No abstract available.
Hemodynamics* ; Hepatocytes* ; Ischemia* ; Liver* ; Urokinase-Type Plasminogen Activator* ; Verapamil*

No abstract available.
Nifedipine* ; Vasopressins*

Portal vein thrombosis is a rare condition occurring in association with a wide variety of precipitating factors. Among these, liver cirrhosis and neoplasm constitute the major etiology of portal vein thrombosis. In oriental countries, as compared with western countries, liver cirrhosis has been reported to be extremely rare cause of portal vein thrombosis. The authors experienced a case of portal vein thrombosis in a 46-years-old man with liver cirrhosis who admitted to our hospital due to abdominal pain. Abdominal CT, angiography and laparotomy showed involvement of portal vein with thrombus and there were no evidences of neoplastic disease. The screening tests for hypercoagulable states were normal. The patient was treated with portal vein thrombectomy and anticoagulation therapy. We report this case with brief review of literature.
Abdominal Pain ; Angiography ; Humans ; Laparotomy ; Liver Cirrhosis* ; Liver* ; Mass Screening ; Portal Vein* ; Precipitating Factors ; Thrombectomy ; Thrombosis ; Tomography, X-Ray Computed ; Venous Thrombosis*

No abstract available.
Radiosurgery* ; Trigeminal Neuralgia*

The gastrointestinal mesenchymal tumors (GIMTs) form a heterogenous group with controversy centering on both the cell of origin and the prediction of clinical behavior. They include a small group of tumors with mature smooth muscle or Schwann cell differentiation and a larger group with inconsistent or no evidence of differentiation. Tumors in the latter are now referred to as gastrointestinal stromal tumors (GISTs). A clinicopathologic and immunohistochemical study was performed on 53 cases of GIMTs to identify cellular differentiation and predictors of clinical behavior. Fifty three cases of GIMTs could be histologically and immunophenotypically divided into three categories, 6 leiomyomas (11.3%), 4 schwannomas (7.6%), and 43 GISTs (81.1%). All leiomyomas (SMA desmin ) and schwannomas (S-100 ) were located in stomach and negative for CD34 and CD117. Thirty nine cases of GISTs were either CD34 (n=26) or CD117 (n=23) immunoreactive. Of these 39 GISTs, 26 were negative for myoid (SMA, desmin) and neural marker (S-100), 10 SMA desmin-S-100-, two SMA-desmin-S-100 , and one SMA desmin-S-100 . Two out of 4 GISTs, which were negative for CD34 and CD117, were immunohistochemically considered leiomyosarcoma (SMA desmin ). GISTs of small intestine had a tendency to be malignant than those of stomach. Pathologic grade of GISTs was not correlated with cellular differentiation. In 29 GISTs with clinical follow-up information, tumor size, mitotic counts, Ki-67 labelling index, tumor necrosis, mucosal invasion, and CD34 expression were significantly correlated with metastasis/recurrence.
Cell Differentiation ; Desmin ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Intestine, Small ; Leiomyoma ; Leiomyosarcoma ; Muscle, Smooth ; Necrosis ; Neurilemmoma ; Stomach

PURPOSE: Differences in phenotypes between the two most common subtypes of Prader-Willi syndrome (PWS) indicate that a distinct response to growth hormone (GH) treatment may exist. To test this hypothesis, we compared the results of GH treatment in individuals with PWS due to uniparental disomy (UPD) to those of individuals with deletions. METHODS: Sixty-five children with PWS who had been treated with GH for more than two years were included in this study. Twenty-one individuals were confirmed as having UPD and 44 individuals had a deletion. Height, body weight, body mass index (BMI), and insulin like growth factor-1 (IGF-I) measurements were recorded before GH treatment and at intervals of 12 months thereafter. RESULTS: After two years of GH therapy, no significant differences were noted for yearly improvements in height standard deviation scores (SDS) between the groups (second year SDS, 0.93 +/- 0.94; deletion, 0.84 +/- 1.31; UPD, P = 0.717). Body weight SDS, BMI SDS, and IGF-I SDS also showed no differences between the two groups. CONCLUSION: Our study showed no significant differences in yearly improvements in height SDS between the deletion and UPD groups, at least for the first two years.
Body Height ; Body Weight ; Child ; Genotype ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Phenotype ; Prader-Willi Syndrome ; Sequence Deletion ; Uniparental Disomy

PURPOSE: Differences in phenotypes between the two most common subtypes of Prader-Willi syndrome (PWS) indicate that a distinct response to growth hormone (GH) treatment may exist. To test this hypothesis, we compared the results of GH treatment in individuals with PWS due to uniparental disomy (UPD) to those of individuals with deletions. METHODS: Sixty-five children with PWS who had been treated with GH for more than two years were included in this study. Twenty-one individuals were confirmed as having UPD and 44 individuals had a deletion. Height, body weight, body mass index (BMI), and insulin like growth factor-1 (IGF-I) measurements were recorded before GH treatment and at intervals of 12 months thereafter. RESULTS: After two years of GH therapy, no significant differences were noted for yearly improvements in height standard deviation scores (SDS) between the groups (second year SDS, 0.93 +/- 0.94; deletion, 0.84 +/- 1.31; UPD, P = 0.717). Body weight SDS, BMI SDS, and IGF-I SDS also showed no differences between the two groups. CONCLUSION: Our study showed no significant differences in yearly improvements in height SDS between the deletion and UPD groups, at least for the first two years.
Body Height ; Body Weight ; Child ; Genotype ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Phenotype ; Prader-Willi Syndrome ; Sequence Deletion ; Uniparental Disomy

