Percutaneous transhepatic cholangiography(PTC) is of value in differential diagnosis of cholestatic diseases. Authors had performed PTC in 120 patients with flexible needle of 23 gauge at the Department of Radiology, KangNam St, Mary's Hospital and Myung Dong St. Mary's Hospital during the period from Jan. 1976 to April 1980. PTC was accomplished successfully in 112 of 120 patients. Diagnoses included cholangiocarcinomas (27 cases), arcinomas ofpancreas head (21 cases), ampullary carcinomas (4 cases), metastatic carcinomas(4 cases), metastatic carcinomas (5cases), bile duct stones(27 cases), sclerosing cholangitis(6 cases), hepatitis(6 cases), liver cirrhosis(6 cases), post operative adhesions(5 cases), chronic pancreatitis(3 cases), stomach carcinomas(3 cases), clonorchiasis(2cases), blood clot (1 case), and remaining normal 4 cases. Some characteristic PTC findings were (1) segmentalannular narrowing and abrupt complete obstruction and polypoid filling defects of the bile duct incholangiocarcinoma, (2) typical nipple or rat-tail appearance of the distal commmon bile duct in pancreatic headcarcinoma, (3) single or multiple sharply and smoothly outlined filling defects whthin bile duct in all cases ofstones, (4) complete obstruction with shallow concavity in ampullary carcinoma, (5) diffuse or segmental narrowingof the intrahepatic bile duct and common bile duct in sclerosing cholangitis, (6) multiple tiny polypoid fillingdefects of gallbladder, common hepatic duct, and common bile duct in clonorchiasis, (7) normal appearance inhepatitis. The overall diagnostic accuracy of PTC in 66 operated cases was 89.4%, and complications following the examination were signficantly reduced by using a fine flexible needle(23 gauge). From the present study it is concluded as follows; 1. To evaluate obstructed or stenosed site accurately, aspiration of bile juice must bepreceded by a 23 gauge needle connected to either 10mo or 5ml syringe. 2. To diagose carcinoma of hte ampullaryportion, serial spot filmings were indispensible ot demonstrated modified appearance of obstructive lesions due tocontraction of Oddi sphincter. 3. In contrast to other reports, the most common site of cholangiocarcinomas wasthe common hepatic duct (12 of 27 cases) in our series. Rat-tail appearance was seen in both pancreatic headcarcinoma and carcinoma involving the distal end of the common bile duct. 4. PTC was a more valuable method for diagnosis of clonorchiasis.
Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangiography ; Cholangitis, Sclerosing ; Clonorchiasis ; Common Bile Duct ; Diagnosis ; Diagnosis, Differential ; Gallbladder ; Head ; Hepatic Duct, Common ; Humans ; Liver ; Methods ; Needles ; Nipples ; Sphincter of Oddi ; Stomach ; Syringes

No abstract available.
Leiomyoma*

Granular Cell Tumors(GCT) were originally described as myoblastic myomas. Subsequent scientific investigations elucidated the origin of this tumor as Schwann cells . Usually they have a predilection for head and neck, but also can occur in many other organs. This tumor is believed to originate from Schwann cells based on subsequent scientific investigations. Although it usually appears in the head and neck, it can also appear in other organs, as well. Endobronchial granular cell tumors are rather rare and should be differentiated from other common diseases of endobronchial location endobronchial diseases such as bronchogenic carcinoma and endobronchial tuberculosis, especially in Korea . We report a A case of a patient with an extremely rare condition of endobronchial granular cell tumor concurrent with malignant mediastinal tumor in a patient (delete) is reported.
Carcinoma, Bronchogenic ; Granular Cell Tumor* ; Head ; Humans ; Korea ; Myoblasts ; Myoma ; Neck ; Schwann Cells ; Tuberculosis

OBJECTIVES: This study was conducted to examine health inequality for gender and region in Korea. Especially it focused on health status such as disease prevalence and medical utilization of rural women. METHODS: Data from the Korea national health and nutrition survey in 2001 were used. The final sample size was 37,108 individuals with age 20 and over. This study applied the logistic regression for nominal variables such as disease prevalence and unmet care needs and with the regression for continuos variables such as the length and costs of medical services. RESULTS: Rates of disease prevalence and unmet care needs for chronic disease in rural area are higher than those in middle cities and big cities, and regional differences of those for women are more than those for mens with controlling ages. There could be interaction effect with region and sex. CONCLUSIONS: This study suggests that health policy maker should take consider of special status of rural women who are in health inequality.
Chronic Disease ; Female ; Health Policy ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Prevalence ; Rural Health ; Sample Size ; Socioeconomic Factors

