Although the ultrasonography has been regarded as a main procedure in the diagnosis of gallbladder diseases, no many papers concerning the ultrasonographic findings of gallbladder empyema appeared in the literature. Twenty-four cases of surgically proven gallbladder empyema were studied by ultrasonography in our hospital during last 15 months. The results were as follows; 1. The size of gallbladder was enlarged in 18 cases. 2. The thicknessof gallbladder wall was more than 3mm in 16 cases. 3. The echogenicity of gallbladder wall was diminished in all cases. the inner margin of gallblaldder wall was also ill-defined in all cases. These findings are considered to be important in the diagnosis of gallbladder empyema. 4. The internal echogenicity of gallbladder (diffuse or localized) was positive in 16 cases and negative in the remainders. The echo genility was thought to beproportional to the amount of pus in gallbladder. 5. The 7 cases presented periocholecystic sonolucent area hadperforation of gallbladder and pericholecystic abscess. 6. Gallstone was found in 17 cases.
Abscess ; Cholecystitis ; Diagnosis ; Gallbladder Diseases ; Gallbladder ; Gallstones ; Suppuration ; Ultrasonography

The authors studied 126 cases (90 patients) of proven avascuar necrosis of femoral head inadult during theperiod from Jan. 1975 to May 1982 at Kyung Hee University Hospital. The results were as follows; 1. The sex ratiowas 63 males to 27 females and the peak incidence of age was in the fifth decade. 2.Among the 90 patients, thecause and conditions associated with avascular necrosis were idiopathic in 33 cases, femoral neck fracture in 32cases, chronic alcholism in 9 cases, anti-inflammatory drugs abuse in 6 cases, corticosteroid therapy in 5 cases,caisson's disease in 2 cases, hip dislocation in 2 cases and macromolecular storage disease in 1 case, in theorder of frequency. 3. Excluding 34 patients of avascular necrosis associaited with trauma, bilateral lesion was36 patients(64.3%) among the 56 patients. 4. The radiographic features in femoral head were variable, such as 118cases of central increased density surrounded by lucent zone, encompassed by dense rim, 110 cases of collapsedarticular cortex and 16 cases of intact articular cortex, 91 cases of flattening of femoral head, 79 cases ofcrescent sign, 51 cases of fragmentation of osteonecrotic segment, 47 cases of superimposed degenerativearthritis, 5 cases of patchy increased density, and 3 cases of no radiographic change. 5. The bone scintigraphywith Tc-99m-MDP was performed in 11 patients (15 cases) and its finding in femoral head were 8 cases of increasedradioactivity, 4 cases of mixed increased and decreased radioactivity, and 3 cases of absent radioactivity. 6. Itwas our belief that comparative study of plain radiographs and bone scintigraphy would be useful in earlydiagnosis and tratment planning of avascular necrosis of femoral head.
Adult ; Female ; Femoral Neck Fractures ; Head ; Hip Dislocation ; Humans ; Incidence ; Male ; Necrosis ; Radioactivity ; Radionuclide Imaging

Hydrocarbon pneumonitis is an inflammatory change in the lungs caused by ingestion or inhalation of household products that contain hydrocarbons. We experienced a rare case of hydrocarbon pneumonitis with a pulmonary hemorrhage in a 3-year-old girl after ingestion of paint thinner which has a high mortality. She was admitted due to dyspnea, vomiting, hemoptysis, and needed to support mechanical ventilation. She recovered completely with no respiratory complicaion, after mechanical ventilatory support, antibiotics, and steroids treatment.
Anti-Bacterial Agents ; Child, Preschool ; Dyspnea ; Eating* ; Female ; Hemoptysis ; Hemorrhage ; Household Products ; Humans ; Hydrocarbons ; Inhalation ; Lung ; Mortality ; Paint ; Pneumonia* ; Respiration, Artificial ; Steroids ; Vomiting

No abstract available.
Fructosamine* ; Hyperthyroidism*

Gastroparesis is rare in children and is defined as delayed emptying of gastric contents into the duodenum without mechanical obstruction. We experienced a case of gastroparesis in a 7-year-old boy after a viral illness. He was admitted because of excessive abdominal bloating and diffuse abdominal pain, and was diagnosed by clinical manifestations and measurement of the gastric emtpyting time. He recovered after dietary management and with commbined medication of erythromycin and domperidone in 50 days of illness.
Abdominal Pain ; Child* ; Domperidone ; Duodenum ; Erythromycin ; Gastroparesis* ; Humans ; Male*

