This paper contains the results of clinical and neuroradiologic studies in 9 cases of histopathologicallyverified intracranial cavernous hemangiomas. The most common clinical presentations were focal seizure andheadache which were accompained by focal neurologic deficits. Skull films revealed abnormality in 3 cases andcerbral angiography revealed an avascular area in 8 cases, but both were of little diagnostic significance. CTusually demonstrated a hyperdense, cystic and calcified lesion without significant mass effect, and mild degereeof tubular or ring like enhancement after contrast injection. The follow-up CT findings in 4 cases over a 6-monthperiod were compatible to repeated minute hemorrhage and resolution. The above clinical and CT findings and , ifpossible, repeated CT could suggest the diagnosis of cavernous hemangioma and provide the proper management,including the avoidance of unnecessory radiation therapy and biopsy related complications.
Angiography ; Biopsy ; Diagnosis ; Follow-Up Studies ; Hemangioma, Cavernous ; Hemorrhage ; Neurologic Manifestations ; Seizures ; Skull

Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

No abstract available.
Gestational Age* ; Humans ; Infant, Newborn*

Interstitial cystitis is an extremely painful and distressing condition, characterized by severe suprapubic pain, which increases with bladder filling and is relieved by voiding. The daily frequency of micturition may approach 100 times, but no incontinence is observed. The symptoms persist throughout the night, which consequently affects sleep. The etiology of this condition is still unknown, but includes infection, autoimmune response, allergic reaction, neurogenic inflammation, epithelial dysfunction and inherited susceptibility. Herein, a case of interstitial cystitis, with severe symptoms, which was successfully treated with lumbar sympathetic block, is reported.
Autoimmunity ; Cystitis, Interstitial* ; Hypersensitivity ; Neurogenic Inflammation ; Urinary Bladder ; Urination

Myopericytoma is a benign tumor that is composed of myoid-appearing oval to spindle-shaped cells with a concentric perivascular pattern of growth. The tumor is morphologically heterogeneous and can exhibit a broad histologic spectrum. We describe a case of multiple myopericytoma occurring in the head and neck skin region with involvement of the parotid gland where it is known to occur very rarely. A 40-year-old woman noticed multiple enlarging, painless, round-shaped masses on her left cheek. The patient had experienced a similar lesion of the same area 8 years earlier which was completely excised and the pathological diagnosis was spindle cell type myoepithelioma. On a computed tomographic image, one mass involved the superficial parotid gland and was well encapsulated. Excision of the facial masses and superficial parotidectomy with facial nerve preservation were performed. A diagnosis of myopericytoma was established in light of the immunohistochemical pattern with the histopathological findings. Over the 4-year follow-up period, there was no evidence of recurrence. As many perivascular myoid neoplasms share common morphologic features with myopericytoma, we should consider the differential diagnosis, and confirm the histological findings with appropriate immunohistochemical staining. After identifying myopericytoma, it should be treated with wide surgical excision to prevent local recurrence.
Adult ; Cheek ; Diagnosis, Differential ; Facial Nerve ; Female ; Follow-Up Studies ; Head ; Head and Neck Neoplasms ; Humans ; Light ; Myoepithelioma ; Neck ; Parotid Gland ; Parotid Neoplasms ; Recurrence ; Skin

