The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.
Hamartoma ; Lung ; Prevalence ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary

The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.
Hamartoma ; Lung ; Prevalence ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary

PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causesof obstuctive jaundice among various radiological procedures. The authors reviewed and radiologically classifiedthe PTC films of 203 cases of obstructive jaundice from July 1977 to June 1983 at Presbyterian Medical Center,Jeon-ju confirmed clinically, operatively and pathologically. The resuls are as follows; 1. The most common causeof obstructive jaundice was bile duct stoen (64/203:31.53%) and the other causes were bile duct cancer(43/203:21.18%), pancreas cancer(41/203:20.19%), biliary ascariasis &/or clonorchiasis(20/203:9.85%), ampulla andduodenal cancer (7/203:3.45%), fibrotic stenosis of sphincter of Oddi(6/203: 2.96%) etc. in that order. Of theseprimary involvement with cancer was more frequent (91/203:44.33%) than stone. 2. 88.33%(179/203) of patients wasover 40-year-of- age and the sex ratio between male and female was about 2:1. 3. The average maximal diameter ofextrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearlyequal(2.36cm:2.38cm). 4. Cancers caused complete bile duct obstruction in about 75%(68/91) of cases and also wereassociated with intrahepatic duct dilatation about 92%(84/91) of cases. But in contrast biliary calculi showedgood drainage of contrast medium in 75%(48/64) of cases and 92%(59/64) showed normal diameter of intrahepaticduct. 5. The differential PTC findings between bile duct cancer and pancreas cancer were not so distinct but inbiel duct cancer the obstruction site of the bile duct was more irregular and serrated than pancreas cancer, whilethe latter showed a more downward convexity and a smoother end. Moreover annular filling defect with overhangingedges was seen only in bile duct cancer.
Ascariasis ; Bile Duct Neoplasms ; Bile Ducts ; Cholestasis ; Constriction, Pathologic ; Dilatation ; Drainage ; Female ; Gallstones ; Humans ; Jaundice ; Jaundice, Obstructive ; Male ; Methods ; Pancreas ; Pancreatic Neoplasms ; Protestantism ; Sex Ratio

The incidence of colorectal cancer of Korea is much lower than that of Western countries, but has shown a tendency to a slight increase recently Barium enema is the most valuable, noninvasive and inexpensive method available to evaluate the size, shape and site of colorectal cancer. The authors reviewed and radiologically classified barium enema studies of 232 cases of colorectal cancer from Aug. 1967 to July 1982 at Presbyterian Medical Center, Jeon-ju , Confirmed clinically, operatively and pat hologically. The results were as follows; 1. The ratio of male and female was 1.3:1, and youngest was 13 year-old and the oldest 86 year-old. 2. The peak incidence occurred from 5th to 7th decades, accounting for 78% of all cases (181/232), and there was a relatively high incidence of the disease in patients below 30 years of age at 7.8% (18/232). 3. Rectum and rectosigmoid region are the most frequently involved regions (127/23 2:54.8%). 4. The positivity of barium enema examination was 4.0% (232/5807), and its accuracy was 96.5% (224/232) . 5. The radiologic findings were classified into 4 groups, and they were annular encircling 62.9% (146/232), polypoid fungating 26.8% (62/232), infiltrating 8.6% (20/232), and primary ulcerating 1.7% (4/232) in order of frequency. 6. The linear length of the cancer ranged from 1.5 Cm to 15 Cm , and the average length was 5.5 Cm. 7. There was no statistical correlation between the length of lesion, the site, and the radiologic findings, and stages of the lesion (P:0.750-0.250). 8. The majority of colorectal cancers was adenocarcinoma (217/232:93.6%).
Adenocarcinoma ; Barium ; Colorectal Neoplasms ; Enema ; Female ; Humans ; Incidence ; Jeollabuk-do ; Korea ; Male ; Methods ; Protestantism ; Rectum ; Ulcer

473 patients who underwent orthopedic surgery of the upper extremities from July 1978 to August 1983 were studied and the results are as follows. 1) Among 473 patients 294 patients given general anesthesis. Axillary brachial piexus block(141 cases), intraveonus regional anesthesia(10 cases), interscalene block(2 cases) and continuous brachial plexus block were given to the rest of the patients. 2) 267 patients were male and 106 patients were female. Age distribution was from 2 to 74 years. 3) Physical status of the patients was A.S.A. (American Society of Anesthesiologists) class 2(52.5%), class 1(43.4%), class 3(4.4%) in the order. 47.2% of the patients underwent emergency operation. 4) There was a tendency that regional anesthesis has been increasing year by year. 5) The type of operations were open reduction(160cases), tendon repair(112cases), and surgery for neuropathy(65 cases). 6) The operations for upper arm, elbow, and forearm were performed mostly under general anesthesia, while regional anesthesia prevailled for hand, wrist, and digits operations. 7) Brachial plexus block was considered as a method of choice for upper extremity surgery, especially for emergency surgical procedures in patients with significant medical problems. 8) A new method was tried in which a flexible disaposable intravenous catheter was introduced into the neurovascular sheath in the axilla and used for injection of local anesthetic solutions to block the axillary brachial plexus. The catheter method constitutes an interesting alternative to the conventional needle techniques and offers a continuous axillary block and a method for postoperative pain relief.
Age Distribution ; Anesthesia, Conduction ; Anesthesia, General ; Arm ; Axilla ; Brachial Plexus ; Catheters ; Elbow ; Emergencies ; Female ; Forearm ; Hand ; Humans ; Male ; Needles ; Orthopedics ; Pain, Postoperative ; Tendons ; Upper Extremity* ; Wrist

Management of cavernous sinus dural arteriovenous fistula (CSDAVF) continues to present significant challenges, particularly when the inferior petrosal sinus is thrombosed, collapsed, or angiographically invisible. In this study, we introduce facilitated retrograde access via the facial vein, which is employed in the transvenous embolization of CSDAVF with isolated superior ophthalmic venous drainage. We also present illustrative cases and technical points.

