Splenoportography has been proved as a useful method for the evaluation of circulatory distrubances in portalhypertension. Authors analyzed the various aspects of these disturbances on splenoportography in 22 cases thatwere performed under the clinical suspicion of portal hypertension during recent 6 years, from May, 1976 to July,1982 at the Department of Radiology, National Medical Center. The results were as follows; 1. Liver cirrhosis wasthe most frequent cause of intrahepatic obstruction type in portal hypertenstion (86%). 2. The portal pressure wasmore than 400 mmH2O in 67% of the cases (range; 300-540 mmH2O). 3. In the majority of the cses, the higher theportal pressure was, the more dilated splenic and portal veins were. The diameter of portal vein was more than15mm in 79%, more than 21 mm in 47% of the cases (range; 10-26mm). The diameter of splenic vein was more than 15mmin 48% of the cases (range; 7-23mm). Especially the diameter of splenic vein was larger than that of portal veinin 20% of the cases. 4. There was no definite correlation between the development of collateral circulation andthe diameter of splenic and portal veins. 5. The filling of collateral circulation was definite sign of portalhypertenstion, though not regular. In portal hypertension, the collateral circulation was formed via coronary vein(91%), short gastric vein (64%), inferior mesenteric vein(36%). 6. Splenic-hilum time was delayed in 64% of thecases. Intrahepatic portal vein emptying time was more than 6 seconds in all the cases. 7. Most of the cases (91%)could be diagnosed as portal hypertension with vasculogram and hepatogram.
Collateral Circulation ; Hypertension, Portal ; Liver Cirrhosis ; Methods ; Portal Pressure ; Portal Vein ; Portography ; Splenic Vein ; Veins

Intracranial aneurysm in pregnancy imposes special consideration for both mother and fetus. During newborn delivery, the risk of aneurysmal rupture should be avoided by careful management. We experienced a case of cesarean section and the clipping of aneurysm in 37 years old pregnant woman at the gestational age of 35 weeks. She had suffered from headache since 30 weeks of gestational age and the ptosis of left eye since 33 weeks of gestational age. Ten millimeter-sized aneurysm of posterior communicating artery was found on the cerebral angiogram. After radial artery cannulation, we anesthetized the woman with nitroprusside infusion, thiopental, succinylchoine and nitrous oxide-oxygen-isoflurane gas mixture. Soon after intubation, systolic blood pressure increased from 140 to 150 mmHg during the infusion of sodium nitroprusside. The delivery of a newborn was done 8 min after induction and clipping of aneurysm was done successfully after the end of cesarean section.
Adult ; Aneurysm* ; Arteries ; Blood Pressure ; Catheterization ; Cesarean Section* ; Female ; Fetus ; Gestational Age ; Headache ; Humans ; Infant, Newborn ; Intracranial Aneurysm* ; Intubation ; Mothers ; Nitroprusside ; Pregnancy ; Pregnant Women* ; Radial Artery ; Rupture ; Thiopental

The clinical triad of relapsing iritis, ulcers of the mouth and genitalia was first described in 1939 by Hulusi Behcet. This entity, originally confined to the above triad of symptoms appears to be systemic disease manifested by skin lesion, thrombophlebitis, neurologic, cardiovascular or visceral symptoms. The vascular involvement in Behcet's syndrome has been reported since Mischima first described a case in 1961, four types of vascular lesion are freuqnetly observed most commonly on the inferior or superior vena cava. Treatments consist of anticoagulation and administering oral steroids. We report a case of SVC obstruction in 36 years old female patient with Behcet's syndrome.
Adult ; Behcet Syndrome* ; Female ; Genitalia ; Humans ; Iritis ; Mouth ; Skin ; Steroids ; Thrombophlebitis ; Ulcer ; Vena Cava, Superior

For several decades, Radiofrequency lesioning has been used for intractable pain that originates from the spinal area. Heating of the tissue has been assumed to be the only mechanism that can cause this effect. There has never been the suggestion that the RF fields themselves can modify the neuro-cellular function independently of the thermal effect. Additionally, Radiofrequency machines can not be used in neuropathic pain because of their thermal effect. Recently, a modified type of Radiofrequency machine was developed, using a non-thermal pulse, and applying a relatively high voltage. Some authors have reported remarkable results using this technique recently. There are several possible mechanisms and several attempts have been tried to explain this therapeutic effect respectively, but none of them explain it fully. One possible mechanism is through an Electro-Magnetic Field (EMF) that doesn't produce high temperature in the tip area. This is done in a pulsed fashion to avoid the high temperature made during the active cycle. However there is no apparent mechanism that explains this therapeutic effect clearly. The patient whom we report now was a 23 year-old male who suffered from repetitive low back pain and radiculopathy. He failed to respond to other oral and invasive conventional therapies. We experienced a successful result in the treatment of his intractable neuropathic pain using this pulsed RF machine.
Heating ; Hot Temperature ; Humans ; Low Back Pain ; Male ; Neuralgia* ; Pain, Intractable ; Radiculopathy ; Young Adult

