BACKGROUND: Thromboembolism is the major complication in patients with the insertion of cardiac prosthetic valves. The purpose of this study is evaluate the risk factors about the formation of left atrial thrombi after cardiac valve replacement. METHOD: Transesophageal(TEE) and transthoracic echocardiography(TTE) were done to evaluate postoperative cardiac condition in 98 patients with cardiac prosthetic valves from Jan. 1991 to Oct 1991. Several clinical and echocardiographic parameters were analyzied to evaluate the relationship with the formation of left atrial thrombi. RESULT: In univariate analysis, important factors related to the formation of left atrial thrombi are type of operation (p=0.027), postoperative left ventricular function(p=0.003), preoperative(p=0.037) and postoperative systolic ventricular size(p=0.024). However, in multivariate analysis postoperative left ventricular size(p=0.017), presence of previous thrombi(p=0.014), preoperative left atrial size(p=0.014) and postoperative left atrial size(p=0.014) are significant factors. CONCLUSION: Patients with high risk and low risk for the formation of left atrial thrombi after valve replacement can be identified by readily available clinical and echocardiographic variables.
Echocardiography ; Heart Valves ; Humans ; Multivariate Analysis ; Risk Factors* ; Thromboembolism

No abstract available.
Myelitis, Transverse* ; Retrospective Studies*

SUMMARY: Benign fibrous histiocytoma of the knee is a very rare entity. We report on one case of benign fibrous histiocytoma that involved the patellar fat pad, an areas of involvement not previously reported. Diagnostic arthroscopy was performed to show retrobulging of infrapatellar fat pad without specific synovial changes. The lesion was completely resected. At short-term follow-up, all symptoms were resolved. Arthroscopy can be used as an diagnostic tool for identification of intraarticular lesions of the knee, but appears not to be a good tool for clean removal of mass within patellar fat pad.
Adipose Tissue* ; Arthroscopy ; Follow-Up Studies ; Histiocytoma, Benign Fibrous* ; Knee

No abstract available.
Colon* ; Gastrointestinal Hemorrhage* ; Varicose Veins*

No abstract available.
Adult* ; Hernia* ; Humans

Primary gastric lymphorna represents one to 7% of all gastric cancer and is the most common type of extranodal lymphoma. In attempt to evaluate the endoscopic characteristics, we analysed clinical and endoscopic findings in 35 patients with primary gastric lymphoma between January 1980 and August 1994 at the Yonsei Medical Center. The results were as follows: 1) The mean age of patients was 47.1 years with male to female ratio of 1.5: l. 2) Gastroscopy was performed in all 35 patienits, which revealed polypoid lesion in one case(2.9%), ulcerative lesion in 15 cases(42.9%), ulcero-infiltrative lesion in 6 cases(17.1%) and diffuse infiltrative lesion in 2 cases(5.7%). Gastric lymphoma was suggested in 6 cases, advanced gastric cancer in 21 cases, early gastric cancer in 5 cases and benign gastric ulcer in 3 cases. Pathologic diagnosis of biopsy specimens were gastric lymphoma in 24 cases, adenocarcinoma in 5 cases and chronic superficial gastritis in one case. 3) The characteristics of the endoscopic findings in gastric lymphoma were intractable or recurrent ulcer in 10 cases, thickened and mounded ulcer margin in 9 cases, multiple ulcers in 9 cases, giant rugae in 7 cases and polypoid or depressed lesion with central ulceration in 4 cases. In conclusion, recognition of specific endoscopic findings such as intractable or recurrent ulcer, volcano-like ulcer, multiple ulcers, giant rugae and combined lesion, the possibility of a lymphoma should be considered and vigorous biopsy attempts should be carried out. Then if the first microscopic report does not suggest this diagnosis, a second investigation including jumbo biopsies, perhaps by diathermy, should be undertaken.
Adenocarcinoma ; Biopsy ; Diagnosis* ; Diathermy ; Female ; Gastritis ; Gastroscopy ; Humans ; Lymphoma ; Male ; Stomach Neoplasms ; Stomach Ulcer ; Ulcer

Segmental spinal dysgenesis (SSD) is a rare congenital abnormality in which a segment of the spine and spinal cord fails to develop properly. Segmental vertebral anomalies involve the thoracolumbar, lumbar, or lumbosacral spine. We report two cases of SSD associated with other spinal dysraphism. Radiologic investigations revealed segmental dysgenesis of thoracic spinal cord without an associated vertebral bony anomaly in one case and segmental dysgenesisof the cervico-thoracic cord with diastematomyelia in the other case. The neurologic picture depends on the severity of the malformation and on its segmental level along the longitudinal embryonic axis. The pathogenesis of SSD syndrome is not clear but its cause is probably related to a segmental maldevelopment of the neural tube.
Axis, Cervical Vertebra ; Congenital Abnormalities ; Neural Tube ; Neural Tube Defects ; Silver Sulfadiazine ; Spinal Cord ; Spinal Dysraphism ; Spine

