A total of 162 patients with invasive cervical cancer was investigated retrospectively with a view to elucidate the efficacy of pretreatment staging procedures of application with intravenous pyelography, cystoscopy, rectosigmoidoscopy. All 72 intravenous pyelograms, 155 sigmoidoscopies, 158 cystoscopies were normal. Of 111 patients with stage Ib who had paraaortic lymph node biopsies, two patients had a positive node(0.02%). Of 51 patients with stage II who had paraaortic lymph node biopsies, five patients had positive paraaortic lymph node(10%). And the accuracy of computed tomography and magnetic resonance imaging in the evaluation of invasive cervical cancer was assessed. In evaluating stage of cervical cancer, clinical staging had an accuracy of 78.9%, compared with 65.7% for CT and 58.9% for MRI. And for detection of parametrial invasion, clincal staging had an accuracy of 85.9%, compared with 85.1% for CT and 78.9% for MRI. Both modalities were comparable in evaluating lymph node metastasis ( 76.1% for CT, 74.4% for MRI ). IVP, cystoscopy and sigmoidoscopy for staging procedure evaluated in this study are unnecessary and should no longer be performed in patients with early stage cervical cancer. In addition, paraaortic lymph node biopsies in the absence of clinically suspicious nodes are not warranted. Compared with CT and MRI, pelvic examination offered improved evaluation of cervical cancer staging, parametrial invasion, but CT and MRI was useful in detecting the pelvic lymph node metastasis which was nearly impossible by clinical evaluation.
Biopsy ; Cystoscopy ; Gynecological Examination ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Retrospective Studies ; Sigmoidoscopy ; Urography ; Uterine Cervical Neoplasms

No abstract available.
Cell Line* ; Gonadotropin-Releasing Hormone* ; Medroxyprogesterone Acetate* ; Medroxyprogesterone* ; Tamoxifen*

PURPOSE: To evaluate the diurnal variation of macular thickness in eyes with diabetic macular edema. METHODS: We measured macular thickness using optical coherence tomography in 33 eyes with diabetic macular edema and 33 normal control eyes at 7 am, 11 am, 2 pm, and 5 pm. We investigated the correlation between macular thickness change and several factors such as sex, duration of diabetes mellitus, presence of hypertension, HbA1c, creatinine clearance, blood urea nitrogen, serum creatinine, blood sugar, blood pressure, severity of diabetic retinopathy, and whether PRP was done or not. RESULTS: Retinal thickness in 3.45 mm macular area was the thickest at 7 am and then decreased over the day to be thinnest at 5 pm (p Blood Glucose ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Diabetes Mellitus ; Diabetic Retinopathy ; Hypertension ; Macular Edema* ; Retinaldehyde ; Tomography, Optical Coherence

BACKGROUND: The improved technique for cardiopulmonary resuscitation(CPR) has resulted in the survival of many patient who experienced cardiac arrest. However, mortality in resuscitated patients is high, and the survival rate without brain damage is very low. Various neurological examination models, neuro-imaging techniques, electrophysiological procedures, and biochemical tests have been studied with respect to the detection of cerebral damage and outcome, but an early, reliable prediction of individual outcomes is still uncertain. METHODS: We studied twenty patient who had been in a coma for more than 24 hours after CPR, Somatosensory evoked potentials(SEP) were measured within the first three days after CPR. RESULTS: Of the twenty patients, seven patients(35%) had a good outcome, and thirteen patients(65%) had a bad outcome. Of the eleven patients with loss of the cortical evoked potential's N20 peak, all had a bad outcome. CONCLUSION: SEPs are of great benefit in prognostic evaluation after CPR.
Brain ; Cardiopulmonary Resuscitation* ; Coma* ; Evoked Potentials, Somatosensory* ; Heart Arrest ; Humans ; Mortality ; Neurologic Examination ; Survival Rate

PURPOSE: We evaluated a rapid preparation procedures for the labeling and quality control of 99mTc-ECD, MAG3, and MIBI using microwave heating and Sep-Pak cartridges. MATERIALS AND METHODS: 99mTc labeling of ECD, MAG3, and MIBI kit preparation was performed according to the package inserts with microwave heating modification. Heating time was 10-15 sec, and heating was performed with 3 mm plastic bottle with screw cap to prevent radiation contamination. Labeling efficiency was obtained with C18 or Alumina N Sep-Pak cartridges. RESULTS: The radiochemical purity of 93~96% for 99mTc-ECD and 95~99% for 99mTc-MIBI was obtained using Alumina N Sep-Pak cartridge. The optimum irradiation time of microwave method for 3 ml 99mTc-labeled radiopharmaceutical solution was 10 sec for 99mTc-ECD and 99mTc-MIBI, and 15 sec for 99mTc-MAG3. The RESULTS of quality control data with Sep-Pak cartridges were well correlated with TLC method. The total preparation time of these radiopharmcaeuticals was 5~6 min including quality control procedure. CONCLUSION: This study demonstrates that radiopharmaceuticals preparation by microwave heating and quality control by Sep-Pak cartridges can be efficiently utilized as an alternative to the recommended method by manufacturer's manual.
Aluminum Oxide ; Heating* ; Hot Temperature* ; Microwaves* ; Plastics ; Product Labeling ; Quality Control* ; Radiopharmaceuticals ; Technetium Tc 99m Mertiatide

