No abstract available.
Anti-Bacterial Agents* ; Appendicitis*

No abstract available.
Anti-Bacterial Agents* ; Appendicitis*

For the diagnosis of upper gastrointestinal (GI) lesions, magnification method is usually used in conjunction with chromoscopy, enabling the endoscopist to view subtle mucosal patterns in exquisite detail. Recently published datas have shown that magnifying endoscopy might be a valuable adjunct for the diagnosis, detection, and characterization of inflammatory and neoplastic lesions of the upper GI tract. It is also proven to be an useful surveillance protocol in identifying dysplastic epithelium or early cancer within a segment of Barrett's esophagus. Possible indications for magnifying endoscopy in upper GI tract include screening and surveillance of Barrett's esophagus, defining the extent of esophageal and gastric adenocarcinoma, detecting synchronous/metachronous gastric and esophageal cancers, diagnosing Helicobacter pylori infection, and recognizing minimal mucosal changes in gastroesophageal reflux disease. By grading the quality of evidence for the currently published trials, it is clear that the majority are case series, case reports, and/or observational studies without randomization, control, or blinding. Moreover, other evidence-based criteria such as independent, blind comparisons of magnifying endoscopy with a standard method which evaluates this technology in an appropriate spectrum of patients to whom the test may be applicable, and standardizing methodology would be crucial before magnifying endoscopy becomes a standard procedure in clinical practice. In the future, a uniform classification system for staining and magnifying patterns should be devised and observer agreement should be tested. Futher studies then could be performed based upon consistent, validated, and standardized terminologies and criteria.
Diagnosis, Differential ; Duodenal Diseases/pathology ; Endoscopy, Gastrointestinal/*methods ; Esophageal Diseases/pathology ; Gastrointestinal Diseases/*pathology ; Humans ; Image Enhancement/*methods ; Stomach Diseases/pathology ; Upper Gastrointestinal Tract/pathology

BACKGROUND: To observe the clinical features and the outcomes from diagnostic work-up in definite multiple sclero-sis (MS) which was diagnosed by using a Poser's criteria. METHODS: We retrospectively evaluated 43 cases who were diagnosed as multiple sclerosis in Seoul National University Hospital by using Poser's criteria from January 1st, 1991 to December 30th , 1995. Among the 43 cases, 35 patients were classified to definite MS group, clinically or laboratory supported. We analyzed age, sex, initial symptom, age of onset, duration between initial symptom and definite MS diagnosis, total numbers of recurrence and symptoms, CSF profile, evoked potential study, follow-up duration and the MRI findings of the definite MS patients. RESULTS: Of 35 cases who were diagnosed as definite MS, 15 patients were male and 20 patients were female. The mean age of onset was 34.6 years, the mean duration between initial symptom onset and diagnosis of definite MS was 16.9 months, and the mean follow-up duration was 34.8 months. The most common site of initial involvement was spinal cord (24 cases), and then optic nerve (5 cases), brain stem (4 cases), and cerebrum (2 cases) were followed. Thoracic spinal cord (24 lesions) was more frequently involved than cervical cord (18 lesions). Moreover 32 cases (91.4%) had at least one time of spinal cord involvement and there is a tendency that the proportion of double spinal cord lesion is increasing with the number of spinal cord recurrence. CONCLUSIONS: Spinal cord involvement in multiple sclerosis is the most common symptom and double spinal cord involvement in MRI is frequently observed. We think that it would be the characteristics of the multiple sclerosis in Korea.
Age of Onset ; Brain Stem ; Cerebrum ; Diagnosis ; Evoked Potentials ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Multiple Sclerosis* ; Optic Nerve ; Recurrence ; Retrospective Studies ; Seoul ; Spinal Cord

