No abstract available.
Stents*

No abstract available.
Carcinoma, Endometrioid*

Postrenal segment anomalies of inferior vena cava such as bilateral inferior vena cava and left-sided inferiorvena cava can simulate lymphadenopathy on CT scan and these anomalous veins need consideration in retroperitonealoperations such as procedures for prevenetion of venous embolism, splenorenal shunt operation and aorticprosthetic repalcement. Retrocaval ureter is a rare cause of obstructive uropathy or medical deviation of ureter.We analysed 16 cases of postrenal segment anomalies daignosed by CT, vena cavography, retrograde pyelography andultrasonography including six rare positional anomalies at hepatic segment of inferior vena cava diagnosed bycardiac angiography. The results were as follows. 1. Postrenal segment anomalies were 6 cases of bilateral IVC, 8cases of left-sided IVC and 2 cases of retrocaval ureters. On CT scan, 3 cases of bilateral IVC and 4 cases ofleft-sided IVC were accompained by malignant tumors, but caval veins could be discriminated from enlarged nodesbecause of continuous tubular nature of vein on consecutive sections with homogeneous strong enhancement. Twocases of retrocaval ureters showed hydroureteronephrosis due to ureteral compression by IVC. 2. Hepatic segmentanomalies were 6 cases. Five cases of IVC on left side of vertebral crossed midline at live to enter right-sidedright atrium and one case of IVC on right side crossed midline to enter left-sided right atrium. Four cases ofcomplex cardiac anomalies, 4 cases of asplenia and 2 cases of situs ambigus were associates with these anomalies.
Angiography ; Embolism ; Heart Atria ; Lymphatic Diseases ; Retrocaval Ureter ; Splenorenal Shunt, Surgical ; Tomography, X-Ray Computed ; Ureter ; Urography ; Veins ; Vena Cava, Inferior

Congenital anomaly of IVC is rare, but understanding of this anomaly is important in radiological diagnosis,angiographic procedures and major retroperitoneal and thoracic surgery. We analysed 23 cases of IVC interruptiondiagnosed by cardiac angiography at Seoul National University Hospital. The results were as follows: 1. Theincidence of infrahepatic interruption of IVC was 0.45% of the patients having cardiac angiography and mostpatients showed cyanosis(91%). 2. The most common associated cardiac anomaly was right ventricular outflow tractobstruction (60%). Other associated cardiac defects were VSD, ASD, valvular anomaliesin 9 cases(39%) respectively;double outlet right bentricle, bilateral superior vena cava, single ventricle in 6 cases(26%) respectively; singleatrim, PDA in 5 cases(22%) respectively. 6 cases of situs inversus, 3 cases of situs ambiguus,2 cases of visceralheterotaxia and one case of asplenia were observed also. 7 cases of left-sided IVC were associated with IVCinterruption in normal situs.
Angiography ; Humans ; Seoul ; Situs Inversus ; Thoracic Surgery ; Vena Cava, Inferior ; Vena Cava, Superior