In recent years, there has been a rapidly increasing interest; in babies whose birthweight is low because their intrauterine growth has been retarded and it has been recognized that the clinical problems of these 'small-for-dates' infants differ from those of true prematures. Although it is very difficult to differentiate 'small-for-dates' infants from true prematures, it can be made readily if the gestational age is known. So there is a need for a rapid, accurate method of clinically assessing gestational maturation and it needs to be reliable and capable of being fully performed regardless of the degree of illness or well-being of infant. Using the Ballard's scoring system which was based on 6 physical criteria and 6 neurogical criteria, the author estimated the gestational age of 265 newborn infants who were born at the Obstetric ward of the Seoul National University Hospital from April to August in 1980. And the author compared the estimated gestional age with the gestational age calculated from LMP. The results were as followings: 1) The age distribution of the 265 newborn infants showed predominance in the weeks of gestational age and there was no discrepancy between two sexes. 2) The weight distribution of the 265 newborn infants showed predominance in the 2,500g-3, 500 g of birthweight. 3) The numbers of babies whose weight was appropriate, small and large for gestational age were 233(88%), 19(7%), and 13(5%) respectively according to University of Colorado Medical Center Example. 4) The examination was performed between 6 hours and 72 hours after birth, and the average time required to complete the full examination ranged from 3 minutes and 25 second to 6 minutes and 50 seconds, averaging 5 minutes and 30 seconds. 5) The predictive values of 6 physical criteria, when compared with the gestational age calculated from LMP were as following: skin(0,855), breast(0.842), plantar creases(0.830), ears (0.823), lanugo (0.773) and genitals (M: 0.760, F: 0.703) . 6) The predictive values of 6 neurological criteria when compared with the gestational age calculated from LMP were as following: popliteal angle(0.752), heel to ear(0.727), scarf sign (0.715), square window(0.693), posture(0682) and arm recoil(0.633). 7) The correlation of the score from the total criteria was greater than that obtined from any of its individual criteria. 8) The correlation coefficiency between the estimated gestational age and that calculated from LMP was 0.745 and the regression formula for the latter(X) against the former(Y) was Y=0.83X+ 6.79. With the above results, the author could conclude that the clinical estimation of the gestational age with the Ballard's scoring system was highly correlated and it deserves to be recommended for clinical purpose if the problems of the maturity rating would be solved.
Age Distribution ; Arm ; Colorado ; Ear ; Gestational Age* ; Hair ; Heel ; Humans ; Infant ; Infant, Newborn* ; Parturition ; Seoul

BACKGROUND: Identifying problems and making a surgical plan through a preoperative analysis is important in facial aesthetic surgery. Thus, popular conceptions of an attractive face must be analyzed beforehand. The landmarks used as reference points may change after rhinoplasty, resulting in errors in the prediction and assessment of outcomes. To reduce such errors, it is advantageous to use reference points and landmarks that are subject to minimal variation. This study measured and analyzed landmarks with little preoperative and postoperative variation in rhinoplasty, and established appropriate standards for landmarks indicative of ideal profiles. METHODS: A photogrammetric analysis was performed of 80 famous and attractive celebrities from Korea, Southeast Asia, Japan, China, and America. The nasofrontal angle, nasal angle, nasolabial angle, angle of facial convexity, and angle of total facial convexity were measured. RESULTS: The angle of total facial convexity differed significantly among countries (P=0.013). No significant difference in nasal angle, facial convexity, or total facial convexity was observed between Western and Eastern countries. A significant difference in the nasofrontal angle (Asian: 138.66°, Western: 134.35°; P=0.006) was observed. The nasolabial angle (Asian: 97.09°, Western: 104.59° degrees; P=0.007) was significantly more acute in Asian than in Western subjects. CONCLUSIONS: In this study, we performed a more accurate analysis using the glabella instead of the nasion to measure the facial profiles of patients planning to undergo rhinoplasty and proposed standard values through an analysis of ideal and attractive facial profiles.
Americas ; Anthropometry ; Asia, Southeastern ; Asian Continental Ancestry Group ; China ; Fertilization ; Humans ; Japan ; Korea ; Photogrammetry ; Rhinoplasty*

