BACKGROUND: Exogenously administered epinephrine under enflurane anesthesia was known to have mild myocardial sensitizing effect. And N2O activates the sympathetic nervous system mildly. We planed this study to confirm cadiovascular effects of clinically administered epinephrine for hemostasis under the enflurane-N2O anesthesia during tonsillectomy. METHODS: Eighty children scheduled to have tonsillectomy were selected randomly and divided into 2 groups as follows; Group E: 1:100,000 epinephrine 2ug/kg and Group EL: 1:100,000 epinephrine containing 1% lidocaine 2 g/kg. Blood pressure, heart rate, and the occurrence of arrhythmia were evaluated before injection, at injection, 1 min, 2 min, 3 min, 5 min and 10 min after injection and 1 min after operation start. RESULTS: In both groups, systolic and diastolic blood pressure and heart rate are increased. But there are no significant statistical differences in each group and between groups. One min after operation, there are significant increases in systolic and diastolic blood pressure and heart rate in both groups (p<0.05), but there is no significant difference between groups. CONCLUSION: Under the enflurane-N2O anesthesia of children, 1:100,000 epinephrine 2ug/kg used for hemostasis could be used comparatively safe without any significant hemodynamic changes. But because there is always the possibility of myocardial sensitization, careful observation is necessary during epinephrine injection under the enflurane-N2O anesthesia.
Anesthesia* ; Arrhythmias, Cardiac ; Blood Pressure ; Child ; Enflurane ; Epinephrine* ; Heart Rate ; Hemodynamics ; Hemostasis* ; Humans ; Lidocaine ; Sympathetic Nervous System ; Tonsillectomy*

We report the case of a 42- year-old woman with spontaneous, right vertebral arteriovenous fistula associated with neurofibromatosis type 1. The patient presented with neck pain, retroauricular bruit, quadriparesis, and cervical spinal cord compression caused by an enlarged epidural vein. Endovascular treatment using coils and a balloon resulted in successful occlusion of the fistula. At six months post-embolization, the patient had improved significantly and was ambulant with support.
Arteriovenous Fistula ; Female ; Fistula ; Humans ; Neck Pain ; Neurofibromatoses ; Neurofibromatosis 1 ; Quadriplegia ; Spinal Cord Compression ; Veins

The malignant schwannoma is the primary malignant tumor, which originating from the schwann cell. The incidence is markedly rare. This malignancy is not uncommonly accompanied by von Recklinghausen's disease with the worse prognosis. Although lung is the common site of the distant metastasis, bone metastasis is extremely rare. Histologically this malignancy is composed mainly of spindle cells, but occasionally the rare type, called malignant epitheloid schwannoma, which is composed of many epitheloid cells and scant spindle cells, is found as in this case. It is difficult to differentiate the malignant epitheloid schwannoma with the amelanotic melanoma histologically. The authors have experienced one case (16 years old female) of malignant epitheloid schwannoma originating from the scalp on the occipital area and metastasizing to the proximal part of the right humerus.
Humerus ; Incidence ; Lung ; Melanoma, Amelanotic ; Neoplasm Metastasis ; Neurilemmoma ; Neurofibromatosis 1 ; Prognosis ; Scalp

