During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complication. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-up in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examination in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examination in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis(n=5) and perforated appendicitis(n=1). Our results show that high-resolution, real-time US is an accureate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complication.
Abscess ; Adenocarcinoma ; Appendicitis* ; Appendix ; Diagnosis* ; Diverticulitis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography*

No abstract available.
Animals ; Captopril* ; Cisplatin* ; Nifedipine* ; Rats*

Although the mechanism of the development of hypertension has not been fully elucidated, abnormal ion transport across the cardiovascular musle membrance may play some role in this mechanism. The elevation of intraceular sodium by inhibition of the Na(+), K(+)-ATPase diminshes the sodium gradient for calcium extrusion and/or increase Na(+)/Ca(++) exchange across the cell membrance. In any event, contractility and vascular tone of cardiovascular system can be incresed as reslut of an increase of intracellular calcium. Recently it is reported that the defects of Na(+), K(+)-ATPase occur in spontaneously hypertensive rat(SHR) hearts, compared to control normotensive Spargue Dawley(SD) rat hearts. However, one missing, unresolved question arose in the previous reports in whether the reduced Na(+)-pump activity in the heart of SHR is associated with the development of hypertension itself in these animals or is a consequence of inhertied pathological features that later reslut in a reduced pump activity. In order to clearify this question it is attempted to measured to measure the change of the Na(+), K(+)-ATPase activities in cardiac sarcolemma purified from both the normotensive SD rats and SHR rats during growth ; Simultaneously the charge of cation concentration in both intracellular space(RBC) and extracelluar space(ECF) are measured to the erythrocyte test(Garay and Meyer) applied to the clinical investiation of hypertension. The results obtained are summarized as follows ; 1) The systolic blood pressure of 7 week old SHR was 120-130mmHg, which was not significantly different from that of the age-matched SD rats. However, the blood pressure was elevated to 160-170mmHg in 13-15 week old SHR, even elevated to 190mmHg in one of 19 week old SHR. On the other hand, SHR, in which hypertension was well established had pronounced cardiac hypertrophy. 2) The Na(+), K(+)-ATPase activities in cardiac sarcolemma of the SHR rats were decreased gradually as hypertension established.The decrease of Na(+), K(+)-ATPase was well associated with the increase of intracellular potassium concentration.By contrast, thr Na(+), K(+)-ATPase activities and cation transports og the normotensive SD rats were not significanlty chaged during growth. 3) The charges of Na(+), K(+)-ATPase activities in SHR were specific because the activities of Ca(++)-ATPase which is one of the membrance bound enzyme were not changed during growth appeared to be a major fator which generated hypertension in SHR rats. However, question on how the Na(+), K(+)-ATPase activities are decreased and which event is initiative between reduction of Na(+), K(+)-ATPase and development of hypertension are still remained unclear. Recent literature suggests the there might be a genetic factor, so-called Na(+)-pump inhibitor, involved in the meachanism.
Animals ; Blood Pressure ; Calcium ; Cardiomegaly ; Cardiovascular System ; Erythrocytes ; Hand ; Heart ; Hypertension ; Ion Transport ; Potassium ; Rats ; Rats, Inbred SHR* ; Sarcolemma ; Sodium

