No abstract available.
Meningitis, Cryptococcal*

Cystadenoma of the liver is a rare neoplasm. Although many cystadenomas are asymptomatic, symptoms can include abdominal pain, postprandial epigastric discomfort, and nausea. Dramatic changes in hepatic imaging techniques have been helpful for diagnosing cystic lesions of the liver, such as simple cyst, hydatid cyst, cystadenoma, cystadenocarcinoma, and metastatic neuroendocrine tumors. However, it remains difficult to differentiate cystadenoma from cystadenocarcinoma for multiseptated cystic hepatic lesions with papillary projection on computed tomography (CT) and magnetic resonance imaging (MRI). Here we report the case of a 47-year-old woman with several months of postprandial discomfort and abdominal fullness. CT and MRI revealed multiseptated cystic lesions with papillary excrescences. A left hemihepatectomy was performed. Histology showed a benign mucinous cystic tumor with ovarian-like stroma.
Abdominal Pain ; Cystadenocarcinoma ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Papillary ; Echinococcosis ; Female ; Humans ; Liver ; Magnetic Resonance Imaging ; Middle Aged ; Mucins ; Nausea ; Neuroendocrine Tumors

We performed immunohistochemical stain of p-glycoprotein using JSB-1 monoclonal antibody to study multidrug resistant(MDR) gene expression in 137 gastric tumor tissues obtained from 87gastric carcinoma patients. The incidence of p-glycoprotein expression was 60 of 87 cases(69%) and it was not correlated with age, sex, depth of tumor invasion, and lymph node metastasis, but was correlated with histologic type of gastric adenocarcinoma. The distribution of p-glycoprotein positive cells in the tumor tissue was diffuse in 34 cases(73.9%) and focal in 12 cases(26.1%), and the dominant staining patterns of p-glycoprotein in the tumor cells were cytoplasmic and golgi staining in 20 cases(43.5%) and 19 cases(41.3%), respectively, and 7 cases(15.2%) showed fine granules in the cytoplasm. The incidence of p-glyco-protein expression in the tumor tissue was higher in A and AB blood type patients who have A antigen than in 0 and B blood type patients. Cytoplasmic staining pattern was dominant in O and B blood types and golgi staining in A and AB blood type patients. Among 27 patients 'who received chemotherapy, partial remission was noted in 9 of 11 p-glyco-protein negative patients(81.8%) and no remission or progression of the tumor was seen in 9 of 16 p-glycoprotein positive patient(56.3%). The p-glycoprotein expression in gastric carcinoma had no direct correlation with known several prognostic factors of the gastric tumor except for histologic type, and it is supposed that p-glycoprotein detection in gastric tumor tissue by immunohisto-chemical stain is a good method for predicting the response of chemotherapy, especially in p-gly-coprotein negative cases.
Incidence

Digital subtraction angiography(DSA) was made in 72 patients at department of radiology, Seoul National University hospital from February 1982 to January 1983 with our system, SRM-II, developed by cooperation of department of medical engineering, Seoul National University Hospital. The results were as follows; 1. In the total 72 cases, vascular disease was 28 cases in which aortic disease including Takayasu's aortitis was 18 cases. Others were vascular tumors in 32 cases and various conditions such as renal donor and artificial arteriovenous shunt. 2. Extent of the lesion was well delineated especially in aortic disease in cluding 8 cases of Takayasu's aortitis, 6 cases of aortic aneurysm and 2 cases of Behcet's syndrome. 3. DSA can be done to outpatient without admission because of its simplicity and non-invasiveness. DSA is useful especially in the evaluation and follow-up of vascular disease and the diagnostic value is expected to grow continuously according to the renewal of system.
Angiography, Digital Subtraction* ; Aortic Aneurysm ; Aortic Diseases ; Aortitis ; Behcet Syndrome ; Follow-Up Studies ; Humans ; Outpatients ; Seoul ; Tissue Donors ; Vascular Diseases

Recently, technical developments in digital electronics and imge intensifier have improved the electronicrecording and processing of images. Both departments of radiology and of medical engineering of Seoul National Univeristy Hospital jointly developed idgital subtraction angiography system(SRM-I) and performed DSA in patients. The system was composed of angiography equipments, computer, video image storage and logarithmic amplifier. Fluoroscopic images were taken before and after 40-60 ml of contrast media were intravenously injected with speedfo 12-15 ml/sec. The images were recorded by V.T.R. with normal speed. The recorded images were processed with digitization, amplification, sutraction, enhancement, position manipulation and image smoothing. Arteriography of neck vessels, abdominal aorta and its branches and extremities were performed successfully by above mentioned methods in 20 cases and results were reviewed.
Angiography ; Angiography, Digital Subtraction ; Aorta, Abdominal ; Contrast Media ; Extremities ; Humans ; Neck ; Seoul

