No abstract available.
Child* ; Humans

Traditionally, it has been emphasized that hemolytic disease was the primary cause of gallstones (cholelithiasis) in most young patients. In recent years, gallstones and common bile duct calculi have been increasingly diagnosed in infants and children, unrelated to hemolytic diseases. On the matter, the World Health Organization (WHO) classified intraepithelial neoplasia (dysplasia) of gall bladder as one of the precursor lesions of invasive cancer. The following article describes the case of a 2-year-old girl who had a laparoscopic cholecystectomy due to cholelithiasis and the pathologic diagnosis was chronic cholecystitis with diffuse, mild mucosal dysplasia.
Child ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholelithiasis ; Gallbladder ; Gallstones ; Humans ; Infant ; Preschool Child ; Urinary Bladder ; World Health Organization

No abstract available.
Appendicitis* ; Barium* ; Enema*

No abstract available.
Subcutaneous Tissue*

No abstract available.
Classification* ; Joints*

PURPOSE: To analyze the characteristies of traumatic brainstem injury by CT and MR MATERIALS AND METHODS: CT and MR studies of 10 patients with traumatic brainstem lesion in MR were retrospectively reviewed, particularly attended to location, signal intensity and associated lesions. RESULTS: CT failed to depict 8 of 10 brainstem lesions. All lesions were detected in MR images with T2-weighted images showing higher detection rate (n=10) (100%) than Tl-weighted images (n=3) (30%) or CT (n=2) (20%). The brainstem lesions located in the dorsolateral aspects of the rostral brainstem(mid brain and upper pons)in 7 (70%) cases, in ventral aspects of rostral brain in 2 (20%) cases and in median portion of pons in 1 (10%) case. Corpus callosal (n=5), Iobar white matter(n=5) diffuse axonal injury, and 2 hemorrhagic lesions in basal ganglia were the associated findings. CONCLUSION: MR imaging is more helpful than CT in the detection of brainstem injury, especially T2 weighted images. Primary brainstem lesions were typically located in the dorsolateral aspect of rostral brainstem(midbrain and upper pons). Corpus callosum and white matter lesions were frequently associated.
Basal Ganglia ; Brain ; Brain Stem* ; Corpus Callosum ; Diffuse Axonal Injury ; Humans ; Magnetic Resonance Imaging ; Pons ; Retrospective Studies

A total of 33 patients with infective endocarditis were observed in the Guro and Hye Hwa Hospitals of Korea University Between September, 1981 and Feb, 1987. Among thses patients four patients presented with heart murmur and heart failure and had vegetation like findings observed on the two dimensional echocardiography. But these patients did not have any fever or leukocytosis in the peripheral blood and the repeated blood cultures were negative. They showed the immunologic phenomena of infective endocarditis such as microscopic hematuria in 4 patients, rheumatoid factor in 3 patients, false positive VDRL in one patient. The serum complement was decreased in 2 patients in whom it was checked. We report these 4 patients because we think these patients might be in the clinical stage in which the infecting organism is spontaneously cleared but the immunologic sequelae are remained.
Complement System Proteins ; Echocardiography ; Endocarditis* ; Fever ; Heart Failure ; Heart Murmurs ; Hematuria ; Humans ; Korea ; Leukocytosis ; Rheumatoid Factor

Neurocristopathy is characterized as having a common origin in aberrant neural crest development. Congenital central hypoventilation syndrome (Ondine's curse) is characterized by marked depression of respiratory drive during sleep and normal ventilation while awake because of no response to both hypercapnea and hypoxia. The girl was full-term, weighing 3020 grams. The girl had poor respiratory effort at birth, but improved with oxygen supply and stimulation. abdominal distention and calcification were noted. During laparotomy transitional zone was found at distal jejunum; a jejunostomy was constructed. Numerous attempts at extubation failed because of apnea. The results of an apnea work-up, including brain sonography, echocardiogram, were normal. The girl died of sepsis at 37 days of age. para-aortic ganglioneuroblastoma was found on autopsy. We experienced a newborn with congenital central hypoventilation syndrome, Hirschsprung's disease and congenital ganglioneuroblastoma representative of neurocristopathy.
Anoxia ; Apnea ; Autopsy ; Brain ; Depression ; Female ; Ganglioneuroblastoma* ; Hirschsprung Disease* ; Humans ; Hypoventilation* ; Infant, Newborn* ; Jejunostomy ; Jejunum ; Laparotomy ; Neural Crest ; Oxygen ; Parturition ; Sepsis ; Ventilation

