No abstract available.
Gardner Syndrome* ; Rectal Neoplasms*

PURPOSE: To evaluate the MR image in the differentiation of benign and malignant lesion in compression of the vertebral body. MATERIALS AND METHODS: MR images of 47 benign(acute traumatic within one month:19, chronic traumatic longer than one month or nontraumatic:28) and 21 metastatic compression fractures were respectively reviewed in terms of margin of lesions, signal intensity, paraspinal mass formation, soft tissue change, and involvement of posterior element of vertebra. MR images of TI-(T1WI) and T2*-weighted gradient echo (GE T2WI) sequences were obtained on 0.5T unit in sagittal and axial orientation with 5mm section thickness. RESULTS: The margin of benign compression fracture was usually indistinct (acute fracture:90% (17/19), chronic fracture:68% (19/28)), whereas it was sharply delineated in metastatic compression fracture (92%, (12/13) (p<0.001). Paraspinal mass was seen in both acute traumatic and metastatic compression fractures (acute fracture :26% (5/19), metastatic fracture: 52% (11/21). Soft tissue change was seen only in acute cornpression fractures (58%, 11/19). Involvement of posterior element of vertebra was noted in metastatic fracture (71%, 15/21), acute fracture (32%, 6/19) and chronic fracture (7%, 2/28) CONCLUSION: On MR imaging, involvement of entire portion of a given vertebral body, sharp margin between normal and abnormal areas in partially involved cases, paraspinal mass formation, and posterior element involvement are more frequently seen in metastatic compression fractures, which are considered to be useful in differentiation between benign and malignant causes of compression fracture.
Fractures, Compression* ; Magnetic Resonance Imaging* ; Spine

Giant cell myocarditis(GCM) is a rare inflammatory heart disease which is characterized by multinucleated giant cells and a granulomatous reaction. It usually progresses rapidly and results in a fatal course. We report a patient with giant cell myocarditis who was treated by cardiac transplantation. A 35-year-old male was admitted with dyspnea which had developed 4 months before. On echocardiography, the right and left ventricles were markedly dilated and severe global hypokinesia was noted. He was diagosed with dilated cardiomyopathy with secondary severe mitral regurgitation. His cardiac function deteriorated progressively. He underwent orthotopic heart transplantation. Grossly the heart was enlarged, weighing 420gm and round with a blunt apex. Both right and left ventricles were markedly dilated. There were numerous white patches, measuring up to 4cm, throughout the epi- and myocardium. Microscopically, extensive fibrosis and multiple exuberant granulomas with numerous scattered multinucleated giant cells were seen. Lymphocytes and eosinophils were also frequent. Coronary arteries were unremarkable. Neither microorganisms nor foreign materials were found. By serial endomyocardial biopsies of the transplanted heart, only mild perivascular lymphocytic infiltration was occasionally observed without any evidence of rejection or recurrence of giant cell myocarditis. The patient's postoperative course has been uneventful so far(postoperative 21 months). The etiology of GCM remains to be clarified, although various factors are suspected. No matter what the cause, our experience suggests that this grave disease might be treated well by heart transplantation.
Male ; Humans ; Biopsy

A 25 year old male was admitted for the reduction of right side mandible fracture. The patient was injured during a fight with someone under the influence of liquor. Nine days after the halothane anesthesia, the patient began to suffer from acute hepatitis with symptoms of fever, diarrhea, nausea, vomiting, and jaundice. The patient was cared for at the department of internal medicine and discharged after 49 day's hospitalization. The exact causes of the acute hepatitis were still unknown.
Adult ; Anesthesia ; Anesthesia, General* ; Diarrhea ; Fever ; Halothane* ; Hepatitis* ; Hospitalization ; Humans ; Internal Medicine ; Jaundice ; Male ; Mandible ; Nausea ; Vomiting

PURPOSE: To evaluate the CT appearance of renal cell carcinoma and to correlate it with nuclear grading andcell type. MATERIALS AND METHODS: The size, outer margin and heterogeneity of inner texture of renal cell carcinomas in 86 patients were evaluated on CT scan and were correlated with nuclear grade and cell type. RESULTS: Tumors less than 5cm were of low grade in 28 of 31 patients, while those larger than 5cm were of low grade in 28 of 55 patients. The lesions which showed no or round protrusion with a sharp margin were of low grade in 26 of 28 patients, while those which showed an undulated or indistinct margin were of low grade in 30 of 58 patients. Lesions which showed a homogeneous solid appearance, focal low densities, or mostly cystic changes were of low grade in 23 of 26 patients, while those which showed multiple or confluent low densites were low grade in 33 of 60 patients. There was a significant difference in the distribution of nuclear grading between the groups. Differences in CT apperance according to cell type were not found. CONCLUSION: Differences in less than 5cm showing no or round protrusion with a sharp margin, homogeneous inner texture with solid appearance, and heterogeneous inner texture with cystic appearance or focal low densities on CT scan were thought to be the findings suggesting low nuclear grading.
Carcinoma, Renal Cell* ; Humans ; Population Characteristics ; Tomography, X-Ray Computed

