Cavernous hemangioma of the renal pelvis is a rare benign vascular tumor. We experienced a case of this disease, which associated with renal infarction and hemorrhage in 35 year-old female. I. V. P, R. G. P and abdominal C. T were performed. Now, we introduced the pathologic and radiographic findings.
Adult ; Female ; Hemangioma, Cavernous* ; Hemorrhage* ; Humans ; Infarction* ; Kidney Pelvis*

No abstract available.
Cholesteatoma* ; Otitis Media* ; Otitis* ; Temporal Bone*

Clinical trial provide reliable basis for evaluating the efficacy and safty of new treatments. To proceed effectively with clinical trial requires an comprehension of the basic principles of clinical design and biostatistical methods. This review focuses on fundamentals of biostatistical theory, on studies of calculating sample size, on definitions for classsification of evidence in epilepsy trials and on examining biostatistical methods for evaluating efficacy of antiepileptic drugs. This review guide how to understand basic statistical concepts and types of study design for epilepsy trials.
Anticonvulsants ; Biostatistics ; Comprehension ; Epilepsy* ; Sample Size

No abstract available.
Epinephrine* ; Tonsillectomy*

An asymptomatic 26-year-old man was initially admitted with a suspicious mediastinal mass. On the basis of the contrast-enhanced chest CT findings, aneurysm formation involving the left cervical aortic arch associated with subaortic left innominate vein was diagnosed. The aneurysm was confirmed by MR angiography and DSA. The arch aneurysm was surgically removed. We describe this case, and review the literature.
Adult ; Aneurysm* ; Angiography ; Aorta, Thoracic* ; Brachiocephalic Veins* ; Humans ; Tomography, X-Ray Computed

BACKGROUND: In general, it is well known that dizzy patients show a remarkable ability to compensate for the loss of peripheral vestubular function. When the patient had decreased response to caloric stimulation and showed no symptoms of vestibular dysfunction, we thought that was a compensated state of unilateral peripheral vestibular loss. OBJECTIVES: The purpose of this study is to provide the basic data for analysis of findings of further rotatory chair test through analyzing the results of rotation test of unilateral peripheral vestibular loss patients. MATERIALS AND METHODS: We analysed the findings of rotatory chair test and clinical manifestations of 24 cases of unilateral vestublar loss which didn't show any symptoms of vestibular dysfunction and they were confirmed by bithermal caloric test and Kobrak's ice water test. RESULTS: We could find that phase lead, low gain and asymmetry could persist despite of chronic compensated state and these findings were relatively common in patients with nonspecific vestibular symptoms. CONCLUSION: Abnornal phase lead and decreased gain were observed in the compensated unilateral vestibular loss patients who showed nonspecific symptoms including oscillopsia, vague unsteadiness. We thought that their compensation was not completely perfect and SHA test was a good tool which detect the minor degree of vestibular dysfunction. We have to consider the past history and nonspecific symptoms of patients through precise history taking. Frequency of SHA test is slower than that of normal human movement and this status is not a real physiologic condition, so it would be advisable to consider the results of other vestibular function tests for precise evaluation the degree of compensation, and the serial check is also recommended.
Caloric Tests ; Compensation and Redress ; Humans ; Ice ; Vestibular Function Tests ; Water

Blunt trauma to the chest may result in various cardiac injuries. But traumatic myocardial infarction with coronary artery fistula as a complication of chest trauma has been reported in very few cases. The etiology of myocardial infarction is not entirely clear. A 40 years old male was admitted after a traffic accident. He complained of acute retrosternal pain of about one hours duration. There was an area of contusion over the right sternal border. The ECQ showed deep Q wave and elevated ST segments in leads 2, 3 and aVF. There was a considerable increase in creatine kinase(CK) peak level and a CK-MB fraction. Coronary angiography revealed a total proximal occlusion of the right coronary that communicated directly with the right atrium. The left ventridulogram showed hypokinesia of the inferior wall. He was managed with conservative treatments and has remained well sebsequently. We reported a middle aged man who developed an acute transmural inferior wall myocardial infarction associated with coronary artery fistula secondary to blunt cheat trauma in an automobile accident.
Accidents, Traffic ; Adult ; Automobiles ; Contusions ; Coronary Angiography ; Coronary Vessels* ; Creatine ; Fistula* ; Heart Atria ; Humans ; Hypokinesia ; Inferior Wall Myocardial Infarction* ; Male ; Middle Aged ; Myocardial Infarction ; Thorax*

BACKGROUND: To evaluate the role of emergency debridement performed in conjunction with an empirical antibiotic therapy in clinically diagnosed, full-blown Vibrio vulnificus sepsis. METHODS: Immediate surgical debridement was performed on 13 out of 15 patients who were clinically diagnosed as having Vibrio vulnificus sepsis. RESULTS: Among 15 patients Vibrio vulnificus was isolated in 8 patients. Underlying diseases were liver cirrhosis (2), chronic alcohol ingestion or chronic liver disease (10), diabetes mellitus (3), gastrectomy (1) and in 4 cases no underlying condition was identified. All patients had skin lesions such as erythema, bulla, vesicle and gangrene. All but one initially showed variable degree of hypotension, thrombocytopenia, hepatic dysfunction, renal failure and mental confusion. Their mean APACHE III score was 84. Immediate survival (within 48hrs) in clinically diagnosed Vibrio sepsis was 80% (12/15) and long term survival rate among them was 66.6%. Forty-eight hour survival rate in bacteriologically confirmed cases of Vibrio vulnificus sepsis was 75%, where their long-term survival was 62.5%. CONCLUSION: In treating full-blown Vibrio vulnificus sepsis, immediate emergency surgical debridement performed in conjunction with the empirical antibiotics gives a possibility to improve both immediate and long term prognosis of the disease.
Anti-Bacterial Agents* ; APACHE ; Debridement* ; Diabetes Mellitus ; Eating ; Emergencies* ; Erythema ; Gangrene ; Gastrectomy ; Humans ; Hypotension ; Liver Cirrhosis ; Liver Diseases ; Prognosis ; Renal Insufficiency ; Sepsis* ; Skin ; Survival Rate ; Thrombocytopenia ; Vibrio vulnificus ; Vibrio*

PURPOSE: Phenylacetate has potent antiproliferative effects in many malignant tumors. However, the exact mechanism as to how phenylacetate induces cell growth arrest remains unclear and very little is known about its effects on human osteosarcoma cells. In this study, we investigated whether phenylacetate is effective against two osteosarcoma cell lines (HOS and U-2 OS) in vitro. MATERIALS AND METHODS: The viability of phenylacetate- treated cell lines was assessed by trypan blue exclusion assay, and the cell cycle distribution was measured by flow cytometry. To measure cell apoptosis, poly (ADP- ribose) polymerase cleavage assay and flow cytometry were employed. The expressions of cell cycle-regulatory proteins and the apoptosis-related genes were evaluated by western blot analysis. RESULTS: Phenylacetate was found to inhibit the growth of osteosarcoma cells, induce cell cycle arrest in the G1 phase, and induce apoptosis. A significant decrease in Bcl-2 expression and a mild up-regulation of Bax were also observed in both phenylacetate-treated cell lines. Reduced phosphorylation of the pRb and the increased expression of p21Cip1 were observed subsequent to treatment with phenylacetate. CONCLUSION: These findings support the idea that pheny lacetate may be an effective chemotherapeutic agent to be employed in the future against osteosarcoma, because phenylacetate acts to inhibit the growth of osteosarcoma cells through cell cycle arrest and apoptosis.
Apoptosis* ; Blotting, Western ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Line ; Flow Cytometry ; G1 Phase ; Humans* ; Osteosarcoma* ; Phosphorylation ; Trypan Blue ; Up-Regulation

Lymphocytic infiltration within and around a tumor and distinctive types of regional lymph node reaction such as sinus histiocytosis, paracortical lymphoid cellular hyperplasia, and follicular hyperplasia at the cortical area are morphological changes often found in solid tumors. These histological features indicate the immunologically mediated tumor-retarding responses of the host. The aim of the present study was to assess the real prognostic value of both lymphocytic infiltration and the various types of lymph node reactions in patients with stage IA gastric carcinoma and their role compared with the value of other prognostic factors. We reviewed 119 patients with stage IA gastric carcinoma who were admitted to and operated on at the Department of Surgery, Presbyterian Medical Center, from January 1989 to December 1991. The 5-year survival rate was 93.23%, and the mean survival time was 91.18 months. Univariate analysis showed that the degree of lymphocytic infiltration was significantly related to survival(p<0.05). The 5-year survival rates according to the degree of lymphocytic infiltration were 66.67% in grade 0, 92.31% in grade 1, 95.83% in grade 2, and 100% in grade 3. The correlation between survival and age, tumor size, tumor site, or nuclear grade was not statistically significant. Our data indicated that the longer survival in cases of stage IA gastric carcinomas was associated with the presence of certain types of lymph node reactions such as sinus histiocytosis, paracortical lymphoid cellular hyperplasia, and follicular hyperplasia at the cortical area, but these correlations were also not stastistically significant. Although arguments may exist for using the presence or absence of sinus histiocytosis to stratify patients in prospective studies of adjuvant treatment, we suggest that adjuvant treatment after curative resection for gastric cancer is needed ever in the group without lymphocytic infiltration and regional lymph node reactivities. Also, we will study advanced gastric cancer, as well as early stomach cancer in future research.
Histiocytosis, Sinus ; Humans ; Hyperplasia ; Lymph Nodes ; Prospective Studies ; Protestantism ; Stomach Neoplasms* ; Survival Rate