A and B blood type isoantigens were investigated in 17 cases surrounding bladder cancer by means of the specific red cell adherence test (SRCA). The tissue specimen were classified into positive, intermediate and negative groups according to SR CA reaction of the primary tumors. The histologically normal epithelium was SRCA-positive in 86.2 % of the specimens in the positive group and 70.0% in the negative, group; for hyperplastic epithelium it was 76.4 % and 50.0% and for the dysplastic epithelium it was 60.0% and 53.3 % respectively. The results may indicate that dedifferentiation expressed as the loss of blood group isoantigens has occurred in the histologically benign epithelium of the tumor-bearing bladders and that its occurrences is frequent in the bladder, associated with SRCA-negative tumors.
Epithelium* ; Isoantigens* ; Urinary Bladder ; Urinary Bladder Neoplasms

Leiomyoma is commonly found in the female genital tract, but occurrence in the urinary bladder is very rare with only 235 cases reported in the literature. These tumors have been classified as intravesical (63%), intramural (7%) and extravesical (30%) depending on the direction of the growth. We report a case of intravesical leiomyoma of the urinary bladder in a 36 year-old woman who exhibited dysuria and urinary retention. The gross and microscopical findings of leiomyoma of the bladder are similar to those of the uterus. Immunohistochemical stains for estrogen receptor (ER) and progesterone receptor (PR) revealed diffuse nuclear staining in smooth muscle cells, supporting the hypothesis of hormonal influence in tumorigenesis.
Adult ; Carcinogenesis ; Coloring Agents ; Dysuria ; Estrogens ; Female ; Humans ; Leiomyoma* ; Myocytes, Smooth Muscle ; Receptors, Progesterone ; Urinary Bladder* ; Urinary Retention ; Uterus

BACKGROUND: To evaluate the efficacy of transesophageal echocardiography(TEE) to detect left atrial thrombi(LAT) and to investigate the clinical and echocardiography parameters which related with LAT. METHOD: We performed TEE and TTE simultaneously to 98 consecutive patients who had native mital valve disease or mital prosthesis as usual method. We examined the presence and location of LAT and spontaneous contrast(SC) in TEE and measured left atrial dimension(LAD), ejection fraction(EF), mital valve area(MVA) in TTE. Cardiac rhythm, history of anticoagulation and systemic embolization were also reviewed. We compared such parameters in LAT positive/negative groups and SC positive/negative groups. RESULTS: 1) In TEE, we detected 26 cases of LAT, among them seventeen cases : left atrial appendage(LAA) thrombi, 3 cases : combined LA and LAA thrombi, 6 cases : LA thrombi. In TTE, six cases showed LAT but we couldn't detect LAA thrombi. The difference between two methods was statistically significant(p<0.05). 2) LAT positive group showed larger LAD, lower EF, and higher prevalence of AF, systemic embolization, and LAT than negative groups(p<0.01). 3) SC positive group showed larger LAD, lower EF, higher prevalence of AF, systemic embolization LAT than SC negative groups(p<0.05). 4) In multiple discriminant analysis, the history of systemic embolization was most important factor which can suspect LAT(Wilk's Lambda:0.77152. p<0.0001). SC, EF, presence of AF, LAD, anticoagulation therapy. MVR were also statistically valuable factors in order. The hit ratio of this analysis was 86.84%. CONCLUSION: We can suggest that TEE is very useful method to detect LAT than TTE, and the spontaneous contrast was very important factor which can suggest LAT and systemic embolization in mitral valve disease.
Echocardiography ; Echocardiography, Transesophageal* ; Humans ; Mitral Valve ; Prevalence ; Prostheses and Implants

A new method of urinary diversion via Skinner`s modification of Koch continent ileal reservoir was tried. With this method continence with storage of urine under low pressure is well maintained so that no external applicances are necessary. Ileorenal reflux is also prevented with this nipple forming technique. From May l986 to September l986, 4 patients underwent urinary diversion that included creation of a modified Koch pouch by Skinner. Previous urinary diversion was by ureterocutaneous diversion in 1 patient. A total of 3 patients underwent radical cystectomies for bladder cancer In 1 patient, simultaneous urethrectomy was done because of carcinoma in situ in the urethra. There were no operative mortalities. All patients are continent and without reflux to the upper urinary tract. The volume capacity of pouch is more than 400ml. The pouch is emptied by self-catheterization every 4 to 6 hours during the day and once at night. Postoperative follow-up presently is short and it is impossible to check late complications. Although preliminary, this clinical trial suggests that the quality of life for patients can be improved markedly by the modified Koch continent ileal reservoir.
Carcinoma in Situ ; Colonic Pouches* ; Cystectomy ; Follow-Up Studies ; Humans ; Mortality ; Nipples ; Quality of Life ; Urethra ; Urinary Bladder Neoplasms ; Urinary Diversion ; Urinary Tract

