The use of isolated intestinal segments is currently the best method of augmenling bladder capacity. Pedicled segments of ileum and colon used in lower urinary tract reconstruction retain their normal neurovascular input and might be expected to retain their physiological function despite their new anatomical situation. The mucus secreted mostly by goblet cells in the grafted intestinal mucosa elicits various problems in patient management. This study was attempted to evaluate the effect of octreotide, a long-acting somatostatin analogue on the mucosal secretion. The animals, weighing 250-320gm, were divided into 2 groups: control group, in which only ileocystoplasty was done, and octreotide injection group after ileocystoplasty. Oclreolide was injected daily S.C. 0.002 micrometer/gm after posloperalive 1 week. Cystectomies were performed at postoperative 1. 2, 3, 4 weeks. Histopathologic examination of the ileocystoplasty specimens was done by light microscopy after PAS reaction. 24-hour urine was collected for each rat weekly and then the amount of lyophilized dry mucus in urine was measured. The number of goblet cells within 10(3) micrometer2 of mucosal epithelium in the grafted ileal segments were evaluated by morphometric analysis using an image analyzer. The results were as follows: 1. Microscopically, transitional epithelium extended well over the intestinal mucosa through the anastomotic site at both 4 weeks groups. 2. The amount of urinary lyophilized dry mucus at control group was increased at postoperative 2. 3 weeks (64.2 mg, 67.7 mg) and decreased at 4 weeks (32.7 mg). After octreotide injection, the amount of lyophilized dry mucus significantly decreased when compared with the control group at 2, 3 weeks (15.2 mg, 18.9 mg, p<0.01) 3. The number of goblet cells within 10(3) micrometer2 of mucosal epithelium in control group was increased at 2. 3 weeks after operation (1.94+/-0.31, 2.19+/-0.36) and decreased at 4 weeks (1.61+/-0.25). After octreotide injection. The number of goblel cells significantly decreased when compared with the control group at 2, 3 weeks (1.28+/-0.36, 1.54+/-0.26, p<0.01). These results suggest that octreotide may be effect on the reduction of mucosal secretion after ileocystoplasty. Further investigation using this method will be needed for clinical application.
Animals ; Colon ; Cystectomy ; Epithelium ; Goblet Cells ; Humans ; Ileum ; Intestinal Mucosa ; Microscopy ; Mucus ; Octreotide* ; Periodic Acid-Schiff Reaction ; Rats* ; Somatostatin* ; Transplants ; Urinary Bladder ; Urinary Tract

From October, 1984 to December, 1988, 1177 cases of posterior chamber lens were implanted. Clinical study was done on 1030 cases which could be followed up for more than 2 months. The results were as follows: 1. The best corrected visual acuity of 0.5 or better was in 981 cases(95.2%) and 1.0 or better was in 676 cases(65.6%). 2. the best corrected visual acuity was achieved with the correction of average -1.07 +/- 1.28D by spherical equivalent. 3. The postoperative astigmatism was average 1.57 +/- 1.70D. 4. The difference between the calculated prediction of postoperative refraction and the actual postoperative refraction was less than 1.00D in 64.1% and calculated prediction tended to be biased toward hypermetropia with mean error of 0.37 +/- 1.21D.
Astigmatism ; Bias (Epidemiology) ; Hyperopia ; Visual Acuity

Video-assisted thoracoscopic surgery has recently evolved as an alternative to thoracotomy for several thoracic disorders. Today it is viewed as a sparing and safe alternative to thoracotomy for a wide spectrum of indication. Using video-assisted operative thoracoscopy, we operated on 33 patients during the 2 years of our experience from June 1993 to June 1995. They were diagnosed as recurrent pneumothorax in 16, visible bulla on X-ray in 6, prolonged air leakage (longer than 7days) in 4, bilataral pneumothorax in 3, hyperhidrosis in 2, previous contralateral pneumothorax in 1, primary hemopneumothorax 1. The average duration of chest tube placement was 2.1+/-0.4 days. The mean postoperative hospital stay was 3.4+/-0.6 days. The complication was persistent air leakage (longer than 48 hours) in 3 case. Video-assisted thoracic surgery is safe, decreased pain, and shortens hospital stay.
Chest Tubes ; Hemopneumothorax ; Humans ; Hyperhidrosis ; Length of Stay ; Pneumothorax ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Thoracotomy

