A case of right simple unilateral renal ectopia with left malrotated kidney in 26 years old female is presented with a brief review of literature. Right ectopic kidney was located between 4th and 5th lumber vertebra Numerous aberrant vessels of ectopic kidney disclosed during nephroureterectomy.
Adult ; Female ; Humans ; Kidney ; Spine

No abstract available.
DNA* ; Lymphoma, Non-Hodgkin*

BACKGROUND: It is well known that intracoronary thrombolysis during the early period of acute myocardial infarction leads to the limitation of myocardial necrosis, preserves left ventricular function, and improves survivals. The recanalization rate of intracoronary rrokinase infusion into infarct-related coronary artery was known as 62-94 percents in previos studies. The various factors influence the outcome of intracoronary thrombolysis, including total dose of urokinase, time from onsrt of chest pain to thrombolysis. The purpose of this study was to evaluate whether the occlusion site morphology influences recanalization rates of intracoronary thrombolysis. METHODS: We evaluated infarct-related coronary artery morphology of 56 acute mycardial infarction patients who performed intracoronary thrombolytic therapy within 6-12 hours after the onset of acute myocardial infarction. Intracoronary urokinase infusion was performed at a rate of 25000 IU/minute. The presence of calcification, collaterals, side branches and the stump site morphologies(thrombus type, pencil type, cutting type) were identified on magnified 35mm cine frames. RESULTS: Reperfusion was successed in 34 patients and failed in 22 patients. There were no statistically significant difference in the pressure of calcification, collaterals, and side branches between success and failure groups. Intracoronary thrombus was identified in 21 percent of success group, but not in failure group. The reperfusion rates according to stump site morphology were 76% in thrombus type, 58% in cutting type, and 42% in pencil type(p<0.05). CONCLUSION: Our study indicates the presence of intracoronary thrombus and the morphology of thrombus type is more effective in intracoronary thrombolysis in acute myocardial infarction. The identification of types of the coronary obstruction will be helpful for the selection of intracoronary thrombolysis in acute myocardial infarction patients. And the results suggest that the difference of stump composition show different stump morphologies.
Chest Pain ; Coronary Vessels* ; Humans ; Infarction ; Myocardial Infarction* ; Necrosis ; Reperfusion ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Ventricular Function, Left

OBJECTIVES: The purpose of this study was to determine the clinical significance of residual amniotic fluid volume, as measured by the amniotic fluid index(AFI), on the prediction of latency period and perinatal outcomes in patients with preterm premature rupture of the membranes(PPROM). METHODS: Study population consisted of 103 singleton pregnancies with PPROM between 24 and 34 weeks' gestation. Amniotic fluid index was determined using transabdominal ultrasound at admission. Latency period was defined as time interval in hours between admission and delivery. All medical records of mothers and neonates were reviewed. Spearman's rho rank correlation, receiver-operator characteristic(ROC) curve analysis, survival analysis and Cox's proportional hazard model were used for statistical analysis. RESULTS: There was a statistically significant correlation between latency period and AFI at admission. ROC curve analysis showed that AFI at admission had a significant predictive value in the prediction of latency period < 48 hours. Survival analysis demonstrated that AFI < 5.0 was strongly associated with the likelihood of shorter latency period, Cox's proportional hazard model indicated that AFI < 5.0 was a significant independent predictor for the occurrence of latency period < 48 hours even after adjustment of other independent variables. The patients with AFI <5.0 had a higher rate of cesarean section due to fetal distress than those with AFI > 5.0 but the incidence of chorioamnionitis was not significantly different between two groups. Comparing the perinatal mortality and neonatal morbidity including infectious morbidity between the neonates born to mothers with AFI <5.0 and those with AFI > 5.0, there was no significance after adjustment of gestational age at birth. CONCLUSION: AFI at admission has a significant correlation with latency period and predictive value in prediction of latency period in the patients with PPROM. AFI <5.0 is a independent predictor for the shorter latency period.
Amniotic Fluid* ; Cesarean Section ; Chorioamnionitis ; Female ; Fetal Distress ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Latency Period (Psychology)* ; Medical Records ; Membranes* ; Mothers ; Parturition ; Perinatal Mortality ; Pregnancy ; Proportional Hazards Models ; ROC Curve ; Rupture* ; Ultrasonography

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2 autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.
Anaphylaxis ; Autopsy ; Forensic Medicine ; Korea ; Mast Cells ; Tryptases

Embolization of the closure device is a rare but potentially fatal complication of percutaneous atrial septal defect (ASD) closure. We report a case of 45-year-old woman who underwent ASD device closure with 32 mm Amplatzer device, which was embolized to the pulmonary artery without symptom one day after successful device implantation.
Female ; Heart Septal Defects, Atrial ; Humans ; Pulmonary Artery ; Septal Occluder Device

