No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment* ; Humans

Primary carcinomas of the fallopian tube are very rare and account for approximately 0.1~1.1% of all gynecological malignancies. This case of primary fallopian tube adenocaricinoma was confirmed postoperatively on the basis of the pathologic examination of resected specimen. We have experienced this case and so report with the breif review of the literature.
Fallopian Tubes* ; Female

No abstract available.

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Pregnancy*

PURPOSE: To evaluate the frequency, distribution, appearance, and clinical outcome of brainstem injury, asseen on MR, in a prospective study of patients with traumatic perimesencephalic subarac-hnoid hemorrhage (pSAH)seen on initial CT scan. MATERIALS AND METHODS: MR images were prospectively obtained in 38 patients with headinjury who on initial CT scans showed pSAH. To identify the amount and location of pSAH, the CT scans of allpatientd, and MRI findings were evaluated according to the presence, location and signal intensity of brainsteminjury, and other combined intracranial injuries. Initial Glasgow coma scale(GCS) and Glasgow outcome scale(GOS),as noted on clinincal records, were reviewed. RESULTS: Brainstem injury was demonstrated on MR images in 30patients(79%). The majority of these lesions (76.7%) were located in the dorsolateral portion, and nonhemorrhagiclesions were more frequent(70%) than hemorrhagic. In patients with brainstem injury, as seen on MR imaging, theGOS score was worse, especially in those with combined diffuse axonal injury in the corpus callosum and cerebralwhite matter. The location and amount of pSAH seen on CT was not related with brainstem injury or clinicaloutcome. CONCLUSION: The presence of pSAH in patients with acute head trauma, as seen on CT was thought to be anindicator of brainstem injury, and MR imaging was necessary. If such injury was identified on MRI, this waspredictive of a worse clinical outcome.
Brain Stem* ; Coma ; Corpus Callosum ; Craniocerebral Trauma ; Diffuse Axonal Injury ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Prospective Studies ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

PURPOSE: The aim of this study was to identify usefulness of simple oral and gastric pH measurement using pH paper on detection of symptomatic gastroesophageal reflux in neonates. METHODS: This prospective study included a total of 66 neonates born at Konyang University Hospital from June 2004 to June 2005. Each neonate's oral and gastric pH levels measured with pH paper at 6 hourly intervals. Suspected gastroesophageal refluex neonates were studied 24-hr lower esophageal pH monitoring or upper GI series and confirmed. We compared oral and gastric pH between symptomatic gastroesophageal reflux (GER) group and asymptomatic (control) group. RESULTS: GER group consist of 12 neonates and control group consist of 54 neonates. Oral and gastric pH were 5.4+/-0.6, 2.9+/-0.5 in GER group, 6.0+/-0.3, 3.9+/-0.9 in control group, the differences between two groups were significant (P<0.05). All neonates of GER group were corfirmed gastroesophageal reflux by 24-hr lower esophageal pH monitoring or upper GI series studies. Our data indicate as a predictor for significantly symptomatic gastroesophageal reflux, at oral pH 5.75, has a sensitivity 92%, specificity 89%, positive predictive value of 65%, and negative predictive value of 98%. The difference between oral and gastric pH (oral pH-gastric pH) was not significant in each group. CONCLUSION: In neonates with symptomatic gastroesophageal reflux oral and gastric pH were significantly lower than asymptomatic neonates. Oral and gastric pH were related with clinically significant symptoms of gastroesophageal reflux. We suggest that pH measurement could be a possible simple screening test of symptomatic gastroesophageal reflux.
Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn* ; Mass Screening ; Prospective Studies ; Sensitivity and Specificity

Bone marrow necrosis is infrequently diagnosed during life, and its presence often signifies a poor prognosis. It has been associated with a variety of disease, including acute and chronic leukemia, carcinoma, malignant lymph oma, infection and sickle cell disease. About 5-26% of acute myeloid leukemia has been reported to express lymphoid differentiation markers, of which CD7 is ex pressed very early during T-cell ontogeny. A 46-year-old male complaining severe bone pain had pancytopenia, leukoerythroblastosis and bone marrow necrosis. Peripheral blood immature cells expressed CD7 as well as myeloid markers such as CD13 and CD33 on immunophenotypic studies. We report a case of CD7 positive acute myeloid leu kemia associated with bone marrow necrosis, confirmed by bone marrow biopsy and immunophenotypic study.
Anemia, Sickle Cell ; Antigens, Differentiation ; Biopsy ; Bone Marrow* ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Male ; Middle Aged ; Necrosis* ; Pancytopenia ; Prognosis ; T-Lymphocytes