We studied the incidence of spontaneous infarct related artery recanalization and it's effect on LV function in 120 patients with acute myocardial infarction by angiography within 1 month after onset of acute MI between Nov. 1983 to Sep. 1988. The total occlusion rate of the infarct related artery in 34 cases catheterized from 1st day to 7th day was 55.8%, that of 33 cases from 8th day to 14th day 51.5%, that of 32 cases from 15th day to 21th day 40.7% and that of 21 cases from 21th day to 30th day was 47.7%. These results suggest that spontaneous recanalization of infarct related artery has mainly occurred within 24 hours after acute MI. LV ejection fraction among those patients who showed spontaneous recanalization(n=59) was not significantly superior to those with persistent occlusion of the infarct related artery. Both anterior and inferior MI patients showed no difference in LV function as regard to whether they showed recanalization or persistent occlusion. Although early spontaneous reperfusion of the infarct related artery is not uncommon in acute MI, LV function was not influnced by the spontaneous recanalization at least until 1 month after MI.
Angiography ; Arteries ; Catheters ; Humans ; Incidence ; Myocardial Infarction* ; Reperfusion ; Ventricular Function, Left*

Cutaneous angiosarcoma is a rare, aggressive vascular malignancy with a grave prognosis. It usually arises in the scalp or face as a locally-advanced patch, plaque or tumor at presentation and most often affects males and the elderly. Histopathologically, well-differentiated angiosarcomas are composed of well- or ill-formed vascular channels, often lined by flattened atypical endothelial cells and are distinguished from benign counterparts by their so-called "collagen dissection pattern" and anastomosing architecture. Varied differentiation may be observed even in the same tumor. Epithelioid angiosarcoma is a rare variant of poorly-differentiated angiosarcoma. The patients were seven cases of angiosarcomas including an epithelioid variant. They were six males and one female with an age range between 65~84 years (avg. 74 years). Lesions resembled seborrheic dermatitis, erysipelas or "spreading bruise" that varied from blue to red in color and from papule to mass in size. They revealed satellite lesions far from the main lesion in some cases. Skin biopsies were performed for all patients and histopathologic features were compatible with angiosarcoma and epithelioid angiosarcoma. We herein report seven angiosarcomas of diverse clinical features because their early detection and precise differential diagnosis should be mandatory for effective management.
Aged ; Biopsy ; Dermatitis, Seborrheic ; Diagnosis, Differential ; Endothelial Cells ; Erysipelas ; Female ; Hemangiosarcoma* ; Humans ; Male ; Prognosis ; Scalp* ; Skin

BACKGROUND: There have been many attempts to alleviate pain after surgery, but there is no common approach to the control of postoperative pain. The use of epidural opioids, with local anesthetics, has been a widely employed formula to date. Ketamine, an N-methyl-d-aspartate receptor antagonist, has an excellent analgesic effect. Although there have been many reports on the dose and route of administrating analgesics, there have been few concerning the continuous epidural infusion of ketamine with fentanyl. We designed this study to find the effects of ketamine compared to those of epidurally injected bupivacaine and fentanyl, and used this trial to study any potential side effects. METHODS: In a double blind trial, 55 patients received either fentanyl, 0.3microgram/kg/h (Group F), or fentanyl, 0.3microgram/kg/h, and ketamine, 0.1 mg/kg/h (Group FK), added to 0.125% bupivacaine, at rates as high as 2 ml/h, for patient controlled epidural analgesia (PCEA) following a transabdominal hysterectomy. Ten minutes before the operation, patients received 10 ml of 0.125% bupivacaine, with either 0.5 mg/kg ketamine or the same amount of normal saline with 50microgram fentanyl added. The pain scores and the side effects were recorded at 1, 3, 6 and 24 hour post operation. RESULTS: There were no differences in the pain scores or side effects between the two groups. CONCLUSIONS: We failed to find any effect of the addition of epidural ketamine compared to the that of the bupivacaine and fentanyl formula. However, it is suggested that further investigations will be required on the dose and route of administration.
Analgesia, Epidural ; Analgesics ; Analgesics, Opioid ; Anesthetics, Local ; Bupivacaine* ; Fentanyl* ; Humans ; Hysterectomy* ; Ketamine* ; N-Methylaspartate ; Pain, Postoperative