Background: Chronic use of glucocorticoid is known to result in osteoporosis. Deflazacort (DFZ), a synthetic glucocorticoid, has been reported to have bone sparing properties in vivo eompared to dexamethasone(DEX). Not only the direct effect of DFZ on human osteoblast but the mechanism by which the drug spares bone remains unclear. This study, therefore, is aimed to investigate the direct effect of DFZ on the proliferation and differentiation of human osteoblast as well as on the gene expression of osteocalcin and osteoblast as well as on the gene expression of osteocalcin and growth factor produced in osteoblast. Methods: Human osteoblast-like cells were cultured from a piece of the tibia removed during selective orthopedic surgery for patients without metabolic bone diseases. The morphological iden- tification of osteoblast-like cell was performed under the light microscope after alkaline phosphatase staining. Cell proliferation rate was determined by [3H] thymidine incorporation into DNA. Cell differentiation was determined by alkaline phophatase activity. mRNA expression was quanti- tatively measured by the competitive reverse transcription-polymerase ehain reaction(RT-PCR). Results: The cultured cells demonstrated 1,25-dihydroxyvitamin D3-induced increases in alkaline phophatase activity and osteocalcin mRNA expression which are the properties of osteoblast. Twenty six percent of the cultured cells were identified as osteoblast-like cells by alkaline phophatase staining. After 24hr incubation with DEX or DFZ, the [3H) thymidine incorporation was significantly inhibited by 100nM DEX or DFL Alkaine phophatase activity was significantly increased by 100nM DEX. Osteocalcin mRNA was significantly decreased by both glueocorticoids. While DEX significantly suppressed expression of asteocalcin mRNA at 10nM and 100nM, DFZ did so only at 100nM. IGF-I mRNA was significantly decreased by 100nM DEX. Conclusion: These results suggest that the inhibitory effect of DFZ on the cell proliferation and protein synthesis is less than that of DEX, which might be responsible for the bone sparing effect of DFZ in vivo.
Alkaline Phosphatase ; Bone Diseases, Metabolic ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Dexamethasone ; DNA ; Gene Expression ; Humans ; Insulin-Like Growth Factor I ; Orthopedics ; Osteoblasts ; Osteocalcin ; Osteoporosis ; RNA, Messenger ; Thymidine ; Tibia

OBJECTIVE: The present study was performed to evaluate the association of p53 codon 72 polymorphism and endometriosis. MATERIALS AND METHODS: We investigate 74 women who were operated for endometriosis and 93 women who had no endometriotic lesion proved by operation. Polymerase chain reaction was used to detect p53 codon polymorphisms. Result: We have found no significant difference between endometriosis and control group in the p53 codon polymorphism. The respective proportion of arginine homozygotes, heterozygotes and proline homozygotes in endometriosis group were 18.9%, 62.2% and 18.9%, respectively, and were 12.9%, 75.2% and 11.9%, respective in the group without endometriosis. CONCLUSION: Endometriosis is not associated with p53 polymorphism in Korean endometriosis patients.
Arginine ; Codon* ; Endometriosis* ; Female ; Heterozygote ; Homozygote ; Humans ; Polymerase Chain Reaction ; Proline

OBJECTIVE: The present study was performed to evaluate the association of p53 codon 72 polymorphism and endometriosis. MATERIALS AND METHODS: We investigate 74 women who were operated for endometriosis and 93 women who had no endometriotic lesion proved by operation. Polymerase chain reaction was used to detect p53 codon polymorphisms. Result: We have found no significant difference between endometriosis and control group in the p53 codon polymorphism. The respective proportion of arginine homozygotes, heterozygotes and proline homozygotes in endometriosis group were 18.9%, 62.2% and 18.9%, respectively, and were 12.9%, 75.2% and 11.9%, respective in the group without endometriosis. CONCLUSION: Endometriosis is not associated with p53 polymorphism in Korean endometriosis patients.
Arginine ; Codon* ; Endometriosis* ; Female ; Heterozygote ; Homozygote ; Humans ; Polymerase Chain Reaction ; Proline

