PURPOSE: The purpose of the study is to investigate the correlation between the symptoms and the incidence of anatomical variant without mucosal abnormality. MATERIALS AND METHODS: Out of 892 patients with CT performed for the evaluation of sinus disease symptoms between March 1991 and March 1993, we observed the anatomic variations in 82 symptomatic patients without mucosal abnormality(male:female=43:39, mean age 36. 4 years). The control group included 88 patients with facial bone CT performed for the evaluation of trauma during the same period while patients with recent paranasal sinusitis were excluded. (male:female=76:12, mean age 22. 4 years). The scouis were performed with 5-ram section thickness from posterior margin of sphenoid sinus to anterior margin of posterior ethmoid and then with 3 mm thickness from anterior margin of posterior ethmoid to anterior margin of frontal sinus. The artatomic variations included nasoseptal deviation, concha bullosa, Hailer cells, Agger nasi cells, etc. RESULTS: The anatomic variations were demonstrated in 71 our of 82 symptomatic patients(86. 5%), whereas they were seen 26 of 88 patients(29. 5%) in control group. CONCLUSION: Our data suggest that there is a possible causal relationship between anatomic variations and symptomas. Even though without accompaning mucosal abnormalities, anatomic variations could contribute simply to its symptomas. ^natomic variants may obstruct or narrow the airway, leading to turbulating air flow or interrupting ucociliary movement, and finally may produce a series os symptoms.
Facial Bones ; Frontal Sinus ; Humans ; Incidence ; Sinusitis ; Sphenoid Sinus

PURPOSE: To determine the enhancing patterns of hepatocellular carcinoma(HCC) and the difference of enhancing patterns according to the tumor size, using spiral CT. MATERIALS & METHODS: We reviewed 213 lesions in 76patients who had been clinically or histopathologically diagnosed as HCC sufferer. The tumors were divided into three groups, according to size(&3 cm, 3-5cm and >5 cm). The enhancing patterns of tumor and capsule in the earlyand delayed phase were analysed. The enhancing patterns of the tumor were divided into five types(high, peripheralhigh, mixed, iso and low attenuation) in the early phase and four types(central high, mixed, iso, and low attenuation) in the delayed phase. The enhancing patterns of the capsule were divided into three types such asiso, low and high attenuation. RESULTS: High attenuating lesions in the early phase were as follows : below 3cm 72% ; 3-5cm., 60% ; above 5cm., 49%. Mixed attenuating lesions in the early phase were as follows : below 3cm., 1%; 3-5cm., 22% ; above 5cm., 36%. Thus, most HCCs were high attenuation type in the early phase, but as the tumorbecame larger, less high attenuation and more mixed attenuation was demonstrated(p<0.01). There was no difference of enhancing patterns according to the tumor size in peripheral high, iso and low-attenuating lesions. In the delayed phase most of the hepatomas appeared as totally hypodense lesions. For capsules, the results were as follows : below 3cm., 20% ; 3-5cm.,58% ; above 5cm., 73%. As the tumors became larger, more capsules were demonstrated(p <0.01). The capsules were visualized as iso or low attenuating rim in the early phase and high attenuating rim in the delayed phase. CONCLUSIONS: To determine the enhancing patterns of HCC using spiral CT is considered to be helpful in the diagnosis of HCC.
Capsules ; Carcinoma, Hepatocellular* ; Diagnosis ; Tomography, Spiral Computed*

PURPOSE: To analyse complications and to review usefulness of large needle(18G) in percutaneous transhepatic biliary drainage(PTBD). MATERIALS AND METHODS: 46 patients underwent PTBD in 52 occassions using large needle. 44 of 46 patients had either definite or suspicious malignant biliary obstruction, and most patients were poor in general dondition. Complications were classified as acute type if developed within 30 days and as delayed type if developed after 30 days. Acute type was subdivided into severe and mild forms. RESULTS: Severe forms of complications were death(5.8%), septicemia(3.8%), and bile peritonitis(1.9%). There were not different from the rate of complication in PTBD using fine needle but the procedure was much more simple. CONCLUSION: We PTBD using large neddie is a simple and safe procedure for prompt bile decompression.
Bile ; Decompression ; Drainage* ; Humans ; Needles*

