The positive binding activity of lectin, peanut agglutinin (PNA), against the mucinous malignancies of the ovary was studied in order to clarify biologic differences among those lesions using immunoperoxidase method (ABC). A total of 23 cases were included in this study and they were classified as 10 cases of mucinous cystadenocarcinoma, 9 mucinous tumors of borderline malignancy and 4 pseudomyxoma peritonei, histologically. Nine of 10 cystadenocarcinomas and all cases of pseuomyxoma peritonei showed more than moderate degree of positive binding activity (>2+) with PNA in the neoplastic epithelial cells. In the cases of borderline malignancy, only 3 of 9 revealed as much similar binding pattern with PNA as cystadenocarcinoma group, in contrast, minimal degree of positivity (1+) was noted in the remainder. These findings may suggest heterogeneity in the biochemical characteristics among the cases of borderline lesion. And it is proposed that the higher PNA binding cases in ovarian mucinous borderline malignancy require extensive sampling by multiple sections and further careful follow-up study.
Follow-Up Studies

Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and a relatively small subset of GISTs whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement is infrequent in GISTs, wide margins with routine lymph node dissection may not be required. Various techniques of limited resection for duodenal GISTs have been described depending on the site and the size of the tumors. In this study, we report two cases of GIST involving the third and fourth portion of the duodenum successfully treated by segmental duodenectomy with end-to-end duodenojejunostomy. This technique should be considered as a treatment option for GIST located at the third and fourth portion of the duodenum.
Duodenum ; Gastrointestinal Stromal Tumors ; Lymph Node Excision ; Lymph Nodes

Percutaneous nephrostomy has been effectively performed 107 times in 72 patients for relief of obstruction,drainage of urinary fistula and renal or extrarenal fluid collection, and functional preservation of urinarysystem, and follow-up check has been made for recent 3 years at department of Radiology in Seoul NatinalUniversity Hospital. All procedures were successful and bilateral nephrostomy was done in 1 case of bilateral congenital UPJ obstruction. Percutaneous nephrostomy was done in left kidney in 38 cases(52.8%), permanent drainagewas done in 55 cases(76.4%) and external drainage was done in 65 cases (90.3%), and the duration of follow-up wasup to 8 months. Underlying disease were supravesical obstruction in 63 cases(87.5%), urinary fistula in 3 casses,inflammatory disease in 5 cases and infravesical obstruction in 1 case. Satisfactory outcomes were made in 68patients, whose BUN and serum creatinine levels have decreased near to upper normal range in at least 3 weeks. Major complications have occurred in 7 cases; symptomatic urinary infection in 3 cases, fracture of the catheterin 2 cases, pneumothorax in 1 case and sepsis in 1 case. Minor complications have occurred in 76 cases; catheterdislodgement or obstruction in 42 cases, fever in 10 cases, perirenal extravasation in 2 cases and periureteralleakage in 2 cases, etc. These complications can be prevented by adequate method duing Seldinger technique undnerultrasonography, CT or fluoroscopy, prophylactic and post-nephrostomy antibiotics, use of disposable catheterkits, frequent irrigation of the catheter and dressing of catheter fixation site when contaminated, prevention ofextraction of the catheter due to patient's carelessness, adequate fixation of the catheter to skin, and continuous follow-up of patients, It is expected that the territory of this iterventional procedure will beextended by instrument insertion and drug instillation through the nephrostomy tract.
Anti-Bacterial Agents ; Bandages ; Catheters ; Creatinine ; Drainage ; Fever ; Fluoroscopy ; Follow-Up Studies ; Humans ; Instillation, Drug ; Kidney ; Methods ; Nephrostomy, Percutaneous ; Pneumothorax ; Reference Values ; Seoul ; Sepsis ; Skin ; Urinary Fistula

