No abstract available.
Ultrasonics*

No abstract available.
Child* ; Humans ; Leukemia*

The rapid spontaneous resolution of an acute epidural hematoma (EDH) has rarely been reported. A possible mechanism of spontaneous resolution is egress of the hematoma into the subgaleal space through a skull fracture. We report a case of rapid redistribution of an acute EDH in a 37-year-old man who had a malignant peripheral nerve sheath tumor of the skull and who slipped and fell when going to the bathroom. A huge EDH without a skull fracture developed in the left parieto-occipital area. The acute EDH was completely alleviated and a newly developed intracerebral hematoma was found on a brain computed tomography scan that was acquired the day after the trauma. Given these findings, a fractured skull and increased pressure in the intradural area may have been the mechanisms underlying the redistribution of the hematoma.
Adult ; Brain ; Hematoma* ; Humans ; Neurofibromatoses ; Peripheral Nerves ; Skull Fractures ; Skull*

Biliary-enteric fistula is in 0.5% to 5% of patients undergoing biliary tract surgery. The most common cause of biliary-enteric fistula is gallstones and their complications, Much less common causes are complieation of peptic ulcer, malignancy, trauma, and rarely, Crohns, disease. The most common type of biliary-enteric fistula is cholecysto-duadenal. Cholecysto-colic, cholecysto-gastric, and choledocho-duodenal fistula are reported much less frequently. The combination of cholecysto-duodenal fistula with cholecysto-colic fistula is a very rare. Symptoms are generally nonspecific, so diagnosis has depended on plain film of abdomen and barium studies. Recently, endoscopic examination and cannulation of the fistula for precise radiographic delineation will help to make a diagnosis. A 78-year-old man was admitted our hospital because of epigastric discomfort, indigestion, nausea and vomiting for 10 days. He was confirmed as cholecysto-duodeno-colic fistula by gastroduodenoscopy, colonoscopy, and endoscopic cholangio-graphic techniques. So, we report a case of cholecysto-duodeno-colic fistula of the patient with a review of relevant literatures.
Abdomen ; Aged ; Barium ; Biliary Tract ; Catheterization ; Colic* ; Colonoscopy ; Diagnosis ; Dyspepsia ; Fistula* ; Gallstones ; Humans ; Nausea ; Peptic Ulcer ; Vomiting

Gastric metaplasia of the duodenum, defined as the presence of groups of gastric mucosal cell within normal duodenal epithelium, is an almost constant feature of duodenal ulcer. The pathogenesis of gastric metaplasia is unclear, but acid and Helicobacter pylori infection are contributory factors to the development of gastric metaplasia. Generally, endoscopic finding of gastric metaplasia in duodenum is typically patchy distribution in duodenal bulb, but polypoid gastric metaplasia in duodenum is very rare. We report that the patient who complaints of abdominal pain has a villous, polypoid gastric metaplasia in duodenal bulb without duodenal ulcer.
Abdominal Pain ; Duodenal Ulcer ; Duodenum ; Epithelium ; Helicobacter pylori ; Humans ; Metaplasia*

Although ascending aortic aneurysm is a uncommon disease, it has fatal complications such as aortic rupture, dissection, or death. So, experts recommend a preemptive aortic operation. A 77-year-old man with hypertension visited for slow progressive exertional dyspnea and general weakness. Chest X-ray showed deviation of trachea to right, mediastinal widening, cardiomegaly, and bulging of right heart border to right. Transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE) showed marked dilated ascending aorta with wall calcification associated with severe aortic regurgitation and pericardial effusion. Measured diameter of ascending aorta was 12 x 11 cm on Chest Computed Tomography (CT) scan, 8.35 cm on TTE, and 10.2 cm on TEE. Our exam found out the obstructive pneumonia and aortic regurgitation as consequences of complications of huge aneurysm. We report a case of huge ascending aortic aneurysm without any previous aortic operation, aortic complications, trauma, or other etiologic factors.
Aged ; Aneurysm ; Aorta ; Aortic Aneurysm* ; Aortic Rupture ; Aortic Valve Insufficiency ; Cardiomegaly ; Dyspnea ; Heart ; Humans ; Hypertension ; Pericardial Effusion ; Pneumonia ; Thorax ; Trachea

Granular cell tumors (GCT), previously termed granular cell myoblastorna, was first described as a myoblastic myoma of the tongue in 1926 by Abrikossoff and has been reported in many different locations throughout the body. In 1931, Abrikossaff described the first granular cell tumor of the esophagus. The gastrointestinal tract is one of the more uncommon locations for granular cell tumors. Until recently, granular cell tumors had been considered rare but, the incidence of granular cell tumors has been slowly raising since endoscopy has been used more commonly as a diagnostic tool. In this study, we report three cases of esophageal granular cell tumors which were successfully diaganosed by an esophagoscopy and an endoscopic ultrasonography and confirmed using an endoscopic esophageal mucosal resection (EEMR).
Endoscopy ; Endosonography ; Esophagoscopy ; Esophagus ; Gastrointestinal Tract ; Granular Cell Tumor* ; Incidence ; Myoblasts ; Myoma ; Tongue

