Localized fibrous mesothelioma of the liver is very rare benign tumor. It usually manifest large palpable hepatic mass in right upper quadrant area, and the prognosis is excellent by surgical resection. Contrast enhanced CT scan shows well defined hyperattenuating mass and celiac anglogram shows hypervascular mass. Recently we experienced 1 case of localized fibrous mesothelioma of the liver, and we report CT and anglographic findings of this tumor.
Liver* ; Prognosis ; Solitary Fibrous Tumor, Pleural* ; Tomography, X-Ray Computed

Thromboembolism is the most common serious complication following total hip arthroplasty and most common cause of death after total hip arthroplasty. A prospective randomized study in 170 cases of elective cementless total hip arthroplasty was carried out to examine the incidence of deep vein thrombosis and pulmonary embolism after cementless total hip arthroplasty from Aug. 1993 to May 1995. Laboratory study, clinical symptoms and signs, chest roentgenograph and precipitating factors were analysed. Venography and lung perfusion scan using radionuclide scan were used for this study. The weight, height, sex, habitus of alcohol and smoking, hypertension, diabetes mellitus, previous operation history of ipsilateral lower extremity, etiology of hip joint disease, and transfusion of blood were not precipitating factors, but the age over 40 and previous history of pulmonary embolism had a significant effect on the incidence of deep vein thrombosis. There was no significant relationship between the incidence of deep vein thrombosis and the laboratory assay, clinical symptoms and signs. Deep vein thrombosis was detected in 29 cases(17.0%), pulmonary embolism in 22 cases(12.9%), and fatal pulmonary embolism in 1 case(0.6%). The most common location of deep vein thrombosis was the popliteal area.
Arthroplasty, Replacement, Hip* ; Cause of Death ; Diabetes Mellitus ; Hip Joint ; Hypertension ; Incidence ; Lower Extremity ; Lung ; Perfusion ; Phlebography ; Precipitating Factors ; Prospective Studies ; Pulmonary Embolism* ; Smoke ; Smoking ; Thorax ; Thromboembolism ; Venous Thrombosis*

A total 400 patients underwent 676 treatments with E.D.A.P.-LTOI extracorporeal shock wave lithotripsy for urinary tract stones between February 25 and August 18, 1987. The results were obtained as follows; 1. sex ratio was about 3: 1, 292(73.0 %) in male and 108(27.0 %) in female patients. The average patient age was 43.9 years, with a range of 2 to 85 years. The fifth decade(30.5 %) was most followed by the forth decade (26.0 %) and sixth decade (20.7 %). 2. Treated stone locations were kidney in 286 (71.5 %);calyx in 187 (46.8%) and renal pelvis in 98 (24.5 %) and ureter in 144 (28.5 %); upper ureter in 71 (17.8%) and lower ureter 43(10.7 %). There were multiple renal stone in 83 (20.7 %), bilateral renal stone in 22(5.5 %), bilateral renal stone in 22 (5.5 %), bilateral ureteral stone in 3 (0.7 %) and unilateral renal and ureteral stones in 23 (5.8 %). The average stone size was 1.6 cm, with a range of 0.6 to 4.8 cm. 3. The average numbers of treatment were 1.4 sessions and the average treatment time was 13.7 minutes, with a range of 12 to 78 minutes. Of the patients, 81 (20.2 %) were complained severe pain but treatment interruption or anesthesia were not required. 4. The success rate of treatment-ended patients were 97.8 % in 0.6~1.0cm(137 cases), 89.2% in 1.0~2.0 cm (93 cases) and 89.2 % in 2.0~3.0 cm (37 cases). Therefore, the total average success rate was 93.6 %. 5. The method of pre-ESWL additional manipulation was used a ureteral stone `push up` in 12 (3.0 %). The post-ESWL additional measures were made in 10 (2.5%); ureteral manipulation in 8 cases and lithotomy in 2 cases. The causes of failed ESWL (21 cases) were stone components in 8, impacted stone in 8, incomplete stone localization in 4 and infundibular stricture in 1. 6. ESWL-complications were required admission and medical management in 18(4.5 %); colic in 12 (3.0 %), acute urinary retention in 2 (0.5 %) and subscapular hematoma in 1(0.3% ), Therefore, we confirmed that E.D.A.P.-LTOI ESWL is a safe and effective method for the treatment of urinary tract stones.
Anesthesia ; Colic ; Constriction, Pathologic ; Female ; Hematoma ; Humans ; Kidney ; Kidney Pelvis ; Lithotripsy ; Male ; Sex Ratio ; Shock* ; Ureter ; Urinary Calculi ; Urinary Retention