Nuclear DNA content of 32 cases of prostate adenocarcinoma diagnosed 1986-1991 was determined by flow cytometry, with the use of paraffin-embedded archival tissue. The present study was done to define the relationship between clinical stage, histopathological grade, and DNA ploidy. Aneuploidy was found in 10(31.3%) cases including 7 cases of near-tetraploidy. Among diploid tumors, 36.4% were localized disease(stage A and B), 13.6% were characterized by invasion outside the prostate(stage C), and 50.0% showed distant metastasis(stage D). Among aneuploid tumors, 10.0% were stage B, 50.0% stage C, and 40.0% stage D. The degree of glandular differentiation was characterized by the Gleason score and the percentage of sampled tissue involved by carcinoma was graded by Dhom's method. Apparent correlation was found between Gleason grade and Dhom grade(P<0.05). All 13 tumors with a Gleason grade I(score of 2 to 5) were diploid. Four of 9 tumors with a Gleason grade II(score of 6 to 7) were aneuploid(near-tetraploidy 33.3%, aneuploidy 11.1%) and 60.0%, of tumors with a Gleason grade III(score of 8 to 10) were aneuploid(near-tetraploidy 40.0%, aneuploidy 20%). The percentage of aneuploid cases increased with advanced clinical stage, but the relationship between aneuploidy versus clinical stage was not significant. However, it can be concluded that DNA ploidy correlates well with Gleason grade(p<0.05), which may have predictive prognostic value for prostate adeno-carcinomas.
Adenocarcinoma

BACKGROUND: The increasing implementation of organ transplantation requires an unequivocal diagnosis of brain death for moral and legal reasons. Among instrumental investigations, angiographic demonstration of absent intracranial blood flow is considered to be the most reliable test in diagnosing brain death. This test should be easily accessible since most brain dead patients are vitally unstable and have various life-supporting equipments besides their beds. To investigate the usefulness of an intracranial CT angiography (CTA) for the diagnosis of brain death, we performed CTA in comatose patients who were either clinically brain dead or not. METHODS: Fourteen comatose patients (11 male and 3 female, aged from 17 to 63 years) with various brain insults were included in this study. Eleven patients were clinically brain dead. Among the remaining three patients, one showed subtle withdrawal movements in one extremity to noxious stimuli with absent brainstem reflexes, and the other two showed multifocal myoclonic seizures. CT scanning was performed with a table speed of 2 mm/sec, twenty seconds after beginning an injection of contrast media. The data were reformatted by maximum intensity projection (MIP) and shaded surface display (SSD) after the reconstruction of a 1 mm interval. A portable electroencephalography (EEG) was also taken serially in clinically brain dead patients except one. RESULTS: Intracranial arterial blood flow was preserved in those who showed either a seizure, abnormal posture or intact brainstem reflexes. On the other hand, intracranial arteries were not visualized in all brain dead patients with electrocerebral silence (ECS) on their EEG with the exception of one patient whose EEG was difficult to determine a ECS due to excessive mechanical artifacts. However, in the clinically brain dead patients, the intracranial arterial flow was preserved in those who suffered from widespread brainstem and cerebellar infarction or whose EEG demonstrated periodic lateralizing epileptiform discharges or a burst suppression pattern. CONCLUSIONS: Intracranial CTA seems to be a safe and noninvasive procedure for the determination of brain death that produces fast, reliable, and easy-to-interpret results. It can be used as an alternative method to the EEG when the EEG is not possible or difficult to interpret due to artifacts.
Angiography* ; Arteries ; Artifacts ; Brain Death* ; Brain Stem ; Brain* ; Coma ; Contrast Media ; Diagnosis ; Electroencephalography ; Extremities ; Female ; Hand ; Humans ; Infarction ; Male ; Organ Transplantation ; Posture ; Reflex ; Seizures ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Transplants