Carcinosarcoma of the pancreas is a rare malignant tumor that shows a combined or mixed proliferation of carcinomatous and sarcomatous cells. This tumor has been variously called carcinosarcoma, pleomorphic large cell carcinoma, giant cell carcinoma, and undifferentiated carcinoma. A 52-year-old man was hospitalized for evaluation of his epigastric pain and jaundice. An abdominal computed tomography revealed the presence of a poorly enhancing mass, arising from the head of the pancreas. Pylorus preserving pancreaticoduodenectomy was performed. The final pathologic diagnosis was undifferentiated carcinoma with 2 distinct components. One component was a conventional infiltrating pancreatic ductal adenocarcinoma, and the other component was sarcoma. We present here a case of carcinosarcoma of the pancreas along with a review of the literatures.
Adenocarcinoma ; Carcinoma ; Carcinoma, Giant Cell ; Carcinoma, Large Cell ; Carcinosarcoma* ; Diagnosis ; Head ; Humans ; Jaundice ; Middle Aged ; Pancreas* ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Pylorus ; Sarcoma

PURPOSE: To evaluate the characteristic CT and cerebral angiographic findings in patients with acutespontaneous subdural hematomas and correlate these imaging findings with causes of bleeding and clinical outcome. MATERIALS AND METHODS: Twenty-one patients with nontraumatic acute spontaneous subdural hematoma presentingduring the last five years underwent CT scanning and cerebral angiography was performed in twelve. To determinethe cause of bleeding, CT and angiographic findings were retrospectively analysed. Clinical history, laboratoryand operative findings, and final clinical outcome were reviewed. RESULTS: The 21 cases of acute spontaneoussubdural hematomas were caused by cerebral vascular abnormalities(n=10), infantile hemorrhagic disease(n=5), orwere of unknown origin(n=6). All ten cases of cerebral vascular abnormality were confirmed angiographically; sixwere aneurysms, three were arteriovenous malformations, and one was moyamoya disease. On CT, subarachnoidhemorrhage was seen to be associated with aneurysms, intracerebral hemorrhage with arteriovenous malformations,and intraventricular hemorrhage with moyamoya disease. All five patients with hemorrhagic disease were infantsaged 1-17 months ; characteristic diffuse distribution of subdural hematoma in both temporoparietal-occipitalregions is typical. The average overall mortality rate was 52.4%(11/21). In patients with cerebral vascularabnormalities, mortality was as low as 20%(2/10), but in hemorrhagic disease was high (60%). In cases of unknownorigin it was 100%. CONCLUSION: Acute spontaneous subdural hematoma is a rare condition, and the mortality rateis high. In patients with acute spontaneous subdural hematoma, as seen on CT, associated subarachnoid orintracerebral hemorrhage is strongly indicative of intracerebral vascular abnormalities such as aneurysm andarteriovenous malformation, and cerebral angiography is necessary. To ensure proper treatment and thus morkedlyreduce mortality, the causes of bleeding should be prompty determined by means of cerebral angiography.
Aneurysm ; Arteriovenous Malformations ; Cerebral Angiography ; Cerebral Hemorrhage ; Hematoma ; Hematoma, Subdural* ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Mortality ; Moyamoya Disease ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To determine clinical outcome in cases of traumatic intraventricular hemorrhage(TIVH) according to the mechanisms and amount of hemorrhage seen on initial CT. MATERIALS AND METHODS: We retrospectively reviewed the initial CT findings of 61 patients with TIVH. The mechanisms of TIVH were analyzed on the basis of the following CT findings: Type I; large intracerebral hematoma extending to adjacent ventricle; Type II: hemorrhagic and/or non-hemorrhagic diffuse axonal injury in the thalamus and basal ganglia; Type III: multiple small hemorrhagic lesions in the septum pellucidum, fornix, corpus callosum, and periventricular region, which may be due to inner cerebral trauma, Type IV: evidence of hypoxic brain injury, and Type V: TIVH with contusion and small subdural or epidural hematomas. The amount of TIVH was classified according to the Graeb score. We analyzed these mechanisms on the basis of CT findings, and for prognosis, correlated these with clinical outcomes and the Glasgow coma score. RESULTS: Prognosis was good in types V and III and poor in type I and II(p=0.001). In patients with a Graeb score of 4 or less, the clinical outcome was better than in those with a Graeb score above 5(p=0.03). Patients with a lower initial Glasgow coma score had poor outcomes(p=0.001). CONCLUSION: The hemorrhage mechanism in patients with TIVH could be important for estimating clinical outcome, especially during the early phase. In patients with type V or III TIVH, clinical outcome was better than in those with type I or II.
Basal Ganglia ; Brain Injuries ; Classification* ; Coma ; Contusions ; Corpus Callosum ; Diffuse Axonal Injury ; Hematoma ; Hemorrhage* ; Humans ; Prognosis* ; Retrospective Studies ; Septum Pellucidum ; Thalamus