BACKGROUND: It has been documented that certain prognostic factors may affect the outcomes of the old aged victims by trauma. Considering that trauma is the sixth most common cause of death in people over the age of 65 years and there is a rapid growth of elderly population, it is paramount to understand the prognostic factors when dealing with geriatric trauma patients. Hypothesis and Goals : It can be hypothesized that the prognostic factors should be determined independently between populations being consisted of different races, countries, socio-economic states, cultures, or so on. Thus, study was designed to evaluate the factors affecting the outcomes of elderly Korean trauma patients. METHODS: One hundred forty six patients aged over 65 years were retrospectively reviewed, who visited the Emergency Canter of Korea University from January, 1997 to June, 1998. Of 146 patients, 7 were excluded due to discharge against advice or transfer to the other hospitals. Parameters analysed were age, sex, mechanism of injuries, body region injured, Injury Severity Score (ISS), previous medical illness, hospital morbidity, duration of hospital stay, and cost. Each patient was classified into improved or not-improved groups depending on the outcomes, and young-old or old-old group depending on the age. The factors affecting the hospital stay in improved patients were analyzed in the parameters of previous medical illness, hospital morbidity, multiple injuries, ISS, and age. All statistical tests were conducted with two-tailed levels of 0.05. RESULTS: Of 139 patients, the mean age was 74+/-7.1 years, mean ISS 9.3+/-7.26, mean hospital stay 27+/-27.1 days. Most commonly injured body region was the extremities due to fall from a level surface. Rate of previous illness showed 0.94 medical diseases per person and were aggravated after trauma in 39 patients (60.9%). Hospital morbidity rate was 0.46 incidents per person. There were no differences in age and duration of hospital stay between the improved and the not-improved group. Substantial differences were noted in affected body region, incidence of previous illness, and hospital morbidity between the groups (p=NS). Not-improved group had higher ISS (p<0.05). ISS, previous illness and hospital morbidity affected the duration of hospital stay in the improved group. Hospital stay was 40+/-25.1 days in patients with ISS over 6 while 6+/-8.6 days in those with ISS 5 (p<0.05). Hospital stay in the improved was 26+/-26.9 days while 31+/- 24.8 days in the improved old-old group (P=NS). Hospital stay in the young-old minor trauma (ISS5) patients with previous illness and hospital morbidity was 26+/-10.1 days while 4+/-7.3 days in those without previous illness and hospital morbidity (p<0.05). CONCLUSION: Previous medical illness and hospital morbidity, not age, are predictive of outcomes of geriatric trauma patients with respect to hospital stay. As most of the hospital morbidity was a trauma-induced aggravation of previous medical illness and hospital morbidity contributing poor outcomes can be potentially avoidable, routine aggressive care far the geriatric trauma patients with previous medical illnesses is needed.
Aged ; Body Regions ; Cause of Death ; Continental Population Groups ; Emergencies ; Extremities ; Humans ; Incidence ; Injury Severity Score ; Korea ; Length of Stay ; Multiple Trauma ; Retrospective Studies

BACKGROUND: Depressive symptoms are common in the medically ill patients although depressive disorders are considerably underdiagnosed and undertreated. Therefore, we examined the characteristics of depressive tendency in medical inpatients. METHODS: The patient group-144 subj.cts(90 males, 54 females) were selected from medical inpatients of Kae Jung hospital. 158 subjects(106 male, 52 females) with no prior history of diseases were selected for the control group. The Beck Depression Inventory(BDI) and Hamilton Rating Scale for Depression(HRSD) was used for both groups from June to December 1997. RESULTS: The patient group had a significant higher BDI and HRSD score than controls(p<0.01). In the patients, 31.3% had scores on the BDI greater than the cutting score of 21, and 26.4% had scores on the HRSD greater than the cutting score of 22. In the patients, demographic and medical variables were evaluated with respect to depression. those in their 60's, with education level of elementary school and below. the divorced, bereaved and separated, and having duration of illness more than one year were statistically more depressed, but depression was not associated with sex, religion and medical diagnosis. CONCLUSIONS: This study indicates that depressive tendency may be a common phenomena in medically ill patients. Therefore, we should suspect depression in the management of these patients.
Depression ; Depressive Disorder ; Diagnosis ; Divorce ; Education ; Humans ; Inpatients* ; Male

