No abstract available.
Stents*

PURPOSE: We evaluated the capability of MR in the diagnosis of anomalous pulmonary venous connection (APVC). MATERIALS AND METHODS: The patient group consisted of 11 total APVC and 8 partial APVC diagnosed with MR. Echocardiography was performed in all cases, cardiac angiography in 12 cases and operation in 12 cases. We compared MR findings with those of operation, echocard iography and cardiac angiography. RESULTS: In surgically proven 12 cases, diagnostic accuracy of preoperative MR, echocardiography and cardiac angiography was 100%, 67% and 63%, respectively. In the remaining cases, MR findings well correlated with those of echocardiography or cardiac angiography. Stenosis of common pulmonary vein or superior vena cava was identified in 4 cases. In one patient, MR depicted associated cor triatriatum clearly. CONCLUSION: MR is an effective modallty in depicting anomalous pulmonary venous con nections.
Angiography ; Constriction, Pathologic ; Cor Triatriatum ; Diagnosis ; Echocardiography ; Humans ; Pulmonary Veins ; Vena Cava, Superior

Carcinoid tumors are derived from the enterochromaffin cells of neural crest origin. Most are commonly found in the gastrointestinal (GI) tract. The rectum is the third most common site for GI carcinoids. Rectal carcinoid tumors make up 13.7% of all carcinoid tumors and the vast majority occurs in the sixth decade of life. Approximately 80% of rectal carcinoid tumors are less than 1 cm in size, limited to the submucosa without metastasis and can be safely treated by local excision. We report a case of rectal carcinoid tumor in a 13 year-old child that was successfully treated by endoscopic polypectomy.
Adolescent ; Carcinoid Tumor* ; Child* ; Enterochromaffin Cells ; Humans ; Neoplasm Metastasis ; Neural Crest ; Rectum

Diabetic nephropathy is characterized by one or a combination of the following lesions: (1) glomerular involvement with three distinctive patterns: diffuse glomerulosclerosis, nodular glomerulosclerosis, and exudative lesions; (2) arteriolo sclerosis; (3) urinary tract bacterial infection with pyelonephritis and sometimes emphysematous pyelonephritis. Emphysematous pyelonephritis is an uncommon life-threatening and acute suppurative infection of the kidney, and usually occurs in diabetic female patients. It is characterized by the production of intraparenchymal gas. Glucose fermentation has been considered the main cause of the gas formation. We presented two illustrative nephrectomy cases of emphysematous pyelonephritis in addition to the typical pathologic features of diabetic nephropathy.
Bacterial Infections ; Diabetic Nephropathies* ; Female ; Fermentation ; Glucose ; Humans ; Kidney ; Nephrectomy ; Pyelonephritis* ; Sclerosis ; Urinary Tract

Postrenal segment anomalies of inferior vena cava such as bilateral inferior vena cava and left-sided inferiorvena cava can simulate lymphadenopathy on CT scan and these anomalous veins need consideration in retroperitonealoperations such as procedures for prevenetion of venous embolism, splenorenal shunt operation and aorticprosthetic repalcement. Retrocaval ureter is a rare cause of obstructive uropathy or medical deviation of ureter.We analysed 16 cases of postrenal segment anomalies daignosed by CT, vena cavography, retrograde pyelography andultrasonography including six rare positional anomalies at hepatic segment of inferior vena cava diagnosed bycardiac angiography. The results were as follows. 1. Postrenal segment anomalies were 6 cases of bilateral IVC, 8cases of left-sided IVC and 2 cases of retrocaval ureters. On CT scan, 3 cases of bilateral IVC and 4 cases ofleft-sided IVC were accompained by malignant tumors, but caval veins could be discriminated from enlarged nodesbecause of continuous tubular nature of vein on consecutive sections with homogeneous strong enhancement. Twocases of retrocaval ureters showed hydroureteronephrosis due to ureteral compression by IVC. 2. Hepatic segmentanomalies were 6 cases. Five cases of IVC on left side of vertebral crossed midline at live to enter right-sidedright atrium and one case of IVC on right side crossed midline to enter left-sided right atrium. Four cases ofcomplex cardiac anomalies, 4 cases of asplenia and 2 cases of situs ambigus were associates with these anomalies.
Angiography ; Embolism ; Heart Atria ; Lymphatic Diseases ; Retrocaval Ureter ; Splenorenal Shunt, Surgical ; Tomography, X-Ray Computed ; Ureter ; Urography ; Veins ; Vena Cava, Inferior

