No abstract available.

Urethral foreign body extended to bladder and scrotum is very rare. We report a case of urethral perforation by plastic tube extended to bladder and scrotum with brief review of literature.
Foreign Bodies* ; Plastics ; Scrotum ; Urethra ; Urinary Bladder

BACKGROUND: Cardiopulmonary bypass (CPB), a standard adjunct for open heart surgery, can also play an important role in treating patients with noncardiac diseases. MATERIAL AND METHOD: We report a collective analysis of noncardiac applications of cardiopulmonary bypass experienced at Seoul National University Hospital from 1969 to 1996. Out of a total of 20 patients, 8 were treated for membranous obstruction of inferior vena cava (MOVC), 5 for malignant melanoma, 3 for pulmonary embolism, 1 for double lung transplantation, 1 for intracranial giant aneurysm (GA), 1 for renal cell carcinoma (RC), and 1 for liposarcoma. CPB was used to induce profound hypothermia with circulatory arrest in 6 patients (MOVC 4, GA 1, RC 1). RESULT: CPB time was 113 mins on average for MOVC, 161 mins for GA, and 156 mins for RC, while the lowest rectal temperature was 26degree C on average in MOVC, and 19degree C in GA and RC. Postoperative recovery was good in all MOVC patients. The patient with GA, who underwent reoperation for the removal of hematoma, died 14 days postoperatively. The patient with RC recovered from the operation in a good condition but died from metastatic spread 6 months later. CPB was instituted for pulmonary embolectomy in 3 patients, in whom postoperative courses were uneventful, except in 1 patient who showed transient neurologic symptoms. CPB was used in a patient with double-lung transplantation for hemodynamic and ventilatory support. The patient was weaned successfully from CPB but died from low output and septicemia 19 days postoperatively. CPB without circulatory arrest was used to treat in 4 patients with MOVC. These patients showed good postoperative courses. CPB was used to administer high concentrations of chemotherapeutic agents to the extremities in 6 patients (malignant melanoma 5, recurrent liposarcoma 1). CPB time was 153 mins on average. No complications such as edema and neurologic disability were found. CONCLUSION: Although CPB has a limited indication in noncardiac diseases, if properly applied, it can be a very useful adjunct in a variety of surgical cases.
Aneurysm ; Carcinoma, Renal Cell ; Cardiopulmonary Bypass* ; Edema ; Embolectomy ; Extremities ; Hematoma ; Hemodynamics ; Humans ; Hypothermia ; Liposarcoma ; Lung Transplantation ; Melanoma ; Neurologic Manifestations ; Pulmonary Embolism ; Reoperation ; Seoul ; Sepsis ; Thoracic Surgery ; Vena Cava, Inferior

Intrahepatic cholangiocarcinoma is the second most common subtype of primary hepatobilliary cancer. Despite advances in surgical and medical therapy, its survival rate remains poor. Compared to hepatocellular carcinoma (HCC), the most common liver malignancy, the underlying mechanisms of cholangiocarcinoma carcinogenesis are poorly characterized. P-cadherin (CDH3) is a cadherin super family member. Although CDH3 is frequently over-expressed in cholangiocarcinoma tissues, its roles have never been characterized. To determine the roles of CDH3 in cholangiocarcinoma, we investigated CDH3 function in HuCCT1 cells using specific siRNA. Transfection with CDH3 siRNA did not affect proliferation of HuCCT1 cells. However, cell migration and invasion were significantly reduced when CDH3 was down-regulated. In addition, expressions of several biomarkers for epithelial-mesenchymal transition (EMT) were not changed by CDH3 down-regulation. These results suggest that CDH3 regulates cell migration independent of EMT in cholangiocarcinoma cells.
Biomarkers ; Cadherins ; Carcinoma, Hepatocellular ; Cell Movement ; Cholangiocarcinoma ; Down-Regulation ; Epithelial-Mesenchymal Transition ; Humans ; Liver ; Liver Neoplasms ; RNA, Small Interfering ; Survival Rate ; Transfection ; Cholangiocarcinoma

We experienced a case of cavernous hemangioma suspected to cerebral cysticecosis. The 23-year-old male patient was admitted to our hospital due to sudden severe headache and generalized tonic-clonic seizure. The computerized tomography showed multiple calcification of bilateral cerebral hemisphere, especially right, and cystic mass on right frontal area with mass effect. The mass was diagnosed cavernous hemangioma under the microscopic examination.
Cerebrum ; Cysticercosis ; Headache ; Hemangioma, Cavernous* ; Humans ; Male ; Seizures ; Young Adult

No abstract available.
Constriction, Pathologic*

BACKGROUND AND OBJECTIVE: The long-term effects of beta-irradiation on intimal hyperplasia (IH) within the stented segment and vessel, and the lumen dimensions of non-stented adjacent segments, have not been sufficiently evaluated in patients with ISR. The long-term (24 months) effects of beta-irradiation ((188)Re-MAG3-filled balloon) were evaluated using intravascular ultrasound (IVUS) in patients with in-stent restenosis (ISR). SUCJECTS AND METHODS: A two-year follow-up IVUS was performed in 30 patients with patent ISR segments at the 6-monthly follow-up angiography. Serial IVUS images were acquired at 5 equidistant intra-stent sites and 3 different reference segment sites (1, 2 and 4 mm from stent margin). RESULTS: The mean intra-stent IH area and IH burden significantly increased between 6 and 24 months-from 2.1+/-1.1 to 2.6+/-1.4 mm2 (p<0.001) and from 26+/-10 to 33+/-14% (p<0.001), respectively. There were significant decreases in the mean external elastic membrane (from 10.1+/-3.9 to 9.7+/-3.9 mm2, p=0.015) and lumen area (from 5.6+/-2.3 to 5.1+/-2.3mm2, p=0.021) within the distal reference segments between 6 and 24 months. Target lesion revascularization (TLR) was performed between 6 and 24 months in 6 patients (20%) following the beta-irradiation therapy. There were no significant differences between the TLR and non-TLR groups, with the exception of a smaller minimum lumen CSA at 24 months in the TLR group. CONCLUSION: Because of a small amount of late loss between 6 and 24 months, most irradiated ISR vessel segments remained stable for up to 2 years. However, quantitative evidence of late catch-up was evident in most patients and was significantly associated with 24-month TLR in some patients with a smaller minimum lumen area.
Angiography ; Brachytherapy* ; Follow-Up Studies ; Humans ; Hyperplasia ; Membranes ; Stents ; Ultrasonography*