PURPOSE: A study was performed to compare the detectability of extrahepatic duct stones between nonenhanced and enhanced computed tomography(CT). MATERIALS AND METHODS: Consecutive 30 patients with extrahepatic duct stones were analyzed with special attention to the detectability of stones between nonenhanced and enhanced CT. The extrahepatic duct was further divided into two segments, one above(suprapancereatic) and the other in(intrapancreatic) the head of the pancreas. Conspicuity of the stone was graded as "visible", "suspicious", and "invisible". Three radiologists reviewed the CT images without prior information and determined the location of stone and grade of their conspicuity. RESULTS: The stones were located at the suprapancreatic common duct in 5 patients, intrapancreatic common duct, in 15 patients and both portion of the duct in 10 patients. There was no difference in the detection rate of stones between the two images at suprapancreatic common duct, and was 93%, However, the rate at intrapancreatic common duct was 95% and 64% on nonenhanced and enhanced CT scans, respectively. The overall detection rate was 95% on nonenhance CT and 75% on enhanced CT. CONCLUSION: We concluded that nonenhanced CT was prerequisite to evaluate the extrahepatic duct stones in addition to enhanced CT.
Head ; Humans ; Pancreas ; Tomography, X-Ray Computed

PURPOSE: To evaluate the effectiveness and safety of primary intravitreal ranibizumab injection as a treatment for retinopathy of prematurity. METHODS: Retrospective analysis of the medical records of patients diagnosed with retinopathy of prematurity and treated with intravitreal ranibizumab injection from January 1, 2013 to January 1, 2016 was performed. We complied with the standards for ‘prethresold, type 1’ established by the Early Treatment of Retinopathy of Prematurity study for intravitreal ranibizumab injection. The follow-up period after injection was at least 9 months. Patients who received additional treatment such as laser photocoagulation or intravitreal injection without reactivation of retinopathy of prematurity were excluded. RESULTS: A total of 21 patients (39 eyes) were included in this study. Nine (16 eyes) were male and 12 (23 eyes) were female. The average duration between treatment decision and intravitreal ranibizumab injection was 2.1 ± 1.5 days. Complete regression of the plus sign occurred 18.2 ± 9.1days after injection. One eye with reactivation was treated with panretinal laser photocoagulation while four other eyes with reactivation were treated with intravitreal bevacizumab injection. There were 87.1% (34/39) eyes that underwent primary intravitreal ranibizumab injection with stable results without any reactivation. There were no systemic complications related to intravitreal ranibizumab injection. CONCLUSIONS: Primary intravitreal ranibizumab injection as a treatment for retinopathy of prematurity showed good efficacy and safety. However, thorough evaluation is needed after primary intravitreal ranibizumab injection due to the potential for reactivation. Long-term monitoring is needed after intravitreal ranibizumab injection.
Bevacizumab ; Female ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Light Coagulation ; Male ; Medical Records ; Ranibizumab* ; Retinopathy of Prematurity* ; Retrospective Studies

No abstract available.
Humans ; Male ; Spinal Cord Injuries* ; Spinal Cord*

Vivax malaria has been endemic in Korea since the 15th century. In the 1960s a Malaria Eradication Project was introduced by the Korean government in conjunction with the World Health Organization (WHO). In 1979, WHO declared Korea a malaria-free area. Thereafter, any cases of malaria in Korea were imported cases. In 1993 a case of malaria, that was not imported, was identified. From then, malaria cases have increased exponentially and have tended to expand toward souther areas of Korea. We experienced three cases showing atypical clinical course of vivax malaria. In the first case, the patient had a spike of fever after the completion of standard chloroquine-primaquine therapy. He revealed the recrudescence of vivax malaria. The second one was asymptomatic parasitemia. The patient had no complaint for the prolonged period despite low level of parasitemia. The third patient was natural healing or vivax malaria with a relative long incubation period. Therefore we report these atypical cases with review.
Fever ; Humans ; Korea ; Malaria ; Malaria, Vivax* ; Parasitemia ; Plasmodium vivax ; Recurrence ; World Health Organization

PURPOSE: To evaluate the safety and usefulness of percutaneous fine needle aspiration biopsy of the splenic lesions. MATERIALS AND METHODS: Fine needle aspiration biopsy was done in 7 patients with splenic lesions. Spleen puncture was perfoled by using 22 gauge Chiba needle, under ultrasound guidance in 6 patients and CT guidance in one patient. RESULTS: No major complication such as bleeding, infection or pneumothorax occurred. Final diagnosis were 2 cases of splenic lymphoma and one case each of metastasis, cystic lymphangioma, tuberculosis, hemangioma, and extramedullary hematopoiesis. Cytologic results were true positive in 4 patients and were clinically useful in all patients. CONCLUSION: This study shows that FNAB of splenic lesions may be a valuable procedure safe from major complications such as fatal bleeding.
Biopsy ; Biopsy, Fine-Needle* ; Diagnosis ; Hemangioma ; Hematopoiesis, Extramedullary ; Hemorrhage ; Humans ; Lymphangioma, Cystic ; Lymphoma ; Needles ; Neoplasm Metastasis ; Pneumothorax ; Punctures ; Spleen ; Tuberculosis ; Ultrasonography