Two cases of Bleeding Meckel's Diverticulum Using (99m)Technetium-Pertechnetate Scanning are presented. (99m)TC-pertechnetate was used in the diagnosis of Meckel's Diverticulum by Jewette et al in 1970 for the first time. The affinity of this isotope for the parietal cell of the gastric mucosa makes it ideal for delincating ectopic gastric tissue. It noninvasiveness can be used in early screening test of occult gastrointestinal bleeding in pediatric age group.
Diagnosis* ; Gastric Mucosa ; Hemorrhage* ; Humans ; Mass Screening ; Meckel Diverticulum* ; Rabeprazole ; Sodium Pertechnetate Tc 99m*

No abstract available.
Ear*

No abstract available.
Transsexualism*

PURPOSE: The purpose of this study is to assist the optimal placement of sacroiliac screw by evaluating the anatomic and radiologic features of upper sacrum. MATERIALS AND METHODS: Fourteen fresh-frozen cadaveric pelvises and 13 normal adults were studied for the evaluation of morphology of first sacrum and dysplastic patterns. Measurement of anatomic parameters and CT imaging of pelvis were performed. Thirty-two patients with complicated pelvic fracture were evaluated for detection of variations in the sacral alar anatomy and slope found in upper sacral segmentation. RESULTS: The mean distance between midpoint of sacrum and sacroiliac joint was 52.75 mm. The height of first sacral body was 21.71 mm. The longest antero-posterior distance in sacral alar was 52.36 mm. The mean angle between the coronal plane of S1 vertebra and anterior aspect of the alar was 29.3 degree. The mean angle between the superior aspect of S1 vertebral body and superior edge of the alar was 34.8 degree. The mean angle between the superior aspect of S1 vertebral body and supero-posterior edge of the alar was 12.5 degree. The studies revealed about 28 to 33% of cases as dysplastic sacrum. CONCLUSIONS: We studied anatomic and radiologic features of upper sacrum in cadaveric and clinical cases to gain information on the optimal placement of sacroiliac screw.
Achilles Tendon* ; Adult ; Cadaver ; Humans ; Pelvis ; Rupture* ; Sacroiliac Joint ; Sacrum ; Spine

Primary peptic ulcer disease in not known to be the result of underlying illness or trauma. These are most frequently duodenal or prepyloric. Since clinical features of peptic ulcer in children can easily be confused with many other disorders, the diagnosis is usually made when one of the more dramatic presentations, such as perforation, bleeding and obstruction. Recently, we experienced 2 cases of duodenal obstruction due to peptic ulcer in children. So, we report it with review of references.
Child* ; Diagnosis ; Duodenal Obstruction* ; Hemorrhage ; Humans ; Peptic Ulcer*

Portal vein anomalies include absence, duplication, and malposition (preduodenal portal vein). Duplication of the portal vein or a preduodenal portal vein are hazards at the time of biliary or duodenal surgery, or liver transplantation. Preduodenal portal vein, which was first reported by knight in 1921, is extremely rare congenital anomaly and may cause duodenal obstruction. Recently, we experienced a case of preduodenal portal vein associated with dextrocardia, situs inversus, and duodenal obstruction in a 3 days old male newborn and report with review of the references.
Dextrocardia ; Duodenal Obstruction* ; Humans ; Infant, Newborn ; Liver Transplantation ; Male ; Portal Vein* ; Situs Inversus

No abstract available.
Gastrointestinal Neoplasms* ; Thymidine Kinase* ; Thymidine*

PURPOSE: This study was performed to determine the incidence of BMM and to correlate the presence of these micrometastases with prognosis and othet clinicopathologic features. Materials AND Methods: BMM was evaluated in 220 breast cancer patients between July, 1991 and January, 1997, using mouse monoclonal antibody (AE1/AE3) against cytokeratin in an immunofluorescent assay. RESULTS: Of the 220 patients, 71 (32.3%) were positive for BMM. There were no association between bone marrow positivity and nodal status, TNM stage, known histopathologic parameters, and hormona1 receptor. Median follow-up for 220 patients was 41.6 month. The relapse rate was 16.8% (37/220). Twenty-four (33.8%) of 37 patients were positive for BMM and 13 (8.7%) were negative (p<0.05). Bone metastasis occurred in 16 cases, and was more common in BMM positive patients (14 of 24, 54.2%, versus 2 of 13, 15.4%, p < 0.05). Twenty-six patients were died of relapsed breast cancer. In overall survival, patients who was negative for BMM showed higher survival rate (p<0.05). CONCLUSION: BMM was a good predictor for distant metastasis, especially bone metastasis, and for poor prognosis. But no association was found between bone marrow positivity and tumor size, nodal status, stage, histologic parameter and hormonal receptor status.
Animals ; Bone Marrow* ; Breast Neoplasms* ; Breast* ; Fluorescent Antibody Technique ; Follow-Up Studies ; Humans ; Incidence ; Keratins ; Mice ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Prognosis ; Recurrence ; Survival Rate

