A thymoma often occurs in patients with myasthenia gravis, but the development of multiple thymoma is very rare. The authors report the radiologic and pathologic findings of multiple invasive thymoma in a 59-year-old male with myasthenia gravis.
Humans ; Male ; Middle Aged ; Myasthenia Gravis* ; Thymoma*

Appendicitis is one of the most common condition causing an acute abdomen in young adult population. Two-hundreds and fifty-nine cases of acute appendicitis provened by surgery and pathology during recent 2 years in Han-ll Hospital were studied and analyzed by preoperative plain abdominal X-ray. One case of barium enema was also done. The results were as follows; 1. Male fo female sex ration was 1:1. 2. In age distribution, the most commonage group was from two to four decade. (75.3%) 3. The most common clinical symptom was classical abdominal pain as86.5%. 4. The positive radiographic findings were obtained 75.7% of all cases. 5. Common radiographic findings as follows; 1) Reflex ileus on RLQ (73.7%) 2) Obliteration of Rt. psoas line (41.3%) 3) Scoliosis of lumbar spine(21.2%) 6. The most common site of appendix was retrocecal in position. (84.2%) 7. One case of appendicolith and one case of appendiceal diverticulum were demonstrated.
Abdomen, Acute ; Abdominal Pain ; Age Distribution ; Appendicitis ; Appendix ; Barium ; Diverticulum ; Enema ; Female ; Humans ; Ileus ; Male ; Pathology ; Reflex ; Scoliosis ; Young Adult

PURPOSE: Our purpose was to examine the relationship between the intrauterine infection and the concentration of cord blood interleukin 6 in preterm infants. METHODS: Patients delivering preterm infants because of spontaneous preterm labor were evaluated for clinical signs of chorioamnionitis, which was defined as a temperature of >or=37.8 degrees C along with >or=2 of the followings : Significant maternal tachycardia (>or= 100/min), fetal tachycardia (>or=160/min), purulent discharge, uterine tenderness, and leukocytosis (WBC >or=15,000c ells/mm3). Their placentas were examined for histologic chorioamnionitis. Cord blood was assayed for Interleukin 6 and CRP. And Interleukin 6 and CRP were sequentially determined at 12-24hour and at 36-48 hour. An elevated interleukin 6 was determined to be 20 pg/mL. Infants were evaluated for the evidences of early and late neonatal sepsis, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, neonatal pneumonia, and bronchopulmonary dysplasia. RESULTS: Umbilical cord blood interleukin 6 was significantly higher in the presence of intrauterine infection than in the absence of intrauterine infection (208.4+/-426.3 pg/mL VS 13.3+/-20.6 pg/mL P=0.018). And the frequencies of histologic chorioamnionitis, early neonatal sepsis, neonatal pneumonia, and morbidity were significantly higher in the presence of intrauterine infection than in the absence of intrauterine infection (P=0.003, P=0.000, P=0.042, and P=0.000, respectively). There was significant difference in gestational age, but no significant differences in maternal age, parity, birth weight, method of delivery, respiratory destress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia. Using receiver operator characteristic curves, the best cutoff for interleukin 6 was found to be 20 pg/mL. CONCLUSION: Cord blood interleukin 6 was significantly elevated in the intrauterine infection in the preterm infant.
Birth Weight ; Bronchopulmonary Dysplasia ; Chorioamnionitis ; Enterocolitis, Necrotizing ; Female ; Fetal Blood* ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Interleukin-6* ; Interleukins* ; Leukocytosis ; Maternal Age ; Obstetric Labor, Premature ; Parity ; Placenta ; Pneumonia ; Pregnancy ; Sepsis ; Tachycardia

The authors measured the lateral & 3rd ventricles and cortical sulci in computerized axial tomographic films of 15 male patients with chronic alcoholism and 16 controls, who had been admitted to Kyng Hee University Hospital from Jan. 1, 1979 to Mar. 31, 1983. The results were as following: 1. The average age of patients was 47.5 yrs., and that of conntrols was 34.5 yrs. The average duration of habitual drinking was 11.6 yrs., and complicated with delirium tremens, head trauma, liver diseases (46.7% each other) and seizure (33.3%). 2. The sulcal widening was found in 9 cases (60.0%) of patients (mean +/- S.D. = 6.7 +/- 1.76mm) and no cases in control group (mean +/- S.D. = 2.3 +/- 0.88mm). The difference between patients and control group was statistically significant, especially in twenties (P<0.05). 3. The lateral ventricular enlargement was seen in 12 cases (80.0%) of patients (mean +/- S.D. = 17.1 +/- 0.93mm), and 8 cases (50.0%) of control group (mean +/- S.D. = 14.7+/- 1.46mm). There was statistical significance, especially in forties (P<0.05). There were no statistical significance except cella media index (P<0.05), according to various measuring indices. The width of 3rd ventricle was 1.88 +/- 0.152mm (mean+/-S.D.) in patients and 1.12+/-0.311mm (mean +/- S.D.) in control group. And the difference was statistically significant. 4. Cerebral atrophy was noticed in 10 cases (67.0%) among 15 taken C.A.T. of brain.
Alcohol Withdrawal Delirium ; Alcoholics* ; Alcoholism ; Atrophy ; Brain ; Cerebral Ventricles* ; Craniocerebral Trauma ; Drinking ; Humans ; Liver Diseases ; Male ; Seizures

