Endoscopic retrograde cholangiopancreatography(ERCP) and its therapeutic developments have become popular in the managemtnt of patients with biliary and pancreatic disease. But certain to anatomical arrangements such as Billroth II partial gastrectomy may cause technical difficulty In the patients with a previous Billroth-II resection, it may be difficult to enter the afferent loop Selectively; and to reach and identify the papilla. Cannulation and sphincterotomy are more difficult because of the direction of approach. Endoscopic retrograde cholangiopancreatography(ERCP) and/or endoscopic sphineterotomy (EST) was perfomed on 12 patients, who had received Billroth II gastrectomy. We could achieve successful cholangiogram in 9 patients(75%) out of 12 patients, And EST was done successfully in 5 patients(83%) out of 6 patients.
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Gastrectomy ; Gastroenterostomy ; Humans ; Pancreatic Diseases ; Sphincterotomy, Endoscopic*

BACKGROUND: Sentinel lymph node (SLN) mapping of the stomach cancer using available techniques is limited by unpredictable lymphatic drainage patterns and skip metastasis. The aim of this study was to test the feasibility of gastric SLN mapping using fluorescent magnetic nanoparticles (FMNP) of uniform nano-size. METHODS: Biocompatible silica-overcoated magnetic nanoparticles containing rhodamine B isothiocyanate (RITC) within a silica shell of controllable thickness with 60 nm thickness were used as model nanomaterials. Gastric lymphatic mapping was performed by injecting 100 microliter of either FMNP or isosulafan blue subserosally. Gastric injections (n=7) were made into the body, approximately 5 cm from the lesser curvature of rabbits. Sentinel lymph nodes were visualized using fluorescent nanoparticle detection system. RESULTS: In 7 rabbits, it was demonstrated that FMNP quickly and accurately detected sentinel lymph nodes. Injection into the stomach resulted in identification of a retrogastric lymph node. Histological analysis in all cases confirmed the presence of nodal tissue. CONCLUSIONS: FMNP can be a potential alternative to existing tracers in the detection of SLN in this animal experiment.
Animals ; Coloring Agents/diagnostic use ; Female ; Fluorescent Dyes/*diagnostic use ; Lymph Nodes/pathology ; Male ; Models, Animal ; Nanoparticles/*diagnostic use ; Rabbits ; Rhodamines/diagnostic use ; Rosaniline Dyes/diagnostic use ; Sentinel Lymph Node Biopsy/*methods ; Stomach/*pathology ; Time Factors

A wide variety of pulmonary disorders related to hemodialysis or pre-existing renal disease occurs in hemodialysis patients. The disorders may be classified as 1) pulmonary abnormalities associated with chronic renal failures; 2) pulmonary complications arising during hemodialysis; 3) pulmonary infection; or 4) pulmonary-renal syndrome. An awareness of the various possible pulmonary disorders arising in hemodialysis patients may be helpful for the proper and timely management of such patients. We describe and illustrate various radiographic and CT findings of variable pulmonary disorders in hemodialysis patients.
Humans ; Renal Dialysis* ; Renal Insufficiency ; Vasculitis

Fifteen cases of the primary duodenal malignancies were radically resected from July 1989 to September 1996. These cases were analysed retrospectively with the literature review. The male to female ratio was 8:7. The mean age was 49 years. Histopatholgically, adenocarcinomas were 10 cases, sarcomas were 4 cases and malignant lymphoma was 1 case. The symptoms and signs were abdominal pain and discomfort, weight loss, nausea and vomiting, jaundice, melena and diarrhea in the order of the frequency. We performed Whipple's operations in 11 cases, regional pancretectomy in 1 case, Whipple's operation with Right hemicolectomy in 2 cases and local resection in 3 cases. There was no operative mortality. The perioperative morbidity was 33%. The post operative complications were abscess in abdomen in 3 cases and wound infections in 2 cases. 1 year and 2 years survival rate were 93.3% and 33.3%. Aggressive and radical treatment with curative intention even in the presence of locally advanced disease, could be performed with acceptable mortality and morbidity and expect a better outcome.
Abdomen ; Abdominal Pain ; Abscess ; Adenocarcinoma ; Diarrhea ; Female ; Humans ; Intention ; Jaundice ; Lymphoma ; Male ; Melena ; Mortality ; Nausea ; Retrospective Studies ; Sarcoma ; Survival Rate ; Vomiting ; Weight Loss ; Wound Infection

