SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

The uterine cervical cancer is the rnost common tumor of malignant gynecologic tumors and complete remission of the cancer has been possible through early diagnosis and treatment. To evaluate the efficacy of tumor markers SCCA and CEA in patients with uterine cervical cancer as markers for monitoring, we analyzed serum SCCA and CEA crncentrations of 43 patients wit.h uterine cervical caner as a study group and 73 patients with benign pelvic disease as a contrnl group, were admitted to depar tment of Obstetncs & Gynecology, College of Medicine, Kyung Hee University from May 1991 to January 1993. The results were as follows ; 1. The distrihution of the clinical stages of 43 cervical cancers were : CIS 9, stage I 11, stage II 12, stageg III 5, stage lV 6. 2. The positive rate of SCCA of control group was 17%, and that of CEA nf control group was 12%. And the positive rate of SCCA of study group was 46.5% and that of CEA of study was 27.9%. 3. The average concentration of SCCA of control group was 0.71ng/ml and that of SCCA of study group was 8.25ng/ml(p<0.05). 4. The average concentration of CEA of control group was 1.95ng/ml and that of CEA of study group was 8.33ng/ml(p<.0.05). 5. The average concentration of SCCA by stage were 1.15ng/rnl for C1S, 1.14ng/ml for stage I, 9.72ng/rnl for stage III, 16.75ng/rnl for stage III, 21.95ng/ml for stage IV. Here, the mean value of SCCA was increased stepwise through cliinical stage, there was a correlation between the clinical stage and the concen tration of serum SCCA (p>0.05). 6.The average concentration of CEA by stage were 3.11ng/ml for CIS, 1.96ng/ml for stage I, 8.11ng/rnl for stage II, 18.92ng/ml for stage III, 19.44ng/ml for stage IV. There was not a correlation between the clinical stage and the concentration of serm CEA. 7. When the cervical cancer was divided by histologic subtypes, the average concentration of SCCA in squamous cell carcinoma of uterine cervix was 11.86ng/ml and the positive rate of SCCA in squamous cell carcinoma was 53.6%(9.46ng/ml & 58.8% in large keratinizing cell type, 15.56ng/ml & 45.5% in large nonkeratinizing cell type). And the average concentration of SCCA in adenocarcinoma was 1.32ng/ml positive rate was 40.0%. The tumor marker SCCA was more sensitive to squamous cell carcinoma rather than adenocarcinoma. 8. The sensitivities of SCCA in preinvasive cancer and invasive cancer were 22.2% and 52.9%, respectively. The average concentration of SCCA in invasive cancer was 10.04ng/ml and was more significantly elevated than of SCCA in preinvasive cancer. 9. Using SCCA & CEA together as markers for monitoring, the positive rate significantly incresaed to 70.6%(p<0.05). But measuring the two tumor marker alone, that not significantly increased. 10) . The diagnostic efficacy of SCCA in cervical cancer was 59.0%, that was higher as compaired with that of CEA. These results suggest that the serum concentration of SCCA is significantly increased stepwise by clinical stage and concomitant measurements of serum SCCA & CEA are more useful in diagnosis of cervical cancer. However measurements of SCCA and/or CEA have little efficacy in the detection of early cervical cancer considering it's low rate of positivity in early cervical cancer. We will evaluate the efficacy of two tumor markers in determining prognosis, therapeutic response and early detection of recurrence for the posttreatment patients in the future.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Early Diagnosis ; Female ; Gynecology ; Humans ; Prognosis ; Recurrence ; Selective Estrogen Receptor Modulators ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

Poisoning may result from self-injection. Previous reports have described acute cholinergic crisis, intermediate syndrome, and delayed toxicity resulting from parenteral organophosphate administration. These complications have been managed with antidotal and conservative treatment. Acute kidney injury was not listed among the complications. We report a case of acute kidney injury after intravenous injection with an unknown liquid. After chemical composition analysis, organophosphate dichlorvos has been identified as the injected liquid substance. A 50-year-old man injected this into his left arm. He visited the emergency department with a mental change accompanied by seizure. During admission, there were no typical cholinergic symptoms or intermediate syndrome; however, there was a development of acute oliguric kidney injury. The patient was treated successfully with a combination of hemodialysis, hemoperfusion, and conservative management. The manifested seizure, altered mental state, and acute kidney injury could have been caused by several types of poisoning. Based on patient history, which was obtained during the early treatment period, there was no information of what the injected material may have been, and there were no signs of a typical organophosphate toxidrome. However, the patient was successfully treated with rapid initiation of renal replacement treatment, without the use of antidotes. Poisoning by unknown causative substances poses a diagnostic challenge to emergency physicians. In many cases, treatment may be delayed while the physician tries to identify the toxin. However, the basic toxicology principle of focusing on the patient treatment rather than the poisonous substance should not be forgotten.
Acute Kidney Injury* ; Antidotes ; Arm ; Dichlorvos ; Emergencies ; Emergency Service, Hospital ; Hemoperfusion ; Humans ; Injections, Intravenous* ; Kidney ; Middle Aged ; Organophosphates ; Poisoning ; Renal Dialysis ; Seizures ; Toxicology

For effective construction of OCS(Order Communication System), the most core part of medical information system on medium and small hospital, this thesis understands the interface types of current medical treatment examination equipments and operational problems and shows the solution through the integrated interface management system. Showing the development cases of real time interface system for integration of clinical pathology inspection equipment, LIS(Laboratory Information System) and medical treatment system, this thesis suggests the basic construction element and the functions.
Clinical Laboratory Information Systems ; Information Systems ; Pathology, Clinical

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome

Malakoplakia is a chronic inflammatory disease. Approximately 75% of cases are located in the genitourinary system. The etiology remains obscure but it appears related to an underlying infection. It mainly occurs in females in a 4:1 ratio, and the peak age is in the sixth decade. Apart from the symptoms associated with urinary tract infections, the clinical manifestations are usually unremarkable. Here, we report a 44-year-old woman suffering from an intraabdominal mass, with histology that was specific for a malakoplakia of the bladder. This case was difficult to differentiate from a urachal cancer.
Adult ; Female ; Humans ; Malacoplakia* ; Urinary Bladder ; Urinary Tract Infections ; Urogenital System

Renal vein thrombosis is a rare, renal disease in adults that is related to hypercoagulability. We experienced a case of renal vein thrombosis in a 30-years old woman who presented with fever, chills and left flank pain after delivery. She was treated with catheter-directed thrombolytic therapy and oral anticoagulants.
Adult ; Anticoagulants ; Chills ; Female ; Fever ; Flank Pain ; Humans ; Pregnancy ; Renal Veins* ; Thrombolytic Therapy ; Thrombophilia ; Thrombosis*

No abstract available.