus ; Diabetic Ketoacidosis* ; Female ; Glucose ; Growth Hormone ; Humans ; Hyperglycemia ; Insulin ; Insulin Resistance ; Insulin-Like Growth Factor I ; Ketosis ; Metabolism ; Plasma ; Somatostatin

Acromegaly is a chronic, debilitating condition caused by excessive secretion of growth hormone (GH). Impaired glucose tolerance is present in about 20-40% of acromegaly, with diabetes mellitus developing in about 10~15% of patients, but diabetic ketoacidosis is a rare association. Herein is reported a case of diabetic ketoacidosis in a 33 year-old female, with a 4 year history of typical acromegaly features. She presented with severe hyperglycemia and ketoacidosis, but with no other cause for this metabolic derangement. She had elevated plasma GH (50 ng/mL) and IGF-1 (1533 ng/mL) levels, and a pituitary macroadenoma. About 200 units of insulin per day were required for her glycemic control. However, the serum IGF-1 level and daily insulin requirement were significantly tapered after a transsphenoidal adenomectomy and long acting somatostatin analogue treatment. There was a good correlation with the daily insulin requirement and plasma IGF-1 level. This case demonstrates that severe GH excess can cause diabetic ketoacidosis, and that its successful treatment improves glucose metabolism.
Acromegaly* ; Adult ; Diabetes Mellitus ; Diabetic Ketoacidosis* ; Female ; Glucose ; Growth Hormone ; Humans ; Hyperglycemia ; Insulin ; Insulin Resistance ; Insulin-Like Growth Factor I ; Ketosis ; Metabolism ; Plasma ; Somatostatin