Thirteen patients with visceroatrial situs abnormalities were evaluated by magnetic resonance(MR) imaging. Eleven patients were confirmed surgically. Two patitnts were diagnosed by MRI and cardiac catheterization. Right isomerism was found in seven patients, left isomerism in two, and situs inversus in four. For the determination of situs, we evaluated the morphology of atrial appendages and main bronchi, the relationship between abdominal aorta and inferior vena cava(IVC), and the status of upper abdominal viscera. The bilateral atrial morphology was differentiated in 8 of 12 patients. The bronchial situs was determined in 11 of 12 patients. Juxtaposition of abdominal aorta and IVC was found in 6 of 7 with right isomerism. IVC interruption with azygos continuation was found in all two with left isomerism. Incidentally three cases of short pancreas were found. MR imaging showed all structures relevant for the assessment of situs, thus obvrating the need for performing additional diagnostic procedures. MR imaging, therefore, is a valuable tool in the clinical management of patients who are suspected of having a situs abnormality.
Aorta, Abdominal ; Atrial Appendage ; Bronchi ; Cardiac Catheterization ; Cardiac Catheters ; Humans ; Isomerism ; Magnetic Resonance Imaging ; Pancreas ; Situs Inversus ; Viscera

No abstract available.
Thyroid Gland* ; Thyroiditis*

On the contrary to congenital anomalies of intestinal rotation in pediatric patients, those in adults are generally nonsymptomatic and of little consequence. Occasionally, however, an adult may have midgut nonrotation and complain of chronic or recurrent abdominal pain. Intestinal nonrotation can be divided into complete or partial failure of rotation and into abnormalities affecting the proximal segment, the distal segment or both. We report herein a 43-year old female patient with symptomatic partial, cecocolic nonrotation.
Abdominal Pain ; Adult* ; Female ; Humans

No abstract available.
Leiomyoma* ; Vagina*

PURPOSE: Vascular endothelial growth factor(VEGF) is an important protein implicated in tumors associated with microvascular hyperpermeability and angiogenesis. Recently, the importance of VEGF in urologic tumors including prostatic cancer has been demonstrated by the immunohistochemical analysis of cancer specimens. However, little is known about the significance of the urinary VEGF value in primary bladder cancer. MATERIALS AND METHODS: In this study, we have investigated the urinary VEGF concentration by ELISA and the urine creatinine concentration In 24h urine collection was used corset the value. A total of 37 transitional cell carcinomas of the bladder were assessed; 8 controls(group 1), 8 superficial bladder tumors(group 11), 11 invasive bladder tumors(group 111) and 8 superficial bladder tumors that had undergone complete transurethral resection(group IV). RESULTS: 1. No correlation was observed between urinary VEGF concentrations and aging, but excretion of urine creatinine decreased according to age(r=-0.4782, p=0.0028), particularly being prominent in females(r=-0.39, p=0.015). 2. Multiple comparison analysis(Duncan's multiple range test) of differences in urinary VEGF expression among 4 groups(1-lV) showed more higher in group 11 than any other of the three remaining groups(p<0.05) and statistical comparison 4 groups was significant(p=0.0035). We also obtained the same results as above when using age-adjusted ANCOVA test. 3. Correlations between urinary VEGF expressions and tumor size and grade were not significant in group 11(p> 0.05). 4. When dividing group 111 into visible and invisible subgroups, no significant differences were observed within the subgroups(p> 0.05). CONCLUSIONS: The evaluation of urinary VEGF concentrations is easy to perform and our results suggest that it may contribute to the predictive diagnostic study of the progression and prognosis of primary bladder cancer.
Aging ; Carcinoma, Transitional Cell* ; Creatinine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Prognosis ; Prostatic Neoplasms ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urine Specimen Collection ; Vascular Endothelial Growth Factor A*

Gorham's syndrome is a rare disorder involing a proliferation of vascular channels associated with extensive loss of bony matrix. It starts in bone, but it may secondarily involve soft tissue and adjacent bones. Although the osteolysis usuakky arrests spontaneously, its biologic behavior is difficult to predict. The mechanism of steolysis is unkown, and the role of osteoclasts is controverwial We have experienced one case of Gorham's syndrome affecting the scapula and clavicle, which is reported in this paper with brief review of literature.
Clavicle ; Osteoclasts ; Osteolysis ; Scapula