PURPOSE: To report the findings of a six-year medial oudit performed at our mammographic screening centre, comparing those findings with the follow-up data stored at our hospital and at the Korea Central Cancer Registry. MATERIALS AND METHODS: We analyzed the findings of 32,289 mammographic examinations of 25,541 women performed at our screening center between 1994 and 1999. For follow-up and outcome monitoring, the guideline of the American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) was used. All mammograms were categorized by means of BI-RADS, and cases in categories 0, 4, and 5 were followed up through a review of our hospital information system. To determine whether any cases were false negative, we compared breast cancer patients registered in our medical record department and in the Korean Central Cancer Registry during the study period, with women whose mammograms were interpreted as normal or benign at our screening center within a year prior to cancer diagnosis. RESULTS: The mean age of women enrolled in this study was 48.6 years, ten years less than reported in the West. The recall rate was 6.2%. Among 256 women whose final assessment category was 4 or 5, breast cancer was diagnosed in 51. The cancer detection rate was 2.0/1,000 women; positive predictive value 1 (PPV1: PPV, based on abnormal findings at screening examination) was 2.5% of cases and PPV2 (PPV when biopsy or surgical consultation was recommended) was 20%. The most common mammographic finding was microcalcifications only (45%). The rate of minimal breast cancer, including invasive cancer less than 1 cm in diameter and ductal carcinoma in situ, was 72.5%. Node positivity was 27%. Sensitivity was 85.0% based on the tumor registry of our institution's medical record department, and 78.5% based on the tumor registry of the Korea Central Cancer Registry. Specificity was 99.0%. CONCLUSION: In our study, the cancer detection rate at screening mammography was 2.0/1,000 women. The rate of minimal breast cancer (72.5%) was very high but measurable sensitivity was 78.5%, somewhat lower than the ACR guideline of 85%. To improve the performance of screening mammography, appropriate interpretation of mammography and constant, follow-up and outcome monitoring are important.
Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Hospital Information Systems ; Humans ; Information Systems ; Korea ; Mammography ; Mass Screening* ; Medical Audit* ; Medical Records ; Sensitivity and Specificity

Microglial activation is thought to play a role in the pathogenesis of many brain disorders. Therefore, understanding the response of microglia to noxious stimuli may provide insights into their role in disorders such as stroke and neurodegeneration. Many genes involved in this response have been identified individually, but not systematically. In this regards, the microarray system permitted to screen a large number of genes in biological or pathological processes. Therefore, we used microarray technology to evaluate the effect of oxygen glucose deprivation (OGD) and reperfusion on gene expression in microglia under ischemia-like and activating conditions. Primary microglial cultures were prepared from postnatal mice brain. The cells were exposed to 4 hrs of OGD and 1 h of reperfusion at 37 degrees C. Isolated mRNA were run on GeneChips. After OGD and reperfusion, > 2-fold increases of 90 genes and > 2-fold decrease of 41 genes were found. Among the genes differentially increased by OGD and reperfusion in microglia were inflammatory and immune related genes such as prostaglandin E synthase, IL-1beta, and TNF-alpha. Microarray analysis of gene expression may be useful for elucidating novel molecular mediators of microglial reaction to reperfusion injury and provide insights into the molecular basis of brain disorders.
Animals ; Brain ; Brain Diseases ; Gene Expression* ; Glucose ; Mice ; Microarray Analysis ; Microglia* ; Oxygen ; Pathologic Processes ; Reperfusion ; Reperfusion Injury* ; RNA, Messenger ; Stroke ; Transcriptome* ; Tumor Necrosis Factor-alpha

