, Young Sook Pae Insulin controls the levels of blood sugar by inhibiting glucose release from liver and by stimulating glucose utilization in muscle and adipose tissues. In addition to its peripheral effects, insulin influences circulating glucose levels by modulating glucose production and its metabolism through central nervous system. But it is presently not well known whether the central effect of insulin on plasma glucose is mediated by directly or indirectly through CNS actions. The autonomic nervous system exerts a dual control over insulin secretion. The parasympathetic nervous system can augment insulin secretion and the sympathetic nervous system can produce a net impairment of insulin release.
In the present study, we measured the changes of blood glucose and pyruvic acid level to examine the effetcs of intracisternally injected insulin. Carbachol and scopolamine in streptozotocin(STZ)-induced diabetic rats.
results are as follows:
1) streptozotocin produced significant increase in blood glucose and pyruvic acid concentrations.
2) Intracisternally injected insulin markedly reduced blood glucose and pyruvic acid concentrations in STZ-induced diabetic rats.
3) Intracisternally injected cholinominetics, carbachol, reduced blood glucose and pyruvic acid concentrations in STZ-induced diabetic rats.
4) Intracisternally injected anticholinergics, scopolamine, increased the concentration of the blood glucose and inhibited the concentration of the blood pyruvic acid in STZ-induced diabetic rats.
Therefore, it is suggested that central parasympathetic nervous system plays an partial role in modulating peripheral blood glucose metabolism and insulin produse hypoglycemic action via central parasympathetic nervous system.
Serum levels of carcinoembryonic antigen(CEA) were determined in 65 patients with non-small cell lung cancer to investigate the correlation with clinico-pathologic characteristics. The most common histologic type was sdenocarcinoma(44.6%), followed by sqaumous cell carcinoma(41.5%) and large cell carcinoma(9.2%). Many patients were in unresectable advanced stage(IIIB : 21.5%, IV : 46.2%). Serum CEA was positive(defined as>10ng/ml) in 28 patients(43.1%). The positivity of Serum CEA was signigicantly higher in adenocarcinoma(69.0%) than that in sqaumous cell carcinoma(25.9%) and large cell carcinoma(0.0%)(p=0.0004). There was no statistically significant difference in positivity of CEA according to stages. Serum CEA level does not seem to be seletive or specific standard tumor marker of non-small cell lung cancer patients. However, it may be useful as prognostic marker or monitor of treatment results, especially in adenocarcinoma.
Ovarian cyst aspiration guided by transvaginal sonography in EWHA Woman's university hospital from 1993 June to 1995 April was performed in 18cases. And the results were as follows.
1) The mean age of patients was 32.2±10.7 years, i-gravida was 8 cases(44.5%). multigravida was 10cases(55.5%), and mean serum CA-125 level before aspiration was 29.5±15.1U/ml.
2) The chief complaints of patients were ; lower abdominal pain in 8 cases(44.5%), post TAH status in 3 cases(16.7%), and vaginal spotting in 2cases(11.0%)
3) The mean diameter of ovarian cyst by transvaginal sonography was 5.9±1.4cm.
4) The mean amount of cystic fluid was 110.8±84.5ml and in 15 cases the fluid was clear yellowish color. In 1 case, that was chocolate color, thick nature and it was compatible with endometrioma.
5) During the follow-up, 3 cases(16.7%) had recurrenece, for the treatment of recurrence, 1 case was by pelviscopy, 1 case was by reaspiration, and 1 case was simply followed-up.
Conclusively, benign ovarian cyst could be managed satisfactorily by transvaginal sonography guided aspiration of cyst. Careful examination using transvaginal sonography and assessment of serum CA-125 is recommended before managing ovarian cyst by transvaginal sonography guided aspiration. And cytologic examination of aspirated fluid is mandatory as well to rule out the existence of malignacy. Therefore, ovarian cyst aspiration guided by transvaginal sonography would be the complete treatment as well as the definite diagnosis.
, Seung Cheol Kim After menopause, the incidence of osteoporosis and cardiovascular is increased and the cause of both disease is estrogen deficiency. So we evaluated the relationship between serum lipid profile which is a good indicator of the cardiovascular disease and spinal bone mineral density. Spinal BMD was measured by dual photon absorptiometry and serum lipid profile and alkaline phosphatase, total calcium measured before initiating hormone replacement therapy. Z score was correlated with inversely with alkaline phosphatase(r=-0.35, p<0.05). Serum lipid level were divided into high and low risk category, after adjustment of risk category total cholesterol had significant affects on relationship with spinal Z score. Our results suggest that postmenopausal women with low Z score also have high total cholesterol should be cosidered as a special high risk group for prevention of cardioavascular disease.
