PURPOSE: We performed this study to assess the value of CT in the differential diagnosis of palpable neck masses in children. MATERIALS AND METHODS: We retrospectively reviewed the CT scans of the palpable neck masses in 30 children. The masses were proved histopathologically and classified into cystic, solid, and inflammatory mass and their CT findings were analyzed. RESULTS: Twelve cases were cystic masses, 4 were solid masses, and 14 were inflammatory lesions. Cystic masses included cystic lymphangiomas (n=6), branchial cleft cysts (n=3), thyroglossal duct cysts (n=2), and ranula (n=l). Cystic lymphangiomas showed insinuating appearances into adjacent structures and 4 cases occurred in the posterior cervical space. All branchial cleft cysts were round cystic masses with smooth wall and displaced the submandibular gland anteriorly and the sternocleidomastoid muscle posteriorly. Two thyroglossal duct cysts occurred centrally adjacent to the hyoid bone and 1 ranula in the submental area. Solid masses were juvenile hemangioma, pleomorphic adenoma in submandibular gland, neurilemmoma, and fibromatosis colli. Juvenile hemangioma showed well-enhancing mass with indistinct margin and the other solid masses had well-defined margin with their characteristic location. Inflammatory lesions were abscess (n=4), deep neck infections with lymphadenopathy (n=4), submandibular gland inflammation (n=3), and tuberculous lymphadenitis (n=3) and they showed strand-like enhancement in adjacent subcutaneous tissues. Tuberculous lymphadenitis had multiple lymph node enlargement with internal low attenuation areas and showed less surrounding strand-like enhancement than suppurative lymphadenopathies. CONCLUSION: Most neck masses in infants and children were of congenital or inflammatory origin. CT is useful for the evaluation of the child presenting with a neck mass, because it can differentiate various forms of neck masses and is able to reveal the relationship of the masses to the adjacent structures with their characteristic location.
Abscess ; Adenoma, Pleomorphic ; Branchioma ; Child* ; Diagnosis, Differential ; Fibroma ; Hemangioma ; Humans ; Hyoid Bone ; Infant ; Inflammation ; Lymph Nodes ; Lymphangioma, Cystic ; Lymphatic Diseases ; Neck* ; Neurilemmoma ; Ranula ; Retrospective Studies ; Subcutaneous Tissue ; Submandibular Gland ; Thyroglossal Cyst ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

No abstract available.
Sterilization, Tubal*

PURPOSE: To evaluate the indication for intracavitary Urokinase(UK) in the treatment of Ioculated pleural effusion. MATERIALS AND METHODS: We analyzed CT and US in 31 patients who were treated with intracavitary UK in Ioculated pleural effusion. In each patient, a single chest catheter (10-12F) was insected under imaging guidance. When the amount of drainage was less than 100ml/day, UK was instilled through the catheter until less than 50ml/day was drained. On follow-up chest radiographs of more than 1 month, we classified the results of treatment into 3 groups:(1) completely effective (lung expansion, over 80%);(2) partially effective (20-80%); (3) ineffective (below 20%) group. Sonographic pattern of pleural fluid was classified into anechoic, septated, and honeycomb appearances and the thickness of parietal pleura was measured on CT. RESULTS: Sixteen patients were completely effective, nine were partially effective, and six were ineffective. patients with completely or partially effective outcome had anechoic and linear septated appearance on had less than 4mm of parietal pleural thickness on CT. Of six ineffective patients, US showed linear septated in one patient and honeycomb appearance in five patients and the thickness of parietal pleura on CT was 3 mm in one patient, 4ram in two patients, 5mm in one patient, and 6mm in two patients. CONCLUSION: UK instillation through percutaneous catheter was an effective method in the treatment of Ioculated pleural effusion. However, we found near complete reaccumulation of pleural fluid when honeycomb appearance of pleural fluid on US or more than 5mm parietal pleural thickness on CT was observed, which might suggest that we should consider the other kinds of treatment method in those patients.
Catheters ; Drainage ; Follow-Up Studies ; Humans ; Insects ; Pleura ; Pleural Effusion* ; Rabeprazole ; Radiography, Thoracic ; Thorax ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

