Shin, Dong Won;Choi, Moon Han;Park, Seung Sik;Park, Sung Woo;Kim, Ki Up;Jang, An Soo;Park, Choon-Sik;Lim, Cheol Wan;Ko, Eun Suk;Paik, Sang Hyun;Kim, Do Jin
Tuberculosis and Respiratory Diseases
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v.65
no.3
/
pp.230-234
/
2008
The incidence of appendiceal metastatic cancer is quite low. In particular, in small cell lung cancer, there is a very low incidence of a metastasis to the appendix. A 75-years old man with right lower quadrant pain, cough and sputum was transferred to our hospital. Abdominal CT revealed acute appendicitis with a perforation. The patient underwent surgery. The frozen sections of the tissue obtained during surgery, indicated a malignancy, but a right hemicolectomy was not performed due to the patient's poor general condition. The histology findings of the appendix were identified as a small cell carcinoma. The abdominal CT scan and chest x-ray at admission day showed a mass in the right lower lobe, and a further evaluation of the lesion was performed including positron emission tomography and flexible bronchoscopy with a biopsy. The pathology findings of the lung mass were also small cell lung cancer. The specimens from both sites stained positive for cytokeratin, cluster designation 56, synaptophysin, chromogranin-A and thyroid transcription factor 1. It was concluded that the appendiceal small cell cancer originated from the lung.
Celiac plexus block is recommended in patients with intractable upper abdominal cancer pain. The success rate of a celiac plexus block is variable among the authors. One of the causes of this is the anatomical variations of the celiac plexus. There has not been a study concerning anatomical observations of the celiac plexus in Korean cadavers. So, anatomical dissections were performed and observations were made of the celiac plexus and related structures in Korean cadavers. The results were as follows: 1) The subjects were 21 male bodies and 5 female bodies. The mean age at death was $69.9{\pm}15.5$ years (range 37~93). The mean height was $155.5{\pm}8.3\;cm$ (range 143~172). 2) The number of celiac ganglia ranged from 1~4. The mean numbers were $2.3{\pm}1.9$ in the right plexus and $1.9{\pm}0.8$ in the left, and the mean sizes were $18.9{\pm}7.7{\times}8.0{\pm}3.8\;mm^2$ and $18.5{\pm}8.3{\times}9.5{\pm}3.9\;mm^2$ respectively. 3) Celiac ganglia were most frequently located at the level of the upper third and middle third of L1 in both sides (65.5% in right, 64.0% in left). The vertical range of celiac ganglia ranged from 1 space, which is one third the height of one vertebral body, to 4 spaces. Mean vertical ranges were $1.5{\pm}0.6$ spaces in the right plexus and $1.6{\pm}0.7$ spaces in the left. The celiac ganglia located at the level of the upper third of L1 in the right and the lower third of L1 in the left side, had the largest vertical ranges respectively ($1.8{\pm}0.5$ spaces in right, $2.3{\pm}0.6$ spaces in left) 4) Right side celiac ganglia were located near the midline of the vertebrae compared to the left ones (mean 5.0 mm) The horizontal dimension was greater in the right ganglia ($24.2{\pm}9.2\;mm$) than in the left ganglia ($l8.8{\pm}7.0\;mm$). 5) There was no vertebral level difference between both celiac ganglia in most cases (60%). However, of the 40% of cases at different levels, in half of these (20%) the right ganglia were located higher than the left ganglia; and in the other 20%, this was reversed. 6) The origin sites of the celiac artery were most frequently in the upper third and middle third of L1 (61.6%). The celiac ganglia were usually located at the same level as the site of origin of the celiac artery (61.6% in right, 52.0% in left). 7) The vertebral level of the splanchnic nerves piercing the abdominal surface of the diaphragm was most frequently in the upper third and middle third of L1 (66.6% in right, 66.7% in left). 8) The level of the origin of diaphragmatic crura from the anterior surface of the vertebral bodies varied from the L1-L2 interspace to the L3-L4 interspace. Right crura most frequently originated at the level of the lower third of L2 to the upper third of L3 (57.6%), while left crura originated from the level of the L2-L3 interspace to the middle third of L3 (69.3%). From the above results, we realized that there were some anatomical variations of the celiac plexus and its relations to adjacent structures in Korean bodies. However, when the needle point is behind the anterior margin of the upper third of L1, it is possible to perform a successful retrocrural splanchnic nerve block.
