No abstract available.
Breast* ; Hamartoma*

PURPOSE: To describe soft-tissue radiographic and high-resolution CT findings of radiation-induced lung injury of rabbit over time and to correlate them with pathologic findings. MATERIALS AND METHODS: 15 rabbits were irradiated in the right lung with one fraction of 2000 cGy. After 4, 6, 12, 20, 24 weeks, 3 rabbits in each group were sacrificed and soft-tissue radiographs and high-resolution CT of their lung tissue were obtained. Radiological findings were correlated with pathologic findings. RESULTS: On soft- tissue radiogram, radiation pneumonitis shown as consolidation with air-bronchogram occurred in 3 cases after 6 weeks, and in 1 case after 12 weeks of irradiation. In addition, pneumonic consolidation with adjacent pleural contraction was seen in 2 cases after 12 weeks of irradiation. Fibrotic changes indicated by decreased volume occurred after 20 weeks and combined bronchiectatic change and bronchial wall thickening appeared after 20 weeks(N=1), and 24 weeks(N=3). HRCT findings of radiation pneumonitis were homogeneous, increased attenuation after 4 weeks(N=3), 6 and 12 weeks (each N=I), patchy consolidation after 6 and 12 weeks(each N=2), discrete consolidation after 12, 20 and 24 weeks(each N=I) and solid consolidation after 20 and 24 weeks(each N=2). Pathologically radiation pneumonitis and pulmonary congestion were seen after 4 and 6 weeks. After 6 weeks, collagen and reticulin fibers were detected along alveolar wall. Mixed radiation pneumonitis and fibrosis were detected after 12 weeks. 20 weeks after irradiation, fibrosis was well defined in interstitium and in 24 weeks, decreased number of alveoli and thickening of bronchial wall were defined. CONCLUSION: Radiation pneumonitis was provoked 4 weeks after irradiation on rabbit lung and progressed into radiation fibrosis 20 weeks after irradiation on soft-tissue radiographs and high-resolution CT. High-resolution CT is more precise in detecting early radiation pneumonitis and detailed pathologic findings.
Collagen ; Estrogens, Conjugated (USP) ; Fibrosis ; Lung Injury ; Lung* ; Rabbits ; Radiation Pneumonitis ; Reticulin

The two most common causes of acute arterial occlusion are embolism and thrombosis in sity. They are mainly originated from the cardiovascular sources. About 70-80 per cent of occlusions occur in the axial limb vessels. Therapeutic options include supportive measures, pharmacologic treatment, surgery, and non-operative interventions. There have been several successful case reports using percutaneous aspiration thromboembolectomy with the advent of new instruments and technical imprevement. We report a case of 70-year-old male with acute anterior wall myocardial infaction who experienced acute embolic arterial occlusion of the left popliteal artery from mural thrombus in the left ventricular apex. It wan managed successfully by percutaneous aspiration thromboembolectomy.
Aged ; Embolism ; Embolism and Thrombosis ; Extremities ; Humans ; Male ; Popliteal Artery ; Thrombosis

No abstract available.
Adult* ; Arteries* ; Humans

The occurrence of the colonic obstruction secondary to colorectal carcinoma (CRC) has been reported in 7~30% of the CRC patients. It is generally believed that obstructive CRC is associated with a poor prognosis with respect to operative mortality and five-year survival. A series of 1064 cases of the CRC treated surgically at Asan Medical Center from June 1989 to December 1996 has been analyzed to compare clinicopathological findings between obstructive and non-obstructive CRC and to evaluate surgical treatment options in obstructive CRC. Complete obstruction was present in 49 cases (4.6%). There were no differences between obstructive and non-obstructive CRC in tumor location, size, Dukes' stage, and differentiation. In forty-nine obstructive CRC cases, primary resections were performed in 29 cases after peri-operative bowel decompression. In this group, right colon cancer was more prevalent than staged operation group (45% vs. 5%, P<0.05) and hospital stay was significantly short (16 days vs. 38 days, P<0.05). Postoperative complication rate was higher in staged operation group (65% vs. 28%, P=0.01). It may be due to stoma related wound complication. In obstructive left colon cancer, there was a significant difference in complication rate between primary resection and staged operation (P<0.05). Overall 5-year survival rate were 66% and 53% in non-obstructive and obstructive group, respectively. Survival rate according to the Dukes' B and C stages did not show statistical differences, either. Conclusively, primary resection is preferred to the obstructive CRC when supportive care, preoperative bowel decompression, and intraoperative colonic irrigation were performed adequately.
Chungcheongnam-do ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Decompression ; Humans ; Length of Stay ; Mortality ; Postoperative Complications ; Preoperative Care ; Prognosis ; Survival Rate ; Wounds and Injuries