OBJECTIVE: The purposes of this study are to find out the long-term effect of motor point block using phenol on spasticity and gait pattern of spastic cerebral palsy children and to examine contributing factors for success of phenol block in functional implication of cerebral palsy. METHOD: We injected 5% phenol into muscles of 35 cases with spastic cerebral palsy under the electromyographic monitoring. Pre, immediate post, and follow-up evaluations for type and severity, grade of spasticity, range of motion, and gait patterns by locomotion rating scale (LRS) were analyzed. RESULTS: The degree of spasticity was reduced dramatically by block, but this effect returned back to the level of pre-block state on follow-up evaluation. There was much improvement in pes equinus, genu recurvatum and scissoring tendency, while little change was observed in crouch gait and hind foot instability. These effects have been sustained on follow-up evaluation. The gait speed, deviation to normal gait, and instability in walking were significantly improved after block and on follow-up. Maintenance of adequate range of motion and good standing balance were the most important contributing factors determining the success in phenol block. Initial spasticity, initial and post LRS score were not significant. CONCLUSION: After phenol block, spasticity returned back to the level of pre-block state but improvement in locomotion activity was maintained over 8 months on follow-up evaluation. The maintenance of adequate range of motion and good standing balance were the most important contributing factors determining the success in motor point block for improving locomotion activity.
Cerebral Palsy* ; Child ; Follow-Up Studies* ; Foot ; Gait ; Humans ; Locomotion ; Muscle Spasticity* ; Muscles ; Phenol* ; Range of Motion, Articular ; Walking

Congenital anomaly of IVC is rare, but understanding of this anomaly is important in radiological diagnosis,angiographic procedures and major retroperitoneal and thoracic surgery. We analysed 23 cases of IVC interruptiondiagnosed by cardiac angiography at Seoul National University Hospital. The results were as follows: 1. Theincidence of infrahepatic interruption of IVC was 0.45% of the patients having cardiac angiography and mostpatients showed cyanosis(91%). 2. The most common associated cardiac anomaly was right ventricular outflow tractobstruction (60%). Other associated cardiac defects were VSD, ASD, valvular anomaliesin 9 cases(39%) respectively;double outlet right bentricle, bilateral superior vena cava, single ventricle in 6 cases(26%) respectively; singleatrim, PDA in 5 cases(22%) respectively. 6 cases of situs inversus, 3 cases of situs ambiguus,2 cases of visceralheterotaxia and one case of asplenia were observed also. 7 cases of left-sided IVC were associated with IVCinterruption in normal situs.
Angiography ; Humans ; Seoul ; Situs Inversus ; Thoracic Surgery ; Vena Cava, Inferior ; Vena Cava, Superior

More than half of the cryptococcal infections occur in acquired immune deficiency (AIDS) patients, and more than half of the non-AIDS patients with cryptococcosis are immunocompromised. Most immunocompromised patients have meningoencephalitis at the time of diagnosis. Without the appropriate therapy, this from of the infection is invariably fatal. Death can occur any time from 2 weeks to several years after the onset of symptoms. Pulmonary crytococcosis in immunocompromised patients is usually asymptomatic, but coughing, chest pain, fever, or hemoptysis may occur in immunocompetent patients. Pulmonary cryptococcosis symptoms in immunocompetent patients tend to improve without treatment. Here, we describe the various pulmonary manifestations of cryptococcal pneumoniae in three immunocmpetent patients.
Chest Pain ; Cough ; Cryptococcosis ; Diagnosis ; Fever ; Hemoptysis ; Humans ; Immunocompromised Host ; Meningoencephalitis ; Pneumonia*