No abstract available.
Bone Marrow* ; Radionuclide Imaging*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin*

No abstract available.
Classification* ; Humans ; Leukemia* ; Survival Rate*

No abstract available.
Population Characteristics* ; Thyroid Gland* ; Thyroiditis*

A case of metastatic alveolar soft part sarcoma is presented with clincal, pathological and radiological features. Alveolar soft part sarcoma is a rare soft-tissue neoplasm that is malignant and invariably fatal. It was first described and named by Christopherson, et al. in 1952. Since 1952 numerous examples of this tumor have been reported and have been studied with the electron microscope, but there is still considerable uncertainty as to the exact histogenesis of the tumor. Most cases occur in young females involving the lower extrimities especially in the right side. The most initial presenting symptom is a slowgrowing painless mass and the principal metastatic sites are the lungs, followed by the brain and skeleton. Cerebral metastasis, in fact, may be the first manifestation of the disease. Treatment is radical surgical excision but radiotherapy and chemotherapy are less effective. We present the reported case of metastatic alveolar soft pat sarcoma with electron microscopic findings.
Brain ; Drug Therapy ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Radiotherapy ; Sarcoma ; Sarcoma, Alveolar Soft Part* ; Skeleton ; Uncertainty

PURPOSE: Iliac vein compression syndrome (IVCS), first characterized by Cockett and Thomas in 1965, is the development of iliofemoral deep venous thrombosis due to compression of the left common iliac vein against the spine and pelvic brim by the right common iliac artery. Thrombectomy treatment of the underlying compression is essential if significant long-term sequelae are to be avoided. Surgical treatment options include venous reconstruction or venous bypass, but treatment using endovascular techniques have recently been described. This study was conducted to evaluate the usability of endovascular treatment (esp. thrombolysis with stent insertion) in a venous outflow obstruction resulting from IVCS. METHOD: During a 2-year period, 20 patients (17 women, 3 men; mean age, 60 years) presented with clinical and imaging findings consistent with IVCS. All patients presented with leg edema or pain. The mean duration of symptom onset was 6.6+/-4.4 days, ranging from 1 to 15 days. All patients were evaluated using a Duplex scan, computerized tomography and venography. After the ascending venography had been performed, an infusion catheter system was placed, and urokinase infused locally into the thrombus burden. After near complete clot dissolution, the residual left common iliac vein stenosis was treated by means of angioplasty and the placement of a Wallstent. All patients continued to receive oral warfarin. Patients were followed-up by means of clinical visits, and the stent patency was assessed by means of a Duplex scan or computerized tomography. RESULT: The total dose of urokinase used and the duration of infusion were 2.28+/-0.93 million unit, ranging from 1.00 to 5.20 and 46.8+/-14.8 hours, ranging from 14 to 72 hours, respectively. Grade III (complete lysis) thrombolysis was achieved in 17 patients. All 17 patients successfully received a Wallstent. The initial clinical success was 100%, with complete resolution of symptoms in all patients. One patient, with combined ovarian cancer, had a recurrent symptomatic deep vein thrombosis and complete occlusion of the stent due to thrombosis 2 months after treatment. However, no other patients showed evidence of deep vein thrombosis after treatment. The overall patency rate of the stenting at 18 months was 94.1%. There were no deaths, pulmonary embolism, cerebral hemorrhage or major bleeding complications. CONCLUSION: These results suggested that the treatment of iliac vein compression syndrome, using catheter directed thrombolytic therapy and venous stent insertion, was a safe and effective method at the mid term evaluation. These patients will continue to be followed up with screening tests to further define the long-term patency.
Angioplasty ; Catheters ; Cerebral Hemorrhage ; Constriction, Pathologic ; Edema ; Endovascular Procedures ; Female ; Hemorrhage ; Humans ; Iliac Artery ; Iliac Vein* ; Leg ; Male ; Mass Screening ; May-Thurner Syndrome* ; Ovarian Neoplasms ; Phlebography ; Pulmonary Embolism ; Spine ; Stents ; Thrombectomy ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis ; Warfarin

