449 hospital patients with no pathologic brain CT findings, 30 yrs of age or older, were selected for the study of cerebral atrophy during the 30 months, from January 1980 to June 1983, at dept. of internal medicine, Hanyang Univ. hospital & following results were obtained. 1) Thoses in male group, A gradually progressive increase in the degree of cerebral atrophy score in the 3rd, 4th & late 5th decades was followed by a dramatic increase in the late 6th & 7th decades. 2) Those in female group, A gradually progressive increase in the degree of cerebral atrophy.
Atrophy* ; Brain* ; Female ; Humans ; Internal Medicine ; Male

449 hospital patients with no pathologic brain CT findings, 30 yrs of age or older, were selected for the study of cerebral atrophy during the 30 months, from January 1980 to June 1983, at dept. of internal medicine, Hanyang Univ. hospital & following results were obtained. 1) Thoses in male group, A gradually progressive increase in the degree of cerebral atrophy score in the 3rd, 4th & late 5th decades was followed by a dramatic increase in the late 6th & 7th decades. 2) Those in female group, A gradually progressive increase in the degree of cerebral atrophy.
Atrophy* ; Brain* ; Female ; Humans ; Internal Medicine ; Male

This study was performed to investigate the effect of endotoxin to the CCl4-induced liver injury. Twelve Sprague-Dawley rats were intraperitoneally injected 1.6 g/kg CCl4 as control group. Another 24 rats were orally administrated 300 mg/kg of neomycin at 16 and 3 hours prior to CCl4 injection as experimental group. Twelve among them were intraperitoneally infected 1.0 mg/kg of endotoxin(E-Coli, 0111:B4, No L-2630, lipopolysaccharide, Sigma, USA) and CCl4 simultaneously for offsetting neomycin effect. The rats were sacrificed at 1, 4, 10, and 24 hours after CCl4 injection. The liver tissues from all experimental groups were observed by light and electron microscopy. The results obtained were summarized as follows: In the CCl4 only group, the hepatocytes revealed sweling of ER and mitochondria with many lipid droplet in the cytoplasm. Focal cellular necrosis was seen at the later phase. The Kupffer cells were activated and showed many cytoplasmic processes, secondary lysosomes, and vaculoles. The endothelial cells were edematous. Several neutrophils, platelets, and microthrombi were scattered in the sinusoid. In the neomycin-CCl4-endotoxin administrated group, both hepatocytic destruction and intrasinusoidal microthrombi formation were more pronounced. In the neomycin pretreated group, the hepatocytes revealed mild cellular destruction without necrosis. There is no intrasinusoidal microthrombi. According to these results, it would be concluded that the small dosage of gastrointestinal tract-derived endotoxin affects to the liver injury caused by CCl4. The synergistic effects of CCl4 and gastrointestinal tract-derived endotoxin which can not be detoxified by damaged Kupffer cells, may be more important in the pathogenesis of CCl4-induced liver injury.
Rats ; Animals

Central diabetes insipidus (CDI) is a clinical syndrome that result from a failure of the neurohypophyseal axis to produce or release a sufficient quantity of arginine vasopressin (AVP) to permit normal function of the urinary concentrating mechanism. Polyuria and polydipsia are the symptoms associated with CDI. The most common cause of CDI is idiopathic variety and head trauma, neurohypophyseal surgery, primary or metastatic brain tumors acount for most of the remaining cases. CDI in Langerhans cell histiocytosis (LCH) is thought to be to infiltration of the hypothalamus-neurohypophyseal system. We report a patient with CDI and LCH underwent water depriviation test, MR imaging of the pituitary-hypothalamic region, and VATS associated open lung biopsy.
Arginine Vasopressin ; Axis, Cervical Vertebra ; Biopsy ; Brain Neoplasms ; Craniocerebral Trauma ; Diabetes Insipidus* ; Diabetes Insipidus, Neurogenic ; Histiocytosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Lung ; Magnetic Resonance Imaging ; Polydipsia ; Polyuria ; Thoracic Surgery, Video-Assisted

The hysteroscope has become a standard part of gynecologists' armamentarium, and hysteroscopy is taught routinely in residency curriculums. In recent years, its use in gynecology has changed from a diagnostic tool only to an instrument for gynecologic operations. An electrolyte-free irrigation fluid is used for hysteroscopic surgery, and it has a possibility of substantial absorption of irrigation fluid. The absorption depends on the rate, volume and nature of the irrigation fluid. Fortunately, large-scale fluid absorption is rare but leads to symptoms severe enough to require intensive care. Several methods have been proposed to reduce the risk but none of them is capable of preventing the complication from fluid absorption. In this case, the patient had pulmonary interstitial edema with hyponatremia after hysteroscopic uterine septectomy but that had resolved without sequelae.
Absorption ; Curriculum ; Edema ; Gynecology ; Humans ; Hyponatremia ; Hysteroscopes ; Hysteroscopy ; Intensive Care ; Internship and Residency ; Pulmonary Edema

