No abstract available.

No abstract available.
Congenital Hypothyroidism* ; Thyroid Dysgenesis*

No abstract available.
Cervix Uteri* ; Drug Therapy* ; Female

Dieulafoys lesion consists of abnormally large gastric submucosal artery which ruptures into the stomach causing massive or recurrent intragikstric bleeding. The lesion is very small and easily overlooked even at laparatomy and aan only be correctly diagnosed by endoscopy or arteriography if the patient is actively bleeding. Three patients who were admitted with bleeding of upper gastrointestinal tract and eventually diagnosed as having Dieulafoys lesions were analysed. All were men with age range of 44 to 55 years. All patient were asymptomatic before presenting with hematemesis. Two of the three patients had had history of upper Gl bleeding. One patient used analgesics daily for ureteral colic and two patient drank alcohol excessively. Gastroscopy was performed during the bleeding episode in all three patients. Dieulafoy's lesion was seen in all three cases and in the second case, there was concomittent diffuse petechia in the whole stomach. The lesion was situated on the posterior wall of upper body in one, on anterior wall of upper body in another, lesser curvature side of gastric fundus in the other case. All three patient underwent laparotomy for persistent bleeding and the lesion was suture ligated only in two patients while in one patient vagotomy and pyloroplasty was added. Resection biopsy was performed in two cases and both revealed only normal gastric mucosa. All patients discharged after complete recover.
Analgesics ; Angiography ; Arteries ; Biopsy ; Endoscopy ; Gastric Fundus ; Gastric Mucosa ; Gastroscopy ; Hematemesis ; Hemorrhage ; Humans ; Laparotomy ; Male ; Renal Colic ; Rupture ; Stomach ; Sutures ; Upper Gastrointestinal Tract ; Vagotomy

Cranial fasciitis is a rare morphological variant of nodular fasciitis. It is characterized by a rapid growing fibroblastic proliferative lesion that develops chiefly in childhood. It has varying size and involves the soft tissues of the scalp and the underlying skull. Accurate diagnosis and surgical excision is the key to management. Prognosis is good with rare recurrence. We report a case of cranial fasciitis in the temporal fossa of a 20-month-old girl and present a review of the literature.
Diagnosis ; Fasciitis* ; Female ; Fibroblasts ; Humans ; Infant ; Prognosis ; Recurrence ; Scalp ; Skull

The influence of isoflurane on local cerebral glucose utilization and local cerebral blood fiow was studied by quantitative autoradiography using 23 male Sprague-Dawley rats. rats had both the femoral artery and vein cannulated and were anesthetized with 0.5 MAC and 1.0 MAC isoflurane. Local cerebral glucose utilization and local cerebral blood flow were compared between conscious controls and isofiurane anesthetized rats. The results were as follows: 1) There was a slight decrease of blood pressure in the anesthetized group but it was within the range of autoregulation. The PaO2 and PaCO2 were influenced by artificial ventilation in the anesthetized group but were in the normal range. 2) 1-CM-Rg was decreased in most regions and there was no significant difference between the 0.5 MAC and 1.0 MAC isoflurane anesthesia groups. 3) Some regions had increased glucose utilization. They were the cerebellum nucleus, vestibular nucleus, substantia nigra pars compacta, and hippocampus molecular layer. 4) Some regions had prominent glucose utilization in the anesthetized rats which did not appear in coscious controls. They were the havenula, havenulo-interpedunculus nucleus and fornix. 5) The order of decreased glucose utilization was cerebral association area>auditory system> visual system > sensory motor system > limbic system > extrapyramidal system = myelinated fiber. This means most of the cerebral cortex and auditory system had decreased glucose utilization but extrapyramidal system was well preserved by isoflurane anesthesia. 6) The order of decreased glucose utilization according to anatomical region was telencephalone> diencephalone > mesencephalone > metencephalone > mylencephalone, which means there is rostraI to caudal gradient of glucose utilization. In other words, forebrain was more affected than the hindbrain, so unconsciousness can be achieved with isoflurane with no specific effect on respiration, blood pressure or temperature. 7) Local cerebral blood flow was significantly increased in anesthetized group, and was especiaBy more increased in 0.5 MAC anesthetized group, but some regions (cerebellum white, thalamus) showed decreased blood flow. 8) The order of increased cerebral blood flow was visual system > sensory motor system > auditory system= limbic system > extrapyramidal system) myelinated fiber> cerebral association area in the 0.5 MAC group; but in the 1.0 MAC group, it was visual system>limbic system>extrapyramidal system>sensorymotor system auditory system>myelinated fiber>cerebral association are. 9) The order of increased cerebral blood flow according to the anatomical region was mesencephalon>myelencephalon>diencephalon>telencephalon Metencephalone in 0.5 the MAC group but in the 1.0 MAC group, it was myelencephalon>mesencephalon>diencephalon>telencephalon>metencephalon. 10) There was flow-metabolism uncoupling, although much less than with other inhalation anesthetics, with low metaholism and high blood flow by isoflurane anesthesia. The ratio (1-CBF/ 1-CMRg) was four times greater than control group in the 0.5 MAC group, and three times greater in the 1.0 MAC. 11) Some nucleus of limbic system were prominent in glucose utilization with no significant eidence of limbic seizure but may have some degree of protective effect in the hypoxic or ischemic brain.
Anesthesia* ; Anesthetics, Inhalation ; Animals ; Autoradiography ; Blood Pressure ; Brain ; Cerebellum ; Cerebral Cortex ; Diencephalon ; Femoral Artery ; Glucose* ; Hippocampus ; Homeostasis ; Humans ; Isoflurane* ; Limbic System ; Male ; Mesencephalon ; Metencephalon ; Myelin Sheath ; Prosencephalon ; Rats* ; Rats, Sprague-Dawley ; Reference Values ; Respiration ; Rhombencephalon ; Seizures ; Substantia Nigra ; Unconsciousness ; Veins ; Ventilation

