The rim sign in renovascular compromise may be defined as a thin nephrographic rim outlinning a kidney with another wise faint nephrogram. Renal infarction with gelform and blood clots was induced experimentally in 5 dogsand high dose IVP and CT were performed to evaluate renal cortical rim sign after renal infarction. One expireddue to anesthetic technical failure, and one was embolized partially. So we could be obtain the result on 3 dogs.The reults were as follows; 1. The high dose IVP films show cortical rim sign on 24 hrs and 72 hrs films in twodogs. The CT films show rim sign in 3 dogs. 2. The rim sign may be visualized, if the renal artery is occuludedenough to drop perfusion presssure below the authoregulatory range. 3. The high dose IVP and early nephrogramphase are necessary for the rim sign.
Animals ; Dogs ; Infarction ; Kidney ; Perfusion ; Renal Artery

The intra-articular osteochondroma arising from soft tissue is very rare and has been reported less than a dozen cases in the English literature. This tumor is the result of extrasynovial metaplasia of the fibrous capsule or of the adjacent connective tissue of a joint. The authors experienced a case of giant intra-articular osteochondroma of the right knee in a 37 year-old man which arised from the medial meniscus. Histology as well as gross findings were consistent with osteochondroma. Excision of the mass with attached meniscus relieved symptoms. No recurrence, or malignant change was identified up to 1 year after excision.
Connective Tissue ; Joints ; Knee ; Menisci, Tibial ; Metaplasia ; Osteochondroma ; Recurrence

No abstract available.
Low Back Pain* ; Pregnancy*

OBJECTIVE: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. METHODS: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. RESULTS: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had 20~30% of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. CONCLUSION: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.
Bromocriptine* ; Cavernous Sinus ; Decompression ; Dopamine Agonists ; Humans ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Pituitary Neoplasms ; Prolactin ; Prolactinoma* ; Prospective Studies ; Tumor Burden ; Visual Acuity ; Visual Fields

Lipoprotein(a)[Lp(a)] is a LDL-like particle with a glycoprotein called apo(a) attached to its apoB through disulfide bond. Many case-control studies support the opinion that plasma Lp(a) levels were associated with coronary artery disease. This study was conducted to assess the relationship between plasma Lp(a) level and coronary artery disease in Korean population. Serum levels of Lp(a), in addition to other lipids and known clinical risk factors for coronary artery disease were determined in 92 subjects undergoing coronary angiography. Among them 30 patients had no obstruction in the coronary artery(cath-control group), while the others revealed the presence of coronary artery stenosis more than 50%(CAD group). The Lp(a) levels of the CAD group were significantly higher the those of cath-control group(31.8+/-25.0mg/dl vs 14.6+/-11.9mg/dl, p<0.005). Other lipids except triglycerides(166.9+/-70.5mg/dl vs 116.2+/-56.1mg/dl, p<0.005) were not significantly different between two groups. The patients with significant coronary artery disease of two or more vessels were found to have higher Lp(a) levels than those of one vessel disease. Lp(a) levels had no relations with other lipids, diabetes, smoking, hypertension and age. Stepwise discriminant analysis revealed that Lp(a) was the best discriminator among risk factors for coronary artery disease. These results suggested that Lp(a) level was a significant independent risk factor for coronary artery disease.
Apolipoproteins B ; Case-Control Studies ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Glycoproteins ; Humans ; Hypertension ; Lipoprotein(a)* ; Plasma ; Risk Factors* ; Smoke ; Smoking

