A histologic analysis of 10 cases of Wilms` tumor in the department of Urology, Chosun University Hospital during 11 years periods from January, l975 to December, l985 has been carried out. A classification based on the tumor differentiation and degree of tubular formation are described. A comparison of the histologic findings with the survival was undertaken and it was found that the histologic classification was significantly correlated with survivals. The results were as follows : I. Low grade tumors(grade I) with predominance of differentiated tubules were associated with a better cure rate than high grade tumors(grade IH) composed mainly of undifferentiated spindle elements : 2 year or more survival rate was lOOf6 for grade I but O% for grade III. 2. Cure rate was lower for the low degree of tubular formation than for the high degree of tubular formation : 2-year cure rates were O%, O%, 33.3%, lOO% for group O, +,++ and +++ respectively. 3. 6 patients with the focal or diffuse anaplasia and sarcomatous stroma had a bad prognosis. giving a survival rate of 0%.
Anaplasia ; Classification ; Humans ; Prognosis* ; Retrospective Studies* ; Survival Rate ; Urology

PURPOSE: To assess the value of MR imaging compared to CT for the staging of gastric carcinoma when body-wrap-around surface coil, intravenous glucagon, motion suppression technique and effervescent granules are used. MATERIAL AND METHOD: CT and MRI were performed for thirty-five patients with gastric carcinoma. Postcontrast CT scan was performed immediately after oral effervescent granules and Buscopan were given. Before MR imaging, BWA surface coil was wrapped around the upper abdomen. T1 coronal, sagittal and axial SE images (TRITE=400/15 msec) were obtained immediately after oral effervescent granules and glucagon were given. Respiratory compensation and presaturation techniques were used for each imaging. Three radiologists evaluated independently for randomly mixed 70 sets of CT and MR images. The signal intensity of gastric mass and enlarged lymph nodes were compared to the signal intensity of the adjacent pancreas, liver and spleen to evaluate any discriminating features between them. RESULTS: The accuracy in the diagnosis of pancreatic invasion was 83.8% on MRI and 74.3% on CT (p < 0.05). The accuracy of MRI and CT was 77.1% and 72.4% in detecting of gastric tumor respectively (p > 0.05), 73.3% and 68.6% in gastric serosal invasion (p> 0.05), 50.5% and 42.9% in lymph node metastasis (p > 0.05). The gastric mass and enlarged lymph nodes were hypointense to the intensity of pancreas and liver in more than 78% of cases. CONCLUSION: MRI was comparable to CT scan for the staging of gastric carcinoma. Therefore, MRI could be used as an alternative or adjunctive diagnostic modality in the staging of gastric carcinoma.
Abdomen ; Butylscopolammonium Bromide ; Compensation and Redress ; Diagnosis ; Glucagon ; Humans ; Liver ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pancreas ; Spleen ; Tomography, X-Ray Computed

The obliteration of a fat plane between the gastric carcinoma and the pancreas is a major criterion on CT scan for pancreatic invasion of gastric carcinoma. However, this sign is not always a reliable indicator of invasion, as the patients with gastric carcinoma are often emaciated. Producing a false positive CT findings. The purpose of our study is to improve the diagnostic accuracy of pancreatic invasion of gastric carcinoma in cases which the fat plane between the gastric carcinoma and the pancreas is obliterated in conventional CT scan. The authors performed lateral decubitus as well as supine CT scans and upper gastrointestinal series(UGIS) in 49 pathologically proven cases in which the fat plane was obliterated between the gastric carcinoma and the pancreas on conventional supine CT scan. Pancreatic invasion was suggested when the fat plane was obliterated persistently in the lateral decubitus view as well as the supine CT images and the involved gastric wall and adjacent pancreas maintained constant approximation despite postural change(CT+), and when the gastric tumor moved downward on the erect view of the UGIS no more than 1.5 time the height of the first lumbar vertevral body(UGIS+). Among 49 cases in which the fat plane between the gastric carcinoma and the pancreas was obliterated on supine CT scan, pancreatic invasion was confirmed pathologically in 11 cases(22.4%). Eight of 11 cases proven as pancreatic invasion were correctly diagnosed as pancreatic invasion by this combined analysis (CT+/UGIS+, 72.7%). Twenty seven of 38 cases proven as no pancreatic invasion were correctly diagnosed as no pancreatic invasion(CT-/UGIS-, 71.1%). Twelve cases showed CT +/UGIS-or CT-/UGIS+, so it was inconclusive whether there was invasion or not. The overall diagnostic accuracy was 71.4%. In conclusion, combined analysis with supine and lateral decubitus CT and UGIS is useful for improving diagnostic accuracy for pancreatic invasion by gastric carcinoma in patients of which the fat plane between the gastric carcinoma and the pancreas is obliterated on conventional supine CT.
Humans ; Pancreas ; Tomography, X-Ray Computed

No abstract available.
Osteoblasts*

It is well known that there always exists danger of injury to the urinary tract associated with gynecologic disorders and treatments. Herein the authors describe two different rare cases: bilateral complete ligations of the lower ureters following total hysterectomy and herniated urinary bladder as exstrophy of the bladder through vesico-vaginal fistula caused by cauterization of the uterine prolapse for treatment.
Bladder Exstrophy ; Cautery ; Fistula ; Hysterectomy ; Ligation ; Ureter ; Urinary Bladder ; Urinary Tract ; Uterine Prolapse

