PURPOSE: To evaluate the usefulness of percutaneous catheter drainage (PCD) in patients who have abdominal abscesses or fluid collections. MATERIALS AND METHODS: We performed PCD for 165 abscesses and fluid collections in 148 patients. The follow-up periods in these patients ranged from 15 days to 42 months (mean, 274 days). The lesion sites were subphrenic space in 46 cases, liver in 33, perihepatic space in 20, pancreas or peirpancreatic space in 14, pelvic cavity in 13, and retroperitoneum in 13. We evaluated the success, failure, and recurrence rates, the causes of failure or recurrence, the mean duration of drainage, and the complications of PCD. RESULTS: Of the 165 cases, one hundred-fifty nine(96.5%) were successfully cured, Although a partial success could be achieved, 2(1.2%) cases were failed and 4(2.4%) were recurred. Multiloculation or fistula formation were the main causes of the unsullessful cases. The duration of drainage rainged from 2 to 605 days (mean, 1 days). Complications occured in 12 cases(7%) during or after procedures, which included fever and chill in 7, transgression of pleura in 2, bowel perforation in 2, and bleeding through catheter in 1. CONCLUSION: PCD is an effective and safe method for various abdominal abscesses or fluid collections.
Abdominal Abscess* ; Abscess ; Catheters* ; Drainage* ; Fever ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Pancreas ; Pleura ; Recurrence

Cardiac myxoma is a rare but potentially treatable cause of stroke. The diagnosis is rarely made on typical triad of constitutional, embolic, and obstructive symptoms, and it is difficult because there is no specific history, physical examination, chest X-ray, or electrocardiographic findings, but with the development of echocardiography the correct diagosis is now usualy made. Neurologic manifestation is frequent(25-45%) and presented with embolic infarction, aneurysm formation, intracranial hemorrhage, and distant metastasis. We experienced five patients with cardiac myxoma who presented with these neurologic manifestations. Also we should be considered in the differential diagnosis of cerebral infarction, particularly when multiple cerebral infarction and constitutional or obstructive symptoms are conjoined in young age stroke. We describe five patients who presented with embolic infarction, cerebral metastasis and aneurysm formation.
Aneurysm ; Cerebral Infarction ; Diagnosis ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Humans ; Infarction ; Intracranial Hemorrhages ; Myxoma* ; Neoplasm Metastasis ; Neurologic Manifestations* ; Physical Examination ; Stroke ; Thorax

We studied 193 Diabetics without any symptoms of coronary artery disease and 39 Normal healthy subjects as Control group, using treadmill exercise test and obtained following results. 1) The positive rate was significantly higher in Diabetics(19.4% in Normal ECG groups and 25.4% in total Diabetics)than Control groups(5.1%)(0.010.05). 5) There was no difference in HbAIC, Total cholesterol and Triglyceride between positive and negative groups(P>0.05). In summary, with exercise test, the positive rate was higher in Diabetics than in Normal control groups and it seemed to be treadmill exercise test is a useful screening method for evaluation of coronary artery disease as well as for assesment of treatment and follow up care.
Blood Pressure ; Cholesterol ; Coronary Artery Disease ; Diabetes Mellitus* ; Electrocardiography ; Equidae ; Exercise Test* ; Heart Rate ; Mass Screening ; Triglycerides

PURPOSE: The purpose.of this study was to characterize the enhancing patterns of hepatocellular carcinoma (HCC) on two-phase dynamic incremental liver scan with spiral CT. MATERIALS AND METHODS: Two-phase dynamic incremental liver scan using spiral CT was performed on 230 lesions in 107 patients with HCC. CT scanning was performed with a table speed of 13mm/sec and a section thickness of 10 mm;120 mL of contrast medium was injected intravenously with a automatic injector at the rate of 3mL/sec. CT scans were started 35 sec(early phase) and 3 min(delayed phase) after beginning injection of contrast medium. The tumors were divided into 2 groups according to size(< or = 3cm and > 3cm), the contrast enhancement patterns of HCCs and capsules in the early and delayed phases were analyzed in each group. RESULTS: Most of HCCs appeared as high-attenuating lesions in the early phase(75% in tumors smaller than 3cm and 61% in tumors larger than 3cm), and as low-attenuating lesions in the delayed phase(68% in tumors smaller than 3cm and 90% in tumors larger than 3cm). Forty-eight percent of HCCs smaller than 3cm and 58% of HCCs larger than 3cm were high-attenuating in the early phase and low-attenuating in the delayed phase. Thirty-two percent of capsules were low- or iso-attenuating in the early phase and high-attenuating in the delayed phase. Capsules were demonstrated in 22% in HCCs smaller than 3cm and 67% in HCCs larger than 3 cm(p <. 01). CONCLUSION: Two-phase dynamic scan with spiral CT is useful in the diagnosis of HCC because of a precise display of hemodynamic characteristics of HCCs.
Capsules ; Carcinoma, Hepatocellular* ; Diagnosis ; Hemodynamics ; Humans ; Liver ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