One family with asymmetric septal hypertrophy was reported. The propositus of this family was 31 years old man who was admitted because of transient syncope. His father and one brother were affected but asymptomatic. His sister was suddenly died at age 21 years. The interventricular septal thickness to left ventricular posterior wall thickness ratios were measured using M-mode echocard ogram. In the affected family, echocardiogram revealed asymmetric septal hypertrophy (1.5:1, 2:1, 1.9:1 respectively). In the propositus, cardiac catheterization and simultaneous biventricular cineangiography were performed. Pressure study revealed mild peak systolic pressure gradient within left ventricular apex and left ventricular outflow tract (4mm Hg respectively). Biventricular cineangiogram showed the septal width increased inferiorly, and left ventricular endocardial surface of the septum was straight, while the right ventricular border convex toward the right ventricle.
Adult ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic* ; Cineangiography ; Fathers ; Heart Ventricles ; Humans ; Siblings ; Syncope

A case of traumatic myositis ossificans arising from both elbow joints in twenty six year old male is reported. This patient had been confined to his bed in comatous state for three months after head trauma by traffic accident. When he awaked from coma, the patient noticed his both elbows stiff. Roentgenograms of both elbows revealed extensive irregular periarticular ossifications around the joints. At posttrauma tenth month, complete excision of the bony mass was carried out from the left elbow and one month later, from the right one. From postoperative one week, active exercise was started. Duration of follow up was seven months in left side and six months in right side, There are no signs of recurrence and, now patients go through satisfactory range of motion of both eldows.
Accidents, Traffic ; Coma ; Craniocerebral Trauma ; Elbow Joint ; Elbow ; Follow-Up Studies ; Humans ; Joints ; Male ; Myositis Ossificans ; Myositis ; Range of Motion, Articular ; Recurrence

The authors have reviewed 71 cases (70 patients) of the ankle fractures that were treated through the admission in Orthopedic Department, Paik Foundation Hospital, from June 1972 to April 1978. The average duration of the follow-up waa 15 months. The summary of the results were as follows; 1. Of the 71 cases, male was 54 cases and female 17 cases. The average age of the patients was 32. 2. The main cause of the injuries was traffic accident, and the other causes were sliding down and falling from a height, industrial accident, and sports injury in order. 3. By the classification of Lauge-Hansen, the pronation-external rotation and,supination-adduction types were commoner than the other types. 4. Open reduction was performed in 48 cases, and closed reduction in 23 cases. 5. The average duration of the cast immobilization after the closed reduction was 8 weeks, and that of the open reduction was 6 weeks. 6. The result of the treatment was better in those cases of the open reduction than that of, the closed reduction. 7. The good clinical results could be achieved by obtaining the anatomical position of the talus in the mortise and the reduction was achieved more satisfactorily when the key role of the lateral malleolus in complete reduction was well understood.
Accidental Falls ; Accidents, Occupational ; Accidents, Traffic ; Ankle Fractures ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Orthopedics ; Talus

BACKGROUND: Angina with normal coronary angiogram has been called syndrome X or microvasclar angina. Pathophysiologic mechanisms for chest pain in this group of patients are not known exactly. This study was performed to compare the insulin level of the patients with syndrome X with that of the healthy asymptomatic volunteers. METHODS: The syndrome X group was consisted of 18 patients(11 men and 7 women). All patients had typical chest pain and positive exercise test with a completely normal coronary andgiogram. Patients with hypertension, diabetes mellitus, and there taking any drug known to affect the insulin secretion were excluded. The control group was consisted of 38 healthy subjects(25 men and 11 women) who were not taking any medications. We measured the plasma glucose insulin and C-peptide concentration during oral glucose tolerance test in both groups. RESULTS: Fasting plasma glucose was normal in all patients in both groups. There were no significant differences in plasma glucose level, during the oral grucose tolerance test. There were no significant differences between control and wyndrome X group in the fasting plasma insulin concentration(5.1+/-2.4 vs 5.9+/-2.7 microg/ml, p>0.05). However, the insulin levels at 60min(47.6+/-20.0 vs 84.0+/-68.0 microg/ml) and 120 min(31.4+/-18.2 vs 92.9+/-83.8 microg/ml)were significantly higher in the syndrome X group(p<0.05). THere were no significant differences in the C-peptide concentrations at fasting, 60 min and 120 min after oral glucose tolerance test between control and syndrome X group(p>0.05). CONCLUSION: As shown in above results, there were significant differences in insulin concentrations, but nor in C-peptide concentrations between control and syndrome X group. Thus it can be suggested that the increased dinsulin level in these patients is resulted from the altered insulin action to the target tissues, not from the pancreatic overproduction of insulin. We suggest that this hyperinsulinemia resulted from the insulin resistance play a possible role in the abnormality of microvascular circulation as a mechanism of Syndrome X.
Blood Glucose ; C-Peptide ; Chest Pain* ; Diabetes Mellitus ; Exercise Test ; Fasting ; Glucose Tolerance Test ; Humans ; Hyperinsulinism* ; Hypertension ; Insulin ; Insulin Resistance ; Male ; Plasma ; Thorax* ; Volunteers

