We encountered a case of far advanced hepatomas involving the lungs and portal veins. The patient was a 38-year-old woman. Chemoembolization had transient effects. Cachexia occurred. After repeated episodes of upper gastrointestinal bleeding, she died. An autopsy revealed a deep gastric ulcer to which a nodule of the hepatocellular carcinoma adhered. Histopathologically, the infiltration of the hepatoma was not evident. These findings suggested that circulatory distarbances of the gastric wall due to the adhesion of the growing hematoma had caused the ulceration.

No abstract available.
Anesthetics, Local* ; Calcium* ; Hypothermia* ; Reperfusion Injury* ; Reperfusion*

We reviewed the magnetic resonance imaging (MRI) of intracranial teratoma to detect the characteristic findings. Five patients with intracranial teratoma were evaluated with MRI from January 1988 to December 1990. Four male and one female patients with age ranging from 6 to 14 years were surgicelly confirmed MRI was done with 2.0T superconducting system(Spectro 20000, Goldstar, Seoul) and gadolinium enhancement was done in 4 patients. We retrospectively reviewed the clinical, operative, pathologic, and radiologic findings. Intracranial teratomas showed fatty component, calcification and cystic component filled with sebum or serous fluid. Peripheral rim enhancement was seen in three and irregular enhancement in two cases. There were hydrocephalus in all teratoma, but neither surrounding edema nor surrounding tissue invasion was seen. Low signal intensity rim was noted around the solid component of all tumors and they were not enhanced. MRI showed multicomponent of intracranial teratoma including the solid and cystic component, and low singal rim which might be the characteristic findings of the intracranial teratoma.
Edema ; Female ; Gadolinium ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Male ; Retrospective Studies ; Sebum ; Teratoma*

BACKGROUND: Previous studies of animal and human experiments have shown excellent correlation between true or angiographic stenosis severity and stenosis severity calculated from intracoronary Doppler flow measurements and continuity equation method. However, there remains practical problems to be solved on its clinical application. To minimize these problems, the concept of modified continuity equation method, calculating the percent area stenosis by comparing the maximal in-stenosis flow velocity to the distal reference flow velocity, was introduced and compared with dipyridamole stress thallium-201 SPECT. METHODS: In this prospective study, 102 patients (mean age 57+/-10 years, 69 men, 33 women) with coronary artery stenoses ranging from 23-89% in percent diameter stenosis, who received coronary angiography, dipyridamole stress thallium-201 SPECT, and successful intracoronary flow velocity measurements were included. Modified continuity equation method and distal coronary flow velocity reserve were compared to the result of dipyridamole stress thallium-201 SPECT and quantitative coronary angiography. RESULTS: Measurements of adequate intralesional and stenosis distal flow velocities were successful in 102 out of 106 stenoses (96%). Minimal luminal area and percent area stenosis calculated from modified continuity equation method showed significant correlations with those of quantitative coronary angiography. Modified continuity equation method significantly underestimated the severity of stenosis than quantitative coronary angiography did. The test accuracy in relation to the result of dipyridamole stress thallium-201 SPECT were 91% in modified continuity equation method, 80% in quantitative coronary angiography and 63% in distal coronary flow velocity reserve. CONCLUSION: Application of intracoronary Doppler guide wire and modified continuity equation method appears to provide useful on-site implications for the anatomic and functional assessment of coronary artery stenosis. The modified continuity equation method would be one of the promising concepts for clinical decision making during coronary interventions.
Animals ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis* ; Coronary Vessels* ; Decision Making ; Dipyridamole* ; Humans ; Male ; Phenobarbital ; Prospective Studies ; Tomography, Emission-Computed, Single-Photon*