Glycogenic acanthosis(GA) of the esophagus,is often found in routine endoscopic examination of the upper GI tract but has not drawn much attention. However, there is controversy concerning the nature, clinical significance and prevalence of this candition. An endoscopic study, performed in 1041 patients, showed that the incidence of GA was 32,9%. Its incidence was found to be significantly higher in male than in female(40.0% vs. 22.1%; p<0.0001) and frequency of high grade(II+III) GA was higher in male than in female(58.1% vs. 45.3~%; p<0.0D01). An increasing tendency was observed with respect to age(X 36~343, p~<0,0001). The frequency of GA was higher in smoker than in non-smoker(49.2% vs. 20.8%; p<0.0001). GA did not have a clear relationship with alcohol intake, dietary habit, condiments, and diet temperature. The frequency of GA was higher in the patient with reflux esophagitis than without reflux esophagitis(3.8% vs. 1.7%; p~<0.05). Therefore, age, sex and smoking appear to be risk factors of GA, as in esophageal carcinoma.
Condiments ; Diet ; Esophagitis, Peptic ; Esophagus ; Food Habits ; Glycogen* ; Humans ; Incidence ; Male ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Upper Gastrointestinal Tract

BACKGROUND/AIMS: Various techniques of hepatocyte transplantation were actively studied as an alternative to liver transplantation, because of the difficulty of obtaining donor organ, technical difficulties, and high cost. Isolated hepatocytes could be appropriately banked and distributed on demand. We tried to investigate the effect of intrasplenic transplantation of allogenic cryopreserved hepatocytes, into spleen prior to 90% partial hepatectomy in rats, on the survival rate. METHODS: Cryopreserved hepatocytes, isolated by collagenase perfusion of the liver via the portal vein, were thawed and transplanted into the spleen of rats prior to induction of acute hepatic failure by resection of all lobes except caudate lobe (2.0x107 hepatocytes/rat). RESULTS: 1. The viability of freshly isolated hepatocyte was 70-5%, but cell viability after cryopreservation 30-0%. 2. Difference of survival in control and transplant group is not statistically significant. but the survival rate, 48 hours after 90% partial hepatectomy, for control (7) and transplanted group (11) were 0% and 18%, respectively. 3. Although the glucose reduction gradient was not significantly different between two groups, it was more prominent in the control group than in the transplanted group. 4. Engraftment and survival of transplanted hepatocytes were noted in the spleen 2 days after transplantation. CONCLUSIONS: We could not observe statistically significant improvement of survival with intrasplenic transplantation of cryopreserved hepatocytes in rats with 90% partial hepatectomy-nduced acute liver failure. However, 18% survival after 90% partial hepatectomy was noted in the transplanted group, compared to no survival in the control group. This suggests that intrasplenic transplantation of cryopreserved hepatocytes might be effective in the treatment of acute liver failure.
Animals ; Cell Survival ; Collagenases ; Cryopreservation ; Glucose ; Hepatectomy ; Hepatocytes* ; Humans ; Liver ; Liver Failure, Acute ; Liver Transplantation ; Perfusion ; Portal Vein ; Rats* ; Spleen ; Survival Rate ; Tissue Donors

BACKGROUND AND OBJECTIVES: The Vascular system exhibits altered morphological and functional properties during hypertension and after anti-hypertensive therapy. To characterize such changes, the contractile, histological and molecular responses in the common carotid arteries (CCA) were compared in 35 rats. MATERIALS AND METHODS: By partial transverse aortic constriction (TAC), the right CCAs were made to lie under a high pressure environment, while the left CCAs remained under normotension, the latter being used as control vessels. The ligations were removed after two weeks, to enable the recovery process to begin. RESULTS: The vessel contractility, two weeks after the TAC, was nearly abolished. The recovery process from high pressure showed an initial hypercontractile period of around 1-2 week after recovery, prior to the subsequent decline to a normal contractility after 2 weeks. The relaxation response due to acetylcholine was minimal at the end of the hypertensive period, recovered slowly, and reached a normal magnitude after 4 weeks. A high pressure increases the medial thickness & area, and enhances the adventitial tissue formation. These changes persist during the first 4 weeks of recovery, after which normotension returns. Apoptosis at the endothelial layer was significantly increased two weeks after the TAC, but normalized two weeks after recovery. The expression of ecNOS was not detect 2 weeks after the TAC, but gradually returned to a basal level at 2 weeks after the untying. CONCLUSION: A high blood pressure causes decreases in the contractility and endothelium-dependent relaxation. It also increases endothelial apoptosis, the medial thickness & area, and enhances the adventitial tissue formation. The recovery processes from high blood pressure are not uniform, but show different normalizations among the structural, contractile and apoptotic parameters.
Acetylcholine ; Adventitia ; Animals ; Apoptosis ; Arteries ; Carotid Arteries* ; Carotid Artery, Common ; Constriction ; Hypertension ; Ligation ; Nitric Oxide ; Rats* ; Relaxation