In a study of intacranial metastases, 46 cases having satisfactory clinical, operative and histological proofswere analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to February, 1986. Theresults were as follows: 1. The male to female ratio of itracranial metastases were 67:33. The 5th decade group(34.8%) was the most prevalent age group, followed by the 6th decade(21.7%) and 7th decade(21.7%). 2. The numberof lesions was found to be: single-25 cases(54.3%); multiple-21 cases(45.7%). 3. The source of intracranialmetastases found to be: lung 15 cases(32.6%); unknown 12 cases(26.0%); chorioca 3 cases(6.5%); liver 3cases(6.5%); liver 3 cases(6.5%); stomach 2 cases(4.3%); parotid, breast, kidney, prostate, melanoma, rectal ca.rhabdomyosarcoma, nasal ca. lymphoma, testicular ca, cervix, each 1 case(2.2%). 4. The locations of theintracranial metastases were as follows: Cerebral hemisphere 37.7% in parietal region Cerebra hemisphere 15.9% inin frontal region Cerebral hemisphere 13.4% in occipital region Cerebra hemisphere 10.5% in temporal regionCerebellar hemisphere 3.2% Cerebellopontine angle 3.2% Intraventricular 4.8% Meninges 4.8% Skull vault 6.5% 5.Peritumor edema was found to be: Grade II-17 cases(37.0%): Grade III-14 cases(30.4%); Grade I-8 cases(17.4%);Grade 0–7 cases(15.2%) in that order. 6. The chief complaints of intracranial metastases on admission, were asfollows: Headache 30 cases(65.2%); Vomiting 11 casees(23.9%); deteriorated mental state 10 cases(21.6%);Hemiplegia 7 cases(15.2%); visual disturbance 6 cases(13.0%); hemiparesis 4 cases(8.7%); seizure 4 cases(8.7%);other symptoms were less frequent. 7. On pre-contrast scan, hyperdense lesions were present in 18 cases(39.1%);hypodense lesions in 15 cases(32.6%); mixed density in 8 cases(17.4%); isodenisty was present in 5 cases(10.9%).On post-contrast scan, ring enhancement was seen in 19 cases(41.3%); nodular enhancement in 17 cases(37%); mixedring-nodular enhancement in 8 cases(17.4%); only hypodense 2 cases(4.3%).
Breast ; Cerebellopontine Angle ; Cerebrum ; Cervix Uteri ; Edema ; Female ; Headache ; Humans ; Kidney ; Liver ; Lung ; Lymphoma ; Male ; Melanoma ; Meninges ; Neoplasm Metastasis ; Occipital Lobe ; Paresis ; Parietal Lobe ; Prostate ; Protestantism ; Seizures ; Skull ; Stomach ; Vomiting

We report 3 cases of multiple myeloma showing ABO discrepancy with missed reaction in serum typing. They showed markedly decreased immunogolobulin level except for monoclonally increased abnormal immunoglobulin. Their blood group was confirmed by saliva test and addition of anti-globulin reagent. As serum immunoglobulin level is raised, the reactivity in serum typing showed improving tendency and ABO discrepancy appeared when immunoglobulin was markedly decreased.
Immunoglobulins ; Multiple Myeloma* ; Saliva

BACKGROUND: Airwayscope (AWS), which has been used successfully for difficult airway in general anesthesia, has been anticipated that hemodynamic response to tracheal intubation in the difficult airway may be attenuated. Also, there is a series of reports demonstrating the successful use of lightwand to open the difficult airway. Thus, we decided to conduct a survey to compare AWS to lightwand and to direct laryngoscopy of cardiovascular response to tracheal intubation. METHODS: Of 64 healthy patients without cardiovascular disease, 22, 21, 21 patients were randomly assigned to AWS group, lightwand group and direct laryngoscope group. After induction of general anesthesia, intubation was performed with manual in-line neck stabilization. During laryngoscopy, a modified Cormack-Lehane grade was assessed and time to intubation was measured. Systolic arterial pressure (SAP) and heart rate (HR) were recorded at the following timepoints: baseline, just before intubation, 1 min, 2 min, 3 min, 4 min and 5 min after intubation. RESULTS: There were no significant differences between the 3 groups in SAP, HR (P > 0.05). However modified Cormack-Lehane grade of all patients in the AWS group was I, while that in direct laryngoscope group was IIB or III. In addition, the mean time to intubation of the direct laryngoscope group was significantly longer than that of the AWS and lightwand (P < 0.05). CONCLUSIONS: In the difficult airway, AWS was very effective in improving laryngeal view and decreasing time to intubation compared to direct laryngoscopey. In addition, lightwand reduced the time to intubation. However we could not find any significant difference in hemodynamic response to tracheal intubation among the 3 groups.
Anesthesia, General ; Arterial Pressure ; Cardiovascular Diseases ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Laryngoscopes ; Laryngoscopy ; Neck