BACKGROUND: To observe the clinical features and the outcomes from diagnostic work-up in definite multiple sclero-sis (MS) which was diagnosed by using a Poser's criteria. METHODS: We retrospectively evaluated 43 cases who were diagnosed as multiple sclerosis in Seoul National University Hospital by using Poser's criteria from January 1st, 1991 to December 30th , 1995. Among the 43 cases, 35 patients were classified to definite MS group, clinically or laboratory supported. We analyzed age, sex, initial symptom, age of onset, duration between initial symptom and definite MS diagnosis, total numbers of recurrence and symptoms, CSF profile, evoked potential study, follow-up duration and the MRI findings of the definite MS patients. RESULTS: Of 35 cases who were diagnosed as definite MS, 15 patients were male and 20 patients were female. The mean age of onset was 34.6 years, the mean duration between initial symptom onset and diagnosis of definite MS was 16.9 months, and the mean follow-up duration was 34.8 months. The most common site of initial involvement was spinal cord (24 cases), and then optic nerve (5 cases), brain stem (4 cases), and cerebrum (2 cases) were followed. Thoracic spinal cord (24 lesions) was more frequently involved than cervical cord (18 lesions). Moreover 32 cases (91.4%) had at least one time of spinal cord involvement and there is a tendency that the proportion of double spinal cord lesion is increasing with the number of spinal cord recurrence. CONCLUSIONS: Spinal cord involvement in multiple sclerosis is the most common symptom and double spinal cord involvement in MRI is frequently observed. We think that it would be the characteristics of the multiple sclerosis in Korea.
Age of Onset ; Brain Stem ; Cerebrum ; Diagnosis ; Evoked Potentials ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Multiple Sclerosis* ; Optic Nerve ; Recurrence ; Retrospective Studies ; Seoul ; Spinal Cord

Magrjetic resonance (MR) imagings with 0.15 Tesla resistive magnet developed by Korea Advanced Institute of 5cience were performed in 27 patients with various neurologic diseases and compared with X-ray computed tomography (CT). The purpose óf the paper is to evaluate the image quality, the diagnostic value and limitation, and the optimal pulse sequence of MR imagings with a resistive magnet. The MR images were obtained by using a variety of pulse sequence with spin echo technique includïng saturation recovery, T2-weighted spin echo, and/or inversion recovery with various pulse repetition(TR) and echo delay (TE) times. The M R imaging demonstrated the capability of detecting the lesions shown on CT in all cases and also detected an additional finding in one case (multiple sclerosis) which was not seen on CT. The MR imaging appeared to be more useful than CT in the evaluation of syringomyelia of spinal cord and white matter disease, while it failed to demonstrate small calcific lesion or inflammatory nodule (less than 1 cm) shown on CT and has shown somewhat poor contrast resolution in the case of meningioma. The spatial resolution of saturation recovery images was similar or superior to CT, whereas the contrast resolution of saturation recovery was inferior to CT. While the saturation recovery images have shown false negative findings in 5 patients (19%), the inversion recovery and T2-weighted spin echo have shown consistently positive findings. The inversion recovery and T2-weighted spin echo images demonstrated better contrast discrimination between normal and pathologic conditions than the saturation recovery images, but somewhat poorer spatial resolution. Authors suggest that the MR images of both the saturation recovery with 300/30 and T2-weighted spin echo with 1000/90 be used as a routine procedure and additional iversion recovery of 1300/300/30 sequence as a option if white matter disease is suspected.
Discrimination (Psychology) ; Humans ; Korea ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Meningioma ; Spinal Cord ; Syringomyelia ; Tomography, X-Ray Computed

An age-dependent cellular change of DNA contents in the testis of Sprague-Dawley rats was investigated by flow-cytometric method. Testicular cell suspensions at the age of 4, 5, 6, 7, 8, 10, 12, 16 and 26 weeks were prepared and stained with propidium iodide. The relative proportions in the number of mature and immature haploid (1n), diploid (2n), S-phase and tetraploid (4n) cells were calculated. The proportion in the number of mature haploid cells was sharply increased to the age of 10 weeks (about 38%), thereafter increased slightly to the level of 42% at the age of 26 weeks. The proportion of immature haploid cells was dramatically increased to the age of 6 weeks, then maintained at the level of 20 to 30% thereafter. The proportion of diploid cells was 64% at the age of 4 weeks, then decreased gradually through the age of 26 weeks. The proportion of S-phase cells was increased to the age of 4 weeks, then maintained at a plateau level to the age of 26 weeks. The proportion of tetraploid cells were about 26% at the age of 4 weeks, then decreased gradually to the age of 26 weeks. These results suggest that the proportions of testicular cells may depend on the age of the rat and that the flow cytometric method may be useful in the evaluation of the spermatogenic status with regard to accuracy and sensitivity.
Animals ; DNA/*analysis/genetics ; Diploidy ; Flow Cytometry/methods/veterinary ; Haploidy ; Male ; Rats ; Spermatogenesis ; Testis/chemistry/*growth & development