PURPOSE: Traditionally vascular reconstruction has been reserved for patients with limb threatening ischemia. So, the surgery for claudication has been discouraged by the fear of bypass graft failure, limb loss, and significant perioperative complication that may be worse than the natural history of the disease. However, in a minority of patients with claudication, the symptoms progress and a severe disability can result, which limit normal daily activities. In these patients intervention may be regarded as worthwhile. METHODS: To evaluate the benefit or risk of revascularization that performed in patients with disabling or incapacitating intermittent claudication, the clinical data of patients who underwent the revascularization for disabling claudication at Yeungnam University hospital were collected and analyzed retrospectively. RESULTS: From January 1990 to June 1999, 98 patients with disabling claudication were performed the surgical or interventional management (13.7% of all lower limb arterial disease registration in our unit). The patients were 93 males and 5 females ranging from 35 to 76 years of age. The mean age was 59, with the highest incidence among people in their 50s, followed by those in their 60s and then in their 70s. History of smoking was noted in 82.7% of the cases. The major arterial occlusive site were aortoiliac artery in 42 cases (42.9%), femoral artery in 23 cases (23.5%), iliofemoral artery in 13 cases (13.3%), popliteal artery in 4 cases (4.1%), tibial artery in 5 cases (5.1%) and multi-level occlusion in 11 cases (11.2%). The operative procedures for disabling claudication were bypass graft operation in 70 cases, thromboembolectomy in 5 cases, endarterectomy in 4 cases and percutaneous transluminal angioplasty (PTA) in 19 cases. Arterial bypass operations were aortobifemoral or aortobipopliteal bypass in 17 cases, iliofemoral bypass in 8 cases, femoropopliteal bypass in 16 cases, femorotibial bypass in 3 cases, popliteotibial bypass in 6 cases, axillobifemoral bypass in 7 cases and femorofemoral bypass in 13 cases. In 98.4% of the operative cases, the early outcome was good with 3 to 2 rating according to Rutherford criteria and cumulative 12, 24, 60-month primary and secondary patency rates were 83.3%, 76.4%, 71.3% and 87.8%, 86.3%, 81.8%. The operative mortality rates were 0% and no limb loss was noted in this series. CONCLUSION: In summary, arterial reconstruction for disabling claudication is noted as safe and durable procedure in some selective patients. Therefore, surgical intervention are valid treatment option in selected patients with disabling claudication.
Angioplasty ; Arteries ; Endarterectomy ; Extremities ; Female ; Femoral Artery ; Humans ; Incidence ; Intermittent Claudication* ; Ischemia ; Lower Extremity ; Male ; Mortality ; Natural History ; Popliteal Artery ; Retrospective Studies ; Smoke ; Smoking ; Surgical Procedures, Operative ; Tibial Arteries ; Transplants

BACKGROUND: Visceral ischemia-reperfusion produces injury both to the visceral organs that are made ischemic and to distant organs, such as the lung, that are not made ischemic. The pulmonary injury after visceral ischemia-reperfusion is, in part, a result of the production and release of a variety of humoral factors, such as proinflammatory cytokines, activated complements and lipid mediators. Two proinflammatory cytokines, tumor necrosis factoralpha (TNFalpha) and interleukin (IL)-1, have been implicated as early initiators of this response to visceral ischemia-reperfusion injury. Recently, additional concepts have been developed to block the synthesis and release of proinflammatory cytokines by using anti-inflammatory cytokine. Interleukin (IL)-10 inhibits proinflammatory cytokine which is produced by activated monocyte/ macrophages and prevents production of TNFalpha in acute inflammatory states. The purpose of this study is to determine the effect of exogenous administration of the anti-inflammatory cytokine, recombinant human IL-10, on proinflammatory cytokine production and pulmonary injury after visceral ischemia-reperfusion. METHODS: Two hours before 25 minutes of supraceliac aortic clamp, ICR mouse which weighed 30-40 g were injected with 0.2 microgram and 2.0 microgram of recombinant human IL-10 intraperitoneally and classified into A and B treatment groups, respectively. A control group underwent 25 minutes of supraceliac aortic clamp, and then reperfusion only. A sham group underwent laparatomy only. Two hours after reperfusion, all animals were sacrificed and submitted for a study of serology and histologic changes. To determine the pulmonary injury, wet/dry ratio, tissue myeloperoxidase (MPO) assay of the lung were measured and the microscopic findings for the lung tissue were analyzed. To evaluate the change in the cytokine during study, murine serum TNFalpha level was also measured. RESULTS: The wet/dry ratios of the lung tissue were significantly decreased in both IL-10 treatmentgroups (A and B treatment group) compared to the control group (p<0.05, p<0.05). The tissue MPO assays of the lung were significantly decreased in the IL-10 2.0 microgram treatment group (B treatment group) compared to the control group (p<0.05). The level of serum TNFalpha was also decreased in B treatment group compared to the control group (p<0.05). Microscopic findings revealed severe neutrophilic infiltration and microvascular congestion in the control group, but in both IL-10 treatment groups, neutrophilic infiltration and microvascular congestion were mild or moderate. CONCLUSIONS: The inhibitory effect of IL-10 on pulmonary neutrophil infiltration and on the level of TNFalpha during visceral ischemia-reperfusion injury was significant in the experiment. The use of exogenous IL-10 may offer a new therapeutic approach for decreasing the complications associated with visceral ischemia-reperfusion.
Animals ; Complement System Proteins ; Cytokines ; Estrogens, Conjugated (USP) ; Humans ; Interleukin-10* ; Interleukins ; Ischemia* ; Lung ; Lung Injury* ; Macrophages ; Mice ; Mice, Inbred ICR ; Necrosis ; Neutrophil Infiltration ; Neutrophils ; Peroxidase ; Reperfusion ; Reperfusion Injury ; Tumor Necrosis Factor-alpha