PURPOSE: We reported clinical results of autologous tricorticocancellous bone grafting and plate-screw fixation for nonunion of the forearm bones. MATERIALS AND METHODS: Ten patients with nonunion of the forearm bones that underwent surgical treatment were evaluated. Tricorticocancellous bone grafting which was harvested from the iliac crest and plate-screw fixation were performed. Radiologic bone union was evaluated based on the simple radiographs. At the final follow-up, range of motion was measured and the Anderson scale was used for functional evaluation. RESULTS: Radiologic bone union was achieved in all cases. The mean range of motion was 139degrees of elbow flexion, 3degrees of flexion contracture, 73degrees of forearm pronation, 72degrees of supination, 70degrees of wrist flexion, and 70degrees of wrist extension. Anderson scale was excellent in 6 patients, satisfactory in three, and unsatisfactory in one. CONCLUSION: Autologous tricorticocancellous bone grafting and rigid plate-screw fixation is a reliable method to achieve successful healing of forearm bone nonunions.
Bone Transplantation ; Contracture ; Elbow ; Follow-Up Studies ; Forearm ; Humans ; Pronation ; Range of Motion, Articular ; Supination ; Wrist

We herein describe a 70-year-old woman who presented with respiratory failure due to extensive lung adenocarcinoma. Despite advanced disease, care in the intensive care unit with ventilator support was performed because she was a newly diagnosed patient and was considered to have the potential to recover after cancer treatment. Because prompt control of the cancer was needed to treat the respiratory failure, empirical treatment with an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor was initiated before confirmation of EGFR-mutant adenocarcinoma, and the patient was successfully treated. Later, EGFR-mutant adenocarcinoma was confirmed.
Adenocarcinoma* ; Aged ; Female ; Humans ; Intensive Care Units ; Lung* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilators, Mechanical ; Erlotinib Hydrochloride

The levels of expressions and catalytic activities of cytochrome P450 (CYP1A1) and glutathione-S-transferase class mu (GSTM1) enzymes in lungs and their metabolic balance may be an important determinant host factor underlying lung cancer. Genetic differences in metabolism, MspI restriction sites, Ile-Val polymorphism of CYP1A1 gene, and the null genotype of GSTM1 have been reported to be associated with susceptibility to lung cancer. The present studies were undertaken to establish frequencies of the polymorphic genotypes of CYP1A1 and GSTM1 in Koreans, and to evaluate linkage disequilibrium of the genotypes associated with higher lung cancer risks among Koreans. GSTM1(-) genotype was found in 52% of control subjects, whereas it was found in 55% of lung cancer patients. The allelic variants in CYP1A1 were distributed differently in lung cancer patients and controls. The heterozygous genotype frequency of the MspI site in lung cancer patients (53%) was higher than in controls (49%). The frequency of Ile/Val genotype of CYP1A1 was low in lung cancer patients, which are mostly squamous cell carcinoma.
Adenocarcinoma/genetics ; Carcinoma, Small Cell/genetics ; Carcinoma, Squamous Cell/genetics ; Cytochrome P-450 CYP1A1/genetics* ; Gene Frequency ; Genotype ; Glutathione Transferase/genetics* ; Human ; Korea ; Linkage Disequilibrium ; Lung Neoplasms/genetics* ; Mutation ; Polymorphism (Genetics)*

Mesenchymal chondrosarcoma is a rare tumor occurring in both bone and soft tissues and exhibits characteristic of a malignant nature. The authors experienced a case of mesenchymal chondrosarcoma occurring in a 23-year-old woman which had invaded the cervical spine. The patient presented with severe both shoulder pain, left upper extremity weakness(Grade IV) and paresthesia at admission. Radiologic studies of the cervial spine showed an aggressive osteolysis of C4 vertebral body, pedicle and lamina with compression of the spinal cord posteriorly on C3, C4, C5 levels. The tumor was totally removed by a combined anterior and posterior approach. The removed vertebral body was replaced with autogenous bone and stabilized by Codman locking plate symtem. The pathological examination showed characteristic of mesenchymal chondrosarcoma.previous symptoms well improved postoperatively. The authors present a case of mesenchymal chondrosarcoma with review of literature.
Chondrosarcoma, Mesenchymal* ; Female ; Humans ; Osteolysis ; Paresthesia ; Shoulder Pain ; Spinal Cord ; Spine* ; Upper Extremity ; Young Adult

In the pediatric ICU and operating room, a central venous catheter (CVC) provides accurate hemodynamic information and serves as a reliable route for the administration of vasoactive drugs, fluids and allogeneic blood products. The placement of CVC is associated with a complication rate of 0.4% to 20%, including hemothorax, pneumothorax, thrombosis, infection and cardiac tamponade. We describe a case of CVC being misplaced in the innominate vein after penetrating the subclavian vein during anesthesia induction for arterial switch operation. Our report discusses the mechanisms by which this mishap took place, and reviews the proper positions of the head, arm, thorax and safe depth of venipuncture for the placement of a CVC in neonates.
Anesthesia ; Arm ; Brachiocephalic Veins ; Cardiac Tamponade ; Central Venous Catheters ; Head ; Hemodynamics ; Hemothorax ; Humans ; Hypogonadism ; Infant, Newborn ; Mitochondrial Diseases ; Operating Rooms ; Ophthalmoplegia ; Phlebotomy ; Pneumothorax ; Subclavian Vein ; Thorax ; Thrombosis