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: Indications and applications of percutaneous transluminal coronary angioplasty(PTCA) has been broaden in reccent years. However,we considered many aspects in performing angioplasty in patient with multivessel disease. There were procedural success rate, complication, risk, restenosis and long-term effect. So we evaluated the initial success rate, safety and follow-up results. METHODS: To assess the likelihood of initial success in patients with multivessel coronary artery disease, single or multiple site angioplasy were performed at 449 lesions from 273 patients(Male 202,Female 71, Mean age 60.0+/-9.4 years). To evaluate the restenosis rate of angioplasty in multivessel disease, follow-up coronary angiogram were performed at 164 lesions from 95 patients at average 6months after angioplasty. RESULTS: The extent of coronary artery disease revealed that two vessel disease were 200(73.3%) and triple vessel disease were 73(26.7%). Single vessel angioplasty(SVA) was performed in 180(40.1%) lesions and multivessel angioplasty(MVA) was performed in 269(59.9%) lesions. Procedural success was achieved 377(84.0%) out of total 449 lesions. The proccdural success rate was 81.1% in SVA and 85.9% in MVA. According to major epicardial coronary artery, procedural success rate of left anterior descending artery was 82.0%, left circumflex artery 92.4% and right coronary artery 79.4%. According to angiographic morphology of lesions, procedural success rate of type A was 95.7%, type B 88.9% and type C 56.4%. Complete revascularization was done in 87 patients(31.9%) out of 273 patients. Major cause of failure of angioplasty in multivessel disease was inability to pass the guide wire cross the lesion due to total occlusion. Complications included dissection in 101, acute closure in 7(9.7%), coronary artery perforation in 2, cardiogenic shock in 1 and ventricular fibrillation in 1. Follow-up coronary angiography revealed the restenosis rate was 42.2%. CONCLUSION: Coronary angioplasty in selected patients with multivessel coronary artery disease might be useful and have relatively good immediate and long-term results.
Angioplasty* ; Arteries ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Shock, Cardiogenic ; Ventricular Fibrillation

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.

Ovarian hyperstimulation syndrome is a serious complication of ovulation induction and has a diverse clinical spectrum from edema to thromboembolism. Antiphospholipid antibody syndrome, one of the well known hypercoagulable states, can be also manifested as an arterial or venous thrombosis and recurrent spontaneous abortion. Sometimes a patient with antiphospholipid antibodies might not notice a miscarriage and seek for assisted reproduction treatment, which harbors a chance of developing ovarian hyperstimulation syndrome. If this happens, the ovarian hyperstimulation syndrome can exacerbate the thrombotic complication of underlying antiphospholipid antibody syndrome, resulting in a catastrophic vascular event. The authors experienced a case of middle cerebral artery infarct, which developed during ovarian hyperstimulation syndrome in a 33-yr-old woman with a previous history of fetal loss. An elevated titer of anticardiolipin antibodies was noticed and persisted thereafter. The authors suggest screening tests for the presence of antiphospholipid antibodies before controlled ovarian hyperstimulation.
Adult ; Antibodies, Anticardiolipin/blood ; Antiphospholipid Syndrome/*complications/pathology ; Female ; Humans ; Iatrogenic Disease ; Infarction, Middle Cerebral Artery/*etiology/pathology ; Magnetic Resonance Angiography ; Ovarian Hyperstimulation Syndrome/*complications/pathology ; Ovulation Induction ; Pregnancy ; *Pregnancy Complications/pathology

Although exercise electrocardiography is commonly used to determine the likelihood of coronary artery disease, data of exercise electrocardiography are limited in Korea. Authors reviewed 409 patients with chest pain who underwent 12 lead treadmill exercise electrocardiography and coronary arteriography at Seoul National University Hospital from January, 1984 through September, 1990. All the patients underwent catheterization within three months after having a standard Bruce protocol treadmill exercise test. None of them had prior myocardial infarction, valvular heart disease, cardiomyopathy, and complete left bundle branch block. The study subjects consisted of 208 patients, including 42 patients of coronary artery spasm, with no or insignificant fixed coronary artery stenosis(less than 50% narrowing of luminal diameter), and 201 with significant fixed stenosis. The results were as follows; 1) The sensitivity of treadmill exercise electrocardiography was 73.6%, and the specificity was 88.2%. Positive exercise test in coronary artery spasm was 21.4%. 2) With increasing the extent of coronary artery disease, the proportion of the patients with one-vessel disease who showed positive ST segment change of stage I increase. Most of the patients with one-vessel disease who showed positive ST segment change on stage I had 90% or more stenosis. 3) With increasing the extent of coronary artery disease, the proportion of the patients with positive ST segment change in multiple lead groups increased. 4) ST segment change appeared most frequently in lead group V4-V6 and next in lead group II III a VF regardless of involved arteries. 5) ST segment elevation in lead group V1-V3 or in I/aVL was usually associated with 90% or more stenosis of left anterior descending artery in one-vessel disease, but similar proportion of the patients was noted in multivessel disease. This suggests that ST segment elevation in lead group V1-V3 or in I/aVL is probably associated with severe ischemia, not a specific predictor of left anterior descending coronary artery disease.
Angina Pectoris* ; Angiography ; Arteries ; Bundle-Branch Block ; Cardiomyopathies ; Catheterization ; Catheters ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Electrocardiography* ; Exercise Test ; Heart Valve Diseases ; Humans ; Ischemia ; Korea ; Myocardial Infarction ; Phenobarbital ; Sensitivity and Specificity ; Seoul ; Spasm