BACKGROUND & PURPOSE: Of thalamic stroke syndrome, according to previous reports, the syndrome of hemiataxia and hemisensory loss (thalamic ataxia syndrome) is known to have localizing value confined to the lesion of posterolateral thalamus. And ataxia in thalamic ataxia syndrome is due to interruption of cerebellar outflow pathways. We observed the clinical characteristics of cerebellar manifestations in patients with thalamic ataxia syndrome to clarify intrathalamic cerebellar pathways because it is known that parts of cerebellar efferent fibers do not pass through the thalamus. METHODS: Ten patients with ataxia (5 men, 5 women ; mean age 64), out of 47 thalamic stroke patients admitted to Kyung Hee University Hospital from Jan. 1994 to May. 1995, were selected. The localization of the lesion was based on CT or MR imaging and ataxia was characterized in view of cerebellar functions - coordination of movement, regulation of equilibrium and muscle tone. RESULTS: Out of 10 patients, 4 patients were thalamic hematoma, 4 patients thalamic hematoma with intraventricular hemorrhage, 2 patients thalamic infarction. Four patients were hemiataxia-hemiparesis-hemisensory loss, 4 patients hemiataxia-hemisensory loss, 2 patients hemiataxia-hemiparesis. Posterolateral thalamus was involved in 4 patients, dorsal thalamus in 3 patients, posterolateral and dorsal thalamus in 3 patients. All patients had dysmetria, dysdiadochokinesia, kinetic tremor. Two patient has gait ataxia. Speech and ocular motility disturbances were not noted. CONCLUSION: Thalamic ataxia syndrome appeared in the lesion of posterolateral and dorsal thalamus. Common cerebellar manifestations symptoms of incoordination.
Ataxia* ; Cerebellar Ataxia ; Female ; Gait Ataxia ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Stroke* ; Thalamus ; Tremor

Quantitative serial measurements of Alpha-fetoprotein (a-FP) and Beta-human chorionic gonadotropin (B-HCG) using radioimmunoassay were performed in a patient with recurrent non-germinomatous germ cell tumor (NGGCT) into CNS during radiotherapy and chemotherapy. When the pineal tumor was initially presented, elevated levels of serum a-FP and B-HCG fell dramatically to normal rage after the completion of cranial irradiation (5,060cGy). Three months later, the patient had a rise in serum and CSF tumor markers coincident with recurrence of tumor into lumbal spinal canal. Serum levels were not changed despite of 15 days of whole spine irradiation (2,000cGy) although decreased remarkably 1 month after the completion of radiotherapy (4,230cGy). At the time of relapse in the suprasella area and the cerebellopontine angle, serum and CSF levels rised again. As a result of two courses of chemotherapy the tumor markers fell markedly, but the tumor was spread to other sites into CNS. We conclude serial measurements of a-FP and B-HCG are useful for the diagnosis of the non-germinomatous germ cell tumor into CNS and for monitoring disease activity.
alpha-Fetoproteins ; Cerebellopontine Angle ; Chorionic Gonadotropin ; Cranial Irradiation ; Diagnosis ; Drug Therapy ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Pinealoma ; Radioimmunoassay ; Radiotherapy ; Rage ; Recurrence ; Spinal Canal ; Spine ; Biomarkers, Tumor*

