Primary biliary cirrhosis is frequently associated with a variety of disorders presumed to be autoimmune in nature, such as Sjogrens syndrome, scleroderma, rheumatoid arthritis, systemic lupus erythematosus, and autoimmune thyroiditis. Scleroderma has been recognized in association with primary biliary cirrhosis. Most cases present as the CREST (calcinosis cutis, Raynauds phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome. Isolated pulmonary hypertension develops in a small proportion of patients, nearly all of whom have limited cutaneous involvement. We report a case who has diffuse scleroderma associated with primary biliary cirrhosis and isolated pulmonary hypertension.
Arthritis, Rheumatoid ; Esophageal Motility Disorders ; Humans ; Hypertension, Pulmonary* ; Liver Cirrhosis, Biliary* ; Lupus Erythematosus, Systemic ; Scleroderma, Diffuse* ; Sjogren's Syndrome ; Thyroiditis, Autoimmune

Intraspinal neurenteric cysts are rare congenital lesions that results from abnormal separation of germ layers in the third week of embryonic development, which may cause spinal compression. Although, the diagnosis of neurenteric cyst was very difficult prior to operation, MRI has proven to be a useful imaging modality in detection, localization and characterization of intraspinal neurenteric cysts. We recently experienced intraspinal neurenteric cyst in two patients who presented with progerssive quadriparesis. Myelography, CT myelography and MRI were taken and complete excision was performed. The MRI findings are presented and the literature is reviewed.
Diagnosis ; Embryonic Development ; Female ; Germ Layers ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neural Tube Defects* ; Pregnancy ; Quadriplegia

PURPOSE: A common finding of carotid artery on magnetic resonance angiograms(MRAs) is a signal dropout along the posterior wall of carotid bulb due to reverse flow. The purpose of this study is to evaluate variable flow patterns on bifurcated carotid arterial phantoms using steady-state flow. MATERIALS AND METHODS: We designed phantoms of a bifurcated carotid artery with acrylic materials. Flow patterns were evaluated with axial and coronal imaging of MRA(2D-TOF, 3D-TOF), color Doppler imaging, and computational fluid dynamics (CFD) within the phantoms constructed of an automated closed-type circulatory system filled with 4% sugar solution. These findings were compared with findings obtained from normal volunteers. RESULTS: Axial 3D-TOF MRA images exhibited closer resemblance to the contour of the inner wall of phantoms when compared to coronal 2D-TOF MRA imaging. However, 2D-TOF MRA showed good contrast difference of signal intensities between forward flow area and reverse flow area. Dark zones with reduced signal intensities due to reversed flow were separated from the outer wall of the internal and external carotid arteries by a thin layer of forward flow along the wall on the source slice image of MRA. The general hemodynamics of the phantoms on MRA were identical to hemodynamics on color Doppler imaging and CFD. The results obtained with the phantoms matched the findings on normal volunteers. CONCLUSION: Although representations of bifurcated carotid arterial phantoms on axial 3D-TOF MRA were excellent if ideally desinged, the zone of reversed flow could be a significant factor in creating distorted image when the zone of reversed flow contacted directly with curved or deformed arterial wall.
Carotid Arteries ; Carotid Artery, External ; Healthy Volunteers ; Hemodynamics ; Humans ; Hydrodynamics ; Magnetic Resonance Angiography* ; Patient Dropouts