No abstract available.
Acid-Base Equilibrium* ; Acidosis*

BACKGROUND: Tamoxifen (TAM) inhibits the action of estrogen by binding to estrogen receptors, and also has non-estrogen receptor mediated cytostatic activities. Transforming growth factor-1 (TGF-1) inhibits the proliferation of many other cell types, such as epithelial, hematopoietic and endothelial cells. METHODS: We investigated the effects of tamoxifen on the growth of 7,12-dimethylbenz(a)anthracene (DMBA)-induced rat mammary tumors and the expression of cyclin D1, cyclin E, p21Cip1, and p27Kip1 by performing immunohistochemistry and Western blot analysis, and studied whether TGF-1 injection amplified the effects of TAM. When tumor size reached between 10-15 mm in the largest dimension, the rats were divided into 3 groups: DMBA-control group (n=12), DMBA-TAM group (n=14) and DMBA-TAM plus TGF-1 group (n=5). RESULTS: The consecutive administration of TAM markedly decreased the tumor development compared with the DMBA-control group. The DMBA-TAM and DMBA-TAM plus TGF-1 groups showed decreased expression of bromodexoyuridine, cyclin D1, cyclin E, and p21Cip1 when compared with those of the DMBA-control group. On the other hand, the labeling index of p27Kip1 was higher in the DMBA-TAM plus TGF-1 group than in the DMBA-control group. CONCLUSION: TAM suppresses tumor development, which may be associated with down-expression of cyclin D1 and cyclin E, and overexpression of p27Kip1, and addition of TGF-1 does not influence tumor development treated by TAM.
Animals ; Blotting, Western ; Breast ; Cell Cycle ; Cyclin D1* ; Cyclin E* ; Cyclins* ; Endothelial Cells ; Estrogens ; Hand ; Immunohistochemistry ; Rats* ; Receptors, Estrogen ; Robenidine ; Tamoxifen* ; Transforming Growth Factor beta

Neurogenic pulmonary edema (NPE) occurs in association with CNS lesions and in the absence of underlying cardiopulmonary disease. The dramatic increase in intracranial pressure (ICP) that follows aneurysmal rupture appears to trigger a massive autonomic discharge which causes virtually instantaneous circulatory adjustments i.e. NPE. When we anesthetize a cerebral aneurysmal patient combined with NPE, not only is there the risk of hypoxemia due to NPE, but also we have difficulty in managing to control hemodynamics and hypervolemia. As we experienced a cerebral aneurysmal patient combined with NPE, we report this case with a review of the literature.
Aneurysm ; Anoxia ; Hemodynamics ; Humans ; Intracranial Aneurysm* ; Intracranial Pressure ; Pulmonary Edema* ; Rupture*

Abdominal wall hematoma is a rare but well-known disease, usually caused by trauma or, on rare occasions, occurring spontaneously. Hematomas of the rectus sheath and the anterolateral abdominal wall are commonly associated with injury to the inferior epigastric artery and the deep circumflex iliac artery, respectively. The diagnosis of spontaneously developed abdominal wall hematoma is sometimes delayed, due its clinical manifestations being similar to those of other causes of the acute abdomen. CT and angiography can be helpful in the diagnosis of the hematoma and the injured vessel. Herein, we report on a rare case of a spontaneously developed anterolateral abdominal wall hematoma treated with microcoil embolization of the left deep circumflex iliac artery.
Abdomen, Acute ; Abdominal Wall* ; Angiography ; Diagnosis ; Embolization, Therapeutic* ; Epigastric Arteries ; Hematoma* ; Iliac Artery ; Rupture, Spontaneous*

PURPOSE: The purpose of this study was to review studies that have examined the quality of life of women with urinary incontinence. MATERIALS AND METHODS: A review was conducted that used the databases PubMED, Proquest, CINAHL, and Sciencedirect. Articles were included that were published in English between 2005 and 2010 the key words use were urinary incontinence, women, and quality of life. RESULTS: A total of 18 studies were identified, and the prevalence of urinary incontinence varied depending on the definition of incontinence used and the age of the population studied. The Incontinence Quality of Life (I-QoL), Incontinence Impact Questionnaire-short form (IIQ-7), and King's Health Questionnaire (KHQ) were the most commonly used instruments. Demographic, medical, physical, psychological, health, and intervention factors were reported as influencing factors on the quality of life of women with incontinence. Age, severity of urinary incontinence, type of urinary incontinence, number of urinary incontinence episodes, body weight, stress, and help-seeking behavior were statistically significant variables influencing quality of life. CONCLUSION: Future studies are needed to identify factors related to quality of life among women with incontinence and to use validated instruments according to specific subjects.
Body Weight ; Female ; Humans ; Prevalence ; Quality of Life ; Urinary Incontinence

