PURPOSE: To evaluate CT features of metastatic ureteral tumors. MATERIALS AND METHODS: CT findings in 16 patients with ureteral metastases were evaluated retrospectively ;there were eight cases of bilateral ureteral involvement. Primary tumors metastatic to the ureter were advanced gastric cancer (n=13), breast cancer (n=l), colon cancer (n=l), or adenocarcinoma of unknown primary (n=l). We analysed CT findings with regard to the site of ureteral obstruction, configuration of obstructed sites of ureter, presence or absence of periureteral soft tissue density, and status in other organs. RESULTS: Among 24 ureters involved, ureteral wail thickening was noted in 15, periureteral soft tissue density in 13. Small nodular enhancing lesions less than lcm, within the retroperitoneal space around the involved ureters were noted in seven patients, and four of them were multiple lesions. CONCLUSION: Among various primary tumors, gastric cancer was the most common cause of ureteral metastasis. The common CT findings of ureteral metastases were thickening of ureteral wall, periureteral soft tissue density, and small periureteral enhancing nodular lesions. The constellation of these CT findings may be helpful in making the diagnosis of ureteral metastases.
Adenocarcinoma ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Retroperitoneal Space ; Retrospective Studies ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction

Superficial gastritis has been classified as a type of chronic gastritis, since a report of Schindler in GASTRLTIS, 1947. Howev~er, Benedict reported that superficial gastritis is only acute gastritis or shows normal mucosa histologically. The com mon endopical findings of chronic superficial gastritis were adherent mucus, edema, redness. The common redness which were encounterd are patchy redness and comb-like redness(Kammrotung). We studied the relationship between the redness of superficial gastritis and acute inflammatory changes histologically. Each case of superfieial gastritis was biopsied to redening and non-redening mucosa respectively. We collected 24 cases with 48 biopsy specimens. The results are as follows: Acute inflammatory changes were found only one case in redness and none in non-redness groups. There was no difference in acute inflammatory changes in two groups. The degree of mucosal atrophy were 62.5%, 66.7% in normal mucosa, 12.5%, 16.7~% in mild atrophy, 25%, 12.5% in moderate atrophy, 0%, 4.l% in severe atrophy with respect to redness and non-redness mucosa respectively. There was no difference in degree of mucosal atrophy in two groups. Mucosal atrophies were higher in older ages above 41 years old than below 40 and with increasing age, there was increasing tendency of mucosal atrophy. In conclusion, There was no relationships between mucosal redness and acute in flammatory changes histologically and also between mucosal redness and degree of atrophy.
Adult ; Atrophy ; Biopsy ; Edema ; Gastritis* ; Humans ; Mucous Membrane ; Mucus

OBJECTIVE: The aim was to assess the value of resistance index(RI) and pulsatility index(PI) to differentiate between benign and malignant ovarian tumors by color and pulsed Doppler ultrasound. METHODS: 129 ovarian tumors identified with ultrasound were referred for color and pulsed Doppler ultrasound evaluation to calculate the lowest RI and PI, and the corresponding histopathologic diagnosis was recorded. RESULTS: The intratumor artery waveforms were obtained in 37.1%(36 of 97) of benign tumors and in 91.0%(29 of 32) of the malignant group. RI and PI were lower in malignant tumors than in benign tumors(p<0.01). Also, there was a significant incremental decrease in both indices value from the benign tumor toward borderline malignancy(p<0.05) and to invasive ovarian cancer(p<0.01). But, there was no significant difference in both indices value according to the FIGO stage of ovarian malignancy. For RI cut-off value of 0.6, sensitivity and specificity were 89.7% and 91.7%; for PI cut-off value of 1.1, 86.2% and 91.7%. Therefore, the most accurate cut-off values of RI and PI were 0.6 and 1.1, respectively. CONCLUSION: RI and PI calculated by color and pulsed Doppler ultrasound can help in the diagnosis and selection of treatment plan of ovarian tumors, especially when the morphological finding of ovarian tumor is equivocal. And during the follow up of benign tumors, both indicies can give us the clue of malignant potential of benign tumors.
Arteries ; Diagnosis* ; Follow-Up Studies ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography

Randomly selected 193 patients who received elective operation under general anesthesia and were able to communicate with anesthesiologists and follow up for 5 days between May and September 1994 at Chonnam University Hospital, were interviewed and evaluated on the night before, 2 and 5 days after their operation. Distribution of physieal status by ASA was that more than half the total patients belongs to class I and 36.8% of patients were under class II. Sedation scores did not chang between on the night before and the day of operation. A significant correlation existed among the visibility of pharyngeal structures, the exposure of glottis by laryngoscopy, and the degree of difficulty with intubation. About 83% of patients was readily intubated, and none of patient was impossible to intubate. All of the patients lost consciousness during induction of anesthesia, and did not recall during operation. Postanesthetic complications were sore throat(30%), nausea and vomiting(28%), lumbago(15%), urticaria(3%), and dizziness(3%).
Anesthesia ; Anesthesia, General ; Consciousness ; Follow-Up Studies ; Glottis ; Humans ; Incidence* ; Intraoperative Awareness* ; Intubation* ; Jeollanam-do ; Laryngoscopy ; Nausea

BACKGROUND: Patients who survive CPR are profoundly disabled and live with reduced quality of life. Therefore advanced directives are needed to ensure that life sustaining therapies are provided appropriately. This study compared the attitudes of elderly subjects toward advanced directives for CPR before and after receiving CPR education. METHODS: Between January and July 2007, 99 ambulatory persons aged older than 64 years were recruited from six community welfare facilities for the elderly. A questionnaire was distributed to obtain demographic data and their basic understanding and attitudes toward CPR. After providing information and showing a video clip on CPR, we compared whether having received this information influenced the thoughts of our subjects on CPR. RESULTS: None had had previous education on CPR, including prognostic information. Most overestimated the survival chance after CPR. Most wished to be resuscitated. After providing prognostic information on CPR and showing a short video clip, there was a change in their decision and the knowledge of CPR outcome seemed to influence their thoughts on CPR. In particular, the information on CPR prognosis greatly influenced their decision. CONCLUSION: Elderly people rarely have a chance to receive information regarding CPR. As a result, their decision to receive CPR may not accurately reflect the patient's wishes in emergency circumstances. It is important to pro- vide accurate prognostic information to help the elderly in their life-sustaining treatment decisions.
Advance Directives ; Aged ; Cardiopulmonary Resuscitation ; Dietary Sucrose ; Emergencies ; Humans ; Prognosis ; Quality of Life ; Surveys and Questionnaires

Twenty-one patients undergoing aortic valve replacement for pure aoritic regurgitation were studied retrospectively to evaluate the left ventricular function and internal dimension change before, 1-6 weeks(early postoperative) and 2-36 months after(late postoperative) aortic valve replacement by serial echocardiography. Postoperatively, NYHA function class improved remarkably (from 3.3+/-0.6 to 1.4+/-0.7). Early postoperatively, left ventricular end-diastolic dimension (EDD), left ventricular end-systolic dimension(ESD), left ventricular fractional shortenting(FS) significantly decreased in all patients(7.6+/-1.2cm vs 5.8+/-1.5cm P<0.001, 5.5+/-1.3cm vs 4.7+/-1.3cm P<0.001, 39+/-12% vs20+/-8% P<0.001 respectively). Interventricular septum thickness(IVS) and posterior wall thickness (PW) were slightly thickened before(1.4+/-0.3cm, 1.3+/-0.3cm respectively) and in the early postoperative period (1.3+/-0.4cm, 1.3+/-0.3cm respectively) without significant interval change. Late postoperatively, EDD and ESD decreased significantly (7.8+/-1.2cm vs 5.1+/-0.8cm P<0.01, 5.1+/-1.1cm vs 3.4+/-0.8cm P<0.001. respectively), and FS increased significantly (25+/-9% vs 34+/-9%, P<0.05). Among 3 patients of so called high risk group mentioned by Henry(22,33), ESD and FS improved to normal range in 2 patients, and ESD decreased to 4.4cm and FS increased to 33% in the other one. EDD and ESD decreased significantly in both group I(preoperative ESD<5.5cm) and group II(preoperative ESD<5.5cm), without no decrement difference between two groups, and there was a significant difference of FS decrement between group I and group II at early postoperative period. Preoperative ESD correlated highly with the early postoperative EDD(r=0.89) and ESD(r=0.87) with statistical significance, and moderately high with late postoperative EDD(r=0.45), ESD(r=0.50) and FS(r=0.42) without statistical signiticance. We concluded that there was significant improvement in left ventricular function in pure aortic regurgitation patients postoperatively. Preoperative left ventricular and systolic dimension above 5.5cm and fractional shortenting below 25% are not so reliabel index of poor postoperative prognosis.
Aortic Valve Insufficiency* ; Aortic Valve* ; Echocardiography* ; Humans ; Postoperative Period ; Prognosis ; Reference Values ; Retrospective Studies ; Ventricular Function, Left

The cause of Moyamoya disease remains unknown, and theories of inflammatory and immunologic pathophysiological mechanisms remain unproven. Moyamoya disease characterized by angiographic findings of intracranial carotid artery stenosis and occlusion, resulting in brain hemorrhage. We experienced that a 32-year-old female patient whose complaint was a suddenly developed occipital headache, decreased vision and visual field defect, and performed transfemoral 4-vessel angiography and magnetic resonance image (MRI). It was defined as Moyamoya disease. So we report a case of Moyamoya disease with right homonymous hemianopsia.
Adult ; Angiography ; Carotid Stenosis ; Female ; Headache ; Hemianopsia* ; Humans ; Intracranial Hemorrhages ; Moyamoya Disease* ; Visual Fields

