No abstract available.
Lymphangioleiomyomatosis*

Emphysematous cholecystitis is an uncommon condition which may mimic acute cholecystitis. But it differs from acute cholecystitis in its relatively greater frequency in men and diabetics and has graver prognosis. The condition is diagnosed by demonstration of air in lumen,wall of gallbladder and/or pericholecystic space using a variety of radiographic techniques: simple abdominal radiography, ultrasonography and CT scanning. One illustrative case is presented herein and the pertinent literature is reviewed.
Cholecystitis, Acute ; Emphysematous Cholecystitis* ; Gallbladder ; Humans ; Male ; Prognosis ; Radiography, Abdominal ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: Left ventricular hypertrophy is a major cardiovascular risk factor for sudden death, acute myocardial infarction and congestive heart failure. The left ventricle is generally thought to adapt to sustained arterial hypertension with increased total peripheral resistance by developing concentric hypertrophy. In recent years, the echocardiogrphy has been developed as a noninvasive method for evaluation of left ventricular geometry and left ventricular mass. However, left ventricular adaptation to hypertension has been shown to be more complex than expected. In fact, many patients with mild to moderate hypertension exhibit normal left ventricular mass and wall thickness, other hypertensive patients have eccentric ventricular hypertrophy that is not related to systolic dysfunction, but rather to increased cardiac output and preload and in some hypertensive patients absolute and relative wall thickness is increased with normal ventricular mass(concentric remodeling). There are differences in the hemodynamics, systolic function and diastolic function in each group. METHODS: From september 1992 to August 1994, in 144 patients with untreated essential hypertension and 50 age and gender matched normal adults studied by two-dimensional, M-mode and Doppler echocardiography. In the present study we used echocardiographically derived left ventricular mass and relative wall thickness to assess the patterns of ventricular geometric adaptation to systemic hypertension and their relations to systemic hemodynamics, left ventricular load and contractile performance. RESULTS: Hypertensive group was 144 cases(M:F=68:76), the mean age 56+/-13years. Normotensive group was 50 cases(M:F=22:28), the mean age 52+/-9years. Among hypertensive patients, left ventricular mass index and relative wall thickness were normal in 42 cases(29%), 24 cases(17%) had increased relative wall thickness with normal ventricular mass(concentric remodelin),48 cases(33%) had both increased relative wall thickness and ventricular mass(concentric hypertrophy), 30 cases(21%) had increased left ventricular mass with normal relative wall thickness(eccentric hypertrophy). Concentric hypertrophy and normal left ventricle group are more common in untreated hypertensive patients in Korea. Systemic hemodynamics showed tendency to paralleled ventricular geomety. In groups with concentric remodeling and hypertrophy, perpheral resistance was increased. Cardiac index was midly increased in eccentric hypertrophy. Diastolic dysfunction was prominent tn concentric hypertrophy. CONCLUSION: Each patterns of left ventricular geometry had different systemic hemodynamics, ventricular pressure overload and ventricular volume overload. Therefore, appropriate selection of antihypertensive agent for the patients with each patterns of hypertrophy reduce the left ventricular hypertrophy and may improve the prognosis.
Adult ; Cardiac Output ; Death, Sudden ; Echocardiography ; Echocardiography, Doppler ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Korea ; Myocardial Infarction ; Prognosis ; Risk Factors ; Vascular Resistance ; Ventricular Pressure

Drash syndrome, which was first reported by Denys et al. in 1967 is a complex disorder which associates a nephropathy, Wilms' tumor, and male pseudohermaphroditism. The common denominator is a nephropathy. The nephropathy may be associated with either genital abnormalities or Wilms' tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms' tumor may appear as s mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.
46, XY Disorders of Sex Development ; Autopsy ; Biopsy ; Denys-Drash Syndrome* ; Disorders of Sex Development ; Genitalia ; Hematuria ; Humans ; Hypertension ; Karyotype ; Kidney ; Male ; Nephrectomy ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Ultrasonography ; Wilms Tumor

CT scans of 21 patients(intrathoracic goiter=7. Castleman disease=6, pulmonary carcinoid tumor=3, parathyroid adenoma=1, thyroid carcinoma=1, paraganglioma=1, benign pleural mesothelioma=1, sclerosing hemangioma=1) with mediastinal tumors that are known to be enhanced with intravenous injection of contrast media, were studied retrospectively to investigate the enhancing capabilities f those tumors and to describe their CT findings. The degree of enhancement was estimated by visual inspection with a grading system. All but one case of cystic parathyroid adenoma showed enhancement on post-contrast scan. The degree of enhancement was not helpful in differentiating these tumors. Characteristic location and pattern of tumor extension were found in cases of intrathoracic goiter, parathyroid adenoma, thyroid carcinoma and paraganglioma. Calcifications were found in intrathoracic goiter(5/7). Castleman disease(2/6). Pulmonary carcinoid(1/3), thyroid carcinoma. Necrotic low-attenuation areas were in intrathoracic goiter(7/7), parathyroid adenoma, thyroid carcinoma and paraganglioma. In conclusion, mediastinal tumors that are known to be enhanced in the literature were enhanced with rare exception, and if we consider the predilection site of those tumors, the scope of differential diagnosis can reasonably be narrowed.
Carcinoid Tumor ; Contrast Media ; Diagnosis, Differential ; Goiter, Substernal ; Injections, Intravenous ; Paraganglioma ; Parathyroid Neoplasms ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Tomography, X-Ray Computed

