We report a case of exogastric schwannoma of the stomach in 41-years-old male patient with papable mass in left upper abdomen. Upper GI series revealed extrinsic compression on the greater curvature of the stomach. CT scan showed a low density mass attached to greater curvature of the stomach with inhomogeneous contrast nhancement in the mass lesion. The mass was removed by surgery, and confirmed pathologically as schwannoma arising from the stomach.
Abdomen ; Humans ; Male ; Neurilemmoma* ; Stomach* ; Tomography, X-Ray Computed

No abstract available.
Adenosarcoma* ; Endometrium* ; Female

No abstract available.
Adenosarcoma* ; Endometrium* ; Female

No abstract available.
Cutaneous Fistula ; Glomerulonephritis, Membranous* ; Humans ; Sarcoma, Kaposi*

PURPOSE: The aim of this experimental study was to evaluate whether the acoustic radiation force (ARF) is a potential source of twinkling artifacts in color Doppler images. METHODS: Color Doppler images were obtained using a clinical ultrasonic scanner (Voluson e, GE Healthcare) for a high contrast (+15 dB) circular scattering phantom at pulse repetition frequencies (PRFs) ranging from 0.1 to 13 kHz. Ultrasound transmissions resulting in ARF were measured using a hydrophone at the various PRFs considered. The influence of ARF on the appearance of twinkling colors was examined via the common parameter PRF. This methodology is based on the fact that alternating positive and negative Doppler shifts induced by the ARF are centered at a PRF twice the maximum Doppler frequency on the color scale bar, whereas the twinkling color aliasing is expected to remain similar regardless of PRF. RESULTS: Color twinkling artifacts were observed to be most conspicuous at the lowest PRF of 0.1 kHz. The extent of twinkling rapidly decreased as the PRF increased, eventually disappearing when the PRF > or =0.6 kHz. The measured ultrasound transmissions, however, were found to be insensitive to the PRF, and therefore it can be inferred that the PRF was insensitive to the ARF. CONCLUSION: Based on our experimental observations, the ARF may not be a source of color Doppler twinkling artifacts.
Acoustics* ; Artifacts* ; Doppler Effect ; Ultrasonics ; Ultrasonography ; Ultrasonography, Doppler, Color

PURPOSE: To evaluate the prevalence of abnormalities seen on sonography and renal scintigraphy, according tothe grade of vesicoureteral reflux (VUR) on in voiding cystourethrography (VCUG). MATERIALS AND METHODS: Onehundred and forty-nine patients (age range : 1 months - 10 years) with urinary tract infection underwentsonography, VCUG, and renal scans, and 32 showed VUR on VCUG. We retrospectively evaluated the frequency andcharacteristic findings of sonographic abnormalities according to the grade of VUR, and also the frequency ofcortical defects seen on renal scans of 32 patients with VUR. The remaining 117 patients without VUR were alsoevaluated for the frequency of abnormal findings seen on sonography and renal scans. RESULTS: Among 32 patients(49 kidneys) with VUR, abnormal findings were not detected in 17 (29 kidneys) on sonography ; thus, findings wereabnormal in 15(20 kidneys, 41%). Among these 20 kidneys, renal calyceal and/or pelvic dilatation and dilatation ofdistal ureter were seen in 11, all of which were grade 4-5 VUR. Renal pelvic dilatation only was noted in eightkidneys ; two were grade 1-3 and six were grade 4-5 VUR. Nineteen patients (24 kidneys, 49%) showed focal corticaldefects on renal scintigraphy. Six kidneys were grade 1-3, and 18 kidneys were grade 4-5 VUR. Of 117 patientswithout VUR, 34 patients (29%) showed renal pelvic dilatation on sonography and in 14 patients (12%), corticaldefects were seen on renal scintigraphy. CONCLUSION: Among 32 patients with VUR, 41% showed abnormal sonographicfindings and in 49%, cortical defects were seen on renal scintigraphy. With a higher grade of VUR, the prevalenceof abnormalities increased on both sonography and renal scintigraphy. Sonographic demonstration of renal calicealand/or pelvic dilatation associated with ipsilateral distal ureteric dilatation was the characteristic finding inhigh grade VUR.
Dilatation ; Humans ; Kidney ; Prevalence ; Radionuclide Imaging* ; Retrospective Studies ; Ultrasonography* ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

Fryns syndrome is a lethal syndrome of multiple congenital anomalies first described by Fryns et al in 1979. A recently developed major diagnostic criteria includes abnormal face, small thorax with widely spaced hypoplastic nipples, distal limb and nail hypoplasia, lung hypoplasia with diaphragmatic hernia, central nervous system anomalies and congenital heart disease. The pathogenesis of Fryns syndrome is not clear. Of the major immediate life-threatening abnormalities of this syndrome, lung hypoplasia associated with diaphragmatic hemia has usually proven to be fatal. We report a case of Fryns syndrome, which has the prenatal ultrasonographic findings of Dandy-Walker malformation and renal hypoplasia.
Central Nervous System ; Dandy-Walker Syndrome ; Extremities ; Heart Defects, Congenital ; Hernia, Diaphragmatic ; Lung ; Nipples ; Thorax