Ketamine, a dissociative anesthetic, produces an increase in heart rate and blood pressure, but the precise mechanism of the cardiovascular stimulating affects of ketamine is not understood clearly. Clonidine, an antihypertensive agent, is an alpha-2 agonist that appears to act primarily on the CNS, where it apparently produces a decrease in the sympathetic outflow from the brain. Prazosin is antihypertensive agent that appears to evert its vasodilator action through the blockade of postsynaptic alpha-1 receptors. In order to investigate the effects of clonidine and prazosin on the heart rate and blood pressure increased by ketamine, ketamine was administered intravenously following administration of clonidine or prazosin in conscious patients. The results were as follows : 1) Intravenous ketamine (2 mg/kg) produced significant increases in heart rate and blood pressure by as much as 25%. 2) Intravenous clonidine (1.25 ug/kg) produced a decrease in the heart rate by 5 beats per minute and decreased blood pressure significantly. 3) In the clonidine pretreated group (1.25 ug/kg, lV), intravenous ketamine (2 mg/kg/kg, lV) produced significant increases in the heart rate and blood pressure without attenuation with clonidine 4) In the prasosin pretreated group (2 mg/kg~70 kg, PO), ketamine (2 mg/kg, lV) produced increases the in heart rate and blood pressure without attenuation with prasosin. From the above results, it was inferred that the action site of the cardiovascular stimulating effect of ketamine isn't a postsynaptic alpha-1 receptor and is different from the action site of clonidine.
Blood Pressure* ; Brain ; Clonidine* ; Heart Rate* ; Heart* ; Humans ; Ketamine* ; Prazosin*

Retinoblastoma is the most common intraocular malignant tumor in childhood. The early diagnosis can be made in children having strabismus, decreased visual acuity, or family history of retinoblastoma. As the tumor grows larger, it produces leukocoria, iris heterochromia, secondary neovascular glaucoma due to rubeosis iridis, ocular protrusion due to mass, optic nerve extension and distant metastasis. Rarely, this tumor shows spontaneous regression to induce phthisis. We recently experienced a case of bilateral retinoblastoma in a 2 year old girl who presented with the protruded right eyeball due to the massive growth of retinoblastoma, simultaneously with the phthisicae left eyeball due to spontaneous regression of retinoblastoma.
Child ; Child, Preschool ; Early Diagnosis ; Female ; Glaucoma, Neovascular ; Humans ; Iris ; Neoplasm Metastasis ; Optic Nerve ; Retinoblastoma* ; Strabismus ; Visual Acuity

PURPOSE: Many reliable articles on the effectiveness of alpha blockers have been published. Evidence-based diagnostic guidelines and therapeutic guidelines for benign prostatic hypertrophy (BPH), which is one of the most common urological diseases, have been proposed in many foreign countries. This paper examines the efficacy of alpha blocker, a common therapeutic drug for BPH, in Korean patients through meta-analysis. MATERIALS AND METHODS: From 1993 to 2001, the term 'BPH' and alpha blocker for BPH were used as key words to search for related articles in the Medical Research Information Center, the National Assembly Library of the Republic of Korea, the Korean Journal of Andrology and the Korean Journal of Urology. A total of 10 articles were selected as being suitable for evaluation and these articles were ranked with levels ranging from I to V, where level I indicated a large randomized controlled trial and level V indicated a non-controlled case accumulation study. RESULTS: There were improvements for the symptom score (45.3%), and for the maximum urinary flow rate (36.0%). The reasons for patient drop-outs were follow-up loss for 60%, drug side effects for 11%, and ineffectiveness of drug for 6.8%. The common side effects were dizziness (4.2%), orthostatic hypotension (2.2%), and headache (1.7%). The blood pressure was sustained in the normotensive patients, wheareas BP showed a tendency to be reduced in hypertensive patients. CONCLUSIONS: Treatment with alpha blocker resulted in the BPH patients in all the studies receiving sustained benefit. Yet most of these papers were short-term, non randomized case-accumulation studies. However, BPH is a chronic disease that may worsen over time. Therefore, evaluation of long term tolerability and efficacy of alpha blocker is necessary.
Adrenergic alpha-Antagonists ; Andrology ; Blood Pressure ; Chronic Disease ; Dizziness ; Follow-Up Studies ; Headache ; Humans ; Hypotension, Orthostatic ; Information Centers ; Korea* ; Prostatic Hyperplasia* ; Republic of Korea ; Urologic Diseases ; Urology