Background: There arc two theories in the development of colon cancer. One is the adenoma-carcinoma sequence theory and the other is the de novo cancer theory. Western countries believe in the adenoma-carcinoma sequence theory, however there are many recent reports from, Japan about cancers developing from small adenomas. Methods: The present study analyzed 408 polyps from 508 cases that were taken by colonoscopic polypectomy at the Department of internal Medicine, Yeungnam University Hospital. Results: The percentage of patients who had a polyp was 41.3% (210 cases out of 526 cases), and the peak incidence was noted in patients in their 50s and 60s, There was no difference between the sexes, but we noted significant increase in the incidence of polyps in patients over the age of thirty. We found 395 polyps below 1cm and 13 polyps above 1cm. Among 408 polyps, 5 cases were cancerous polyps and 3 cases showed polyp size of less than 1cm each. The first case was a polyp of 0.4cm in size with elevated mucosa at the ascending colon. The second was 0.5cm in size with round elevation and hyperemic mucosa in the rectum. The third was 0.6cm in size with tubular elevation at the hepatic flexure. Conclusions: Colon polyp is a common disease in Koreans, Even small polyps can have cancer tissue, which should be removed if discovered during colonoscopy. We believe that not all colon cancer originates in the manner described by the adenoma-carcinoma sequence theory. However further studies with a larger sample population arc needed to determine the exact role of colon polyps in the development of colon cancer.
The fibrous layer of mandibular condyle of the neonatal, 1-, 7-, 14-, 27-, 55-days and 1 year old rats were examined in the electron microscope with particular attention to the ultrastructure and diameter of collagen fibrils. In the 1-day rats, most of the cells of the fibrous layer were undifferentiated mesenchymal cells and fibroblasts with rough a little developed rough endoplasmic reticulum(RER) and golgi apparatus(GA). In 7-, 17 and 27-days old rats, most of the fibroblast showed well developed GA and RER with widely distended cisternae containing granular materials. In many of these cells contained intracytoplasmic filaments among the cytoplamic organelle. In 55-day and 1-year old rats, three types of cells were observed, ie, cells containing well developed cytoplasmic organelle presumed to be involved in the collagen fibril synthesis, cells showing well developed lysosomes, golgi apparatus, mitochondria and short cytoplasmic process presumed to be involved in the active resorption of the injured collagen fibrils or cellular debris, cells containing many intracytoplasmic filaments and a little organelle presumed to be cells of inactive state. The average diameters of collagen fibrils were similar in 1- and 7-day old rats as $38.48{\pm}3.81nm$, $38.06{\pm}3.86nm$. That was thickest in 14 days old rats as $50.21{\pm}3.93nm$ among experimental groups. They were gradually thinner in 27-, 55-day rats as $40.05{\pm}2.52nm$, $43.63{\pm}1.20nm$ and thinnest in 1-year old rats as $37.38{\pm}2.17nm$. The distribution pattern of diameters of collagen fibrils were unimordal with peak of 30-60nm in rats from 1-day to 17-day old. With aging from 27-day to 1 year old rats, collagen fibril diameters showed wide distribution pattern and percentage of thin collagen fibrils increased. These results may show the functional adaptation of fibrous layer of mandibular condyle to the increased mechanical forces with aging.
Purpose : In order to investigate the functional brain anatomy associated with mental calculation, functional magnetic resonance imaging was performed. Materials and Methods : In six normal right handed subjects, functional MR images were obtained using a 1.57 MR scanner and the EPI BOLD technique. The study included experiment I and experiment II. Each experiment consisted of five resting and four activation periods with each period of 30 seconds. During the activation period of both experiment I and II, calculation equations[an example: $(4+5)\times8=72$] were presented and the subjects were instructed to decide true or false of them. During the resting period of experiment I, the subjects were instructed to visually fixate on a crosshair. During the resting period of experiment II, two diagrams (an example: $(\bullet,\;\blacksquare)$)were presented and the subjects were instructed to decide they are same or not. For the post-processing of images, the SPM program was used, with the threshold of significance set at p<0.00001. The activated areas during the tasks were assessed. Results : In experiment 1, the inferior frontal gyrus, prefrontal cortex, promoter area, supplementary motor area, and intraparietal sulcus including superior parietal cortex were activated bilaterally. Although these areas were also activated in experiment II, the activated signals in the right frontal and parietal lobes were lessened. Conclusion : The left inferior frontal gyrus and prefrontal cortex and bilateral intraparietal sulci were activated during mental calculation. The right frontal and parietal lobes might be related to attention and decision making.