BACKGROUND: Preservation of antigen determinants while retaining morphological detail is prerequisite for high quality immunohistochemistry. Conventional formalin fixation and paraffin embedding procedures are useful in preserving tissue architecture and cytologic detail. However, they destroy the antigenicity of many proteins is tissue samples. On the other hand, fresh frozen section preserve the antigenicity of most proteins, but vield poor morphological preservation. OBJECTIVE: The purpose of this study is to evaluate the AMeX method as to the ability to preserve both antigenicity and morphologic details of the skin basement membrane zone so that precise localization of antigens can be attained in immunohistochemistry. METHODS: Tissues were fixed in acetone at -20degrees C over night, then cleared in methyl benzoate and xylene, consecutively, and embedded in ordinary paraffin at 58-60degrees C. Sections made from this paraffinembedded tissue were stained with hematoxylin and eosin for a morphologic study and immunolabelled with antibodies against major basement membrane antigens to evaluate antigenic preservation. The staining intensity and preservation of the morphology by the AMeX method were compared with conventional formalin processed tissues and frozen tissues. RESULTS: Morphological preservation of the AMeX method-processed sections was good throughout the epidermis, basement membrane, and dermis, and as good as that of routinely formalin-fixed paraffin-embedded sections. Frozen sections usually revealed revealed various degrees of damage by ice crystal formation throughout the epidermis to the dermis. The AMeX method-processed sections showed better or same antigenic preservation comparing the frozen sections when the sections were immunolabelled with specific monoclonal antibodies. But, when the sections were immunolabelled with patient's sera, the AMex method showed less antigenic preservation than the frozed sections. The anti-type IV collagen monoclonal antibody exhibited immunoreactivity only conventional formalin-fixed paraffin-embedded skin sections, but the intensity of the staining was weaker than the AMeX processed sections and the frozen sections. CONCLUSION: The AMeX method can be utilized for the demonstration of skin basement membrane antigens and is superior to the fresh-frozen method in that the histologic figures are more distinct and antigencity can be preserved for a long time.
Acetone* ; Antibodies ; Antibodies, Monoclonal ; Basement Membrane* ; Benzoates* ; Collagen ; Dermis ; Eosine Yellowish-(YS) ; Epidermis ; Formaldehyde ; Frozen Sections ; Hand ; Hematoxylin ; Ice ; Immunohistochemistry ; Paraffin ; Paraffin Embedding ; Skin* ; Xylenes*

No abstract available.
Emergencies* ; Emergency Medicine* ; Internship and Residency*

1. A Case of osteosarcoma is reported which arose 8 years after synovima of the knee had been locally excised. The patient is a 51-year-old housewife who had received irradiation therapy upon her knee for 30 days post-operatively. Following irradiation, asymptomatic latent period lasted 8 years when mass appeared on the site, which was biopsied and diagnosed as osteosarcoma one year later. 2. This case generally suffices the McKennas criterias for irradiation-induced osteosarcoma, 3. It seems to be worthwhile to keep an eye upon the prognosis of this possible case of irradiation- induced osteosarcoma, which is largely reported to be very grave.
Humans ; Knee ; Middle Aged ; Osteosarcoma ; Prognosis ; Sarcoma, Synovial

Functional-Below-Knee Total Contact Cast characterized by early weight bearing and free motion of affected knee joint during the cast immobilizaton has brought to significant result on trearment of tibial fractures, and is considered to take early bony union by establishment of almost physiological environment on fracture site during immobilization. For recent 2 years, writers have experienced many tibial fractures to treat with Functional Below-Knee Total Contact Cast. In them, clinical data and results of 17 cases which were studied well are reviewed, and method of cast application is illustrated.
Clinical Study ; Immobilization ; Knee Joint ; Methods ; Tibial Fractures ; Weight-Bearing

