Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

No abstract available.
Magnetic Resonance Imaging* ; Tuberculosis, Spinal*

No abstract available.
Cysticercosis* ; Spine*

This dealt with the 23 cases of giant cell tumor of femur and tibia who were treated with curettage and cementation of the lesion, over 14 year period. Cement by virtue of it's heat of polymerization may “sterilize” the wall upto 3-5mm in depth. Authors adoped cement treatment as an effective adjuvant after intra-lesional surgery(curettage). Curettage was indicated in all stage I lesions; most stage 2 and some stage 3 lesions, provided the residual bone stock were sufficient to make it oncologically and mechanically effective. The follow-up period ranged from 3 to 14 years(oaverage 8 years and 6 months). The sites of the lesions were proximal tibia in 8, dital femur in 13, proximal femur in one, and distal tibia in one. Among these cases, 3(13.0%) cases(two grade 1 and one grade 2) of stage II(To: active), and 2(8.7%) of stage III(grade 2) (Tl or T2: aggressive). Utmost attention was paid to nulify or to reduce the local seeding of the tumor cell during aggressive curettage, which was followed by electrical cautery of the cavitey wall, and lastly by the cavity obliteration with bone cement. None of the cases had lung metastasis. Only in a stage III GCT case(4.3%) of local recurrence after curettage and bone and artificial bone graft, recurettage and cementation brought the successful outcome. Through this study, it was reconfirmed that with correct indications the use of cement as a local adjuvant in conjuction with curettage was effective method in treating GCT without any side effects.
Cautery ; Cementation ; Curettage ; Femur ; Follow-Up Studies ; Giant Cell Tumors ; Hot Temperature ; Lung ; Methods ; Neoplasm Metastasis ; Polymerization ; Polymers ; Recurrence ; Tibia ; Transplants ; Virtues

The study was undertaken to assess the CT density of the antibiotics solution. CT scan of six antibioticssolution-streptomycin, chloramphenicol, Na-penicillin, ampicillin, kanamycin and cefamezine-in concentration ofabout 33% (approximatly single dose of intramuscular injection) was performed, using plastic syringes. Variousconcentrations of striptomycin, chloramphenicol and Na-panicillin were also examined for evaluation of relationbetween concentration and the CT density of the antibiotics. In addition, relationship between CT number andmathematically calculated effective atomic number and electron density of the antibiotics was evaluated. Theresults are as follows; 1. The CT densities of all antibiotics reveal high density (CT number 80–150) inconcentration of single intramuscular injection dose. 2. CT number of striptomycin, chloramphenicol andNa-penicillin gradually increased with increase of concentration of the antibiotics, producing linear proportionto concentration, effective atomic number and electron density of the antibiotics. 3. Therefore, density ofantibiotics should be included in differential diagnosis when high density on CT scan is observed.
Ampicillin ; Anti-Bacterial Agents ; Chloramphenicol ; Diagnosis, Differential ; Injections, Intramuscular ; Kanamycin ; Plastics ; Syringes ; Tomography, X-Ray Computed

CT provides a valuable new perspective in assessing abnormalities of the thorax. In patients with amediastinal mass or widening detected by plain chest radiography, a definite diagnosis is sometimes possible whichwould not obtainable by conventional radiological technique. Clinical staging of bronchogenic carcinoma can beachieved by CT better than any other radiologic method. In fifty patients with histologically or angiographically confirmed disease of the thorax,an analysis of chest radiography and chest CT manifestations was made, and theresults were as follows; 1. 27 patients with mediastinal mass detected by chest radiography, a definite diagnosiswas possible in 10 patients (36%), who were 6 with teratodermoid, 1 with thymic cyst, 3 with aneurysm. In allpatients, the extent and localization of mediastinal mass could be established more precisely than by the chestradiography. 2. In 15 patients wtih bronchogenic carcinoma, 9 patients (60%) showed hilar adenopathy ormediastinal adenopathy which could not be noted on the chest radiography. 3. Main CT findings of braonchogeniccarcinoma were peripheral lung mass, spiculated or lobulated margin, adhesion to pleura or chest wall, andatelectasis or chronic pneumonia. 4. Commonly observed CT findings of teratodermoid were well capsulated mass,calcification, fat density , and multi-loculation. 5. Commonly observed CT findings of thymoma were homogenousmass, round contour, partially preserved mediastinal fat. CT was superior in evaluation of mediastinum and in the detemination of the extent of known bronchogenic carcinoma.
Aneurysm ; Carcinoma, Bronchogenic ; Diagnosis ; Humans ; Lung ; Mediastinal Cyst ; Mediastinum ; Methods ; Pleura ; Pneumonia ; Radiography ; Thoracic Wall ; Thorax ; Thymoma ; Tomography, X-Ray Computed