BACKGROUND: The aim of the current study was to analyze the early and intermediate-term performance of aortic valve replacement. MATERIAL AND METHOD: Between January 1986 and January 1996, records of 61 consecutive patients who had received aortic valve replacement were reviewed. 38 were male and 23 were female patients, ranging from 10 to 71 years of age (mean: 40.5+/-11.2). RESULTS: The early death rate was 4.9% (3/61). A thorough follow-up rate of 93.1% was accomplished in these 58 patients who left the hospital (mean: 51.5+/-32.0 patient-months) under the assistance of the same operator. Three of these patients who left the hospital died. The late death rate was 5.2% (3/58). Five patients experienced anticoagulant-related hemorrhage (all were minor). Three patients had thromboembolic episodes. There was no clinical evidence of hemolysis and structural failure of valves used. Of those patients who survived, the NYHA functional class improved significantly. Linearized rate were 1.58%/patient-year and 2.0%/patient-year respectively for thromboembolism and anticoagulant-related hemorrhage. The 10 year actuarial survival rate was 83.6%. CONCLUSION: This early and intermediate-term follow-up suggests that the mechanical valve is a reliable and durable prosthesis with good hemodynamic function and low rate of prosthesis-related complication.
Aortic Valve* ; Female ; Follow-Up Studies ; Hemodynamics ; Hemolysis ; Hemorrhage ; Humans ; Male ; Mortality ; Postoperative Complications ; Prostheses and Implants ; Survival Rate ; Thromboembolism

Neurilemmoma is wel1 encapsulated tumor of Schwann cell origin. It is more often solid than cystic and. usually solitary and may be benign. The treatment is surgical excision. We report a 42-year-old man hospitalized with complaints of RUQ pain and palpable mass. There was no endocrinological abnormality. Ultrasonography, computerized tomography and angiography revealed right huge extrarenal mass without metastatic evidence. The patient underwent surgical excision.
Adult ; Angiography ; Humans ; Neurilemmoma* ; Ultrasonography

Collecting duct carcinoma is an unusual variant of renal cell carcinoma, which is originated from the collecting tubules of the kidney. The typical histological appearance is that of a papillary adenocarcinoma with infiltrating tubules and desmoplastic reaction. And there is mainly tubulo-papillary. structure in histologic examination. We report a case of collecting duct carcinoma of kidney in a 47 years old female, which was managed by radical nephrectomy.
Adenocarcinoma, Papillary ; Carcinoma, Renal Cell* ; Female ; Humans ; Kidney ; Middle Aged ; Nephrectomy

Purpose: Early recurrence of hepatocellular carcinoma (HCC) remains a challenging issue after hepatic resection (HR) because of the associated poor prognosis. Models for tumor recurrence after liver transplantation (MoRAL) have been designed to predict tumor recurrence in HCC patients in the liver transplantation setting. This study aimed to validate the predictability of MoRAL for HCC recurrence or patient death and to evaluate the predictors of early HCC recurrence in hepatectomy patients with treatment-naïve solitary HCC. Methods: This study included 443 patients with HCC recurrence after HR from January 2005 to December 2011. Patients were stratified into early recurrence (n = 312) and late recurrence (n = 131) groups according to the development of recurrence either within or more than 2 years after hepatectomy. Results: The median levels of alpha-fetoprotein and protein induced by vitamin K absence-II and the median MoRAL score were significantly higher in the early recurrence group than in the late recurrence group. Regarding pathologic characteristics, the median tumor size, prevalence of tumor grade 3 or 4, microvascular invasion, presence of tumor necrosis, and macrovascular invasion in the early recurrence group were greater than those in the late recurrence group.Multivariate analysis showed that tumor grade 3 or 4, microvascular invasion, and high preoperative MoRAL score were predisposing factors for early HCC recurrence after HR. Conclusion The MoRAL score can be used to predict early recurrence in patients with HCC who undergo curative HR.Using this model, other treatments could be considered for patients with early recurrence predicted after HR.