No abstract available.
Intestinal Atresia*

No abstract available.
Colonoscopy*

For the successful autologous chondrocyte transplantation, it is important to maximize the number of chondrocyte and maintain its original morphology and phenotypic change of the chondrocyte in the culture. In this study, the effect of ascorbic acid and human serum which are known to promote cell proliferation and collagen synthesis was observed in the culture of human chondrocyte. Media were prepared with the conditions of fetal bovine Serum(FBS) treated group, FBS +ascorbic acid(asc) treated group, human serum(HuS) treated group, and HuS+asc treated group, respectively. Proliferation was measured by cell counting using trypan-blue staining method. We used to determine the degree of expression of aggrecan of mRNA and type II collagen using RT-PCR. Type II collagen in cultured cell and medium was measured by western blot analysis and proteoglycan synthesis by DMB (Dimethylene Blue) assay. Under all conditions, aggrecan on mRNA level was well expressed. On the other hand, expression of type II collagen was reduced on HuS treated group than FBS treated group, and ascorbic acid treated groups showed decreased expression of type II collagen. Western blot analysis showed increased expression of type II collagen on HuS treated group than FBS treated group, and ascorbic acid treated groups showed increased level. HuS+asc treated group showed the most significant effect than the other groups. The increased effects of ascorbic acid on the proliferation and collagen synthesis were more prominent in the culture with human serum. It might be due to the synergic effect with some growth factors which were present in human serum.
Aggrecans ; Ascorbic Acid* ; Blotting, Western ; Cell Count ; Cell Proliferation ; Cells, Cultured ; Chondrocytes* ; Collagen ; Collagen Type II ; Hand ; Humans* ; Intercellular Signaling Peptides and Proteins ; Phenotype* ; Proteoglycans ; RNA, Messenger

There has been several reports that tissue plasminogen activator(tPA) accelerated the fibrinolysis in vitreous cavity in-vivo. We investigated the efficacy of intravitreal tPA injection(25 microgram/100 microgram, 0.1 ml) for treatment of vitreous hemorrhage in non-vitrectomized patients(58 patients, 61 eyes). 1. Visual acuity was improved in 43 eyes(70.5%) and fundus was relatively well seen in 29 eyes(47.5%). 2. There were no clinical differences of intraocular pressure between before injection and the day after injection of tPA. 3, The complication of tPA injection were rebleeding(3 eyes, 4.9%) and inflammatory reaction(1 eyes, 1.6%). On these results, it appears that intravitreal tPA injection is useful for treatment of vitreous hemorrhage before vitrectomy.
Fibrinolysis ; Humans ; Intraocular Pressure ; Plasminogen ; Tissue Plasminogen Activator* ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage*

PURPOSE: To compare the results of mitomycin C trabeculectomy and Ahmed valve implant surgery for neovascular glaucoma (NVG). METHODS: We reviewed the medical records of 58 patients (66 eyes) with NVG who had undergone mitomycin C trabeculectomy or Ahmed valve implant surgery in the previous 5 years. Trabeculectomy (A group) was performed in 27 eyes of 24 patients and valve implant surgery (B group) in 39 eyes of 34 patients. Intraocular pressure (IOP), visual acuity, complications and the rate of surgical success of the two groups were compared. IOP under 21 mmHg without medication was considered as complete success (CS), under 21 mmHg with medication as qualified success (QS), and IOP over 22 mmHg despite medication as failure (F). RESULTS: IOP at postoperative 2 months was lower in the trabeculectomy group than in the drainage implant surgery group (16.4 +/- 11.3 mmHg, 20.9 +/- 8.7 mmHg, P=.087), but at 12 months, there was no statistically significant difference (18.4 +/- 11.5 mmHg, 17.0 +/- 6.4 mmHg, P=.608). Visual acuity also showed no significant difference. The respective rate of success between A and B groups was 66.7% and 38.5% (CS), 25.9% and 33.3% (QS), and 7.4% and 28.2% (F), at postoperative 2 months, and 47.8% and 42.3% (CS), 30.4% and 46.2% (QS), and 21.7% and 11.5% (F), at 12 months. The most common postoperative complication was hyphema in both groups, while other complications were shallow anterior chamber, valve problems, etc. CONCLUSIONS: The type of surgery had no significant effect on the success rate of neovascular glaucoma treatment at postoperative 12 months.
Anterior Chamber ; Drainage ; Glaucoma, Neovascular* ; Humans ; Hyphema ; Intraocular Pressure ; Medical Records ; Mitomycin* ; Postoperative Complications ; Trabeculectomy* ; Visual Acuity