The detection of renal disorders now involves a series of complicated diagnostic procedure such as radiologic pyelography, function studies in laboratory and others These add up to a painful, expensive, and time consuming experience for the patient, others may be spared the discomfort of unnecessary. Consequently, the development of methods for preliminary screening of patients is significant both with regard to the diagnostic information obtained and to the selection of those patients requiring complete urologic work up. In particular, a reliable screening test is important in establishing or ruling out renal pathology as an underlying factor in hypertension the finding of a disorder of one kidney in the hypertensive patient may be at indication for nephrectomy or other surgical measures of renal artery. A positive preliminary investigation warrants precise diagnosis by aortography and confirmation by individual renal clearance tests. Finally the primary objective of the screening test is the restriction of more exacting procedures such as aortography with its inherent risk of serious complications to the preoperative evaluation of a demonstrated lesions. The visualization of an internal structure by determining the spatial distribution of a gamma radiation-emitting isotope was started in 1950 when Cassen and his associates utilized newly developed scintillation counters to print mechanically the spatial distribution of radioactive iodine in the thyroid gland. Visual and functional informations referable to each kidney separately may be obtained by radioisotopes and tracer or by scanning techniques rapidly and without trauma. The renogram or tracing of the renal uptake and excretion of a labeled contrast medium is a clinically useful measure of renal vascularity, tubular cell function, and the patency of the upper urinary passage, and especially valuable as a screening test for the hypertensive patient with suspected unilateral disease of the kidney. Similarly, scanning images are achieving an important place in medical diagnosis of irregularities effecting the kidneys and other specific organs. Radioactive contrast media, such as I131 labeled diodrast, miokon, Urokon, or hippuran have been widely used for renal function studies. They are entirety unsatisfactory, however, for renal scintillation scanning because they are rapidly excreted by the kidneys without retention in the renal parenchyma in contrast but mercurial diuretics labeled with radioactive mercury are concentrated to a high degree in the renal tubular cells, chiefly in the cortex, prior to their appearance in the urine (Borghgraef 1956.MaAfee and Wagner 1960). Following the report of these letter writers, scintillation scanning of the kidney after the intravenous injection of Hg Neohydrin have been widely used in urological clinics for preliminary screening method of renal disease such as delineating the parenchyma of the kidney and space-occupying lesions by Krevitz, Berk, and others(Reley, Blahd, Mins, Morgan, Kuhl, Bender, Simmons, Blau, Kim) and remained several problems which is anticipated to improvements in resolution for further using of renal scan. The main purposes of this experimental study were: 1) to learn at which period of time it is best to visualize the renal parenchyma following the intravenous administration of Hg Neohydrin, 2) to learn the minimal detectable size of space-occupying lesion within the kidney phantom, and 3) to compare the renal scan with aortography and pyelography on various period of hydronephrosis for visualization of renal parenchyma, 4) to compare the renal scan with aortography on various degree of narrowing of the renal artery for visualization of renal parenchyma. MATERIALS AND METHODS: These experiments have been performed on 17 normal adult mongrel dogs anesthetized with intravenous injection of sodium amycal. Ofthese 3 dogs were used for determining the optimal time of visualization of the renal parenchyma. 8 dogs for the visualization of the parenchyma of hydronephrotic kidneys as created by partial ligation of the left ureter for the period of 1. 2. 3 and 4 weeks as devided in 4 groups, and 6 dogs were used for the visualization of the narrowed renal artery produced by partial obstruction to various degrees. A wax phantom of the kidney was utilized for the study of detectable minimal size of the intrarenal space occupying lesion, the phantom measures 12.5 X 6.2 X 3.5cm. All animals underwent renal scintiacan received 80 microcuri of Hg neohydrin intravenously, they were placed in a prone position and the study was carried out using a Nuclear-Chicago dual scanner with a 62-hole coarse focusing collimator containing a 3x3 inch sodium iodide crystal, the collimator was passed back and forth over the target are at a rate of 12-15cm, per minute. The scan usually required 30 minutes for complete of scan. The pyelography was performed in retrograde way with 30% diodrast injected through ureteral catheter and the amount of dye injected was adjusted to replace the urine from renal pelvis. The aortography was performed by transfemoral arterial catheterization technique as described by Seldinge. RESULTS: 1. The optimal opacification period of renal parenchyma after injection of Hg 203 neohydrin was found to range from 1 to 6 hours 2. By kidney phantom study it was demonstrated that the space-occupying lesion measuring 2cm. in diameter can not be detected on scan. While the lesion measuring 3cm, or more can be successfully visualized. 3. The effect of partial obstruction of the ureter upon the renal scintiscan for visualization of renal parenchyma was not. dependable, the renal scintiscan continued to appear up to at least the 2 weeks after partial obstruction of ureter whereas the retrogredepyelography and aortography showed the definite picture of hydronephrosis to various degree. 4. The renal scan is inconsistent in many instances of renal artery stenosis, the scan showed a diminished concentration of mercury in the kidney with stenotic main renal artery and complete failure of visualization of the renal substance in cases with completely obstructed renal artery. 5. It is possible to demonstrate the value and usefulness of renal scan of Hg neohydrin as a routine preliminary screening test for renal pathology, the alteration of the concentration of the mercury can might be expected to give additional information.
Administration, Intravenous ; Adult ; Animals ; Aortography ; Catheterization ; Catheters ; Contrast Media ; Diagnosis ; Diuretics ; Dogs* ; Humans ; Hydronephrosis ; Hypertension ; Injections, Intravenous ; Iodine ; Iodopyracet ; Kidney ; Kidney Pelvis ; Ligation ; Mass Screening ; Nephrectomy ; Pathology ; Prone Position ; Radioisotopes ; Renal Artery ; Renal Artery Obstruction ; Scintillation Counting ; Sodium ; Sodium Iodide ; Thyroid Gland ; Ureter ; Urinary Catheters ; Urography

