PURPOSE: Lymph node analysis is essential for staging colorectal cancer. Intraoperative lymphatic mapping and sentinel lymphadenectomy remain to be investigated for most gastrointestinal neoplasms. Previous attempts to identify the sentinel node (SN) in solid tumors have used intraoperative techniques. This study describes a novel approach to identify the SN in colorectal cancer using ex vivo lymphatic mapping. METHODS: Eighty-two colorectal cancer patients underwent ex vivo lymphatic mapping and a sentinel lymph node biopsy using isosulfan blue dye following a standard surgical resection between March 2002 and September 2003. Within 5 minutes of resection, colorectal specimens were submucosally injected with isosulfan blue dye in four quadrants. Blue lymphatic channels were identified in the mesentery, and followed to the blue-stained SN(s), which were har vested. The specimens were fixed in formalin and subsequently analyzed in the usual fashion. In patients with T1 or T2 tumors, which were blue-stained nodes, but negative to hematoxylin and eosin staining, were further analyzed by serial section and immunohistochemical staining (IHC). RESULTS: At least one SN was identified in 79 patients of the 82 patients (96.3%). The average number of SNs identified per patient and nodes in each colorectal cancer specimen were 3 (range, 1~7) and 17.1 (range: 11~47). Thirty five patients had lymph nodes containing a metastatic disease. Thirteen patients had metastases in both sentinel and nonsentinel nodes. There were 7 sentinel lymph nodes as the only site of metastatic disease. In 15 patients the sentinel nodes were negative for disease, whereas the nonsentinel lymph nodes contained a metastatic disease (false negative rate = 42.9%). The false negative rates of SN(s) metastasis in the 26 patients with T1 or T2 tumors were 16.7 and 7.7% by H&E and by serial section and IHC. CONCLUSION: Ex vivo mapping of the colon is technically feasible, and may provide a useful approach to evaluate lymph node metastasis in patient with T1 or T2 colorectal cancers.
Colon ; Colorectal Neoplasms* ; Eosine Yellowish-(YS) ; Formaldehyde ; Gastrointestinal Neoplasms ; Hematoxylin ; Humans ; Lymph Node Excision ; Lymph Nodes ; Mesentery ; Neoplasm Metastasis ; Sentinel Lymph Node Biopsy

BACKGROUND: The aim of this study was to compare the efficacy of ketorolac, paracetamol, and paracetamol plus morphine on pain relief after thyroidectomy. METHODS: Eighty patients were randomly allocated to one of the 4 groups: normal saline (group C), ketorolac 30 mg (group K), paracetamol 1 g (group P), and paracetamol 700 mg plus morphine 3 mg (group PM). Each regimen was administered intravenously (IV) 30 min. before the end of surgery. If pain was not relieved, patients received an IV bolus of pethidine hydrochloride 25 mg. Pain intensity using a visual analogue scale (VAS) was recorded at 0.5, 1, 2, 4, and 6 hr after the end of surgery. RESULTS: VAS at 0.5 and 1 hr after the end of surgery were significantly lower in group K, group P, and group PM than in group C (P < 0.05). The number of patients receiving pethidine hydrochloride at 0.5 and 1 hr after the end of surgery was significantly lower in group K, group P, and group PM than in group C (P < 0.05). There was no significant difference among the groups in the incidences of adverse events associated with study medications and patient satisfaction (P > 0.05). CONCLUSIONS: Paracetamol 1 g IV possesses a similar analgesic efficacy to ketorolac 30 mg IV after thyroidectomy. Paracetamol may represent an alternative to ketorolac for pain prevention after mildly to moderately painful surgery in situations where the use of NSAIDs is unsuitable.
Acetaminophen ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal ; Humans ; Incidence ; Ketorolac ; Meperidine ; Morphine ; Patient Satisfaction ; Thyroidectomy