No abstract available.
Thanatophoric Dysplasia*

The authors analysed the CT findings in 75 cases diagnosed as gastric carcinoma by U.G. I.S. or endoscopy in a 3)1, year period. The comparative analysis betw~en CT findings and surgical pathologic findings was done in 55 cases who underwent surgery. 20 cases could not be operated upon because of distant metastasis. The gastric carcinoma was devided into 4′ stages according to the staging system of the American joint Committee on Cancer. The CT findings were then compared and the following results noted : 1. The relationship with gastric wall thickening and penetratioil degree of tumori no thickening (Iesser than 1.0 cm) of 3 cases showed all of T1, 11 of localized thickening (1. 0.1 .5cm) showed 7 of T2, 38 of localized thickening (more than 1.5 cm) showed 37 of T3 and 3 of diffuse thickening showed all of T4a. 2. The accuracy of Iymph node detection by CT scan, 1) Regionaf tymph node showed 86% in operative f in ding and 73% in pathologic. 2) Extragastric Iymph node showed 87% in operative finding and 89% in pathologic. 3) Retro-peritoneallymph node showed 96% in operative finding and 95% in pathologic. ic. 3. In operated cases, there was one case of false positive distant metastasis and three false negative cases. 20 cases of non-operated cases showed distant metastasis such as liver, lung or kidney. 4. 55 cases were classified as stage 1 in 4 cases, 11 in 18, 111 in 23 and IV in 10 by pathologic findings, and 1 in 3, 11 in 24, 111 in 19 and IV in 9 by CT. The overall accuracy by CT stagi ng is 75%. 5. Among a total of 75 cases, there were 46 operable cases by CT finding an d 43 operabl e cases by pathologic staging. There we re 29 inoperable cases by CT finding and 27 cases by pathologic staging. Therefore, there was a 93% overall accuracy by CT stagi ng in terms of determination of operability. 6. The accuracy of adhesion into adjacent structure by CT finding was 69%. compared with operable finding.
Endoscopy ; Joints ; Kidney ; Liver ; Lung ; Neoplasm Metastasis ; Tomography, X-Ray Computed

The following are summary of the clinical observations on 184 pregnant women underwent cesarean section under general and spinal anesthesia. 1. Ages of pregnant women ranged from 18 to 45 years The second and third decades. comprised 94% of all cases. 2. 83% of the cases were emergency and others were elective operations. 3. Surgical indications revealed dystocia in 43%, hemorrhage in 35%, and others in 22%. 4. 92 cases were performed by general anesthesia, 88 cases by spinal and the remains by local. 5. Apgar scores checked one minute after delivery were as follows. That was Poor category (0 to 4): 42% Fair category (5 to 7): 19% Good category (8 to 10): 39% Resuscitation of Apgar score 0 babies were successful in 8 cases.
Anesthesia* ; Anesthesia, General ; Anesthesia, Spinal ; Apgar Score ; Cesarean Section* ; Dystocia ; Emergencies ; Female ; Hemorrhage ; Humans ; Pregnancy ; Pregnant Women ; Resuscitation

PURPOSE: The purpose of this study was to evaluate the clinicopathological significance of the microvessel density and macrophage and mast cell counts in invasive breast carcinomas. MATERIALS AND METHODS: 45 invasive breast carcinomas were immunohistochemically stained with the endothelial antigen, CD34, and macrophage marker, CD68. 0.1% toluidine blue was used to highlight mast cells. The microvessel and mast cell counts were performed at x200 magnification and the macrophages at x400 magnification. RESULTS: With the 45 invasive breast carcinomas, there were no statistically significant associations between the mast cell, macrophage and microvessel counts and the tumor size and lymph node status. ER and PR negative mast cells infiltrated more than in cases of positive stati, with statistical significance (p-value=0.010 and 0.005, respectively). The macrophage counts were negatively correlated with the PR status (p-value=0.030). With respect to the c-erbB-2 status, there was no significance correlation with the mast cell, macrophage and microvessel counts. The mast cell counts showed significantly positive correlation with the microvessel counts in the invasive breast carcinomas (p-value=0.015). In a comparison of the macrophage counts with the microvessel counts, a positive tendency for both parameters, but without statistical significance (p-value=0.310). CONCLUSION: Increasing numbers of mast cells and macrophages were recruited in invasive breast carcinomas, which contribute to angiogenesis. The microvessel density in invasive breast carcinomas had no statistically significant association with the tumor size, lymph node status, and histological grade, presence of DCIS component, estrogen/progesterone receptor status and cerbB-2 status. The evaluation of angiogenesis using these methods is not thought to provide an independent clinicopathological factor in invasive breast carcinomas.
Antigens, CD34 ; Breast Neoplasms ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Lymph Nodes ; Macrophages* ; Mast Cells* ; Microvessels* ; Tolonium Chloride

