Endoscopic retrograde cholangiopancreatography(ERCP) is a new diagnostic method for pancreatic and biliarydiseases which has been made possible by the development of fiberoptic duodenoscopy. It has been thought that ERCPwell serve an important role in the early detection of pancreatic cancer, but in order to detect minor lesions ofthe pancreas and improve the diagnostic accuracy of resectable pancreatic cancer, Endoscopic RetrogradeParechymography of the pancreas (ERPP) was developed recently. The authors analyzed 117 cases of ERCP performed atthe Kwangju Christian Hospital between Jan. and Dec. 1980, and compared them with the final diagnosis. The resultswere as follows; 1. Out of 117 cases, successful visualization of the duct of concern was achieved in 105 cases.Of these, 25 cases were ERPP. 2. The ratio of males to female was 1.44:1. Most patients were in the 4th to 6thdecade. 3. The commmonest clinical manifestations were upper abdominal pain (77cases), jaundice(23 cases),indigestion, vomiting and abdominal mass, in order of frequency. 4. Out of 46 cases of suspected pancreaticdiseases, the pancreatic duct was visualized in 36 cases, and 24 cases revealed pathognomonic findings. These werediagnosed as 16 cases of pancreatic cancer, 4 cases of chronic pancreatitis, 2 cases of pancreatic pseudocyst and2 cases of periampullary cancer with pancreas invasion. In pancreatic cancer findings were; encasement, localdilatation, delayed excretion, poor filling, obstruction of pancreatic duct, accompanying C.B.D. obstruction orstenosis and so called double duct sign. The chronic pancreatitis findings included; ductal dilatation (with orwtihout) obstruction, tortuosity with dilated saccular lateral branching, stone formation and the parenchymalfilling defect. 5. Out of 71 cases of suspected biliary tract diseases, the biliary tract was visualized in 57cases, and in 31 cases abnormalities were suggested; such as 20 cases of biliary stone, 1 cases of ascariasis, 1case of clonorchiasis with cholangitis, 1 case of clonorchiasis with stone, 2 cases of C.B.D. ca. 2 cases of G.B.ca, 3 cases of intrahepatic disease, 1 case of stones in the biliary tree with ampullary ca. 6. Complications ofERCP and ERPP were extremely raare. Transient abdominal distention, abdominal discomfort and elevated serumamylase were noted, but were not clinically significant.
Abdominal Pain ; Ascariasis ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Clonorchiasis ; Diagnosis ; Dilatation ; Duodenoscopy ; Female ; Gwangju ; Humans ; Male ; Methods ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Pancreatitis, Chronic ; Vomiting

Endoscopic Retrograde Cholangiopancreatography(ERCP) is one of the important diagnostic methods for pancreaticcancer. It has an essential role in the early detection of pancreatic cancer. The ERCP findings of 35 cases ofpathologically proven pancreatic cancer during the period of five and a half years from April 1977 through Nov.1982 at Kwangju Christian Hospital were studied. The resuls were as follows; 1. The ratio of male of female was3.4:1, and most of the patients were over 40 years of age (88.5%). 2. The locations of the lesions were the headin 28 cases (80%), the body in 7 cases(20%), and the ail in 3 cases (8.6%). 3. The ERCP findings of pancreaticcancers were as follows; 1) Encasement or obstruction of common bile duct, 18 cases (51.4%). 2) Obstruction ofpancreatic duct, 16 cases (45.7%). 3) Irregular stenosis of pancreatic duct, 8 cases (22.3%). 4) Double duct sign,7 cases (20%). 5) Diffuse narrowing of pancreatic duct, 2 cases (5.7%).
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Constriction, Pathologic ; Female ; Gwangju ; Humans ; Male ; Pancreatic Ducts ; Pancreatic Neoplasms

The ultrasound-guided fine needle aspirations were performed in order to diagnose a suspected neoplastic orinfectious diseases in 52 patients with focal liver disease. Of these, neoplastic lesions were suspected in 31patients and infectious lesions in 21 patients ultrasonically and/or clinically. The overall accuracy for bothsuspected malignant and infectious disease was 79%(41/52). The primary indication for fine needle aspiration wasto document the presense of malignancy and to avoid a diagnostic laparotomy, and to drain hepatic abscesses.Consequently we were convinced that the ultasound
Aspirations (Psychology) ; Biopsy ; Biopsy, Fine-Needle ; Communicable Diseases ; Diagnosis ; Humans ; Laparotomy ; Liver Diseases ; Liver ; Methods ; Needles ; Ultrasonography