ICAM-l(Intercellular adhesion molecule-1) is an important early marker of immune activation and response. ICAM-1 is expressed on varous cell types and observed in a variety of diseases, including patients with asthma, melanoma, prostatic cancer, ovarian and colon cancer. Some authors demonstrated the expression of ICAM-1 protein in high-grade intraepithelial squamous neoplasia of cervix by immunohistochemistry and suggested that the expression was related to human papillomavirus infection. The aim of this study was to determine the serum levels of soluble intercellular adhesion molecule-1(sICAM-1) in patients with squamous cell carcinoma of the cervix, Serum levels of sICAM-1 were measured by enzyme-linked immunosorbent assay(ELISA), We evaluate invasive squamous cell carcinoma of the cervix (40), carcinoma in situ (16) and control (15) patients. Serum levels of sICAM-1 in healthy volunteers, in parients with carcinoma in situ and invasive cervical cancer were 150.1+/-41.3, 182.7+/-105.9, 189.8+/-60.0 ng/ml, respectively. Although the serum levels of sICAM-1 in patients with carcinoma in situ did not increase, serum levels of ICAM-1 in patients with invasive cervical cancer were significantly increased (control vs invasive cervical cancer, p < 0,05). From the above results, sICAM-1 is shed from the cancerous tissue in patients with squamous cell carcinoma of the cervix.
Asthma ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri ; Colonic Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Female ; Healthy Volunteers ; Humans ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Melanoma ; Papillomavirus Infections ; Prostatic Neoplasms ; Uterine Cervical Neoplasms*

Congenital chylothorax is a rare disorder and can be diagnosed by prenatal ultrasonography recently. Most cases of congenital chylothorax were characterized by different clinical courses of respiratory distress. We describe two female cases with congenital chylothorax observed by ultra- sonography prenatally. In the first case, left-sided pleural effusion was noted by prenatal ultrasonography taken at 34 weeks of gestation, and then pleural fluid was extracted by intrauterine thoracentesis under sonography guidance. After birth, this patient was managed by TPN(total parentral nutrition) and intermittent thoracentesis without surgical treatment. But, pleural fluid was accumulated recurrently and respiratory distress was aggravated. At 15th hospital day, shock state was developed and patient died. In the second case, bilateral pleural effusion and ascites were noted by prenatal ultrasonography, and then patient was delivered immediately without intrauterine thoracentesis. After birth, the second case received conservative therapy including mechanical ventilation, TPN, intermittent thoracentesis and paracentesis. The patient was discharged with complete regression of chylothorax. We report the two cases with brief review of related literatures.
Ascites ; Chylothorax* ; Female ; Humans ; Paracentesis ; Parturition ; Pleural Effusion ; Pregnancy ; Respiration, Artificial ; Shock ; Ultrasonography, Prenatal*