PURPOSE: To evaluate the usefulness of the West point view, we investigated the osseous pathology of the glenoid rim associated with shoulder instability and estimate the inter-observer reliability. MATERIALS AND METHODS: The West point views of sixty-seven patients with labral lesion confirmed by operation were mixed with those of thirty-three normal controls. Six observers independently reviewed the mixed radiographs and checked the lesion by identifying the glenoid erosion, bony defect, ectopic ossification and Hill-Sachs lesion. The incidence of osseous lesions suggesting instability was estimated. Sensitivity in the patient group, specificity in the normal control and inter-observer reliability were calculated to evaluate study susceptibility. RESULTS: The sensitivity of 67 patients group was 81.8% on average (73-94%), the specificity of 33 member control group was 85.2% (82-94%). The most frequent finding was glenoid erosion, with an average of 54.7%, which providing a sensitive clue of shoulder instability. Inter-observer reliability analyzed by using Kappa values showed significant agreement. (alpha=0.1 significant level). CONCLUSION: The West point view is considered to be a reliable diagnostic modality for shoulder instability. The additional sophisticated method is indicated only when a discrepancy between physical examination and radiologic findings exists.
Humans ; Incidence ; Ossification, Heterotopic ; Pathology ; Physical Examination ; Sensitivity and Specificity ; Shoulder*

Background: /Aim: Abdominal ultrasonography (USG) is recommended as a surveillance test for high-risk groups for hepatocellular carcinoma (HCC). This study aimed to analyze the current status of the national cancer surveillance program for HCC in South Korea and investigate the effects of patient-, physician-, and machine-related factors on HCC detection sensitivity. Methods: This multicenter retrospective cohort study collected surveillance USG data from the high-risk group for HCC (liver cirrhosis or chronic hepatitis B or C >40 years of age) at eight South Korean tertiary hospitals in 2017. Results: In 2017, 45 experienced hepatologists or radiologists performed 8,512 USG examinations. The physicians had a mean 15.0±8.3 years of experience; more hepatologists (61.4%) than radiologists (38.6%) participated. Each USG scan took a mean 12.2±3.4 minutes. The HCC detection rate by surveillance USG was 0.3% (n=23). Over 27 months of follow-up, an additional 135 patients (0.7%) developed new HCC. The patients were classified into three groups based on timing of HCC diagnosis since the 1st surveillance USG, and no significant intergroup difference in HCC characteristics was noted. HCC detection was significantly associated with patient-related factors, such as old age and advanced fibrosis, but not with physician- or machine-related factors. Conclusions This is the first study of the current status of USG as a surveillance method for HCC at tertiary hospitals in South Korea. It is necessary to develop quality indicators and quality assessment procedures for USG to improve the detection rate of HCC.

BACKGROUND/AIMS: The most appropriate treatment for acute gastric variceal bleeding (GVB) is currently endoscopic gastric variceal obturation (GVO) using Histoacryl(R). However, the secondary prophylactic efficacy of beta-blocker (BB) after GVO for the first acute episode of GVB has not yet been established. The secondary prophylactic efficacy of BB after GVO for the first acute episode of GVB was evaluated in this study. METHODS: Ninety-three patients at Soonchunhyang University Hospital with acute GVB who received GVO using Histoacryl(R) were enrolled between June 2001 and March 2010. Among these, 42 patients underwent GVO alone (GVO group) and 51 patients underwent GVO with adjuvant BB therapy (GVO+BB group). This study was intended for patients in whom a desired heart rate was reached. The rates of rebleeding-free survival and overall survival were calculated for the two study groups using Kaplan-Meyer analysis and Cox's proportional-hazards model. RESULTS: The follow-up period after the initial eradication of gastric varices was 18.14+/-25.22 months (mean+/-SD). During the follow-up period, rebleeding occurred in 10 (23.8%) and 21 (41.2%) GVO and GVO+BB patients, respectively, and 39 patients died [23 (54.8%) in the GVO group and 16 (31.4%) in the GVO+BB group]. The mean rebleeding-free survival time did not differ significantly between the GVO and GVO+BB groups (65.40 and 37.40 months, respectively; P=0.774), whereas the mean overall survival time did differ (52.54 and 72.65 months, respectively; P=0.036). CONCLUSIONS: Adjuvant BB therapy after GVO using Histoacryl(R) for the first acute episode of GVB could decrease the mortality rate relative to GVO alone. However, adjuvant BB therapy afforded no benefit for the secondary prevention of rebleeding in GV.
Adrenergic beta-Antagonists/*therapeutic use ; Adult ; Aged ; Enbucrilate/therapeutic use ; Endoscopy, Digestive System ; Esophageal and Gastric Varices/*drug therapy ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage/mortality/*therapy ; Heart Rate ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Proportional Hazards Models ; Propranolol/therapeutic use ; Risk Factors ; Severity of Illness Index