PURPOSE: Cerebral palsy or hearing disability of hyperbilirubinemic complication was reduced by blood exchange transfusion(BET) and phototherapy(PT). But in spite of these treatment, abnormal Auditory Brainstem evoked Response(ABR) finding after BET or PT and neurodevelopmental defect due to chronic bilirubin encephalopathy were observed. So we have studied risk factors and outcome of chronic bilirubin encephalopathy after BET, and treatment of hyperbilirubinemia. METHODS: We have analyzed clinical characteristics, the finding and change of ABR after BET in 17 hyperbilirubinemic neonates, and in 8 hyperbilirubinemic neonates who were treated by phototherapy and 15 normal control neonates. RESULTS: 1) Mean bilirubin concentraion were 27.5+/-4.1mg/dL in BET group and 22.1+/-2.3 mg/dL in PT group. There were no difference of clinical findings between BET and PT group. 2) Change of ABR (1) Wave I loss resulted in 4 neonates, wave III loss in 3 neonates, and wave V loss in 2 neonates in BET group(P<0.05). (2) Wave I peak latency and hearing threshold in BET group were significantly increased more than normal control group(P<0.01). 3) In 10 neonates(58.8%) among 17 BET group, 4 neonates(50%) in 8 PT group were observed abnormal initial ABR finding after jaundice treatment. Age at treatment and duration of jaundice(interval between onset of jaundice and treatment) in abnormal ABR group were significant prolongation compared with normal ABR group(P<0.05). 4) Chronic bilirubin encephalopathy(CBE) was observed in 3 neonates(17.6%) among 17 BET group and showed higher of bilirubin level than normalized group after BET (31.1mg/dL vs 26.6mg/dL), other clinical findings showed no significant differences. CONCLUSION: Bilirubin level was significantly elevated in CBE more than in BET group and duration of jaundice, age at treatment were longer in abnormal ABR group than in normal ABR group. So not only bilirubin level but also duration of jaundice shoud be considered at jaundice treatment, and ABR has a potential utility in detection of acute brain toxicity of bilirubin and follow up evaluation of bilirubin encephalopathy.
Bilirubin ; Brain ; Brain Stem ; Cerebral Palsy ; Follow-Up Studies* ; Hearing ; Humans ; Hyperbilirubinemia ; Infant, Newborn* ; Jaundice ; Kernicterus ; Phototherapy* ; Risk Factors

No abstract available.
Posterior Cruciate Ligament*

We have many unsolved problems about the femoral neck fracture, especially non-union of the fracture and avascular necrosis of the femoral head. It seems clear that underlying these are two basic problems; first, the mechanical difficulties in maintaining secure fixation; and second, biological factors interfering with union, paramount of which is damage to the blood supply of the femoral head. Intra-capsular fracture of the femoral neck heals in the same way as other intra-articular fractures-only by endosteal and not by periosteal repair. If the femoral head has an intact blood supply, repair appears early on both sides of the fracture. But if the femoral head is not viable, this repair appears only on the neck side of the fracture. It can migrate into the head and heal the fracture only if there is close apposition and rigid fixation of well reduced fracture fragments. Clearly the femoral neck fracture heals not by periosteal callus but by callus arising from the marrow supporting structure. Yet there is still no reliable clinical method of determining early the union of the femoral neck fracture and the viability of the femoral head. The femoral head intra-osseous venography, first described by Hulth (1953), to predict viability of the femoral head after fracture of the femoral neck has been carried by various previous authors (Hulth1953 1956 1958, Dahlgren 1959, Harrison 1962, Hulth and Johansson 1962, Nagai 1962). However, they did not mention healing process of fractures of the femoral neck in these studies. To observe the fracture healing and to predict the viability of the femoral head, authors adopted a femoral trochanteric intra-osseous venographic technique. The precedure was carried out under the control of a T-V image intensifier. Venous drainage of the femoral head parallels the arterial supply. There are several venous drainage routes in the hip region; the medial and lateral circumflex vein, gluteal vein, nutrient vein, femoral vein, vein of the ligamentum teres and obturator vein. With the aid of a T-V image intensifier, a bone marrow needle is driven 1 inch below the femoral greater trochanter. When the tip of the needle is in the marrow cavity, about 30cc, of 75% Urograffin is injected. Next X-rays are taken at intervals of 2 seconds, the last film at 5 minutes. A positive venography is one in which venous drainage is seen, and opaque fluid is seen in mottled distribution throughout neck region and part of the head. A negative venography is one in which no venous drainage is seen, on the contrary, opaque fluid pools within the trochanteric region are evident and remain for at least 5 minutes. A positive venography indicates that the head has an intact circulation, thus it may be predicted that the fracture can unite and the head is alive. Negative venography suggests that fracture union is not and will not take place and that the head may be dead. This study provided information about fracture heaIing processes and vascularities of the femoral head and its surrounding tissues during and after fractures healing. We have found that trochanteric intra-osseous venography is a useful diagnostic tool in hip injuries.
Biological Factors ; Bone Marrow ; Bony Callus ; Drainage ; Femoral Neck Fractures ; Femoral Vein ; Femur ; Femur Neck ; Fracture Healing ; Head ; Hip Injuries ; Hip ; Methods ; Neck ; Necrosis ; Needles ; Phlebography ; Round Ligaments ; Veins