BACKGROUND AND OBJECTIVES: Intracoronary radiation therapy for in-stent restenosis has been demonstrated to reduce restenosis and major adverse cardiac events. However, the long-term angiographic and clinical outcomes after beta radiation therapy have not been sufficiently evaluated. SUBJECTS AND METHODS: The long-term angiographic and clinical outcomes of 50 consecutive patients who had received beta-radiation therapy with an 188Re-MAG3-filled balloon after rotational atherectomy for diffuse in-stent restenosis (lesion length>10 mm) in native coronary arteries were evaluated. The radiation dose was 15 Gy at a depth of 1.0 mm into the vessel wall. RESULTS: The mean lesion length was 25.6+/-12.7 mm. Radiation was delivered successfully to all patients, without any procedural or in-hospital complications. At the 6-month angiogram, the restenosis rate was 10% (5/50). There were no major adverse cardiac events (MACE), such as death, myocardial infarction or target lesion revascularization (TLR), by the 6-month follow-up. Long-term clinical data were obtained from all patients during 30.1+/-4.5 months of follow-up. No myocardial infarction and one noncardiac death occurred during follow-up. A two-year follow-up angiogram was performed in 26 (58%) of 45 patients that showed a patent radiation segment at the 6-month angiogram. Significant narrowing of the diameter stenosis greater than 50% occurred in 6 (23%) of 26 patients between 6- and 24-months after the beta-radiation. Late TLR was performed in 6 patients. The rate of 30-month death-free survival and MACE-free survival were 98.0+/-2.0 and 86.9+/-5.0%, respectively. CONCLUSION: Beta-radiation using an 188Re-MAG3-filled balloon after rotational atherectomy is associated with favorable long-term angiographic and clinical outcomes.
Atherectomy, Coronary* ; Beta Particles ; Brachytherapy ; Constriction, Pathologic ; Coronary Restenosis ; Coronary Vessels ; Follow-Up Studies ; Humans ; Myocardial Infarction

PURPOSE: To determine which contrast media are both efficient and safe for the imaging of airways. MATERIALS AND METHODS: We evaluated five contrast media (barium, gastrografin, iotrolan, ioxaglate, iopentol) in terms of image quality and their effects on the lungs of 25 white rabbits. For bronchography 0.5ml of contrast media was used. In each contrast group, HRCT scans were obtained immediately (n=5), 12 hours (n=4), 1 day (n=3), 2 days (n=2), and 1 week (n=1) after bronchography. Histopathologic specimens were obtained immediately, 12 hours, 1 day, 2 days, and 1 week later. Bronchograms were evaluated for image quality by three radiologists working independently, and were scored as 1(poor), 2(moderate), or 3(good) in terms of contrast quality and bronchial coating. HRCT was evaluated by two radiologists who reached a concensus; they determined the presence of contrast media, and then the pattern and extent of pulmonary opacity, and any related changes. Histopatholgic specimens were evaluated by two pathologists who sought consensus as to the extent of inflammation, pulmonary edema, and hemorrhage, and any changes in these aspects. RESULTS: Bronchography indicated that the sum of scores for contrast quality was 45 for barium, 33 for gastrografin, 28 for iotrolan, 30 for ioxaglate, and 28 for iopentol, while for each of these media, the sum of scores for bronchial coating was 39, 19, 25, 23, and 21, respectively. Barium showed the best image quality. In all rabbits, HRCT demonstrated the variable extent of groundglass attenuation and/or consolidation. Lesions were most extensive at 1-2 days and then regressed at 1 week; these HRCT findings correlated well with histologic findings. In histologic studies of all five contrast media groups, variable severe inflammatory reactions were observed, with or without necrosis, congestion, edema, and hemorrhage. It was noted that ioxaglate appeared to cause least tissue reaction. CONCLUSIONS: The imaging results of this experimental study indicate that for bronchography, barium is the best available contrast media, On the basis of the histologic and HRCT results, however, ioxaglate is the best.
Barium ; Bronchography* ; Consensus ; Contrast Media* ; Diatrizoate Meglumine ; Edema ; Estrogens, Conjugated (USP) ; Hemorrhage ; Ioxaglic Acid ; Lung ; Necrosis ; Pneumonia ; Rabbits

A series of 24 cases of gun shot and explosive injuried patients of the brain is analyzed according to causes, types, operability, the relation between Glasgow coma scale(GCS) and operative mortality, associated injuries, complications and sequelae. The authors notice that gun shot and explosive injury of the brain are more worse than blunt head trauma because of injury mechanism by itself.
Brain* ; Coma ; Craniocerebral Trauma ; Humans ; Mortality