One hundred forty nine cases of single digital replantation were performed in the digital amputated patients from March 1988 to December 1933. Prospective study for the postreplanted edema and late functional recovery was carried out in the 149 patients. For exclusion of additional effects on the edema in replanted digits, multiple finger replantations were excluded in this study.
The results of the analysis were as follows:
1) The early postreplanted edemas were decreased on the 28th postoperative day but it significantly persisted until the 28th postreplanted day.
2) The more increased edema was developed, the more decreased functional recovery rate was seen.
3) The early postreplanted edema was an injurious obstacle for late functional recovery. In conclusion, we try to persevere in our effort for revascularization of possible vein for reducing the postreplanted edema and make the patient early exercise.
Intravascular embolization of fragments of indwelling intravascular diagnostic polyethylene catheter continues to occur. This causes many complications such as sepsis, thromboembolism, endocarditis and even perforation of cardiac chambers. The author experienced 3 cases of successful retrieval of intravascular iatrogenic catheter foreign bodies which were iocated in right pulmonary artery and inferior vena cava, using loop-snare technique.
Percutaneous transluminal retrieval of catheter foreign bodies were underwent within 30minutes. There were no complications following retrieval of foreign bodies. This study suggests that the loop-snare technique is a safe and effective method for retrieval of iatrogenic foreign bodies in the great vessels.
Citations
, Seung Ki Ryu, Seung Jung Kim, Jun-Hyuk Choi, Soon Nam Lee, Kwang Ho Kim, Woo Sup Han Although the role of surgical management of metastatic disease from primary carcinoma of the coln and recutm is still controversial, resection of hepatic metastasis improves survival rate of patients with primary colorectal carcinoma treated locally. The lung is the most common site of extra-abdominal metastasis following resection of a prymary colorectal tumor and not amenable to curative therapy.
It is possible to resect the pulmonary metastasis in selected patients following resection of colorectal cancers, but the 5-year survival rates are ranged from 9% to 57%. Authors report a case of resection of pulmonary metastasis occured 3 years after resection of primary colon carcinoma.
The neuroendoscopic third ventriculostomy is becoming the standard treatment for aquired aqueduct stenosis because of its exellent results and very low morbidity. Usually the floor of third ventricle is perforated by closed forcep. Fogarty catheter, laser, saline torch, monopolar coagulator and endoscope itself. Whatever the method of ventriculostomy, the obstruction may occur. Recently the author experienced a case of obstruction at the previous site of third ventriculostomy. A 54 yr old man who had long standing ataxia developed headache, vomiting and urinary incontinence suddenly. It was revealed that he had cerebellar tumor, which had compressed the aqueduct of Sylvius anteriorly. I performed the endoscopic third ventriculostomy by monopolar coagulator and Fogarty ballon catheter. During this procedure, there was some bleeding from opening margin but all these bleedings were stopped by rinsing and electric coagulation. He was improved immediately in the postoperative period. 1 month later, the reattack of hydrocephalus developed and it was operated. On intraoperative view, the newly grown gliotic plug originated from the right mammillary body. On 5th day after reoperation., the patency of the artficial aqueduct was confirmed by 2-D cine PC MR CSF(2 dimensional cine phase contrast magnetic resonance cerebrospinal fluid) flow study.
I may suggest that in order to minimize the occlusion the opening should be made at the center of midline, thinnest area in front of both mammillary bodies, with less bleeding and without electric coagulation.
, Jong Ki Kim, Seok Heun Jung, Bong Suk Shim Paraurethral leiomyoma is a very rare condition. A case of paraurethral leiomyoma in a 37 years old female was presented. The presenting symptoms were a protruding mass at the anterior wall and residual urine sensation.
The mass was resected surgically and confirmed as a leiomyoma histologically.
, Seok Heun Jang, Bong Suck Shim, Sung Won Kwon, Hye su Gu Cystic lymphangioma is a very rare condition of unknown etiology. It is generally regarded as a developmental malformation in which obstruction or agenesis of lymphatic tissue results in lymphagi-ectasis secondary to lack of normal communication of the lymphatic system.
Most lymphagiomas occur in the neck(75%) and axillary region(20%). Lymphagiomas may rarely occur in the retroperitoneum, mediastinum and mesentery.
We report a case of 42-year-old woman with histologically proven cystic lymphagioma retroperitoneum.
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