PURPOSE: To evaluate the efficacy of stereotaxic breast core biopsy using a prone table system, and theeffects of operator experience, lesion characteristics and number of samples on biopsy results in cases involvingnonpalpable breast lesions. MATERIALS AND METHODS: We performed stereotaxic core biopsies of 62 nonpalpablemammographic lesions in 61 patients. Subsequent surgical excision was performed in 11 cases with micro calcifications and one case with a mass. We equally divided patients with micro calcifications into two groups(early and late periods) and analyzed the mammographic findings. Correlation of the pathologic results of corebiopsy with those of surgical excision were investigated. RESULTS: In two patients, stereotaxic biopsy wasimpossible due to poor visibility of micro calcifications and thinness of the compressed breast. In 59 patients,core biopsy was successfully performed and specimens were adequate for pathologic examination. The average numberof micro calcifications seen on specimen mammography in the two groups was 1.8 (range: 0~8) and 2.5 (range:0~4)respectively. In patients from whom less than five and five or more samples were taken, the average number of micro calcifications seen on specimen mammography was 1.5 (range: 0~6) and 2.6 (range: 0~8), respectively,throughout the whole period. The pathologic findings were fibrocystic change in 50 cases, fibroadenoma in four,ductal carcinoma in situ in four, invasive ductal carcinoma in one, and atypical ductal hyperplasia in one. Theagreement rate of pathologic results between core biopsy and surgical excision was 83% (10/12) for malignancy and75% for histology. In three cases with disagreement between core and surgical pathologic results, the samplingnumber was small (3~4 times) and in two of the three cases, micro calcifications were not visible on mammography. CONCLUSION: Operator experience and sampling numbers larger than five results in an increased number of micro calcifications in specimens and more reliable core biopsy.
Biopsy* ; Breast* ; Carcinoma in Situ ; Carcinoma, Ductal ; Fibroadenoma ; Humans ; Hyperplasia ; Mammography ; Thinness

BACKGROUND: Cytomegalovirus (CMV) infection is one of the important opportunistic infections in immuno-compromised patients. In Korea, seroprevalence of IgG against CMV is over 95%. Therefore, CMV diseases are expected to be a prevalent opportunistic infection in AIDS patients in Korea. METHODS: We reviewed the medical records of 128 patients with HIV infection who visited the Seoul Na-tional University Hospital during the period from Nov. 1987 to Sep. 1996. All the patients were examined by one ophthalmologist and the diagnosis of CMV retinitis were made by funduscopic findings. Other CMV dise-ases were diagnosed when histopathologic examinations showed the characteristic cytomegalic cells. RESULTS: Median duration of follow-up was 8 (0 ~ 59) months. Eleven CMV diseases were found in 7 patients (5.4%) : 6 patients had retinitis, 2 esophagitis, 1 colitis, 1 pneumonitis, and one patient developed disse-minated infection. Fifteen percent (6/33) of the patients whose CD4 + lymphocyte counts were less than 200/ mm 3 at baseline developed CMV diseases. Out of the 9 cases treated with ganciclovir, 7 improved or were stabi-lized. No patient received maintenance treatment and 3 had relapsed. CONCLUSION: CMV diseases are common opportuni-stic infections in AIDS patients in Korea.
Colitis ; Cytomegalovirus* ; Diagnosis ; Esophagitis ; Follow-Up Studies ; Ganciclovir ; HIV ; HIV Infections ; Humans ; Immunoglobulin G ; Korea ; Lymphocyte Count ; Medical Records ; Opportunistic Infections ; Pneumonia ; Retinitis ; Seoul ; Seroepidemiologic Studies

Major histocompatibility complex (MHC) class II molecules, which are recognized for their primary function of presenting an antigen to the T cell receptor, are involved in various signaling pathways in B cell activation. We identified heterogeneous nuclear ribonucleoprotein (hnRNP) A2B1 as an MHC class II molecule-associated protein involved in MHC class II-mediated signal transduction in lipopolysaccharide (LPS)-stimulated 38B9 B cells. Although the function of hnRNP A2B1 in the nucleus is primarily known, the level of hnRNP A2B1 in the cytoplasm was increased in LPS-stimulated 38B9 cells, while it was not detected in the cytoplasm of non-treated 38B9 cells. The silencing of hnRNP A2B1 expression using siRNA disturbed B cell maturation by regulation of mitogen-activated protein kinase signaling, NF-κB activation, and protein kinase B activation. These results suggest that hnRNP A2B1 is associated with MHC class II molecules and is involved in B cell activation signaling pathways in LPS-stimulated 38B9 cells.
B-Lymphocytes ; Cytoplasm ; Heterogeneous-Nuclear Ribonucleoproteins* ; Major Histocompatibility Complex ; Protein Kinases ; Proto-Oncogene Proteins c-akt ; Receptors, Antigen, T-Cell ; RNA, Small Interfering ; Signal Transduction