No abstract available.
Anemia, Aplastic* ; Discitis* ; Humans ; Low Back Pain*

PURPOSE: Cerebrovascular disease in children is more common than was once recognized and the etiology and prognosis of the disease in children are quite different from those of adults. Recently according to medical reports and clinical experiences, the incidence of childhood cerebrovascular disease is increasing in Korea. To clarify the clinical features of childhood cerebrovascular disease and to analyze its prognostic factors, retrospective study was perinatal problem, trauma or hypoxia. METHODS: We reviewed clinical records of the patients who had admitted to Seoul National University Children's Hospital during 5 years from Jan. 1989 to Dec. 1993. RESULTS: There were 82 cases(66.8%) of ischemic cerebrovascular disease as well as 41cases(33.3%) of hemorrhagic cerebrovascular disease. Various predisposing causes were known in 108 cases(87.8%); vasculopathy was frequent in ischemic group while hemato-oncologic disease was frequent in hemorrhagic group. The presenting symptoms and signs of childhood cerebrovascular disease were seizure, motor paralysis, headache, altered consciousness, etc. Transient ischemic attack and bulbar palsy were relatively common in ischemic group while ltered consciousness was more frequent in hemorrhagic group. The overall mortality of childhood cerebrovascular disease in this study was 11.4%, and deaths were frequent in hemorrhagic group(24.4%) than in ischemic group(4.9%) (p<0.005). Patients with a hemato-oncologic disease as a predisposing cause, and with an alteration of consciousness as a presenting sign were at increased risk for death (p<0.0005). Only 37 cases(33.9%) of the 109 patients surviving stroke were recovered completely while 72 cases(66.1%) had one or more residual deficits. Residual deficits occurred more often following ischemic stroke(71.8%), than after hemorrhagic stroke (51.6%), and complete recovery vice versa. Motor deficit was the commonest of the residual deficits. But the majority of motor deficits were mild and disability in fine motor control is common. Unlike in adults, seizure, mental retardation and learning disability were common as residual deficits in children. CONCLUSIONS: Considering above results childhood cerebrovascular disease is not so rare in Korea. And the clinical features and prognosis of cerebrovascular disease in children were somewhat different from those in adults. Since the outcome of childhood cerebrovascular disease is not so good, further exact and inclusive studies on this subject are required for early diagnosis and treatment which are important in decreasing mortality and morbidity of the disease.
Adult ; Anoxia ; Bulbar Palsy, Progressive ; Child ; Consciousness ; Early Diagnosis ; Headache ; Humans ; Incidence ; Intellectual Disability ; Ischemic Attack, Transient ; Korea ; Learning Disorders ; Mortality ; Paralysis ; Prognosis ; Retrospective Studies ; Seizures ; Seoul ; Stroke

BACKGROUND: The dipyridamole and dobutamine stress echocardiography have been studied as a non-invasive diagnostic test in coronary artery disease. Recently, some authors have extended the usefulness of these tests to predicting the prognosis of myocardial infarction patients. But as far as we know, there was no literature which tried boh tests to the same infarcted patients group. So, we performed both tests in the 23 infarcted patients to compare and evaluate both tests as predicting the prognosis in myocardial infarction. METHODS: Patients underwent (1) two-dimensional echocardiography under basal condition and after dipyridamole infusion for 4 minites at the dose of 0.14mg/kg/min, (2) another two dimensional echocardiography under basal and during dobutamine infusion at each dose of 5 to a maximum of 20microg/kg/min at 1 or 2 days after dipyridamole stress echocardiography, and (3) coronary and left ventricular angiography. Preinfusion and peak infusion images were analyzed independently by two different observers using Nova Micro Sonic soft were(DataVueII and ColorVue II analysis system). The segmental wall motions were scored as follows ; hyperkinetic : 1, normal : 2, hypokinetic : 3, akinetic : 4. THe test response was considered positive if abnormal wall motion and reduced myocardial thickening were observed during drug infusion at the vascular distributions except the akinetic infarcted segment identified during basal condition. The coronary angiography was analyzed by measuring the maximal luminal diameter stenosis with caliper and 50% or greater diameter narrowing was considered significant. The sensitivity and specificity were calculated by comparing echocardiographic prediction and angiographic findings. RESULTS: 1) Among 22 patients with sufficient image in dipyridamole stress echocardiography, 13 patients have myltivessel coronary disease without resting akinesia of non-infarcted segments. Only 5 patients showed positive findings in dipyridamole stress echocardiography(sensitivity, 38.4%). Among 9 patients who has single or minimal disease, 9 patients were negative finding(specificity, 100%). 2) Among 21 patients with sufficient image in dobutamine stress echocardiography, 12 patients have multivessel coronary disease without resting akinesia of non-infarcted segments. 7 patients showed positive finding in dobutamine stress echocardiography(sensitivity, 58.3%). Among 9 patients who has single or minimal disease, 8 patients showed negative finding(specificity, 88.8%). 3) In hemodynamic changes, dipyridamole stress echocardiography showed significant changes in heart rates and double products and dobutamine stress echocardiography showed significant changes in heart rates, systolic blood pressure and double products. 4) There was no significant side effect during both stress tests inacute and old myocardial infarction patients. CONCLUSION: 1) The dobutamine and dipyridamole stress echocardiography are safe and easy test for myocardial infarction patients. 2) The dobutamine stress echocardiography has higher sensitivity than dipyrdamole stress echocardiography for identifying multivessel coronary disease in myocardial infarction patients but the dose of both drugs were relatively small to get the adequate results. So the high dose of drugs must be tried in feature study.
Angiography ; Blood Pressure ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Diagnostic Tests, Routine ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Exercise Test ; Heart Rate ; Hemodynamics ; Humans ; Myocardial Infarction* ; Phenobarbital ; Prognosis ; Sensitivity and Specificity

No abstract available.
Appendicitis* ; Barium* ; Enema*

No abstract available.
Intellectual Disability ; Muscle Weakness ; Muscular Dystrophy, Duchenne*