Cystic malformations of the common bile duct have usually been found to occur in the extrahepatic portion of the common bile duct. A rare type occurs at the terminal end of the common bile duct and lies in the intraluminal portion of the duodedum; this latter type has been called a choledochocele. The lesion is undoubtedly congenital. The case of an extrahepatic choledochal cyst and choledochocele (type IVB choledochal cyst in the Totani classification) in a 63-year-old woman is presented. This is rare, combined choledochal cyst.
Choledochal Cyst* ; Common Bile Duct ; Female ; Humans ; Middle Aged

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Dermabrasion* ; Eyebrows* ; Foreign Bodies* ; Foreign-Body Reaction*

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No abstract available.
Stomach Neoplasms*

PURPOSE: Cerebral cortical dysplasias are one of the important causes for epileptic seizures and developmental disabilities in children, particularly in diffuse or bilateral cases. These developmental malformations are generally regarded as a group of neuronal migration disorders, however, the classification system and pathogenetic mechanisms of cortical dysplasias are not yet entirely clear. Even a novel entity, congenital bilateral perisylvian syndrome, characterized by speech delay, pseudobulbar Palsy, intractable seizures, and bilateral perisylvian abnormalities on imaging studies, have rather diverse figures on morphology and symptomatology than initially considered. We have studied the clinical features and correlations of clinical outcomes 3nd magnetic resonance imaging(MRI) findings of bilaterally involved cortical dysplasias. METHODS: 20 cases of bilateral cortical dyspalsias were grouped into three categories on the basis of MRI findings; centroparietal dysplasias(6 cases), diffuse dysplasias with (5) or without white matter lesions(4), and schizencephaly(5). EEGs, motor and language development, epilepsy, and outcomes were reviewed in each groups. RESULTS: Language delay(100%), motor developmental delay(94.7%), motor deficit(65%), epilepsy(40%) were the main reasons for their initial hospital visits. A meaningful word expression was possible at the mean age of 2 years and 2 months(1 to 4 years of age). Hypotonia and spastic motor paralysis were evident in all the cases of diffuse dysplasia with white matter lesions and the schizencephaly groups. All but one case of centroparietal dysplasia showed motor developmental delay. Epilepsies were developed in 8 cases at the mean age of 5 years and 5 months(2 months to 12 years of age) and the seizures were relatively well controlled with anticonvulsants. EEG findings were variable; normal, focal or diffuse abnormalities. High amplitude diffuse fast activities were only noted in the diffuse dysplasia group. CONCLUSION: The severity of neurological deficits and developmental delay had correlated to the size of cortical abnormalities. The epilepsies were relatively well controlled during childhood and the EEG finding of high amplitude diffuse fast activities was specific for the diffuse cortical dysplasias. Bilateral centroparietal dysplasias should be included on consideration of the causes for developmental aphasia.
Anticonvulsants ; Aphasia ; Child ; Classification ; Developmental Disabilities ; Electroencephalography ; Epilepsy ; Humans ; Language Development ; Language Development Disorders ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Muscle Hypotonia ; Muscle Spasticity ; Neuronal Migration Disorders ; Paralysis ; Pseudobulbar Palsy ; Seizures

No abstract available.

