Congenital dilatation of the common bile duct is relatively rare anomaly. Its pathogenesis has not been completely understood. Complications of the choledochal cyst are mainly suppurative cholangitis, liver cirrhosis, stone formation, malignant change, bile peritonitis due to spontaneous and traumatic rupture. We experienced one case of choledochal cyst associated with hemorrhagic tendency and a cerebral hematoma, which is extremely rare complication. The 3 months old male patient reported here was treated with complete excision of cyst and Roux-en-Y choledochojejunostomy after correction of bleeding tendency and removal of cerebral hematoma. Postoperative course was relatively uneventful. 11 days after operation, the patient was discharged with full improvement.
Bile ; Cholangitis ; Choledochal Cyst* ; Choledochostomy ; Common Bile Duct ; Dilatation ; Hematoma* ; Hemorrhage ; Humans ; Liver Cirrhosis ; Male ; Peritonitis ; Rupture

BACKGROUND: Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway resposiveness to a variety of stimuli. METHOD: Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of 'Global initiative for asthma, Global strategy for asthma management and prevention' (NHLBI/UNO) with PFR(%) larger than 8055, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/HNO, group 5 (long term control group). patients who were controlled for more than 2 years by step 1 or 2 treatment of NHHI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC2O and Peripheral blood eosinophil counts pulmonary function test steroid doses and aggrevation numbers after treatment. RESULTS: On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and Initial pulmonary function was better. The long term control group required 1ower amounts of oral steroid, had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control. Atopy, allergic skin tests sputum and blood eosinophil, total IgE, nonspecific bronchial resposiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was 20.3α9.7 months and relapse did not occur. CONCLUSION: Patients who had asthma of onset age younger, shorter symptom duration better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.
Adult ; Age of Onset ; Aspirin ; Asthma* ; Cough ; Eosinophils ; Follow-Up Studies* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Methacholine Chloride ; Recurrence ; Respiratory Function Tests ; Respiratory Sounds ; Rhinitis ; Skin Tests ; Smoke ; Smoking ; Sputum ; Thorax

PURPOSE: The purpose of this paper is to discuss the characteristic CT and MR findings in persistent hyperplastic primary vitreous(PHPV) and to compare the detectability of those findings in each modality. MATERIALS AND METHODS: We retrospectively evaluated CT and MR findings in 32 patients with PHPV. Twenty-five patients had CT, 13 patients had MR, and 6 patients had both CT and MR. RESULTS: Major findings of PHPV in 32 patients on both imaging modalities were lens deformity(78%), shallow anterior chamber(72%), heterogeneous vitreous opacity(72%), enhancing hyaloid artery or remnant of fibrotic hand(69%), and microophthalmos(67%). Minor findings were retinal detachment(22%), and vitreous hemorrhage(6%). In MRI, lens deformity(92%) and shallow anterior chamber(85%) were detected most commonly whereas in CT, opaque vitreous(80%) was the most common finding. Findings of enhancing hyaloid vessel or remnant of fibrotic band, considered characteristic of PHPV, were more commonly detectable in MR (85%) than CT(52%). CONCLUSION: Characteristic MR and CT findings of PHPV were lena deformity, shallow anterior chanber, heterogeneons vitreons opacity, enhanciny hgalind artery or remnant fibrotic band, and microphthalmos. MR seemed to be more useful than CT in detecting Globe pathology.
Arteries ; Congenital Abnormalities ; Humans ; Magnetic Resonance Imaging ; Microphthalmos ; Pathology ; Retinaldehyde ; Retrospective Studies

