CT has become the most useful, non-invasive diagnostic method as the initial exmination in the diagnosis ofruptured intracranial aneurysm with intracranial hemorrhage(subarachnoid, intracerebral and intraventricularhemorrhage), hydrocephalus and infarction. Furthermore, high resolution CT can demonstrate aneurysm itself. Butangiography is the last and conclusive method as yet, for better evaluation of vascular anatomic structure ofaneurysm for surgery. Authors analyzed 40 cases of ruptured intracranial aneurysm confirmed by CT, angiographyand/or surgery at Chonnam National University Hospital from July, 83' to July, 85'. The results were as follows:1. The most prevalent age group was the 5th decade(35%), and female patient(57.5%) was more comon than male. 2.Angiographic findings were as follows: 1) Multiple aneurysm was found in 8 patients (20%): the one of thesepatients is tripple, the others are double. 2) The location of aneurysm, in order ot frequency, were : ACA andA-com aneurysm in 23 cases(47%). ICA and P-com aneurysm in 17 cases(35%), basilar tip aneurysm in 4 cases(8%), MCAaneurysm in 3 cases(6%) and PCA aneurysm in 1 case(2%). 3) Hydrocephalus was detected in 22 cases (55%): 21 cases(95%) of these cases were demonstarated within the first 3 weeks after attack. 4) Detection of aneurysm itseslfwas 20 cases(50%). 5) Cerebral infarction was 5 cases(12.5%). 6) Subarachnoid enhancement on post-contrast scanwas 8 cases(20%).
Aneurysm ; Cerebral Infarction ; Diagnosis ; Female ; Humans ; Hydrocephalus ; Infarction ; Intracranial Aneurysm ; Jeollanam-do ; Male ; Methods ; Passive Cutaneous Anaphylaxis

Percutaneous antegrade pyelography guided by ultrasonography and fluoroscopy was attempted in 25 patients with supravesical obstructive hydronephrosis and suctessful in 23 patients to evaluate the site and nature of urinary obstruction. The etiology of the obstructive uropathies were urinary stricture in 11 cases,urinary Tbc. in 5 cases, urinary stone in 3 cases, uterine prolapse with cystocele, pyonephrosis, ureteral metastatic testicular carcinoma in 1 case respectively. No significant complication of the percutaneous antegrade pyelography was observed. Percutaneous antegrade pyelography provides significant diagnostic informations on the obstructive lesion and can be accomplished with ease and safe in patients with obstructiv hydronephnosis as a diagnostic procedure of choice in infants and children or as an alternative to a retrograde pyelography.
Child ; Constriction, Pathologic ; Cystocele ; Fluoroscopy ; Humans ; Hydronephrosis ; Infant ; Pyonephrosis ; Ultrasonography ; Ureter ; Urinary Calculi ; Urography ; Uterine Prolapse

A primary adenosquamous carcinoma of the liver is a rare subtype of a cholangiocarcinoma. Adenosquamous carcinoma is known to have an aggressive biologic behavior and is associated with a poor prognosis. Recently, we experienced a case of a primary adenosquamous carcinoma of the liver. A 69-year-old man was subjected to a right hemicolectomy five months ago due to an ascending colon cancer. At a periodic check-up, abdominal ultrasonography and magnetic resonance imaging showed a ~1.1 cm-sized hepatic mass which was highly suspicious of being a hepatic metastasis from the ascending colon cancer. A hepatic segmentectomy was performed. The tumor was microscopically composed of an adenocarcinoma and a squamous cell carcinoma, and it was different from the previous colon cancer as determined by immunohistochemistry. Three months after the hepatic segmentectomy, multiple hepatic metastasis was found and the patient has been treated as an outpatient with capecitabine.
Adenocarcinoma* ; Aged ; Carcinoma, Adenosquamous* ; Carcinoma, Squamous Cell ; Cholangiocarcinoma ; Colon* ; Colon, Ascending ; Colonic Neoplasms ; Humans ; Immunohistochemistry ; Liver* ; Magnetic Resonance Imaging ; Mastectomy, Segmental ; Neoplasm Metastasis ; Outpatients ; Prognosis ; Ultrasonography ; Capecitabine

Cutaneous fistula of dental origin is the most common type of cutaneous fistula that is formed on the face and neck. This lesion can be a diagnostic challenge to clinicians who are not familiar with cutaneous fistula since many patients with cutaneous fistula of dental origin do not have any complaints such as toothache. Diagnostic errors may result in multiple excisions, biopsies, and ineffective long-term antibiotic therapy. However, if the lesion could be suspected of being of dental origin, the diagnosis can be easily confirmed by radiologic examinations. We report four cases of cutaneous fistula of dental origin. All four patients had a characteristic cutaneous findings with chronically draining, fixed, erythematous papule on their nasolabial fold or submental region. Ultrasonography, fistulography or plain roentgenography were needed to confirm the diagnosis of cutaneous fistula originating from dental problems.
Biopsy ; Cutaneous Fistula* ; Diagnosis ; Diagnostic Errors ; Humans ; Nasolabial Fold ; Neck ; Radiography ; Toothache ; Ultrasonography