PURPOSE: To determine the long-term follow-up CT findings of paraquat-induced lung injury. MATERIALS AND METHODS: Six patients who ingested paraquat underwent sequential follow-up CT scanning during a period of at least six months, and the results were analysed. Scans were obtained 1-6 (mean, 3.3) time during a 7-84 (mean, 25.7) months period, and the findings at 1-2 months, 3-12 months, 1-2 years, 2-3 years, and more than above 7 years after poisoning were analyzed. RESULTS: We observed irregular-shaped areas of consolidation with traction bronchiectasis at 1-2 months (5/5), irregular-shaped consolidation and ground-glass opacity (5/5) at 3-12 months, and irregular-shaped consolidations/ ground-glass opacity (4/5) and focal honeycombing (1/5) one year later. In the same patients, follow-up CT scans showed that some areas of focal consolidation could not be visualized and the radio-opacity of the lesions had decreased. CONCLUSION: The HRCT findings of paraquat-induced lung injury were irregular shaped areas of consolidation 1-2 months after ingestion, and irregular-shaped consolidation and ground-glass opacity or focal honeycombing 3-12 months later. At this thim slight improvement was observed.
Bronchiectasis ; Eating ; Follow-Up Studies* ; Humans ; Lung Injury* ; Lung* ; Paraquat* ; Poisoning ; Tomography, X-Ray Computed ; Traction

One hundred seven isolates of Staphylococcus aureus from bovine mastitis were investigated for colony morphology in serum-soft agar (SSA), autoagglutination in salt, and capsular serotype. Capsular polysaccharide (CP) was purified and quantified from the extracts of clinical isolates. Overall, 89 isolates (83.2%) were diffuse in the SSA, without any difference in the proportion of diffuse colony between type 5 and type 8 strains. Some strains exhibited compact colonies in the SSA and expressed CP as determined by an enzyme-linked immunosorbent assay, indicating that compact morphology does not exclude encapsulation. The majority of the strains (11/12) showed autoagglutination in the salt aggregation test. The serotype 336 accounted for 46.7% of the isolates followed by serotype 5 (12.1%) and serotype 8 (12.1%). Particularly, twenty-six (24.3%) isolates reacted with two serotypes; 7 for type 8/336 and 19 for type 5/336. Five isolates (4.7%) were nontypeable with monoclonal antibodies specific for CP serotype 5, 8, or 336. The CP concentration in culture supernatants varied with the serotypes, and the total amount of CP produced by cells grown in a liquid medium was much less than that produced by cells grown on a solid medium. The Western blotting indicated that the CP bands of S. aureus serotype 5 and 8 were ranged in the molecular mass of 58-84 kilodalton (kDa), with additional bands in the region of approximately >or= 48 or Agglutination Tests ; Animals ; Bacterial Vaccines/administration & dosage ; Cattle ; Cattle Diseases/immunology/microbiology ; Female ; Mastitis, Bovine/*microbiology ; Polysaccharides, Bacterial/*classification/isolation & purification ; Serotyping/methods/veterinary ; Staphylococcal Infections/immunology/*veterinary ; Staphylococcus aureus/*classification/*immunology/isolation & purification

In carpal injury, a good functional end result seems to correlate with final anatomic alignment of carpus after treatment. Some cases are often misdiagnosed and result in inadequate treatment. Forty six cases of carpal injuries were analysed which were treated for 9 years from 1975 to 1984 at the Department of Orthopedic Surgery, Seoul National University Hospital. The observations can be summarized as follows. 1. The male to female ratio was 3.5: 1 and 82% of total cases were in the third and fourth decades. 2. The most frequent cause of injury was fall from height with outstretched hand. 3. Trans-scaphoid perilunar dislocation and its variant were the most common diagnosis in this analysis. 4. All of the scapho-lunate dissociation showed volar flexion intercalated segmental instability with scapho-lunate gap more than 2 mm in our series. 5. In 11 cases of trans-scaphoid perilunar dislocation and its variant, carpal collapse was found in 10 cases. In 5 cases dorsiflexion intercalated segmental instability pattern and in one case volar flexion intercalated segmental instability pattern were found to be present. 6, There was an increase in scapho-lunate angle in all cases of dorsiflexion intercalated segmental instability, but a decrease in scapho-lunate angle is not a consistent finding in volar flexion intercalated segmental instability. 7. In 24 cases more than 6 months follow-up, excellent and good results were obtained in 20 cases. 8. As a result of above findings, authors conclude that scapho-lunate gap more than 2mm has diagnostic value in scapho-lunate dissociation but that dorsiflexion intercalated segmental instability or volar flexion intercalated segmental instability only means the changes in the relationship between carpal bones and does not have definite or specific diagnostic value for a specific carpal injury.
Carpal Bones ; Diagnosis ; Dislocations ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Orthopedics ; Seoul ; Wrist

