Lymphangioma of the spleen is a rare neoplasm and approximately 100 cases have been reported in the world literature. This lesion may involve the spleen alone or may be a part of a syndrome of multivisceral involvement. The pathogenesis is unclear whether this is a true neoplasm of a developmental defect. We report a case of a 87-year-old woman with solitary splenic lymphangioma. The cut surface mass is not encapsulated and located at the subcapsular area in the mid portion of spleen. It is composed of variable sized cystic spaces containing myxoid tissue. Microscopic finding reveals dilated lymphatic spaces lined by endothelial cells and the content is proteinaceous eosinophilic fluid.
Female ; Humans

This paper describes the incidence of transport accident for the period, 1955-1965. Transport accidents were classified into three categories, viz. railway(WHO Classification of Diseases, E-802), watercraft(E850-E858) and motor vehicle accidents(E810-E835, E840-E841, E844-E845). Crude data on the subject were collected from the various sources of Government Statistical Books including Statistical Year Books edited by the Central Office of Economic Planning Board, Annual Police Reports by the Ministry of Home Affairs, and the national and local associations for road traffic safety. From the data incidence and mortality rates by year, month and local province were computed and other variables relevant to the epidemiology of accidents were observed. The following summary could be drawn: 1. Death rates due to transport accidents per 100,000 population were 12.3 for 1955 and 9.7 and 1965. The incidence of injury due to the same cause were 34.0 for 1955 and 35.9 for 1965. 2. Death rates by transportation vehicle showed 9.0 due to motor vehicle accidents, 1.7 due to water-crafts, and 1.6 due to railway trains for 1955. In 1965 death rates were 6.0 due to motor vehicles, 1.2 to water-crafts and 2.4 to railway. 3. Seasonal distribution of transport accidents revealed that car accidents occur more frequently in spring and fall seasons while ship accidents do in winter and train accidents more in summer. 4. Both car and ship accidents slightly decreased during the past decade, 1955-1965, whereas the accidents of railway trains showed a tendency of increase. 5. Although the survey on railway accidents excluded the injuries of passengers or railway employees corresponding to WHO classification of diseases, E801, due to inaccuracy of data, it is roughly estimated that the same number of causalities as the incidence among pedestrians or any other than passengers or employees assumed to be at work(E 802).
Classification ; Epidemiology ; Humans ; Incidence ; Korea* ; Mortality* ; Motor Vehicles ; Police ; Seasons ; Ships ; Transportation

The purpose of this paper is to review the colonoscopic fingings of twenty two patients with colonic tuberculosis which were diagnosed by colonoscopic finding, histopathology, and follow-up observation after antituberculosis chemotherapy at Pusan National University Hospital from January 1992 to December 1994. The results were as follows: 1) The male to female ratio was 1: 1.2, and the average age of the patients was 39.4 years with a slight predominance in women. The age of peak incidence was the 4th decade 40.9%). 2) Abdominal pain(95%), diarrhea(63%), and weight loss(50%) were the most common clinical findings. Others were constipation, melena, and palpable abdominal mass. The location of the pain was right lower abdomen, epigastrium, central abdomen, and left lower abdomen in decreasing order. 3) Hematologic findings showed decrease in hemoglobin level, increase in ESR, and positive CRP(61.5%). The white blood cell counts were mostly normal. 4) The stool examination showed positive occult blood in 7 cases among 18 cases (38.9%). Acid-fast bacteria was observed in stool of one case. 5) On colonoscopy, the lesion sites were ileoeecal valve(75%), ascending colon(72.7 %), terminal ileum(52.6%), cecum(42.9%), transverse colon(31.8%), descending colon (27.3%), sigmoid colon(9%), and rectum(9%) in decreasing order of frequency. Most of them involved ileocecal area. 6) On colonoscopy, the shape of ulcer revealed circular(41%), fusion(36%), and irregular pattern(18%). It found skipped area in 9 cases, pseudopolyp in 8 cases, patency of ileocecal valve in 5 cases, and severe deformity of ileocecal valve in 6 cases. 7) Microscopic finding of biopsy specimens revealed noncaseating granulomatous inflammation in 12 cases, and nonspecific ulcerative inflammation in 10 cases. In conclusion the diagnostic yield may be greatly enhanced by obtaining multiple target biopsies frorn tbe deep portion of the ulcer bed and margins. Judged from the colonoscopic finding and clinical improvement after antituberculosis chemotherapy, more accurate diagnosis can be acquired.
Abdomen ; Bacteria ; Biopsy ; Busan ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Congenital Abnormalities ; Constipation ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Ileocecal Valve ; Incidence ; Inflammation ; Leukocyte Count ; Male ; Melena ; Occult Blood ; Tuberculosis* ; Ulcer

