Five patients with obstruction of the hepatic portion of the inferior vena cava diagnosed by digital subtraction inferior vena cavography were reported. All of these patients, aged from 38 to 52, were female who had never used the oral contraceptives. Main collateral pathway of these patients was the central channels through ascending lumbar veins, internal and external vertebral plexuses, azygos-hemiazygos complex, and inferior vena cava itself above the obstructed segment.
Contraceptives, Oral ; Female ; Humans ; Veins ; Vena Cava, Inferior

No abstract available.
Arthritis, Juvenile*

PURPOSE: The purpose of this study was to evaluate the CT features of second branchial cleft cysts. MATERIALS AND METHODS: We retrospectively analyzed the computed tomographic images in nine cases of second branchial cleft cyst which was confirmed pathologically. Emphasis was on localization of the masses to fascial spaces as defined by the deep cervical fasica. RESULTS: In all nine cases, the lerions were located in the submandibular and carotid spaces. Among these cases, six(67%) had simultaneous involvement of the other contiguous spaces, such as anterior and posterior cervical spaces. All cases had round or oval, unilocular, cystic masses with partial or complete rim enhancement. In eight cases(89%), smooth and thin walls were observed. In one case, thick wall and septations were noted. No definite calcifications were noted in all cases. The internal contents of cystic masses showed relatively homogeneous appearance, and CT number ranged from 20 to 35.2 Hounsfield unit(HU)(mean, 28.4HU). CONCLUSION: CT diagnosis of second branchial cleft cyst would be easily obtained from recognition of frequent simultaneous involvement of the other contiguous spaces, along with a typical location and characteristic morphology.
Branchial Region* ; Branchioma* ; Diagnosis ; Retrospective Studies

Individual identification procedure is one of the most improtant part in medicolegal fields. Recently, radiolegal investigation methods have been widely applicated to the medicolegal field for the purpose of individual identification. So authors attempted to determine sex and calculate stature by using roentgenographic findings of long bones of 248 subjects the living materials. In orthoscanographic study for long bones, we measured total length, midshaft width, epiphyseal width, cortical width, head diameter of each bones The total length, midshaft width, cortical width, condylar breath, horizontal & vertical head diameter of femur show statistically significant differentiation between two sexes, in tibia, total length, midshaft, cortical width, proximal and distal epiphyseal width show statistically significant. In fibula, Humerus, radius and ulna, total length is only statistically significant. And other wresults are statistically insignificant. Using femoral and fibial lengths (mm) with "Regression Analysis method" in SAS program, we derived the following fomulae. Height (cm)=95.62±0.148×Total length of Femur. (mm) Height(cm)=82.07±0.22×Total length of Tibia. (mm). In conclusion, radiologic measurement of long bone might be one of the useful methods in individual identification of unknown subject in Korea.
Femur ; Fibula ; Head ; Humerus ; Korea ; Radius ; Tibia ; Ulna

From June 1990 to December 1998, 792 kidney transplantations were performed at Asan Medical Center. 436 cases(55M) were from living-related donors, 139 cases(17.6%) were from living-unrelated donors and 217 cases(27.4%) were from cadaveric donors. The results of the trasnplantation were analyzed according to the various factors known to influence the outcome of transplantation. In living transplants, the overall patients survival rate was 98.2% at 1 year and 95.8% at 5 years, the corres-ponding allograft survival rate was 96.9 and 86.1N. In cadaveric transplants, the overall patients survival rate was 94.3% at 1 year and 94.3% at 5 years, the corresponding allograft survival rate was was 90.296 and 84.8%. In living transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, pretrans-plant blood transfusion, diabetic history had no effect on allograft survival rate. But HLA DR cornpa-tability, serum creatinine(2.5mg/dL) at discharge and rejection history had effect on allograft survival(p<0.05). In living-related transplants, 5 year allograft survival rate was 100% at HLA identical group and 86% at HLA haplomatched group. But the statistical significance was not found(p=0.052). In cadaveric transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, HLA DR match, diabetic history, pretransplant transfusion had no effect on allograft survival. But serum creatinine at discharge(>2.5mg/dL) and posttransplant rejection had effect on allograft survival.
Allografts ; Blood Transfusion ; Cadaver ; Chungcheongnam-do* ; Creatinine ; Humans ; Kidney Transplantation ; Survival Rate ; Tissue Donors

