A case of pigmented villonodular synovitis developed in the right ankle joint is reported. The patient was a 25 years old house wife who had complained marked swelling and tenderness over the anterolateral aspect of the right ankle for 2 years. Roentgenological studies showed marked swelling of the ankle joint and erosion of the neck of the talus. Synovectomy of the affected joint was performed. The tumor mass, measuring about 7cm×5cm×2cm in size, was yellowish brown in colour, elastic and soft in consistency, and contained several well encapsulated nodules.
Ankle ; Ankle Joint ; Humans ; Joints ; Neck ; Spouses ; Synovitis, Pigmented Villonodular ; Talus

BACKGROUND: Pregnancy in human and rodents is associated with dramatic matemal metabolic changes. Insulin-like growth factors (IGFs) are mitogenic peptides that are essential for fetal and maternal tissue growth during pregnancy. They circulate complexed primarily with a serum IGF-binding protein (IGFBP-3) which regulates the availability of the IGFs to their specific target tissues. METHODS: To examine the changes of IGFs and IGFB-3 during pregnancy, we measured serum total IGF-I, free IGF-I, IGF-II and IGFBP-3 by using specific radioimmunoassay, immunoradio-metric assay, western ligand blot and western immunoblot. Blood samples were obtained from 88 pregnant women between 6-40 weeks gestation. RESULTS: While serum IGF-I levels increased up to 50% in late pregnancy, serum IGF-II levels remained unchanged. However, serum free IGF-I levels were significantly higher during pregnancy than in nonpregnancy. Western ligand blot analysis revealed that IGFBP-3 in pregnancy serum was significantly decreased at 6 weeks of gestation, continued decreased level until term, and returned to a nonpregnant level by postpartum 10 day. Serum IGFBP-3 profiles in Western immunoblot analysis revealed that 30 kDa fragments of IGFBP-3 were detectable in pregnancy serum but not in nonpregnancy serum. In contrast, serum IGFBP-3 levels using radioimmunoassay was significantly increased in late pregnancy. CONCLUSIONS: 1) serum IGF-I was significantly elevated in late pregnancy 2) serum IGF-II was not significantly changed 3) free IGF-I significantly elevated throughout gestation 4) intact IGFBP-3 was markedly reduced after 6 weeks of gestation.
Blotting, Western ; Female ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Peptides ; Postpartum Period ; Pregnancy* ; Pregnant Women ; Radioimmunoassay ; Rodentia ; Somatomedins

Bleeding from esophageal or gastric varix is the most critical and life-threatening complication of portal hypertension and the most common cause of deaths in the patients with cirrhosis. In the management of variceal bleeding, the various therapeutic interventions including operation and nonoperative procedure were tried, but neither of management was successfully achieved. Between February 1992 and November 1994, we performed endoscopic injection sclerotherapy(EIS) in 35 cirrhotic patients who had recently bled from esophageal varices and had a past history of esophageal variceal bleeding in Chonbuk National Univesity Hospital. Among 35 patients, 32 were male and 3 were female. The underlying severity of liver disease was graded A, B or C according to modification of Child-Pugh classification. EIS was repeated every 1 week until the esophageal varices had been complete obliterated and removed. To investigate the effects of esophageal varix eradication by EIS on combined peri- cardial varix, endoscopic examinations were performed both before procedure and after complete EIS sessions and this study was performed to examine a changes of combined pericardial varices after EIS procedure for the treatment of esophageal varices bleeding secondary to portal hypertesion. We reviewed medical records and compared changes or sizes of pericardial varices before and after EIS procedure. Mean follow up peiod was 61 days. Total number of 162 EIS for variceal eradication were performed. Mean session for eradication of esophageal varices was 4.6 per person, mean amount of injected sclerosant was 8.3cc(1-18cc), mean duration of EIS was 39 days, and mean follow up was 62 days after complete EIS procedure. In total 162 EIS procedure, complications associated with EIS including substernal discomfort 53.7%(n=87), substernal chest pain 45.7%(n=74), fever 4.9%(n=8), dysphagia 14.2%(n=23) and pleural effusion 3.1%(n=5), were transient and not required specific management. During the follow-up period, complete disapperance of pericardial varix or reduction of size was appeared in l8 cases(51.4%) among total 35 patients. No significant changes of variceal size before and after procedure were l6 cases(45.7%) and only 1 case(2.9%) was more aggravated. So, these results suggest that EIS procedure of esophageal varix on pericardial varix seems either to improve or to maintain the severity of the pericardial gastric varix without aggravation.
Cause of Death ; Chest Pain ; Classification ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Ethanolamine* ; Female ; Fever ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension, Portal ; Jeollabuk-do ; Liver Diseases ; Male ; Medical Records ; Oleic Acid* ; Pleural Effusion ; Sclerotherapy* ; Varicose Veins

