No abstract available.
Anal Canal* ; Carcinoma, Squamous Cell*

PURPOSE: The purpose of this study was to understand the principle of percutaneous nephrolithotomy(PNL), toincrease its success rate, and to base the radiologic approach on preoperative interventional tract dilatation. MATERIALS AND METHODS: Twenty-six patients(male, 19, female, 7) with staghorn or pelviocalyceal calculi who hadundergone PNL were included in this study. After percutaneous nephrostomy(PCN) was performed in each patient, thetract was dilated to 30F with Amplatz dilators using coaxial techniques or a 30F, 10cm high-pressure tractdilatation balloon. One day before the calculi were fragmented and removed by PNL, a 30F Amplatz sheath wasinserted under local anesthesia. The time required for tract dilatation, complications, and surgery was analyzed. RESULTS: Percutaneous tract dilatation were successful in all patients, and forceps, a nephrolithotome and anephroscope were successfully introduced into the pelvocalyceal system. The average procedure time was 19.5minutes ; a double J stent was replaced in the pelvocalyceal system of 13 of 26 patients (50%) ; because ofimproper catheter direction or/and bleeding, the Amplatz sheath was replaced in three. After PNL, complicationsinvolving renal hematoma occurred in one patient. This did not affect the patient's prognosis, however. CONCLUSION:Owing to its short procedure time and low complication rate, interventional preoperative tract dilatation forPNL is thought to be an effective technique for patients with staghorn or pelvocalceal calculi.
Anesthesia, Local ; Calculi ; Catheters ; Dilatation* ; Female ; Hematoma ; Hemorrhage ; Humans ; Nephrostomy, Percutaneous* ; Prognosis ; Stents ; Surgical Instruments

Pelvic lipomatosis is a rare disease of unknown etiology characterized by overgrowth of mature, nonmalignant fat cells in the pelvis, especially in the perivesical and perirenal space. An overgrowth of fat surrounding the bladder and rectosigmoid colon produces a radiologic picture characterized by 1) radiolucent pelvic densities, 2) elevation and vertical elongation of the bladder, 3) straightening and elevation of the rectosigmoid colon and 4) absence of malignant vessels on pelvic angiography. Cystoscopy has shown a high incidence of cystitic changes: chronic inflammation, cystitis glandularis and cystitis cystica. We report a case of pelvic lipomatosis associated with cystitis glandularis.
Adipocytes ; Angiography ; Colon ; Cystitis* ; Cystoscopy ; Incidence ; Inflammation ; Lipomatosis* ; Pelvis ; Rare Diseases ; Urinary Bladder

No abstract available.
Hemangioma, Cavernous*

This study was designed to investigate the effect of cholestyramine on the formation of pigment gallstones in high carbohydrate diet-fed hamsters and whether that effect occurred because of cholecystokinin action. Forty seven hamsters were divided into three groups: group I(n = 16) was fed on normal rodent chow(43% carbohydrate), group II(n = 14) was fed on a high CHO diet(65% carbohydrate), group III(n = 17) was fed on a high CHO diet containing 4% cholestyramine. Gallstones developed in 0% of group I, 42.9% of group II and 5.9% of group III(P< 0.05, group II vs III). To evaluate the chronic status of cholecystokinin level, the wet weight of pancreas and the average area of pancreatic acinar in microscopic high power field were measured. There was no significant difference between group II and group III in pancreatic weight and average area of pancreatic acinar(P> 0.05). In gallbladder bile analysis, there was also no significant difference between group II and group III in cholesterol, phospholipid, total calcium, total bilirubin and bile acid levels. In conclusion, cholestyramine decreases the frequency of pigment gallstone formation in high CHO diet-fed hamsters, but it is not clear whether the mechanism of cholestyramine decreasing the gallstone formation is due to the action of cholecystokinin.
Animal ; Bilirubin/metabolism ; Cholecystokinin/*analysis ; Cholelithiasis/*pathology ; Cholesterol/metabolism ; Cholestyramine/*administration & dosage ; Dietary Carbohydrates/*administration & dosage ; Female ; Gallbladder/*metabolism/pathology ; Hamsters ; Male ; Mesocricetus ; Organ Weight ; Pancreas/physiopathology ; Phospholipids/metabolism ; Pigmentation ; Support, Non-U.S. Gov't

No abstract available.