BACKGROUND: We addressed the problem of the circadian changes in neural control of the circulation in ambulant hypertensive subjects. With spectral analysis of heart rate variability the tonic sympathetic and vagal activities and their changes are respectively assessed by the power of 0.050 - 0.015Hz(low frequency, LF) and 0.150 - 0.350Hz(respiratory linked, high frequency, HF) components of the spectrum of the beat by beat variability of RR interval. METHODS: Heart rate variability(HRV) and its circadian rhythm were evaluated in 15 patients with hypertension. By using 24-h Holter monitoring, HRV and its spectral components were measured. Finding were compared with 15 age-matched normal controls. RESULTS: The 24-hour plot of the SDs revealed that heart rate variability was significantly lower in the hypertensive patients, and the differences reached statistical significance during hours 2, 3, 9, 13, 16, 18, 19, and 23(p<0.05). Spectral analysis showed that power in the high-frequency range(0.150 to 0.350Hz) was lower among the hypertensive patients than among the normal controls during 22 of 24 hours but that the difference was statistically significant only during 2 hours(p<0.05). Power in the low frequency range(0.050 to 0.150Hz) was low at night, increased in the morning, and high during the day among controls ; this circadian rhythm was absent among hypertensive patients. CONCLUSIONS: Among hypertensive patients, HRV is decreased with a partial withdrawal of parasympathetic tone, and the circadian rhythm of sympathetic/parasympathetic tone is altered.
Circadian Rhythm ; Electrocardiography, Ambulatory ; Heart Rate ; Humans ; Hypertension

BACKGROUND AND OBJECTIVES: Effective myocardial reperfusion following primary percutaneous coronary intervention for AMI, in lesions with a thrombus, is limited by distal embolization and slow/no reflow phenomenon. We evaluated the safety and efficacy of a thrombus reduction technique, using the export aspiration catheter for thrombosuction prior to primary PCI for AMI. SUBJECTS AND METHODS: We analyzed 61 AMI patients who had a thrombus burden on angiography, after having undergone primary PCI, either with or without EAC (EAC group; n=31, 24 males, mean ages 54.7+/-11.8 years)(control group; n=31, 20 males, mean ages 65.5+/-12.2 years). After the primary PCI, the angiographic findings and clinical outcomes at 1 and 6 months were recorded. RESULTS: The procedural and angiographic success rates were 100 (31/31) and 93.5 (29/31), and 100 (31/31) and 87.1% (27/31), respectively. After PCI, the recovery rate to TIMI 3 flow was higher in the EAC than the control group (26/31 vs. 20/31, p<0.05), and the corrected TIMI frame count was less in the EAC than the control group (23.9+/-15.1 vs. 34.8+/-22.5, p<0.05). However, there were no different in the TIMI perfusion grade between the two groups. Although there was no statistical significance, distal embolization was more commonly observed in control (16.1%, 5/31) than the EAC group (0/31)(p=0.056). There were no differences in the incidences of MACE at 1 (0 vs. 7.7%, p=0.237) and 6 months (6.9 vs. 0%, p=0.500) between two groups. In the 31 patients who underwent successful thrombosuction, gross thrombi were obtained from 25 (80.6%). CONCLUSION: In AMI, the use of thrombosuction, with EAC prior to PCI, provides a simple, rapid and potentially effective method for removal of the thrombus burden and restoration of coronary flow.
Angiography ; Catheters* ; Humans ; Incidence ; Male ; Myocardial Infarction* ; Myocardial Reperfusion ; Percutaneous Coronary Intervention* ; Perfusion ; Thrombosis