Colovesical fistulae secondary to diverticulitis usually manifest themselves as non-specific lower abdominal discomfort and urologic symptoms. CT is known to be the most sensitive modality for diagnosing this entity. Ultrasonography is the initial diagnostic tool used for evaluating patients with these symptoms, but there have been no reports describing the ultrasonographic findings of colovesical fistulae in Korea. Therefore, we present a case of an ultrasonographically diagnosed colovesical fistula complicating sigmoid diverticulitis. Color Doppler ultrasonography was used in conjunction with lower abdominal compression in order to determine if the fistulous tract was open or obliterated.
Colon ; Colon, Sigmoid ; Diverticulitis ; Fistula ; Humans ; Intestinal Fistula ; Korea ; Ultrasonography, Doppler, Color ; Urinary Bladder

BACKGROUND: Angiotensin converting enzyme (ACE) is heavily expressed in the lung and plays a role in the metabolism of angiotensin II, bradykinin and substance P. Nitric oxides, including those produced by endothelial nitric oxide synthase (ecNOS), may regulate vascular and airway tone in the lung and influence various aspects of airway homeostasis. They are potentially involved in the pathogenesis of asthma, but the role of ACE and ecNOS gene in bronchial asthma is not completely understood. OBJECTIVE: To examine the possible involvement of ACE and ecNOS genes in the genetic basis for bronchial asthma, we investigated the association between genetic polymorphism and bronchial asthma, and its severity. METHOD: We determined the ACE and ecNOS genotypes by the polymerase chain reaction in 160 patients with bronchial asthma and 121 healthy subjects. Severity of asthma was classified by the guideline of NHLBI/WHO workshop. RESULTS: The frequency of the ID genotypes of ACE and bb genotype of ecNOS was highest in both groups, respectively. The distribution of ACE genotypes did not differ between the two groups (p=0.27). There was a higher frequency of the bb genotype of ecNOS in the asthma group than in the control population (p=0.004). In asthmatic patients, there were no differences in the distribution of ACE and ecNOS genotypes in different severity groups (p= 0.17, 0.06). CONCLUSION: These results suggest that the polymorphism of the ecNOS gene, not ACE gene, may be associated with development of asthma. But, the severity of asthma may not be influenced by polymorphisms of the ecNOS and ACE genes.
Angiotensin II ; Angiotensins* ; Asthma* ; Bradykinin ; Education ; Genotype ; Homeostasis ; Humans ; Lung ; Metabolism ; Nitric Oxide Synthase Type III* ; Oxides ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Substance P

We report the computed tomography (CT) and magnetic resonance imaging (MRI) findings in a patient with peripelvic and perirenal lymphangiectasia associated with bilateral renal vein thrombosis. CT scanning revealed multiple hypodense masses in the bilateral peripelvic and perirenal space, and on MR images, these masses had a multiple cystic appearance, with low signal intensity on T1-weighted and high signal intensity on T2-weighted images. CT, MR, and renal angiography failed to visualize bilateral renal veins, though serpigi-nous collateral veins were seen in the perirenal spaces.
Angiography ; Humans ; Magnetic Resonance Imaging ; Renal Veins* ; Thrombosis* ; Tomography, X-Ray Computed ; Veins

PURPOSE: To describe the CT findings of portal vein aneurysm in eight patients. MATERIALS AND METHODS: Allpatients included in this study (two men and six women) under went CT examinations between October 1996 and June1998. Of these eight, three were suffering from hepatic disease and portal hypertension. We determined thelocation, shape, size, and characteristics of the lesions, and the presence or ab-sence of portal vein anomaly. RESULTS: S even patients had intrahepatic portal vein aneurysm (at the umbilical por-tion of the left portal veinin five patients, between the transverse and umbilical por-tion of the left portal vein in one, and at thebifurcation of the anterior and posterior branch of the right portal vein in one), while extrahepatic portal veinaneurysm, at the confluence of the superior mesenteric and splenic vein was found in only one. Lesions werecyst-shaped in seven cases and saccular in one, and showed well - circum scribed, markedly enhanced mass, whichcommunicated with the portal vein and/or gives off major branches. Portal vein anomaly, in which the rightanterior segmental portal vein originated from the umbilical portion of the left portal vein, was seen in threepatients. In all three, intrahepatic portal vein aneurysm was present at the umbilical portion of the left portalvein, and in one, the umbilical portion of the left portal vein was located to the right of the Cantlie line. CONCLUSION: CT examination can help reveal portal vein aneurysm by detectinga well - circumscribed, markedlyenhanced mass which communicates with the portal vein and/or gives off major branches.
Aneurysm* ; Humans ; Hypertension, Portal ; Male ; Portal Vein* ; Splenic Vein