This study was conducted as a nationwide survey in Korea to determine the THM (trihalomethane) concentration levels in the drinking water of 14 selected cities. The survey was undertaken in one city (Kwangju) during September and October of 1988 and 14 cities in January through February of 1988. The results were as follows: 1. The KMnO4 consumption was 10.6 mg/l - 11.6 mg/l in Pusan and Ulsan, exceeding the drinking water standard of 10 mg/l. Pusan, Inchon, Kwangju, Ulsan, Mokpo and Junju areas also exceeded the ammonia nitrate standard of 0.5 mg/l, Other tap waters surveyed were detected below the drinking water standards. 2. The THM concentrations of tap water measured in January and February of 1989 were detected in the range 1.20 microgram/l - 150.8 microgram/l. 3. In the comparative study of the THM concentration of tap water measured in the Kwangju area during September and October of 1988, the average THM concentration of 145.63 +/- 70.72 microgram/l showed a sifford increase compared to that of 23.8 +/- 8.31 microgram/l surveyed in January and February 1989. 4. The proportion of the four THM compounds found in tap water was bromoform, 47%; chloroform, 30%; chlordibromomethane, 13%; and dichlorobromomethane, 10%. 5. Since the results indicate that the concentration of bromoform was 2 - 10 times higher than that of chloroform measured in the seaside district of Pusan, Ulsan and Cheju Island, it is reasonable to assume that the raw water was somehow influenced by seawater. 6. The average lifetime cancer rate of the population exposed to chloroform measured in the surveyed areas was 17 cancer incidences per 1 million population. From the above results, the existence of THM in the distribution systems seems to be inevitable, since chlorine disinfection is performed in water treatment plants in our country. There seems to be a trend of increasing. THM concentrations due to the contamination of raw water. In order to establish any form of regulations, health risk assessment is an imminent subject.
Ammonia ; Busan ; Chlorine ; Chloroform ; Disinfection ; Drinking Water* ; Drinking* ; Gwangju ; Incheon ; Incidence ; Jeju-do ; Jeollanam-do ; Korea ; Risk Assessment ; Seawater ; Social Control, Formal ; Trihalomethanes* ; Ulsan ; Water ; Water Purification

The diagnosis of gallstone ileus is occasionally challenging due to the variability of its presentation. We herein present a very rare case of gallstone ileus inducing obstructive jaundice at the afferent loop of Roux-en-Y hepaticojejunostomy after 10 years of bile duct cancer surgery. We describe the case of a 74-year-old Korean woman with obstructive jaundice, treated conservatively. She showed severely impaired liver function test and obstructive jaundice. The computed tomography (CT) scan led to a diagnosis of very rare type of gallstones ileus at the afferent jejunal loop. Since the clinical manifestation was improved, we decided to observe her closely. On the next follow-up CT scan, the gallstone disappeared with mild distension of the afferent bowel loop, implicating spontaneous passage of the gallstone. She recovered and returned to normal life after 10 days of initiation of clinical manifestations. We presume that the gallstone may enter the afferent jejunal loop through the hepaticojejunostomy and later increase in size. The presence of narrow tract of intestine may facilitate the incidence of gallstone ileus. It appears to be the first report on this rare type of gallstone ileus inducing obstructive jaundice.
Aged ; Bile Duct Neoplasms* ; Diagnosis ; Female ; Follow-Up Studies ; Gallstones* ; Humans ; Ileus* ; Incidence ; Intestines ; Jaundice, Obstructive* ; Liver Function Tests ; Tomography, X-Ray Computed

Typical vasculitic neuropathy commonly manifests as a subacute multiple mononeuropathy, symmetrical or asymmetrical sensori-motor polyneuropathy. Various clinical presentations of peripheral neuropathy may confuse the diagnostic approach sometimes. A 76-year old man presented progressive areflexic ascending paralysis. gait ataxia, severe vibration and position sense impairment for 1 month. We initially considered as subacute demyelinating polyneuropathy. Electrophysiologic studies showed mainly axonopathy with some evidence of demyelination. We performed sural nerve biopsy and diagnosed as vasculitic neuropathy. No laboratory data or clinical findings favored systemic vasculitic involvement. So we concluded vasculitis confined to the peripheral nerves. Vasculitic neuropathy rarely presented as large myelinated nerve fiber disease. It should be considered the clinical variability of vasculitic neuropathy so extensive studies are needed in the case of peripheral polyneuropathy with indefinite cause.
Aged ; Biopsy ; Demyelinating Diseases ; Gait Ataxia ; Humans ; Mononeuropathies ; Nerve Fibers, Myelinated ; Paralysis* ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Polyneuropathies ; Proprioception ; Sural Nerve ; Vasculitis ; Vibration

No abstract available.
Hemorrhage* ; Kidney Transplantation*

No abstract available.
Cause of Death* ; Kidney Transplantation* ; Kidney*

In published article by Li et al., an author's name was misspelled.