GH concentration in plasma decline with age. GH and GH response to GHRH are influenced by sex hormones, thereby changing around the menopause. In several aspects, features of aging resemble those of a state of GH deficiency. It has been argued the declining GH function, along with other factors, might be a causal factor in osteoporosis. The purpose of this study was to investigate that postmenopausal osteoporosis in ovariectomized rat could be prevented by rhGH. Fifty-four Sprague-Dawley rats(weight 140-200g) were devided 3 groups. Group 1(n=18) was sham operation; Group 2(n=18) was ovariectomized and received subcutaneous injection with 0.05 cc normal saline; Group 3(n=18) was ovariectomized and received subcutaneous injection with 0.2 IU rhGH. Group 2 and 3 were injected daily, 6 day per week. Each group was devided three subgroups(n=6) and were sacrificed at 6 week, 10 week, 14 week, respectively. Group 2 showed a significant increase in body weight, femur length, serum IGF-1 level, serum PICP and ICTP level at 6 weeks, 10 weeks, 14 weeks and a significant decrease in ash weight of tibia, width of bony spicules, at 14 weeks than Group 1. Group 3 demonstrated a significant increase in body weight, femur length, serum IGF-1, serum PICP and ITCP levels and a insignificant decrease in ash weight of tibia and width of bony spicules, at 6 weeks, 10 weeks, 14 weeks than Group 1. At 14 weeks, Group 3 showed a significant increase in serum IGF-1, Serum PTH, Serum PICP. From these data, we conclude that although rhGH administration leads to an activation of bone turnover and more stimulation of bone formation, it does not prevent a bone loss in ovariectomized rat.
Aging ; Animals ; Body Weight ; Female ; Femur ; Gonadal Steroid Hormones ; Humans* ; Injections, Subcutaneous ; Insulin-Like Growth Factor I ; Menopause ; Osteogenesis ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Ovariectomy ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Tibia

Cubitus varus deformity following elbow fracture in children rarely limits the function of the upper extremity, but the patients and/or their parents often request an operation for the aesthetic purpose. Various surgicsl techniques have been proposed to correct the deformity, however, the complications following operation are still common. We critically reviewed 55 patients with cubitus varus deformity treated by supracondylar closing osteotomy at Seoul National University Hospital between January, 1980 and April, 1989, and report on 25 patients who had at least one year follow-up (average 4.0 years). The results were graded as excellent (13 cases), good (8 cases), and poor (4 cases). The average amount of correction was 29.1 degrees by humero-elbow-wrist angle. There were two cases with ulnar nerve palsy and one case with radial nerve palsy, however, all of which were spontaneously recovered with time. The factors related to poor results were age at operation, degree of deformity, improper wedge size, and nerve palsy. In this article, we also illustrate our new, simple and safe technique of supracondylar closing spring (incomplete) osteotomy based on careful preoperative planning and special attention to surgical details.
Child ; Congenital Abnormalities ; Elbow ; Follow-Up Studies ; Humans ; Humerus ; Osteotomy ; Paralysis ; Parents ; Radial Nerve ; Seoul ; Ulnar Neuropathies ; Upper Extremity

PURPOSE: All procedures for the removal of retained intrahepatic stones were performed on inpatient basis. We evaluated the advantage of the procedures performed on inpatient basis compared with outpatient basis in terms of the success rate, causes of failure and the complication. MATERIALS AND METHODS: Percutaneous removal of retained intrahepatic stones was performed in 58 patients through a T-tube tract on inpatient basis from April 1990 to December 4992. Stones were exclusively intrahepatic in 28 patients, whereas 30 patients had combined stones in common bile duct. Preshaped catheters, baskets, and balloon catheters were used to remove the stones and dilate the strictures of the ducts. Extracorporeal shock wave lithotripsy and choledochoscopy with electrohydraulic lithotripsy were used to crush the impacted stones. RESULTS: The stones were completely removed in 34 (58.6%) of 58 patients and most of the stones were removed in 17 patients (29.3%). The overall success rate was 87.9%. The complications (cholangitis in 13% and pancreatitis in 0.8% per session) were found and successfully managed by appropriate care. CONCLUSION: Better success rate could be achieved by more aggressive appraoch on inpatient basis when compared with previous reports on outpatient basis. We suggest that the procedures should be performed on inpatient basis especially in a case with severe strictures or impacted stones.
Catheters ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Inpatients ; Lithotripsy ; Outpatients ; Pancreatitis ; Shock

This rare venous congenital anomaly has been diagnosed preoperatively in a 24-year-old female with complaints of the right flank and low back pain, and urinary frequency. In the I. V. P. the dilated upper right ureter forms a reversed "J" appearance. The right R.G.P. shows the "S"-shaped course of the ureter. The vena cavogram discloses crossing with the right R. G. P. at L3-4 intervertebral space level. 2.5cm. of strictured, postcaval segment of ureter is excised and end-to-end oblique anastomosis is done over splinting ureteral catheter. 4 months after the operation, the I. V. P. shows marked improvement of hydronephrosis and satisfactory drainage of urine compared with the preoperative films.
Drainage ; Female ; Humans ; Hydronephrosis ; Low Back Pain ; Retrocaval Ureter* ; Splints ; Ureter ; Urinary Catheters ; Young Adult