Peri-vater divertieula may interfere with the normal flow of biliary and pancreatic secretion, thus leading to pancreatobiliary diseasa and the very presence of juxtapapillary diverticulum makes cannulation technically difficult and contributes to the low success rate. In this present series, the relationship between duodenal diverticula and age, sex, and biliary-pancreatic pathology was stud.ied in 1400 patients examined with ERCP. The results are as follows. 1) Duodenal diverticula was demonstrated in 73 of 1400 patients(5, 2%). 2) The incidence of duodenal divertieular increased with age and they were more frequent in men. 3) The cannulation of one or both duct system was suecessful in 69 of the 73 patients, the success rate was 94. 5%. 4) The biliary pathology was found in 41 of the 73 patients and the pancreatic pathology in 6 of the 73 patients. The rnost common finding was biliary calculi which were demonstrated in 35 patients(47. 9%).
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis* ; Diverticulum* ; Gallstones ; Humans ; Incidence ; Male ; Pathology

We developed an animal model to recreate the condition of an open fracture in communication with the maxillary sinus. We then studied wound healing of the sinus wall structures following fracture in the presence of autogenous bone and alloplastic implant. This model is designed to simulate the repair of an orbital floor fracture in humans. The New Zealand White rabbit was used as the animal model. Standardized 8mm defects were made bilaterally in the maxillary sinuses to include bone and mucosa in 36 rabbits. Two different implants and autogenous calvarial bone graft were placed in the soft-tissue pockets to obturate the defects, exposing one surface of the implant to the open sinus. Medpor porous polyethylene, silicone and calvarial bone implant were compared. Animals were killed at 1, 2 and 8 weeks after implantation. Gross examination of the specimens for the amount of mucosal closure and implant tissue fixation was performed. Histological sections were evaluated for bone and soft-tissue morphology juxtaposed to the implant. Complete closure of the mucosal defect was demonstrated with each type of implant. Medpor implants showed both vascular and soft-tissue ingrowth into pores by week 1. Bone ingrowth was seen by week 2. Closure of the Medpor obturated defects occurred more rapidly than in the silicone group. The Medpor implants and calvarial bone demonstrated bone and soft-tissue fixation, callus formation and maturation, while mature overlying mucosa was reconstituted over the defects. Silicone implants demonstrated a fibrous tissue reaction within 1 week of implantation and they never became fixed to bone or soft tissue. Maxillary sinus wall regeneration occurred in all defects. This study supports clinical observations of maxillary sinus wall regeneration in humans.
Animals ; Bony Callus ; Fractures, Open ; Humans ; Maxillary Sinus ; Models, Animal ; Mucous Membrane ; New Zealand ; Orbit ; Polyethylene ; Rabbits ; Regeneration ; Silicones ; Tissue Fixation ; Transplants ; Wound Healing

Aneurysm of the superficial temporal artery is rare. We reviewed seven cases of aneurysm of the superficial temporal artery, which were confirmed surgically and angiographically. The results were as follows: The most common site of aneurysm was left superficial temporal artery, major feeding artery was anterior branch of superficial temporal artery, mean diameter was 7.8mm×12.6mm, and all aneurysms showed lobulated margin with intraluminal filling defects.
Aneurysm* ; Arteries ; Temporal Arteries*

No abstract available.
Angiofibroma ; Carbon ; Carbon Dioxide ; Lasers, Gas

Upper gastrointestinal bleeding in cirrhotic patients is a serious emergency which is associated with high mortality. Cirrhotic patients commonly have, in additian to esophageal varices, other upper gastrointestinal lesions which accont for occasional bleeding episodes. Since the theapy of bleeding esophageal varices differs from the treatment of nonvariceal bleeding, delay and inaccuracy in determining the source of bleeding contribute ta high mortality. (continue...)
Emergencies ; Esophageal and Gastric Varices* ; Hemorrhage ; Humans ; Mortality

A delayed hemolytic transfusion reaction (DHTR) is the result of delayed anamnestic alloantibody response four to fourteen days after transfusion of apparently compatible blood. Most DHTRs are very mild and may not be recognized clinically. Some are manifested only by anemia. Only a few cases are severe enough to induce a massive hemolytic reaction followed by frank renal failure. Recently, we experienced a case of DHTR with acute renal failure (ARF) due to anti-E. A 21-year-old woman received compatible four units of packed red cells after right artificial total hip replacement arthroplasty due to juvenile rheumatoid arthritis. She had a history of transfusion 4 years ago. Fourteen days after the transfusion, she showed a fall in hematocrit, hemoglobinuria and a positive indirect antiglobulin test, and accompanied by ARF. Anti-E was identified in the patient's serum by antibody screening and identification test at that time. She recovered from ARF after hemodialysis with conservative management. However, eventually, she died due to disseminated intravascular coagulopathy.
Acute Kidney Injury* ; Anemia ; Arthritis, Juvenile ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Blood Group Incompatibility* ; Coombs Test ; Female ; Hematocrit ; Hemoglobinuria ; Humans ; Mass Screening ; Renal Dialysis ; Renal Insufficiency ; Young Adult

