No abstract available.
Acrocephalosyndactylia*

PURPOSE: To evaluate the usefulness of percutaneous catheter drainage (PCD) in patients who have abdominal abscesses or fluid collections. MATERIALS AND METHODS: We performed PCD for 165 abscesses and fluid collections in 148 patients. The follow-up periods in these patients ranged from 15 days to 42 months (mean, 274 days). The lesion sites were subphrenic space in 46 cases, liver in 33, perihepatic space in 20, pancreas or peirpancreatic space in 14, pelvic cavity in 13, and retroperitoneum in 13. We evaluated the success, failure, and recurrence rates, the causes of failure or recurrence, the mean duration of drainage, and the complications of PCD. RESULTS: Of the 165 cases, one hundred-fifty nine(96.5%) were successfully cured, Although a partial success could be achieved, 2(1.2%) cases were failed and 4(2.4%) were recurred. Multiloculation or fistula formation were the main causes of the unsullessful cases. The duration of drainage rainged from 2 to 605 days (mean, 1 days). Complications occured in 12 cases(7%) during or after procedures, which included fever and chill in 7, transgression of pleura in 2, bowel perforation in 2, and bleeding through catheter in 1. CONCLUSION: PCD is an effective and safe method for various abdominal abscesses or fluid collections.
Abdominal Abscess* ; Abscess ; Catheters* ; Drainage* ; Fever ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Pancreas ; Pleura ; Recurrence

PURPOSE: The purpose.of this study was to characterize the enhancing patterns of hepatocellular carcinoma (HCC) on two-phase dynamic incremental liver scan with spiral CT. MATERIALS AND METHODS: Two-phase dynamic incremental liver scan using spiral CT was performed on 230 lesions in 107 patients with HCC. CT scanning was performed with a table speed of 13mm/sec and a section thickness of 10 mm;120 mL of contrast medium was injected intravenously with a automatic injector at the rate of 3mL/sec. CT scans were started 35 sec(early phase) and 3 min(delayed phase) after beginning injection of contrast medium. The tumors were divided into 2 groups according to size(< or = 3cm and > 3cm), the contrast enhancement patterns of HCCs and capsules in the early and delayed phases were analyzed in each group. RESULTS: Most of HCCs appeared as high-attenuating lesions in the early phase(75% in tumors smaller than 3cm and 61% in tumors larger than 3cm), and as low-attenuating lesions in the delayed phase(68% in tumors smaller than 3cm and 90% in tumors larger than 3cm). Forty-eight percent of HCCs smaller than 3cm and 58% of HCCs larger than 3cm were high-attenuating in the early phase and low-attenuating in the delayed phase. Thirty-two percent of capsules were low- or iso-attenuating in the early phase and high-attenuating in the delayed phase. Capsules were demonstrated in 22% in HCCs smaller than 3cm and 67% in HCCs larger than 3 cm(p <. 01). CONCLUSION: Two-phase dynamic scan with spiral CT is useful in the diagnosis of HCC because of a precise display of hemodynamic characteristics of HCCs.
Capsules ; Carcinoma, Hepatocellular* ; Diagnosis ; Hemodynamics ; Humans ; Liver ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

Although many invasive studies in the biliary tract disase are replaced by noninvasive techniques such asultrasonography and CT, PTC does still play an important role indiagnosis of obstructive jaundice. Authors hadperformed 42 patients of PTC with Chiba needle at the department of radiology, Han Gang Sacred Heart Hospital for4 years from Jan. 1978 to April 1982. And we reviewed literatures. The results were as follows; 1. Forty twopatients of PTC were 22 males and 20 females. The success rate was 90.5%(38/42). The failed 4 cases of PTC werenonobstructive hepatobiliary diseases. 2. The PTC diagnosis of 38 cases were biliary stone (21 cases),cholangiocarcinoma(7 cases), pancreatic carcinoma (2 cases), hepatoma (2 cases), ascariasis(2 cases), andclonorchiasis(1 case), and the remainders were normal. 3. We made 2 cases of misdiagnosis on the basis of PTCfindings. They were one case of distal CBD stone with severe cholangitis diagnosed as ampullary carcioma andanother case of proximal CBD stone with cholangitis diagnosed as pancreas carcinoma. 4. We experienced 2 cases ofcomplication such as sepsis and severe hypotension, but they were recovered.
Biliary Tract ; Carcinoma, Hepatocellular ; Cholangiography ; Cholangitis ; Diagnosis ; Diagnostic Errors ; Female ; Heart ; Humans ; Hypotension ; Jaundice, Obstructive ; Male ; Needles ; Pancreas ; Sepsis

Background: Femoral neck stress fractures (FNSFs) are rare but potentially disabling injuries if the diagnosis is missed or delayed and proper treatment is not provided. The aim of this study was to investigate and describe the characteristics and clinical course of FNSFs in South Korean male military recruits. Methods: Between May 2015 and October 2019, 16 fractures in 12 young male military recruits were reviewed. The characteristics of the fractures were ascertained by detailed analysis of the history and clinical course, as well as radiographs, bone scintigrams, and magnetic resonance images. Results: The median duration between endurance training and the development of hip pain was 5 weeks, while the median duration of pain before the patient sought medical attention was 3 weeks. Four patients (33.3%) exhibited bilateral fractures, and concomitant lesions involving the proximal tibia were found in 3 patients (25%). Fourteen of the 16 fractures (87.5%) were compression-type fractures, and surgery was performed for 7 hips. Complete union without malunion or osteonecrosis was achieved in all cases, and all cadets returned to their full activity levels in an average of 10 weeks. Conclusions We observed excellent prognosis of FNSFs. Our report highlights the importance of early reporting, detection, and treatment regarding the challenging management of FNSFs. When a military recruit reports hip pain, a FNSF should be considered; furthermore, the bilaterality of the fracture and the presence of concomitant lesions should also be investigated.

BACKGROUND: A laparoscopic cholecystectomy has many clinical advantages and is now recognize as the choice for treatment for gallstones. However a laparoscopic cholecystectomy is often not feasible or is converted to the conventional open method in patients with acute cholecystitis because of surrounding adhesion, tissue edema, and high postoperative complications. Lately, good clinical results have been reported by many authors for a percutaneous cholecystostomy followed by a laparoscopic cholecystectomy in the management of acute cholecystitis. METHODS: Between January 1996 and March 1997, 56 acute cholecystitis patients were surgically treated in our institution. Thirteen patients underwent percutaneous drainage followed by a laparoscopic cholecystectomy (Group I). Also a laparoscopic cholecystectomy without a prior percutaneous cholecystostomy was attempted in 43 patients (Group II). RESULTS: There were no differences in the age and the sex distributions, the chief complaints on admission, and the severity of inflammation between the two groups. The only significant difference was the wall thickness of the gallbladder on postoperative pathologic examinations, 4.7 mm for Group I and 6.2 mm Group II (p=0.038). For the patients in Group I, percutaneous drainage of the gallbladder continued for 5.4 days on average, and the cholecystectomy was usually performed about 15 days later. A laparoscopic cholecystectomy was possible in 10 patients (76%) in Group I, but had to be converted to the open method in 3 patients. In Group II, only 17 patients (39.5%) out of 43 underwent a successful laparoscopic cholecystectomy. In other words, the open conversion rate was 24% in Group I and 60.5% in Group II. The wall thicknesses of the gallbladder excised laparoscopically were 3.98 mm and those of the conventionally removed gallbladder were 6.96 mm on average. This difference in the wall thickness was statistically significant (p=0.013) and was the only factor related with the open conversion rate. CONCLUSIONS: We think that a laparoscopic cholecystectomy performed several days after percutaneous drainage of the gallbladder to eliminate acute inflammation may be recommended for management of acute cholecystitis patients with severe clinical symptoms and ultrasonographic findings of marked gallbladder dilatation or pericholecystic fluid collection.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Cholecystostomy* ; Dilatation ; Drainage ; Edema ; Gallbladder ; Gallstones ; Humans ; Inflammation ; Postoperative Complications ; Sex Distribution ; Tissue Adhesions

The aortic dissection is an acute aortic syndrome, caused by an intimal tear and subsequent splitting of the media by the pulsatile blood flow. Though there would be differences in the origin of aortic dissection and therapeutic modalities, the intermediate and long-term prognoses are poor. Endovascular Stent-graft implantation is a revolutionary technique in the treatment of aortic dissection. The endovascular stent grafting in aortic dissection is less invasive and feasible method and is an effective tool for closing the entry site and promoting clot formation, reducing the size of the false lumen. Therefore, endovascular Stent-graft implantation makes possible the desirable remodelling of aorta. We report 33 year-old male with aortic dissection in the thoracic aorta, which was treated with endovascular Stent-graft implantation. Over the favorable remodelling, his dissection was healed completely by the endovascular treatment using Stent-graft.
Adult ; Aorta ; Aorta, Thoracic* ; Blood Vessel Prosthesis ; Humans ; Male ; Prognosis

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Physical Examination

Patients with aortic root disease, frequently seen in Marfan syndrome have progressive dilatation of the aortic sinuses and dilatation and distortion of the aortic annulus, leading to aortic incompetence. They are currently treated with composite graft replacement of the ascending aorta and aortic valve and reimplantation of the coronary arteries. Recently, we experienced an aortic root replacement with aortic valve preservation in a patient with annuloaortic ectasia. The ascending aorta and sinus was excised except the aortic annulus and aortic valve. The aortic valve was reimplanted inside of a collagen-impregnated tubular Dacron graft. The coronary arteries were also reimplanted. The patient was followed up for six months and reevaluated with the echocardiography. Postoperative Doppler echocardiography revealed normal aortic valve function. With this technique, it is possible to preserve the native aortic valve if the aortic leaflets are anatomically normal.
Aorta ; Aortic Valve ; Aortic Valve Insufficiency ; Coronary Vessels ; Dilatation ; Dilatation, Pathologic* ; Echocardiography ; Echocardiography, Doppler ; Humans ; Marfan Syndrome ; Polyethylene Terephthalates ; Replantation ; Sinus of Valsalva ; Transplants

PURPOSE: N-(3-[18F]Fluoroporpy)-2beta- carbomethoxy-3beta-(4-iodophenyl) nortropane ([18F]FP-CIT) has been shown to be very useful for imaging the dopamine transporter. However, synthesis of this radiotracer is some what troublesome. In this study, we used a new method for the preparation of [18F]FP-CIT to increase radiochemical yield and effective specific activity. MATERIALS AND METHODS: [18F]FP-CIT was prepared by N-alkylation of nor-beta-CIT (2 mg) with 3-bromo-l-[18F]fluoropropane in the presence of Et3N (5-6 drops of DMF/CH3CN, 140 degree C, 20 min). 3-Bromo-l-[18F]fluoropropane was synthesized from 5 microliter of 3-bromo-l-trifluoromethanesulfonyloxypropane (3-bromopropyl -l-triflate) and nBu4N18F at 80 degree C. The final compound was purified by reverse phase HPLC and formulated in 13% ethanol in saline. RESULTS: 3-Bromo-l-[18F]fluoropropane was obtained from 3-bromopropyl-l-triflate and nBu4N18F in 77-80% yield. N-Alkylation of nor-beta-CIT with 3-bromo-l-[18F]fluoropropane was carried out at 140 degree C using acetonitrile containing a small volume of DMF as the solvents. The overall yield of [18F]FP-CIT was 5-10% (decay-corrected) with a radiochemical purity higher than 99% and effective specific activity higher than the one reported in the literature based on their HPLC data. The final [18F]FP-CIT solution had the optimal pH (7.0) and it was pyrogen-free. CONCLUSION:: In this study, 3-bromopropyl-l-triflate was used as the precursor for the [18F]fluorination reaction and new conditions were developed for purification of [18F]FP-CIT by HPLC. We established this new method for the preparation of [18F]FP-CIT, which gave high effective specific activity and relatively good yield.
Chromatography, High Pressure Liquid ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Ethanol ; Hydrogen-Ion Concentration ; Positron-Emission Tomography ; Solvents