Microsurgical tumor removal is the treatment of choice to relieve the mass effect for the treatment of acoustic neurinoma patients. Gamma knife radiosurgery is another treatment option for patients with tumor size of less than approximately 4cm. Between May, 1990 and March, 1994, 55 tumor lesions from 50 patients were treated with gamma knife radiosurgery at Asan Medical Center. Following microsurgery, 20 patients underwent gamma knife radiosurgery for tumors not removed surgically. The remaining 30 patients underwent gamma knife radiosurgery alone. For an average follow-up period of 26 months(ranging from 6 to 45 months), 37 lesions out of 39 lesions responded, giving a tumor growth control rate of 94.9%. Facial neuropathy and trigeminal neuropathy were noted in 8% and 6%, respectively. According to these results, it is suggested that gamma knife radiosurgery in an effective altrnative therapeutic modality for the management of small to moderate sized acoustic neurinomas.
Acoustics* ; Chungcheongnam-do ; Facial Nerve Diseases ; Follow-Up Studies ; Humans ; Microsurgery ; Neuroma, Acoustic* ; Radiosurgery ; Trigeminal Nerve Diseases

For treatment of the pressure sore, variable methods have been developed such as skin graft, local flap, myocutaneous or fasciocutaneous flap. The myocutaneous flap has been used commonly for the coverage and padding of the wound. However, sacrifice of the deep muscles causes some problems such as intraoperative bleeding, functional disabilities of donor sites, and difficulty in controling the volume of the flap for the skin reability of myocutaneous flaps. To overcome these disadvantages, we tried perforator-based myocutaeous island flaps for reconstruction of buttock area. During the dissection of the flap, we could control the volume and shape of the flap exactly depending on the perforator. And minimal morbidity of the donor site is expected because of significant volume of gluteus maximus muscle need not be sacrificed. The perforator-based flaps are especially indicated for ambulatory patients, and for paraplegic patients as well. Clinically, total of 20 cases were treated with 13 parasacral perforator-based myocutaneous island flaps and 7 parasacral perforator-based fasciocutaeous island flaps. The mean operating time was 84 minutes, and the mean flap size was 8x9.2 cm. In donor sites, primary closure were done in all cases, post operative complications were wound dishescence in 1 case, venous congestion in 3 cases, but immediately improved. Recurrence was not reported.
Buttocks ; Hemorrhage ; Humans ; Hyperemia ; Muscles ; Myocutaneous Flap ; Pressure Ulcer* ; Recurrence ; Skin ; Surgical Flaps ; Tissue Donors ; Transplants ; Wounds and Injuries

BACKGROUND: The laparoscopic cholecystectomy (LC) has been accepted as the procedure of choice for chronic cholecystitis. However in cases of acute cholecystitis, the safety and the efficacy of LC has not been fully determined. Thus we performed this study to assess the clinical outcomes of a LC for acute cholecystitis to evaluate it's efficacy and safety. METHODS: The authors retrospectively analyzed 1,164 LCs performed in Yeungnam University Hospital from May 1991 to March 1996. Among the 1,164 LCs, 118 were performed for acute cholecystitis and 1,046 were performed for chronic cholecystitis. The authors compared the mean operation time, the conversion rate to an open cholecystectomy (OC), the reasons for conversion, the complication rate, the postoperative hospital stay, and the postoperative use of analgesics between the patients with acute cholecystitis and the patients with chronic cholecystitis. RESULTS: In the 1046 patients with chronic cholecystitis, the mean operation time was 55.9 minutes, the conversion rate to an OC was 2.7%, the complication rate was 4.0%, the mean postoperative hospital stay was 3.3 days, and analgesics were used in 48% of the patients. However in the 118 patients with acute cholecystitis, the mean operation time was 65 minutes, the conversion rate to an OC was 11.8%, the complication rate was 16.9%, the mean hospital stay was 4.4 days, and analgesics were used in the 60% of the patients. Also the authors found that the longer duration of preoperative symptoms and an advanced state of inflammation (e.g., GB empyema or gangrenous changes) were the two most common causes of conversion to an OC in the case of acute cholecystitis. Although all the analyzed parameters (especially, the conversion rate and the complication rate) were higher in the patients with acute cholecystitis than they were in the patients with chronic cholecystitis, a LC for acute cholecystitis seems to be acceptable because there were no mortalities and there were no life threatening complications. CONCLUSIONS: From, the aspects of safety and efficacy, a LC can be performed in most patients with acute cholecystitis. However, it should be remembered that the prolonged duration of symptoms prior to a LC increases the conversion rate to O.C. and if we confront the advanced cholecystitis (GB empyem or gangrenous change) with difficult Calot's triangle during a L.C., early conversion to an OC should be considered.
Analgesics ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute* ; Empyema ; Humans ; Inflammation ; Length of Stay ; Mortality ; Retrospective Studies