Background: Superior hypogastric plexus block has been advocated as a useful technique for the treatment of cancer related pelvic pain. The aim of this study was to evaluate the effect of neurolytic trans-intervertebrodiscal superior hypogastric plexus block for pelvic cancer pain. Methods: Twenty-eight patients with gynecologic, colorectal or genitourinary cancer who suffered intractable pain were studied. We performed superior hypogastric plexus block by trans-intervertebrodiscal approach at L5/S1 level under the C-arm fluoroscopic guide unilaterally or bilaterally. Ten ml of 100% dehydrated alcohol was injected through each needle. We evaluated the change of visual analog pain score (VAS; 0~100 mm) and daily dose of oral morphine sulphate at the time of pre-block and 7 days after the block. Results: Fourteen patients (50%) had satisfactory pain relief (VAS<30) while five patients (18%) had moderate pain control (VAS 30~60). The remaining nine patients (32%) had mild or little pain relief (VAS>60) and their daily oral morphine doses were above 160 mg. Additional pain control method may be needed for those patients who received high dose of opioid before neurolytic block. Conclusions: We conclude trans-intervertebrodiscal neurolytic superior hypogastric plexus block was effective in relieving pelvic cancer pain. Neurolytic block, earlier stage, may provide better effects for more comfortable life at the end stage for cancer patients.
Introduction. The human cutaneous scars manifest themselves many ways in different types according to the factors such as the age, sex, race of the patient as well as the location,. kind and heal ing process of the wound. Among the scars it is quiet difficult to verify the clinical course of the hypertrophic or keloidal scars from the true keloids. However, clinical observations indicate that stress, either mechanical or in the forms of chronic infections, can induce a functional change in the fibroblasts causing an excessive production of collagenous matrix. In this study, we preliminary attempt to justify any difference of the cellular structure between keloids and hypertrophic scars by using electron microscope. Material and Methods. A total of 23 cases: 2 scars, 2 hypertrophic scars and 19 keloids are examined. Immediately, the biopsy tissue was fixed in 10% neutral formalin and 4% glutaraldehyde solution in phosphate buffer for 4 hours, post fixed in 1 % osmium tetraoxide for two hours, dehydrated with graded alcohol, and embedded in Epon 812. Thick sections were stained with hematoxylin eosin, periodic acid-Schiff(PAS) and Van Gieson stain. Thin sections were cut and uranyle acetate, lead citratestain and examined with the electron microscope. Result. The morphologic features of keloid showed thick, homogenously eosinophilic bands of collagen and numberous large active fibroblasts. The hypertrophic scar and soft scar are more cellular than keloid and composed thinner collagenous fiber. For this paper in the etiology of keloids can not as be defined, but and interesting keloidal tissue fibroblast showed irregular nucleus with irregular shape dense bodies and fibril materials contained in to the cytoplasm.
Background: Radiofrequency ablation (RFA) is the most widely used and studied method internationally for the local treatment of liver tumors. However, the extension of coagulation necrosis in one RFA procedure is limited and incomplete coverage of the damaged area can lead to a high local recurrence rate. Objective: In this study, we compared the effects of different solutions in enhancing hepatic radiofrequency by establishing a rabbit VX2 liver cancer model. We also determined the optimal solution to maximise effects on the extent of RFA-induced coagulation necrosis. Methods: Thirty VX2 tumor rabbits were randomly assigned to five groups: group A, RFA alone; group B, RFA with anhydrous ethanol injection; group C, RFA with 5% hypertonic saline injection; group D, RFA with lidocaine injection; and group E, RFA with a mixed solution. Routine ultrasound examinations and contrast-enhanced ultrasound (CEUS) of the ablation areas were performed after RFA. Then, we measured the major axis and transverse diameter and compared the areas of coagulation necrosis induced by RFA. Results: The mean ablation area range increased in groups B, C and especially E, and the scopes were greater compared with group A. Preoperative application of anhydrous ethanol, hypertonic saline, lidocaine and the mixed solution (groups B, C, D and E, respectively) resulted in larger coagulation necrosis areas than in group A (p<0.05). Among the groups, the coagulation necrosis areas in group E was largest, and the difference was statistically significant compared with other groups (p<0.05). Pathological findings were consistent with imaging results. Conclusions: A mixture of dehydrated alcohol, hypertonic saline and lidocaine injected with RFA increases the extent of coagulation necrosis in the liver with a single application, and the mixed solution is more effective than any other injection alone.