No abstract available.
Lupus Nephritis*

PURPOSE: Surfactant protein A(SP-A) is involved in surfactant physiology and structure, and plays a major role in innate host defense and inflammatory processes in the lung. Steroid therapy is widely used for mothers who threaten to deliver prematurely and also used commonly in the management of preterm infants with chronic lung disease. Two SP-A genes(SP-A1, SP-A2) and several alleles have been characterized for each SP-A gene in human. Preliminary evidence indicates that differences may exist among alleles in response to Dexamethasone(Dexa) and that the SP-A 3'UTR plays a role in this process. We studied whether 3'UTR-mediated differences exist among the most frequently found SP-A alleles in response to Dexa. METHODS: Constructs containing the 3'UTR from eight different SP-A alleles were made using luciferase as a the reporter gene. These constructs were driven by the SV40 promotor and were transfected along with a transfection control vector in H441 cells that express SP-A. The activity of the reporter gene in the presence or absence of Dexa(100 nM) treatment was measured. All the experiments for the eight SP-A alleles studied, were performed in triplicate and repeated five times. The results were normalized to the transfection control. RESULTS: Expression of alleles of 6A3, 6A, 1A were significantly decreased in response to Dexa. CONCLUSION: Three UTR mediated differences exist among human SP-A variants both in the basal expression and in response to Dexa. These genotype-dependent differences may point to a need for a careful consideration of individual use of steroid treatment in the prematurely born infant.
3' Untranslated Regions ; Alleles ; Dexamethasone* ; Genes, Reporter ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Luciferases ; Lung ; Lung Diseases ; Mothers ; Physiology ; Transfection

Satisfactory surgical reconstruction of the external ear and nose is still a major challenge for the plastic surgeon. Therefore, the use of prosthesis in selected cases should be considered as viable alternative. During the period from December, 1995 to January, 1998, 10 patients, including 9 patients of ear defect and 1 patient of nose defect resulting from the resection of recurrent tumor ablation, were reconstructed by using osseointegration and prosthesis. The surgery was performed in two stages. All procedures were performed under local anesthesia and on an outpatient. At the first stage, the fixtures of titanium implant were placed in the mastoid process and maxilla. These implants were then left for 3 months before the second stage takes place, in which the skin penetrating abutments were attached. After 3-4 weeks, the impression of the defect area were taken and the silicone prosthesis was made by Anaplastologist. Two patients had focal infection but healed without problem. One patient had soft tissue infection, then flap was excised and skin graft performed. There was one loss from 20 fixtures, that was 3 years after implantation. We have concluded that osseointegration for reconstruction of the ear and nose defect is simple, soft, reliable method, which is more than autologous reconstruction and provides excellent aesthetic results.
Anesthesia, Local ; Ear ; Ear, External ; Focal Infection ; Humans ; Mastoid ; Maxilla ; Nose* ; Osseointegration* ; Outpatients ; Prostheses and Implants ; Silicones ; Skin ; Soft Tissue Infections ; Titanium ; Transplants

BACKGROUND: During bilateral transthoracic endoscopic sympathicotomy (TES), we have noticed a tendency for hypoxemia during deflation of the second lung despite adequate reinflation of the first one. This study was designed to compare PaO2 during TES of the first side with that of TES of the second side and to investigate whether PaO2 during the sequential one-lung ventilation (OLV) was correlated with two-lung ventilation (TLV) time after reinflation of the collapsed first lung. METHODS: Forty patients were randomly allocated into two groups. After TES of the first side, OLV of the second side was immediately performed after reinflation of the collapsed first lung (group A), or after 10 minutes of TLV when switching between the operated sides (group B). Arterial blood gas samples were taken at TLV before surgery, at 2 minute intervals during OLV, and during the period of TLV when switching between the operated sides. RESULTS: In group A, the significantly decreased PaO2 was observed during TES of the second side compared with TES of the first side (P < 0.01). In group B, there was no significant difference in PaO2 except 2 minutes after OLV. PaO2 during TLV and 4 and 6 minutes after OLV of the second side TES in group A significantly decreased compared with those of group B (P < 0.05). The lowest PaO2 during OLV of the second side TES was significantly lower in group A (93.5 +/- 28.7 mmHg) than in group B (154.1+/- 48.3 mmHg). CONCLUSIONS: A significantly decreased PaO2 was observed during TES of the second side, compared with TES of the first side, and time was needed after lung collapse for its full oxygenation function to recover.
Anoxia ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen ; Pulmonary Atelectasis ; Ventilation*

BACKGROUND: During bilateral transthoracic endoscopic sympathicotomy (TES), we have noticed a tendency for hypoxemia during deflation of the second lung despite adequate reinflation of the first one. This study was designed to compare PaO2 during TES of the first side with that of TES of the second side and to investigate whether PaO2 during the sequential one-lung ventilation (OLV) was correlated with two-lung ventilation (TLV) time after reinflation of the collapsed first lung. METHODS: Forty patients were randomly allocated into two groups. After TES of the first side, OLV of the second side was immediately performed after reinflation of the collapsed first lung (group A), or after 10 minutes of TLV when switching between the operated sides (group B). Arterial blood gas samples were taken at TLV before surgery, at 2 minute intervals during OLV, and during the period of TLV when switching between the operated sides. RESULTS: In group A, the significantly decreased PaO2 was observed during TES of the second side compared with TES of the first side (P < 0.01). In group B, there was no significant difference in PaO2 except 2 minutes after OLV. PaO2 during TLV and 4 and 6 minutes after OLV of the second side TES in group A significantly decreased compared with those of group B (P < 0.05). The lowest PaO2 during OLV of the second side TES was significantly lower in group A (93.5 +/- 28.7 mmHg) than in group B (154.1+/- 48.3 mmHg). CONCLUSIONS: A significantly decreased PaO2 was observed during TES of the second side, compared with TES of the first side, and time was needed after lung collapse for its full oxygenation function to recover.
Anoxia ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen ; Pulmonary Atelectasis ; Ventilation*