A number of noninvasive technics have been advocated as reflecting left ventricular performance. These methods include systolic time intervals, echocardiography and imaging of the left ventricular chamber with radionuclides during systole and diastole. Radionuclide evaluation of left ventricular function by means of the gamma camera and gating currently appears to be the most reliable noninvasive method for approximating angiographic evaluation of left ventricular performance. Utilizing the radionuclide angiography, we measured the left ventricular function in 19 normal healthy control, 60 patients with coronary artery diseases 7 patients with dilated cardiomyopathy, 5 patients with hypertension. 1) Left ventricular ejection fraction decreased in 12 patients with anterior myocardial infarction (39.9+/-11.6%), 17 patients with inferior myocardial infarction (49.9+/-8.4%) and 7 patients with dilated cardiomyopathy (19.0+/-5.8%), and there was a statistically significant difference compared with 19 normal control group (63.5+/-8.2%)(p<0.005). However there were no statistically significant difference between normal control group, patients with hypertension (58.8+/-7.6%) and patients with angina pectoris (60.1+/-6.5%). 2) Left ventricular ejection fraction decreased in both anterior and inferior myocardial infarction, and there was a statisically significant difference between both groups (p<0.01). All 13 patients with acute myocardial infarction had abnormal LVEF (40.5+/-9.1%) whcih was significantly lower than that of 16 patients with old myolardial infarction (50.1+/-10.5%)(p<0.01).
Angina Pectoris ; Cardiomyopathy, Dilated ; Coronary Artery Disease* ; Coronary Vessels* ; Diastole ; Echocardiography ; Gamma Cameras ; Humans ; Hypertension ; Infarction ; Inferior Wall Myocardial Infarction ; Myocardial Infarction ; Radioisotopes ; Radionuclide Angiography* ; Stroke Volume ; Systole ; Ventricular Function, Left*

Prior to 1988, endometrial cancer was clinically staged but there was the considerable discrepancy between clinical and aetual stage. FIGO surgical staging classification of endometrial cancer(I988) provides the advanatage of recognizing the true disease distribution and extension, and more rational treatraent can be accomplished. This retrospective study was based on a clinical review of 73 patients with endometrial carcinoma from l982 through 1991 who underwent primary surgical evaluation. A11 cases were restaged ueing the newly adopted FIGO surgical staging. The distribution of FIGO clinical staging was as follows:85 patients(89.1%) were with stage I, 5(6.9%) with stage II, 2(2.7%) with stage III and 1(l.3%) with stage IV. Surgical restaging according new FlG0 classification reveald 56(76.7%) patients with stage I, 1(1.4%) with stage II, 14(19.2%) with stage III and 2(2.7%) with stage IV. Surgery upstaged 12.3% of clinical stage I patients, In clinical stage II patients, 80.0% was doenstaged. There wes no stage changing in cliaical stage III and IV patients. The acturial survival rates for surgical stages I a, I b, I c, and III were 80.0%, 77.2%, 68.4A%, and 35.0% respectively. By using FIGO surgical staging, the initial extent of endometrial cancer can be more accurately evaluated and we may predict prognosis and survival relatively well.
Classification ; Endometrial Neoplasms* ; Female ; Humans ; Prognosis ; Retrospective Studies ; Survival Rate

Ciliated hepatic foregut cyst (CHFC) is a rare benign lesion consisting of ciliated pseudostratified columnar epithelium, loose subepithelial connective tissue, a smooth muscle layer, and an outer fibrous capsule. We encountered a patient with retroperitoneal and posterior mediastinal neurilemmoma and additional CHFC mimicking metastasis. Abdominal CT examination demonstrated that the posterior mediastinal and retroperitoneal lesions were lobulated, well-defined tumors with a neural foraminal extension that were pathologically confirmed as neurilemmomas. Unenhanced CT indicated that the additional lesion was a slightly hypodense mass relative to surrounding parenchyma at the medial segment of the left lobe of the liver, and after the IV ad-ministration of contrast material, the lesion did not show enhancement.
Connective Tissue ; Epithelium ; Humans ; Liver ; Muscle, Smooth ; Neoplasm Metastasis* ; Neurilemmoma ; Tomography, X-Ray Computed