OBJECTIVES: We examined the effects of neurotrophins and insulin-like growth factors on cell death induced by haloperidol, a typical anti-psychotic agent. METHOD: Neocortices from 14- or 15-daysold fetal mice for neuron-glia co-cultures were used for this experiment. RESULT: Twenty-four hours treatment of mouse cortical cell cultures with 30 M haloperidol-induced wide spread neuronal apoptosis characterized by cell body shrinkage, DNA fragmentation and condensation. Concurrent treatment with growth factors, BDNF, NT4/5, IGF-I and IGF-II, protect the neurons from the haloperidol-induced neuronal apoptosis(HINA) in a dose dependent manner(10-100ng/ml). CONCLUSION: The present study suggests the possibility that haloperidol toxicity can be hampered with growth factors. Further study about the mechanism underlying the protective capacity of the growth factors on HINA may lead to the development of the new protective strategy for tardive dyskinesia.
Animals ; Apoptosis* ; Brain-Derived Neurotrophic Factor ; Cell Culture Techniques* ; Cell Death ; Coculture Techniques ; DNA Fragmentation ; Haloperidol ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Intercellular Signaling Peptides and Proteins ; Mice* ; Movement Disorders ; Neocortex ; Nerve Growth Factors* ; Neurons* ; Somatomedins

We report a rare case of scalp arteriovenous malformation(AVM). A 55-year-old woman presented with a pulsatile palpable mass on her left temporo-parietal scalp. She complained of insomnia because of bruit, which was audible when she lay on her left side. Computed tomography angiography(CTA) for the scalp vessel showed AVM on the left temporo-parietal region. Multiple enlarged arteries, such as the superficial temporal artery, posterior auricular artery, and occipital artery, were directly connected to the elongated dilated superficial temporal vein. Digital subtraction angiography also showed similar results. Fistulous portions were clearly delineated on both modalities. Surgical excision of the malformations, including feeding arteries and the draining vein, resulted in immediate relief of the symptoms. Usefulness of CTA in the diagnosis of vascular lesions on the scalp was emphasized.
Angiography* ; Angiography, Digital Subtraction ; Arteries ; Arteriovenous Malformations* ; Diagnosis ; Female ; Humans ; Middle Aged ; Scalp* ; Sleep Initiation and Maintenance Disorders ; Temporal Arteries ; Veins

Among 13 patients with pemphigus : 8 of pemphigus vulgaris(PV), 4 of pemphigus foliaceus(PF), l of pemphigus erythematosus(PE), we have examined the sites of early lesions and the clinical appearances of the skin lesions. The most common site of the early lesions in PV was the oral mucosa, however, in PF and PE the face was affected first. The clinical appearances of the early lesions were flaccid bullae, erythematous papules and eczematoid patches. Clinicians should be aware of these clinical features of pemphigus for a more precise diagnosis and better management.
Diagnosis ; Humans ; Mouth Mucosa ; Pemphigus* ; Skin

The diagnosis of acute inflammation of the placenta, represented as acute chorioamnionitis, is important in that it is associated with a poor clinical outcome for both the mother and the fetus, including major perinatal morbidities such as sepsis, respiratory distress syndrome, and CNS damage. However, current medical trends in Korea seem to overlook the significance of a histopathological diagnosis of acute placental inflammation, mainly due to the indifferences of clinicians and pathologists. Since late 1993, histopathological examinations have been performed on preterm placentas at Seoul National University. These examinations have demonstrated acute placental inflammation in a significant number of cases. In the present study the incidence of acute placental inflammation was analyzed in 521 placentas which were submitted for pathological examinations in 1995. Examinations were performed to provide basic information on the incidence and profile of acute placental inflammation in this hospital and, thereby, to emphasize the significance of histopathological examinations of the placenta in the routine surgical pathology service. Among the 521 placentas, acute inflammation was found in 194 cases (37.2%). In preterm placentas acute inflammation was found in 39.6% of the cases (67/169), while 36.1% (127/352) of term placentas showed acute inflammation. Taking the delivery mode into account, 26.3% (49/186) of the placentas delivered by cesarean section showed acute inflammation, while 43.3% (145/335) of the transvaginally delivered placentas showed inflammation. The present analysis demonstrates the existence of acute inflammation in a significant proportion of placentas with different clinical settings. The importance of a histopathological examination in routine hospital practice should be emphasized.
Incidence