Surface ECG findings in 29 patients with left isomerism were reviewed. Among the total 46 wave axis distributions, 25(54%) were abnormal axis, not originated from sinus node. Congenital atrioventricular block was found in 2 children. 6 patients showed the bradycardia and junctional escape rhythm intermittently or persistently. 4 of them, not related with heart surgery, were much older than 2 patients who showed these ECG findings after heart surgery. These ECG findings suggested the possibility of occurrence of sinus node or subsidiary pacemaker dysfunction in the patients with left isomerism, especially in the older patients. So we thought that electrophysiologic evaluation is necessary in some patients with left isomerism.
Atrioventricular Block ; Axis, Cervical Vertebra ; Bradycardia ; Child ; Electrocardiography* ; Humans ; Isomerism* ; Sinoatrial Node ; Thoracic Surgery ; United Nations

Recently many studies have shown the usefulness of computed tomogram in diagnosing abdominal mass when clinical and conventional radiologic examinations fail to reveal the nature of abdominal mass or the cause of abdominal distension. To evaluate the usefulness of CT in diagnosing neuroblastoma, we retrospectively analyzed computed tomographic findings of 16 neuroblastoma patients, who pathologically proved in Yeungnam University Hospital from 1986 to 1995. The age range of the patients studied were from 8months to 18years. The most frequent sith of origin was adrenal gland and the next was retroperitioneum. The presenting symptoms were palpable mass, abdominal distension, and abdominal pain.- The viewpoints of this analysis were tumoral calcifications, midline cross, shape, margin, internal structure, contrast enhancement patterns, major vessel involvement, and lymph node involvement. ':haracteristic CT findings were 'as follows: Fine dense curvillinear calcification within the tumor(56%), midline cross(50%), lobulation(75%), well-circumscribed margin(56%), cystic degeneration(56%), heterogeneous contrast enhancement(690/o), encasement of major vessels such as aorta, IVC and celiac trunk(50%), and paraaortic lymphadenopathy(87%). We conclude that these CT findings were very common and could be helpful in diagnosting and differentiation neuroblastoma in infant and children.
Adrenal Glands ; Aorta ; Child ; Diagnosis ; Humans ; Infant ; Lymph Nodes ; Neuroblastoma* ; Retrospective Studies

Takayasu's arteritis is an arterial inflammatory disease of unknown etiology, which most commonly affects the aorta and its large branches, and the pulmonary artery. This pathological condition which is prevalent in. Asian females results in occlusive changes in the lamina, often combined with dilation and secondary thrombus formation. It is associated with four main complications, which is Takayasu's retinopathy. secondary hypertension, aortic regurgitation and aortic or arterial aneurysms. The authors have experienced a case of Takayasu's arteritis (25 years old female) with severe retinopathy, complicated cataract. cyanotic engorged conjunctival vessels and new vessels as a collateral circulation in both eyes.
Aneurysm ; Aorta ; Aortic Valve Insufficiency ; Asian Continental Ancestry Group ; Cataract ; Collateral Circulation ; Female ; Humans ; Hypertension ; Pulmonary Artery ; Takayasu Arteritis* ; Thrombosis

Phylloides tumor is very similar to giant fibroadenoma in that they have benign appearance in breast radiologic image. Fibroadenoma has no malignant potential, but phylloides tumor is locally recurrent, invasive and may occasionally metastasize. It thus appears that evaluation of the differential point of the two tumor groups by radiologic study is very important. We retrospectively compared sonographic find;.ngs of 6 cases of phylloides tumor with those of 4 cases of fibroadenoma, which proved pathologically in Ye mgnam University Hospital from 1984 to 1986. The mean age of the patients were 31.8 years old(from 14 to 41 years old) in phylloides tumor and 28.8 years old (from 17 to 40 years old) in giant fibroadenoma, respectively. The viewpoints of this analysis were size, shape and contour of the masses, internal echo pattern, posterior enhancement, and especially the existence of peripheral cyst or septal band echo. We found that diffenentiation of these two tumors by sonography was difficult. But peripheral cyst was found only in phylloides tumor and septal band echo was found largely in giant fibroadenoma. Although the existence of peripheral cyst or septal band echo in the breast mass was not pathognomonic findings, we suggest that the existence of septal band echo is preferential finding to fibroadenoma, and peripheral cyst is preferential finding to phylloides tumor.
Breast ; Diagnosis, Differential* ; Fibroadenoma* ; Humans ; Retrospective Studies ; Ultrasonography