Since Steeg, et al.(1988) identified NM23/NDP kinase as non -metastasis gene, other multiple functions of have reported. One of them, Postel, et al.(1993) suggested that transcription factor PuF, being encoded by NM23 -H2/NDP kinase gene, interacts with nuclease hypersensitive element located upstream of the c -myc gene. C -myc amplification and activation can be present in squamous cell carcinoma of the head and neck as well as in an increased metastatic propensity for individual tumor. To clarify the role of NM23/NDP kinase on c -myc expression, comparison of these two gene expressions in cell lines was done. No direct correlation of expression kinetics was found. A plasmid containing human c -myc fragment was cloned upstream of chloramphenicol acetyltransferase (CAT) gene. When murine melanoma cell line was cotransfected with a murine NM23 -M2 including expression vector and c -myc CAT, CAT activity was elevated, while no change of CAT activity was found in the cotransfectant of human NM23 -H2 and c -myc CAT. Data suggest that murine NM23 -M2 gene transactivates c -myc gene indirectly with a cellular factor in murine cell line which dose not work with human NM23 -H2 gene. Additionally, we found same kinetics of NM23 -H2/NDP kinase and c -myc expression change correlated with proliferation of PLC/PRF/5 which was induced by HGF.
Animals ; Carcinoma, Squamous Cell ; Cats ; Cell Line* ; Chloramphenicol O-Acetyltransferase ; Clone Cells ; Gene Expression ; Head ; Humans ; Kinetics ; Melanoma ; Neck ; Phosphotransferases* ; Plasmids ; Transcription Factors ; Transcriptional Activation

BACKGROUND AND OBJECTIVES: Cavernous sinus is a small venous space enclosed by leaves of dura and periosteum and located on either side of sella turcica. Approach and treatment of lesions of this sinus are very difficult and perilous because they contain critical neural and vascular structures. Surgery relating to cavernous sinus lesions are extremely rare in otorhinolaryngology and such surgeries are usually referred to the fields of neurology and neurosurgery. However, in the case of a lesion that extends from the nasal cavity and the paranasal sinuses, an intranasal approach is necessary and cooperation with head and neck surgeons are desirable to achieve a superior result. This study examines the nature of these rare cases of cavernous sinus lesions and assesses the results of cooperation with doctors of other specialties. MATERIALS AND METHODS: We summarize here three cases of cavernous sinus lesions (angiofibroma, tuberculosis, foreign body) extendeding from the nasal cavity and paranasal sinuses. These lesions were treated in cooperation with a reconstructive surgeon and a neurosurgeon. RESULT: All of these cases showed successful results. CONCLUSION: Close cooperation from each department is critical in order to achieve successful results.
Angiofibroma ; Cavernous Sinus* ; Foreign Bodies ; Head ; Nasal Cavity ; Neck* ; Neurology ; Neurosurgery ; Otolaryngology ; Paranasal Sinuses ; Periosteum ; Sella Turcica ; Tuberculosis

Primary sclerosing cholangitis(PSC) is rare disease which is characterized by inflammation and obliteration of bile duct leading to biliary cirrhosis and liver failure. The cause of PSC is unknown although a number of potential etiologic factor have been investigated. The diagonsis is confirmed by typical cholangiographic demonstration with clinical features. On endoscopic retrograde cholangiopancreatography(ERCP), multifocal strictures involving both intra and extrahepatic bile ducts are most common; they were diffusely distributed, short, and annular, alternating with normal or slightly dilated segments to produce a "beaded" appearance, the "pruned-tree" appearance due to diminished arborization of the intrahepatic duct, band-like stricture, and diverticular-like outpouching(s) are seen occasionally on cholangiography, and the report of primary sclerosing cholangitis in Korea is being increased due to increased use of ERCP. Recently, magnetic resonance cholangiography(MR cholangiography) and computed tomography cholangiography(CT cholangiography) are newly developed adjunctives for evaluation of patients with biliary disease(s). We performed MR cholangiography and CT cholangiography through the nasobiliary tube in two patients with PSC, in which typical intrahepatic bile duct changes of PSC were seen as in ERCP. Now, we report MR cholangiographic and CT cholangiographic findings in patients with PSC and suggest that these radiologic studies, especially MR cholangiography, can be used as an alternative methods for serial follow-up after definite diagnosis by ERCP.
Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing* ; Constriction, Pathologic ; Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Korea ; Liver Cirrhosis, Biliary ; Liver Failure ; Rare Diseases