Background: Adiponectin is an adipose-derived hormone that plays a role in various metabolic diseases. We previously demonstrated that adiponectin inhibits melanin synthesis through adenosine monophosphate-activated protein kinase (AMPK) activation in melanocytes. However, melanocytes can be affected by neighboring keratinocytes, and the effect of adiponectin on these functional units has not been investigated. Objective: We investigated the effect of adiponectin on melanogenesis in co-cultured models of normal human melanocytes (NHMs), normal human keratinocytes (NHKs), and human dermal fibroblasts (HDFs), and the effect of adiponectin on melanin content in human skin tissues. Methods: Quantitative real-time polymerase chain reaction (qPCR) was performed for tyrosinase and microphthalmia-associated transcription factor (MITF). The degree of phosphorylation of AMPK, cAMP response element binding protein (CREB), and AKT was evaluated by western blot assay, and Fontana-Masson staining was performed on cultured human skin tissues. Results: Adiponectin decreased the melanin content in the co-culture models of NHMs with NHKs, NHMs with HDFs, and NHMs with both NHKs and HDFs. qPCR revealed that both tyrosinase and MITF were decreased after adiponectin treatment in the co-culture system. Following adiponectin treatment, AMPK was activated in all cell groups; however, the phosphorylation of CREB was decreased in HDFs and NHKs. The phosphorylation of AKT was decreased in only NHMs. In the experiment with human skin tissues cultured ex vivo, the densitometric analysis of Fontana-Masson staining revealed that adiponectin treatment reduced the melanin level of ultraviolet-irradiated human skin tissues. Conclusion Adiponectin inhibited melanogenesis in both co-culture models and human skin tissues ex vivo.

PURPOSE: Augmentation mammoplasty by cohesive silicone gel implant is becoming more popular nowadays. Many types of complications have been reported, such as hematoma, seroma, infection, capsular contracture and etc. But there were no report of deep vein thrombosis(DVT) after augmentation mammoplasty in Korea. The authors experienced one case of DVT after augmentation mammoplasty using a cohesive silicone gel implant. METHODS: A 38-year-old woman with breast cancer underwent reconstruction by tissue expander and augmentation mammoplasty by cohesive silicone gel implant, and exchange of expander to cohesive silicone gel implant. The operation was finished without any complicating event. On 4th day after the operation, the patient complained of intermittent right lower leg pain. By doppler ultrasonography, the patient was diagnosed with acute venous thrombosis of the popliteal vein, posterior tibial vein and peroneal vein. RESULTS: Intravenous heparinization and oral warfarin were started immediately and elastic compression stocking was applied. Intravenous heparinization was continued until INR(blood coagulation unit) reached to target levels. The patient was discharged on 11th day of operation with oral warfarin. Other complication has not been reported after 10 weeks of operation. CONCLUSION: To our knowledge, this is the first report of DVT after silicone implant based breast augmentation.
Adult ; Breast ; Breast Neoplasms ; Contracture ; Female ; Hematoma ; Heparin ; Humans ; Korea ; Leg ; Mammaplasty ; Popliteal Vein ; Pulmonary Embolism ; Seroma ; Silicone Gels ; Stockings, Compression ; Tissue Expansion Devices ; Ultrasonography, Doppler ; Veins ; Venous Thrombosis ; Warfarin

PURPOSE: We have done this retrospective study to know the relative incidence and clinical manifestations of organic acidopathies in Korea during 8 years(from Jul. 1997 to May 2005). This results of organic acid analysis of 1,787 patients were compared with the results of organic acid analysis that were published three years ago. METHODS: The results of quantitative organic acid analysis of samples of 1788 patients, referred from Jul. 1997 to May 2005, were analyzed retrospectively according to four age group(-2 mon, 3 mon-2 years, 3-12 years) and major clinical manifestations. Quantification of 83 organic acids was done with gas chromatography and mass spectometry. RESULTS: We diagnosed 470 patients with 27 diseases of organic acid metabolism during this study period. Diseases found more than 10 cases are cytosolic 3-ketothiolase deficiency, mitochondrial respiratory chain disorders, PDHC deficiency, mitochondrial 3-ketothiolase deficiency, glutaric aciduria type II, biotinidase deficiency, methylmalonic aciduria and propionic aciduria. Other diseases were diagnosed in less than 10 cases. CONCLUSION: Though the incidence of individual organic acidemia is low, the overall incidence of organic acidemia as a whole seems to be relatively high in Korea. Compared with the results of organic acid analysis that were reported three years ago, we couldn't find a new disease and the difference of the relative incidences of high incident diseases. We were apprehensive of the errors that was owing to the short study period(3 years), but the relative incidences of our study(8 years) were similar to the results of organic acid analysis that were reported three years ago.
Acetyl-CoA C-Acyltransferase ; Biotinidase Deficiency ; Chromatography, Gas ; Cytosol ; Electron Transport ; Humans ; Incidence ; Korea* ; Metabolism ; Multiple Acyl Coenzyme A Dehydrogenase Deficiency ; Neurologic Manifestations ; Propionic Acidemia ; Pyruvate Dehydrogenase Complex Deficiency Disease ; Retrospective Studies

