PURPOSE: To determine the significance of anomalous position of the gallbladder. MATERIALS AND METHODS: Sixteen patients with anomalous position of the gallbladder were evaluated for analysis. The diagnosis was confirmed by ultrasonography(15 patients) and oral cholecystography(1patient). Among those, six patients underwent CT scan and a patient had 99mTc-DISIDA scan. The images were analysed with respect to the location of the GB and configuration and associated abnormality of the liver and hepatobiliary systems. Medical records of each patient were also reviewed. RESULTS: Among 16 patients having an anomalous position of the gallbladder, nine had retrodisplaced gallbladder, four had left-sided gallbaldder, two had suprahepatic gallbladder, and one had floating gallbladder. Except for one patient, fifteen had abnormality in the liver such as focal atrophic or hypoplastic change and liver cirrhosis. Intrahepatic stones were demonstrated in 6 patients. CONCLUSION: Our results showed that anomalous position of the gallbladder was commonly associated with atrophy or hypoplasia of the liver rather than congenital in origin. The possiblity of an anomalous location of gallbladder should be kept in mind when GB is not in its normal location.
Atrophy ; Diagnosis ; Gallbladder* ; Humans ; Liver ; Liver Cirrhosis ; Medical Records ; Technetium Tc 99m Disofenin ; Tomography, X-Ray Computed

PURPOSE: Spiculation pathologically correlated with irregular fibrosis, localized lymphatic spread of tumor, or an infiltrative growth pattern of tumor, and the spiculation was Observed in malignant mass. But the spiculation was also observed in benign mass, particularly in tuberculoma. We retrospectively reviewed the length of spiculation under the hypothesis that the length of spiculation could be one of differential diagnostic points between lung cancer and tuberculoma. MATERIALS AND METHODS: We studied thirty seven patients (27 men and 10 women) ranging in age from 35 to 80 years (mean, 60 years). Analysis of spiculation included (a) the number of spicules (b) the mean length of spicules (c) the mean length of the longest spicule (d) the percentage of the mean length of spicules to the longest diameter of mass (e) the percentage of the mean length of spicules to the shortest dia, meter of mass. RESULTS: The mean length of spicules of tuberculoma was 13.8 mm (S. D. 6.7) and that of lung cancer was 5.7 mm (S. D. 3.5). The percentage of the mean length of spicules to the longest diameter of tuberculoma was 63.6% and that of lung cancer was 13.7%. The percentage of the mean length of spicules to the shortest diameter of tuberculoma was 90.4% and that of lung cancer w~s 18.3%. CONCLUSION: It is hard to differentiate lung cancer from tuberculoma on the basis of the spiculation being present or not, but we suggest that the longer spiculation be more highly suggestive of tuberculoma rather than lung cancer. The length of spiculation may help us differentiate lung cancer from tuberculoma.
Fibrosis ; Humans ; Lung Neoplasms ; Lung* ; Male ; Retrospective Studies ; Tuberculoma*

Sparganosis usually means the plerocercoid larval infection of Spirometra species. It is endemic mainly in countries where the habit of eating raw snake or frog, or the habit of poulticing with snake skin exists. The most common endemic area is Korea, Japan and China, and the most common localizations are subcutaneous connective tissue and superficial muscles. We experienced a case of scrotal sparganosis in a 32-year-old man presenting with painless hard masses in left scrotum. He underwent by serum Enzyme Linked Immunosorbent Assay (ELISA) and was treated by surgical excision.
Adult ; China ; Connective Tissue ; Eating ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Japan ; Korea ; Muscles ; Scrotum ; Skin ; Snakes ; Sparganosis* ; Spirometra

PURPOSE: We tried to discover the normal voiding pattern, which was diurnal & nocturnal urinary volume, voiding frequencies in healthy older men without prostate disease. MATERIALS AND METHODS: All voided volumes, times and frequencies were recorded for 3 days in 158 healthy men without any voiding problems. The subjects ages ranged from 31 to 49 for 47 men (mean age 42.8), 50 to 59 for 38 men (mean age 54.1), 60 to 69 for 39 men (mean age 67.3), 70 to 81 for 34 men (mean age 74.5). The subjects age related changes in bladder capacity, urinary volume and frequency were evaluated. The causes of nocturnal urinary frequency and its increase with age in healthy older men were evaluated using 3 days of voiding diaries. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. RESULTS: Nocturnal bladder capacity, functional bladder capacity, total urinary voiding volume and daytime urinary voiding volume decreased with age. Nocturnal urinary frequency increased with age. Nocturnal urinary volume did not change with age. 76 (48%) of the 158 volunteers had 2 or more voidings per night. 9 (12%) of the 76 volunteers had nocturnal polyuria. 39 (51%) had decreased nocturnal bladder capacity, and 28 (37%) had mixed type. CONCLUSIONS: Normal voiding patterns changed with age, especially in subjects over 60 years. In most cases, nocturia was caused by decreased nocturnal bladder capacity, since nocturnal urinary volume did not change with age but nocturnal bladder capacity decreased with age.
Adult* ; Aging ; Humans ; Male* ; Nocturia ; Polyuria ; Prostate ; Urinary Bladder ; Volunteers