This study has been carried out to investigate the cause, pathological mechanism and treatment of symptoms regarded as the ischemic heart disease in Nei-jing(內經). I've got the following conclusions. 1. From the side of xing-bi(胸痺), the ischemic heart disease(IHD) was caused by that the energy in one's heart wasn't extended in the way of Yin-xie(飮邪), namely waste matter of human body and symptoms and treatment wern't written. 2. From the side of xin-bi (心痺), HID was catched by the mechanisms that the blood vessel is blocked. or the heart's blood was deficient owing to the mutation of mo-bi(脈痺), the lack of yang-ming(陽明) and excessive thoughts and worry and others. The symptoms were feeling oppressed in one's brest, palpitating, sudden dyspnea, the dryness of thorat, frequent belching and the fear by the inverse flow of the energy(氣). The treatment was that the yin(陰) was cured immediately, but the yang(陽) mustn't be attacked. 3. From the side of xing-tong(心痛), IHD was suffered from by mechanisms that following the han-sa(寒邪), namely the cold makes a invasion on humanbody, the vessel was blocked, spasm, filled and the amount of blood flow was poor, or caused by injury of vessel, the inverse flow and the disease of shi-dong(是動病) of shou-shao-xin-jing(手少陰心經) and so on. The pain was cramped into the upper and lower back or lower abdomen or throat and accompanied with nausea, abdominal dropsy, constipation, the impending of breathing and so on. The cure was mainly that acupuncture was applied at the jin-su(筋縮) region or meridian in relation to symptoms, but if the pain were severe, acupuncture mustn't be applied. The prog nosis was worse. 4. From the side of xing-tonge(心痛), IHD was divided into zhen-xing-tong(眞心痛) and jue-xing-tong(厥心痛), but pi-xiog-tong(脾心痛) and wei-xing-tong(胃心痛) out of jue-xing-tong(厥心痛) also included the symptoms of the digestive disease.
Purpose: The present study intended to reveal the association between the physique of adolescent women and dysmenorrhea, and the factors related to the frequency of dysmenorrhea. Methods: The study subjects included 511 girls of a women's high school in Daejeon city and they were, during the period of March 1st through April 30th, 2005, given self-administered questionnaires about frequency of menstruation, age, physique, exercise, and such menstruation-related items as age of menarche, menstrual period and days, and amount. Results: As with the frequency of dysmenorrhea, 38.4% experienced it 「always」, 44.6% 「occasionally」, and 17.0% 「almost scarcely」, and those with dysmenorrhea accounted for 83.0% of the subjects. The frequency of dysmenorrhea was not significant difference according to the BMI and HPI. However, the lower the age of menarche and the greater the amount of menstrual flow, the more frequent dysmenorrhea. The symptoms of dysmenorrhea included the highest frequency of low back pain(68.5%) and it was followed by abdominal pain(65.9%), sensibility(54.0%), fatigue(51.7%), and nervousness(49.5%). These accompanied symptoms tended to be worse as the frequency of dysmenorrhea increased. The multiple logistic regression analysis revealed that the relative risk of frequency of dysmenorrhea is 2.2 times in age of 14, by a standard age of 15 as menarchial age, 2.2 in 13, and 3.1 in below 12. The menstrual days was 3.0 times in both below 2 days and over 8 days with the standard days of 3-7 days. The menstrual amount was 1.9 times in the group with a greater amount of menstrual bleeding and 1.5 times in the group with a less amount than the normal group, respectively. Conclusion: The above results suggest that the rate of experiencing dysmenorrhea was up to 83.0% and 38.4% from these had dysmenorrhea upon every menstruation. It is thought that dysmenorrhea could be a great disadvantage sufficient to impair optimal health to a larger body of school girls. Further, for quality of life, it is required that more fundamental strategies instead of pain killers or others for palliation of dysmenorrhea would be established among adolescents.
Sarcoma of the uterus is very rare malignant tumor originating from uterine muscle or connective tissue. We have experienced 20 cases of uterine sarcoma from January 1991 to June 1998. The results were as follows: 1. The pathologic types were 13 cases(65.0%) of leiomyosarcoma, 5 cases(25.0%) of malignant mixed Mullerian tumor, 1 case of rhabdomyosarcoma, and 1 case of angiosarcoma. 2. The average age and parity was 50.2 and 3.7. The chief complaints were irregular vaginal bleeding(35.0%), lower abdominal pain(25.0%), and abdominal mass(25.0%). 3. Nine cases(45.0%) were FIGO stage I, 1 case(5.0%) was stage II, 6 cases(30.0%) were stage III, and 4 cases(20.0%) were stage IV. 4. The survival was from 1.5 months to over 130 months(median 16.5 months), and there was no correlation between survival and FIGO stage or pathologic type. The correlation between survival and number of mitotic figure was incalcurable. 5. CA 125 levels were serially measured as a tumor marker in monitoring patients and the positive rate was 40%. Further study was needed to make a conclusion for usefulness of CA 125 as a tumor marker.
