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

No abstract available.

No abstract available.
Dermabrasion* ; Eyebrows* ; Foreign Bodies* ; Foreign-Body Reaction*

No abstract available.
Stomach Neoplasms*

No abstract available.

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.

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*

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*

To know the efficacy of intravenous gammaglobulin(IVGG) treatment and the resulting outcome at 18 months for acute Guillain-Barr syndrome (GBS) in children, clinical courses of 27 GBS patients who had been treated with IVGG in a dose of 1g/kg/day oyer 2 consecutive days were investigated. One died with respiratory failure and 8 patients received assisted ventilatory care with improvement. All consecutively treated patients responded well to IVGG. The mean plateau period in 26 recovered patients was 8.5 days. At the 6th month evaluation, only one failed to reach grade 2 on GBSSG scales. At the 18th month evaluation, minor motor symptoms such as easy fatigability or mild tremor on writing were remained in 9 patients. 9 patients showed mild to moderate febrile response to IVGG infusion, but no significant side effects were noted. IVGG can be chosen as an initial treatment for acute GBS in children because of its rapid effect, relative safety even in unstable patients and convenience of administration.
Child* ; Humans ; Respiratory Insufficiency ; Tremor ; Weights and Measures ; Writing