In order to observe the effect on cardiovascular depression due to ether, halothane or penthrane anesthesia with pretreatment of propranolol (1mg) , change in the blood pressure and pulse rate were measured after intravenous administration of atropine(0.5mg), ephedrine(20mg) or aramine(2mg) to healthy volunteers. The results were as follos, 1) In conscious patients, intravenous administration of propranolol(1mg) caused a statistically significant decrease in pulse rate but no significant change in the blood pressure. 2) The atropine group showed that blood pressure increased by 33/23(p<0.01), 15/13(p<0.01) and 3/4(NS) mmHg, and pulse rate also increased by 20(p<0.01), 24(p<0.05), 11(p<0.05) per min. respectively during ether, halothane and penthrane anesthesia. 3) The ephedrine group showed that blood pressure decreased by 5/0(NS) during ether anesthesia, and increased by 27/17(p<0.01) and 30/15(p<0.01) mmHg during halothane and penthrane anesthesia respectively. Pulse rate decreased by 7(p<0.05) per min. during ether anesthesia but showed no significant change during halothane and Penthrane anesthesia. 4) The aramine group showed that blood pressure increased by 70/34(p<0.01), 29/19(p<0.01) and 28/19Ip<0.001) mmHg during ether, halothane and Penthrane anesthesia respectively. Pulse rate increased by 7(NS) per min. during ether anesthesia and decreased by 8(p<0.05) per min. during halothane and Penthrane anesthesia respectively. 5) The above results have shown that atropine caused effective correction of the cardiovascular depression induced by ether, halothane and Penthrane anesthesia with pretreatment of propranolol. Ephedrine showed futher depression and aramine effected elevation of the blood pressure.
Administration, Intravenous ; Anesthesia* ; Atropine ; Blood Pressure ; Depression ; Ephedrine ; Ether* ; Halothane* ; Healthy Volunteers ; Heart Rate* ; Humans ; Metaraminol ; Methoxyflurane* ; Propranolol*

PURPOSE: To report clinical appearances and the outcomes of patients treated for wrist laceration with suicidal intent. MATERIALS AND METHODS: Between March 2005 and February 2008, patients with wrist laceration were treated at our center. Among them, 14 patients with suicidal intent were reviewed retrospectively. They were 8 females and 6 males with a mean age of 33 years at the time of treatment. The side of injured wrist, injured structures, suicidal instrument, the time of injury, a suicidal motive, drug or alcohol abuse or not, indication of combined psychiatric disease, the duration of postoperative treatment, and the results of treatment were analyzed. RESULTS: The injured wrist was the left one in 13 cases (93%), and knife wounds in 11 cases (79%) was the most frequent mechanism of injury. An average of 4.6 structures were injured including 3.5 tendons, 0.57 nerves and 0.5 arteries. The most frequently injured structures were the palmaris longus (71%), FCU (50%), FCR (43%), FDS 3 (36%), FDS 2, median nerve, and ulnar artery (each 29%). Simultaneous injury of both median and ulnar nerves occurred in 3 cases (21%), and simultaneous injury of both radial and ulnar artery occurred in 1 case (7%). The injury time was the night in 12 cases (86%), and the most frequent suicidal motive was human relations such as lover or spouse in 12 cases (86%). In 9 cases (64%), the injured were in a drunken state, 3 cases (21%) had been treated for a psychiatric disease at the time of the injury. The durations of postoperative treatment were an average of 5 days of admission and 1 day follow up. Only 1 case results could be evaluated. CONCLUSIONS: Patient's poor compliance in wrist laceration with suicidal intent should be expected and these characteristics may affect the management plan.
Alcoholism ; Arteries ; Compliance ; Female ; Follow-Up Studies ; Humans ; Lacerations ; Male ; Median Nerve ; Retrospective Studies ; Spouses ; Suicide ; Tendons ; Ulnar Artery ; Ulnar Nerve ; Wrist