Trisomy 9 mosaicism is a disease characterized not only by intrauterine growth retardation and mental retardation but also congenital heart defects, musculoskeletal, genitourinary and CNS anomalies, as well as craniofacial anomalies such as microcephaly, micrognathia, narrowed temples, prominent occiput, broad-based nose with bulbous tip, low set ears, deeply set eyes, short palpebral fissure and small mouth. This syndrome was first reported back in 1973 by Haslam and others, and has hardly ever been reported since. In Korea, a complete form of trisomy 9 syndrome was first reported in 1998 by Chun and others, but trisomy 9 mosaicism has not been reported yet. We recently experienced a case with a patient who was most likely suspected as diet therapy requiring Smith-Lemli-Opitz Syndrome(SLO), since the patient had unilateral ptosis, hypospadias, micrognathia, simian crease, and low set ears, which are the characteristics not yet reported as trisomy 9 mosaicism, but most similar to Smith-Lemli-Opitz syndrome. Also, the patient did not show the typical characteristics of trisomy 9 mosaicism such as broad nose or enophthalmosis. However, further evaluation was taken in order to make the correct diagnosis, and the serum cholesterol level of the patient was shown to be normal, which implied normal cholesterol metabolism, but the chromosomal studies of the patient confirmed the karyotype of 47,XY,+9/46,XY, which proved that the patient has trisomy 9 mosaicism.
Cholesterol ; Diagnosis ; Diet Therapy ; Ear ; Female ; Fetal Growth Retardation ; Heart Defects, Congenital ; Humans ; Hypospadias ; Intellectual Disability ; Karyotype ; Korea ; Male ; Metabolism ; Microcephaly ; Mosaicism* ; Mouth ; Nose ; Smith-Lemli-Opitz Syndrome* ; Trisomy*

PURPOSE: Upper gastrointestinal bleeding (UGIB) is an urgent medical condition that emergency medicine doctors commonly encounter in the emergency room (ER). Initial management and triage of UGIB patients depend on nonendoscopic findings, so we sought risk factors for UGIB patients by using only the initial clinical data and the patient's condition in the ER. METHODS: By reviewing the data of 302 patients with the impression of UGIB between January of 1998 and December of 2000, the authors attempted to predict risk factors related to rebleeding, mortality, and need for surgical treatment. Based on blood analysis, physical exam, and history taking performed at the ER, the authors conducted a retrospective study in order to determine factors which influence rebleeding and overall mortality. RESULTS: From the blood pressure, pulse rate, and blood analysis taken at the time of admission, the levels of hemoglobin and hematocrits were shown to be related to rebleeding (p<0.05). If there was on-going bleeding, the relative risk of rebleeding was 2.314 times (p=0.023), and if the hemoglobin value was under 8 gm/dL, relative risk of rebleeding was 6.809 times (p=0.000). The factors which influenced the overall mortality rate were the blood pressure measured at the time of admission (p=0.001), the presence of on-going bleeding and rebleeding (p=0.000), and the level of hemoglobin, hematocrits and creatinine (p=0.001). A logistic regression analysis showed that when there was on-going bleeding, the relative risk of the mortality was 10.4 times (p=0.000) and when there was a high creatinine level, it was 7.8 times (p=0.001) CONCLUSION: When a patient with UGIB reports to the ER and shows unstable vital signs, a low hemoglobin level, and evidence of on-going bleeding, one should perform gastroendoscopy as soon as possible, and a need exists for aggressive treatment, even after admission.
Blood Pressure ; Creatinine ; Emergency Medicine ; Emergency Service, Hospital ; Heart Rate ; Hematocrit ; Hemorrhage* ; Humans ; Logistic Models ; Mortality* ; Retrospective Studies ; Risk Assessment* ; Risk Factors ; Triage ; Vital Signs

BACKGROUND: The orthostatic hypotension in response to the assumption of an upright posture is regulated by activation of sympathetic nerves. Role of the vestibular system and neural pathway on orthostatic hypotension were investigated. METHODS: Changes of arterial blood pressure produced by head-up tilting, rotatory stimulation of the vestibular system, or electrical stimulation to the vestibular nerve, vestibular nuclei, and rostral ventrolateral medulla (RVLM) were measured in Sprague-Dawley rats. Also, field potentials were recorded in the vestibular nuclei and RVLM and c-Fos expression was evaluated in the brain stem in order to investigate the vestibulosympathetic pathways. RESULTS: The three phasic blood pressure responses were elicited by head-up tilting: initial fall, early recovery, and late sustained pressure at near control levels, the magnitude of the pressure fall was parallel with the degree of head-up tilting in normal rats. Return position from head-up tilting recovered control level of blood pressure after a brief rapid elevation. However, bilateral labyrinthectomy resulted in exaggerated initial falling and devoid of early recovery phase during postural change. Sinusoidal rotation about off-vertical axis of the vestibular system elicited more elevation of blood pressure than rotation about earth vertical axis. Electrical stimulation of the vestibular nerve, vestibular nucleus, and RVLM produced elevation of blood pressure, which was the most prominent by stimulation of RVLM. Field potentials composed of P, N1, N2 waves in the vestibular nuclei were recorded by stimulation of the vestibular nerve, while weak potentials in RVLM were recorded by stimulation of the vestibular nuclei. An electrical stimulation of the vestibular nuclei expressed c-Fos immunoreactive cells in RVLM. CONCLUSION: These results suggest that the otolith organ of the vestibular system plays a major role in control of orthostatic hypotension, and the pathway of vestibulosympathetic reflex in control of blood pressure involves the vestibular nuclei, RVLM, intermed-iolateral nuclei of the thoracic spinal cord.
Animals ; Arterial Pressure ; Axis, Cervical Vertebra ; Blood Pressure ; Brain Stem ; Electric Stimulation ; Hypotension, Orthostatic* ; Neural Pathways ; Otolithic Membrane ; Posture ; Rats* ; Rats, Sprague-Dawley ; Reflex* ; Spinal Cord ; Vestibular Nerve ; Vestibular Nuclei