PURPOSE: Recently, biodegradable collagen matrix has been used as a possible substitute for anti-metabolite in trabeculectomy in order to control the responsiveness of the wound healing process. This paper reports a case of encapsulation of the biodegradable collagen matrix after trabeculectomy. CASE SUMMARY: We conducted a fornix-based trabeculectomy on a 58-year-old man with medically uncontrollable steroid-induced glaucoma. We implanted biodegradable collagen matrix onto the sclera flap beneath the conjunctiva. Immediately after the surgery, we observed a localized bleb with high elevation. In the three months of follow-up, the bleb became encapsulated, and an increase in intraocular pressure was noted. During the wound revision, encapsulated material surrounded by thick fibrous membrane was found and removed from the subconjunctival space, followed by biopsy. Biopsy results demonstrated that amorphous collagenous material was surrounded by spindle and inflammatory cells. CONCLUSIONS: It is important to note that the fibrous encapsulation of collagen material is a possible complication of biodegradable collagen matrix-augmented trabeculectomy.
Biopsy ; Blister ; Collagen ; Conjunctiva ; Follow-Up Studies ; Glaucoma ; Glycosaminoglycans ; Humans ; Intraocular Pressure ; Membranes ; Middle Aged ; Sclera ; Trabeculectomy ; Wound Healing

PURPOSE: Ketamine may decrease core-to-peripheral redistribution of heat through direct central sympathetic stimulation and inhibition of norepinephrine uptake into postganglionic sympathetic nerve endings. The purpose of this study was to evaluate the efficacy of epidural ketamine in preventing shivering during transurethral resection of the prostate (TURP) under epidural anesthesia. MATERIALS AND METHODS: Ninety-three male patients scheduled for TURP under epidural anesthesia were enrolled in this study. Patients were randomized into one of three groups. Group 1 consisted of 31 patients who received epidural 0.75% ropivacaine, group 2 consisted of 32 patients who received epidural ketamine (0.2 mg/kg) in addition to 0.75% ropivacaine, and group 3 consisted of 30 patients who received epidural ketamine (0.4 mg/kg) in addition to 0.75% ropivacaine. Shivering and side effects such as hypotension, bradycardia, nausea, and hallucination were recorded during the anesthesia and for 2 hours while in the postanesthetic recovery room. RESULTS: Shivering was statistically more frequent in group 1 than in the other groups. The incidence of sedation was significantly higher in group 3 than in the other groups. The incidences of side effects such as hypotension, bradycardia, and nausea were significantly higher in group 1 than in the other groups. CONCLUSIONS: In this study, epidural ketamine 0.2 mg/kg and 0.4 mg/kg was shown to have a lower incidence of shivering and other side effects except sedation. In patients who undergo TURP under epidural anesthesia, the prophylactic use of low-dose epidural ketamine would be helpful in preventing any adverse effects, including shivering.
Amides ; Anesthesia ; Anesthesia, Epidural ; Bradycardia ; Hallucinations ; Hot Temperature ; Humans ; Hypotension ; Incidence ; Ketamine ; Male ; Nausea ; Nerve Endings ; Norepinephrine ; Prostate ; Recovery Room ; Shivering ; Transurethral Resection of Prostate

Objective: To evaluate the radiographic characteristics of the ampulla of Vater cancer. Subjects and Methods:The authors analyzed retrospectively the US(n=25) and CT(n=15) findings in 25 cases of ampulla of Vater cancer, with emphasis on the potential of CT & US in regand to the detectibility of the mass. ERCP(n=15) and hypotonic duodenography(n=5) were also evaluated for the configuration of obstructed duct. RESULTS: The tumor was detected on sonography in only 12 cases(48%) as a small, relatively well delinated mass with slighty low echogenicity to the pancreas. The tumor was shown by CT in 8 cases(53% ) as a well delinated mass protruding into the second portion of duodenal lumen with slightly low attenuation to the pancreas. CBD was dilated in 25 cases(100%), but pancreatic duct was dilated in 15 cases(60%). Obstructed end of CBD was nipple shaped in 7 cases(47%), clubbed in 3, flat in 3, and indistict in 2 by ERCP. Hypotonic duodenogram showed irregular filling defect in the medial wall of second portion of the duodenum in 5 cases (100%). CONCLUSION: Mas detection rate crsing US or CT were not high in ampulla of Vater cancer. Except for a CT finding of a small mass protruding into the regional duodenal lumen, other finclings were nonspecific. Therefore, additional studies or more afgressive approach should be attempted for a correct diagnosis.
Ampulla of Vater* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Duodenum ; Nipples ; Pancreas ; Pancreatic Ducts ; Retrospective Studies