PURPOSE: To assess the value of CT for the differential diagnosis of malignant ovarian tumors. MATERIALS AND METHODS: We reviewed CT scans of 31 patients with surgically confirmed 46 malignant ovarian tumors. (29 epithelial tumors, 9 Krukenberg tumors, 6 germ cell tumors, and 2 sex cord-stromal tumors.) CT scans were evaluated for the mass (bilaterality, size, internal component, and margin), peritoneal spread pattern, ascites, invasion of adjacent organ, and lymphadenopathy. RESULT: Bilateral masses were seen in epithelial or Krukenberg tumor in 61.1%(11/18) and 80%(4/5) respectively. Epithelial tumors showed predominantly cystic mass(37.9%, 11/29), irregular margin(82.8%, 24/29) of mass, and accompanying peritoneal and omental spread (66.7%, 12/18), whileKrukenberg tumor showed predominantly solid mass(55.5%, 5/9), smooth margin of mass(100%, 5/5), and no peritoneal and omental spread. All cases with germ cell tumor or sex cord-stromal tumor showed unilateral mass. Relatively young aged, unilateral solid (66.7%, 4/6) tumors were germ cell tumor. Of these cases, septa within solid portionof mass were prominent in all dysgerminoma. (3/3) CONCLUSION: CT may be a valuable tool for the differential diagnosis of malignant ovarian tumors.
Diagnosis, Differential* ; Dysgerminoma ; Humans ; Krukenberg Tumor ; Lymphatic Diseases ; Neoplasms, Germ Cell and Embryonal ; Sex Cord-Gonadal Stromal Tumors ; Tomography, X-Ray Computed

PURPOSE: This study is to describe authors'experience on mammographic findings of breast cancer and to know if there is difference between 35 years of age or younger and older groups. MATERIALS AND METHODS: Mammograms of 72 patients with breast cancer detected from January, 1991 to December, 1993 were retrospectively analysed. Mammographic findings were classified into mass only, mass with microcalcifications, microcalcifications only and others. Marginal characteristics of mass were classified into spiculated, poorly marginated and well marginated. Shape of microcalcifications were classified into casting, granular and mixed types. These findings were compared between 35 years of age or younger and older groups. RESULTS: Mammogram showed mass only in 33 patients(46%), mass with microcalcifications in 26 patients (36%), microcalcifications only in seven(10%) and other findings in six(8%). Other findings were architectural distortion, asymmetric high density and incidental breart carcinoma from paraffinoma in one patient respectively, and dense breast in three patients. The margins of the breast mass were spiculated in ten(17%) poorly marginated in 30(51%), well-marginated in 19(32%). Shape of microcalcifications were casting type in 13(40%), granular in 14(42%) and mixed in six(18%) cases. 3 patients had dense breast with which mammography did not demonstrate the lesion. 3 patients without mammographically demonstrable lesions due to dense breasts were under 35 years in age. and there was statistically significant difference between the two groups(p-value<0.05). Microcalcifications only was more common findings in 35 years of age or younger. CONCLUSION: The most important mammographic findings of breast cancer were mass and microcalcifications. Architectural distortion and asymmetric high density were additional findings. In 35 years of age or younger, microcalcifications only was an important finding because mass lesions are frequently masked by dense breast. Thus other imaging modalities, such as ultrasonography, were required.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Masks ; Retrospective Studies ; Ultrasonography

PURPOSE: The aim of this study was to determine the role of the CT scan in blunt hepatic injury and the significance of CT degree of hepatic injury in the decision making of treatment plan. MATERIALS AND METHODS: We retrospectively analysed the CT findings of 22 patients with hepatic injury. We graded hepatic injury on CT scan into five according to the severity. Clinical records, type of management and clinical outcome of the patients were also reviewed. RESULTS: Of the 22 patients, 17 had conservative treatment and five had surgery. The numbers of patients treated conservatively were 0, 4, 11, 2 and 0 in the grade 1, 2, 3, 4 and 5, respectively and the numbers of surgically treated cases were 0, 0, 3, 2 and 0 respectively. There was no significant statistical difference between surgically and conservatively treated groups(p-value > 0.05). All patients with conservatively treated group were hemodynamically stable and had no complication during hospitalization. Hemoperitoneum was observed in 11 of 22 patients. CONCLUSION: In blunt hepatic injury, CT plays an important role in the demonstration of location and extent of the hepatic injury, size of hemoperitoneum and the post operative course. However, we believe that physiologic status of the patients may be more important than the extent of CT based hepatic injury for determining a mode of treatment.
Decision Making ; Hemoperitoneum ; Hospitalization ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed