No abstract available.
Amniotic Fluid* ; Corticotropin-Releasing Hormone* ; Female ; Obstetric Labor, Premature* ; Pregnancy

PURPOSE: We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. MATERIALS AND METHODS: We have made an analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom,statistically. We also reviewed CT findings in 15 study groups. RESULTS: The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p <0.01) CONCLUSION: The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.
Congenital Abnormalities* ; Spondylolisthesis*

OBJECTIVE:To evaluate the biodurability of the covering material in retrievable metallic stents covered with polycarbonate polyurethane. MATERIALS AND METHODS: Using a peristaltic pump at a constant rate of 1ml/min, bile was recirculated from a reservoir through a long tube containing four stents. Each of these was removed from the system every two weeks and a radial tensile strength test and scanning electron microscopy (SEM) were performed. Each stent, removed at 2, 4, 6 and 8 weeks, was compared with a control stent not exposed to bile juice. RESULTS: Gross examination showed that stents were intact at 2 weeks, but at 4, 6 and 8 weeks cracks were observed. The size of these increased gradually in accordance with the duration of exposure, and at 8 weeks several large holes in the polyurethane membrane were evident. With regard to radial tensile strength, extension and peak load at break were 84.47% and 10.030 N/mm, 54.90% and 6.769 N/mm, 16.55% and 2.452 N/mm, 11.21% and 1.373 N/mm at 0, 2, 4 and 6 weeks, respectively. Scanning electron microscopy at 2 weeks revealed intermittent pitting and cracking, and examination at 4, 6 and 8 weeks showed that the size of these defects was gradually increasing. CONCLUSION: When the polyurethane membrane was exposed to bile, biodegradation was first observed at week two and increased gradually according to the duration of exposure.
Bile Acids and Salts/physiology ; Biodegradation ; Hydrogen-Ion Concentration ; Microscopy, Electron, Scanning/*instrumentation ; Phantoms, Imaging ; *Polyurethanes ; *Stents ; Support, Non-U.S. Gov't ; Tensile Strength ; Time Factors

OBJECTIVES: APL, which characteristically shows t(15:17), accompanies fatal coagulopathy during remission induction with systemic chemotherapy alone. ATRA, a derivative of vitamin A, can differentiate APL cells as well as HL-60 cells in vitro and induce higher rate of complete remission(CR). Hence, we assessed the effect of ATRA on remission induction and coagulopathy in APL patients. METHODS: (1) 42 patients diagnosed histologically in St. mary's hospital from June 1991 to June 1994 were included. (2) We compared the CR rate, the time required for restoration of derranged coagulation profiles, and the amount of coagulation factors including platelets among the chemotherapy group (control) and ATRA group. RESULTS: 1) There was no difference in CR rate between the control group and ATRA group [84.2%(16 out of 19) vs 87.0%(20 out of 23), p>0.05)] and also no difference between two subgroups of ATRA [ATRA with chemotherapy; 83.3%(10 out of 12) vs ATRA without chemotherapy; 90.9%(10 out of 11), p>0.05] 2) In the ATRA group, the CR rate of newly diagnosed patients was 82.4%(14 out of 17). The first relapsed patients (4) and the second (2) were all achieved CR. 3) The mean duration of coagulopathy, time to normalization of PT, aPTT, FDP, fibrinogen level, was 12.0+/-10.4, 11.1+/-10.2, 16.5+/-9.3, 15.4+/-10.2 days after chemotherapy alone and 4.5+/-4.4, 3.7+/-3.7, 8.9+/-6.1, 8.1+/-6.5 days in the ATRA group(p<0.05). The amount of fresh frozen plasma used in the ATRA group for the purpose of correction of coagulopathy were significantly lower than the control group(p<0.05). The incidence of profound coagulopathy during the remission induction treatment in the ATRA group was significantly lower than the control group[40% (8 out of 20) vs 96.7%(13 out of 15), p
Blood Coagulation Factors ; Drug Therapy ; Fibrinogen ; HL-60 Cells ; Humans ; Incidence ; Leukemia, Promyelocytic, Acute* ; Plasma ; Remission Induction* ; Tretinoin* ; Vitamin A