No abstract available.
Carbamazepine* ; Haloperidol*

PURPOSE: To obtain reliable clinical data arthroscopic discectomy, the authors compared the treatment results of the arthroscopic discectomy (AS) with microscopic discectomy (MS) only in the protruded type of lumbar disc herniations. MATERIAL AND METHODS: Each arthroscopic and microscopic discectomy groups consisted of 39 patients who were operated between May 1993 and October 1997. Minimum follow-up period was 12 months. Method of operation was selected at random and was performed under local infiltration anesthesia in all cases. Clinical and radiological results were evaluated by same protocol before and at one, three, six and 12 months after operation. The herniations of the AS group affected L4-5 in 35 patients and L5-S1 in 4 patients, and of MS group affected L4-5 in 31 patients and L5-S1 in 8 patients. Age, sex and level showed no statistical differences in both groups. RESULTS: Average admission periods were 2.8 days in AS and 4.8 days in MS group. The overall objective clinical result was satisfactory in 92% and 90% respectively. At L4-5 level, it was 97% and 87%, while 50% and 100% at L5-S1. In accordance with the direction of protrusion, midline type showed 100% and 83%, while posterolateral type showed 91% in both group respectively. Disc space height was changed in AS group from 12.2mm preoperatively to 11.2mm (8.3%) postoperatively, and in MS group, from 12.4mm to 10.9mm (16.9%) (p<0.05) . CONCLUSION: From the clinical and radiological results, it was concluded that although overall objective and subjective clinical results were similarly satisfactory in both methods, the clinical result of AS was better in L4-5 level, while that of MS were much better in L5-S1. Radiologically, narrowing of disc space height after AS were significantly less than in MS. So, arthroscopic discectomy is more recommended in the protruded type of lumbar disc herniation at L4-5 level than microscopic discectomy.
Anesthesia, Local ; Diskectomy* ; Follow-Up Studies ; Humans ; Prospective Studies*

Injuries to extensor tendons can be as serious as those of digital flexors. These injuries require accurate approximation, appropirate splinting and careful mobilization. Scarring which always occurs following injury can provoke greater problems in digital extensor injuries than in flexor tendons. The loss of 2mm of excursion of extensor tendon at level of the proximal interphalangeal joint may results in a 50 percent loss of motion of the finger. A special problem associated with extensor tendon healing is loss of gliding. This study was carried was carried out to evaluate the results of the extensor injuries according to their etiology, location and type of treatment. Seventy six lesions in fifty patients treated for extensor tendon injuries were analysed for the comparison of the results of specific treatment. The follow up was from 1 to 3 years with average of 19 months. Following results were obtained. l. Among 50 patients, 16 cases (32%) were acute and 34 cases (68%) were chronic. 2. The etiology were crushing in 19 cases (30%), knife or glass in 20 cases (40%), and avulsion in 8 cases (16%) etc. 3. Mallet finger were observed in 14 tendons, buttonhole in 10 tendons. Nine tendons were injured at the metacarpophalangeal level and 16 tendons were injured at wrist level. 4. Percentage of satisfactory result which means less than 15 degrees of extension loss were 68.1 % in primary repair and plication, and 30.7% in tendon transfer or graft. 5. Prognosis was better when the lesion was proximal to MP joint, and results were more favorable in primary repair and plication than tendon transfer graft.
Cicatrix ; Fingers ; Follow-Up Studies ; Glass ; Humans ; Joints ; Prognosis ; Splints ; Tendon Injuries ; Tendon Transfer ; Tendons ; Transplants ; Wrist

PURPOSE: To elucidate high-resolution CT(HRCT) findings and their pathologic basis in pulmonary oil embolism induced by LipiodoI-Adriamycin emulsion. MATERIALS AND METHODS: Pulmonary oil embolism was induced by infusing LipiodoI-Adriamycin emulsion through a peripheral vein in twelve Yorkshire pigs. Serial HRCT scans were performed on 2rid, 4th, 7th, 14th, and 28th day after the procedure. The pigs were sacrificed immediately after HRCT and histologic specimens were prepared in the same plane and level with HRCT. RESULTS: The basic pathology was reversible hemorrhagic edema of the lung. On HRCT, intraalveolar hemorrhage and edema in the acute stage manifested as ground-glass opacity or air-space consolidation of the whole secondary Iobule. The lesions were predominantly distributed over the dependent posterior lung fields because the specific gravity of Lipiodol is 1.28. Interlobular septal thickening due to edematous fluid collection was also associated. With the elapse of time, the extent and severity of the acute lesions resolved and, sometimes, changed into small nodular opacities. Pulmonary opacity was most severe on the post-embolization 2nd day and completely resolved within 2 weeks. CONCLUSION: Pulmonary embolization of LipiodoI-Adriamycin emulsion causes reversible hemorrhagic edema of the lung and Lipiodol toxicity seems to play a major role. HRCT findings of pulmonary oil embolism are quite different from those of pneumonia and pulmonary metastasis, which suggests the possibility of clincal application.
Edema ; Embolism* ; Ethiodized Oil ; Hemorrhage ; Lung ; Neoplasm Metastasis ; Pathology ; Pneumonia ; Specific Gravity ; Swine ; Veins