Purpose : To evaluate the relationship between superior labral dimension of the glenohumeral joint on direct MRA and presence of SLAP lesion. Materials and Methods: IRB approval was obtained and informed consent was waived for this retrospective study. Direct MRA studies of the shoulder in 296 patients (300 shoulders) with arthroscopic surgery were analyzed by two radiologists blinded to the arthroscopic results, which were used as gold standard. One of the radiologists reviewed the images twice (session 1 and 2) for the evaluation of intra-observer variability. Transverse and longitudinal dimensions of superior labrum on coronal T1-weighted images were measured as base and height of the inverted triangular-shaped superior labrum and compared between patients with SLAP lesions vs. non-SLAP patients. Presence of meniscoid labrum was noted. Statistical analysis was done using unpaired t-test. Results: Among 279 patients (283 shoulders), 122 patients (43.1%) had SLAP lesions. The mean base/height of superior labrum in SLAP and non-SLAP patients measured on T1-weighted MR image were 8.8 mm / 5.2 mm, 8.5 mm / 4.9 mm for reader 1; 8.2 mm / 4.9 mm, 8.1 mm / 4.5 mm for session 1 of reader 2; 8.0 mm / 4.8 mm, 7.6 mm / 4.3 mm for session 2 of reader 2. In SLAP group, the mean labral height was larger than non-SLAP group with statistically significant difference (p<0.05). Fifteen patients (5.3%) had meniscoid labrum according to operation records. Conclusion: In patients with SLAP lesion, the height of the superior glenoid labrum on oblique coronal image of MRA was slightly larger than non-SLAP patients. A larger height of superior glenoid labrum may be associated with SLAP lesions.
Journal of the Korean Institute of Traditional Landscape Architecture
/
v.31
no.2
/
pp.103-117
/
2013
This research analyzed the spatial components and establishment of the Tap-gol Park according to the plans between 1897 to 1916 when the discussions on the construction of the park began and it was accomplished as an urban park. The results are as follows. The establishment of Tap-gol Park can be divided by three period. Firstly, Tap-gol Park was owned by the royal family from 1987 to 1904. The discussions on construction of Tap-gol Park as a first urban park of Gyeongseong(京城) in 1897, and the private houses were tear down in order to secure land for the park in 1899. Gates and fences surrounding of Tap-gol Park were organized and it was opened in 1902 based on park plane of turtle - shaped. The octagonal pavilion for 'Lee-Wang-Jik musical band(李王職音樂隊)' was relocated in the southwestern part of the park in 1903. Secondly, Tap-gol Park was used actively by the public between 1910 to 1913, because it was opened for individuals. Also The boundary of Park were changed by surrounding facilities and recreational facilities and benefits was complemented for users. Tap-gol park was opened at nighttime in August 1913. Tap-gol Park was used as a place of amusement park. Thirdly, commercial facilities were made as the park facility between 1914 to 1916. The purpose of 'Kkikdajeom(喫茶店)' was similar to the one of modern cafes. It was built as a typical Japanese tea-house with a small pond having an island and a bridge constructed inside. With the increase of usage of Tap-gol Park as a recreational area by the citizens in 1916, the pavilion as a rest area and toilet as amenities were supplemented. Superintendent's office was equipped too. Simple chairs made from the wooden logs were installed around greenhouse, concert hall, the Wongaksa Buddhist temple(圓覺寺址十層石塔), and the flower garden was fenced round. After the relocation of Yongsan music band to Tap-gol Park, the existing concert hall was demolished. The shape of the park which was seen from the pictures of the magazines of 1920s were achieved as early as 1916. The importance of this research includes the basis to revise the errors of the preexistence researches and value of historical material of the design plan reference of the park which was accomplished during the Japanese colonial era. Also this research is to study on the spatial components of the modern landscape architecture and parks.