A total of 72 cases of internal biliary drainage procedure has been done percutaneously at Departement ofRadilogy, Seoul Natinal Universtiy Hospital for recent 4 and half years since August 1981. Five different types ofinternal drainage including endoprosthesis were applied to various conditions with different obstruction levels.The different method of procedure in each type of internal drainage was described and the results were analysed.1. Among the clinical diagnosis in 72 cases, carcinoma of bile duct was in 37 cases as the most frequent one. Thenext was pancreas head carcinoma in 16 cases, followed by metastatic carcinoma and other disease. 2. Type Iinternal drainage, classical internal and external type with distal end in duodenum, was applied in 43 cases asthe most comon one. Type II, modification of type I with distal end in CBD, was applied in 17 cases. Type III,endoprosthesis distal end into duodenum, was applied in 7 cases. Type IV, endoprosthesis just across theobstruction in bile duct, was applied in 2 cases, Type V, combined type of any internal drainage with externaldrainage, was applied in 3 cases. 3. According to various obstruction level, prefered type could be selected. Forproximal obstruction type II and IV were preferred and for distal obstruction type III was chosen. However, type Icould be applied in any situation. 4. Early complication occurred in 9 cases(12.5%). Clinical imporvement withdecrease in bilirubin level was observed 17 of 21 cases in which follow-up data was available over 2 months. 5.Though the experience with those 72 cases it is recommended that appropriate type of internal biliary drainageshould be selected according to prognosis, obstruction level and clinical findings of each patient.
Bile Ducts ; Bilirubin ; Diagnosis ; Drainage ; Duodenum ; Follow-Up Studies ; Head ; Humans ; Methods ; Pancreas ; Prognosis ; Seoul

Clonidine, an a2-adrenergic agonist, has sedative and analgesic properties and reduces the inhalation anesthetic requirement and modifies the hemodynamic responses to surgery. But occasionally, severe bradycardia and hypotensian during inhalation anesthesia develops following oral clonidine premedication. To predict intraoperative hemodynamic changes during enflurane anesthesia, author evaluated noninvasive autonomic tests consisted of respiratory sinus arrhythmia (RSA), Valsalva's maneuver (VSV), R-R interval difference in head up tilt (HTR) and diastolic blood pressure difference in head up tilt (HTP) in fifty-one patients (ASA physical status I~II ) scheduled for elective surgery. Patients were received 5 ug/kg of oral clonidine at 90 min before operation. Anesthesia was maintained with enflurane, oxygen (2 liter/min) and nitrous oxide (2 liter /min). The enflurane concentration was controlled to maintain blood pressure within +/-20% of preinduction value. After anesthesia, patients were allocated to two groups according to above and below 0.5 MAC (0.84 vo1%) enflurane concentration. Each preoperative autonomic test results revealed significant correlation with heart rate (HR), mean arterial pressure (MAP), and enflurane concentration (EC), respectively (p<0.05). Values of RSA, HTR, HTP, MAP and HH wm 81+/-14.4 ms, 76+/-43.5 ms, -6+/-5.2 mmHg, 76+6.4 mmHg and 63+/-5.5 beats/min, respectively in below 0.5 MAC enflurane concentration group and were significantly different from values of RSA; 16933.7 ms, HTR; 175+/-41.7 ms, HTP; 6+/-3.1 mmHg, MAP; 90+/-11.0 mmHg and HR; 76+/-7.6 beats/min in above 0.5 MAC enflurane concen- tration group (p<0.05). In conclusion, the simple noninvasive autonomic tests are recommended in prediction of intra-operative hemodynamic changes during enflurane anesthesia when oral clonidine premedication is indicated.
Anesthesia* ; Anesthesia, Inhalation ; Arrhythmia, Sinus ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Clonidine* ; Enflurane* ; Head ; Heart Rate ; Hemodynamics* ; Humans ; Inhalation ; Nitrous Oxide ; Oxygen ; Premedication ; Valsalva Maneuver

Clonidine, an a2-adrenergic agonist, has sedative and analgesic properties and reduces the inhalation anesthetic requirement and modifies the hemodynamic responses to surgery. But occasionally, severe bradycardia and hypotensian during inhalation anesthesia develops following oral clonidine premedication. To predict intraoperative hemodynamic changes during enflurane anesthesia, author evaluated noninvasive autonomic tests consisted of respiratory sinus arrhythmia (RSA), Valsalva's maneuver (VSV), R-R interval difference in head up tilt (HTR) and diastolic blood pressure difference in head up tilt (HTP) in fifty-one patients (ASA physical status I~II ) scheduled for elective surgery. Patients were received 5 ug/kg of oral clonidine at 90 min before operation. Anesthesia was maintained with enflurane, oxygen (2 liter/min) and nitrous oxide (2 liter /min). The enflurane concentration was controlled to maintain blood pressure within +/-20% of preinduction value. After anesthesia, patients were allocated to two groups according to above and below 0.5 MAC (0.84 vo1%) enflurane concentration. Each preoperative autonomic test results revealed significant correlation with heart rate (HR), mean arterial pressure (MAP), and enflurane concentration (EC), respectively (p<0.05). Values of RSA, HTR, HTP, MAP and HH wm 81+/-14.4 ms, 76+/-43.5 ms, -6+/-5.2 mmHg, 76+6.4 mmHg and 63+/-5.5 beats/min, respectively in below 0.5 MAC enflurane concentration group and were significantly different from values of RSA; 16933.7 ms, HTR; 175+/-41.7 ms, HTP; 6+/-3.1 mmHg, MAP; 90+/-11.0 mmHg and HR; 76+/-7.6 beats/min in above 0.5 MAC enflurane concen- tration group (p<0.05). In conclusion, the simple noninvasive autonomic tests are recommended in prediction of intra-operative hemodynamic changes during enflurane anesthesia when oral clonidine premedication is indicated.
Anesthesia* ; Anesthesia, Inhalation ; Arrhythmia, Sinus ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Clonidine* ; Enflurane* ; Head ; Heart Rate ; Hemodynamics* ; Humans ; Inhalation ; Nitrous Oxide ; Oxygen ; Premedication ; Valsalva Maneuver

No abstract available.
Myasthenia Gravis*

No abstract available.
Endometrial Neoplasms* ; Female