No abstract available.
Child* ; Humans

No abstract available.
Humans ; Kidney Transplantation* ; Living Donors*

No abstract available.
HL-60 Cells* ; Humans ; Mass Screening* ; Protein Kinases*

Primary ampullary carcinoma is one of rare gastrointestinal malignancies which can be diagnosed by ERCP and endoscopic biopsy. However, sometimes it is difficult to comfirm the diagnosis when the tumor is not exposed out of orifice of ampulla. Recently, we diagnosed early stage ampullary carcinoma using endoscopic sphincetrotomy for the exposure of tumor in 54 year old woman ia whom ERCP revealed rather impacted stone like filling defect in distal common bile duct. we describe a case of papillary adenocarcinoma of the ampulla of Vater diagnosed by edoscopic sphincterotomy.
Adenocarcinoma, Papillary ; Ampulla of Vater* ; Biopsy* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Female ; Humans ; Middle Aged ; Sphincterotomy, Endoscopic*

The CT digital radiography is a new accurate technique for measuring the long bone length. Authors performed acomparative study on accuracy, time and film consumption and radiation dose between conventional spot scanogramand CT scanogram. We used two femur and two tibia specimen for materials, the Somatom II(Siemens) for CTscanogram, and Rad Check(Voctoreen) for radiation dosimetery. There was no significant difference in accuracybetween direct measurement, conventional scanogram and CT scanogram(lesser than 1% difference). The examinationtime of conventional scanogram was about 35 minutes, CT was 15 minutes, and the film consumption of spot scanogramwas 3 of 14x17'' size, but the CT scanogram need only one 8x10'' film for completion of study. The radiation doseof hip, knee and ankle joint were 220 mRad, 365 mRad, respectively, in spot scanogram, but it was lesser than 5mRad in all joints in CT scanogram. The advantages of the CT scanogram are simple, rapid and reduced radiation.
Ankle Joint ; Femur ; Hip ; Joints ; Knee ; Radiographic Image Enhancement ; Tibia

Intrahepatic stones are frequently associated with recurrent pyogenic cholangiohepatitis and complete surgical removal of the stones is almost always difficult because of the large number of stones and associated bile duct strictures. One hundred and seventy-nine patients with retained intrahepatic stones underwent percuttaneous stone removal utilizing a preshaped angulated catheter and a Dormia basket under fluoroscopy with a combination of techniques including irrigation-suction. crushing of large stones. balloon dilatation of strictures and extracorporenal shock wave lithotripsy. The procedure was performed through a mature T-tube tract (177 patients) and a mature transhepatic tube tract (two patients). Stones were exclusively intrahepatic in 130 patients. whereas 49 patients also had stones in the common bile duct. In 91 (50.8%) of 179 patients. the stones were completely removed and in 36 (20.1%) patients most of the stones were removed. The overall success rate was 70.9% ngulation deformity. stricture of bile ducts and impacted stones were the factor most often responsible for failure, No significant complications were observed. Fluoroscopicalyy-guided percutaneous interventional procedures with a preshaped angulated catheter is an useful complementary procedure to surgery for patients with intrahepatic stones. the major benefits of an individually fitted angulated catheter are its safety and easy access to small peripheral bile ducts.
Bile Ducts ; Catheters* ; Common Bile Duct ; Congenital Abnormalities ; Constriction, Pathologic ; Dilatation ; Fluoroscopy ; Humans ; Lithotripsy ; Shock

Endovascular aneurysm repair (EVAR) for the treatment of abdominal aortic aneurysm (AAA) is a widely used method, and its decreased invasiveness compared to traditional surgical repair has brought about reduced rates of morbidity and mortality. Several vascular complications related to the procedure have been reported, but non-vascular complications have rarely occurred. We report herein the case of a 78-year-old man who underwent EVAR for AAA and presented with active duodenal ulcer bleeding and acute acalculous cholecystitis as complications after the procedure. We must consider that a wide spectrum of complications may occur following EVAR, and therefore it is important to evaluate the risks of complication and to take the necessary measures to minimize them.
Acalculous Cholecystitis ; Aged ; Aneurysm ; Aortic Aneurysm, Abdominal ; Duodenal Ulcer ; Hemorrhage ; Humans

For the evaluation of exercise induced R wave amplitude changes in lead V5 (big up tri, openR) and multiple leads(summation operatorR), we studied 20 normal subjects and 21 ischemic heart disease patients with positive exercise test. All underwent submaximal, multiple leads multistage treadmill exercise testing. 14 to 20 normal subjects(70%) there were decreased R wave amplitude in multiple leads on treadmill exercise testing. 16 of 21 patients(76%) there were increased R wave amplitude on treadmill exercise testing. In normal group, R wave amplitude between rest and exercise was significantly decreased in lead V5 and multiple leads. In patients grous, R wave amplitude between rest and exercise was significantly increased in lead V5 and multiple leads. It is suggested exercise induced R wave amplitude changes probably enhance the diagnostic reliability by ST segment changes on treadmill exercise testing.
Exercise Test* ; Humans ; Myocardial Ischemia

Hydroxychloroquine (HCQ) has been used widely for the treatment of several rheumatologic and dermatologic conditions, including systemic lupus erythematosus and rheumatoid arthritis. Its toxic effects on the retina, HCQ retinopathy, is not uncommon among long-term users, and produces characteristic irreversible and progressive outer retinal damage. Recent studies of Asian populations showed different patterns of retinopathy according to ethnicity; for example, a pericentral pattern is more common in Asian populations, whereas the parafoveal type is more prevalent in Caucasian patients. The pericentral pattern, which is common in Asian patients, is likely to lead to a late diagnosis with conventional imaging modalities, thereby necessitating increased attention to the screening of Asian patients. The most recent American Academy of Ophthalmology guidelines suggest optical coherence tomography and a visual field examination as the primary screening tests, and multifocal electroretinogram and fundus autofluorescence as other recommended objective screening tests. The optimal timing and frequency of annual screening depend on the systemic and ocular risk factors. Annual screening should begin from 5 years of drug use in cases without any known risk factors, but patients with major risk factors require earlier regular screening. After a diagnosis of HCQ retinopathy, a decision regarding whether to stop the drug should be made in consultation with the prescribing physician, and the progression of retinopathy should be monitored carefully because the retinopathy can progress even after drug cessation.
Arthritis, Rheumatoid ; Asian Continental Ancestry Group ; Delayed Diagnosis ; Diagnosis ; Humans ; Hydroxychloroquine* ; Lupus Erythematosus, Systemic ; Mass Screening ; Ophthalmology ; Retina ; Retinal Diseases ; Retinaldehyde ; Risk Factors ; Tomography, Optical Coherence ; Visual Fields

STUDY DESIGN: Retrospective study of prospectively-collected data. OBJECTIVES: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients. SUMMARY OF LITERATURE REVIEW: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. MATERIALS AND METHODS: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. RESULTS: The average area of the spinal canal was 81.40±53.61 mm2 in the surgical group, compared to 127.75±82.55 mm2 in the nonsurgical group (p=0.042). The muscle area in the spinal canal was 5.17±1.30 cm2 in the surgical group, whereas it was 6.40±1.56 cm2 in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). CONCLUSIONS: The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.
Fitness Centers ; Humans ; Lumbosacral Region ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Canal ; Spinal Stenosis ; Sprains and Strains