Fine needle aspiration cytology (FNAC) is an easy convenient non-invasive method in the diagnosis of superficial palpable masses. The cytologic findings by FNAC of reactive and neoplastic lesions in various organs including breast, lymph node, thyroid, salivary gland, etc., have been described, but, those of soft tissue lesions including proliferative fasciitis are relatively rare to find. We recently experienced a case of FNAC of proliferative fasciitis in the left back of a 72-year-old male. The FNAC smears were scant in cellularity and contained large cells with abundant basophilic cytoplasm, one to two nuclei lying at the periphery, and prominent nucleoli that resemble ganglion cells.
Aged ; Basophils ; Biopsy, Fine-Needle* ; Breast ; Cytoplasm ; Deception ; Diagnosis ; Fasciitis* ; Ganglion Cysts ; Humans ; Lymph Nodes ; Male ; Salivary Glands ; Thyroid Gland

No abstract available.
Atrial Natriuretic Factor* ; Humans* ; Lymph Nodes* ; Polymerase Chain Reaction*

No abstract available.
Catecholamines* ; Female ; Labor Stage, Second* ; Parturition* ; Plasma* ; Pregnancy ; Supine Position*

Basically laboratory vestibular function testing use the vestibular ocular reflex and vestibular spinal reflex like as bedside examination or outpatients' evaluation. Such vestibular laboratory testing can aid diagnosis and can be used to document an abnormality suspected at bedside evaluation. The ability to perform serial vestibular evaluations allows an assessment over time of patients who are undergoing treatment for dizziness or treatment with potentially ototoxic medication. Generally speaking, it includes spontaneous nystagmus, some kinds of evoked nystagmus, ocular eye movement testing, Caloric's testing, rotational chair testing, vestibular evoked myogenic potential, subjective visual vertical, posturography and so on. Those testing have been developed with biomedical engineering based on the proven scientific facts together.
Biomedical Engineering ; Dizziness ; Eye Movements ; Humans ; Reflex ; Vestibular Function Tests

PURPOSE: Some authors noted unilateral testicular torsion often leading to a damage in the contralateral testis. But it is not known whether this is the result of an intrinsic abnormality in the remaining testis or testicular injury associated with the ischemic event. Recently some authors noted an increase in germ cell apoptosis in the contralateral testis and suggested the involvement of nitric oxide (NO) in the apoptosis of germ cells. We aimed at the NO involvement in testicular torsion in this study, in which we measured inducible nitric oxide synthase (iNOS) expressions and found pathological changes in the torsed and detorsed testes of the rats. MATERIALS AND METHODS: Adult, male, Sprague-Dawley rats were divided into two groups: I) unilateral left testicular torsion persisting for 1, 4, 8 hours. II) torsion for 4 or 8 hours followed by detorsion. Testes were fixed in scrotal wall with a suture. Testes were fixed in formalin solution and prepared in paraffin blocks and slide mounted. All histologic examinations were done by a single observer. The expression of iNOS gene in the testis was determined by reverse transcriptase-polymerase chain reaction and relative iNOS mRNA levels were assessed with normalization to beta-actin mRNA levels. RESULTS: Histologically, the degeneration and inflammation were found in 4 hours after torsion and the necrosis was found in 8 hours after torsion. In contralateral testis, normal findings were noted in 4 hours and 8 hours after torsion. iNOS gene expression was found in the normal control testis. In the torsed testis, iNOS gene expression significantly increased in 1 hour after torsion, then decreased to the control level. In contralateral testis, iNOS gene expression was also increased in 1 hour to 8 hours after torsion. After detorsion, iNOS gene expression significantly decreased in detorsed testis, but constantly increased in contralateral testis. CONCLUSIONS: In rats, iNOS gene expression and histological changes were observed in torsed and detorsed testes. These results support the hypothesis that NO by iNOS protein may play a role in contralateral testicular damage, such as ischemic-reperfusion injury.
Actins ; Adult ; Animals ; Apoptosis ; Formaldehyde ; Gene Expression ; Germ Cells ; Humans ; Inflammation ; Male ; Necrosis ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Paraffin ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Spermatic Cord Torsion ; Sutures ; Testis*