This study is the case of groundwater development based on the geometrical fracture model of target area established only through geological fracture mapping technique. A fracture mapping of $9km^2$, eastern Munsan, has been conducted to determine geological and hydrological factors for new water well placement in the Gyeonggi gneiss complex. Geophysical exploration was not applicable because of small restricted area and dense underground utilities at the site. Form line mapping on the basis of foliation orientation and rock type revealed a synform of NS fold axis bearing to the south. An EW geological cross-section passed through the site area shows a F2 synform as a double-wall ice cream spoon shape. Three regional faults of $N20^{\circ}E,\;N30^{\circ}W$, and NS have been dragged into the site to help understand extensional fault paths. The $N20^{\circ}E$ fault with dextral sense is geometrically interpreted as a western fault of two flexural conjugate type-P shear faults in the F2 synformal fold. The NE cross-section reveals that a possible groundwater belt in the western limb of super-posed fold area is formed as a trigonal prism within 100 m depth of the intersectional space between the $N20^{\circ}E$ fault plane and the weakly sheared plane of transposed foliation. Another possible fault for water resource strikes $N40^{\circ}E$. Recommended sites for new water well placement are along the $N20^{\circ}E\;and\;N40^{\circ}E$ faults. As a result of fracture mapping, 145 ton/day of water can be produced at one well along the $N20^{\circ}E$ fault line. Exploration of groundwater in the area is succeeded only using with geological fracture mapping and interpretation of geological cross-section, without any geophysical survey. Intersection of fault generated with the F2 synformal fold and foliation supply space of groundwater reserver.
Purpose: In arthroscopic rotator cuff repair, the crucial step is secure fixation of Anchor to bone. However, osteoporosis of the tuberosity is frequently encountered in old patients, and can cause insecure fixation of anchors. The Aim of our study was to introduce a technique for anchor hole augmentation with bone cement when fixation failure of an anchor occurs, and to investigate the outcome. Materials and methods: Among 223 rotator cuff repairs performed between 2005 and 2009, anchor hole augmentation with polymethylmethacrylate was performed in 15 cases (all females; mean age of 65 years: range 49~77). Bone cement was injected into the anchor hole in a thick fluid state and the procedure was repeated to make a pot-like cement mantle. The anchor was inserted into the cement mantle while the cement hardened. The outcome was investigated, on average, at 16 months (6~32). Results: Radiographs showed cystic changes of the tuberosity. On follow-up radiographs and MRI, a change in the cement mantle was not noted. The final average UCLA score was 31 (28~35); 6 had excellent, 8 good and 1 fair results (p=0.008). Age-sex matched Constants score was 90 (74~98) (p=0.008). Conclusion: Anchor hole augmentation with bone cement is useful when fixation failure of an anchor is encountered due to bone atrophy. Anchor hole augmentation with bone cement does not negatively influence the outcome.