The Authors observed 16 cases of Parathion intoxication from 1972 to 1974 in LC.U. of Busan National University Hospital. The results were as follows; 1. Parathion solution (20%) was taken for the purpose of suicide in all 16 cases. 2. Male-to-female ratio was 1. 28: 1. Age distribution ranged from 18 to 31, and the highest age group was 2 nd decade (ll cases), next 3 rd (3 cases), and 1st decade (2 cases) in order. 3. Culture of bronchial secretion was done in 6 cases and Pseudomonas Aeruginosa were detected in 5 cases. 4. Adequate control of respiratory problems and drug therapies for this intoxication resulted.
Age Distribution ; Busan ; Drug Therapy ; Humans ; Parathion* ; Pseudomonas aeruginosa ; Suicide

Although crystalloid solutions such as Ringer's lactate have become the standard for initial volume replacement after hemorrhage, it is controversy whether this fluid alone restores and maintains the depressed physiologic function after severe hemorrhage. Six anesthetized dogs were bled(35ml/kg) and resuscitated with Ringers lactate solution (100 ml/kg). Physiologic variables are measured initialy, after hemorrhage, after resucitation. Compared with initial value, after resuscitation data show marked reduction in hemoglobin, oxygen carrying capacity, vascular resistance, and electrolyte. But cardiac output and blood gas analysis data was not changed. Prothrombin time and partial thromboplastin time was prolongated. From this study crystalloid resuscitation in severe hemorrhagic shock restore cardiac output and perfusion, but fail to maintain adequate oxygen carrying capacity.
Animals ; Blood Gas Analysis ; Cardiac Output ; Natural Resources ; Dogs* ; Hemorrhage ; Lactic Acid ; Oxygen ; Partial Thromboplastin Time ; Perfusion ; Prothrombin Time ; Resuscitation* ; Shock, Hemorrhagic* ; Vascular Resistance

PURPOSE: The purpose of this study is to assess the usefulness of dynamic MR imaging after contrast enhancement with Gd-DTPA in the differential diagnosis of hepatic focal lesions. MATERIALS AND METHODS: The population consists of 22 cases of hepatocellular carcinoma, 44 cases of hemangioma, and five cases of metastasis. Diagnosis of hepatocellular carcinoma was made by surgery, fine needle biopsy, ultrasonography, CT and conventional angiography. Hemangioma was diagnosed on the basis of ultrasonography, CT, conventional spin-echo MRI and clinical data. Diagnosis of metastasis was done by fine needle aspiration biopsy. Dynamic and delayed images were obtained using 1.5T superconductive magnetom after Gd-DTPA(0.1mmol/kg) intravenous injection. Quantitative and qualitative evaluation was done for each lesion. RESULTS: Early contrast enhancement with rapid or gradual washout was noted in 15 lesions of hepatocellular carcinoma(68.2%) ;on the delayed images, no contrast enhancement was noted in 18 lesions(81. 8%). Peripheral contrast enhancement pattern was predominantly(86.4%) observed in hemangiomas during dynamic phase. On the delayed images, homogeneous and persistent contrast enhancement of masses were noted in all hemangiomas. Characteristic centripetal fill-in pattern was observed in 32 lesions of hemangioma (72.7%). Contrast inversion of masses during contrast enhancement study was noted in all hemangiomas, while continuous negative contrast was noted in hepatocellular carcinomas and metastases. CONCLUSION: Dynamic MR imaging after contrast enhancement with Gd-DTPA is an useful method in the differential diagnosis of hepatic focal lesions.
Angiography ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential* ; Evaluation Studies as Topic ; Gadolinium DTPA ; Hemangioma* ; Injections, Intravenous ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Ultrasonography