To assess the effectiveness of Magnetic Resonance Imaging (MRI) with endorectal surface coil in the ataging of carcinoma of the uterine cervix with emphasis on parametrial involvement. Thirty women with clinically and radiographically proven carcinoma of the uterine cervix were initially included for this study, but thirteen patients were excluded since the stages of tumors wore beyond stage IIa. CT and MR findings of the remaining seventeen patients were performed at Cheil General Hospital and compared a1ong with clinical findings with the special emphasis on the parametrial involvement by the tumor. Staging was assessed by CT and MRI, and the results were compared with the pathologic staging. Radiea1 abdominal hysterectomy with the pelvic and paraaortic lymphnode dissection was done to all sewenteen patients. The staging made primarily by CT and MRI was either stsge 1 or Ila, but MR images with endorectal surface coil was superior to CT in the visualization of depth of tumor infiltration, especially parametrial involvement. The determination of the depth of the tumor made by MR images showed statistically significant correlation with histologic evaluation(R =0.768, p<0.01). The accuracy rate for the evaluation of the parametrial invo1vement was 82.3% far CT and 94.1% for MRI with endorectal surface coil. The overall accuracy rate for tumor staging was 70.5% for clinical, 58.8% for CT and 82.3% for MR evaluation. The accurecy rate in evaluation of the pelvic and paraaortic lymphnode was 88.2% for CT, but the evaluation done by MRl was not adequate due to small FOV(field of view). In assessment of The steging of careinoma of the uterine cervlx, MR images with endorectal surface coil was superior to CT, especially in the evaluation of the parametrial involvement.
Cervix Uteri* ; Female ; Hospitals, General ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Neoplasm Staging

This investigation was performed to evaluate Doppler mitral valve flow velocity profiles in hypertensive heart disease for the detection of the left ventricular diastolic dysfunction which preceded the systolic dysfunction. Doppler derived parameters included; the duration of the early diastolic flow velocity peak(DF duration), the downward slope of the early diastolic flow velocity peak (EF slope) and the ratio between the height of the early and the late diastolic flow velocity peak (E-E'/A-A'). Doppler flow velocity profiles were measured in 19 normotensive subjects and 28 hypertensive patients. We found decreased EF slope in hypertensive patients (3.6+/-1.4./sec) in comparison with normotensive subjects (5.2+/-2.4m/sec) (p<0.01). In hypertensive patients, E-E'/A-A' value was significantly lower (0.8+/-0.2) than that of normotensive subjects (1.6+/-0.4)(p<0.001). DF duration was similar in both groups. In conclusion, we found that Doppler mitral valve flow velocity profiles, EF slope and E-E'/A-A', were decreased in hypertensive patients, which may be due to the left ventricular diastolic dysfunction.
Echocardiography* ; Heart Diseases ; Humans ; Hypertension* ; Mitral Valve*

Congenital lung cyst is known to be very rare. Recently we experienced one case of congenital lung cyst wihich was confirmed by autopsy. Review of literature was done briefly.
Autopsy ; Lung*

We analyzed 57 patients with tuberculous nonfunctioning kidneys, which were diagnosed pathologically or bacteriologically at Seoul National University, from October 1981 to December 1989. The patients were divided into 3 groups according to the treatment ; Group 1 : 12 patients, only chemotherapy for more than 12 months ; Group 2 :32, nephrectomy and chemotherapy for more than 6 months ; Group 3 . 13, nephrectomy and chemotherapy only for 3 months. As a standard antituberculous regimen, isoniazid, rifampin, and ethambutol were used, and pyrazinamide was added in 15 patients. The follow-up tests were urinalysis, urine AFB smear and culture, and intravenous pyelography. The duration of the follow-up was 6 to 1O8 months, with a mean of 23.3 months. There was no evidence of recurrence in any patient among the 3 groups. Two postoperative complications (hematoma and fistula formation) occurred in 45 nephrectomized patients. Pathologic examination of the resected kidneys revealed findings compatible with tuberculosis in all patients of Groups 2 and 3. Coexisting cortical adenomas were found incidentally in 2 patients. Final diagnoses of the other 2 patients were hydronephrosis and chronic pyelonephritis without any evidence of tuberculosis, although these 2 patients were excluded in this study. Severe drug toxicity occurred in 7 patients that belonged to Groups 1 and 2. In conclusion, early nephrectomy for accurate diagnosis and removal of infective foci was the justifiable initial procedure, and this should be followed by postoperative antituberculous chemotherapy for the shortest acceptable period in tuberculous nonfunctioning kidneys. In highly selective cases where the lesion is completely localized in one kidney, we can consider early nephrectomy and a 3-month course of chemotherapy as one treatment modality.
Adenoma ; Diagnosis ; Drug Therapy ; Drug-Related Side Effects and Adverse Reactions ; Ethambutol ; Fistula ; Follow-Up Studies ; Humans ; Hydronephrosis ; Isoniazid ; Kidney* ; Nephrectomy ; Postoperative Complications ; Pyelonephritis ; Pyrazinamide ; Recurrence ; Rifampin ; Seoul ; Tuberculosis ; Urinalysis ; Urography