PURPOSE: Some authors have suggested that erectile dysfunction correlates with the level of glycemic control and glycosylated hemoglobin can be used to predict erectile dysfunction in diabetic patients. This study evaluated whether or not glycosylated hemoglobin level can predict the effectiveness of sildenafil citrate, which is a first line therapy for erectile dysfunction. MATERIALS AND METHODS: A consecutive sample of 32 men with type 2 diabetes and erectile dysfunction completed the International Index of Erectile Function (IIEF) and had their glycosylated hemoglobin levels measured. 50mg of sildenafil citrate was prescribed at the first visit, which was then increased to 100mg if the symptom persisted. According to the response, the patients were divided into responders and nonresponders. The pretreatment clinical parameters (age, diabetic duration, erectile dysfunction duration, glycosylated hemoglobin level, body mass index, IIEF, diabetic complications, smoking, alcohol drinking) were recorded. The patients were divided into 3 groups according to the drug dosage (group 1 was 50mg responders, group 2 was 100mg responders, group 3 was nonresponders in any dosage) and the clinical parameters were compared and analyzed. RESULTS: The mean hemoglobin A1c level was 8.68 0.74% and 7.64 1.67% in the nonresponders and responders (p < 0.05), respectively. Diabetic neuropathy and diabetic retinopathy were significantly higher in the nonresponders (p < 0.05). The mean hemoglobin A1c levels of the three groups were 7.36 1.01, 7.78 0.98, and 8.64 0.44%, respectively and group 3 was significantly higher than the other groups (p < 0.05). CONCLUSIONS: High levels of glycosylated hemoglobin suggests a poor response to sildenafil citrate in diabetic patients with erectile dysfunction. Diabetic patients with neuropathy or retinopathy may have a low response for sildenafil citrate.
Body Mass Index ; Citric Acid* ; Diabetes Complications ; Diabetic Neuropathies ; Diabetic Retinopathy ; Erectile Dysfunction* ; Hemoglobin A, Glycosylated* ; Humans ; Male ; Smoke ; Smoking ; Sildenafil Citrate

Although many papers concerning the ultrasonographic findings of liver abscess have been appeared, there is afew literatures for the analysis of its echognic patterns. Twenty-nine cases of surgically proven liver abscesswere studied by ultrasonography in our hospital during recent 3 years. The results were as follows: 1.Ultrasonography permitted correct diagnosis in 26 of 29 patients with sensitivity 90%. 2. All the 7 cases ofamebic abscess were single lesions and 6 cases of them were distributed in the right lobe of liver, while pyogenicabscesses showed single or multiple lesions. It was very difficult to distinguish pyogenic abscess from amebicabscess in cases of single lesion. 3. It was impossible to differentiate pyogenic abscess from amebic abscess bythe echopattern of abscess wall and internal echogenicity. 4. The wall of obscess was ill-defined in the majority,and internal echogenecity of abscess was variable although weak internal echogenecity was more comon. 5. Theechopattern of abscess was gradually converted to echolucent or hypoechoic area with weak internal echoes infollowing up study. 6. Clinical findings and ultrasonic findings should be carefully analysed to secure correctdiagnosis of there is any possibility of co-existing necrotizing metastatic lesion.
Abscess ; Amebiasis ; Diagnosis ; Humans ; Liver Abscess ; Liver ; Ultrasonics ; Ultrasonography

STUDY DESIGN: A retrospective study. PURPOSE: To evaluate the prevalence and risk factors of asymptomatic cervical or thoracic lesions in elderly patients who have undergone surgery for lumbar spinal stenosis. OVERVIEW OF LITERATURE: Concurrent multiple spinal lesions have been reported in many studies with a varied prevalence, and described the characteristics of the disease and its treatment options. However, the cervical or thoracic lesions without apparent symptoms in patients with symptomatic lumbar stenosis had not been evaluated. METHODS: A total of 101 elderly patients (aged 65 or more), who had undergone surgery for lumbar spinal stenosis from January 2005 to December 2005, were enrolled in this study. All patients underwent lumbar magnetic resonance imaging (MRI) along with T2-weighted cervical and thoracic sagittal MRI prior to surgery. The concurrent cervical or thoracic lesions were classified according to the disease entity, and the severity of the lesions was graded from grade 0 (no lesion) to grade 4 (any lesion compressing the cord with a signal change). The prevalence of concurrent cervical and thoracic lesions was then analyzed. In addition, the risk factors for the development of concurrent lesions were evaluated, and the risk factors affecting the severity of the concurrent lesion were analyzed individually. RESULTS: Seventy-seven (76.2%) and 30 (29.7%) patients had a concurrent cervical and thoracic lesion, respectively. Twenty-six patients (25.7%) had both a cervical and thoracic lesion. There was a positive correlation between the symptom duration of lumbar stenosis and the prevalence of both cervical (p = 0.044) and thoracic (p = 0.022) lesions. CONCLUSIONS: The incidence of asymptomatic cervical or thoracic lesions is apparently high in elderly patients who have undergone surgery for lumbar spinal stenosis, particularly in those with longer symptom duration. This highlights the need for a preoperative evaluation of the cervical and thoracic spine in these patients.
Aged ; Constriction, Pathologic ; Humans ; Incidence ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spine