The purpose of this study was to investigate the main sensory trigeminal nucleus in the aging rat brain by means of electron microscope. Male Sprague-Dawley rats, two (control group) and thirty six (aging group) months of age, were used. These animals were sacrificed by perfusion fixation with 2.5% glutaraldehyde-2.0% paraformaldehyde (0.1M phosphate buffer, pH 7.4) under sodium pentobarbital. The objective area was punched out with a sharp-edged metal cylinder of 0.8 mm in diameter. These blocks of tissue were then washed in 0.1M phosphate buffer, postfixed in 2% osmium tetroxide, dehydrated in a graded series of ethyl alcohol, and embedded in Epon 812. Thin sections were cut with Super Nova ultramicrotome, pick up on grids and double stained with lead citrate and uranyl acetate, and observed in JEOL 100B electron microscope. The results were as follows: 1. In the control group, the neuronal cell body of the main sensory trigeminal nucleus was filled with nucleus, Golgi complex, Nissl substance, mitochondria, microfilaments and microtubules. However, few Nissl substances are seen in neuronal cell body. Axoaxonic synapse, axodendritic synapse, axosomatic synapse, axospinous synapse, myelinated and unmyelinated nerve fibers were well organized around cell bodies. Neurons with abnormal changes were not seen. 2. In the aging group, the neuronal cell body of the main sensory trigeminal nucleus contained large number of lipofuscin granules, dense body and swollen mitochondria. Terminal boutons contained glycogen, crystal-like vesicle and membranous indicating first signs of degeneration. The dendrites were found to be in synaptic contact with altered axon terminals. Frequently axons filled with dark axoplasn and splitted myelin sheath were noticed.
An experimental study on the acute irradiation effects on the substantia nigra of head-irradiated rats were carried out. Rats anesthetized with sodium thiopental, were exposed only on their head areas with a single dose of 3,000 rads or 6,000 rads, respectively. Radiation was produced by Mitsubishi linear accelerator at the speed of 200 rads/min. Aminals were sacrificed on 6 hours, 2 days and 6 days following irradiations. By the perfusion fixation through the heart, rats were fixed with 1% glutaraldehyde-1% paraformaldehyde solution. Two hours later, brains were exposed and immersed in the same fixatives over night. Tissue blocks from subtantia nigra were punched out, and they were refixed in the 2% osmium tetroxide solution. Blocks were dehydrated through alcohol series, and embedded in the araldite mixture. Ultrathin sections were stained with uranyl acetate and lead citrate solutions, From the ultrastructural study, following results were made: 1. Six hours after irradiation, severe depletion of synaptic vesicles was occurred in the many axon terminals of the nigral neuropil. 2. Dramatical decrease of lysosomes and dense granules was observed. 3. Two days following irradiation, alterations of ribosomes, granular endoplasmic reticula, mitochondria, etc, were noticed. 4. Many of the malformations were seen to be repaired on the 6th day. 5. Above results were interpreted as follows. At the acute stage of heavy irradiation, neurotransmitters in the substantia nigra are released severely. But they are recovered within 6 days. It is concluded that acute head-irradiation may result severe disturbance of nigral motor control function during the first few days.
The purpose of this study was to compare sealing ability between lateral condensation and continuous wave of condensation in depend of root canal curvature. In this study, we divided fifty-six human molar teeth into two group in depend of Schneider method, and then subdivided them into four experimental group (each group is composed of twelve teeth) by canal curvature and obturation method, and eight teeth were served as positive and negative controls. Specimens were prepared by Quantac 2000 series file and obturated by lateral condensation or System B. Specimens were immersed in india ink for 7 days, decalcified by 10% nitric acid, dehydrated by 75, 95 and 100% alcohol in order, cleared by methyl salicylate and then measured of dye penetration with stereomicroscope(${\times}6.5$ magnification) and Image Pro plus. The data were analyzed stastically by one-way ANOVA and Scheffe test. The data were as follows: 1. The mean leakage was $0.725{\pm}1.167$ for group A, $0.813{\pm}0.921$ for group B, $0.809{\pm}0.997$ for group C, $1.111{\pm}1.147$ for group D, but no significant difference among them(p>0.05). 2. Lateral condensation had better sealing ability than continuous wave of condensation, but no significant difference among them(p>0.05). 3. There was no significant difference between root canal curvature degree and microleakage(p>0.05).
