To make an accurate diagnosis of esophageal rupture during balloon dilatation without the help of esophagograph, an infusion pump, a pressure transducer and a radiopaque esophageal balloon were connected through a three-way connector. The pressure transducer was connected consecutively to an amplifier, a differentiator and a speaker to detect a pressure drop in the esophageal balloon. Under fluoroscopic monitoring, a radiopaque balloon catheter was inserted in the mid-thoracic esophagus of 30 rabbits and inflated with air until the esophagus was ruptured. A pressure drop in the balloon at the time of esophageal rupture was not only recorded graphically, but also was identified through a speaker. To examine esophageal rupture grossly, the rabbits were sacrificed after esophagography. We could detect the time of esophageal rupture during balloon dilatation in all rabbits accurately by observing the pressure drop on the pressure recorder and by hearing the sound made on a speaker. In 8 patients with esophageal stricture, a deflated radiopaque balloon catheter was inserted to the position inside the narrowing point and inflated by injecting air until the 'hourglass' deformity created by the stricture disappeared from the balloon contour which the pressure change in the balloon was monitored with a pressure recorder. The balloon pressures at the time of disappearance of the "hourglass" deformity from the balloon contour ranged from 200 mmHg to 2000 mmHg in 8 patients with esophageal strictures. Esophageal ruptured did not occur in these patients. In conclusion, our results indicate that this new method is not only safe but promising for patients in the future with esophageal strictures. First, it would reduce the chance of mediastinitis in patients of esophageal rupture. Second, esophageal balloon dilatation can be performed more effectively and safely. Third, it is cost-effective. Forth, radiation esposure to the patient can be reduced.
Catheters ; Congenital Abnormalities ; Constriction, Pathologic ; Diagnosis* ; Dilatation ; Esophageal Stenosis ; Esophagus ; Hearing ; Humans ; Infusion Pumps ; Mediastinitis ; Methods ; Rabbits ; Rupture* ; Transducers, Pressure

To make an accurate diagnosis of esophageal rupture during balloon dilatation without the help of esophagograph, an infusion pump, a pressure transducer and a radiopaque esophageal balloon were connected through a three-way connector. The pressure transducer was connected consecutively to an amplifier, a differentiator and a speaker to detect a pressure drop in the esophageal balloon. Under fluoroscopic monitoring, a radiopaque balloon catheter was inserted in the mid-thoracic esophagus of 30 rabbits and inflated with air until the esophagus was ruptured. A pressure drop in the balloon at the time of esophageal rupture was not only recorded graphically, but also was identified through a speaker. To examine esophageal rupture grossly, the rabbits were sacrificed after esophagography. We could detect the time of esophageal rupture during balloon dilatation in all rabbits accurately by observing the pressure drop on the pressure recorder and by hearing the sound made on a speaker. In 8 patients with esophageal stricture, a deflated radiopaque balloon catheter was inserted to the position inside the narrowing point and inflated by injecting air until the 'hourglass' deformity created by the stricture disappeared from the balloon contour which the pressure change in the balloon was monitored with a pressure recorder. The balloon pressures at the time of disappearance of the "hourglass" deformity from the balloon contour ranged from 200 mmHg to 2000 mmHg in 8 patients with esophageal strictures. Esophageal ruptured did not occur in these patients. In conclusion, our results indicate that this new method is not only safe but promising for patients in the future with esophageal strictures. First, it would reduce the chance of mediastinitis in patients of esophageal rupture. Second, esophageal balloon dilatation can be performed more effectively and safely. Third, it is cost-effective. Forth, radiation esposure to the patient can be reduced.
Catheters ; Congenital Abnormalities ; Constriction, Pathologic ; Diagnosis* ; Dilatation ; Esophageal Stenosis ; Esophagus ; Hearing ; Humans ; Infusion Pumps ; Mediastinitis ; Methods ; Rabbits ; Rupture* ; Transducers, Pressure

Congenital pancreatic duct anomalies result from an error in the complex developmental process. Congenital pancreatic duct anomalies may be categorized by their mechanisms into migration anomaly, fusion anomaly, and duplication anomaly. These ductal abnormalities have been implicated to be potential causes for both acute and chronic pancreatitis. We have recently observed a congenital anomaly of the pancreatic ducts in which bifurcated main pancreatic ducts drain through the major papilla in a 10 year-old boy presenting with recurrent acute pancreatitis. Although its causal relationship with acute pancreatitis is unclear, this kind of pancreatic ductal anomaly has not been found in the literature.
Child* ; Humans ; Male ; Pancreatic Ducts* ; Pancreatitis* ; Pancreatitis, Chronic

PURPOSE: To characterize the magnetic resonance (MR) imaging features of myelofibrosis and compare them with bone marrow biopsy findings. MATERIALS AND METHODS: The authors retrospectively reviewed sagittal T1-and T2 weighted and short tau inversion recovery (STIR) images of the thoracolumbar spine of six patients (five males and one female, mean age 46) with biopsy-proven myelofibrosis. Marrow signal intensity of the thoracolumbar spine was classified with respect to those of muscle and fat, based on the consensus of two radiologists after visual inspection. These MR features were compared with the degree of fibrosis and marrow cellularity, as determined by bone marrow biopsy. RESULTS: In all patients, marrow signal intensity of the thoracolumbar spine was reduced onT1 and T2 weighted images (invariably low on T1 weighted images, low (2/6) to intermediate (4/6) on T2 weighted images). On STIR images, marrow signal intensity was variable (high (3/6) or low (3/6)), and this correlated with degree of fibrosis, not with marrow cellularity. The signal intensity of marrow with mild to moderate fibrosis was high on STIR images, while that of marrow with marked fibrosis was low. CONCLUSION: MR imaging features of myelofibrosis were characterized as low on T1 weighted images and low to intermediate on T2 weighted images. In addition, the signal intensity of STIR imaging correlated with degree of fibrosis.
Biopsy* ; Bone Marrow* ; Consensus ; Female ; Fibrosis ; Humans ; Magnetic Resonance Imaging ; Male ; Primary Myelofibrosis* ; Retrospective Studies ; Spine

PURPOSE: To characterize the magnetic resonance (MR) imaging features of myelofibrosis and compare them with bone marrow biopsy findings. MATERIALS AND METHODS: The authors retrospectively reviewed sagittal T1-and T2 weighted and short tau inversion recovery (STIR) images of the thoracolumbar spine of six patients (five males and one female, mean age 46) with biopsy-proven myelofibrosis. Marrow signal intensity of the thoracolumbar spine was classified with respect to those of muscle and fat, based on the consensus of two radiologists after visual inspection. These MR features were compared with the degree of fibrosis and marrow cellularity, as determined by bone marrow biopsy. RESULTS: In all patients, marrow signal intensity of the thoracolumbar spine was reduced onT1 and T2 weighted images (invariably low on T1 weighted images, low (2/6) to intermediate (4/6) on T2 weighted images). On STIR images, marrow signal intensity was variable (high (3/6) or low (3/6)), and this correlated with degree of fibrosis, not with marrow cellularity. The signal intensity of marrow with mild to moderate fibrosis was high on STIR images, while that of marrow with marked fibrosis was low. CONCLUSION: MR imaging features of myelofibrosis were characterized as low on T1 weighted images and low to intermediate on T2 weighted images. In addition, the signal intensity of STIR imaging correlated with degree of fibrosis.
Biopsy* ; Bone Marrow* ; Consensus ; Female ; Fibrosis ; Humans ; Magnetic Resonance Imaging ; Male ; Primary Myelofibrosis* ; Retrospective Studies ; Spine