A renal cell carcinoma with tumor thrombus extension into the inferior vena cava occurs in approximately 5 percent of cases. Despite invasion of the inferior vena cava, an aggressive surgical approach for these neoplasms is recommended, but pulmonary and tumor embolisms have been common complications. Therefore, the prevention of tumor emboli during operation is necessary. Placement of a suprarenal filter in the inferior vena cava has become the procedure of choice for preventing tumor emboli during a radical nephrectomy.
Carcinoma, Renal Cell* ; Neoplastic Cells, Circulating ; Nephrectomy* ; Thrombosis ; Vena Cava Filters ; Vena Cava, Inferior*

OBJECTIVE: Morphometric data for the sympathetic ganglia (SG) of the upper thoracic spine was investigated to identify the exact location of the SG in order to reduce normal tissue injury in the thoracic cavity during thoracoscopic sympathectomy. METHODS: In 46 specimens from 23 formalin-fixed adult cadavers, the authors measured the shortest distance from the medial margin of the T1, T2 and T3 SG to the most prominent point and medial margin of the corresponding rib heads, and to the lateral margin of the longus colli muscle. In addition, the distance between the most prominent point of the rib head and the lateral margin of longus colli muscle and the width of each SG were measured. RESULTS: The shortest distance from the medial margin of the SG to the prominent point of corresponding rib head was on average 1.9 mm on T1, 4.2 mm, and 4.1 mm on T2, T3. The distance from the medial margin of the SG to the medial margin of the corresponding rib head was 4.2 mm on T1, 5.9 mm, and 6.3 mm on T2, T3. The mean distance from the medial margin of the SG to the lateral margin of the longus colli muscle was 6.7 mm on T1, 8.8 mm, 9.9 and mm on T2, T3. The mean distance between the prominent point of the rib head and the lateral margin of the longus colli muscle was 4.8 mm on T1, 4.6 mm, and 5.9 mm on T2, T3. The mean width of SG was 6.1 mm on T1, 4.1 mm, and 3.1 mm on T2, T3. CONCLUSION: We present morphometric data to assist in surgical planning and the localization of the upper thoracic SG during thoracoscopic sympathectomy.
Adult ; Cadaver ; Ganglia, Sympathetic ; Head ; Humans ; Muscles ; Ribs ; Spine ; Sympathectomy ; Thoracic Cavity ; Thoracic Vertebrae ; Thoracoscopy

Endoscopic variceal ligation(EVL) is effective in both emergent and elective treatment of esophageal varices and can be used as a safe alternative to sclerotherapy. However, as yet no transparent ligating device is widely available, the endoscopic view through the present commercial ligating device is so narrow that it is often difficult to both approach the target and accurately define and position the bleeding site. To assess the benifit of transparent EVL device, total 143 patients, 632 sessions, underwent EVL treatment. In 545 sessions the non-transparent, conventional-type ligating devices (Stigmann-Goff ligating devices) were used, whereas in 87 sessions the transparent ligating devices used. 35 patients underwent EVL under active bleeding conditions; in 29 patients a conventional ligation devices, whereas in 6 patients a transparent ligating devices were used. The remaining l08 patients were either electively treated by EVL. The visual fields decreased to 20-30% with the conventional devices, but no change of visual fields were noted with the transparent devices. In electively treated cases by EVL, the times need to ligate one band were not significantly different in the conventional devices (average, 18.5 sec) compared with that in the transparent devices (average, 16.7 sec), but in active bleeding conditions it took a significantly longer times in the conventional devices (mean, 30.7 sec) compared with that in the transparent devices (average, 19.4 sec). The hemostatic success rates in active bleeding conditions were 89.7%(26/29) using the conventional devices, 100%(6/6) using the transparent devices. In conclusion this newly developed transparent ligating device provides an improved visual field and shortens ligating time, especially in active bleeding condition. Therefore EVL using transparent device is more effective method in treatment of esophageal varices, especially active bleeding conditions.
Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Ligation* ; Sclerotherapy ; Visual Fields