Bleeding from esophageal or gastric varix is the most critical and life-threatening complication of portal hypertension and the most common cause of deaths in the patients with cirrhosis. In the management of variceal bleeding, the various therapeutic interventions including operation and nonoperative procedure were tried, but neither of management was successfully achieved. Between February 1992 and November 1994, we performed endoscopic injection sclerotherapy(EIS) in 35 cirrhotic patients who had recently bled from esophageal varices and had a past history of esophageal variceal bleeding in Chonbuk National Univesity Hospital. Among 35 patients, 32 were male and 3 were female. The underlying severity of liver disease was graded A, B or C according to modification of Child-Pugh classification. EIS was repeated every 1 week until the esophageal varices had been complete obliterated and removed. To investigate the effects of esophageal varix eradication by EIS on combined peri- cardial varix, endoscopic examinations were performed both before procedure and after complete EIS sessions and this study was performed to examine a changes of combined pericardial varices after EIS procedure for the treatment of esophageal varices bleeding secondary to portal hypertesion. We reviewed medical records and compared changes or sizes of pericardial varices before and after EIS procedure. Mean follow up peiod was 61 days. Total number of 162 EIS for variceal eradication were performed. Mean session for eradication of esophageal varices was 4.6 per person, mean amount of injected sclerosant was 8.3cc(1-18cc), mean duration of EIS was 39 days, and mean follow up was 62 days after complete EIS procedure. In total 162 EIS procedure, complications associated with EIS including substernal discomfort 53.7%(n=87), substernal chest pain 45.7%(n=74), fever 4.9%(n=8), dysphagia 14.2%(n=23) and pleural effusion 3.1%(n=5), were transient and not required specific management. During the follow-up period, complete disapperance of pericardial varix or reduction of size was appeared in l8 cases(51.4%) among total 35 patients. No significant changes of variceal size before and after procedure were l6 cases(45.7%) and only 1 case(2.9%) was more aggravated. So, these results suggest that EIS procedure of esophageal varix on pericardial varix seems either to improve or to maintain the severity of the pericardial gastric varix without aggravation.
Cause of Death ; Chest Pain ; Classification ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Ethanolamine* ; Female ; Fever ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension, Portal ; Jeollabuk-do ; Liver Diseases ; Male ; Medical Records ; Oleic Acid* ; Pleural Effusion ; Sclerotherapy* ; Varicose Veins

A mesenteric cyst is considered one of the rarest type of abdominal tumor. We have experienced unusual case of large mesenteric cyst arising from jejunum in a 10-year-old boy. CT disclosed cystic intrabdominal mesenteric mass with attenuated coefficiency +3-+11 Hounsfield units (HU). Pathologically it was confiremed to be benign mesenteric cyst.
Child ; Humans ; Jejunum ; Male ; Mesenteric Cyst

This study represents the radiologic, histologic features & clinical analysis of hyaline mambrane disease in 47 newborn infants who were delivered in Ewha Womans Univ. Hospital & expired caused by repiratory distress & confirmed by autopsy , during Jan. 1981 to June, 1984. The results were as follows; 1. Classification ofradiolgraphic stage (by Wolfson's criteria); Stage III(34.1%) was the most frequent. 2. Male to female ratio was 2.4:1. 3. Method of delivery; Cesarean section (44.7%) was the highest frequency, compared with percent ofcesarean section to total delivery(29.0%). 4. Distribution of birth weight; 1.0-2.0 Kg(48.9%) was the mostfrequent. 5. Distribution of gestational period; 32-36 weeks (29.8%) was the most frequent. 6. Complication; Pulmonary hemorrhage(31.9%) was the most frequent, in order, subarachnoid hemorrhage & pneumothorax were followed.7. Final diagnosis of hyaline membrane disease was based on histo-pathologic diagnosis.
Autopsy ; Birth Weight ; Cesarean Section ; Classification ; Diagnosis ; Female ; Humans ; Hyalin ; Hyaline Membrane Disease ; Infant, Newborn ; Infant, Newborn ; Male ; Methods ; Pneumothorax ; Pregnancy ; Subarachnoid Hemorrhage

Prior to the introduction of CT, the clinical and radiological diagnosis of the intraventicular hemorrhage inliving patients was difficult. C.T. scanning is an invaluable investigation provding the rapid and noninvasivediagnosis of intracerebral and intraventricular hemorrhage. It reliably demonstrated the presence and distributionof fresh blood within the ventricular system. CT is also useful as a surgical guidance and in the evaluation offate of the hematoma by easily performable follow-up studies. We reviewed 3 cases of intraventricular hemorrhagein CT in the departement of radiology of Ewha Womans University hospital during the period from August, 1982 toAugust, 1983. The results were as follows: 1. The most patients were encountered in the 5th decade and the male tofemale ratio was 1.2:1. 2. Hypertension was the main cause of the intraventricular hemorrhage; 18 out of 31patients. Remaning 13 patients were caused by hypoxia, aneurysm, Moya Moya disease, coagulation defect, trauma andundetermined etiology. 3. 18 out of 31 patients showed hemorrhage in the lateral ventricles only and allventricles in 10 patients. 4. 28 out of 31 patients showed associated with intracranial hematoma: Those wereintracerebral hematomas in 16 patients, intracerebral hematoma with subarachnoid hemorrhage in 4 patients andextracerebral hematoma in 2 patients. 5. Outcome was assessed using the Glasgow scale. According to them the totalmortality rate was 54.8%, however, 32.2% of patients retured to normal or minor disablity. Patients, who hadhypertension and markded degree of hemorrhage in the ventricular systems had a poor outcome. Patients with onlyventricular hemorrhage had better outcome than associated intracranial hematoma. 6. 16 out of 31 patients weretreated by surgical methods and 15 out of 31 patients by conservative methods. 75% of patients were died inconservative treatment. 7. Conclusively, causes, degree of intraventricular hemorrhage and associatedintraventricular hematoma play an important role in outcome. And surgical treatment was beneficial in only a smallselective number of cases in intraventricular hemorrhage.
Aneurysm ; Anoxia ; Diagnosis ; Female ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Lateral Ventricles ; Male ; Moyamoya Disease ; Subarachnoid Hemorrhage

PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causesof obstuctive jaundice among various radiological procedures. The authors reviewed and radiologically classifiedthe PTC films of 203 cases of obstructive jaundice from July 1977 to June 1983 at Presbyterian Medical Center,Jeon-ju confirmed clinically, operatively and pathologically. The resuls are as follows; 1. The most common causeof obstructive jaundice was bile duct stoen (64/203:31.53%) and the other causes were bile duct cancer(43/203:21.18%), pancreas cancer(41/203:20.19%), biliary ascariasis &/or clonorchiasis(20/203:9.85%), ampulla andduodenal cancer (7/203:3.45%), fibrotic stenosis of sphincter of Oddi(6/203: 2.96%) etc. in that order. Of theseprimary involvement with cancer was more frequent (91/203:44.33%) than stone. 2. 88.33%(179/203) of patients wasover 40-year-of- age and the sex ratio between male and female was about 2:1. 3. The average maximal diameter ofextrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearlyequal(2.36cm:2.38cm). 4. Cancers caused complete bile duct obstruction in about 75%(68/91) of cases and also wereassociated with intrahepatic duct dilatation about 92%(84/91) of cases. But in contrast biliary calculi showedgood drainage of contrast medium in 75%(48/64) of cases and 92%(59/64) showed normal diameter of intrahepaticduct. 5. The differential PTC findings between bile duct cancer and pancreas cancer were not so distinct but inbiel duct cancer the obstruction site of the bile duct was more irregular and serrated than pancreas cancer, whilethe latter showed a more downward convexity and a smoother end. Moreover annular filling defect with overhangingedges was seen only in bile duct cancer.
Ascariasis ; Bile Duct Neoplasms ; Bile Ducts ; Cholestasis ; Constriction, Pathologic ; Dilatation ; Drainage ; Female ; Gallstones ; Humans ; Jaundice ; Jaundice, Obstructive ; Male ; Methods ; Pancreas ; Pancreatic Neoplasms ; Protestantism ; Sex Ratio

Synovial sarcoma is a very rare malignant tumor which arising from the synovial lining connective tissue, tendon sheaths and bursae. However, there are a few case reports of this tumor arising from the bone. We have experienced 3 cases of the tumor from the bone, i. e. the head of the left fibula, the sacrum and the right ileum, and the distal end of the left femur. Microscopically they showed typical slit like spaces, lined by epitheloid cells or cuboidal cells and one could easily find out spindle, polygonal, or giant cells. The proximal third of the left fibula was excised, and the other case arising from the sacrum & right ilium was treated with radiation therapy. Another case refused hip disarticulation, The effectiveness of the treatment is uncertain.
Connective Tissue ; Disarticulation ; Femur ; Fibula ; Giant Cells ; Head ; Hip ; Ileum ; Ilium ; Sacrum ; Sarcoma, Synovial ; Tendons

Osteoid osteoma is a small, oval or roundish, nidus like neoplasm of bone. The lesion usually does not exceed a centimenter in its greatest dimension, and it consists of osteoid, trabeculae of newly formed osseous tissues and a substratum of highly vascularized osteogenic connective tissue. In a differential diagnosis, consideration should be given to Brodies abscess, sclerosing osteomyelitis of Garre, Fibrous dysplasia and healing fractures. From Janua 1960 to December 1980, we have seen and studied 18 cases of osteoid osteoma and the results obtained from this study were follows: l. Eleven cases were found in second decade and 17 cases were developed before thirty years old. 2. The sex ratio was nearly equal and duration of disease from onset was average 16 months. 3. Location of lesions were predominantly in lower extremities, 9 in tibia and 3 in femur. 4. Pain was noted in 16 cases and aspirin affected in 8 cases. 5. Nidus was found in 11 cases. 6. All cases were treated by radical excision of lesions with disappearance of pain and satisfactory results.
Abscess ; Aspirin ; Clinical Study ; Connective Tissue ; Diagnosis, Differential ; Femur ; Lower Extremity ; Osteoma, Osteoid ; Osteomyelitis ; Sex Ratio ; Tibia