No abstract available.
Drug Therapy* ; Ovarian Neoplasms*

The aquatic quality of the Naktong river after two of three months in June, 1991 with phenol spillage from a electrical factory in Kumi was investigated. The samples were collected at six sites of the Naktong river basin and Kachang and Kongsan lakes. Phenol was not detected from all water samples. Turbidity was very much increased to the down stream in the Naktong river. The BOD and COD values exceeded the 2nd grade(3 mg/l) of the Korean standard quality of Environmental Water Act at the all sampling sites of the Naktong river. Especially, the value of COD at Kaejin (12.5 mg/l) was poorly classified as to the 5th grade of water class for the environmental quality standards. Organophosphorous pesticides such as parathion, malathion, fenitrothion and diazinon were investigated but not detected. Diazinon was only detected at the Ilson bridge(1.42 ppb), Okkye stream(6.95 ppb), Waekwan bridge(0.32 ppb), Gangjung reservior(0.13 ppb), Kaejin(0.05 ppb). Of the carbamates such as carbanyl, isoprocarb and cabofuran, the carbofuran was detected all sites except tap water, and Kachang and Kongsan lakes. The content of heavy metals such ans Cd, Pb, Zn, Fe, Mn, Hg were not exceeding for drinking water standards at the all sampling region, but only mecury was detected from Okkye stream(0.018ppb) and Kaejin(0.09ppb). In the regions of Kachang and Kongsan lakes, the content of heavy metals were lower than that of reservoir of Naktong river.
Carbamates ; Carbofuran ; Diazinon ; Drinking Water ; Fenitrothion ; Gyeongsangbuk-do* ; Korea* ; Lakes ; Malathion ; Metals, Heavy ; Parathion ; Pesticides ; Phenol* ; Rivers* ; Water ; Water Quality

Since Jafferson has reported the atlantal fracture in 1920, and its mechanism and type of fracture in detail, a few authers have reported the cases in their literature because the atlantal fractures are one of rare case in cervical injuries. The clinical signs are sparse indeed after acute transection or contusion of medulla. One survived has had a minimal neurologic deficit on account of wide vertebral canal for the cervical cord. The patient has complained the occipital headache and limited motion of neck commonly, without any neurological disturbance. The cervical tracton has been applied for the case usually. Recently, we experienced a case of atlantal fracture with occipito-atlantal dislocation and atlanto-axial dislocation, associated-with quadriplegia for 2.5 years progressively after cervical injury. On simple films of lateral view of cervical spine, it revealed a separated posterior arch was anteriorly dislocated and impacted into the vertebral canal, and anterior arch was markedly displaced anteriorly and had a bony union with the axis in angulated form. The odontoid process of axis is upward translocation. No fracture was found in open mouth view for the axis. The occipito-atlantal and atlanto-axial dislocation were found. On myelogram, the contrast media was almost obliterated in the false occipito-axial joint level by the compression of the fragmented posterior arch of atlas. On vertebral angiogram, it revealed a reverse curve of 3rd. portion of vertebral artery, representing the anterior arch of atlas included the arch retracted the vertebral artery anteriorly. We performed the suboccipital craniectomy and lanimectomy on the atlas for removal of posterior arch of atlas without any spine fusion, Because of the dislocated atlanto-axial joint had a bony union alreadly. The post-operative recovery was very rapid and satisfactory.
Atlanto-Axial Joint ; Axis, Cervical Vertebra ; Contrast Media ; Contusions ; Dislocations* ; Headache ; Humans ; Joints ; Ligaments* ; Mouth ; Neck ; Neurologic Manifestations ; Odontoid Process ; Quadriplegia* ; Rupture* ; Spine ; Vertebral Artery

The post-traumatic leptomeningeal cyst, so-called growing fracture, is one of the complication of the skull fracture in childhood especially under the 3 years old, but very rare in the adult. Since Taveras and Ranschoff proposed the mechanism for production of the expanding fracture post-traumatically in 1953, many authers have explained the mechanism clinically and experimentally. Now we proposed a additional mechanism for producing the brain herniation into the expanding fracture as a case of post-traumatic leptomeningeal cyst reported. A 25 years old male patient was admitted to the department of Neurosurgery, Seoul Red Cross Hospital, because of headache, convulsion, and growing the mass with skull defect. The patient has had a history of skull fracture at the age of 2 years old. The simple skull films revealed a scalloped and saucerized margin of skull defect on left parietal bone. On electroencephalogram, we found a moderated abnormalities in the left parietal area. The left carotid angiogram showed a stretching of middle cerebral artery and elevation of left Sylvian point. The small capillary branches of middle cerebral artery has pushed out through the skull defect, which indented brain herniation into the skull defect. No cystic picture was found. We operated this case with the dura repair and grafting, and then cranioplasty with resion. On operative finding, we found that one edge on torn dura has impacted into the opposite edge of fractured skull tightly, which suggested the pulling up the dura and brain into the skull defect by growing rate of the skull bone. By the craniectomy for the bone, impacted dura, was free from the impacted bone and the above continued procedure had completely successful . The post-operative course was very satisfactory. According to the operative finding, the skull fracture with dural tearing are essential factors in producing the post-traumatic leptomeningeal cyst in infancy(usually under the 3 years old). When the one edge of torn dura is impacted into the edge of same side of fractured bone, or was left free, it will produce the simple leptomeningeal cyst during the improportional growing the skull bone and brain. On the other hand, when one edge of torn dura is impacted into the opposite edge of fracture bone, the growing parietal bone pulled up the encircled brain into the skull defect aperture gradually, which produced the brain herniation, a type of post-traumatic leptomeningeal cyst. We reported a case of the post-traumatic leptomeningeal cyst in adult very rarely, and proposed a mechanism for producing a brain herniation into skull defect, a type of post-traumatic leptomeningeal cyst.
Adult ; Arachnoid Cysts* ; Brain ; Capillaries ; Child, Preschool ; Electroencephalography ; Hand ; Headache ; Humans ; Male ; Middle Cerebral Artery ; Neurosurgery ; Parietal Bone ; Pectinidae ; Rabeprazole ; Red Cross ; Seizures ; Seoul ; Skull ; Skull Fractures ; Transplants

