BACKGROUND: The warts may promptly return despite being treated with a myriad of destructive methods. The most successful treatment has been the intralesional injection of bleomycin sulfate, but unplessant side effects caused by the difficulty of infiltrating only the wart tissue have limited its use. OBJECTIVE: Our purpose was to determine the effects of bleopunciure technique in the treatment of warts. METHODS: We performed a multiple puncture technique using a 25 gauge hypodermic needle to introduce bleomycin hydrochloricle into warts. RESULTS: This technique resulted in elimination of 91.4% of a random series on 105 warts after a single treatment. Recurrence and side effects were not observed during a 1 year follow-up period. CONCLUSION: We experienced a superior technique for introducing Heomycin into the wart, which has resulted in the cure of a signficant number of warts following a sing treatment.
Bleomycin ; Follow-Up Studies ; Injections, Intralesional ; Needles ; Punctures ; Recurrence ; Warts*

PURPOSE: We reviewed 13 cases of pancreatic pseudocysts treated by percutaneous catheter drainage to determine the value and effectiveness of the procedure. MATERIALS AND METHODS: Sixteen pancreatic pseudocysts(nine infected, seven noninfected) were drained in 13 patients. Access routes were determined by images on CT scan and procedures were performed under fiuoroscopic guidance. Ultrasonogram was used as a guide for drainage when there were bowel loops near the access routes. Various access routes were used for catheter drainage:transperitoneal (10), retroperitoneal (3), transsplenic (2) transhepatic (1). RESULTS: Percutaneous catheter drainage cured 15 of 16 pancreatic pseudocysts(93.8%). No recurrance was encountered in the clinical follow-up of 7 to 69 months(mean 35 months). The mean duration of drainage was 29 days(infected, 24 days; noninfected, 39 days). Five pseudocysts(31%) were communicated with pancreatic duct The mean duration of drainage in these cases was 38 days. Spontaneous of the pancreatic pseudocysts to the gastrointestinal tract was occurred in 3 pseudocysts. Mean duration of drainage in pseudocysts with fistulas was 19 days. CONCLUSION: Percutaneous cather drainage is a safe and effective front-line treatment method in most pancreatic pseudocysts if drainage is done with a adequate follow-up and catheter care.
Catheters ; Drainage* ; Fistula ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Pancreatic Ducts ; Pancreatic Pseudocyst* ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

The aim of this study was to investigate the role of the 5-HT receptors in acetylcholine (ACh) release from the striatum. Slices from the rat striatum and synaptosomes were incubated with [3H]-choline and the release of the labelled products was evoked by electrical (3 Hz, 2 ms, 5 V/cm, rectangular pulses, 2 min) and potassium-stimulation (25 mM), respectively, and the influence of various serotonergic drugs on the evoked tritium outflows was investigated. Serotonin decreased the electrically-evoked ACh release in striatum in a concentration-dependent manner without the change of basal release. In hippocampal and entorhinal cortical slices, serotonin did not affect the evoked and basal release of ACh, but, at large dose (30 microM) decreased the evoked ACh release in hippocampus. 2,5-Dimethoxy-4-iodoamphetamine (DOI), a specific 5-HT 2A/2C agonist, decreased evoked ACh release in the striatum. CGS-12066A (5-HT 1B agonist), m-chlorophenyl-biguanide (5-HT 3 agonist) and 5-[(dimethyl -amino)methyl]-3-(1-methyl-1H-indol-3-yl)-1,2,4-oxadiazole (5-HT 3 antagonist) did not affect the evoked and basal ACh release in all tissues. Ritanserin, a specific 5-HT 2A/2C antagonist, blocked the inhibitory effects of serotonin and DOI, whereas, ketanserin, an another type of specific 5-HT 2A/2C antagonist did not affect the inhibitory effects of serotonin and DOI. In striatal synaptosomal preparation, serotonin and DOI did not affect the K +-evoked ACh release. These findings suggest that ritanserin-sensitive 5-HT 2A/2C receptors located in the soma and/or axons of the striatal cholinergic neurons play a important role in ACh release.
Acetylcholine* ; Animals ; Axons ; Carisoprodol ; Cholinergic Neurons ; Hippocampus ; Ketanserin ; Rats* ; Receptors, Serotonin* ; Ritanserin ; Serotonin Agents ; Serotonin* ; Synaptosomes ; Tritium