PURPOSE: To evaluate the effect of intermittent bleeding method in the distal phalanx replantation. MATERIALS AND METHODS: From January 2007 through June 2009, authors have replanted 117 cases of distal phalangeal amputation in adults at Soo Hospital and Chonbuk National University Hospital. Cases of zone II were 60 cases and zone III 57 according to Allen classification. Male to female ratio was 8.7:1.3. The most common cause was machinery injury in the factory, 98 cases(83.8%), next one was belt injury of the machine, 11 cases(9.4%) and others, 8(6.8%). At least one digital artery and digital nerve were anastomosed under the operating microscope, but vein was impossible to anastomosis as unable to find out in the zone II and III. After anastomosis of one or more digital arteries and nerves, heparine(6,000-10,000 units) was kept to intravenous injection for 24 hours and at the same time fish mouth incision in 2-3 millimeter diameter was made in the distal radial and ulnar margin of the replanted distal phanlanx. From the first 30 minutes to an hour after replantation, incision site was swabbed with heparinized cotton ball for 5 minutes in every 30 to 40 minutes to make sure perfusion for 24 hours, every an hour at the second day, every two hours at the postoperative third to fifth day. RESULTS: 92 cases(78.6%) was completely survived at average postoperative third week follow-up and satisfied with preservation of the finger nail, digit length, good range of motion of the distal interphalangeal joint and acceptable sensibility at average 1.2 years follow-up. CONCLUSIONS: Intermittant bleeding method in replantation of crushed distal phalanx impossible to anastomosis of vein at zone II and III of Allen classification was regarded as one of the notable salvage procedure.
Adult ; Amputation ; Arteries ; Female ; Fingers ; Follow-Up Studies ; Hemorrhage ; Heparin ; Humans ; Injections, Intravenous ; Joints ; Male ; Mouth ; Nails ; Perfusion ; Range of Motion, Articular ; Replantation ; Veins

OBJECTIVES: AGUS often reflects an immediate cervical cancer precursor such as a HSIL mimicking an endocervical glandular lesion. In this study, we attempted to assess the clinical significance of a cytologic diagnosis of atypical glandular cells of undetermined significance (AGUS) and determine the usefulness of the human papillomavirus (HPV) DNA testing as the triage strategies in evaluating AGUS. METHODS: Between 1994 and 1998, 67,730 Papanicolaou smears were evaluated at Kangnam and Uijongbu St Mary's Hospital. There were 87 (0.13%) cases of AGUS smears during that time. Colposcopy was performed on all women, and HPV DNA testing was performed on 11 persons. RESULTS: Mean age of these patients was 45.8 years. Histologic diagnosis of AGUS were kolocytosis and CIN-I in 6 (6.9%), CIS in one, endometrial hyperplasia in 2 (2.3%), endometrial adenocarcinoma in 7 (8.0%), cervical adenocarcinoma in 14 (16.1%) and cervical squamous cell carcinoma in 2 (2.3%) cases. Endometriosis was 8.9% under 46 years old and none in over 46. CIN was 8.9% and 7.2%, respectively. Cervical adenocarcinoma was 6.7% under 46 and 19.1% over 46. Endometrial cancer was 4.4% and 11.9%, respectively. The risk of cervical cancer and endometrial cancer was high in the AGUS with Adenocarcinoma ; Carcinoma, Squamous Cell ; Colposcopy ; Diagnosis ; DNA* ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometriosis ; Female ; Human Papillomavirus DNA Tests ; Humans ; Middle Aged ; Papanicolaou Test ; Triage ; Uterine Cervical Neoplasms

Thirty percutaneous liver biopsy and one liver necropsy were reviewed in Severance Hospital, Yonsei University from June 1979 to September 1980. This procedure is the safe and accurate means of diagnosing and studying liver diseases in the pediatric patients especially persistent conjugated hyperbilirubinemia, chronic liver disease, and some rare diseases (eg. Histiocytosis-X, Storage disease disease, Gilbert syndrome), The significance of the technique and following results were obtained. 1. Among 31 cases, 14 cases were under 1 year of age 21 cases were male. 2. Evaluation of persistent neonatal conjugated hyperbilirubinemia, chronic hepatitis, Gaucher's disease, gilbert syndrome, congenital hepatic fibrosis, portal hypertension, and Histiocytosis-X were possible by the pathologic findings of percutaneous liver biopsy speciments. 3. Pathologic findings of 10 cases of neonatal conjugated hyperbilirubinemia are Giant cell hepatitis (4), acute hepatitis (1), acute fulminant hepatitis (1), extrahepatic biliary atresia (2), intra hepatic biliary hypoplasia (2), and hepatic fibrosis (1), Causative agents are hepatitis virus B (4), toxoplasma gondii (2), herpes simplex (1), syphilis (1), unknown (2). 4. One case of acute fullminent hepatitis due to herpes simplex was confirmed by electronmicroscopic study of the specimen. 5. One case of tuberculous empyema of the liver was confirmed by the discovery of tuberculi bacilus on the direct smear of the biopsy speciments, although the pathologic findings showed non specific findings of reactive hepatitis. 6. There was nonspecific information in systemic disease and hepatomegaly with fever of unko\nown origine. 7. There was no complication in 30 cases of percutaneous liver biopsy.
Biliary Atresia ; Biopsy* ; Empyema, Tuberculous ; Fever ; Fibrosis ; Gaucher Disease ; Giant Cells ; Gilbert Disease ; Hepatitis ; Hepatitis Viruses ; Hepatitis, Chronic ; Hepatomegaly ; Herpes Simplex ; Histiocytosis, Langerhans-Cell ; Humans ; Hyperbilirubinemia ; Hypertension, Portal ; Liver Diseases ; Liver* ; Male ; Needles* ; Rare Diseases ; Syphilis ; Toxoplasma