A clear cell islet cell tumor of the pancreas is extremely rare and characterized by extensive clear cell components. Electron microscopic and immunohistochemical findings are essential to prove that the mass with clear cells is an unusual manifestation of an islet cell tumor. Herein, we report a case of clear cell islet cell tumor of a 54-year-old woman with abdominal pain. The tumor was composed of polygonal clear cells arranged in nests, trabeculae, and ribbon pattern with the extensively fibrous stroma. These tumor cells showed strong reactivity for chromogranin and weak reactivity for somatostatin and glucagon. An electron microscope revealed that the important contributing factor of the clear cytoplasmic change was mainly due to an accumulation of lipid droplets, coupled with cytoplasmic swelling in some areas. Some tumor cells showed many endosecretory granules ranging from 111 to 297nm in diameter. In the clinical and immunohistochemical findings these granules were consistent with somatostatin granules in morphology and size.
Abdominal Pain ; Adenoma, Islet Cell* ; Cellular Structures ; Cytoplasm ; Female ; Glucagon ; Humans ; Islets of Langerhans* ; Middle Aged ; Pancreas* ; Somatostatin

A clear cell islet cell tumor of the pancreas is extremely rare and characterized by extensive clear cell components. Electron microscopic and immunohistochemical findings are essential to prove that the mass with clear cells is an unusual manifestation of an islet cell tumor. Herein, we report a case of clear cell islet cell tumor of a 54-year-old woman with abdominal pain. The tumor was composed of polygonal clear cells arranged in nests, trabeculae, and ribbon pattern with the extensively fibrous stroma. These tumor cells showed strong reactivity for chromogranin and weak reactivity for somatostatin and glucagon. An electron microscope revealed that the important contributing factor of the clear cytoplasmic change was mainly due to an accumulation of lipid droplets, coupled with cytoplasmic swelling in some areas. Some tumor cells showed many endosecretory granules ranging from 111 to 297nm in diameter. In the clinical and immunohistochemical findings these granules were consistent with somatostatin granules in morphology and size.
Abdominal Pain ; Adenoma, Islet Cell* ; Cellular Structures ; Cytoplasm ; Female ; Glucagon ; Humans ; Islets of Langerhans* ; Middle Aged ; Pancreas* ; Somatostatin

Rectus sheath hematoma of the abdominal wall is a well-recognized, but uncommon condition, caused by a tear in an epigastric vessel and characterized by sudden onset of severe abdominal pain and palpable mass. In most cases, a precipitating cause can be demonstrated. Causes include external trauma, strenuous activities, coughing, lifting, sneezing, vomiting, straining while urinating or defecating, golfing, pregnancy and the puerperium, anticoagulation therapy, infection, chronic diesase, arteriosclerosis, hypertension, prior paracentesis or laparotomy, inadequate hemostasis or excessive retraction in surgery, and idiopathy. Unfortunately, the correct diagnosis often is missed, and the hematoma is found only during an exploratory laparotomy. Treatment should be conservative in most instances. Although the mortality rate for patients with rectus sheath hematoma is low, the condition may be fatal if the volume of the hemorrhage is large and if treatment is delayed. Hence, it should be included in the differential diagnosis of any patient who presents to the emergency department with acute onset of abdominal pain. Our purpose is to familiarlize emergency physicians with the pathophysiology, the diagnosis, and the treatment of rectus sheath hematoma. We describe a patient with fatal rectus sheath hematoma presenting to the emergency department and give a review of the literature.
Abdominal Pain ; Abdominal Wall ; Arteriosclerosis ; Cough ; Diagnosis ; Diagnosis, Differential ; Emergencies ; Emergency Service, Hospital ; Golf ; Hematoma* ; Hemorrhage ; Hemostasis ; Humans ; Hypertension ; Hypovolemia* ; Laparotomy ; Lifting ; Mortality ; Paracentesis ; Postpartum Period ; Pregnancy ; Shock* ; Sneezing ; Vomiting

No abstract available.
Choledochal Cyst* ; Humans ; Infant, Newborn*

PURPOSE: To correlate histologic subtypes with MR signal intensity in meniagioma and to find etiologic factors responsible for the signal characteristics of T2WI. MATERIALS AND METHODS: We. reviewed MRIs and histopathologic studies in 35 cases of meningioma. MR signal intenisty was measured with respect to cerebral cortex(gray matter) as hypointense, isointense, or hyperintense. Pathologically, meningioma was classified into subtypes, acording to the new WHO classification of brain tumors. The degree of cellularity, collagen, and vascularity was graded from 1 to 3, and presence or absence of psammoma bodies, microcysts, micronecrosis and microhemorrhage was obeserved. Multiple linear regression analysis was done to find relationship between the pathologic findings and MR signal intensity of T2WI. RESULTS: Even in the same subtype, cellularity, collagen and vascularty of the tumor were different. T1WI was not useful in discriminating pathologic subtype because most tumors were isointense or hypointense to the cortex regardless of histologic type. Most tumors showed various signal intensity on T2WI, but T2WI were not useful, either. Exceptionally, all five cases of microcystic meningiomas were hyperintense on T2W1. In analysing the relationship between MR signal intensity and pathologic factor, increased collagen content produced decreased signal intensity(P<0.01) and the existence of microcyst resulted in high signal intensity(P<0.01). Cellularity, vascularity, microcalcification, micronecrosis and microhemorrhage had no relationship with signal intensity on T2WI. CONCLUSION: Except for the five microcystic meningiomas with hyperintenty on T2WI there was no relationship between MR signal intensity and subtype of meningiomas. Pathologic factors influencing T2 signal intensity were microcyst and collagen. Even in the same subtypes of meningiomas, the T2 signal intensity was different. This may be due to different ratio of microcyst and collagen.
Brain Neoplasms ; Classification ; Collagen ; Linear Models ; Magnetic Resonance Imaging* ; Meningioma*