Spondylolisthesis, frequently encountered problems with increasing incidence, has been recognizid as an important clinical entity in orthopaedic field. Several methods were applicated as operative treatment of spondylolisthesis; posterior fusion or H-graft, posterolateral fusion, anterior fusion, fixation with internal devices and etc. During the past 12 years from March 1972 to February 1984, 34 patients among the 42 patients were treated surgically at Department of Orthopaedic Surgery of Ewha Womans University Hospital and following results were obtained. 1. The average age was 45.2 years(19 ~ 64 years) and female was predominent(64.7%). Isthmic type was 17 patients(50.0%), degenerative type was 13 patients(38.2%) and dysplastic type was 4 patients(11.8%). Below 40 year old, dysplastic and isthmic type were predominent and degenerative type was more common in the age group above forties. 2. The most prevalent site was L5-Sl; 21 cases(61.8%) and L4-5; 13 cases(38.2%) in orders. In isthmic type L5-Sl was 13 cases and in degenerative type, L4-L5 was 9 cases. By Meyerding classification, grade I was most common(26 patients, 76.5%). 3. The clinical pictures were low back pain only and little improvement with conservative treatment(type I: 9 patients), low back pain with sciatica(type II: 13), type II plus neurologic signs such as motor weakness, sensory change or change of D.T.R(type III, 10) and little low back pain with mainly sciatica(type IV, 2). 4. Of 34 patients, anterior interbody fusion were done in 10 patients ; posterior and posterolateral fusion with decompression were done in 22 patients. Only laminectomy were done in 2 patients(type IV). 5. Fusion rate was observed in 21 patients(95.5%) among 22 patients with posterior or posterolateral fusion and 8(80%) among the 10 patients with anterior fusion. Postopertive functional results by Gill's criteria were excellent or good in 31 patients(91%). 6. There were no difference in fusion rate and functional results in operative methods.
Classification ; Clinical Study ; Decompression ; Female ; Humans ; Incidence ; Laminectomy ; Low Back Pain ; Neurologic Manifestations ; Spondylolisthesis

Central venous catheterization is a common diagnostic and therapeutic procedure in modern clinical practice. Pseudoaneurysms of the subclavian artery are rare and usually occur immediately after the causative event, whether the cause was trauma or a medical procedure. Here we report the rare case of a 71-year-old woman with delayed presentation of catheter-related subclavian pseudoaneurysm. The patient was treated for aspiration pneumonia with respiratory failure in another hospital. The patient's chest wall swelling began two weeks after the initial catheterization in the other hospital, probably because of slow leakage of blood from the injured subclavian artery caused by incomplete compression of the puncture site and uremic coagulopathy. She was successfully treated with ultrasound-guided thrombin and angiography-guided histoacryl injection without stent insertion or surgery. Her condition improved, and she was discharged to her home.
Aged ; Aneurysm, False* ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Enbucrilate ; Female ; Humans ; Pneumonia, Aspiration ; Punctures ; Respiratory Insufficiency ; Stents ; Subclavian Artery* ; Thoracic Wall ; Thrombin

No abstract available.

PURPOSE: This study was designed to evaluate diagnostic accuracy of serial electrocardiograms(ECG), myocardial band of creatinine phosphokinase(CK)(CK-MB/CK ratio) and two dimensional echocardiography(ECHO) for myocardial injury in patients with blunt chest trauma. METHODS: We prospectively investigated 54 patients(male : 38, female : 16, mean age : 41) with severe blunt chest trauma. Presence of myocardial injury was determined by increase(>0.1ug/L) of peak serum troponin T(TnT) concentration from serial mesurements. RESULTS: Among 54 patients with blunt chest trauma, 23 patients(43%) had increased peak TnT level which suggested of myocardial injury. Among 23 patients with increased TnT, abnormal ECG findings were found in 18(78%) and echocardiographic abnormalities were observed in 17(74%). Cardiovascular events in 9(39%) of 23 patients with increase Tnt. There was no cardiovascular events in patients with normal TnT. CONCLUSION: Significant proprotion of patients with blunt chest trauma had elevated TnT value which suggested of myocardial injury. We recommend echocardiagraphy and serial tracing of ECG to verify the clinical significance of elevated TnT in patients with blunt chest trauma.
Creatinine ; Diagnosis* ; Echocardiography ; Electrocardiography ; Female ; Humans ; Prospective Studies ; Thorax* ; Trinitrotoluene ; Troponin ; Troponin T