Bone formation by osteoblast may be closely related to the increase in intracellular Ca2+ activity of osteoblast. In order to study the effects of changes in Ca2+ activity of osteoblast-like cell on fracture healing, we changed intracellular Ca2+ activity of osteoblast-like cells by vanadate and verapamil. And the process of fracture healing was observed after injection of the treatment osteoblast-like cells into the fracture site by hematoxylin-eosin (H-E) stain and bromodeoxyuridine (BrdU) stain. The results were as follow: 1) The most effective range of concentration which could facilitate bone formation was 10-6 to 10-5 M. 2) H-E stain showed more abundant osteoblast and osteoid tissues, more active mitotic division of osteoblast, and earlier appearance of chondroblast and chondroid tissue, making the maturation of woven bone faster in the vanadate-treated group than in the control group. The opposite was true in the verapamil-treated group compared with the control group. 3) BrdU labeling index showed more active osteoblastic proliferation in the vanadate-treated than in the control group. The opposite was observed in the verapamil-treated group compared with the control group. From these results, the fracture healing appears to be facilitated and decelerated by vanadate which apparently increase intracellular Ca2+ activity of osteoblast and verapamil which decreases it, repectively. Therefore the change of intracellular Ca2+ activity of osteoblast can be considered to be one of fracture healing mechanisms and expected to be applied for clinical purpose.
Bromodeoxyuridine ; Chondrocytes ; Fracture Healing ; Osteoblasts ; Osteogenesis ; Vanadates ; Verapamil

No Abstract Available.
Chondrocytes* ; Phenotype*

The classical Roentgenographic features of tuberculosis of the spine such as narrowing of the intervertebraldisc, collapse of the vertebral bodies, with or without the shadow of a cold abscess, present a specific pictureof the actural pathological process. However, the diagnosis of tuberculosis is not confirmed unless proven bybiopsy, or the finding of the tubercle bacillus. 120 cases of proven spinal tuberculosis, at Kwangju ChristianHospital during the period form Jan 1973 through Aug. 1980, were studied and analysed. The results were asfollows; 1. The ratio of male to female was 1:1.1. The age preference was under 30 years old. 2. The most frequentsite of involvement was the lumbar spine(44.1%) and next the thoracic(39.2%0. 3. The incidence of lytic type was50.8%, mixed type 36.7%, and sclerotic type 12.5%. 4. Associated pulmonary tuberculous lesions were observed in 94patients (78.3%). 5. The central type, with wedging or collapse of the vertebral body, was more common in theyounger age group and the intrevertebral articular type in older patients. 6. The incidences of typical radiologicfindings were : Collapse of vertebral body(90%), cold abscess (78.3%) and narrowing of intervertebral space(70%).7. Associated kyphosis was observed in 37 cases (30.8%). Among these 37 cases the range of angulation was between21 to 40 degrees in 40%.
Abscess ; Bacillus ; Diagnosis ; Female ; Gwangju ; Humans ; Incidence ; Kyphosis ; Male ; Spine ; Tuberculosis ; Tuberculosis, Spinal

No abstract available.
Sterilization, Tubal*