No abstract available.
Hearing Loss, Sensorineural*

No abstract available.
Animals ; Metaphase* ; Mice* ; Oocytes*

No abstract available.
Humans

The authors present a case in which an organized chronic subdural hematoma(CSDH) was incidentally found in a 9-year-old boy with no significant medical history after a pedestrian traffic accident. Preoperative magnetic resonance(MR) imaging showed calcification on the inner membrane and an irregular heterogeneous structure in the hematoma cavity. The findings from the preoperative brain computed tomogram(CT) and MR image were very useful for making the preoperative diagnosis and surgical decision. In choosing the proper surgical strategy for removing the organized CSDH, it was thought that burr hole trephination would present unnecessary difficulties. Thus, craniotomy was selected and the organized CSDH was successfully removed with no complications.
Accidents, Traffic ; Brain ; Child* ; Craniotomy ; Diagnosis ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Magnetic Resonance Imaging ; Male ; Membranes ; Trephining

BACKGROUND: Ventricular remodeling after myocardial infarction increase mortality and morbidity. Two-dimensional echocardiography in acute myocardial infarction provides a useful diagnostic tool for evaluation of ventricular remodeling. The aims of this study were to verify whether follow-up two-dimensional echocardiography could detect ventricular enlargement after acute myocardial infarction and to find early echocardiographic predictors and clinical charateristics of ventricular enlargement. METHODS: Two-dimensional echocardiography was done prospectively at 2 week, 3 month, and 6 month after the first Q-wave acute myocardial infarction in 18 patients. The control group was 11 patients of a normal chest roentgenogram and echocardiogram who were studied for chest pain or arrhythmia. The patients were divided by the mean value of the control group left ventricular end-diastolic volume index(LVEDVI) 56.8ml/m2. The group A was more than 60ml/m2(the control group LVEDVI 56.8ml/m2) and the group B was less than 60ml/m2 of LVEDVI at 2 week post myocardial infarction. The left vantricular volume was measured by the modified disk method at the apical four chamber view. The wall motion abnormality of left ventricle was examined by the recommendation of the American Society of Echcardiography. RESULTS: The left vntricular end-diastolic volume and the left ventricular end-systolic volume were enlarged after 3 month of acute myocardial infarction in the group A compare with those of the control group. There was no ventricular enlargement during 6 month after myocardial infarction in the group B. The frequency of ventricular enlargement was increased in anterior myocardial infarction. There was no difference in left ventricular ejection fraction at 2 week post myocardial infarction between the group A(51.4+/-15.7%) and the group B(50.8+/-10.3%). The wall motion score index more than 1.5 at 2 week post myocardial infarction means the enlarged LVEDVI more than 60ml/m2 and the group of ventricular enlargement. CONCLUSION: The left ventricular enlargement could be diagnosed by the follow-up two-dimensional echocardiography in acute myocardial infarction. The echocardiographic early predictors of ventricular enlagement were the left ventricular end-diastolic volume greater than 60ml/m2 and increased wall motion score index more than 1.5 at 2 week post myocardial infarstion. The anterior myocardial infarction was the electrocardiographic predictor of ventricular dilatation. Therefore these early predictors could identify the patients of ventricular enlargement and these patients could be a candidate of follow-up echocardiography and of a specific treatment for limiting ventricular remodeling.
Arrhythmias, Cardiac ; Chest Pain ; Dilatation ; Echocardiography* ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mortality ; Myocardial Infarction* ; Prospective Studies ; Stroke Volume ; Thorax ; Ventricular Remodeling

Optic pits are congenital craterlike holes or indentation in the surface of the optic disc. They are oval in shape and located in the inferior temporal quadrant of the optic disc. The authors experienced a case of congenital optic pit of the left eye of 18 year old male-patient. Fluorescein angiography showed hypofluorescence of the pit in early arteriovenous phase, becomming hyperfluorescence in the late phase. Ophthalmoscopic view of the diseased eye showed no abnormality of macular area. There was no visual field defect except the enlarged physiologic blind spot. Here we briefly report a case of congenital optic pit. referring the literature relating to the optic pit.
Adolescent ; Fluorescein Angiography ; Humans ; Optic Disk ; Visual Fields

No abstract available.
Cholecystitis ; Emphysematous Cholecystitis* ; Pneumoperitoneum*