No abstract available.
Cervix Uteri* ; Female ; Magnetic Resonance Imaging*

No abstract available.
Transposases*

No abstract available.

Endomyocardial biopsy (EMB) is a valuable diagnostic procedure for the surveillance of cardiac allograft rejection. Interpretation of individual cases is still problematic due to variations of findings for grading of rejection and other associated lesions. We reevaluated an experience on endomyocardial biopsies to develop better diagnostic criteria for rejection and other complications. Immunohistochemical studies against cytokines were performed to assess the usefulness of the method for the diagnosis or researches. A total of 249 EMBs taken from 33 cardiac allograft recipients were reviewed. There were 25 males and 8 females. Dilated cardiomyopathy was present (24 cases) and valvular heart disease (4 cases), restrictive cardiomyopathy (3 cases) were also common conditions. We applied the grading system of the International Society for Heart Transplantation (ISHT) for the assessment of acute cellular rejection. Grades of 0, 1A, 1B, 2, 3A and 3B were 39.0%, 28.1%, 11.2%, 11.5%, 12.4% and 1.6% respectively, but 3.2% were inadequate. Thirty five episodes of grade 3A or 3B were present in 17 patients. The response to therapy was assessed using a next follow up biopsy, which revealed resolving or resolved rejection in 85% of patients. The intensity of immunohistochemical stains for IL-6 and TNF-alpha was increased in proportion to the histologic grade but Quilty lesion and cardiomyopathy also showed a positive reaction. The other pathologic findings were ischemic change, previous biopsy site, interstitial edema and fibrosis, and Quilty lesion. These findings showed usefulness of endomyocardial biopsy not only for the evaluation of cardiac allograft rejection but also for the diagnosis of associated cardiac lesions. Immunohistochemical study of the cytokines was related to the degree of inflammation rather than degree of rejection.
Allografts ; Biopsy* ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cardiomyopathy, Restrictive ; Coloring Agents ; Cytokines ; Diagnosis ; Edema ; Female ; Fibrosis ; Follow-Up Studies ; Heart Transplantation* ; Heart Valve Diseases ; Heart* ; Humans ; Inflammation ; Interleukin-6 ; Male ; Tumor Necrosis Factor-alpha

PURPOSE: Studies concerning the relationship between gene polymorphisms and potentially implicated cardiovascular disease have produced conflicting findings, in part due to differences in ethnic background between populations. These led us to evaluate the impact of polymorphisms in the ACE and E-selectin genes on peripheral artery atherosclerosis in a Korean population. METHODS: We studied 92 male patients (median age: 65.9, range: 48~82) with severe peripheral atherosclerosis documented by angiography and ABI (ankle brachial index). The control group comprised 290 healthy persons (male 216, female 64, median age 61.3, range 20~90) without symptoms for peripheral vascular disease. The blood samples were stored at -20oC until DNA was ready to be extracted. The inorganic procedure for DNA extraction was based on the method described by Miller et al. The ACE and E-selectin polymorphisms were detected by polymerase chain reaction (PCR) amplification. RESULTS: The distribution of ACE genotypes of the patient group was as follows: II, 34 (37.0%); ID, 46 (50.0%); and DD, 12 (13.0%). It was not significantly different from that of the control subjects: II, 104 (37.1%); ID, 133 (47.6%); and DD, 43 (15.3%) (P=0.80). The allele frequencies of the patient group were as follows: I, 114 (62.0%); and D, 70 (38.0%). It was not significantly different from that of the control subjects: I, 341 (60.9%); and D, 219 (39.1%) (P= 0.80). The frequencies of E-selectin genotypes in the patient group were as follows: Ser/Ser 85 (93.4%); Ser/Arg, 6 (6.6); and Arg/Arg, 0 (0%). It was not significantly different from that of the control subjects: Ser/Ser, 262 (93.6%); Ser/Arg, 18 (6.4%); and Arg/Arg, 0 (0%) (P=0.95). In addition, the allele frequencies of the patient group were as follows: Ser, 176 (96.7%); and Arg, 6 (3.3%). It was not significantly different from that of the control subjects: Ser, 542 (96.8%); and Arg 18 (3.2%) (P=0.95). CONCLUSION: The I/D polymorphism of the ACE gene and E-selectin S128R polymorphism were not significantly different between the atherosclerotic patient group and the normal control group in Koreans.
Angiography ; Angiotensins* ; Arteries ; Atherosclerosis ; Cardiovascular Diseases ; DNA ; E-Selectin* ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Peptidyl-Dipeptidase A* ; Peripheral Vascular Diseases ; Polymerase Chain Reaction ; Polymorphism, Genetic