In the volume-cycled ventilator, the actual tidal volume delivered to the patient is influenced by the compression volume and elasticity of the circuit. The purpose of the present study is to compare the set tidal volume with the measured tidal volume, and calculate the compression factor of the ventilator. We studied twenty pediatric patients weighting above 10 kg. The set tidal volume ( V(r)), the exhaled volume displayed in the ventilator ( V(exh)) and the actual tidal volume measured by the Wright spirometer ( V(sp)) were compared. The results were as follows: 1) Mean tidal volume was 248+/-92 ml, mean exhaled volume was 233+/-102 ml and mean spirometer volume was 19+/-97 ml. Thus the set and the measured tidal volume were different significantly (p<0.05). but we may calculate the actual tidal volume by the relationship with the set tidal volume ( Vsp-1.03V(T) - 56 ) 2) Mean compression factor was 1.35+/-0.92 ml/cmH2O.
Adult* ; Elasticity ; Humans ; Tidal Volume* ; Ventilators, Mechanical*

BACKGROUND: An epidural blockade has been considered a standard therapy for the management of pain in acute herpes zoster. However, it has many complications. Recently, we experienced good analgesia with a combination therapy including intravenous lidocaine infusion and intradermal injection of a local anesthetic and steroid in acute herpes zoster. Therefore, this study was performed to evaluate the necessity of an epidural steroid injection, added in a combination therapy, on the pain control of acute herpes zoster. METHODS: This retrospective study was based on the analysis of data of medical records. Forty-three patients suffering severe acute herpes zoster pain, were randomly divided into two groups. Intravenous lidocaine infusion (5 mg/kg) and an intradermal injection of lidocaine and a steroid into the wound were used twice a week in the Lidocaine group (n = 23), and in the Epidural group (n = 20), an epidural block with 0.5% lidocaine 6-8 ml with triamcinolone 30 mg was added once a week in addition to the above. We compared the efficacy of pain control using a pain relief scale (PRS) at 4 weeks after the initial visit to the pain clinic. RESULTS: Both groups were similarly managed in pain control. There were no statistical differences comparing the PRS between the two groups. CONCLUSIONS: Our results suggest that an epidural steroid injection, added in a combination therapy such as an intravenous lidocaine infusion and an intradermal injection of a local anesthetic and steroid, has no more advantages for the management of pain in acute herpes zoster. A further prospective study is recommended to compare the efficacy of pain control and the incidence of postherpetic neuralgia in a large number of acute herpes zoster patients.
Analgesia ; Herpes Zoster* ; Humans ; Incidence ; Injections, Intradermal* ; Lidocaine* ; Medical Records ; Neuralgia, Postherpetic ; Pain Clinics ; Pain Management* ; Retrospective Studies ; Triamcinolone ; Wounds and Injuries

In the management of postoperative fluid collection, the conventional percutaneous drainage method can be employed. Because of abdominal incisions and various types of surgical drains and/or T-tubes, the application of this method is not always easy, however. We inserted a drainage catheter through a pre-existing percutaneous track formed by a surgical drain located adjacent to the site of abnormal fluid collection. There was no need to remove the drain nor make an additional puncture in the abdominal wall. A dilator was inserted along the drain, and a guide wire was used to negotiate its intraperitoneal track and readch the accumulated fluid. The procedure was simple and safe. We briefly deseribe our experience of this modified percutaneous drainage technique, as used in three cases involving postoperative fluid collection.
Abdominal Wall ; Catheters ; Drainage* ; Punctures

BACKGROUND: A retrospective study was performed to estimate the frequency of red cell antibodies in blood donors (n=1,620,023) and transfusion candidates (SNUH n=12,111, YUMH n=26,665) for last 2 years (2000~2001). The results of the antibody screening and identification tests, the frequency and specificities of antibodies identified compared with blood centers and two hospitals had been used the different test methods each others. METHOD: Blood centers had been used tube and micro-plate method simultaneously with an in house and commercial panels. SNUH had been used micro-plate method using V plate with an in house and commercial panels. YUMH had been used gel agglutination technique (DiaMed ID System : DiaMed, Murten; Switzerland) since 1998. RESULTS: The frequencies of red blood cell antibodies were 0.26% (4,204 / 1,620,023 donor sera ), 0.11% (135 / 12,111 patient sera in SNUH) and 0.48% (128 / 26,665 patient sera in YUMH). Female donors and old ages showed higher frequency of red cell antibodies than male and young ages. Most of antibodies detected in donors were clinically less relevant antibodies such as Anti-Lea and Leb (38.9%), anti-P1 (18.1%), anti-H(IH) (8.4%), anti-M (6.2%) and so on. Clinically significant antibodies including Rh system antibodies (2.0%) were few, and composed only 12% of all the antibodies detected. In patients, clinically relevant antibodies including Rh antibodies (40.4% in SNUH, 71.9% in YUMH) were more frequently observed comparing with in donors. CONCLUSION: Antibodies found in donors were mostly clinically less relevant. Antibody screening method used in blood centers would be standardized. Blood banks using gel technique showed high detection rate of clinically significant antibodies comparing with facilities using other methods.
Agglutination ; Antibodies* ; Antibody Specificity ; Blood Banks ; Blood Donors* ; Erythrocytes ; Female ; Humans ; Korea* ; Male ; Mass Screening ; Retrospective Studies ; Tissue Donors