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

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

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

No abstract available.
Cystitis*

BACKGROUND: The morphological characteristics of hepatocytes transplanted into the spleen have been studied. However few attempts has been made to determine the expression of genes in intrasplenically transplanted hepatocytes. The aim of this study was to explore whether the pattern of expression of albumin gene in intrasplenically transplanted hepatocytes is similar to that in adult liver, resulting in the long-term expression of this hepatocyte-specific gene. METHODS: Hepatocytes isolated from liver of syngeneic Fischer 344 rats and transplanted into the spleen of rats from the same strain survived for 12 months in the absence of immunosuppressive drugs. Microscopic examination of intrasplenic hepatocytes and Northern blotting for albumin gene expression of RNA extracted from liver and spleen was performed. RESULTS: Microscopy demonstrated that hepatocytes attached themselves only in the red pulp of the spleen and isolated hepatocytes preserved the fine structures characteristic of normal hepatic parenchymal cells. Throughout the 12 months period, intrasplenically transplanted hepatocytes expressed albumin mRNA. CONCLUSIONS: Intrasplenically transplanted hepatocytes represent a unique in vivo system of extrahepatic maintenance of hepatocytes. This novel transplantation system could be used to investigate hepatocyte engraft, proliferation and gene expression.
Adult ; Animals ; Blotting, Northern ; Gene Expression* ; Hepatocytes* ; Humans ; Liver ; Microscopy ; Rats ; RNA ; RNA, Messenger ; Spleen

Nonimmune hydrops fetalis is becoming a predominant form of fetal hydrops due to the declining incidence of immune hydrops fetalis triggered by Rh isoimmunization. Infantile polycystic kidney appeared to be related to hydrops fetalis whether it is causal or merely coincidental and may represent another entry to differential diagnoses. Infantile polycystic kidney was diagnosed by an elevated maternal serum alpha-fetoprotein (AFP) value coupled with an ultrasonographic abnormality scanned as a multicystic mass with ascites in the fetal abdomen antenatally. This study presents a case of infantile polycystic kidney that resulted in a stillborn baby with hydrops fetalis and extensive placental calcification; it was the first case in Korea in which nonimmune hydrops fetalis was associated with infantile polycystic kidney in consecutive siblings by autosomal recessive inheritance in one family. In addition, this paper comprehensively reviews the incidence, etiology, prenatal diagnosis and proper management of nonimmune hydrops fetalis.
Adult ; Female ; Fetal Death/complications ; Fetal Diseases/*complications/pathology ; Human ; Hydrops Fetalis/*complications/pathology ; Pedigree ; Polycystic Kidney Diseases/*complications/pathology ; Pregnancy ; Recurrence

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

BACKGROUND: Transluminal balloon coronary angioplasty is one of the most widely used therapeutic procedures in the treatment of patients with coronary artery disease. However, restenosis remains a major limitation of percutaneous coronary angioplasty despite extensive efforts to prevent recurrence. We examined the immediate and long-term results of 516 patients (617 lesions) who underwent coronary angioplasty to evaluate the initial success rate, complications, restenosis rate, and the factors affecting initial success and restenosis. METHODS: The coronary angioplasty of 516 patients(M/F : 388/128, mean age : 57 years), 671 lesions was done with conventional technique and follow-up coronary angiogram was obtained 4 to 6 months after angioplasty in 168 patients. The angiographic restenosis was defined as >50% luminal narrowing in a previously dilated lesion, and the clinical restenosis defined as the recurrence of typical angina and/or positive tests of treadmill test, or thallium scintigraphy during follow-up period. RESULTS: 1) The coronary angioplasty was successful in 459 of 516 patients(89%), 604 of 671 lesions(90%). The success rate was significantly lower in subgroups with type C lesion(52.2%, p<0.001), right coronary artery (83.7%, p<0.05) and <3.0mm of size of lesion(81.4%, p<0.001). 2) The procedural complications were as follows : intimal dissection in 143 lesions(21.3%) including acute closure in 9 lesions(1.3%), emergency bypass surgery in 6 patients(1.2%), myocardial infarction in 9 patients(1.7%), rupture of coronary artery in 2 patients, air embolism in 1 patient, and death in 1 patient(0.19%). 3) The causes of the procedural failure(n=57 patients) included guidewire passage failure in 27, balloon passage failure in 4, catheter engagement failure in 1, acute closure in 7, coronary artery rupture in 2, and suboptimal result in 16 patients. 4) Clinical follow-up was obtained in 455 patients for a mean follow-up duration of 13.2months and clinical restenosis rate was 31%(141/455). The repeat coronary angiogram was performed in 168 patients(209 lesions) for a mean follow up duration 5.4month and demonstrated 48%(100/209) angiographically restenosis rate. The clinical restenosis rate was significantly lower in subgroups with <10% of residual stenosis(18.9%, p<0.05), left circumflex coronary artery(18.5%, p<0.05). 5) The restenosis following angioplasty(n=100 lesions) was treated with repeated PTCA in 57, Stent(Palmaz-Schatz) in 6, DCA in 3, elective CABG in 9, and medication in 25. 6) During the clinical follow-up, there were nonfatal myocardial infarction in 4 patients. CONCLUSION: 1) The coronary angioplasty is an effective treatment for revascularization that has a high success rate, low incidence of complications and excellent long-term survival. 2) The restenosis rate was affected by residual stenosis which suggests that the implication of minimal residual stenosis is the most important determining factor to reduce the restenosis rate after angioplasty.
Angioplasty* ; Catheters ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Embolism, Air ; Emergencies ; Exercise Test ; Follow-Up Studies ; Humans ; Incidence ; Myocardial Infarction ; Phenobarbital ; Radionuclide Imaging ; Recurrence ; Rupture ; Thallium