BACKGROUND/AIM: Serial measurement of serum carcinoembryonic antigen was assessed to define its significance and to determine the adequacy in detecting recurrence after curative resection for colorectal cancer. METHODS: Six hundred forty-five patients with colorectal cancer underwent curative resection were included. The median follow-up period was 49 months (range, 24~94 months). Serum CEA was analyzed in accordance with location, histologic differentiation, stage of the tumor, recurrence and survival. RESULTS: The incidence of elevated preoperative serum CEA (> 6 ng/ml) was correlated with tumor stage (stage I vs. II, P=0.01; stage II vs. III, P=0.0001). Fifty five patients among 87 patients with recurrence (63.2%) had concomitant elevation of serum CEA, whereas 32 of 558 patients (5.7%) without recurrence showed a false-positive result. Measurement of serum CEA was more sensitive in patients with elevated preoperative serum CEA and liver metastases than in patients without elevated preoperative serum CEA and local recurrence (P=0.0397). The leading time of serum CEA between the first elevated serum CEA and the identification of recurrence was 3.5 months (range, 1~12 month). Tumor stage and preoperative serum CEA level were found to be significant prognostic variables by multivariate analysis. The overall 5-year survival rate in the normal preoperative serum CEA and the elevated group were 76% and 64% respectively (P=0.00019). CONCLUSION: Serum CEA seemed to be closely correlated with survival and to be an useful tool to detect recurrence after curative resection for colorectal cancer. The appropriate measurement of serum CEA might be suggested in stage II and III postoperatively: every three month for two years, every 6 month for succeeding 2 years, and annually thereafter. Monitoring of serum CEA in stage I could be individualized by preoperative serum CEA and clinical course.
Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Incidence ; Liver ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Survival Rate

The computerized image analysis is a useful tool for the quantitative assessment of histopathologic findings. In contrast to the usual microscopic examination by pathologists, the computerization should be accompanied with the standardization process of the image. We developed an algorithm to standardize images and to determine the optimal gray level threshold, using a myocardial fibrosis model. Sirius red staining was more convenient for the image analysis than Masson's trichrome staining because of a better contrast with the surrounding structures. To get an optimal measurement, light intensity was standardized at each of the fibrosis, myocardium and background. In this study, the most promising method to determine the degree of fibrosis was that of revising the background without tissue to a gray level of 200, obtaining a green component of the color image, revising the myocardial fiber to 163, and defining a partial ratio as fibrosis index when the gray level threshold was 120. These threshold levels and parameters were determined after drawing the binarization index curves according to the change of the gray level threshold and by the morphological examination of the actual binarization figures overlaid to the original color image. Through these processes we could get a consistent result on the myocardial fibrosis and we expect a similar principle applies when we analyze color images in the histopathologic quantitation by computerized image analysis.
Fibrosis* ; Myocardium