CT has become one of the most important diagnostic method in the evaluation of ruptured intracranial aneurysm with direct detection of subarachnoid, intracerebral and intraventricular hemorrhage, and identification of complications such as recurrent bleeding, hydrocephalus and infarction secondary to arterial spasm. Angiography gives precise information on the location, size of aneurysm and presence of arterial spasm. Authors attempted toperedict the location of ruptured intracranial aneurysm confiremd by CT and angiography at Keimyung University Hospital for last 2 years. The results were as follows; 1 The age and sex distribution; the most prevalent agegroup was 5th to 6th decades (70%), and female patient was slightly more than male patient(57.5%: 42.5%). 2. The locaiton of aneruysms were; posterior communicating artery group 17 cases (42.2%), middle cerebral artery group 10 cases (25.0%), anterior communicating artery group 7 cases (17.5%), basilar artery bifucation 1 case (2.5%),posterior inferior cerebellar artery 1 case(2.5%), and multiple aneurysms 4 case (10%) in order to frequency. 3.Characteristic distributions of intracranial hemorrhage in CT were as follows; 1) In 6 cases (85.7%) of anterior communicating artery aneurysm, interhemispheric fissure hemorrhage was noted. 2) The ipsilateral sylvian fisuurehemorrhage was noted in all cases of middle cerebral artery aneurysm(10 cases) and 12 cases (70.6%) of posterior communicating artery aneurysm. 3) Localized hematoma in frontal lobe near interhemispheric fissure (2 cases:28.6%), septum pellucidum (1 case: 14.3%) and corpus callosum (1 case: 14.3%) were characteristic in anterior communicating artery aneurysm. 4) Comma-shape sylvian fissure hematoma (5 cases: 50%) and temporal lobe hematomanear sylvian fissure (5 cases: 50%) may indicate middle cerebral artery anerysm, 5) Intraventricular hemorrhage (6cases: 15%) has no particular predilection of aneurysmal location. 4. In 9 patients (22.5%) of clinicallysuggesting subarachnoid hemorrhage, no extravasated blood was noted in preenhancement CT alone. 5. Six cases (15%)showed aneurysm itself on preenhancement CT as a round or ovoid hyperdense area or isodense area with mass effectsuch as cisternal obliteration. 6. Hydrocephalus was noted in 9 cases (22.5%). 7. There was no direct correlation between the size of the intracranial aneurysm and extent of the hemorrhage in CT, and between the size of the intracranial aneurysm and clinical grade. 8. There was direct correlation between the extent of blood in CT andclinical grade.
Aneurysm ; Angiography ; Arteries ; Basilar Artery ; Corpus Callosum ; Female ; Frontal Lobe ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Infarction ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Male ; Methods ; Middle Cerebral Artery ; Septum Pellucidum ; Sex Distribution ; Spasm ; Subarachnoid Hemorrhage ; Temporal Lobe

We assessed quantitatively conjunctival biopsy specimens from 48 primary open angle glaucoma patients[62 eyes]undergoing filtration surgery by light microscopy. The patients were subdivided depending on age, sex, and their therapeutic regimen and duration before surgery. With age, there was a significant increase in lymphocytes and macrophages within the substantia propria of conjunctiva[p<0.05]. The longer the total treatment duration with topical antiglaucoma medication was, the higher the number of lymphocytes and macrophages were[p<0.05]. Whereas, when the treatment duration was adjusted, there was no significant difference between the single therapeutic regimen group and the multiple regimen group. There were some differences in the number of fibroblasts, lymphocytes and macrophages between the group that needed postoperative-antiglaucoma medication[surgical failure group]and the group without postoperative-antiglaucoma medication[surgical success group]but there were no statistically significant differences. In conclusion, administration of topical medication induced a significant degree of subclinical inflammation and change of conjunctival cell profile. However it did not depend on multiple drug regimen but on total treatment duration.
Biopsy ; Fibroblasts ; Filtering Surgery ; Filtration* ; Glaucoma, Open-Angle ; Humans ; Inflammation ; Lymphocytes ; Macrophages ; Microscopy

The adrenal gland is the second most common site of metastasis from a hepatocellular carcinoma (HCC). Radiofrequency ablation (RFA) for these tumors has been reported to be a potentially effective alternative to an adrenalectomy, especially for inoperable patients. However, for intermediate or large adrenal tumors, combination therapy of transarterial chemoembolization (TACE) and RFA can be attempted as it may reduce the heat sink effect. A 74-year-old patient presented with abdominal discomfort. Abdominal CT images revealed a 5.0 cm sized right adrenal mass. A percutaneous biopsy of the adrenal mass revealed a metastatic hepatocellular carcinoma. TACE was performed on the adrenal mass. However, a one-month follow-up CT image revealed a residual viable tumor. RFA was performed for the adrenal tumor six weeks after the TACE. No procedure-related major complications were noted. The serum alpha-fetoprotein level had also been normalized after the treatment, and 10-month follow-up CT images showed no definite evidence of viable adrenal tumor.
Adrenal Glands ; Adrenalectomy ; Aged ; alpha-Fetoproteins ; Biopsy ; Carcinoma, Hepatocellular* ; Catheter Ablation* ; Follow-Up Studies ; Hot Temperature ; Humans ; Neoplasm Metastasis ; Tomography, X-Ray Computed