Fasciola hepatica is a parasite of cattle, sheep and other herbivorous mammals and lives in the bile ducts and occasionally liver parenchyma. Fasioliasis is characterized by hyperplasia or proliferation of the biliary epithelium, dilatation of biliary passages, leukocyte infiltration and periductal fibrosis. Man is thought to be infected incidentally. Numerous cases of hepatic fasioliasis have been reported in the medical litherature. In Korea, about 10 cases of human infection has been recorded in the literature. We report a case of biliary fascioliasis diagnosed by percutaneous cholangioscopy.
Animals ; Bile Ducts ; Cattle ; Dilatation ; Epithelium ; Fasciola hepatica ; Fascioliasis* ; Fibrosis ; Humans ; Hyperplasia ; Korea ; Leukocytes ; Liver ; Mammals ; Parasites ; Sheep

We describe here a 57-year-old woman with a chronic-contained rupture of an internal iliac arterial aneurysm, and this was eroding the sacral neural foramen. Although an isolated internal iliac arterial aneurysm is known to be rare, the ruptured internal iliac arterial aneurysm was diagnosed based on the characteristic radiolgic findings with performing color Doppler ultrasound, MRI and multi-slice computed tomography. The ruptured aneurysm was successfully treated by coil embolization. Color Doppler US, MRI and multi-slice CT are useful for evaluating a mass of a vascular origin that involves the neural foramen.
Aneurysm ; Aneurysm, Ruptured ; Cytochrome P-450 CYP1A1 ; Embolization, Therapeutic ; Female ; Humans ; Middle Aged ; Rupture ; Spine

PURPOSE: The physicochemical properties of a xenograft are very important because they strongly influence the bone regeneration capabilities of the graft material. Even though porcine xenografts have many advantages, only a few porcine xenografts are commercially available, and most of their physicochemical characteristics have yet to be reported. Thus, in this work we aimed to investigate the physicochemical characteristics of a porcine bone grafting material and compare them with those of 2 commercially available bovine xenografts to assess the potential of xenogenic porcine bone graft materials for dental applications. METHODS: We used various characterization techniques, such as scanning electron microscopy, the Brunauer-Emmett-Teller adsorption method, atomic force microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, and others, to compare the physicochemical properties of xenografts of different origins. RESULTS: The porcine bone grafting material had relatively high porosity (78.4%) and a large average specific surface area (SSA; 69.9 m²/g), with high surface roughness (10-point average roughness, 4.47 µm) and sub-100-nm hydroxyapatite crystals on the surface. Moreover, this material presented a significant fraction of sub-100-nm pores, with negligible amounts of residual organic substances. Apart from some minor differences, the overall characteristics of the porcine bone grafting material were very similar to those of one of the bovine bone grafting material. However, many of these morphostructural properties were significantly different from the other bovine bone grafting material, which exhibited relatively smooth surface morphology with a porosity of 62.0% and an average SSA of 0.5 m²/g. CONCLUSIONS: Considering that both bovine bone grafting materials have been successfully used in oral surgery applications in the last few decades, this work shows that the porcine-derived grafting material possesses most of the key physiochemical characteristics required for its application as a highly efficient xenograft material for bone replacement.
Adsorption ; Bioprosthesis ; Bone Regeneration ; Bone Transplantation ; Chemical Phenomena ; Dental Materials ; Durapatite ; Heterografts* ; Methods ; Microscopy, Atomic Force ; Microscopy, Electron, Scanning ; Porosity ; Spectrum Analysis ; Surgery, Oral ; Transplants* ; X-Ray Diffraction

We present two cases of focal fatty sparing caused by a nontumorous arterioportal shunt. Two patients underwent ultrasonography (US) as a part of routine medical screening, which revealed a hypoechoic lesion in the diffuse fatty liver. Each lesion appeared to be an arterioportal shunt on triphasic mutidetector computed tomography (CT) and was seen as being slightly hyperdense on noncontrast CT. No tumors were delineated around or within the arterioportal shunt. Both lesions remained unchanged on six-month follow-up US.
Fatty Liver* ; Follow-Up Studies ; Humans ; Mass Screening ; Ultrasonography

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient’s medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient’s medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.