No abstract available.
Adenoma* ; Kidney*

No abstract available.
Adenoma* ; Kidney*

No abstract available.
Vesico-Ureteral Reflux*

BACKGROUND: The fluid kinetics of intravenously infused colloid during inhalation anesthesia and hemorrhage have not been investigated. We therefore assessed fluid space changes during infusion of hydroxyethyl starch solution after hemorrhage in conscious and desflurane-anesthetized individuals. METHODS: Following the donation of 400 ml of blood, 500 ml of hydroxyethyl starch solution was infused over 20 minutes into wakeful and desflurane-anesthetized volunteers. Blood was repeatedly sampled to measure hemoglobin concentration, a marker of plasma dilution, and fluid kinetic analysis was performed to evaluate changes in fluid space. RESULTS: Using a fluid kinetic model, we found that the mean volume of fluid space was 7,724 +/- 1,788 ml in wakeful volunteers and 6,818 +/- 4,221 ml in anesthetized volunteers, and the elimination rate constants were 7.1 +/- 3.5 ml/min and 19.4 +/- 4.6 ml/min, respectively. CONCLUSIONS: Infusion of colloid after mild hemorrhage resulted in similar expansions of plasma volume in desflurane-anesthetized and conscious individuals. During anesthesia, however, the expansion of plasma volume by colloid was decreased and of shorter duration than observed in conscious patients.
Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation ; Blood Donors ; Colloids ; Fluid Therapy ; Hemoglobins ; Hemorrhage ; Hetastarch ; Humans ; Kinetics ; Plasma ; Plasma Volume

Colorectal cancer is the third most common malignancy in Korea. In contrast, pericolic or mesenteric lymphoma is relatively rare. We experienced an extremely rare case of synchronous primary colon cancer in the ascending colon with T-cell lymphoma in the pericolic lymph node. A 79-year-old woman presented with complaints of epigastric and right lower abdominal pain combined with anorexia and nausea. Colonoscopic evaluation and biopsy were performed, and the diagnosis was cecal adenocarcinoma. She underwent right hemicolectomy with lymph node dissection. The pathology report revealed adenocarcinoma in cecum with metastasis to 1 regional lymph node out of 37 lymph nodes. In addition, there was malignant angioimmunoblastic T-cell lymphoma in 1 pericolic lymph node. There was no evidence of lymphoma in ileum, cecum and ascending colon, so the possibility of early phase of lymphoma was suggested.
Abdominal Pain ; Adenocarcinoma ; Aged ; Anorexia ; Biopsy ; Cecum ; Colon ; Colon, Ascending ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Humans ; Ileum ; Korea ; Lymph Node Excision ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell ; Nausea ; Neoplasm Metastasis ; T-Lymphocytes

BACKGROUND: Changes in the volume of the fluid space expanded by i.v. infusion of crystalloid solution have been analysed recently using mathematical models. The models are based on the assumption that the body strives to maintain volume homeostasis of fluid spaces and that the rate of restoration is a function of deviation from resting volume. METHODS: In this work mathematical models were developed to represent the kinetics of volume changes of fluid spaces associated with infusion of Ringer's solution. Based on the characteristics of fluid transportation, two expansion models were tested. The single-fluid space model has a single volume into which fluid is fed and from which fluid is left, and the two-fluid space model has another space in addition to the first volume so that fluid exchanges between these two spaces are possible. Volunteers (six men) were given Hartman's solution for 30 min and the changes in blood hemoglobin were detected. RESULTS: From the comparison with experimental data, the single-fluid space model was found to represent adequately in all volunteers, however, two-fluid space model was found to represent 75% of volunteers. CONCLUSIONS: These models may be useful in the description and analysis of the effects of i.v. fluid therapy.
Blood Volume ; Body Fluids* ; Fluid Therapy ; Homeostasis ; Kinetics ; Models, Theoretical ; Space Simulation ; Transportation ; Volunteers

PURPOSE: Chronic inflammation induces cancer and cancer induces local tissue damage with systemic inflammation. Therefore, the aim of this study is to investigate the potential relationship between the severity of inflammation and prognosis in cancer patients. MATERIALS AND METHODS: This study enrolled 220 patients from January 2002 to December 2006 who underwent gastric surgery. We evaluated the relationship between preoperative inflammatory parameters (erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio) and other clinicopathological factors. Survival outcomes were compared according to the extent of inflammation. RESULTS: Significant elevation of erythrocyte sedimentation rate was related with old age, increased neutrophil-to-lymphocyte ratio, decreased hemoglobin, increased carcinoembryonic antigen, increased tumor size and advanced TNM stage. Neutrophil-to-lymphocyte ratio was significantly correlated with old age, increased erythrocyte sedimentation rate and advanced TNM stage. In the univariate analysis, elevated erythrocyte sedimentation rate and increased neutrophil-to-lymphocyte ratio had significantly poorer survival than those without elevation (all P<0.05). However, the multivariate analysis failed to prove erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio as independent prognostic factors. CONCLUSIONS: The elevation of erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio were correlated with poor prognosis in the univariate analysis and there was a strong correlation between inflammatory parameters (erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio) and tumor progression. Thus, erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio are considered useful as follow-up factors.
Blood Sedimentation ; Carcinoembryonic Antigen ; Follow-Up Studies ; Hemoglobins ; Humans ; Inflammation ; Multivariate Analysis ; Prognosis ; Stomach Neoplasms