PURPOSE:To describe the features of displaced bucket-handle tears of the menisci on magnetic resonance (MR) images and to assess associated knee injuries. MATERIALS AND METHODS: We retrospectively reviewed coronal and sagittal MR images in 21 bucket-handle tears. The subjects were patients who had underwent preoperative MR evaluations of the knee and were identified from the arthroscopic surgical records as bucket-handle tear. We also described patterns of associated injuries. RESULTS:On coronal MR images, (a) in all cases, peripheral portion of the meniscus(bucket) had the appearance of a truncated or altered wedge;(b) central fragments(handle) were observed to be sitting in the intercondylar notch(16 cases) or located between the fernoral condyle and tibial plateau (5 cases). On sequential sagittal MR images, (c) the bow-tie appearance of the body of the meniscus was not seen (13 cases);(d) the bow-tie appearance of the displaced inner fragment was seen at the intercondylar notch level (9 cases);(e) "double posterior cruciate ligament" sign was presented (7 cases). Associated joint abnormalities included anterior cruciate ligament tears(l 1), contralateral meniscal tears(l 1), posterior cruciate ligament tears(3), medial collateral ligament tears(3), osteoarthritis(1), and Baker's cyst(l). CONCLUSION:Awareness of these characteristic MR findings(a-e) may increase the sensitivity of MR imaging in the diagnosis of displaced bucket-handle tears, and the MRI may be helpful to correctly characterize the displaced fragment and patterns of associated injury, providing arthroscopists a guide to appropriate surgical plans.
Anterior Cruciate Ligament ; Collateral Ligaments ; Diagnosis ; Humans ; Joints ; Knee ; Knee Injuries ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Percutaneuous transvenous mitral commissurotomy(PTMC) has been performed as an effective non-surgical treatment modality of rheumatic mitral stenosis. Mitral regurgitation(MR) as a complication of the procedure occur in 20-53% of the patients. The moderate to severe mitral reguargitation, created by the PTMC, sometimes leads to the requirement for mitral valve replacement, but most of the MR limits the optimal dilation of mitral commissure due to the worry about the progression of the MR. This study was designed to evaluate the occurrence of mitral regurgitation and predictive factors for the moderate to severe mitral regurgitation(grade> or =2) induced by PTMC. METHODS: This study enrolled 46 patients(female 42, mean age 45 years) who have performed PTMC in Yeungnam University Hospital from May 1996 to May 1999. We analyzed the occurrence rate of mitral regurgitation(MR) and predictive factors for MR grade> or =2 after procedure. RESULTS: MR was detected in 35% of the patients prior PTMC, and in 56% after the procedure(grade 1, 30%; grade 2, 15%; grade 3, 11%). 21 cases of the MR was commissure MR as a grade< or =2. MR grade 3, occured in 5 patients, was non-commissure MR caused by the unilateral rupture of the lateral commissure in 4 patients and tearing of the annulus in one patient. On the univariate analysis, patients with MR grade> or =2 showed more frequent atrial fibrillation, mitral regurgitation and fluoroscopic calcification, and had more severe symptoms than patients with MR grade<2 before the procedure. On the analysis of the calcification, there was no significant difference of the leaflet calcification score, but the commissure calcification score was significantly higher in MR> or =2 group than MR<2 group(1.5+/-0.54 vs 2.5+/-0.96, p=.02). On the multivariate logistic regression analysis, independent predictor of MR grade> or =2 was fluoroscopic mitral calcification(OR 6.38, p=.048). CONCLUSION: Mild to moderate commissure MR was observed in most of the patients after PTMC. Commissure calcification have more influence on the development of MR grade> or =2 than valvular calcification, and the fluoroscopic mitral calcification can predict the occurrence of MR grade> or =2 mitral regurgitation after PTMC.
Atrial Fibrillation ; Humans ; Logistic Models ; Mitral Valve ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis ; Rupture

We report two cases of malignant schwannoma of skin in association with non-familial neurofibromatosis. Case 1, a 47 year old man, had a large subcutaneous tumor on the sacral area and case 2, a 62 year old woman, a painful, ulcerating tumor on the posterior aspect of the left arm. Both cases were histopathologically confirmed as malignant schwannomas and immunohistochemical studies showed 5-100 protein in the tumor cells. After surgical excision of the tumors, case 1 was lost to follow up, while case 2 remained without evidence of disease for more than one and half years.
Arm ; Female ; Humans ; Lost to Follow-Up ; Neurilemmoma* ; Neurofibromatoses* ; Skin ; Ulcer

BACKGROUND: It is well known that ischemic preconditioning protects the heart against infarction or arrhythmias from a subsequent ischemic injury. Two phases of the effect of preconditioning has been explored, early protection and second window of protection at 24 hours. The late protection was seen in some animal model, but the precise mechanism is controversal. This study was designed to evaluate the late cardioprotective effect and role of HSP70 in ischemic preconditioning of cat heart. METHODS: Two groups of cats were studied. Control animals were subjected to an episode of 40-min coronary artery occlusion followed by 30-min reperfusion. Experimental animals were subjected to ischemic preconditioning before the 40-min ishcemia/reperfusion. The preconditioning protocol was comprised of three 5-min episodes of ischemia interspersed by 10-min episodes of reperfusion. After sustained ischemia and reperfusion, left ventricular risk area and infart area were measured by injection of Evans blue bye and triphenyltetrazolium staining, and myocardial HSP70 mRNA was examined in risk(left ventricular anterior wall) and nonrisk(left ventricular posterior wall) area using northern blot hybridization. HSP70 mRNA expression was quantified as a percent of GAPDH. The late cardioprotective effects of ischemic preconditioning were determined by infarct size (% area at risk). RESULTS: Infarct size was markedly limited by ischemic preconditioning when compared with the control group (18.5+/-6.9% vs 38.5+/-11.1%; p<0.001). HSP70 mRNA expression in risk area was much higher in preconditioning group than control group(78+/-12% vs 41+/-11%; p<0.01). But, there was no significant difference of HSP70 mRNA expression in the posterior wall between control and ischemic preconditioning group. CONCLUSIONS: These data suggest that ischemic preconditioning have delayed myocardial protective effect from ischemia. The increase in myocardial HSP70 mRNA may be one of the contributing factors to the delayed cardioprotective effects of ischemic preconditioning in cats.
Animals ; Arrhythmias, Cardiac ; Blotting, Northern ; Cats* ; Coronary Vessels ; Evans Blue ; Heart* ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Models, Animal ; Reperfusion ; RNA, Messenger