No abstract available.
Contrast Media*

Studies of the pathophysiology of intracranial artery following vasospasm remains yet incomplete. The present investigation was undertaken for the purpose of elucidating ultrastructural changes in the cerebral arterial wall sequentially from 1 hour to 24 hours following subarachnoid hemorrhage. Experimental vasospasm was induced by injecting autogenous blood into the cisterna magna of cats. The following observations were made : 1) One hour after the induction of subarachnoid hemorrhage, endothelial cells in the intima became more round and their cellular surface was markedly corrugated, these changes culminated at 7 to 24 hours with intimal thickening(due to subendothelial tissue). 2) In the media, the smooth muscle cells were most consistently and severly affected showing degeneration of mitochondria and vacuoles containing fine particles. 3) Twelve hours following SAH, some endothelial cells in the intima were displaced or seemed to have partially broken apart from the adjoining cells. On the basis of the above findings, it was concluded that the ultrastructural changes in the cerebral arterial wall was observed after the induction of SAH with normal cat's blood occurred as a consequence of vasospasm of the intracranial arteries.
Animals ; Arteries* ; Cats ; Cisterna Magna ; Endothelial Cells ; Mitochondria ; Myocytes, Smooth Muscle ; Subarachnoid Hemorrhage* ; Vacuoles

Benzodiazepine derivatives, chlordiazepoxide(Librium), diazepam(Valium), nitrazepam(Mogadon) and oxazepam(Serenid-D) are mainly used as hypnotics at present. Diazepam has been used mainly for premedication in anesthesia and as an intravenous anesthetic agent. The pharmacological actions of these drugs are tranquilizing effects for central nervous system, slight depression on the cardiovascular and respiratory system, anticonvulsant, anxiolytic and antidepressant effects. A new benzodiazepine derivative, Flunitrazepam(Ro 5-4200) has strong hypnotic action, is anticonvulsant and antidepressant in spite of slight depression of the cardiovascular and respiratory systems. Furthermore the onset and duration of this drug are shorter than the others. In our clinical study, flunitrazepam in the dosage of 0.005mg/kg was administered intravenously, as an intravenous anesthetic induction agent, for 22 surgical adult patients. In each patient, the blood pressure, pulse rate, respiratory rate, minutes volume and arterial gas study were done, before and after administration of the Ro 5-4200. The results are as follows; 1. Dosage of this flunitrazepam is not constant as other benzodiazepines. 2. The effects of flunitrazepam on the cardiovascular system showed slight depression but no effect by one hour post-operation. 3. In respiratory system, the minute volume was depressed slightly and the respiratory rate was increased but negligibly. 4. Undesirable side effects attributed to this drug were not found, except the developing of cough (one case).
Adult ; Anesthesia ; Benzodiazepines ; Blood Pressure ; Cardiovascular System ; Central Nervous System ; Clinical Study* ; Cough ; Depression ; Diazepam ; Flunitrazepam ; Heart Rate ; Humans ; Hypnotics and Sedatives ; Premedication ; Respiratory Rate ; Respiratory System ; Tranquilizing Agents