STATEMENT OF PROBLEM & PURPOSE: The purpose of this study was to investigate the effect of a mouth guard material properties on the skull and brain when they were under impact loads on mandible. MATERIAL AND METHODS: Two customized mouth protectors having different material propeerst ieach other were made for a female Korean who had no history of brain trauma, no cerebral diseases, nomal occlusion and natural dentition. The 3D finite element model of human skull and brain scanned by means of computed tomography was constructed. The FEM model of head was composed of 407,825 elements and 82,138 nodes, including skull, brain, maxilla, mandible, articular disc, teeth and mouth guard. The stress concentrations on maxillary teeth, maxilla and skull with two mouth guards were evaluated under oblique impact load of 800N onto mandibular 3 loading points for 0.1sec. And the brain relative displacement was compared in two different mouth guard materials under same condition. RESULT AND CONCLUSION: The results were as follows; 1. In comparison of von Mises stress on maxillary teeth, a soft mouth guard material had significantly lower stress values on measuring point than a hard mouth protector materials (P < .05). 2. In comparison of von Mises stress on maxilla and skull, A soft mouth protector material had significantly lower stress values on measuring point than a hard mouth protector materials (P < .05). 3. For impact loads on mandible, there were more stress concentrated area on maxilla and skull with hard mouth guard than soft with mouth protector. 4. For impact loads on mandible, brain relative displacement had little relation with mouth guard material properties. In results of this study, soft mouth guard materials were superior to hard mouth guard materials for mandible impact loads for prevention of sports injuries. Although the results of this study were not enough to figure out the roles of needed mouth guard material properties for a human head, we got some knowledge of the pattern about stress concentration and distribution on maxilla and skull for impact loads with soft or hard mouth protector. More studies are needed to substantiate the relationship between the mouth guard materials and sports injuries.
Athletic Injuries ; Brain ; Brain Injuries ; Dentition ; Displacement (Psychology) ; Female ; Head ; Humans ; Mandible ; Maxilla ; Mouth ; Mouth Protectors ; Skull ; Tooth

Mg2+ is an important regulator of many cardiac functions. However, regulation of intracellular Mg2+ activity in the heart is not well characterized. To assess the effect of histamine H2-receptor stimulation on intracellular Mg2+ regulation, changes in extracellular Mg2+ concentration were examined under a variety of conditions in perfused guinea pig hearts. Mg2+ in the cardiac perfusate was measured by atomic absorbance spectrophotometry. The histamine (10(-6) M induced a marked Mg2+ efflux from the heart. The H2-receptor antagonists, cimetidine (10(-5) M), ranitidine (10(-5) ND, but not a H1-receptor antagonist, diphenhydramine (3 X 10(-6) M), completely blocked the histamine-induced Mg2+ efflux. The Mg2+ efflux could also be induced by forskolin (3 X 10(-6) M), 8-Cl-cAMP (2 X 10(-4) M), permeable cAMP analogue, or dimaprit, (10(-5) M). However, the carbachol (10(-5) M) considerably decreased the efflux of Mg2+. In the presence of papaverine (10(-5) M), a phosphodiesterase inhibitor, dimaprit-induced Mg2+ efflux was potentiated. These results suggest that a significant Mg2+ efflux from perfused guinea pig heart by histamine can be induced by the histamine H2-receptor stimulation and it is suggested that cytosolic cAMP may be linked.
Animals ; Carbachol ; Cimetidine ; Colforsin ; Cytosol ; Dimaprit ; Diphenhydramine ; Guinea Pigs* ; Guinea* ; Heart* ; Histamine* ; Magnesium ; Papaverine ; Ranitidine ; Spectrophotometry

A change in pH can alter the intracellular concentration of electrolytes such as intracellular Ca2+ and Na+ ([Na+]i) that are important for the cardiac function. For the determination of the role of pH in the cardiac magnesium homeostasis, the intracellular Mg2+ concentration ([Mg2+]i), membrane potential and contraction in the papillary muscle of guinea pigs using ion-selective electrodes changing extracellular pH ([pH]o) or intracellular pH ([pH]i) were measured in this study. A high CO2-induced low [pH]o causes a significant increase in the [Mg2+]i and [Na+]i, which was accompanied by a decrease in the membrane potential and twitch force. The high [pH]o had the opposite effect. These effects were reversible in both the beating and quiescent muscles. The low [pH]o-induced increase in [Mg2+]i occurred in the absence of [Mg2+]o. The [Mg2+]i was increased by the low [pH]i induced by propionate. The [Mg2+]i was increased by the low [pH]i induced by NH4Cl-prepulse and decreased by the recovery of [pH]i induced by the removal of NH4Cl. These results suggest that the pH can modulate [Mg2+]i with a reverse relationship in heart, probably by affecting the intracellular Mg2+ homeostasis, but not by Mg2+ transport across the sarcolemma.
Animals ; Cations, Divalent ; Female ; Guinea Pigs ; Heart Ventricles/metabolism ; Hydrogen-Ion Concentration ; Ion Transport/physiology ; Ion-Selective Electrodes/veterinary ; Magnesium/*metabolism ; Male ; Membrane Potentials/physiology ; Papillary Muscles/*metabolism ; Propionates/pharmacology ; Sodium/*metabolism