This study was designed to observe the adaptive changes of mandibular condyles to displacement of mandibular condyle in adult animals. In this study, 16 rabbits weighting about 3.5 kg was selected. Four rabbits were preserved for control group and 8 animals were divided into 3 groups, 2 weeks, 4 weeks and 8 weeks. The experimental animals were performed oblique osteotomy on both mandibular ramus and internal wiring at mandibular border. The experimental animals were sacrificed consecutively on the 2 weeks, 4 weeks and 8 weeks after oblique osteotomy and mandibular condyles were dissected out carefully to produced tissue specimen. The specimens were fixed with 10% N formaline solution for 24 hours and rinsed with phosphate buffer solution. It was decalcified with 5% nitric acid for 15 days. Thereafter the specimens were dehydrated in alcohol series and embedded paraffin as usual manner. The mebedded specimen were sectioned in $4-6{\mu}m$ microtome, stained with hematoxylin-eosin and azan stain and observed through light microscope. The following results were observed from this experiment. When there was postional change of condyle head after mandibular ramus oblique osteotomy in adult rabbit, 1. The density of chondrocyte was generally increased at condylar cartilage and the thickness of condylar cartilage was increased posterosuperior aspect of the mandibular condyle slightly. 2. The density of chondrocyte was increased at proliferative zone so fibrous articular zone, porliferative zone and hypertrophic zone was clearly distinguished. 3. Active endochondral bone formation was occurred at mandibular condyle.
This study was performed to clarify the morphological structures of the epithelia of the renal papilla, renal pelvis and ureter of the sheep (Ovis aries L.) through the light and scanning electron microscopes, Tissue specimens were taken from the renal papilla (common renal papilla and peripelvic column) and the renal pelvis (pelvis proper and pelvic pouch) of the kidney and the ureter. For the light microscopy, tissue blocks were fixed in 10 % neutral buffered formalin and embedded in paraffin wax, serially sectioned at a thickness of $6{\mu}m$. These sections were stained with hematoxylin-eosin and periodic acid-Schiff reaction. For the scanning electron microscopy, tissue blocks were prefixed in 1% glutaral-dehyde-1.5% paraformaldehyde solution and postfixed in 1% osmium tetroxide solution, dehydrated in graded alcohol, transferred to isoamyl acetate, and then dried by the critical point dryer (Polaron E 3000). These dried tissues were coated with gold and observed with a scanning electron microscope (JSM-35C), The results were as follows: The apex of the common renal papilla was lined with simple columnar epithelium having many microvilli on its luminal surface. Lateral portion of the papilla was lined with stratified epithelium $2{\sim}3$ layers thick, and its superficial cells were microvillar cells having many microvilli. The epithelium lining the peripelvic column was $1{\sim}2$ layers thick. The superficial layer was made of the microvillar cells, but a few microplica cells were appeared in the region near the pelvic pouch. The epithelium of the pelvic pouch was $1{\sim}2$ layered transitional type, and its superficial cells were microplica cells. The epithelia of the pelvis proper and ureter were $4{\sim}6$ layered transitional type, and their superficial cells were typical facet cells existing many round depressions and ridges of cell membranes of the luminal side.
Background: Estrogen deficiency affects the structure and function of the salivary glands in women, leading to a decrease in salivary secretion and a change in the composition of saliva. Previous studies on changes in the salivary glands that cause estrogen deficiency have reported only partial results for the parotid and submandibular glands, and there are few comparative morphological studies of histological changes between the parotid and submandibular glands in ovariectomized rats (OVX) leading to estrogen deficiency. This study aimed to analyze the histopathological and histochemical changes in the parotid and submandibular salivary glands causing estrogen deficiency by using OVX, and to discuss the mechanism on these changes. Methods: The parotid and submandibular glands from sacrificed control and OVX groups were fixed with cold 4% paraformaldehyde in phosphate buffer (pH 7.2). The tissues were dehydrated using a series of graded ethyl alcohol and embedded in paraffin. For histopathological analysis, sections cut to a thickness of 6 to 7 ㎛ were stained with hematoxylin and eosin (H&E). For histochemical analysis, Periodic acid-Schiff (PAS), Alcian blue (AB, pH 2.5), and PAS+AB (pH 2.5 and pH 1) staining was performed. Results: Histopathological analysis of OVX tissue showed that the parotid and submandibular salivary glands were broadly and clearly separated and divided into lobes. In OVX, acinar and ductal cells with condensed polymorphic or pyknotic nucleus, which are presumed to be characteristic of apoptotic cells, and degenerated cells with lipid deposition in cytoplasmic granules and ruptured membranes were increased. Histochemical analysis of OVX, confirmed an increase in the number and acidification of acinar secretory granules. Conclusion: Histopathological and histochemical changes and the effects of estrogen deficiency are more evident in the submandibular salivary gland than in the parotid gland.
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