No abstract available.
Memory*

No abstract available.
Animals ; Cardioplegic Solutions* ; Oxygen* ; Rats*

No abstract available.
Humans ; Pneumothorax*

No abstract available.
Cervix Uteri* ; Female ; Lymph Nodes* ; Neoplasm Metastasis*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels*

BACKGROUND AND OBJECTIVES: Intracardiac pathology results in 15 - 20% of ischemic stroke, but transthoracic echocardiography (TTE) has a number of limitations because of suboptimal precordial windows or ultrasound interference with prosthetic materials. Transesophageal echocardiography (TEE) provides superior resolution of basal structures such as the left atrium, left atrial appendage, mitral valvular apparatus, atrial septum, and aorta. The purpose of this study was to describe the various TEE findings which were sources of cerebral emboli. MATERIALS AND METHOD: The study population was comprised of 122 patients (mean age:54.5, male 83, female 39) who were admitted to Severance Hospital because of ischemic stroke from 1991 to 1997. All patients underwent TEE with agitated saline contrast administration. Patients without a definitive cardiac source of embolism underwent Holtor monitoring, internal carotid and cerebral angiography, as well as transcranial Doppler. RESULTS: 1) The number of patients diagnosed as cardioembolic stroke was 55 (45.1%). Atrial fibrillation was noted in 31 patients of cardioembolic stroke and it was the most frequent finding. Among these patients, 16 did not have any other cardiac problem. 2) We were able to find the possible source of embolism in 49 (40.2%) patients with TEE. Among these patients, 12 did not have dysrhythmia or any known previous heart problem. We found spontaneous echo contrast in the left atrium and left atrial appendage in 33 cases. There were 8 patients who had intracardiac thrombus. Among these patients, 6 patients had thrombi in the left atrial appendage, 1 in left atrium and 1 in left ventricular apex. We found patent foramen ovale in 3 cases and atrial aneurysm in 1 case. We found atheromatous plaque and/or thrombi of the aorta in 16 cases, while there were 4 cases where lesions located in the ascending aorta and aortic arch and which were considered as the source of embolism. Small thrombi in the left atrial appendage and left atrium were only detectable with TEE. CONCLUSIONS: We described TEE findings in ischemic stroke patients. And we assert TEE is a useful diagnostic tool in detecting the source of cardioembolic stroke and it may be used as a primary diagnostic tool in patients who are being evaluated for ischemic stroke.
Aneurysm ; Aorta ; Aorta, Thoracic ; Atrial Appendage ; Atrial Fibrillation ; Atrial Septum ; Cerebral Angiography ; Dihydroergotamine ; Echocardiography ; Echocardiography, Transesophageal* ; Embolism ; Female ; Foramen Ovale, Patent ; Heart ; Heart Atria ; Humans ; Intracranial Embolism ; Male ; Pathology ; Stroke* ; Thrombosis ; Ultrasonography

Since the introduction of extracorporeal shock wave lithotripsy(ESWL), percutaneous nephrolithotomy(PNL) has been performed in limited cases of the patients requiring a stone procedure. The roles of PNL in the era of ESWL were reviewed through analysis of 86 patients treated with PNL. From July 1987 to December 1994, 86 patients(89 renal units) underwent percutaneous extraction of renal or upper ureteral stone. From July 1987 to January 1990, PNL was performed as the first choice for the treatment of 69 cases out of 119 renal or upper ureteral stone, and PNL was done in 58.0% (69/119) of the cases. From February 1990 to December 1994 when ESWL was available at our hospital, PNL was done in 20 cases of ESWL resistant stone or large volume stone, and PNL was done in 1.5%(20/1,362) of renal or upper ureteral stone. In the era of ESWL in our hospital, ESWL were performed in 94.5% of renal or upper ureteral stone, open surgery in 3.0%, PNL in 1.5% and conservative treatment in 1.0%. Initial success rate of PNL was 86.9%(60/69 cases) and subsequently when ESWL was available at our hospital, it became 95.0%(19/20 cases), probably due to accumulated experiences. Subsequently decreased complications of PNL such as persistent urinary leakage, prolonged hematuria, ureteral perforation and paralytic ileus. Though the introduction of ESWL in our hospital also brought about dramatic ally decreased use of PNL, PNL continues to have a primary role in the management of renal or upper ureteral stone in limited cases such as patients refusing ESWL, ESWL resistant stone or large volume stone.
Hematuria ; Humans ; Intestinal Pseudo-Obstruction ; Lithotripsy* ; Nephrostomy, Percutaneous* ; Shock* ; Ureter