PURPOSE: To investigate the causes of gastric wall shortening in early gastric cancer, upper gastrointestinal study was correlated with pathologic findings. MATERIALS AND METHODS: We evaluated 41 cases(M :F=1.7:1, average age=49) of early gastric cancer, retrospectively. The gastric wall shortening were classified as Grade I; none, Grade II ;intermediate, and Grade III; prominent. Pathologic findings such as size of lesions, depth of tumor invasion, degree of the submucosal fibrosis, degree of thickness of the submucosa and muscularis propria, and morphologic patterns of lesions including conversing mucosal folds were correlated with the degree of gastric wall shortening on upper gastrointestinal series. RESULTS: Submucosal fibrosis was present in 4 cases in Grade I (n=21), 4 cases in Grade II (n=6) and 8 cases in Grade III (n=10). Positive conversing mucosal folds were seen in 5 cases in Grade I (n=17), 0 case in Grade II (n=2) and 9 cases in Grade III (n=9). Gastric wall shortening was significantly associated with submucosal fibrosis and conversing mucosal folds of early gastric cancer. (p=.0001 and p=.002, respectively) CONCLUSION: Upper gastrointestinal finding of gastric wall protrusion in patients with early gastric cancer should not misinterprete as advanced gastric cancer since the finding could be a result of submucosal fibrosis.
Fibrosis ; Humans ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: To investigate the causes of gastric wall shortening in early gastric cancer, upper gastrointestinal study was correlated with pathologic findings. MATERIALS AND METHODS: We evaluated 41 cases(M :F=1.7:1, average age=49) of early gastric cancer, retrospectively. The gastric wall shortening were classified as Grade I; none, Grade II ;intermediate, and Grade III; prominent. Pathologic findings such as size of lesions, depth of tumor invasion, degree of the submucosal fibrosis, degree of thickness of the submucosa and muscularis propria, and morphologic patterns of lesions including conversing mucosal folds were correlated with the degree of gastric wall shortening on upper gastrointestinal series. RESULTS: Submucosal fibrosis was present in 4 cases in Grade I (n=21), 4 cases in Grade II (n=6) and 8 cases in Grade III (n=10). Positive conversing mucosal folds were seen in 5 cases in Grade I (n=17), 0 case in Grade II (n=2) and 9 cases in Grade III (n=9). Gastric wall shortening was significantly associated with submucosal fibrosis and conversing mucosal folds of early gastric cancer. (p=.0001 and p=.002, respectively) CONCLUSION: Upper gastrointestinal finding of gastric wall protrusion in patients with early gastric cancer should not misinterprete as advanced gastric cancer since the finding could be a result of submucosal fibrosis.
Fibrosis ; Humans ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: A few studies have been reported on extrahepatic metastasis after curative resection for hepatocellular carcinoma (HCC). We investigated the patterns of extrahepatic recurrence and we identified the risk factors for extrahepatic recurrence after curative resection for HCC. METHODS: We retrospectively reviewed 587 patients who underwent surgical resection with a curative aim from January 1998 to December 2007 in the Yonsei University Health Care System. Among the 571 patients, 291 (51.0%) patients developed recurrence. Sixty five patients initially presented with extrahaptic recurrence. The patients with extrahepatic recurrence were divided into Group A (peritoneal recurrence) and Group B (non-peritoneal extrahepatic recurrence). RESULTS: Group A had higher rates of intraoperative bleeding>1,500 ml and perioperative transfusion too. On the multivariate analysis, perioperative transfusion, satellite nodule and the tumor size were the independent risk factors for Group A. The Edmondson-Steiner grade, satellite nodule and the tumor size were the independent risk factors for Group B. The 1, 3 and 5-year overall survival rates after curative resection for the patients with extrahepatic recurence were 83.1%, 48.9% and 27.4%, respectively. The recurrence patterns and treatment modalities did not affect the overall survival after treatment for extrahepatic recurrence. CONCLUSION: A perioperative transfusion was found to be a different risk factor for peritoneal recurrence, as compared to those risk factors for non-peritoneal extrahepatic recurrence. Therefore, efforts by physicians to decrease intraoperative bleeding may prevent peritoneal recurrence after performing curative resection for HCC.
Carcinoma, Hepatocellular ; Delivery of Health Care ; Hemorrhage ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Risk Factors ; Survival Rate