Background: For the treatment of isolated left main coronary artery disease, twelve arterial revascularizations with Y-composite grafts using left internal thoracic artery and radial artery or right gastroepiploic artery were peformed. This study was performed to investigate whether V-composite graft can satisfy the blood flow required to make myocardium act properly or not. Borderline stenotic lesions on the left main coronary artery, which are very prone to remodel the bypassed vessels due to competitive flows, were also considered. Material and Method: Among 247 patients who underwent coronary artery bypass grafting from March 2000 to April 2003, 12 patients (4.7%) who had received total arterial revascularizations for the isolated left main coronary artery disease were studied retrospectively. Result: left anterior descending arteries were bypassed with left internal thoracic artery by off-pump technique in all patients, however, 2 cases of left obtuse marginal branches were bypassed under on-pump beating heart. Except for one patient, who did not have an obtuse marginal branch more than 1 mm in diameter, 11 patients had gone through complete arterial revascularizations by use of the Y shape arterial graft. Among five patients who had less than 75% stenosis, one patient showed string sign on left internal thoracic artery grafted to left anterior descending artery. However, two grafts to obtuse marginal blanches were completely obstructed and one showed slender sign. There were no graft-dominant flow in patients with stenotic lesion less than 75%. On the contrary to the result of patients with stenotic lesions less than 75%, all the patients with stenotic lesions more than 90% showed graft-dominant blood flow. Conclusion: In conclusion, it is assumed that, when stenotic lesions are over 90%, coronary artery bypass grafting with an Y shape arterial graft could possibly give enough help to the obstructed coronary arteries in blood supplying to myocardium, which needs massive quantity of blood to act well. However, when patients have borderline stenoses, through scrupulous examinations, more prudent and flexible decisions are required in choosing the treatment methods, such as, direct anastomosis of vein or artery to aorta, or adding supplementary treatment methods like percutaneous coronary intervention, rather than choosing a fixed treatment methods.
Purpose : Neonatal hydronephrosis has been detected with increasing frequency with the widespread use of prenatal ultrasonography, but the consensus about its postnatal management has not yet been reached, especially about surgical intervention. We attempted to determine the guideline of follow-up study and surgical intervention of hydronephrosis by analyzing clinical outcomes of neonates with hydronephrosis. Materials and Methods : Between 1994 and 2000, 128 hydronephrotic kidneys were postnatally confirmed. Cases associated with other urologic anomalies were excluded and 90 unilateral hydronephrotic kidneys with a minimum follow-up of 12 months were enrolled in this study. We classified the patients into 6 groups according to the anterior posterior pelvic diameter(APPD) at initial ultrasonography(USG) within 1 month after birth. Renal USG and $Tc^{99m}-mercaptoacetyl$ triglycerine(MAG3) scan were done according to a set protocol, and pyeloplasty was performed when indicated according to our protocol. Results : Most cases whose APPD were below 10 mm improved or resolved. Only few cases with APPD above 20 mm showed spontaneous improvement and most(88%) had undergone operation. Those with initial APPD within 10-19 mm showed variable outcomes. When the risk factors for irreversible renal functional deterioration were analyzed, the age at pyeloplasty and pre-operative functional deficit were significant. Conclusion : We concluded that in infants with initial APPD below 10 mm, consideration of surgery is not needed, and in those with initial APPD above 20 mm, early operation is recommended. Our set protocol based on initial USG is useful, but the cut-off value of relative renal function(RRF) for operation might be increased to 40% to improve post operative RRF.
Classification of esophageal motility disorders not yet finalized and is still ongoing as the new disorders are reported, and the existing classification is changed or removed. In terms of radiology, the primary peristalsis does not exist, and the lower end of the esophagus show the smooth, tapered, beak-like appearance. The esophageal motility disorder, which mostly occurs in the smooth muscle area, show the symptoms of reduction or loss (hypomotility) or abnormal increase (hypermotility) of peristalsis of the esophagus. It is important to understand the anatomy and physiology of the esophagus for the appropriate radiological method and diagnosis. Furthermore, the symptom of the patient and the manometry finding must be closely referred for the radiological diagnosis. The lower esophageal sphincter can be normally functioning and open completely as the food moves lower. Sperandio M et al. argues that the name diffuse esophageal spasm must be changed to distal esophageal spasm (DES) as most of the spasm occurs in the distal esophagus, composed of the smooth muscle. According to Ott et al., usefulness of barium method for diagnosing the esophageal motility disorder is Achalasia 95%, DES 71% and NEMD 46%, with the overall sensitivity of 56%. However, excluding the nutcracker esophagus or nonspecific disorder which cannot be diagnosed with the radiological methods, the sensitivity increases to 89%. Using videofluoroscopy and 5 time swallows, the average sensitivity was over 90%. In conclusion, the barium method is a simple primary testing method for esophageal motility test. Using not only the image but also the videofluoroscopy with good knowledge of the anatomy and physiology, it is believed that the method will yield the accurate diagnosis.
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