BACKGROUND: Topoisomerase II (topo II) is a major target of anthracyclines and epipodophyllotoxins for anticancer treatment. The expression of topo II is low in drug resistant cell lines. High levels of glutathione S-transferase (GST)pi have been associated with emergence of cell lines resistant to alkylating agents or adriamycin. METHODS: By immunostaining with paraffin embedded bone marrow tissues, the expression of topo II alpha and GSTpi was investigated in 51 patients with acute myeloid leukemia (AML), and the relation of topo II alpha and GSTpi expression to treatment response in 29 patients with AML following induction chemotherapy was also evaluated. RESULTS: Topo II positive cells varied from less than 1% to 60% of leukemic cells and 20 (39.2%) were negative for topo II (positive cells<10%). Treatment response following chemotherapy was not related to topo II. 26 (51.0%) were positive for GSTpi. GSTpi expression was related to treatment resistance of the patients following chemotherapy. In the patients who showed both topo II alpha negative and GSTpi positive, the frequency of treatment resistance following chemotherapy was high. CONCLUSIONS: This study suggests that immunostaining of topo II alpha and GSTpi with the bone marrow paraffin sections of AML patients can be useful to predict the treatment response following chemotherapy and that further study including more patients with prospective study may substantiate topo II alpha and GSTpi as multidrug resistant markers.
Alkylating Agents ; Anthracyclines ; Bone Marrow ; Cell Line ; DNA Topoisomerases, Type II* ; Doxorubicin ; Drug Resistance, Multiple ; Drug Therapy ; Glutathione S-Transferase pi* ; Glutathione Transferase* ; Glutathione* ; Humans ; Immunohistochemistry ; Induction Chemotherapy ; Leukemia, Myeloid, Acute* ; Paraffin ; Podophyllotoxin

BACKGROUND: Approximately two thirds of acute myeloid leukemia(AML) have recognizable clonal chromosome abnormalities. We have performed the cytogenetic monitoring of 35 de novo AML to follow the karyotype changes at diagnosis, in remission, and in first relapse. METHODS: The study is based on 35 cases of AML seen between January 1, 1996 and June 30, 1999. They were subdivided in accordance with the FAB classification and treatment response was evaluated by the National Cancer Institute(NCI)-sponsored workshop criteria. Chromosome studies were done with standard 24-48 hour methotrexate synchronization. RESULTS: The frequency of FAB M0, M1, M2, M3, M4, M5, and M6 was 1, 5, 18, 6, 3, 1, and 1, respectively. Clonal chromosome abnormalities were detected in 25 of 35(71%) in the decreasing order of t(8;21), t(15;17), +8, del(9q), etc. Thirty-one(89%) entered complete hematologic remission and 4(11%) represented partial remission. All 31 cases of complete remission had normal karyotypes. Three partial remission patients having both normal and abnormal metaphases at diagnosis and first follow-up had only normal cells after reinduction, however, in 1 case of induction failure, only abnormal metaphases persisted. In 5 of 7 relapses, karyotypes at diagnosis and relapse were identical. Two cases underwent a normal-to-abnormal change and clonal evolution, respectively. CONCLUSIONS: In this study the karyotypes were normal during complete remission, and in relapse the original aberrations returned sometimes with newly acquired clonal abnormalities. Therefore, cytogenetic study yields basic important information for understanding of cancer genetic mechanisms and molecular biologic analysis.
Chromosome Aberrations* ; Classification ; Clonal Evolution ; Cytogenetics ; Diagnosis* ; Education ; Follow-Up Studies ; Humans ; Karyotype ; Leukemia, Myeloid, Acute* ; Metaphase ; Methotrexate ; Recurrence*

Thrombosis of the inferior vena cava (IVC) is a rare condition that can result from various underlying diseases including deep vein thrombosis, major trauma, hypercoagulability disorders, and an obstruction due to tumor involvement and idiopathic causes. Chronic obstruction of the IVC may not be recognized due to the lack of signs and symptoms. Here we report a case of a chronic post-thrombotic obstruction of the inferior vena cava, which was believed to be the cause of a painless gross hematuria.
Hematuria* ; Thrombophilia ; Thrombosis ; Vena Cava, Inferior ; Venous Thrombosis