PURPOSE: To determine whether spontaneous a splenorenal shunt can be used as an imaging predictor of early renal hemodynamic changes in patients with cirrhosis. MATERIALS AND METHODS: The study included 82 cirrhotic patients and 41 control subjects. Three-phase CT was performed and CT attenuation values (Hounsfield units) of the renal cortex in three phases were measured to evaluate renal perfusion. Likelihood ratio tests for trend were conducted for age, presence of ascites, and Child's grade. RESULTS: The mean CT attenuation values of the renal cortex in cirrhotic patients were significantly lower than the values of control subjects in three phases: 153.3 +/- 37.9 versus 173.3 +/-25.2 in the arterial phase, 172.6 +/- 41.0 versus 197.6 +/- 26.5 in the portal phase and 136.9 +/- 26.0 versus 152.7 +/- 20.0 in the delayed phase, respectively. The mean CT attenuation value of cortices in patients with renal hypoperfusion was 119.9 +/- 11.8 in the portal phase. Child's class C (aOR: 58.4, 95% CI: 3.6-956.2; p < 0.01) and the presence of a renal shunt (aOR: 7.5, 95% CI: 1.8-30.5; p < 0.01) were associated with renal hypoperfusion. The incidence of renal hypoperfusion was associated with Child's grade (trend: p < 0.01), and not with the grade of ascites or age. CONCLUSION: A dilated spontaneous splenorenal shunt may be a risk factor for renal hypoperfusion in cirrhosis.
Ascites ; Fibrosis ; Hemodynamics ; Humans ; Incidence ; Liver ; Liver Cirrhosis ; Perfusion ; Risk Factors ; Splenorenal Shunt, Surgical

No abstract available.

No abstract available.
Cisterna Magna*

PURPOSE: To assess the safety and long term effectiveness of polyurethane-covered retrievable expandable nitinol stents in the treatment of benign and malignant tracheobronchial strictures. MATERIALS AND METHODS: Under fluoroscopic guidance, the stents were placed in 32 patients with dyspnea whose strictures were malignant in 15 cases and benign in 17. A stent was removed when complications occurred,or -electively- 2-6 months after placement in patients with benign strictures. The range of follow-up period was 1 -98 weeks (median, 47; range, 50) weeks. RESULTS: Stent placement was well tolerated in 30 patients. After placement, all 32 showed immediate symptom improvement and in none were complications such as ingrowth of a tumor or granulation tissue observed during the follow up period. Stent migration occurred in six patients. In one of six and four of five patients from whom, respectively, stents had been electively removed two and six months after placement, tracheo-bronchial restenosis did not occur during follow up. Second stents were placed in six patients in whom dyspnea recurred due to restenosis after elective stent removal. In two of these six, stents were removed six months after placement and dyspnea did not recur during follow up. CONCLUSION: The use of covered retrievable tracheobronchial stents is safe and feasible in the conservative treatment of patients with malignant tracheobronchial strictures as well as for selected patients with benign strictures.
Constriction, Pathologic* ; Dyspnea ; Follow-Up Studies* ; Granulation Tissue ; Humans ; Stents*

Leiomyoma is a neoplasm of smooth muscle relatively common in the stomach, but very rare in the duodenal location. Recurrent bouts of severe melana remain the most frequent presenting symptom for leiomyoma. A 69-year-old man presented to us with a 4-day history of melena. Endoscopy revealed norinal mucosa covered ovoid elevated lesion with central linear depression and ulcer at the second portion of duodenum. Endoscopic biopsy showed chronic inflammation only. Duodenal mass was excised through a duodenotomy. Pathological diagnosis was leiomycena.
Aged ; Biopsy ; Depression ; Diagnosis ; Duodenum ; Endoscopy ; Esophagus* ; Hemorrhage* ; Humans ; Inflammation ; Intestines* ; Leiomyoma* ; MART-1 Antigen ; Melena ; Mucous Membrane ; Muscle, Smooth ; Stomach* ; Ulcer

BACKGROUND: We have studied the 67Ga SPECT to determine the activity of pulmonary tuberculosis, especially in patients with minimal extent of the disease on chest radiographs. Because active minimal pulmonary tuberculosis is sometimes difficult to diagnose by means of initial chest X-ray, sputum examination and 67Ga planar imaging, we compared 67Ga planar imaging with SPECT to evaluate minimal pulmonary tuberculosis activity. METHODS: 67Ga planar imagings and SPECTs of 69 patients suspected of minimal pulmonary tuberculosis by the initial chest X-ray were performed and compared to each other. Active pulmonary tuberculosis was defined by a positive AFB smear and/or culture in the sputum and changes shown on the serial chest X-ray findings. RESULTS: 1)67Ga planar imaging imagings showed positive uptakes in 24 patients and no uptakes in 13 patients, which confirms active pulmonary tuberculosis. But SPECT imagings showed positive uptakes in 25 patients and no uptakes in 12 patients. 2) Patients confirmed with inactive pulmonary tuberculosis showed no up-take on 67Ga planar imaging. Only one of the 32 patients confirmed as having inactive pulmonary tuberculosis showed positive uptake on 67Ga SPECT imaging. CONCLUSIONS: According to the results of our study, 67Ga planar imaging and SPECT are both sensitive in detecting the activity of minimal pulmonary tuberculosis. The difference between the two methods is not statistically significant, and the negative predictive value of the 67Ga SPECT is not higher than that of 67Ga planar imaging.
Humans ; Radiography, Thoracic ; Sputum ; Thorax ; Tomography, Emission-Computed, Single-Photon* ; Tuberculosis, Pulmonary*