OBJECTIVE: To define the ultrasonographic findings of the median nerve within the carpal tunnel and to verify the differences of the median nerve according to age, sex and the wrist in the normal Korean adults. METHOD: We studied 152 hands of 76 normal Korean adults who had no symptoms of carpal tunnel syndrome such as hand numbness, pain, dysesthesia or hand weakness. All subjects were examined with a real-time ultrasonography. We evaluated the flattening ratio (FR) and cross-sectional area (CSA) of the median nerve within the carpal tunnel. RESULTS: The CSA of the median nerve was 6.44+/-0.02 mm2 (at distal radioulnar joint), 6.34+/-0.02 mm2 (at pisiform) and 6.31+/-0.02 mm2 (at hamate). The FR at distal radioulnar joint is 2.36+/-0.02, at pisiform is 2.33+/-0.01 and at hamate is 2.33+/-0.01. Men have a larger cross-sectional area and flattening ratio of the median nerve than women. The older group over age 50 years has a smaller cross-sectional area and flattening ratio than the younger group. There were differences between men and women in body mass index (BMI) as well as between the older and the younger. There was also a linear relationship with CSA and FR in weight and height. CONCLUSION: The ultrasonographic finding of the normal Korean adult's median nerve in the carpal tunnel were different according to age and sex. Weight, height and BMI might be important factors to bring different results according to race, sex and age.
Adult ; Body Mass Index ; Carpal Tunnel Syndrome ; Continental Population Groups ; Female ; Hand ; Humans ; Hypesthesia ; Joints ; Male ; Median Nerve ; Paresthesia ; Wrist

We present a rare case of a pituitary adenoma revealing a sedimentation level on MRI, which has not been previously documented. This 55-year-old woman was referred with the diagnosis of craniopharyngioma. She presented with four-month history of progressive headache and visual dimness. Neurological examination revealed a bitemporal hemianopsia and decreased visual acuity. Laboratory data including endocrine examination were unremarkable. An additional three-dimensional MRI was taken for further evaluation, and demonstrated a sedimentation level within the tumor. The patient underwent transcranial removal of the tumor. About 12cc of dark-red blood was aspirated from the tumor. Histological examination revealed a pituitary adenoma with hemorrhage. Postoperatively, the patient showed gradual improvement of visual function. Considering that the pituitary adenoma is one of more common tumors that cause tumoral bleeding, a cystic sellar tumor that has a sedimentation level should be sought first for a pituitary adenoma rather than a craniopharyngioma. This may have an important impact when deciding surgical approach.
Craniopharyngioma ; Diagnosis ; Female ; Headache ; Hemianopsia ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Neurologic Examination ; Pituitary Apoplexy ; Pituitary Neoplasms* ; Visual Acuity

Taxol, an anticancer drug, blocks cell division by stabilizing microtubules. However, taxol has distinct cell-cycle-independent effects. For example, taxol and bacterial LPS induce strikingly similar responses in murine microglial cells. Here, we report that taxol, like LPS, provides a ""second"" signal for murine microglial cell activation to induce tumoricidal activity. Tumoricidal activity determined by MTT assay appeared that taxol or LPS alone weakly activated microglial cells to kill P815 mastocytoma cells, whereas combinations of taxol or LPS with IFN-r synergized to activate macrophages to lyse tumor cells in a dose dependent manner. Secretion of nitric oxide (NO) correlated with tumor cell killing, and the activated microglial cells failed to kill tumor cell targets in the presence of N'-monomethyl-L-arginine (N'MMA), a competitive inhibitor of NO synthase (NOS). Treatment of the cells with anti-TNF-a neutralizing antibodies clearly blocked taxol plus IFN-r induced tumoricidal activity as well as NO production. Collectively, the data illustrate the potential for taxol to activate microglial cell mediated-antitumor mechanisms in addition to its better characterized role as an anti-mitotic agent.
Antibodies, Neutralizing ; Cell Division ; Homicide ; Macrophages ; Mastocytoma ; Microglia ; Microtubules ; Nitric Oxide Synthase ; Nitric Oxide* ; Paclitaxel*