PURPOSE: To prevent intraperitoneal bleeding, it is critical that the extrahepatic portal vein should not bepunctured during transjugular intrahepatic portosystemic shunt (TIPS). There has, however, been no procedure fordefining the anatomic relationship between the hepatic capsule and the portal vein segment before shunt formation.To avoid a possibly catastrophic outcome of extrahepatic portal puncture before shunt creation, we thereforedevised a new method; the purpose of this study is to report its efficacy and feasibility. MATERIALS AND METHODS:Whenever a portal vein was punctured, we advanced a 9F sheath over a guidewire into the portal vein before balloondilatation of the tract. Contrast material was then injected through the sheath as this was slowly withdrawn fromthe portal vein towards the hepatic vein. When contrast material extravasated or spilled into the peritonealspace, thus suggesting extrahepatic portal vein puncture, a more peripheral segment of the portal vein waspunctured, and a shunt was created using this new tract. We applied this method to 130 consecutive patients whounderwent TIPS to control variceal bleeding due to liver cirrhosis. In all cases, portography and ultrasonographywere used for immediate confirmation of the procedure. RESULTS: Puncture of the extrahepatic portal vein segmentoccurred in three out 130 (2.3%) patients. In these three, TIPS was successfully created using the methoddescribed above. Clinical and ultrasonographic follow-up showed that no patients suffered intraperitonealbleeding. CONCLUSION: For preventing intraperitoneal hemorrhage during TIPS creation, our method is effective andfeasible.
Esophageal and Gastric Varices ; Follow-Up Studies ; Hemorrhage* ; Hepatic Veins ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Portal Vein ; Portasystemic Shunt, Surgical ; Portography ; Punctures

No abstract available.
Acute Kidney Injury* ; Nifedipine* ; Plasma* ; Renin*

The authors performed prospectively the transcranial Doppler monitoring of bilateral anterior and middle cerebral arteries in 15 patients with ruptured cerebral aneurysm. The entry criteria for the study were confined to the patients who were admitted within 3 days after bleeding and had clinical grades of I, II, or III. The mean frequency shifts of bilateral anterior and middle cerebral arteries were increased immediately after ictus and showed continous further elevation between the 3rd and 8th rupture days. After that, they normalized slowly. The increase of frequency shift preceded clinical ischemic symptoms and an early steep increase of frequency shift was correlated to a high chance for suffering delayed ischemic deficits. The thick clots in subarachnoid cisterns shown on CT scans taken within the third rupture day were correlated well to the severe increase of frequency shifts. The aggressive treatment was done on asymptomatic patients who showed relatively rapid increase of frequency shifts, and they had shown no or trasient mild ischemic symptoms.
Hemorrhage ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prospective Studies ; Rupture ; Tomography, X-Ray Computed

BACKGROUND: Cerebral cortical dysplasia (CD) is one of the important causes of intractable epilepsies and characterized histologically by disorganized cortical lamination and cytomegalic dysplastic neurons. Although various cytoskeletal abnormalities have been found in dysplastic neurons of CD, the pathogenetic role of dysplastic neurons has rarely been investigated. METHODS: In this study, immunohistochemical analysis was performed using antibodies against non-phosphorylated high- or medium-molecular weight neurofilament protein and microtubule-associated protein 2 (MAP-2) in surgical specimens of CD. In order to know the possible relationship of dysplastic neurons with cytoskeletal abnormalities and various neurotrophin receptors, NGFR p75, trkA, trkB, and trkC immunoreactivities were also analyzed. RESULTS: Dysplastic neurons showed strong immunoreactivities for non-phosphorylated high- or medium-molecular weight neurofilament protein and MAP-2, which might reflect abnormal outgrowth and altered plasticity of the dysplastic neurons. TrkB and trkC were strongly expressed in dysplastic neurons and NGFR p75 was also strongly expressed in some dysplastic neurons. CONCLUSIONS: Since it has been known that brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) have effects on the differentiation of neuronal precursor cells from the cortex and on dendritic and axonal arborization, increased expression of trkB and trkC may play a role in cytoskeletal abnormalities and altered synaptic transmission in dysplastic neurons.
Antibodies ; Axons ; Brain-Derived Neurotrophic Factor ; Epilepsy ; Malformations of Cortical Development* ; Microtubule-Associated Proteins ; Neurons* ; Plastics ; Receptors, Nerve Growth Factor ; Synaptic Transmission

PURPOSE: To evaluate the feasibility and efficacy of revision of the transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: Sixteen malfunctioning TIPS (10 occlusions, 6 stenoses) in 14 patients of 103 patients (117 procedures) were revised. Fifteen patients underwent revision to control recurrent variceal bleeding after TIPS and one to restore severely stenotic TIPS found on portal venogram obtained during transarterial chemoembolization of a hepatocellular carcinoma. One patient underwent three revisions. The time intervals between initial TIPS placement and revisional procedures varied between four and 43 months (mean, 17.6 months). Nine occlusions and four stenoses were treated with an additional stent placed in a parallel or overlapping fashion with transjugular approaches. Two stenoses and one acute occlusion were treated with balloon dilatation involving transfemoral approaches. RESULTS: In patients with complete occlusion of TIPS, the sites of occlusion were all within the stent, with or without associated stenosis of the hepatic vein. In five of six patients, with TIPS stenosis, however, the stenoses were located at the hepatic vein just distal to the stents, rather than within the stents. The procedures for revision were in all cases technically feasible and hemodynamically successful. No significant procedure-related complications were encountered. CONCLUSION: The revision of TIPS is a safe and effective method in cases of its partial or complete occlusion.
Carcinoma, Hepatocellular ; Constriction, Pathologic ; Dilatation ; Esophageal and Gastric Varices ; Hepatic Veins ; Humans ; Hypertension, Portal ; Portasystemic Shunt, Surgical* ; Stents