The mutation of p53 tumor suppressor gene is the most common genetic variation of primary malignant tumors. The occurrence, progression and reaction for medical management of cancers can be different according to the characteristics of p53 gene, even if they are same kinds of malignant tumors. In this study, the property of p53 gene in 4 kinds of squamous cell carcinoma cell lines were investigated by using immunocytochemistry, PCR-SSCP, sequencing and Western blot methods. As a result, p53 mutation detected in 3 kinds of squamous cell carcinoma cell lines. Namely, it is found that T in codon 176 changed to A, and G in codon 281 changed to A in KUMA3 cell lines; CC in codon 241 changed to TT in KUMA4 cell lines; G in codon 266 changed to T in KUMA6 cell lines. In single nucleotide polymorphism of codon 72 of p53 gene, the genetic variations are Arg/Pro heterozygote in KUMA3 and KUMA4 cell lines; Arg/Arg homozygote in KUMA5 cell lines; Pro/Pro homozygote in KUMA6 cell lines. These results will provide useful data for p53 gene researches of various squamous cell carcinomas.
Blotting, Western ; Carcinoma, Squamous Cell* ; Cell Line* ; Codon ; Genes, p53* ; Genes, Tumor Suppressor ; Genetic Variation ; Heterozygote ; Homozygote ; Immunohistochemistry ; Polymorphism, Single Nucleotide

Primary aldosteronism is characterized by hypokalemic metabolic alkalosis, low plasma renin activity, elevated plasma aldosterone level and can be suspected in the patients with hypertension and unexplained hypokalemia. Small adrenal cortical adenomas are responsible for this syndrome in most cases. The incidence of thyrotoxic periodic paralysis ranges from 1.9 to 6.2 % in Japan. Thyrotoxic periodic paralysis usually subsides following treatment of hyperthyroidism and has good prognosis. A 56 year-old man presented with hyperthyroidism, hypertension and recurrent hypokalemia. During the treatment of hyperthyroidism, he repeatedly experienced weakness of both lower extremities. Hormonal evaluation was performed and he was found to have a 2*2*1.5 cm sized right adrenal tumor by abdominal computerized topography(CT). After right adrenalectomy, hypokalemic periodic paralysis was improved. Both thyroid and adrenal function should be comprehensively investigated in periodic paralysis. In conclusion, physicians must be aware of the possibility of primary aldosteronism in hyperthyroid patients with hypokalemic periodic paralysis. We report a case of aldosteronoma complicated with hyperthyroidism and literatures are reviewed.
Adrenalectomy ; Adrenocortical Adenoma ; Aldosterone ; Alkalosis ; Humans ; Hyperaldosteronism ; Hypertension ; Hyperthyroidism* ; Hypokalemia ; Hypokalemic Periodic Paralysis ; Incidence ; Japan ; Lower Extremity ; Middle Aged ; Paralysis ; Plasma ; Prognosis ; Renin ; Thyroid Gland

PURPOSE: To evaluate the diagnostic role of a three-dimensional MR cholangiopancreatography(MRCP) over endoscopic retrograde cholangio- pancreatography(ERCP) in various extrah-epatic biliary disease. MATERIALS AND METHODS: MRCP and ERCP were performed in 45 consecutive patients with suspected extrahepatic biliary diseases. MRCP was obtained using a reverse fast imaging with a steady-state free precession (reverse FISP : PSIF) sequences, and then images were reconstructed by standard MIP algorithm. The predictability of biliary dilatation and level of obstruction of MRCP was evaluated using ERCP as a gold standard. The accuracy distinguishing malignant from benign lesions, and overall diagnostic accuracy were compared between MRCP and ERCP. RESULTS: The sensitivity, specificity and accuracy of MRCP in predicting biliary dilatation were 94.6%, 75.0% and 91.1%, respectively. The level of obstruction was accurate in 87.0% with MRCP. The sensitivity, specificity and accuracy MRCP and ERCP in distinguishing malignant from benign lesions were 76.2%, 87.5% and 82.2% and 71.4%, 83.3% and 77.8%, respectively. The overall diagnostic accuracy was 60.0% with MRCP and 55.6% with ERCP. CONCLUSION: 3D MRCP shows a good diagnostic value compared to that of ERCP, and can replace a ERCP.
Cholangiopancreatography, Endoscopic Retrograde* ; Dilatation ; Humans ; Sensitivity and Specificity