BACKGROUND: Unexpected deaths of the patients at ED are surprising to the medical staffs as well as the families. It may also increase the possibilities of medico-legal problems. This study was conducted to review the unexpected death in ED and find the predictive factors leading patients to unexpected death. METHODS: A retrospective study with reviewing available medical records of 183 patients who were expired at ED of Shinchon Severance Hospital from Mar. 1997 to Feb. 1998 and 103 patients of Youngdong Severance Hospital from Mar. 1996 to Feb. 1998 was done. Analyses were 4one on 30 variables of physical findings, laboratory results, procedures and therapies. We used univariate analysis, such as t-test and x2-test and multiple logistic regression analysis. RESULTS: Of the total 286 deaths in ED, 153 cases were enrolled in this analysis. The number of unexpected deaths were 76. Age, mental status, fraction of neutrophil count, BUN level, whether endotracheal incubation was done, use of inotropics were the factors with statistical ,significance on the univariate analysis, but only comatose mentality, endotracheal incubated case, and use of the inotropics were significant on logistic regression analysis. The longer the ED length of stay, the higher the rate of mortality and unexpected death. CONCLUSION: This result suggest that medical attention is needed on the patients with comatose decreased mental stylus, endotracheally intubated case and needing inotropic agents to prevent unexpected deaths. Shortening the ED length of stay may also be a factor for decrease the unexpected death rate.
Coma ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Length of Stay ; Logistic Models ; Medical Records ; Medical Staff ; Mortality ; Neutrophils ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Herpes zoster(HZ) is a well known viral infection of the nervous system. HZ is associated with the neurologic complication. It may have been expected a change in the cerebrospinal fluid(CSF) of patients with HZ. The purpose of this paper is to present the correlation between CSF findings and neurologic complications in HZ. METHOD: The patients(n=75) with HZ were 31 male and 26 females, who were ranged in age from 15 to 79years(mean 53.4 years) admitted to department of Neurology of Chung Ang Gil General Hospital from June 1992 to May 1995. The patients were evaluated for the etiology, lesion distribution, and complications. CSF study was performed in 32 patients(male/female=20/12), whose age ranged from 16 to 79 years(means 51years) during 5 days to 10days after initial symptom onset. CSF findings were analyzed for their etiology, lesion distribution and complication. RESULTS: The CSF of 25 patients(78.1%) showed pleocytosis(5 to 49/mm3 in 10 patients, means, 62.1/mm3). 7 patients(12.3%) had meningitis symptoms, whose cell counts of CSF were more than 50/mm3(means 128.4/mm3) postherapeutic neuralgia was more common in elder patient than younger patients(p=0.005). Complications tended to correlate with the cell counts of CSF. There was no difference in CSF finding between cranial segmental involvements. CONCLUSION: We confirmed the pleocytosis in CSF of patients with HZ and suggest the development of complications in patients in patients with HZ tend to correlate with the cell counts of CSF.
Cell Count ; Female ; Herpes Zoster* ; Hospitals, General ; Humans ; Leukocytosis ; Male ; Meningitis ; Nervous System ; Neuralgia ; Neurology

BACKGROUND AND OBJECTIVES: Herpes zoster(HZ) is a well known viral infection of the nervous system. HZ is associated with the neurologic complication. It may have been expected a change in the cerebrospinal fluid(CSF) of patients with HZ. The purpose of this paper is to present the correlation between CSF findings and neurologic complications in HZ. METHOD: The patients(n=75) with HZ were 31 male and 26 females, who were ranged in age from 15 to 79years(mean 53.4 years) admitted to department of Neurology of Chung Ang Gil General Hospital from June 1992 to May 1995. The patients were evaluated for the etiology, lesion distribution, and complications. CSF study was performed in 32 patients(male/female=20/12), whose age ranged from 16 to 79 years(means 51years) during 5 days to 10days after initial symptom onset. CSF findings were analyzed for their etiology, lesion distribution and complication. RESULTS: The CSF of 25 patients(78.1%) showed pleocytosis(5 to 49/mm3 in 10 patients, means, 62.1/mm3). 7 patients(12.3%) had meningitis symptoms, whose cell counts of CSF were more than 50/mm3(means 128.4/mm3) postherapeutic neuralgia was more common in elder patient than younger patients(p=0.005). Complications tended to correlate with the cell counts of CSF. There was no difference in CSF finding between cranial segmental involvements. CONCLUSION: We confirmed the pleocytosis in CSF of patients with HZ and suggest the development of complications in patients in patients with HZ tend to correlate with the cell counts of CSF.
Cell Count ; Female ; Herpes Zoster* ; Hospitals, General ; Humans ; Leukocytosis ; Male ; Meningitis ; Nervous System ; Neuralgia ; Neurology