No abstract available.
Bedbugs*

No abstract available.
Corylus* ; Hypersensitivity*

No abstract available.
Colorectal Surgery*

Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three group and aspirates were categorized into three cytologic groups. The cytologic result was reported benign masses (cytologic group 1) in 71 cases (52%), malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 cases (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benigh masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer.
Biopsy ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: To evaluate initial technical success, procedural complication rate, and early patency of duplex sound guided angioplasty we studied 10 consecutive cases. METHOD: From June to August 2005, 10 patients (all male, mean age 64.8) underwent duplex sound guided femoral balloon angioplasty. The common femoral artery was cannulated under ultrasound guidance. Under continued ultrasound guidance a guide wire was introduced into the proximal superficial femoral artery. After the guide wire crossed the diseased segment, a balloon catheter was introduced and then the balloon catheter was inflated. Completed duplex examinations and ABI (ankle/brachial artery pressure index) were obtained in all cases. RESULT: Critical ischemia was included for the procedure in 60% and disabling claudication in remaining 40%. Anatomical lesions were identified at the superficial femoral artery in 90% of cases and at the deep femoral artery in remaining 10%. The lesion characteristics were critical stenosis in 80% of case and occlusion in 20%. For seven patients it was performed as a single therapeutic procedure; however, for three patients it was performed as an added procedure for bypass surgery. Technical success was noted in 100% of cases with an average increase of ABI of 0.4. CONCLUSION: Duplex ultrasound guided balloon angioplasty appears to be a safe and effective technique for the treatment of infrainguinal arterial occlusive disease. Technical advantages include accurate selection of the proper size balloon and confirmation of the adequacy of the technique by hemodynamic and imaging parameters as well as the avoidance of radiation exposure. But needs long term follow up.
Angioplasty ; Angioplasty, Balloon* ; Arterial Occlusive Diseases ; Arteries ; Catheters ; Constriction, Pathologic ; Femoral Artery* ; Follow-Up Studies ; Hemodynamics ; Humans ; Ischemia ; Male ; Ultrasonography

PURPOSE: To evaluate initial technical success, procedural complication rate, and early patency of duplex sound guided angioplasty we studied 10 consecutive cases. METHOD: From June to August 2005, 10 patients (all male, mean age 64.8) underwent duplex sound guided femoral balloon angioplasty. The common femoral artery was cannulated under ultrasound guidance. Under continued ultrasound guidance a guide wire was introduced into the proximal superficial femoral artery. After the guide wire crossed the diseased segment, a balloon catheter was introduced and then the balloon catheter was inflated. Completed duplex examinations and ABI (ankle/brachial artery pressure index) were obtained in all cases. RESULT: Critical ischemia was included for the procedure in 60% and disabling claudication in remaining 40%. Anatomical lesions were identified at the superficial femoral artery in 90% of cases and at the deep femoral artery in remaining 10%. The lesion characteristics were critical stenosis in 80% of case and occlusion in 20%. For seven patients it was performed as a single therapeutic procedure; however, for three patients it was performed as an added procedure for bypass surgery. Technical success was noted in 100% of cases with an average increase of ABI of 0.4. CONCLUSION: Duplex ultrasound guided balloon angioplasty appears to be a safe and effective technique for the treatment of infrainguinal arterial occlusive disease. Technical advantages include accurate selection of the proper size balloon and confirmation of the adequacy of the technique by hemodynamic and imaging parameters as well as the avoidance of radiation exposure. But needs long term follow up.
Angioplasty ; Angioplasty, Balloon* ; Arterial Occlusive Diseases ; Arteries ; Catheters ; Constriction, Pathologic ; Femoral Artery* ; Follow-Up Studies ; Hemodynamics ; Humans ; Ischemia ; Male ; Ultrasonography

Spontaneous gastric perforation is an important but rare cause of gastrointestinal perforation in neonates. Just over 200 cases have been reported in the literatures. In spite of recent surgical advances in its managements, mortality rate has been reported as high as 25~50%. Because of physiologic differences, immature immune mechanisms, variations in gastrointestinal flora and poor localization of perforation, a neonate with gastric perforation is at high risk. The pathogenesis is greatly debated. Five patients with spontaneous neonatal gastric perforation who were operated upon at the Department of Pediatric Surgery, Seoul National University Hospital from 1980 to 1993 were reviewed. Four patients were male and one female. The first indication of perforation was 1 day to 6 days of life. All of 5 perforations were located along the greater curvature of the stomach. The size of perforation ranged from 2 cm to 10 cm. Debridement and primary closure were performed in all patients. The operative mortality was 40%(2 of 5). The cause of perforation was not identified in all cases. Prematurity and necrotizing enterocolitis, synchronous or metachrotlous, were thought to be crucial prognostic factors. Earlier recognition and surgical intervention are necessary to reduce morbidity and mortality.
Debridement ; Enterocolitis, Necrotizing ; Female ; Gastrointestinal Microbiome ; Humans ; Infant, Newborn ; Male ; Mortality ; Seoul ; Stomach