OBJECTIVE: To assess the pre-pregnancy and pregnancy factors influencing pregnancy outcome in renal transplanted women Materials and METHODS: This retrospective study included all pregnancies in renal transplanted women in Asan Medical Center between June 1996 and February 1998. We collected data from the medical records of allograft recipients. Pre-pregnant status and pregnancy outcome were described. RESULTS: Seventeen pregnancies in 13 allograft recipients resulted in 7 term deliveries, 4 preterm births, 2 spontaneous abortions, and 4 therapeutic abortions. All but one patient received immunosuppressive therapy with cyclosporin A, azathioprine, and prednisolone during pregnancy. The mean interval from the time of transplantation to conception was 28.8+/-14.3 months(range 6-60 months). In live birth group, the mean gestational age at delivery was 37.7+/-1.2 weeks and the mean birth weight of their offspring was 2.85+/-0.37 kilogram. Apgar scores at 5 minutes were 8 or more in all of them. The obstetric complications were distributed as follows: pregnancy induced hypertension in 6 cases(55%), pregnancy aggravated hypertension in 2 cases(18%), fetal growth restriction in 1 case(9%), prematurity in 4 cases(36%). Cesarean sections were done in 4 cases(36%) because of previous Cesarean section(3 cases) and uncontrolled hypertension(1 case). Neonatal complication, transient tachypnea of the newborn, was found in one case. Graft rejection after transplantation occurred in 4 cases: 3 cases in preterm births and 1 case in therapeutic abortions. Maternal renal functions were normal during pregnancy and postpartum period whose pre-pregnant renal functions had been normal. No patient experienced any rejection episode or graft loss during pregnancy. CONCLUSION: Successful pregnancy can be expected in women with a renal transplant, although there was high incidence of pregnancy-related complications, especially hypertensive disorders. Pregnancy can be encouraged to these allograft recipients if they have good renal function.
Abortion, Spontaneous ; Abortion, Therapeutic ; Allografts* ; Azathioprine ; Birth Weight ; Cesarean Section ; Chungcheongnam-do ; Cyclosporine ; Female ; Fertilization ; Fetal Development ; Gestational Age ; Graft Rejection ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Incidence ; Kidney Transplantation ; Live Birth ; Medical Records ; Postpartum Period ; Prednisolone ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Retrospective Studies ; Transient Tachypnea of the Newborn ; Transplants

OBJECTIVES: There are much controversy about the duration of antibody persistence, necessity and time of booster for hepatitis B vaccine(HB vaccine). The long term follow-up study is lack in Korea. Therefore this study is designed for evaluating the long-term immunogenicity of HB vaccine, necessity and time of booster vaccination. METHODS: The plasma derived HB vaccine (He-pavax-B(R)) was administered to healthy volunteers (28cases) as usual method. Secondary booster immunization was done at the 2nd year after primary vaccination in 6 cases(anti-HBs<10 mIU/ml). The serum transaminase levels, the HBsAg and anti-HBs were checked at the 9th month, 1st, 2nd, 3rd, 5th and 10th year after primary vaccination. RESULTS: 1) The positivity of anti-HBs (over 10mIU/ml) was 93%, 96%, 92% at the 3rd, 5th, 10th year respectively. In the children under 20 years old, it was 94Yo at the 3rd, 5th and 10th year without the secondary booster. 2) The good responders(anti-HBs>or=100mIU/ml) at the 9th month after primary vaccination are 21 cases (7%), low responders(anti-HBs: 10-100mIU/ml) 5 cases (18%), and non-responders(anti-HBs Adult ; Child ; Follow-Up Studies* ; Healthy Volunteers ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines ; Humans ; Immunization, Secondary ; Korea ; Plasma* ; Vaccination ; Young Adult