No abstract available.
Carcinoma, Bronchogenic* ; Lung, Hyperlucent*

It is well known that metastatic bone tumor is very rare below knee and elbow joint. Recently, we experienced two cases of metastatic tumor from kidney and lung to the tibia at Koryo General Hospital.
Elbow Joint ; Hospitals, General ; Kidney ; Knee ; Lung ; Tibia

The oncogenes, which have been detected in various human solid tumors, transform culture cells, and the level of m-RNA specific for an oncogene increases in the cellular extract of the tumor cells. These findings suggested that oncogene expression was closely related with carcinogenesis. Recently, oncogen products were considered as tumor markers, but it was not confirmed that the relationship between quantitative change of oncogene product and malignant potential of a neoplasm. To evaluate the relationship between the quantitative change of oncogene product and malignant potential, immunohistochemical staining for the ras and myc oncogene products was performed in the sections of papilloma and transitional cell carcinoma of urinary bladder. 1) Positive reaction of c-ras oncogene product was noted along the cell membrane and in the cytoplasm, and c-myc oncogene product in the nucleus, and along the unclear membrane and cell membrane. 2) Tissue expression of c-ras oncogene was homogeneous and strong in the transitional cell carcinoma rather than in papilloma. 3) The ratio of the positive cells with c-ras oncogene product was 35.1% in the papilloma, 79.4% in the grade I, 81.9% in the grade II, 87.6%, in the grade III of transitional cell carcinoma of the urinary bladder. There was a tendency for the ratio to increase with the degree of histological grading. 4) By the immunoperoxidase staining of c-myc oncogene product, the number of the cells showing positive nuclear staining incrased with the tumor grading.
Humans ; Tumor Markers, Biological ; Carcinogens

The value of the computed tomography(CT) in the diagnosis of the pelvic bone (especially acetabulum) is being explored. Simple radiographic projections, including specially designed views, although very helpful, often can not provide sufficient information to give a true sense of the fractures.CT,converoly displays the anatomy in a axial plane, thereby providing the missing pieces of information and greatly fascilitating accurate classification of these fractures. In addition, the extent of the soft tissue damage and joint involvement is precisely demonstrated. 10 patients with acetabular fracture, were adimitted to Koryo General Hospital and were taken the CT, were reviewed. Comparing simple radiographic findings with those of the CT, we have made the following conclusions: 1. CT was shown to be useful in the evaluation of the acetabular fractures. 2. CT could detect the pattern of acetabular fracture including degree of fracture fragment, displacement and loose body fragment, and stability of the hip joint. 3. Follow-up of the CT was helful in confirming the extent of bony union of the acetabular fracture. 4. CT was more sensitive than simple radiography in detecting fractures involving the anterior column of the acetabulum.
Acetabulum ; Classification ; Diagnosis ; Follow-Up Studies ; Hip Joint ; Hospitals, General ; Humans ; Joints ; Pelvic Bones ; Radiography

In planning treatment of tibial condylar fracture, the patient's age and physical condition, associated ligament injury and accurate fracture diagnosis, such as presence and degree of separatiori of split fragment, type of fracture and the severity of comminution must be considered. For accurate diagnosis, many kinds of methods including simple X-ray, arthroscopy, arthrography and tomography can be used. In spite of these procedures, sometimes we cannot know the accurate fracture morphology. The computed tomography(CT) has many advantages over other diagnostic methods. The application of CT in the evaluation of patients with spinal and pelvic fractures has been established, but rarely has its usefulness been noted in tibial condylar fracture. We thought that in assessing tibial condylar fracture, CT is more useful and accurate than conventional radiography. From March 1985 to August 1986, we took 17 patients(18 cases) of tibial condylar CT and were convinced with that it is a good diagnostic method. The results are as follows: l. In 5 cases, we could find a new fracture on CT film, which was impossible to be detected on simple X-ray. 2. In 7 cases, the fracture classification by plain X-rays was changed after CT check-up. 3. We could make the decision of treatment methods easily through more realistic classification and better recognition of split and comminution. 4. Proper approach could be done by understanding the accurate fracture size and localization.
Arthrography ; Arthroscopy ; Classification ; Diagnosis ; Humans ; Ligaments ; Methods ; Radiography

As the result of the study concerning "bone inducibility of chitosan", 1. "BMP-2"was observed mainly through the test when the "osteoblast"is exposed to the "chitosan". The expression of BMP-2 was 542.63 times compared to control after 2 hours exposure and it was maintained 16.60 times till 24 hours. 2. The expression of BMP-4 was decreased compared to control during exposure. 3. The expression of BMP-7 revealed two peaks during exposure. 4. The expression of osteocalcin was increased in early phase, and then decreased. Although it is not clear whether the "chitosan"is clinically effective material as a "bone induction material", we could say that it has a function for bone induction. Further detailed study will be required.
Bone Morphogenetic Protein 7 ; Chitosan* ; Humans* ; Osteoblasts* ; Osteocalcin