OBJECTIVE: To determine the life expectancy and causes of death of the children with Down syndrome(DS), longitudinal follow-up study was done for 29 cases of DS who were born at CHA hospital located in Seoul During the period from July 1991 to Dec. 1994. METHODS: 29 cases were divided into groups according to the presence of congenital heart disease (CHD) and leukemia. CHD group was subdivided into DS with complete AVSD(atrioventricular septal defect) and DS without complete AVSD. Survival curves were calculated by kaplan-Meier product limit method. Each group were compared by log rank test. The factors affecting mortality rate were analyzed by Cox's proportional hazard regressional model. RESULTS: There were no statistical differences in mortality rate between groups with CHD(35.3%) and without CHD(33.3%)(p=0.7373). Statistical difference was not observed between CHD subgroups with AVSD and with CHD other than AVSD. There were significant statistical difference in mortality rate between groups with leukemia and without leukemia(p=0.0001). CONCLUSION: The factor affecting mortality rate of DS was the presence of leukemia regardless of presence of CHD in our study cases with DS.
Cause of Death ; Child* ; Down Syndrome* ; Follow-Up Studies ; Heart Defects, Congenital ; Humans ; Kaplan-Meier Estimate ; Leukemia ; Life Expectancy ; Mortality ; Seoul ; Survival Analysis*

PURPOSE: The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression on exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. MATERIALS AND METHODS: The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercies was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. RESULTS: The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. CONCLUSION: These RESULTS suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmill exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease.
Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Diagnosis ; Electrocardiography ; Exercise Test ; Female ; Heart Rate ; Humans ; Male ; Myocardial Ischemia ; Myocardium ; Perfusion ; Prevalence ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

Ventricular tachycardia is an important tachyarrhythmia which is encountered commonly in clinical field. The accompanying manifestations could be variable just from palpitation to sudden cardiac death. The classification of this arrhythmia has not completly settled yet, but in a broad way this arrhythmia is classified according to the prescence or abscence or underlying heart disease, especially coronary artery disease. Recently, therapeutic modalities for this arrhythmia have been changed a lot from classical antiarrhythmic drugs to radiofrequency ablation or ICD implantation although there are still some problems to overcome. We experienced a case of 34-year-old female having an incessant ventricular tacycardia which was abolished after endomyocardial biopsy performed to differentiate underlying myocardial pathology.
Adult ; Anti-Arrhythmia Agents ; Arrhythmias, Cardiac ; Biopsy* ; Catheter Ablation ; Classification ; Coronary Artery Disease ; Death, Sudden, Cardiac ; Female ; Heart Diseases ; Humans ; Pathology ; Tachycardia ; Tachycardia, Ventricular*

PURPOSE: To determine the histopathologic changes occurring in normal pig organs after percutaneous injection of hot saline. MATERIALS AND METHODS: Under sonographic guidance, the livers, the gallbladders, kidneys, stomachs, and lungs of ten pigs weighing 15-20kg were punctured with a fine needle. Physiologic saline mixed with contrast medium and Lipiodol was heated to 100 degreeC and injected under fluoroscopic guidance. One to four weeks after injection, the animals were sacrificed and histopathologic examination was performed to investigate acute and chronic tissue responses. RESULTS: In all organs, coagulation necroses developed during the acute phase. Histopathologic changes observed four weeks after injection were as follows: in the liver, most damage was restored, though central necrosis persisted; in the kidney, parenchymal and uroepithelial damage fully recovered, and in the gallbladder and stomach, superficially located damage also fully recovered. In the lung, however, extensive pneumonic infiltration developed during the chronic phase. Fluoroscpoic examination revealed that saline in the liver or kidneys tended to leak easily into blood vessels, the bile duct, or ureter, and corresponding regions showed mild to moderate damage during the acute phase which fully recovered in the chronic phase. CONCLUSION: In normal pigs, significant chronic damage after the injection of hot saline mixture occurred only in the lungs.
Animals ; Bile Ducts ; Blood Vessels ; Ethiodized Oil ; Gallbladder ; Hot Temperature ; Kidney ; Liver ; Lung ; Necrosis ; Needles ; Stomach ; Swine* ; Ultrasonography ; Ureter