A single center experience of adrenalectomy for adrenal tumors

PURPOSE: In this study, we reviewed 16 cases of adrenalectomy, focusing specifically on the surgical outcomes and clinical courses.METHODS: The data from 16 patients who underwent an adrenalectomy at our hospital between January 2007 to December 2016 were retrospectively analyzed based on their medical records. Data available for each patient included age, sex, tumor location, length of postoperative hospital stay, tumor size, tumor pathology, final diagnosis, operation time, operative blood loss, and type of operation.RESULTS: The study population consisted of eight males and eight females, with a mean age of 58.00±11.34 years (range, 33–76 years). The mean tumor size was 2.78±2.02 cm (range, 0.5–7 cm). Fourteen patients were diagnosed with functional adrenal tumors and two with nonfunctional adrenal tumors. Compared to laparoscopic adrenalectomy, open surgery resulted in a statistically significantly longer operating time, increased operative blood loss, and a longer postoperative hospital stay.CONCLUSION: If the hormonal activity of adrenal tumors is not confirmed, the tumor should be considered functional when accompanied by related symptoms and an adrenalectomy should be performed. In addition, we suggest that a laparoscopic adrenalectomy is superior to an open adrenalectomy in terms of recovery after surgery, despite the small number of cases evaluated. Open adrenalectomy should be considered following comprehensive consideration of the patient's condition, such as accompanying surgery or metastatic cancer.

Effects of Repeated Citalopram Treatments on Chronic Mild Stress- Induced Growth Associated Protein-43 mRNA Expression in Rat Hippocampus

Although growth associated protein-43 (GAP-43) is known to play a significant role in the regulation of axonal growth and the formation of new neuronal connections in the hippocampus, there is only a few studies on the effects of acute stress on GAP-43 mRNA expression in the hippocampus. Moreover, the effects of repeated citalopram treatment on chronic mild stress (CMS)-induced changes in GAP-43 mRNA expression in the hippocampus have not been explored before. To explore this question, male rats were exposed to acute immobilization stress or CMS. Also, citalopram was given prior to stress everyday during CMS procedures. Acute immobilization stress significantly increased GAP-43 mRNA expression in all subfields of the hippocampus, while CMS significantly decreased GAP-43 mRNA expression in the dentate granule cell layer (GCL). Repeated citalopram treatment decreased GAP-43 mRNA expression in the GCL compared with unstressed controls, but this decrease was not further potentiated by CMS exposure. Similar decreases in GAP-43 mRNA expression were observed in CA1, CA3 and CA4 areas of the hippocampus only after repeated citalopram treatment in CMS-exposed rats. This result indicates that GAP-43 mRNA expression in the hippocampus may differently respond to acute and chronic stress, and that repeated citalopram treatment does not change CMS-induced decreases in GAP-43 mRNA expression in the GCL.

Effect of Peritonsillar Lidocaine Infiltration on Posttonsillectomy Pain in Children / 대한마취과학회지

BACKGROUND: Recent studies suggest the hypothesis that blockade of nociceptive input with local anesthetics before surgery can decrease pain beyond the immediate postoperative period. The purpose of this study was to determine if the preincisional infiltration with local anesthetics affected postoperative pain relief. METHOD: Among 30 patients having tonsillectomy, 15 patients(group 1) given peritonsillar infiltration using lidocaine with epinephrine(1 : 200,000) were compared with 15 patients(group 2)given peritonsillar infiltration using saline with epinephrine(1 : 200,000). Following general anesthesia with a mixture of O2-N2O(50%) and enflurane(1-2vol.%), peritonsillar infiltration were performed 5 minutes before surgery. Constant incisional pain and pain on swallowing were assessed using a visual analogue scale at 4 hour, 1, 2, 3 and 4 days postoperatively. The time to emergence and behaviour of patient at 0.5, 1 and 4 hour were recorded postoperatively. RESULT: Preincisional infiltration with lidocaine resulted in a significant decrease in postoperative pain during 4 days after surgery and smoother emergence. CONCLUSION: There were significant difference in pain scores between lidocaine group and saline group during 4 days after surgery. Preincisional lidocaine infiltration seemed to have analgesic activity beyond the residual anesthetic period. The results of this study support the theory of pre-emptive analgesia.