Recently it has been stated that animals without ischemic arrhythmia would be at almost no risk for reperfusion ventricular fibrillation(VF) in contrast to animals with ischemic arrhythmias. In order to observe the differences of ararrhythmias characteristics between ischemic and reperfusion period, and correlationship between occlusion and reperfusion arrhythmias, the left anterior descending(LAD) coronary artery was occluded for 20 minutes and reperfused for 10 minutes in 24 anesthetized cats. The results were as follows; 1) After ligation of LAD coronary artery, the R wave, S-T segment and T wave of epicardial EKG were elevated to reach maximum level at 5-10 minutes. 2) During reperfusion, the changes of R wave, S-T segment, and T wave of epicardial EKG were not significant. 3) The incidence of arrhythmias at early phase and late phase of occlusion period were 41.6% and 100% respectively. The ischemic arrhythmia score was 2.38+/-1.61 and incidence of ventricular tachycardia(VT) was 66% 4) The incidence of VT and VF during reperfusion was 100% and 62.5% respectively. The reperfusion arrhythmia score was 5.88+/-1.72. 5) The two morphologies of ventricular arrhythmias were observed at occluson and reperfusion period. 6) The disparities between occlusion and reperfusion arrhythmias were observed. 7) The cats with shorter R-R internal and/or lower systolic left ventricualr pressure had the higher incidence of VF. In summary, although the morphology of occlusion ventricular arrhythmias was similar to that of reperfusion ventricular arrhythmias, the lack of correlation between reperfusion VF and ischemic arrhythmias was observed. So we suggest that further studies which provide the different mechanisms involved in occlusion and reperfusion arrhythmias were needed.
Animals ; Arrhythmias, Cardiac* ; Cats* ; Coronary Vessels ; Electrocardiography ; Incidence ; Ligation ; Reperfusion*

Cystoscopy is important in staging of cervix cancer. However, there have been controversies about its routine use, interpretation of the result and necessity of biopsy during cystoscopy. Herein we analysed 1,049 cases. Among 1,049, 53 abnormalities (5.1 %) were found.; 22 grossly visible tumor invasion (2.1 %), 30 bullous edema (2.9 %), 1 transitional cell carcinoma (0.1 %). Transurethral biopsy was done on 14 cases with gross tumor invasion and 13 (92.9 %) showed microscopic bladder mucosa invasion, all of which were in from stage II b to IV. Bullous edema was analyzed by biopsy results, operative findings and computed tomography scan in 25 cases.; 13 bladder muscle invasion (52 %), 2 bladder mucosa invasion (8%), 5 normal bladder wall (20 %), 5 nonspecific inflammation (20 %). However, cystoscopic biopsy was unreliable in evaluation of bullous edema. Biopsy confirmed bladder mucosa invasion were found in 15 of 1,049 (1.4 %).; stage 0 to II a 0. stage II b 2.4%, III 11.3%, IV 15%. We conclude that cystoscopy is useful only in stage more than II b, bullous edema means bladder wall invasion in majority of cases and should be evaluated by noninvasive computed tomography and that biopsy should be reserved only in suspicious cases.
Biopsy ; Carcinoma, Transitional Cell ; Cervix Uteri* ; Cystoscopy* ; Edema ; Female ; Inflammation ; Mucous Membrane ; Urinary Bladder ; Uterine Cervical Neoplasms*

Survival after acute myocardial infarction (AMI) is related to the number of diseased vessel, ejection fraction, extent of residual ischemic tissue, presence of ventricular arrhythmia. Because a variety of revascularization modalities are tried in recent years, the natural course after AMI seems to become difficult ot assess. From the experience of 129 cases of coronary angiography in AMI from Jan 1984 to Apr 1987, the factors related to invasive modality were analysed to evaluate the effect on the survival after AMI. The following results are obtained. 1) Single vessel disease and insignificant lesion were present in 60%, and multivessel disease comprised 40% in all group. 2) Patients were followed for a mean of 16.3 months and 2 cases(1.6%) expired suddenly and reinfarction developed in 6 cases(4.7%). 3) After exclusion of 4 cases taken CABG operation, the event free survival of all patients was 0.98, 0.90, 0.78, 0.78, 0.78 in double vessel disease, 0.94, 0.87, 0.87, 0.77, 0.51 in triple vessel disease. The survival was better in single vessel disease compared to multivessel disease (p<0.05), but no difference was present between double and triple vessel disease. 5) Event free survival in group with left ventricular end diastolic pressure(LVEDP) >16mm Hg was better than that of a group with LVEDP <16mm Hg. But no difference was present between group with ejection fraction <40% and group with ejection fraction >40%. From the above results, it can be concluded that the event free survival after mainly uncomplicated AMI in Koreans depends on the number of diseased vessel and LVEDP.
Arrhythmias, Cardiac ; Coronary Angiography ; Disease-Free Survival* ; Humans ; Myocardial Infarction*