OBJECTIVE: To evaluate the concordance, or discordance, of the osteoporotic diagnosis between femur neck and lumbar spine, using DEXA T-scores and the WHO classification. MATERIALS AND METHODS: The BMD (Define?) on both hips and of the lumbar spine of 718 Korean females were measured. The mean age of the subjects was 55.5 years (31-91). The BMD data were obtained from 3 hip regions and from the lumbar spine, anteroposteriorly, using dual-energy x-ray absorptiometry (Lunar). The BMDs of femur neck and the L2-4 vertebrae were classified into normal (a T-score >-1), osteopenia (-1 < or = T-score < -2.5) and osteoporosis (-2.5< or =T-score) using the WHO definitions. RESULTS: There was significant correlation between the femur neck and lumbar BMDs (r=0.772). However, the discordance rate was 33% for all the cases, but this was 20% in the subjects below 50 of age, 31% in the subjects in their 50's, 47% in their 60's and 42% when 70 or above. The discordance rates of the normal, osteopenic and osteoporotic groups were 21, 54 and 17% respectively, with the highest discordance rate in the osteopenia group. Among the 649 persons in the normal or osteopenia groups, in relation to the femur neck BMD, there were 67 (10.3%) in the osteoporotic group with L2-4 BMD. But the reverse situation was only 12 persons from 594 (2.0%). (Eds note: this whole section makes little sense? What were the BMDs? The last sentence is completely meaningless.) CONCLUSIONS: The discordance rate between the femur neck and lumbar spine was as high as 33%, and was the highest in the osteopenia persons in their 60's. Therefore, in these persons the BMD of both sites should be checked together, but if not, the lumbar BMD should be checked first.
Absorptiometry, Photon ; Bone Diseases, Metabolic ; Classification ; Diagnosis ; Female ; Femur Neck ; Hip* ; Humans ; Osteoporosis ; Spine*

Primary Sjogren's syndrome (pSS) is a chronic autoimmune disease with welldocumented association of lymphoid malignancies during the progress of the disease. Although several types of malignancy and pseudomalignancy have been reported in pSS, low-grade non-Hodgkin's lymphomas are the most frequently observed. Reactive plasmacytosis mimicking myeloma is a very rare condition in association with pSS. We describe a 72-yr-old woman with pSS who presented with hypergammaglobulinemia, and extensive bone marrow and lymph node plasmacytosis, which mimicked multiple myeloma. In this patient, there was an abnormal differentiation of memory B cells to plasma cells in the peripheral blood suggesting underlying pathogenetic mechanism for this condition.
Aged ; Antigens, CD19/analysis ; Antigens, CD27/analysis ; Bone Marrow Examination ; Diagnosis, Differential ; Female ; Fluorescent Antibody Technique/methods ; Humans ; Multiple Myeloma/*pathology ; Plasma Cells/chemistry/*pathology ; Sjogren's Syndrome/*pathology

BACKGROUND AND OBJECTIVES: Olfactory neuroblastoma is a rare tumor arising from the olfactory neuroepithelium, for which surgery is the mainstay of treatment; but there are no generally accepted treatment approaches, according to tumor stage. In this study, we present our experiences with this tumor and the results of treatment to consider the clinical analysis and treatment modality. SUBJECTS AND METHOD: All of the patients, who had been treated for olfactory neuroblastoma at Severance hospital during the past ten years, were analyzed retrospectively and each of their diagnosis of olfactory neuroblastoma was histologically confirmed. RESULTS: Eleven patients aged 8 to 70 years were assessed, and 5 year disease-free survival rate were 60%. Sixty-four percent of those patients had received surgical treatment. Craniofacial resection was used mainly as an initial surgical treatment and followed by postoperative radiotherapy in 57% of the patients. If only cervical lymph node metastasis had developed at the initial diagnosis, elective neck treatment including bilateral neck dissection was performed. Chemotherapy was used either as postoperative adjuvant therapy, initial therapy with radiotherapy or salvage therapy, but not as an initial single treatment modality. Forty-five percent of the patients had recurrence and metastasis developed after the initial treatment. In the patients with cervical lymph node metastasis (n=1) and nodal recurrence (n=2), neck dissection was effective in nodal control. CONCLUSION: Complete surgical resection and postoperative radiotherapy were the main treatment modalities of olfactory neuroblastoma. Especially, postoperative radiotherapy is an essential treatment to both early- and advanced-stage olfactory neuroblastoma. Craniofacial resection is a main surgical modality, but in early stage, limited external intervention including endoscopic mass excision can be considered. If the patient has cervical lymph node metastasis or nodal recurrence, radical neck dissection should be performed. Chemotherapy seems to be considered as an adjuvant therapy, not single treatment modality.
Diagnosis ; Disease-Free Survival ; Drug Therapy ; Esthesioneuroblastoma, Olfactory* ; Humans ; Lymph Nodes ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Treatment Outcome*