The common bile duct and the duct of Wirsung cojoin at the level of the duodenum, forming the major. papilla of Vater. Existence of a double major papilla, i.e., two neighboring independent papillary structure:, is infrequent. In our endoscopy unit we have experienced one case of double papilla of Vater wherein canulation of the common bile duct and pancreatic duct could be accom plished through either orifice independently.
Common Bile Duct ; Duodenum ; Endoscopy ; Pancreatic Ducts

No abstract available.
Echocardiography*

No abstract available.
Brain* ; Neoplasm Metastasis*

No abstract available.
Adenocarcinoma* ; Estrogens*

Though intravenous digital subtraction angiography (IV DSA) has several advantages over conventionalangiography in diagnosis and follow up of various vascular disease, it also has several undesirable problems suchas large volume of the contrast medium and inferior image quality compared to conventional angiography. Sorecently intraarterial digital subtraction angiography (IA DSA) was introduced for better image quality usingsmall amount of contrast medium. The authours had good clinical results IA DSA which were made in 20 patients withour own system, SRM-II, developed by cooperation of Departements of Radiology and Medical engineering, Seoul.National University Hospital. Intraarterial digital substraction angiography was found to have several advantagesover conventional angiography: (a) small amount of contrast medium, (b) reduced need for selective arterialcatheterization,(c) lower film cost, (d) shortened examination time, (e) ability to obtain a “road map”, and (f)easier detection of contrast medium. Also IA DSA has several advantages over IV DSA : (a) less dependency oncardiac output, (b) far less vessel overlapping, (c) reduction in patient motion through less painful procedure byreduced volume of contrast media and shorter imaging time.
Angiography ; Angiography, Digital Subtraction ; Contrast Media ; Diagnosis ; Follow-Up Studies ; Humans ; Vascular Diseases

Evaluations of residual renal function and the therapeutic effectiveness in renal tuberculosis have largely been dependent on intravenous pyelogram or Contrast-CT scan, even though, exact renal function are not evaluated with there methads. 99mTc-DMSA is a radiopharmaceutical that is trapped in the functioning tubular cells of the kidney and therefore, quantitative renal function could be evaluoted by ineasuring the counts of renal radioactivity and concomittant evaluation of renal morphology could be passible with the analog imapes of the radioactivity. The authors retrospectively analyzed 99mTc-DMSA scans of 75 kidndys of 67 patients with confirmed renal tuberculosis. We classified the morphologies of tuberculous kidneys as 6 types. We classified the morphologies of tuberculous kidneys as 6 types such as the type with small cortical defect, with parenchymal ulcerocavernous lesions, ulcerocavernous fistula to pelvis, mass-like defects, contracted kidney with ureter visualization, and the type with nonvisualization of kidney, corresponding to the characters of renal tuberculous pathogenesis with abscess formation, ulcerocavernous fistula, and fibrosis, and correspondings to the renal anatomy with parenchyma, and pelvocalyceal collecting system. Their mean residual renal functions measured with 99mTc-DMSA uptake rates were 19.0%, 18.4%, 7.9%, 12%, 4.1%, 3.4% respectively.
Abscess ; Fibrosis ; Fistula ; Fluspirilene ; Humans ; Kidney ; Pelvis ; Radioactivity ; Retrospective Studies ; Succimer* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Tuberculosis, Renal* ; Ureter

Huntington's disease is an autosomal dominant neurodegenerative disorder that usually begins in mid-life and is characterized by a progression of involuntary choreiform movements, personality change, and dementia. 4 specific unstable trinucleotide (CAG) repeat expansion in a gene on the short arm of chromosome 4 was recently identified as the pathogenic mutation for this disease. We have analysed the CAG expansion in peripheral leukocyte from a woman suspected with Huntington's disease and her family. A 40-year-old woman visited for the 6 years history of progressing intractable involuntary hyperkinetic movement and antagonistic personality. She showed bilateral caudate nucleus atrophy with mild enlargement of both frontal horn at brain MRI and showed the decrement of glucose metabolism in both basal ganglia at 18F-FDG PET scan. We also studied about the clinical manifestations of her family. Her younger brother also showed mild cognitive impairment and dysarthria. She and her relatives (n = 6) were tested for the existence of high risk allele of Huntington's disease by polymerase chain reaction method. The high risk allele (above 40 CAG repeat) in the 1715 gene was confirmed in 6 persons including the patient. The CAG repeat variance was 46 to 54. Only one person showed the normal range of CAG repeat.
Adult ; Alleles ; Animals ; Arm ; Atrophy ; Basal Ganglia ; Brain ; Caudate Nucleus ; Chorea ; Chromosomes, Human, Pair 4 ; Dementia ; Diagnosis* ; Dysarthria ; Female ; Fluorodeoxyglucose F18 ; Genes, vif ; Glucose ; Horns ; Humans ; Huntington Disease* ; Hyperkinesis ; Leukocytes ; Magnetic Resonance Imaging ; Metabolism ; Mild Cognitive Impairment ; Neurodegenerative Diseases ; Polymerase Chain Reaction* ; Positron-Emission Tomography ; Reference Values ; Siblings

A relationship between preceding acute paralytic poliomyelitis and the later development of motor neuron disease has only occasionally been suggested since it was first postulated by Charcot in 1875. The authors recently experienced a 20-year-old male who was considered to have postpoliomyelitis muscular atrophy. We report this case in view of its rarity and necessity of differential diagnosis from other neuromuscular disorders. Clinical presentation included slowly progressive muscle wasting of left thigh for 4 years, mild weakness of left arm and both thigh, intermittent fasciculation, and previous history of acute paralytic poliomyelitis. Electromyographic findings showed fibrillation potentials, positive sharp waves, fasciculations, giant motor unit potentials and reduced interference patterns. Muscle biopsy revealed scattered small angulated fibers, individual myofiber degeneration and mild inflammatory cell infiltration.
Arm ; Biopsy ; Diagnosis, Differential ; Fasciculation ; Humans ; Male ; Motor Neuron Disease ; Poliomyelitis ; Postpoliomyelitis Syndrome* ; Thigh ; Young Adult

There are considerable discrepacies between clinical symptoms and imaging diagnosis in the localization of the responsible radiculopathy. The purposes of this study are to analyzed the dynamic alteration of contrast filling of the spinal nerve sleeves during positional changes and to determine how the abnormalities of nerve sleeves no lateral bending A-P views correlate with sciatica. The criteria indicationg the root abnormality in functional myelography were (1) bad filling of ipsilateral root to sciatica and (2) good filling of contralateral root compared with those in neutral A-P view. Of total 77 patients, 67 had radiculopathy and 10 had no radiculopathy. In 23 (34.3%) of 67 patients with radiculopathy and 6 (60%) of 10 patients with no radiculopathy, their clinical symptoms well correlated with conventional myelographic findings. However, in 35 (52.2%) of 67 patients with radiculopathy and 6(60%) of 10 patients with no radiculopathy, their symptoms well correlated with functional myelographic findings. This study suggests that the functional myelogaphy using both lateral bending A-P views can be used as a complementary tool in the evaluation of the radiculopathy.
Diagnosis ; Humans ; Myelography* ; Radiculopathy* ; Sciatica ; Spinal Nerves

Transcatheter arterial embolization was applied in 7 cases of hepatic disease including hemobilia of various causes and malignant tumors at Department of Radiology, Seoul National University Hospital during recent several years. The embolic materials were autologous blood clot and Gelfoam particle. Successful control of bleeding or devascularization of tumor vessel was made in 6 of the 7 patients. There was no serious complications; however, post embolization syndrome was found including pain, fever, nausea and vomiting in all cases and subsided after a few days. Transcatheter hepatic arterial embolization is suggested to be a safe and effective treatment in control of hemobilia and devascularization of malignant hepatic tumors.
Fever ; Gelatin Sponge, Absorbable ; Hemobilia ; Hemorrhage ; Humans ; Nausea ; Seoul ; Vomiting