This study was undertaken for the clinical evaluation and statistical analysis on the 88 women with histopathologically confirmed ectopic pregnancies who were admitted and treated from grand opening on May-28, 1983 to Sept.-30, 1985. Incidence of ectopic pregnancy was 1 in 22.2 deliveries and the most common age group was in 30~34 years of age. There was tendency of decreasing incidencies as the gravidity, panty or artificial abortion were over 3. The most common etiologic factor was pelvic inflammatory disease and procedures for family planning were the next common. Common symptoms were lower abdominal pain (85.2%) and vaginal spotting (56.8%). At the admission, hemoglobin level under 10gm% were 44.3%, 69.5% of urine HCG tests were positive. Culdocentesis was positive only in 75.9%. Termination was frequent at 6 ~ 7 weeks of gestation mostly with rupture or abortion. Free blood in the abdominal cavity was averaged 1,224 ml. 4 cases of clinicobiochemically suspected ectopic pregnancies with spontaneous regression were excluded, and there was no fatal case treated in hospital.
Alpha-fetoprotein-producing gastric cancer is associated with poor prognosis because of frequent liver and lymph node metastasis. We present a case with synchronous liver metastasis who survived for 5 years. A 69-year-old man with upper abdominal pain was referred to our hospital. Gastrointestinal endoscopy revealed a Borrmann II-like tumor in the lower part of the stomach. Computed tomography revealed a tumor in the left lobe of the liver. Serum alpha-fetoprotein levels were markedly increased. We performed distal gastrectomy after administering oral tegafur/gimeracil/oteracil potassium and administered hepatic intra-arterial cisplatin injection. Liver metastasis showed partial response on computed tomography. Despite left hepatic lobectomy, further metastases to the liver and mediastinal lymph nodes became difficult to control. After sorafenib tosylate administration, stabilization of the disease was observed for 4 months. We conclude that hepatic intra-arterial chemotherapy and oral administration of sorafenib tosylate may potentially improve the prognosis in such cases.
Journal of rehabilitation welfare engineering & assistive technology
/
v.7
no.2
/
pp.85-90
/
2013
Core muscle is the most crucial for rehabilitation of patients with musculoskeletal and nervous problem, there is pain, imbalance and functional movement disorder of upper and lower extremities. In this study, low-frequency electrical stimulator was developed for the purpose increasing the activity of rectus abdominis (RA) and the thickness of transverse abdominis (TrA), internal obliquus abdominis (IO), and external obliquus abdominis (EO). Fifteen female in their 20's was divided into a experiment groups (traditional electrical stimulation group, developed electrical stimulation group) and control group. Low-frequency electrical stimulation was performed in experimental groups for 4 times a week, 4 weeks. The muscle activities (RA) by EMG and muscle thickness (TrA, IO, EO) by Ultrasonogrphy imaging were measured, respectively. In the result, the muscle activity of RA and muscle thickness of TrA and EO were significantly increased at developed electrical stimulation group (p<.05). Therefore, the developed low-frequency electrical stimulation is useful for rehabilitation with CNS and PNS subjects.
Objective : Although chronic non-bacterial prostatitis is a common disease, it is very difficult to treat effectively. Toosendan fructus(TOF) has been traditionally used in treatment of abdominal pain and parasite. In this study, we investigated the therapeutic effects and action mechanism of Toosendan fructus (TOF) in the rat model of non-bacterial prostatitis induced by castration and testosterone treatment. Method : Eight-month-old rats were treated with $17{\beta}$-estradiol after castration for induction of experimental non-bacterial prostatitis, which is similar to human chronic prostatitis in histophatological profiles. Toosendan fructus(TOF) and testosterone were administered as an experimental specimen and a positive control, respectively. The prostates were evaluated by histopahological parameters including the epithelial score and epithelio-stromal ratio for glandular damage. Also, the prostates were observed by hematological alterations of WBC, RBC, hemoglobin, hematocrit and platelet. Results : While prostates of control rats revealed severe acinar gland atrophy and stromal proliferation, the rats treated with Toosendan fructus(TOF) showed a diminished range of the tissue damage. Epithelial score was improved in Toosendan fructus(TOF) than that of the control. The epithelio-stromal ratio was lower in Toosendan fructus(TOF) when compared to that of the control. Also, the examination of bloods were not observed hematological change. Conclusions : These findings suggest that Toosendan fructus(TOF) may protect the glandular epithelial cells and may take hematological safety. We concluded that Toosendan fructus(TOF) may could be a useful remedy agents for treating the chronic non-bacterial prostatitis.
Imperforate hymen is, with an incidence of 0.1%, a rare female anomaly, which can appear with symptoms such as lower abdominal pain, primary amenorrhea, dysuria, anuria, caused by retention of menstrual blood after the onset of menstruation. Generally urinary retention is caused by psychological conditions, drug effect, infection or congenital anomaly causing acute urinary obstruction. We experienced a patient with symptoms of acute urinary retention, suggesting acute urinary obstruction. The cause for the retention turned out to be an imperforated hymen, which should therefore be mentioned in the literature as a possible cause in cases suspected of urinary retention.
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