A solitary fibrous tumor (STF) is a relatively unusual neoplasm first described as a distinctive tumor arising from pleura. Some reports have shown that STF also affect extrathoracic regions. A 70-year-old woman was referred to our hospital for surgical treatment of an incidentally discovered thigh mass. We performed complete removal of the tumor. It was a soft tissue tumor with muscle indentation but without invasion to the surrounding muscles. The resected specimen was 7.0x6.3x5.2 cm. Histologically, the tumor was composed of a haphazard proliferation of spindle cells and epitheloid cells with hypercellularity and high mitotic activity. Immunohistochemistry showed positive immunoreactivity for CD34, CD99, bcl-2 protein, CD117, vimentin, smooth muscle actin and epithelial membrane antigen. We report, herein, on a rare case of malignant SFT in the thigh region along with a review of the literature.
Actins ; Aged ; Female ; Humans ; Immunohistochemistry ; Mucin-1 ; Muscle, Smooth ; Muscles ; Pleura ; Solitary Fibrous Tumors ; Thigh ; Vimentin

PURPOSE: Prognostic indicators are used increasingly in clinical trials and to guide surveillance for patients with colorectal cancer (CRC). The significance of a preoperative, elevated erythrocyte sedimentation rate (ESR) as a predictive indicator for malignancy and for prognosis in colorectal cancer has not been elucidated. Hence, the current study was conducted to evaluate the ESR as a prognostic indicator in patients with CRC. METHODS: This study enrolled 232 patients who underwent surgery in our hospital between 1997 and 2004. ESR with clinicopathologic features and overall survival were evaluated retrospectively. RESULTS: The ESRs of 139 patients were elevated, and those of 93 patients were normal. Elevated ESR was associated with the male gender, decreased hemoglobin, increased platelet count, high preoperative CEA, high preoperative CA19-9, tumor size (> or =5 cm), T stage, and TNM stage. Patients with elevated ESR had poorer survival (P=0.001), but a multivariate analysis did not reveal an elevated ESR as an independent factor for prognosis. CONCLUSIONS: Preoperative elevation of ESR in patients with CRC suggests the presence of a tumor with aggressive behavior and a poor outcome.
Blood Sedimentation ; Colorectal Neoplasms ; Erythrocytes ; Hemoglobins ; Humans ; Male ; Multivariate Analysis ; Platelet Count ; Prognosis ; Retrospective Studies

BACKGROUND: In a previous study, fluid kinetic models were applied to describe the volume expansion of the fluid space by administration of crystalloid and colloid solutions. However, validation of the models were not performed, it is necessary to evaluate the predictive performance of these models in another population. METHODS: Ninety five consenting patients undergoing elective spinal surgery under general anesthesia were enrolled in this study. These patients were randomly assigned to three fluid groups i.e. Hartmann's solution (H group, n = 28), Voluven(R) (V group, n = 34), and Hextend(R) (X group, n = 33). After completion of their preparation for surgery, the patients received a loading and maintenance volume of each fluid predetermined by nomograms based on fluid pharmacokinetic models during the 60-minute use of an infusion pump. Arterial samples were obtained at preset intervals of 0, 10, 20, and 30 min after fluid administration. The predictive performances of the fluid kinetic modes were evaluated using the fractional change of arterial hemoglobin. The relationship between blood-volume dilution and target dilution of body fluid space was also evaluated using regression analysis. RESULTS: A total of 194 hemoglobin measurements were used. The bias and inaccuracy of these models were -2.69 and 35.62 for the H group, -1.53 and 43.21 for the V group, and 9.05 and 41.82 for the X group, respectively. The blood-volume dilution and target dilution of body-fluid space showed a significant linear relationship in each group (P < 0.05). CONCLUSIONS: Based on the inaccuracy of predictive performance, the fluid-kinetic model for Hartmann's solution showed better performance than the other models.
Anesthesia, General ; Bias (Epidemiology) ; Body Fluids ; Colloids ; Humans ; Infusion Pumps ; Nomograms* ; Pharmacokinetics