OBJECTIVE: We wanted to evaluate the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) for detecting breast tumors, as compared with the T1- and T2-weighted images. MATERIALS AND METHODS: Forty-one female patients underwent breast MRI, and this included the T1-, T2-, DWI and dynamic contrast-enhanced images. Sixty-five enhancing lesions were detected on the dynamic contrast-enhanced images and we used this as a reference image for detecting tumor. Fifty-six breast lesions were detected on DWI and the histological diagnoses were as follows: 43 invasive ductal carcinomas, one mucinous carcinoma, one mixed infiltrative and mucinous carcinoma, seven ductal carcinomas in situ (DCIS), and four benign tumors. First, we compared the detectability of breast lesions on DWI with that of the T1- and T2-weighted images. We then compared the ADCs of the malignant and benign breast lesions to the ADCs of the normal fibroglandular tissue. RESULTS: Fifty-six lesions were detected via DWI (detectability of 86.2%). The detectabilities of breast lesions on the T1- and T2-weighted imaging were 61.5% (40/65) and 75.4% (49/65), respectively. The mean ADCs of the invasive ductal carcinoma (0.89 +/- 0.18x10(-3)mm2/second) and DCIS (1.17 +/- 0.18x10(-3)mm2/ second) are significantly lower than those of the benign lesions (1.41 +/- 0.56x10(-3)mm2/second) and the normal fibroglandular tissue (1.51 +/- 0.29x10(-3)mm2/ second). CONCLUSION: DWI has a high sensitivity for detecting breast tumors, and especially for detecting malignant breast tumors. DWI was an effective imaging technique for detecting breast lesions, as compared to using the T1- and T2-weighted images.
Adenocarcinoma, Mucinous/*diagnosis ; Adult ; Aged ; Breast/pathology ; Breast Neoplasms/*diagnosis ; Carcinoma, Ductal, Breast/*diagnosis ; Carcinoma, Intraductal, Noninfiltrating/*diagnosis ; Contrast Media/administration & dosage ; Diffusion Magnetic Resonance Imaging/*methods ; Female ; Gadolinium DTPA/diagnostic use ; Humans ; Image Enhancement/methods ; Imaging, Three-Dimensional/methods ; Middle Aged ; Observer Variation ; Sensitivity and Specificity

BACKGROUND: The morphological characteristics of hepatocytes transplanted into the spleen have been studied. However few attempts has been made to determine the expression of genes in intrasplenically transplanted hepatocytes. The aim of this study was to explore whether the pattern of expression of albumin gene in intrasplenically transplanted hepatocytes is similar to that in adult liver, resulting in the long-term expression of this hepatocyte-specific gene. METHODS: Hepatocytes isolated from liver of syngeneic Fischer 344 rats and transplanted into the spleen of rats from the same strain survived for 12 months in the absence of immunosuppressive drugs. Microscopic examination of intrasplenic hepatocytes and Northern blotting for albumin gene expression of RNA extracted from liver and spleen was performed. RESULTS: Microscopy demonstrated that hepatocytes attached themselves only in the red pulp of the spleen and isolated hepatocytes preserved the fine structures characteristic of normal hepatic parenchymal cells. Throughout the 12 months period, intrasplenically transplanted hepatocytes expressed albumin mRNA. CONCLUSIONS: Intrasplenically transplanted hepatocytes represent a unique in vivo system of extrahepatic maintenance of hepatocytes. This novel transplantation system could be used to investigate hepatocyte engraft, proliferation and gene expression.
Adult ; Animals ; Blotting, Northern ; Gene Expression* ; Hepatocytes* ; Humans ; Liver ; Microscopy ; Rats ; RNA ; RNA, Messenger ; Spleen