Eosinophilic granuloma, Hand-Schuler-Christian and Abt-Letterer-Siwe syndrome are considered to be different manifestations of one and the same disease of the reticulohistiocytic system, and are included under the term histiocytosis X, clinical and morphological manifestations are variable. The syndromes can be differentiated according to their course and extent of spread. Eosinophilic granuloma of bone is the mildest form, usually restricted to one or a few foci. This occurs chiefly in children but may occur at any age. The male sex is affected almost twice as often as the female. Cranial vault is most commonly affected site and jaw, humerus, rib and femur are also often affected. Recently we have experienced 2 cases of eosinophilic granuloma of the skull bone. One was 10 years old male with protruding mass on the right frontal bone, and the other was a mass on right parietal bone in 12 years old male. On admission, the patients had headache and local tenderness without any abnormal neurological signs. Histopathologic findings show the fibrocartilagenous tissue and bone. The soft tissue is densely replaced by infiltrations of histiocytes, eosinophils, lymphocytes, plasma cells and multinucleated giants cells. Bone tissue is also infiltrated with identical cells. The differential diagnosis distiction between the cerebral granulomatosis is difficult.
Bone and Bones ; Child ; Diagnosis, Differential ; Eosinophilic Granuloma* ; Eosinophils* ; Female ; Femur ; Frontal Bone ; Headache ; Histiocytes ; Histiocytosis, Langerhans-Cell ; Humans ; Humerus ; Jaw ; Lymphocytes ; Male ; Parietal Bone ; Plasma Cells ; Ribs ; Skull*

PURPOSE: Although the conventional clinical, histopathological, and moleculobiological factors of bladder tumor provide a certain degree of stratification of tumor biological potential, it is difficult to make an accurate and reliable prediction of tumor recurrence with known prognostic factors due to tumor heterogeneity. So we attempted to devise a scoring system reflecting various prognostic factors to predict tumor recurrence more accurately in superficial bladder carcinoma. MATERIALS AND METHODS: We reviewed retrospectively the clinical records and pathological specimens of 46 patients with superficial bladder cancer, who underwent transurethral resection of bladder tumor and intravesical Bacillus Calmette-Guerin (BCG) instillation between September, 1991 and December, 1996. The mean follow-up was 29 months. We examined the prognostic parameters such as tumor stage, grade, tumor with or without CIS, size, number, p53 expression and investigated the relation between the prognostic factors and the tumor recurrence. We assigned 1 and 2 for Ta and T1; 1 and 2 for tumor size(<3cm and > or =3cm); 1 and 2 for tumor number( < or =2 and > or =3); 1, 2 and 3 for grades( I, II and III); 2 if CIS is found and 1 if not; 2 if p53 is expressed more than 20%(strong positive) and 1 if p53 is not expressed or less than 20%(weakly positive). We summed the points assigned to all categories for each patient, and investigated tumor recurrence according to total points by the scoring system. We corrected the scoring system by deleting the insignificant prognostic factors in this study which was named the corrected scoring system. We recounted the points based on it. RESULTS: Tumor recurred in 15 out of 46 patients(32.6%). Recurrence rate in patients with p53(strong positive) and with p53(weakly positive) was 47.3 and 18.5%, respectively (p<0.05). The recurrence rate of stage Ta and T1 was 40.0 and 30.6%(p>0.05) and that of grades I, II and III was 0, 20.8 and 55.6%(p<0.05), respectively. The recurrence rate of patients with and without CIS was 52.9 and 26.9%(p<0.05), respectively. The recurrence rate for patients with size of tumors > or =3cm and<3cm was 50 and 26.5%, respectively (p>0.05). Patients with number of tumors < or =2(22.6%) have a lower recurrence rate than those with tumors> or =3(53.3%)(p<0.05). p53 expression, high grade, tumor with CIS and number(> or =3) were considered as prognostic factors that affected the recurrence. For patients with summed points 4 to 9 based on the corrected scoring system, the recurrence rate was zero%(0/16) in patients with lower score(4 or 5), 31.8%(8/21) in those with intermediate score(6 or 7), and 77.8%(7/9) in those with higher score(8 or 9)(lower and intermediate score vs higher score: p<0.005). CONCLUSIONS: The results suggested that this scoring system reflecting various prognostic factors can be a reliable method predicting the tumor recurrence. This scoring system awaits its application to more cases of bladder tumor and its refinement, if necessary.
Bacillus ; Follow-Up Studies ; Humans ; Population Characteristics ; Recurrence* ; Retrospective Studies ; Urinary Bladder Neoplasms ; Urinary Bladder*

Malignant growth of the small bowel accounts for approximately 1 to 3 percent of malignant tumors of the gastrointestinal tract. Leiomyosarcomas are the second most common primary tumor of the small bowel, their frequency being one-third to one-half of adenocarcinoma. The common clinical symptoms of leiomyosarcoma of the small intestine are hemorrhage and abdominal pain. Accurate diagnosis cannot be based on solely on the roentgenographic finding, although in certain situations the dignosis of leiomyosarcoma may be suggested strongly. We report a case of bleeding leiomyosarcoma located in the second portion of the duodenum which was first recognized by endoscopic examination and confirmed by explolaparotomy.
Abdominal Pain ; Adenocarcinoma ; Diagnosis ; Duodenum* ; Gastrointestinal Tract ; Hemorrhage ; Intestine, Small ; Leiomyosarcoma*