It is well established that the CT is an essential part not only in screening primary brain tumors, but alsoin staging known malignancy. This paper reports various CT findings demonstrated in 12 cases of choriocarciomawith brain metastasis. The CT findings such as the number, location and density of the metastatic lesions, thedegree of brain edema, mass effect and effect of contrast enhancement are reviewed as well as the episode ofstroke syndrome and survival duration after neurologic symptoms attacks. The results were as follows; 1. Ten ofthese cases showed solitary metastatic lesion and remaining 2 cases were multiple lesions. 2. One was isodensedensity and the others were hemorrhagic increased denstiy by CT. 3. All of these showed mass effect to thesurrounding structures along with moderate to marked brain edema. 4. The position of the metastatic lesion werelocated at the supratentorially in all cases. Most of them were at the unilateral frontal or parietal area of bothof them. One which noted multiple metastatic foci showed at the bilateral occipital regions. 5. Nine cases showedring enhancement after contrast infusion. One which noted isodense density on the noninfusion scan showed alsoring enhancement after contrast infusion. 6. Nine cases showed positive stroke syndrom. One of them was perforemdemergency craniotomy. The remainging 3 cases noted progressive neurologic symptoms. 7. Two cases were noted onlybrain metastasis but the others also had various degree of pulmonary metastasis and 2 of latter had hepaticmetastasis, too. 8. Most of the cases were treated with CHAMOCA regimen, and one of them was taken whole brainirradiation (3000 rads/2 weeks). Another one case revealed marked regression of not only metastatic brain lesionbut the pulmonary lesion after the 8th course of CHAMOCA regimen and still alive for over 460 days.
Brain Edema ; Brain Neoplasms ; Brain ; Choriocarcinoma ; Craniotomy ; Female ; Mass Screening ; Neoplasm Metastasis ; Neurologic Manifestations ; Occipital Lobe ; Pregnancy ; Rabeprazole ; Stroke

CT findings of twenty-four patients with adrenal gland tumors were analyzed to evaluate their location, size,shape, density etc. The post-surgical confirmation was made in 17 cases. The findings were as follows: 1. 4-10cmsized tumor messes were most common (42%). 2. Round or oval shaped forme were most common (59%). 3. Functionaltomors were 71% (17/24) including Cushing's syndrome of 10 cases, pheochromocytomas of 6 cases and aldosteronismof 1 case. 4. Abnormal adrenal glands were delineated in 88%(21/24), most effectively by CT. We concluded that CTwas the valuable study in the evaluation of the adrenal gland tumors and in the determination of surgicaloperation.
Adrenal Glands ; Cushing Syndrome ; Humans ; Pheochromocytoma

Supracondylar fracture of the humerus is the most common fracture about the elbow in children and much has been written about its treatment and the prevention of both Volkmann's ischemia with contracture and the nerve injuries associated with these fractures. However, it is still one of the most difficult fractures to manage and is frequently associated with significant residual complications. Among these complications, the change in carrying angle is the most common one. In a retrospective survey of 102 children with supracondylar fractures of the humerus treated at the Department of Orthopedic Surgery of Kyungpook National University Hospital, 68 cases were found to have sufficient clinical and roentgenographic data to classify the fractures and to determine the carrying angles at end result. The results are as follows: 1. The mean age of the 102 patients at the time of fracture was 7.3 years (range, 2 to 17 years), and the fractures were on the left side in 67.6%, and male comprised 70.1%. 2, Of all fractures, 98% were the extension type, and the most common direction of initial displacement of the distal fragment was postero-medial. 3. According to Arnold et al classification, fractures with moderate varus or valgus displacement were the most common types in our series. 4. In the associated injuries with fractures, there were 5 nerve palsies and 5 fractures at the other sites. 5. In our series, the carrying angle of the opposite side of the fractured elbow ranged from 2 to 23 degrees of valgus angulation, with a mean of 9.2 degrees. 6. The decrease in carrying angle was most common in fractures with postero-medial displacement. 7, As far as the position of immobilization after reduction of the fracture is concerned, there was less tendency of decreasing the carrying angle in pronated group. 8. Most cases were treated by conservative method. There was no significant difference in change of carrying angle between the cases treated by closed reduction and those by skeletal traction.
Child ; Classification ; Clinical Study ; Contracture ; Elbow ; Gyeongsangbuk-do ; Humans ; Humerus ; Immobilization ; Ischemia ; Male ; Methods ; Orthopedics ; Paralysis ; Retrospective Studies ; Traction