PURPOSE: The Behcet's Disease Quality of Life (BD-QoL) is a BD-specific measure developed in the UK. The aim of this study was to adapt the BD-QoL for use in Korea. PATIENTS AND METHODS: The translation was based on the guidelines for cross-cultural adaptation. A total of 201 Korean patients with BD participated in this study. To evaluate the psychometric properties, internal consistency and test-retest reliability were used. Factor analysis was performed to examine the construct validity. To provide further evidence for validity, the correlation of BD-QoL with the Clinical Activity Form for Korean Patients with BD (BDCAF-K) and the Center for Epidemiologic Studies-Depression (CES-D) scales was assessed. RESULTS: The Korean version had high internal consistency (Cronbach's alpha, 0.93) and test-retest reliability (r = 0.835). Factor analysis of the questionnaire revealed one interpretable factor as a general health-related quality of life factor. The Korean version significantly correlated with scores of CES-D (r = 0.749, p = 0.000), self-rating scale of well-being over the past 28 days (r = 0.446, p = 0.000), and BDCAF-K score (r = 0.502, p = 0.000). CONCLUSION: Adaptation of the BD-QoL for use in Korea was successful. Together with the BDCAF-K, it may be a valuable tool for assessing the influence of interventions in BD patients and outcome in clinical trials.
Adolescent ; Adult ; Aged ; Behcet Syndrome/diagnosis/*psychology/therapy ; Child ; Cultural Characteristics ; Female ; Humans ; Korea ; Language ; Male ; Middle Aged ; *Quality of Life ; Questionnaires/*standards

Urachal anomalies are very rare. The umbilicus and the structures which lead to its formation rarely cause trouble except in patients with an error. Embryologically, the urachus represents the vestigial remnant of the allantois which, in the fetus, communicates with the cloaca. The patent urachus results from failure of luminal closure of the urachus Herein a case of congenital patent urachus reported with a brief review of literatures.
Allantois ; Cloaca ; Fetus ; Humans ; Phenobarbital ; Umbilicus ; Urachus*

The aim of the present study was to examine the effects of platycodin D and D3, which are active components derived from the roots of Platycodon grandiflorum A. DC., on the contractile force of the i3olated rat aorta and blood pressure of the anesthetized rat, and also to elucidate its mechanism of action. Both phenylephrine (an adrenergic alpha1-receptor agonist) and high potassium (a membrane- depolarizing agent) caused great contractile responses in the isolated aortic strips. Platycodin D at high concentration (24microgram/ml) inhibited contractile responses induced by phenylephrine (10 (-5) M) and high potassium (5.6x10 (-2) M), while low concentrations of platycodin D (4~8microgram/ml) did not affect those responses. However, platycodin D3 (8~32microgram/ml) did not alter the contractile responses evoked by phenylephrine and high K+. Interestingly, the infusion of platycodin D3 (1.0 mg/kg/30 min) significantly reduced the pressor responses induced by intravenous norepinephrine. However, platycodin D3 (1.0 mg/kg/30 min) did not affect them. Taken together, these results show that intravenously administered platycodin D depresses norepinephrine-induced pressor responses in the anesthetized rat, at least partly through the blockade of adrenergic alpha1-receptors. Platycodin D also caused vascular relaxation in the isolated aortic strips of the rat via the blockade of adrenergic alpha1-receptors, in addition to an unknown direct mechanism. However, platycodin D3 did not affect both norepinephrine-induced pressor responses and the isolated rat aortic contractile responses evoked by phenylephrine and high potassium. Based on these results, there seems to be much difference in the mode of action between platycodin D and platycodin D3.
Animals ; Aorta ; Blood Pressure ; Norepinephrine ; Phenylephrine ; Platycodon ; Potassium ; Rats* ; Relaxation