In the past 8 years, strides have been made in the diagnosis and treatment of renovascular lession which induces hypertension. The most significant methods are differential renal function studies. excretory urography. redioactive renogrsm. and renal angiogram in the field of diagnosis and nephrectomy, by-pass graft, and endarterectomy including vein patch graft are the most significant in the treatment of renovascular hypertension. But simple excretory urography is. still of great help in screening large numbers of patients, and nephrectomy is used in one half the patients. These advances have been a natural outgrowth of early work by Gold blatt, Page. and others. The accepted and relatively we11-established theory is, of course. that reduced renal blood flow leads to renal ischemia which in turn stimulates production of Renin by the kidney. Renin is an enzyme which reacts with alpba-2 globulin to liberate the decapeptid angiotensin 1, Neither renin nor angiotensin I is a pressure substance, but still another enzyme rapidly converts angiotensin l to an octapeptide, angiotensin II, which is the most potent pressure substance known. CASE REPORT S. H. Chung. a 10 year-old Korean girl. was admitted with severe headache and unconsciousness of only 3 weeks. duration. B100d Pressure was 200/140. The urogram disclosed the left kidney measured l1 cm by 6 cm. With an appearance time of the contrast material at 5 minutes. while the right kidney measured 8.5cm by 4cm and contrast material did not appear until 2 hours and the pelvis. calycial systems were quite normal on both kidneys by retrograde pyelogram. Exploration revealed a smaller right kidney with almost total obliteration of the renal artery in dense fibrotic reaction. Nephrectomy was done and the b1ood pressure dropped. to l20/60 within t8 hours. The kidney substance appeared to be good and biopsy of the kidney revealed essentially normal renal architecture.
Angiotensin I ; Angiotensin II ; Angiotensins ; Biopsy ; Child ; Diagnosis ; Endarterectomy ; Female ; Headache ; Humans ; Hypertension ; Hypertension, Renovascular* ; Ischemia ; Kidney ; Mass Screening ; Nephrectomy ; Pelvis ; Renal Artery ; Renal Circulation ; Renin ; Research Report ; Transplants ; Unconsciousness ; Urography ; Veins

Malignant growth of the small bowel accounts for approximately 1 to 3 percent of malignant tumors of the gastrointestinal tract. Leiomyosarcomas are the second most common primary tumor of the small bowel, their frequency being one-third to one-half of adenocarcinoma. The common clinical symptoms of leiomyosarcoma of the small intestine are hemorrhage and abdominal pain. Accurate diagnosis cannot be based on solely on the roentgenographic finding, although in certain situations the dignosis of leiomyosarcoma may be suggested strongly. We report a case of bleeding leiomyosarcoma located in the second portion of the duodenum which was first recognized by endoscopic examination and confirmed by explolaparotomy.
Abdominal Pain ; Adenocarcinoma ; Diagnosis ; Duodenum* ; Gastrointestinal Tract ; Hemorrhage ; Intestine, Small ; Leiomyosarcoma*

The c-erbB-2 oncogene, which is a new human proto-oncogene similar to EGFR structurally, generates a glycoprotein of tyrosine kinase family with a molecular weight of 185,000 To evaluate the prognostic significance of c-erbB-2 oncogene expression in colorectal carcinoma, We analysed 73 colorectal carcinomas in paraffin sections immunohistochemically, using the monoclonal antibody specific for the c-erbB-2 oncogene product and correlated with clinicopathological data. The results were as follows 1) The immunoreactivity for c-erbB-2 oncogene was localized to cell membrane of the tumor cells and occasionally observed within the cytoplasm. 2) The positivity of c-erbB-2 oncogene expression was 71.2%(52/73) of the colorectal carcinomas overall. According to the histological types, the positivity of c-erbB-2 oncogene in adenocarcinoma(77.4%) was higher than that in mucinous carcinoma(36.4%)(p<0.05). 3) Expression of c-erbB-2 oncogene was significantly correlated with lymph node metastasis or distant metastasis(p=0.0117), Dukes stage(p=0.0432), and TNM classification(p=0.0102). These results suggest that c-erbB-2 oncogene expression may be used as a prognostic factor of colorectal carcinoma because of its correlation with other clinicopathological prognostic factors.
Humans ; Neoplasm Metastasis