PURPOSE: Borrmann type IV gastric cancer is often diagnosed only at an advanced stage, resulting in a prognosis poor. We performed a retrospective study of the clinical characteristics of Borrmann type IV gastric cancer and the prognostic factors affecting the survival rate in such patients. MATERIALS AND METHODS: Of 4, 063 patients with all gastric cancers, 370 (9%) with Borrmann type IV gastric cancer were analyzed. RESULTS: The clinical characteristics of these patients included a higher incidence rate in young females, and higher rates of serosa exposure, metastasis to lymph nodes and early peritoneal dissemination. Of patients presenting with peritoneal seeding, those resected had a higher survival rate than those that were not. A univariate analysis showed that the prognostic factors affecting the survival rate following a curative resection were the location, occupied area and depth of the primary tumor, as well as the presence of lymph node metastasis and the tumor stage. A multivariate analysis indicated that the tumor location and stage were significant independent prognostic factors after a curative resection for Borrmann type IV gastric cancer. CONCLUSION: In conclusion, the early diagnosis and treatment of patients with Borrmann type IV gastric cancer are essential for the better survival of these patients. Even in patients with advanced tumors, a noncurative palliative resection may improve the prognosis.
Early Diagnosis ; Female ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Serous Membrane ; Stomach Neoplasms* ; Survival Rate

A 17 year-old female patient with chief complaints of pneumaturia and fecaluria was found to have s vesicocolonic fistula. A transurethral attempt to catheterize the suspect tract, which was on the left posterior wall of the bladder, and radiography, following injection of dye through the catheter, proved that the fistu1ous tract was communicating with the sigmoid colon. Excision of the fistulous tract corrected successfully the pathology. Histopathologic findings were of chronic non-specific colitis.
Adolescent ; Catheters ; Colitis ; Colon, Sigmoid ; Female ; Fistula* ; Humans ; Pathology ; Radiography ; Urinary Bladder

The authors have experienced 9 cases of postgastrectomy efferent loop obstruction during the past 16 months' period and analyzed the clinical features, radiological findings, causes, and types of obstruction. The incidence of efferent loop obstruction was 1.3%(9/673). Among the 9 cases, eight patients were male and one patient was female. Median age was 60 years and more than half(5 out of 9 cases) of the patients were obese(defined by more than 110% of ideal body weight). None of the cases showed signs of strangulation, including persistent pain, fever, focal abdominal tenderness, and/or leukocytosis. Gastrointestinal anastomoses were done using a GIA stapler in 6 cases, and manually in 3 cases. The diagnoses were made on the basis of clinical symptoms and signs, further supported by radiologic contrast studies. All the patients were initially treated with conservative measures, including nasogastric drainage and fluid therapy for about 2 weeks in average. 7 cases underwent re-laparotomy using separate left subcostal incisions as conservative management had failed. Among the relaparotomy cases, adhesiolysis and side to side jejunojejunostomy were performed in 5 patients, Roux-en-Y gastrojejunostomy in 1 patient, and gastrojejunostomy revision in 1 patient. Causes of the obstruction in the seven re-opened cases were confirmed as postoperative adhesion. The authors have analyzed the pattern of obstruction and classified the patterns into 4 types. One of the remaining two patients underwent balloon dilatation successfully and the other was managed with prolonged nasogastric decompression. The average hospital stay was 32 days. Adequate omentectomy, gentle tissue handling during dissection, avoidance of ischemia along the suture line of anastomosis, and the use of biologically inert suture material would prevent this kind of postoperative adhesive obstruction.
Adhesives ; Decompression ; Diagnosis ; Dilatation ; Drainage ; Female ; Fever ; Fluid Therapy ; Gastric Bypass ; Humans ; Incidence ; Ischemia ; Length of Stay ; Leukocytosis ; Male ; Stomach Neoplasms ; Sutures

There were 105 patients with multiple rib fracture or flail chest who had underwent surgical rib fixation using Judet's strut from Aug. 1989 to Aug. 1995. They were 86 men and 19 women, and the age distribution was from 17 to 77(mean 48+/-12). The most common cause of accident was a traffic accident(81%). The mean number of rib fracture was 5.5 and the distribution of patient were flail chest(72, 64.7%), severe displaced rib Fracture(18, 17.1%), traumatic chest wall deformity(10, 95%) and others(5, 4.7%). The operative mortality was 1 patient(0.96%) and the incidence of postoperative complication were 13 patients(12.3%). The duration of perioperative artificial ventilator therapy was 90.5+/-22.6 hours. Our method allowed shorter duration of an artificial ventilation and decreased a functional sequelae. We find this technique to be better than previously published methods, since it provides better stabilization and immobilization of the ribs and thus obviates the need for artificial ventilation and prevents post-traumatic chest deformity.
Age Distribution ; Congenital Abnormalities ; Female ; Flail Chest* ; Humans ; Immobilization ; Incidence ; Male ; Mortality ; Postoperative Complications ; Rib Fractures* ; Ribs* ; Thoracic Wall ; Thorax ; Ventilation ; Ventilators, Mechanical

PURPOSE: In Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists. RESULTS: For the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms. CONCLUSION: The results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.
Adrenergic alpha-Antagonists/therapeutic use ; Cholestenone 5 alpha-Reductase/antagonists & inhibitors ; Data Collection ; Humans ; Korea ; Male ; Prostatic Hyperplasia/*diagnosis/*drug therapy ; Urology/statistics & numerical data