PURPOSE: To evaluate the usefulness of whole body bone mineral densitometry in the diagnosis of frequent osteopenia of preterm infants by comparison with the wrist radiographs and biochemical parameters. MATERIALS AND METHODS: From January 1995 to January 1996, we obtained whole body bone mineral density(BMD) studies using dual energy X-ray absorptiometry(DXA) and wrist radiographs of 39 preterm infants. They were divided into three groups according to birth weight, under 1500g, 1501g to 2000g and above 2000g, and four grades of skeletal change, as seen on wrist radiography, according to the scoring method of Koo et al. Groups of birth weight and grades of skeletal change were then correlated with whole body BMD and biochemical parameters. For comparison, normal data were obtained from 13 infants born at full term. Data were analyzed by one way analysis of variation(ANOVA) and correlation and regression analysis. A p-value of less than 0.05 was considered significant. RESUTLS: Whole body BMDs were significantly lower in the more premature and smaller birth weight infants(r=0.77, p=0.0000), and in the higher grade of skeletal change (r=-0.5276, p=0.0000). Aggravated skeletal changes were found in infants with lower birth weight(r=-0.3822, p=0.01). Interobserver variation in grading skeletal change was 42.9%, and intraobserver variation was 18.4%. Biochemical parameters such as serum calcium, phosphate, alkaline phosphatase, parathromone, calcitonin and 25-hydroxy-vitamine D did not vary significantly according to either birth weight or skeletal change (p>0.05). CONCLUSION: Premature osteopenia is more effectively diagnosed by measuring whole body BMD using DXA than by grading radiographical skeletal change or by biochemical parameters.
Alkaline Phosphatase ; Birth Weight ; Bone Diseases, Metabolic* ; Calcitonin ; Calcium ; Densitometry* ; Diagnosis ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Observer Variation ; Parturition ; Radiography* ; Research Design ; Rickets ; Wrist*

He died after 2 months from diagnosis due to massive bleeding in esophageal lesion with complication. He died after 2 months from diagnosis due to massive bleeding in esophageal lesion with complication. We report one case of plasma cell leukemia associated with esophageal cancer. A 71-year-old man was admitted due to dysphagia and diagnosed as undifferentiated squamous cell cancer based on esophagogram and biopsy. In peripheral blood smear, large parcent of plasma cell like cells are found, so bone marrow examination was done and 52.5% of plasma cells are found with unusual morphology such as convoluted, multilobulated nuclei. Immunochemical stain and immunophenotypic features of these cells were suggestive of plasma cell origin with positivity for methylgreen pyronin positivity and CD38, CD56 positivity. Serum rotein electrophoresis and immunoelectrophoresis showed monoclonal gammopathy of Ig G ,k type. This patient had no history of previous multiple myeloma or other maligancy. He died after 2 months from diagnosis due to massive bleeding in esophageal lesion with complication.
Aged ; Biopsy ; Bone Marrow Examination ; Deglutition Disorders ; Diagnosis ; Electrophoresis ; Esophageal Neoplasms* ; Hemorrhage ; Humans ; Immunoelectrophoresis ; Leukemia, Plasma Cell* ; Multiple Myeloma ; Neoplasms, Squamous Cell ; Paraproteinemias ; Plasma Cells* ; Plasma*

Living donor liver transplantation is increasingly performed as an alternative to cadaveric transplantation. Preoperative screening of the donor candidates is very important. The quality, size, and vascular and biliary anatomy of the liver are best assessed with magnetic resonance (MR) imaging or computed tomography (CT). In particular, the volume of the potential graft must be measured to ensure sufficient liver function after surgery. Preoperative liver segmentation has proved useful for measuring the graft volume before living donor liver transplantations in previous studies. In these studies, the liver segments were manually delineated on each image section. The delineated areas were multiplied by the section thickness to obtain volumes and summed to obtain the total volume of the liver segments. This process is tedious and time consuming. To compensate for this problem, automatic segmentation techniques have been proposed with multiplanar CT images. These methods involve the use of sequences of thresholding, morphologic operations (ie, mathematic operations, such as image dilation, erosion, opening, and closing, that are based on shape), and 3D region growing methods. These techniques are complex but require a few computation times. We made a phantom for volume measurement with pig and evaluated actual volume of spleen and liver of phantom. The results represent that our semiautomatic volume measurement algorithm shows a good accuracy and repeatability with actual volume of phantom and possibility for clinical use to assist physician as a measuring tool.
Animals ; Cadaver ; Dietary Sucrose ; Humans ; Liver ; Liver Transplantation ; Living Donors ; Magnetic Resonance Spectroscopy ; Mass Screening ; Mathematics ; Spleen ; Tissue Donors ; Transplants