The complications of bile duct stone are cholangitis, pancreatitis, obstructive jaundice, liver abscess, and secondary biliary cirrhosis. Liver abscess may produce pyothorax, peritonitis, subphrenic abscess, and pyogenic pericarditis. The case studies of pyogenic pericarditis secondary to pyogenic liver abscess are rarely reported. Stones greater than 20mm in diameter are difficult or impossible to remove with a standard basket or balloon after sphincterotomy. There are several nonsurgical treatment options for large bile duct stone: mechanical lithotripsy, endoprosthesis, extracorporeal shock-wave lithotripsy (ESWL), electrohydraulic lithotripsy, contact dissolution therapy, and laser lithotripsy. We experienced a case of large bile duct stone which complicated by pyogenic pericarditis, liver abscess, and pyothorax. He treated with antibiotics, closed thoracostomy, partial pericardiectomy, and removal of bile duct stones by extracorporeal shock-wave and mechanical lithotripsy after endoscopic sphincterotomy and nasobiliary drainage.
Anti-Bacterial Agents ; Bile Ducts* ; Bile* ; Cholangitis ; Drainage ; Empyema ; Empyema, Pleural* ; Jaundice, Obstructive ; Lithotripsy ; Lithotripsy, Laser ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver Cirrhosis, Biliary ; Liver* ; Pancreatitis ; Pericardiectomy ; Pericarditis* ; Peritonitis ; Sphincterotomy, Endoscopic ; Subphrenic Abscess ; Thoracostomy

Dieulafoy lesion is very small and easily overlooked as a course of massive, often recurrent hemorrhage that results from the crosion of a submucosal artery, typically in the gastric cardia or fundus. The clinical picture of Dieulafoy lesion is quite uniform: patients commonly present with massive hemorrhage and melena without any relevant history. The diagnostic procedure of choice in patients with severe gastrointestinal bleeding is emergency endoscopy. The lesion is rare but potentially life threatening source of upper gastrointestinal bleeding. Before the endoscopic era, the prognosis for patients with these lesions was quite poor. However, recent reports have described the success of endoscopic therapy in the management of Dieulafoy lesion. We performed emergency endoscopy in 3 patients who had massive or recurrent episode of upper gastrointestinal bleeding, identified to the Dieulafoy lesion. We tried to Endoscopic "0" band ligation, successfully in hemostasis and prevention of recurrence.
Arteries ; Cardia ; Emergencies ; Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Hemostasis ; Humans ; Ligation* ; Melena ; Prognosis ; Recurrence

The hypokalemic periodic paralysis is characterized by intermittent falccid paralysis of extremities with spontaneous recovery. It is rarely accompanied by cardiac arrhythmia, especially fatal ventricular tachycardia or torsades de pointes. We observed a 29 year old man, who had suffered from intermittent periodic paralysis and fatal ventricular tachyarrhythmia. He had the first episode of muscle weakness in his low grade of elementary school, which lasted for 20 -30 hours. Similar episodes of muscle weakness occurred 1 -7 times per year, especially after carbohydrate rich food. On admission to emergency room, his chief complaints were generalized weakness and chest tightness, serum potassium level was 1.6mEq/l, and four extremities showed Grade 0 motor weakness. His electrocardiography(ECG) showed Atrioventricular dissociation due to sinus tachycardia and accelerated junctional rhythm, intraventricular conduction distrubance. During intravenous potassium administration, ECG showed sustained ventricular tachycardia and cardiovascular collapse occurred. So we carried out resuscitation and cardioversion. After resuscitation, he recovered from cardovascular collapse and ECG showed sinus tachycardia. But during continuous monitoring ECG showed torsades de pointes with cardiovascular collapse. We carried out resuscitation and defibrillation repeatedly. Serum potassium level was 1.7 - 1.8mEq/L at that time. After successful resuscitation, ECG showed sinus rhythm, and his mental status was fully recovered. After he admitted to intensive care unit, paralytic attack and cardiac arrhythmia did not occurred any more. Serum potassium level was maintained between 3.9 -6.1lmEq/L during his hospital days. He was fully recovered but could not take any medications(e.g. acetazolamide, potassium supplying agent and antiarrhythmic drugs) due to severe gastrointestinal disturbances. During the 30 months of postdischarge period, he experienced three mild paralysis attacks, but they were not accompanied by chest tightness, palpitation or syncope.
Acetazolamide ; Adult ; Arrhythmias, Cardiac* ; Electric Countershock ; Electrocardiography ; Emergency Service, Hospital ; Extremities ; Heart Block ; Humans ; Hypokalemia ; Hypokalemic Periodic Paralysis* ; Intensive Care Units ; Muscle Weakness ; Paralysis ; Potassium ; Resuscitation ; Syncope ; Tachycardia ; Tachycardia, Sinus ; Tachycardia, Ventricular ; Thorax ; Torsades de Pointes

Primary lymphoma is rare lesion of the intracranial neplasm. We have recently experienced a case of primary lymphoma invoving cerebellar vermis and hemisphere. The patient presented with headache, vomiting, ataxia and dysmetria. The brain CT scan and MR imaging revealed round mass lesion involving the left cerebellar hemisphere and vermis with minimal surrounding brain edema. On vertebral angiography, tumor stain appeared during the late arterial phase. Preoperative CSF analysis showed no specific abnormal findings. The CSF cytology was normal. The mass was surgically removed and the histological feature was diffuse histiocytic lymphoma. In the postperative and postradiation period, the metastasis occurred to the head of the caucate nucleus and cervical spinal cord. A case of primary lymphoma of the cerebellum is presented with review of literature.
Angiography ; Ataxia ; Brain ; Brain Edema ; Brain Neoplasms ; Cerebellar Ataxia ; Cerebellum* ; Head ; Headache ; Humans ; Lymphoma* ; Lymphoma, Large B-Cell, Diffuse ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Spinal Cord ; Tomography, X-Ray Computed ; Vomiting