No abstract available.
Cystitis*

BACKGROUND AND OBJECTIVES: QT dispersion (QTd) represents the inhomogeneity of ventricular repolarization and has been suggested to predict ventricular arrhythmia in patients with coronary artery disease (CAD). This study investigates the short-term effect of percutaneous transluminal coronary angioplasty (PTCA) on QTd in patients with CAD and no history of previous myocardial infarct. MATERIALS AND METHODS: In 84 angina patients (65 men and 19 women, mean age of 58.3+/-9.0 yeras) who underwent successful PTCA of single coronary artery, ECG was checked in baseline, immediate, 1day and 1 month after PTCA. QTd and corrected QTd (c-QTd) were measured in these ECGs by digitizer. RESULTS: PTCA was performed at left anterior descending artery (LAD) in 56, left circumflex artery (LCx) in 12 and right coronary artery (RCA) in 16 patients. Mean and standard error of QTd (c-QTd) at baseline, immediate, 1day and 1month after PTCA was 51.3+/-4.2 (50.7+/-4.1), 54.2+/-4.5 (52.8+/-4.5), 47.7+/-4.3 (48.5+/-4.8) and 36.3+/-4.5 (37.5+/-4.6)msec, respectively. QTd and c-QTd significantly decreased at 1 month following PTCA. The difference was more prominent in pateints with LAD lesion than LCx or RCA lesion and independent of gender, severity of stenosis and use of beta-blockers. CONCLUSION: QTd decreases in CAD patients with no history of myocardial infarct at 1 month following successful PTCA. This may facilitate a favorable recovery from inhomogenous repolarization. These findings call for long-term follow-up of QTd and the incidence of ventricular tachyarrhythmias and sudden death following successful PTCA.
Angioplasty, Balloon, Coronary ; Arrhythmias, Cardiac ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Death, Sudden ; Electrocardiography ; Female ; Humans ; Incidence ; Male ; Myocardial Infarction ; Tachycardia

OBJECTIVE: This study analyzed the relationship between prognosis and multiple clinical factors of ruptured middle cerebral artery (MCA) aneurysm with intracerebral hemorrhage (ICH), to aid in predicting the results of surgical treatment. METHODS: Enrolled subjects were 41 patients with ruptured MCA aneurysm with ICH who were treated with surgical clipping. Clinical factors such as gender, age, and initial Glasgow coma scale were assessed while radiological factors such as the volume and location of hematoma, the degree of a midline shift, and aneurysm size were considered retrospectively. Prognosis was evaluated postoperatively by Glasgow outcome scale. RESULTS: Age and prognosis were correlated only in the groups with ICH over 31 mL or ICH at the frontal lobe or sylvian fissure. When initial mental status was good, only patients with ICH on the temporal lobe had a better prognosis. If the midline shift was less than 4.5 mm, the probability of better prognosis was 95.5% (21 of 22). If the midline shift was more than 4.5 mm, the probability of poor prognosis was 42.1% (8 of 19). Patients with ICH less than 31 mL had higher survival rates, whereas if the ICH was more than 31 mL, 41.2% (7 of 17) had a poor clinical pathway. CONCLUSION: Even if the initial clinical condition of the patient was not promising, by carefully examining and taking into account all factors, neurosurgeons can confidently recommend surgical treatment for these patients.
Aneurysm ; Cerebral Hemorrhage ; Frontal Lobe ; Glasgow Coma Scale ; Hematoma ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Prognosis ; Retrospective Studies ; Surgical Instruments ; Survival Rate ; Temporal Lobe

Foreign body accidents in the air and food passages are common problem encountered in the ENT field. Especially the foreign body accidents in the air passage in the children are serious and urgent. They are influenced by mode of living, customs, habits and environment1). We have clinico-statistically analysed 83 cases removal of foreign bodies in air and food passages under general anesthesia from January 1979 to March 1991 in Korea Univer- sity Hospital. The results are as follows: 1) Of the total 83 cases,64 cases(77.1%) were in food passage and 19 cases(22.9%) were in air passage. 2) Peanuts and beans were the most common intruders of air passage(79%). In the food passage coins enjoyed the greatest popularity(31.3%) and bones, Badook stones, and meats follow in order of frequency. 3) In the age distribution, 42.1% of foreign bodies in food passage and 78.9% of foreign bodies in air passage were under 5 years. 4) Of the total numbers of foreign body cases, 61.4% of the patients were male and 38.6 % were female. 5) In duration of lodgement, 44 cases(68.8) of foreign bodies in food passage and 6 cases(31.6%) in air passage were removed within 24 hours. 6) In food passage, 56 cases(87.5%) of all were diagnosed initially by chest P-A but 9 cases(47%) were diagnosed initially in air passage.
Age Distribution ; Anesthesia, General* ; Arachis ; Child ; Esophagus ; Fabaceae ; Female ; Foreign Bodies* ; Humans ; Korea ; Male ; Meat ; Numismatics ; Thorax ; Trachea

Hypertrophic olivary degeneration (HOD) is caused by the damage of dentator rubroolivary pathway which triangular area is consisted of red nucleus, dentate nucleus, inferior olivary nucleus and the connection fibers. It usually resulted from vascular damage in pons or cerebellum, and also fromencephalitis, degenerative disease, multiple sclerosis, tumor and trauma. We experienced this case of a 56-year-old man with characteristic clinical findings of HOD such as palatal myoclonus, ipsilesional facial palsy, crossed hemiplegia and truncal ataxia after right pons and midbrainhemorrhage. Therefore we report this case with observation of olivary nucleus size in brain MRI followed up after 5 years.