The neurovascular cross-compression (NVCC) of the eighth cranial nerve (CN) is a clinical entity with symptoms of recurrent vertigo or tinnitus. Although the diagnostic criteria have been defined, the precise clinical presentation and pathomechanism have not been clarified. The treatment response to the carbamazepine; drug of choice for first line medical treatment, has been considered as one of the diagnostic criteria. Herein, we present a case of chronic uncompensated unilateral vestibular hypofunction who responded dramatically to carbamazepine medication. A 55 year-old male admitted to the hospital with symptoms of recurrent oscillopsia and headache for more than 7 years. His symptoms were aggravated by positional changes. Vestibular function tests showed spontaneous nystagmus, canal paresis on caloric test and vestibular dysfunction on dynamic posturography, which represented unilateral uncompensated vestibular hypofunction. Although his symptom was not relived by vestibular rehabilitation, he was treated with carbamazepine. A long standing uncompensated unilateral vestibular hypofunction without any auditory symptoms could be one of the clinical presentations in NVCC of the eighth CN.
Caloric Tests ; Carbamazepine ; Headache ; Humans ; Male ; Nerve Compression Syndromes ; Paresis ; Tinnitus ; Vertigo ; Vestibular Function Tests ; Vestibular Neuronitis ; Vestibulocochlear Nerve

Craniometaphyseal dysplasia is a rare bone disorder of unknown etiology characterized by overgrowth of the craniofacial bones and abnormal remodeling of the metaphyses. This disease can be sporadic or transmitted by autosomal dominant and recessive modes of inheritance, with recessive cases being more severe. Excessive net bone formation leads to frontal and paranasal bossing, hypertelorism, extremely broad and flat nasal bridge with a saddle deformity, lacrimal duct obstruction, paranasal sinus and mastoid obliteration, compression of cranial nerves, with resultant loss of vision, strabismus, facial paralysis, and deafness. Also, abnormal bone remodeling results in widening in the metaphyses of the long tubular bones, giving the appearance of an Erlenmeyer flask. We present a sporadic case of craniometaphyseal dysplasia associated with the facial paralysis observed in a 4 year-old female, emphasizing the importance of early detection of accompanying lesions for proper management.
Bone Remodeling ; Child, Preschool ; Congenital Abnormalities ; Cranial Nerves ; Deafness ; Facial Paralysis* ; Female ; Humans ; Hypertelorism ; Lacrimal Duct Obstruction ; Mastoid ; Osteogenesis ; Strabismus ; Wills

PURPOSE: Planning target volume (PTV) for tumors in abdomen or thorax includes enough margin for breathing-related movement of tumor volumes during treatment. Depending on the location of the tumor, the magnitude of PTV margin extends from 10 mm to 30 mm, which increases substantial volume of the irradiated normal tissue hence, resulting in increase of normal tissue complication probability (NTCP). We developed a simple and handy method which can reduce PTV margins in patients with liver tumors, respiratory motion reduction device (RRD). MATERIALS AND METHODS: For 10 liver cancer patients, the data of internal organ motion were obtained by examining the diaphragm motion under fluoroscope. It was tested for both supine and prone position. A RRD was made using MeV-Green and Styrofoam panels and then applied to the patients. By analyzing the diaphragm movement from patients with RRD, the magnitude of PTV margin was determined and dose volume histogram (DVH) was computed using AcQ-Plan, a treatment planning software. Dose to normal tissue between patients with RRD and without RRD was analyzed by comparing the fraction of the normal liver receiving to 50% of the isocenter dose. DVH and NTCP for normal liver and adjacent organs were also evaluated. RESULTS: When patients breathed freely, average movement of diaphragm was 12+/-1.9 mm in prone position in contrast to 16+/-1.9 mm in supine position. In prone position, difference in diaphragm movement with and without RRD was 3+/-0.9 mm and 12 mm, respectively, showing that PTV margins could be reduced to as much as 9 mm. With RRD, volume of the irradiated normal liver reduced up to 22.7% in DVH analysis. CONCLUSION: Internal organ motion due to breathing can be reduced using RRD, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.
Abdomen ; Carcinoma, Hepatocellular* ; Diaphragm ; Humans ; Liver ; Liver Neoplasms ; Prone Position ; Respiration ; Supine Position ; Thorax

Angiosarcoma of spine is a rare neoplasm derived from vascular endothelium. Synonymous term include hemangiosarcoma and malignant hemangioendothelioma. The authors present the clinical, radiological and pathological features of a patient with angiosarcoma located in the thoracic spine. The treatment of this case is discussed.
Endothelium, Vascular ; Hemangioendothelioma ; Hemangiosarcoma* ; Humans ; Spine