No abstract available.
Ectodermal Dysplasia*

Although vascular injury after clavicular fracture is a extremely rare, it is a complication which is serious problem. Vascular injury associated with the fracture can be immediate or delayed. We report a case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture and include a review of the literature.
Brachial Artery* ; Cicatrix ; Subclavian Artery* ; Subclavian Steal Syndrome* ; Vascular System Injuries

Primary gout is a metabolic disease that has its basis in an inborn error in the intermediary metabolism of purines and related compounds. It is characterized by hyperuricemia, recurrent attacks of acute arthritis, deposition of monosodium urate crystals in and around the joints of the extremities, urolithiasis, renal and cardiovascular disease. Thirty-eight patients with gout managed at the department of orthopaedic surgery, Dong-A University Hospital, from April, 1990 to November 1993, had been reviewed retrospectively and the following results were obtained. 1. Most of cases were male(95%) and the mean age was 55.4 years old. 2. The case of first attack was 8 cases(21%), the most common age of first attack was fifth decade and mean duration of disease was 7.4 years. 3. The most common precipitating factor was overindulgence in food and alcohol. 4. The avarage uric acid level of serum and that 24-hour urine collection in acute attacks were 11.2 mg/dl and 24.5mg/D. Respectively all of the cases except four revealed increased ESR (average 43 mm/hr). 5. When the acute attack was developed, the most common involved joint was the first M-P joint (83%) of the foot, but as the acute gout was progressed to the chronic form, multiple joints were affected. 6, The punched out lesion in the radiograph was found in 7 cases(25 joints), among them 6 cases had suffered from the disease for longer than 3 years. 7. The most common complication was nephropathy(18 cases). 8. In case of acute gouty attack, we administered colchicine in the 22 cases. The therapeutic method of colchicine usually consisted of oral administration of 2 tablets(1.3mg) initially, followed by 1 tablet(0.65mg) every hour untill the relief of joint pain or the development of gastointestinal symptoms. We rocomended 6-8 tablets of colchicine for the management of acute gouty attack with safety. 9. Colchicine in small daily dose(0.65mg qd or bid) could be effective to prevent the recurrent attacks of high risk gouty arthritis.
Administration, Oral ; Arthralgia ; Arthritis ; Arthritis, Gouty ; Cardiovascular Diseases ; Clinical Study ; Colchicine ; Extremities ; Foot ; Gout ; Humans ; Hyperuricemia ; Joints ; Metabolic Diseases ; Metabolism ; Methods ; Precipitating Factors ; Purines ; Retrospective Studies ; Tablets ; Uric Acid ; Urine Specimen Collection ; Urolithiasis

Radilogic findings in 30 patients with intestinal tubeculosis and 10 patients with intestinal Behcet'sdiseases, who had been diagnosed at seoul National University Hospital during the recent 5 years, were analysedretrospectively to evaluate the radiologic differential diagnosis of the two diseases. Intestinal tuberculosisseverely involved the cecum, the ileocecal valve, the distal ileum and colons, but Behcet's disease mainlyinvolved th distal ileum and infrequently the ileocecal valve and the cecum. The ulcers in tuberculosis wereusually multiple small barium collected areas among psuedopolyps on the contrary, those in Behcet's disease weremultiple, discrete, well marginated, geographic, ring-like deep penetrating or collar-button shaped. Intestinaltuberculosis tended to involved long segments of intestines, with severer mucosal irregularity and deformity ofthe ileocecal valve and the ascending colon in comparison with Behcet's disease. Mesenteric and/or peritonealinvolvment were accompanied in 1/3 cases of intestinal tuberculosis,a nd active pulmonary tuberculosis or pleuraleffusion also in 1/3 cases of intestinal tuberculosis.
Barium ; Cecum ; Colon ; Colon, Ascending ; Congenital Abnormalities ; Diagnosis, Differential ; Humans ; Ileocecal Valve ; Ileum ; Intestines ; Seoul ; Tuberculosis ; Tuberculosis, Pulmonary ; Ulcer