No abstract available.
Breast Neoplasms* ; Breast* ; Humans ; Soil*

To investigate the relationship between craniofacial growth and bone maturity of the hand wrist in normal occlusion, the author took cephalogram and handwrist radiogram of 391 students (male 192, female 199) and assessed the measurements of cephalogram according to skeletal maturity stages of the hand and wrist. In this study, four skeletal stages and 36 linear, angular measurements of the cephalometrics were selected. In hand-wrist X-ray the bones used to determine skeletal maturity were the middle phalanges of the third finger, and distal epiphysis of the radius. In cephalogram, the landmark used to measure the angle and length were N, S, Po , Ar., Go., Me, Gn., Pog, Point B, Point A, ANS, PNS, Or, U1, L1, U6, L6 etc. The results were as follows, 1 The table of mean, standard deviation, p-value from measurements were made in each group and both sex. 2 The increased measurements according to skeletal maturity were anterior cranial bese length, posterior cranial base length, ramus height, anterior facial height, posterior facial height, L1 to mandibular plane (mm), facial plane angle. In contrast to, decreased measurements were gonial angle, facial cnvexity and facial plane angle. 3 Denture pattern measurements (IMPA, FMIA, occlusal plane to Go-Gn, interincisal angle, U1 to SN plane, U1 to SN plane, U1 to facial plane, L1 to facial plane etc) had nothing to do with skeletal maturity. 4 Skeletal maturity had close relationship with craniofacial growth, but had little to do with tooth development.
Dental Occlusion ; Dentures ; Epiphyses ; Female ; Fingers ; Hand* ; Humans ; Radius ; Skull Base ; Tooth ; Wrist*

No abstract available.
Constriction, Pathologic*

Intraductal papillary mucinous neoplasm (IPMN) involving the biliary system is rare. To date, only a few cases of IPMN arising from the extrahepatic bile duct have been reported. In our case, extrahepatic IPMN arose in the remnant cystic duct after cholecystectomy, and to the best of our knowledge, this is the first report in the remnant cystic duct after cholecystectomy. A 74-year-old woman was referred for right upper quadrant pain lasting one day. Ultrasonography (US) showed a lobulated and hyperechoic mass with an outer linear hypoechoic lesion located adjacent to the dilated common bile duct. Contrast enhanced computed tomography showed a heterogeneously enhancing mass. Magnetic resonance imaging (MRI) showed a heterogenous mass with an outer semicircular high signal portion indicating remnant cystic duct.
Aged ; Bile Ducts, Extrahepatic ; Biliary Tract ; Biliary Tract Neoplasms ; Cholecystectomy ; Common Bile Duct ; Cystic Duct* ; Female ; Humans ; Magnetic Resonance Imaging ; Mucins* ; Ultrasonography

Management of unstable angina has evolved progressively. Although coronary angioplasty has recently shown to be relatively safe and effective treatment strategy for unstable angina, aute occlusion due to intracoronary thrombus accumulation during or immediately after coronary angioplasty remains to be one of the most common serious complication of this procedure. Intracoronary urokinase has been used to treat flow-limiting intracoronary thrombus accumulation that complicated initial successful percutaneous transluminal coronary angioplasty(PTCA) in unstable angina patient, which made the patient stablilzed. Thus in patient with flow-limiting intracoronary thrombus accumulation complicating PTCA, intracoronary urokinase proved to be highly effective in restoring vessel patency and preventing acute myocardial infarction. We report a case of successful revascularization with intracoronary infusion of urokinase in patient with intracoronary thrombus accumulation that complicated PTCA.
Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary* ; Humans ; Myocardial Infarction ; Thrombosis ; Urokinase-Type Plasminogen Activator

PURPOSE: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. MATERIALS AND METHODS: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. RESULTS: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). Follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. CONCLUSION: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our RESULTS suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.
3-Iodobenzylguanidine ; Female ; Follow-Up Studies ; Gamma Cameras ; Humans ; Kidney ; Lymph Nodes ; Mediastinum ; Middle Aged ; Neoplasm Metastasis ; Nuclear Medicine ; Pheochromocytoma