BACKGROUND: Nonrheumatic atrial fibrillation is common in elderly and associated with an increased risk for thromboembolism. Left atrial spontaneous echo contrast(SEC) and thrombus. which are easily detected by transesophageal echocardiography(TEE) in patients with rheumatic mitral valve disease and atrial fibrillation, have been known as markers of thromboembolism. However, most of the previous studies on left atrial SEC and thrombus were performed in rheumatic mitral valve disease or various conditions including rheumatic mitral valve disease. Therefore this study was underaken in order to investigatd 1) the prevalence of left atrial SEC and thrombus, and 2) clinical and echocardiographic variables related to left atrial SEC and thrombus in nonrheumatic atrial fibrillation. METHODS: In patients with estabished atrial fibrillation over 7 days, we examined the clinical gistory and performed transthoracic echocardiography(TTE) and TEE simultaneously. Enlisted patients were those without rheumatic mitral valve disease, prosthetic valves, previous thromboembolism, and recent anticoagulant therapy. RESULTS: 1) Left atrial SEC was detected in 32(62.7%) of 51 patients and left atrial thrombus in 10(19.6%). All thrombi were located in the left atrial appendage. 2) In univariate analysis, SEC positive group showed higher prevalence of congestive heart failure(CHF)(56.3% vs 0%, p<0.001), lower ejection fraction(42.2+/-14.1% vs 50.8+/-9.7%, p<0.05), lower left atrial appendage blood flow velocity(peak positive flow velocity ; 18.7+/-11.1cm/sec vs 32+/-12.4cm/sec, p<0.01, and peak negative flow velocity ; 21.4+/-12.4cm/sec vs 31.9+/-12.8cm/sec, p<0.01) than SEC negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial SEC(p=0.02, Odds ratio ; 2.38, 95% CI ; 1.18-4.82). 3) In univariate analysis. left atrial thrombus positive group showed higher prevalence of CHF(70% vs 26.8%, p<0.05), larger left atrial demension(34+/-3.4mm/m2 vs 30.6+/-4.6mm/m2, p<0.05) than thrombus negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial thrombus(p=0.04, Odds ratio ; 4.30, 95% CI ; 1.11-16.68). 4) Left atrial thrombus is more frequent in SEC positive group than in SEC negative group(28.1% vs 5.3%), however, there was no statistical significance(p=0.07). CONCLUSION: 1) Left atrial SEC is common in nonrheumatic atrial fibrillation and significantly related to CHF. 2) Left atrial thrombus is frequently detected in SEC positive patients, however, it is more realted to CHF than left atrial SEC itself.
Aged ; Atrial Appendage ; Atrial Fibrillation* ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart ; Humans ; Mitral Valve ; Multivariate Analysis ; Odds Ratio ; Prevalence ; Thromboembolism ; Thrombosis*

BACKGROUND: Twenty-four-hour ambulatory blood pressure(ABP) monitoring has become increasingly popular for diagnosing and treating hypertension. Therefore the reference value of normotensive subjects was necessary for interpretation of hypertensive subjects. Several studies were reported on reference values in normotensive subjects. The purpose of this study was to determine 24-hour ABP in normotensive Korean adults stratified for sex and five age groups. This study also assessed ABP in relation to a family history of hypertension, smoking and body mass index(BMI). METHODS: ABP monitoring was performed in 200 healthy normotensive volunteers(ranged in age from 20 to 69 years, five decades, 20 men and 20 women per each decade), over 24 hours, taking measurement at 30-min intervals. The 24-hour interval was divided into day-time(6am-10pm) and night-time(100pm-6am) periods. Mean ABP and pressure loads(percentage of systolic readings>140mmHg, diastolic readings>90mmHg) were obtained. RESULTS: The mean ABP in 200 subjects was 113+/-8.6/72+/-6.9mmHg over 24 hours, 117+/-9.7/75+/-7.0mmHg during day-time, and 106+/-9.8/67+/-8.3mmHg at night-time, and pressure loadd averaged 5.1+/-7.4/7.9+/-8.9% over 24 hours. The +2 standard deviation(SD) as the upper limit of normal was 130/86mmHg over 24 hours in 200 subjects. The mean ABP and pressure load were 116+/-7.6/74+/-7.6mmHg and 6.4+/-8.3/10.1+/-10.2% in 100 subjects of men, and 110+/-8.3+/-70+/-6.6mmHg, 3.7+/-6.0/5.7+/-6.8% in women. Mean ABP and pressure load showed significant difference in relation to age group and sex, however, no significant difference in relation to a family history of hypertension or smoking. In relation to BMI group, diastolic blood pressure and diastolic pressure load were significantly different.
Adult* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Male ; Reference Values ; Smoke ; Smoking