PURPOSE: This study was designed to investigate the correlation between the clinicopathologic characteristics and the recurrence pattern of gastric cancer and to define survival difference according to treatment modality after diagnosis of recurrence. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 4184 patients who had undergone radical surgery for primary gastric cancer from 1986 through 1996. Clinicopathologic factors were analyzed for the relationship of each factor with the pattern of recurrence. And the survival after diagnosis of recurrence was compared among the treatment modalities. RESULTS: Recurrence pattern was confirmed in 1141 patients. Loco-regional recurrence occurred in 291 patients (20.1%), peritoneal recurrence in 383 (26.5%), distant recurrence in 290 (20.1%), and mixed recurrence in 177 (12.3%), respectively. Early recurrence (less than 2 years) occurred in 767 (69.3%), intermediate recurrence (2~5 years) in 286 (25.8%), and late recurrence (more than 5 years) in 54 (4.9%). In multivariate analysis, T stage, N stage, size of tumor and perineural invasion were independent prognostic factors for recurrence. Median survival from diagnosis of recurrence was 24.2 months in the curative operation group, 7.7 months in the chemotherapy group, 7.1 months in the non-curative operation group and 3.3 months in the conservative treatment group, respectively (p=0.000). CONCLUSION: The clinicopathological analysis of recurrent gastric cancer showed recurrent patterns and prognostic factors. Curative resection is suggested to have survival benefit in recurrent gastric cancer patients, although it was possible in patients with limited extent of disease.
Diagnosis ; Drug Therapy ; Humans ; Medical Records ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*

BACKGROUND: To this date, efforts to develop effective methods for the education of diabetic patients have been limited. The important goal of self-management and weight control for diabetic treatment can not be attained without long and intensive period of education. This study was undertaken to assess the effectiveness of an intensive educational program, of behavior and diet control, which was carried out on subjects with type 2 diabetes, on an out-patient basis. We compared the effectiveness of an intensive education programme with that of a conventional education programme for the self-management of type 2 diabetic patients. METHODS: Subjects with type 2 diabetes were randomly selected, and allocated to one of two groups. One group received a conventional education programme of self-management(the CE group), and the second group received an intensive education programmes for three months, after which the effectiveness of the programmes were evaluated. RESULTS: 1) The levels of fasting blood sugar(FBS), postprandial 2 hour blood sugar(PP2h) and HbA1c were significantly lowered in both groups following the intervention(p<0.05). In the IE group, the FBS declined from 12.4nmol/L to 7.7nmol/L, PP2h declined from 20.3nmol/L to 10.9nmol/L, and the HbA1c showed a similar decline from 9.4 to 7.0% after intervention(p<0.05). In the CE group, the FBS declined from 10.9 to 9.4nmol/l, the PP2h decreased from 17.1 to 14.6 nmol/l, and the HbA1c also decreased from 8.5 to 7.3% after intervention(p<0.05). The decrease in the FBS and HbA1c following the educational intervention was more pronounced in the IE group than the CE group (p<0.05). 2) The effectiveness of the education programmes in promoting appropriate dietary behavior in the diabetic subjects was assessed by a scoring system in three parts: a regularity score, a balance score and an attitude score. From a comparative study of the three scores, the patients attitudes were observed to be much improved in both the groups following the intervention compared to before the programmes, but the balance and total scores were significantly higher in the IE group than the CE group(p<0.05). CONCLUSION: We can conclude that the intensive diabetic education programme is more effective than a conventional programme, not only in improving the patients' levels of glucose, HbAlc, and dietary score, but also the diabetic patients self-control abilities, promoting behavioral change, and prompting problem solving capabilities in respect to the everyday problems that they have to face throughout their lives.
Diet ; Education* ; Fasting ; Glucose ; Humans ; Outpatients ; Problem Solving ; Self Care

No abstract available.
Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular*