PURPOSE: To evaluate the results and complications of placement of implantable port according to approach routes and methods. MATERIALS AND METHODS: Between April 2001 and October 2002, a total of 103 implantable chemoport was placed in 95 patients for chemotherapy using preconnected type (n=39) and attachable type (n=64). Puncture sites were left subclavian vein (n=35), right subclavian vein (n=5), left internal jugular vein (n=9), right internal jugular vein (n=54). We evaluated duration of catheterization days, complications according to approach routes and methods. RESULTS: Implantable chemoport was placed successfully in all cases. Duration of catheterization ranged from 8 to 554 days(mean 159, total 17,872 catheter days). Procedure related complications occurred transient pulmonary air embolism (n=1), small hematoma (n=1) and malposition in using preconnected type (n=2). Late complications occurred catheter migration (n=5), catheter malfunction (n=3), occlusion (n=1) and infection (n=11). Among them 15 chemoport was removed (14.5%). Catheter migration was occured via subclavian vein in all cases (13%, p=.008). Infection developed in 10.7% of patients(0.61 per 1000 catheter days). There were no catheter-related central vein thrombosis. CONCLUSION: Implantation of chemoport is a safe procedure. Choice of right internal jugular vein than subclavian vein for puncture site has less complications. And selection of attachable type of chemoport is convenient than preconnected type. Adequate care of chemoport is essential for long patency.
Catheterization ; Catheters ; Drug Therapy ; Embolism, Air ; Hematoma ; Humans ; Jugular Veins ; Punctures ; Subclavian Vein ; Thrombosis ; Veins

The variations of the sigmoid sinus were studied in 50 Korean adults (average age 67). The classification of the shape and a measurement of the diameters of the sinus were done and the morpological. 1. The shape was classified into 4 types, and the round type was the most common in both sides. S shaped type was below 10% in both sides. 2. The breadth was regular in 54% of the right and in 70% of the left sinuses. According to the breadth change, the shape was classified into 4 shapes. 3. The average diameter was 8.6mm on the right side and 7.2mm on the left side. 4. Symmetry was present in 16% of all. 5. The right transverse sinus was absent in 1 case (2%) and the superior petrosal sinus did not open into the sigmoid sinus in 2 cases (4%). 6. Petrosqamous sinus was observed in 16%.
Adult* ; Classification ; Colon, Sigmoid* ; Humans

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

PURPOSE: We evaluated the results and complications of implantable port placement between the interventional radiological procedure and the surgical procedure. METHODS: From April 2001 to December 2003, 151 implantable ports were placed in 135 patients by an interventional radiologist and 191 ports were placed in 185 patients by a surgeon. RESULTS: The implantable port was successfully placed in all cases. The duration of catheterization was 219.8 days for the interventional radiological procedure and 203.8 days for the surgical procedure. 139 patients underwent port placement via the internal. jugular vein using the peel-away sheath by the interventional radiologist and 163 patients had their ports placed via the external jugular vein cut-down method by the surgeon. Early complications that occurred were pulmonary air embolism (1 case) and hematoma (1 case) for the radiological procedure and catheter malposition (1 case) for the surgical procedure. Late complications that occurred were infection (24 cases), catheter migration or occlusion (6 cases), catheter-related fever (4 cases) for the radiological procedure and infection (7 cases), migration (3 cases), central vein thrombosis (1 case), catheter-related fever (2 cases) for the surgical procedure. CONCLUSION: The safety of the surgical central venous port placement was high and the complication rate was low. In comparison with the interventional radiological procedure, the surgical procedure may be considered as a potentially useful primary procedure for implantable central venous port placement.
Catheterization ; Catheters ; Embolism, Air ; Fever ; Hematoma ; Humans ; Jugular Veins ; Thrombosis ; Veins

No abstract available.
Varicocele*

The morphdogical changes in mast cells, induced by horseradish peroxidase (HRP) and distilled water were studied, using light and electron microscopy. The mesenteries of rats sacrificed at 30 minutes; at 1, 2, 4 and 18 hours; and at 1, 2, 3 and 6 weeks after an intraperitoneal injection of 250 microgram or 500 microgram of HRP or 10 ml of distilled water were used for observation of degranulation rates and morphological changes in cell organelles during specified time intervals. The results were as follows: 1) A distinct increase in the mast cell degranulation was observed in the mesenteries after injection of HRP. In particular, all mast cells were disrupted or degranulated significantly 18 hours after injection of distilled water. 2) The degranulating mast cells of the group injected with HRP showed a progressive decrease in electron density of the granules, formation of perigranular cavities, and extrusion of the granules after partial loss of the plasma membrane. 3) At 2 weeks after injection of HRP, some indicators of the early stage of regeneration, that is, peripherally placed nucleus, the expanded Golgi area containing numerous vesicles, and progranules in these vesicles, were observed. 4) After 6 weeks, the morphological characteristics of most mast cells in the group injected with HRP were nearly the same as those of the control group. 5) In degranulating mast cells of the group injected with distilled water, partial rupture of the plasma and cytoplasm with wide dispersion of the granules.
Animal ; Cytoplasmic Granules/ultrastructure* ; Female ; Horseradish Peroxidase ; Male ; Mast Cells/ultrastructure* ; Microscopy, Electron ; Rats ; Rats, Inbred Strains

BACKGROUND: Postprimary pulmonary tuberculosis is located mainly in upper lobes. The tuberculous lesion involving the lower lobes usually arises from the upper lobe cavity through endobronchial spread. When tuberculosis is confined to the lower lung field, it often masquerades as pneumonia, lung cancer, bronchiectasis, or lung ahscess. Thus the correct diagnosis may be sometimes delayed for a long time. METHODS: We carried out, retrospectively, a clinical study on 50 patients confirmed with lower lung field tuberculosis who visited the Department of Pulmonary Medicine at Hanyang University Hospital from January 1992 to December 1994. The following results were obtained. RESULTS: Lower lung field tuberculosis without concomitant upper lobe disease occurred in fifty patients representing 6.9% of the total admission with active pulmonary tuberculosis over a period of 3 years. It occurred most frequently in the third decade but age distribution was relatively even. The mean age was 43 years old. Female was more frequently affected than male (male to female ratio 1:1.9). The most common symptom was cough(68%), followed by sputum(52%), fever(38%), and chest discomfort(30%). On chest X-ray of the S0patients, consolidation was the most common finding in 52%, followed by solitary nodule(22%), collapse(16%), cavitary lesion(l0%), in decreasing order. The disease confined to the right side in 25 cases, left side 20 cases, and both sides 5 cases. Endobronchial tuberculosis (1) Endobronchial involvement was proved by bronchoscopic examination in 20 of S0patients. (2) Mean age was 44years old and female was more affected than man (male to female ratio 1 : 3). Sputum AFB stain and Mycobacterium tuberculosis culture were positive only in 50% of cases unlikely upper lobe tuberculosis, additional diagnostic methods were needed. In our study, bronchoscopic examination and percutaneous fine needle aspiration biopsy increased diagnostic yield by 18% and 32%, respectively. The most common associated condition was diabetes mellitus(18%) and others were anemia, anorexia nervosa, stomach cancer, and systemic steroid usage. CONCLUSION: When we find a lower lung field lesion, we should suspect tuberculosis if the patient has diabetes mellitus, anemia, systemic steroid usage, malignancy or other immune suppressed states. Because diagnostic yield of sputum AFB smear & Mycobacterium tuberculosis culture was low, additional diagnostic methods such as bronchoscopy and fine needle aspiration biopsy were needed.
Adult ; Age Distribution ; Anemia ; Anorexia Nervosa ; Biopsy ; Biopsy, Fine-Needle ; Bronchiectasis ; Bronchoscopy ; Diabetes Mellitus ; Diagnosis ; Female ; Humans ; Lung Neoplasms ; Lung* ; Male ; Mycobacterium tuberculosis ; Pneumonia ; Pulmonary Medicine ; Retrospective Studies ; Sputum ; Stomach Neoplasms ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary

PURPOSE: To assess the results and usefulness of interventional procedures for hepatic arterial stenosis or thrombosis following liver transplantation. MATERIALS AND METHODS: During the past five years, eight patients aged 1-59 (mean, 39) years among 187 liver transplant recipients showed elevated of liver enzyme levels (AST/ALT) and decreased arterial flow at Doppler ultrasound. Hepatic arteriography revealed luminal stenosis or occlusion at the proper hepatic artery, and six patients, one of whom required thrombolysis before the procedure, underwent percutaneous transluminal angioplasty (PTA) using a balloon. In two with thronbosis, thrombolysis without PTA was performed. In order to increase hepatic arterial flow, four patients underwent additional coil embolization of the gastroduodenal or splenic artery. RESULTS: Hepatic arterial flow recovered in all six patients after PTA. Three required repeat PTA for restenosis and one of these needed stent placement after repeated PTA. At follow-up, 6-17 months later, the three had good hepatic function. Within four days, the other three expired due to graft failure, hepatorenal syndrome and sepsis. One of the patients who underwent thrombolysis without PTA expired and the other required retransplantation. In this case there were no procedure - related complications. CONCLUSION: Radiologic interventions are useful for treatment of hepatic arterial stensis or thrombosis in patients with liver transplantations.
Angiography ; Angioplasty ; Constriction, Pathologic* ; Embolization, Therapeutic ; Follow-Up Studies ; Hepatic Artery ; Hepatorenal Syndrome ; Humans ; Liver Transplantation* ; Liver* ; Phenobarbital ; Sepsis ; Splenic Artery ; Stents ; Thrombosis* ; Transplantation ; Transplants ; Ultrasonography

PURPOSE: To describe the imaging findings of traumatic intracranial aneurysms (TICA) in children. MATERIALS AND METHODS: Five boys aged 3-15 (mean, 7) years with surgically confirmed TICA were included in this study. All had a history of nonpenetrating head trauma, and they underwent precontrast CT imaging immediately after the injury and follow-up CT or MRI. In all cases, angiography revealed the presence of aneurysms, which at surgery were shown to be pseudoaneurysms with severe adhesions. RESULTS: Angiography demonstrated that all aneurysms were located in the anterior cerebral artery (ACA) or its branches. The precise locations were the A2 segment of the ACA, the site of origin of the callosomarginal artery or its first branch, or of the anterior internal frontal artery, or between the first and second branch of the pericallosal artery. In all patients, precontrast CT performed immediately after trauma depicted subarachnoid hemorrhage (SAH) in the anterior interhemispheric fissure (AIHF). Follow-up precontrast CT showed nodular high density around the anterior falx in three, recurrent SAH in the AIHF in two, and intracerebral hemorrhage (ICH) with intraventricular hemorrhage in two. In two patients with a nodular high-density lesion, nodular enhancement was demonstrated at postcontrast CT, and in one, follow-up MRI revealed a nodular signal void around the anterior falx; nodular enhancement was seen at postcontrast imaging, and MR angiogram depicted a saccular aneurysm. In one patient, MRI demonstrated infarction in the caudate nucleus and ACA territory. CONCLUSION: If, after head injury, an area of nodular high density is revealed by CT, or a signal void by MRI, or if SAH or ICH is present around the anterior falx, the possibility of TICA should be considered.
Aneurysm ; Aneurysm, False ; Angiography ; Anterior Cerebral Artery ; Arteries ; Caudate Nucleus ; Cerebral Hemorrhage ; Child* ; Craniocerebral Trauma ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Subarachnoid Hemorrhage