PURPOSE: Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament(ACL) injury in MR image. MATERIAL AND METHODS: The knee MR images of 47 patients with ACL injury(complete; 24, partial; 23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament(PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. RESULTS: The means( +/- 2standard errors) of anterior translocation were different significantly in statistical analysis(p<0.001, student t-test) between injury group(7.51 +/- 1.16mm) and normal group(-0.56 +/- 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 +/- 0.02) and normal group(0.17 +/- 0.01)(p<0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear(66%), thirteen lateral meniscus tear(28%), ten medial collateral ligament injury(28%), one PCL injury (2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients {43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients(19%) and avulsion fractures of anterior tibial spine in four patients(9%). CONCLUSION: The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.
Anterior Cruciate Ligament* ; Arthroscopy ; Bone Marrow ; Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Spine ; Tibia

PURPOSE: Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament(ACL) injury in MR image. MATERIAL AND METHODS: The knee MR images of 47 patients with ACL injury(complete; 24, partial; 23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament(PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. RESULTS: The means( +/- 2standard errors) of anterior translocation were different significantly in statistical analysis(p<0.001, student t-test) between injury group(7.51 +/- 1.16mm) and normal group(-0.56 +/- 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 +/- 0.02) and normal group(0.17 +/- 0.01)(p<0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear(66%), thirteen lateral meniscus tear(28%), ten medial collateral ligament injury(28%), one PCL injury (2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients {43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients(19%) and avulsion fractures of anterior tibial spine in four patients(9%). CONCLUSION: The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.
Anterior Cruciate Ligament* ; Arthroscopy ; Bone Marrow ; Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Spine ; Tibia

No abstract available.
Bronchopulmonary Sequestration* ; Esophageal Fistula* ; Hernia, Diaphragmatic* ; Pyloric Stenosis*

Epidermal growth factor receptor (EGFR) is overexpressed in various malignancies including carcinoma of the breast, lung, esophagus, cervix, and stomach. In patients with cervical carcinoma, its overexpression may be associated with advanced stage and poor prognosis. So, we evaluated the levels of serum EGFR in patients with cervical carcinoma. The level of EGFR extracellular domain was determined in serum from 57 cervical carcinoma patients(adenocarcinoma: 2, squamous cell carcinoma: 39, carcinoma in situ(CIS): 16) and 28 cases of healthy control using enzyme-linked immunosorbent assay(Calbiochem). In invasive carcinoma, serum EGFR level was measured in 11 cases of Stage Ia, 9 cases of Stage Ib, 4 cases of Stage IIa, 15 cases of Stage IIb, 2 cases of stage III patients. The mean ages of the healthy controls, of the wome with carcinoma in situ(CIS), and with invasive cervical carcinoma were not different(49.3, 44,4, 49.5, respectively, p 0.241). The mean serum level of EGFR in healthy control(n 28), carcinoma in situ(CIS)(n 16), and invasive carcinoma patients(n=41) were not significantly different(71.4+/-12.8fmol/ml, 79.2+/-26.8fmol/ml, 61.8+/- 18.4 fmol/ml, respectively, p=0.071). In conclusion, the expression of EGFR was not increased in patients with cervical cancer compared with normal women. And no significant differences were found depending on the clinical stage.
Breast ; Carcinoma, Squamous Cell ; Cervix Uteri ; Enzyme-Linked Immunosorbent Assay ; Esophagus ; Female ; Humans ; Lung ; Prognosis ; Receptor, Epidermal Growth Factor ; Stomach ; Uterine Cervical Neoplasms*