STATEMENT OF PROBLEM: Anatomic landmarks have been used in the orientation of occlusal plane and the determination of vertical dimension for edentulous patients. Such as labial vestibules of anterior region and hamular notches, retromolar pads of posterior region are very useful anatomic landmarks for fabrication of occlusion rim because they are to be identified on master casts. Therefore, if average distances between landmarks of maxillae and mandible in dentate subjects are measured and applied, not only occlusal plane but also vertical dimension can be established initially. PURPOSE: The purpose of this study is to measure vertical distances between anatomic landmarks and to present a guide to the orientation of occlusal plane and the determination of vertical dimension of edentulous patients. MATERIAL AND METHOD: Upper and lower border-molded casts were made in 93 Korean dentulous subjects, mean age 25 years. Incisal edges of central incisors, bottoms of labial vestibules, hamular notches and the half level of retromolar pads were marked on casts. Measurements of vertical distances from incisal edge of central incisor to the bottom of labial vestibule, between upper and lower bottoms of labial vestibules, from hamular notch to retromolar pad and from hamular notch to the occlusal plane established by the incisal edge of maxillary central incisor and mesiopalatal cusps of both maxillary first molars were made on each cast. RESULTS AND CONCLUSION: 1. The mean distance from the incisal edge of central incisor to the bottom of labial vestibule was 20.8mm(SD 1.7) on upper casts and 17.3mm(SD 1.4) on lower casts. 2. The mean distance between both bottoms of labial vestibules of upper and lower casts was 35.0mm(SD 2.7). 3. The mean distance from hamular notch to the half level of retromolar pad was 5.0mm(SD 1.3). 4. The mean distance from hamular notch to occlusal plane was 7.9mm(SD 1.5). 5. Distances from incisal edge of central incisor to labial vestibule on lower casts(p<0.01) and from hamular notch to retromolar pad(p<0.0001) were greater in male than in female.
Adult* ; Anatomic Landmarks ; Dental Occlusion* ; Dentition* ; Female ; Humans ; Incisor ; Male ; Mandible ; Maxilla ; Molar ; Vertical Dimension*

Titanium requires special ceramic system for veneering. Low fusing dental ceramics with coefficients of thermal expansion matching that of titanium have been developed. The purpose of this study was to determine the bond strengths between cast and noncast pure titanium and two commercial titanium porcelains, and to compare the results with a conventional nickel-chromium alloyceramic system. The bond strengths were determined using a 3-point flexure test. Three-point flexure specimens 25x3x0.5mm were prepared. After removal of alpha-case layer, they were veneered with 8x3x1mm of ceramics at the center of the bar. Specimens were tested in a universal testing machine. Within the limits of this study, the following conclusions were drawn: 1. The bond strengths between pure titanium and two commercial porcelains exceeded th lower limit of the bonding strength value in ISO 9693(25MPa). 2. There was no significant difference between cast and noncast titanium-porcelain bonds. 3. There was no significant difference between two commercial titanium porcelains. 4. The bond strengths of the titanium-porcelain systems ranged from 73% to 79% of that of the Ni-Cr-conventional porcelain system.
Alloys* ; Ceramics* ; Dental Porcelain ; Titanium*