Accessory breast is an ectopic breast tissue from developemental remnants. It sometimes begins to make symptoms, pain and swelling, during premenstrual period or pregnancy. For it has been known as a rere condition, it has occasionally misdiagnosed as a abnormal mass, such as lymphadenitis or hidradenitis. We have analyzed 52 accessory breast tissues prospectively, to document the characteristic findings of accessory breast. In summary, the characteristic sonographic findings of accessory breast were the presence of breast tissue superficial to the axillary fascia or underlying fascia if not in axilla, resembling the patient's own breast pattern, the presence of converging appearance of dilated ducts, presence of nipple and/or areola, the obliteration of inner wall of dermis, the obliteration of sucutaneous fat layer, and the downward displacement of axillary fascia or underlying fascia if not in axilla wighout interruption.
Axilla ; Breast* ; Dermis ; Fascia ; Hidradenitis ; Lymphadenitis ; Nipples ; Pregnancy ; Prospective Studies ; Ultrasonography

Disorders of coagulation and uncontrollable bleeding are major problems during a major surgical operation. The correct diagnosis, appropriate treatment and preparation for abnormal coagulation and bleeding conditions with specific factors and blood products are procedure of utmost importance. Detailed history, physical examination and performance of appropriate laboratory tests including specific factor assay are essential for the diagnosis of an abnormal coagulation and bleeding problem. We have experienced a case of factor ll deficient patient who had surgery for a glioma of the forebrain. He had a past history of two episodes of massive bleeding during operation and showed a bleeding tendency after angiography for this last admission, but he didn't show any abnormal blood coagulation tests except for a factor ll deficiency. He had received Vitamine K 20 mg/day for 7days preoperatively. All laboratory coagulstion tests became normal and he had a surgical removal of a forebrain glioma uneventfully under general anesthesia. He received only 1 unit of fresh frozen plasma during operation and had an uneventful postoperative course.
Anesthesia, General ; Angiography ; Blood Coagulation Tests ; Diagnosis ; Glioma ; Hemorrhage ; Humans ; Hypoprothrombinemias* ; Physical Examination ; Plasma ; Prosencephalon ; Vitamins

No abstract available.
Adenoma* ; Colorectal Neoplasms*

Amyloidosis is a rare systemic disease caused by extracellular deposition of insoluble protein. Systemic amyloidosis is subclassified into idiopathic primary and secondary form. The cause of secondary amyloidosis includes tuberculosis, familial Mediterranean fever, rheumatoid arthritis and multiple myeloma. We report a case of tuberculosis-related, secondary systemic amyloidosis which involved liver, spleen, kidneys, stomach, urinary bladder and lymph nodes.
Amyloidosis* ; Arthritis, Rheumatoid ; Familial Mediterranean Fever ; Kidney ; Liver ; Lymph Nodes ; Multiple Myeloma ; Spleen ; Stomach ; Tuberculosis* ; Urinary Bladder

The ability of CT sanning of the mediasinum to distinguish specific tissue densitie and to display in a transverse plane often provides unique diagnsotic information unobtainable with conventional radiographic methods. We retrospectively analyzed the CT findings of 20 cases of proven mediastinal masses at the Departement of Radiology, St. Mary's Hospital, Catholic Medical College from Feb. 1982 to June 1984. CT scans were performed witha Siemens Somatom 2 scanner. The technical factors involved were tube voltage 125 kVp, exposure time 5 seconds,230 mAs, 256x256 matrices, and pixel size 1.3mm. 8mm slices were obtained at 1cm interval or magnifying scans were obtained. After pre-contrast scans, contrast scans were routinely taken with rapid drip-infusion of contrast media(60% Conray, 150cc). The results obtained were as follows; 1. Among 20 cases, 11 were tumors, 4 infectious masses and 5 aneurysms of great vessels, tortuous brachicephalic artery and pericardial fat pad. In each case CT showed accurate location, extent, and nature of the masses. 2. Solid tumors were thymic hyperplasias, thymoma,thymus carcinoid, neurilemmoma and germ cell tumors(seminoma, embryonal cell carcinoma). Internal architecture was homogeneous in thymoma, thymus carcinomoid, neurilemmoma, seminoma but inhomogeneous in thymic hyperplasias andembryonal cell carcinoma. CT number ranged from 16 to 49 HU and were variably enhanced. 3. Cystic tumors consistedof teratomas, cystic hygroma, and neurilemmoma. Teratomas contained calcium and fat, inhomogeneous mass withstrongly enhancing wall. Cystic hygroma was nonenhancing mass with HU of 20. 4. All of germ cell tumors (2 teratomas and one each of seminoma and embryonal cell carcinoma) and one of 2 thymic hyperplasias had calciumdeposit. 5. Tuberculous lymphadenopapthies presented as a mass in the retrocaval pretracheal space and hilarregion with HU ranging from 34 to 64 and enhancement was variable. Mediastinal abscess was alsmost not enhancing,presenting as an inhomogeneous mass of 21 HU with mottled air densities. 6. Aneurysm of great vessels, tortuouobrachiocephalic artery and pericardial fat pad which were often misinterpretted as mediastinal tumor on the conventional radiographic study could be easily distinguishable on CT scan.
Abscess ; Adipose Tissue ; Aneurysm ; Arteries ; Calcium ; Carcinoid Tumor ; Germ Cells ; Lymphangioma, Cystic ; Neoplasms, Germ Cell and Embryonal ; Neurilemmoma ; Retrospective Studies ; Seminoma ; Teratoma ; Thymoma ; Thymus Gland ; Thymus Hyperplasia ; Tomography, X-Ray Computed