No abstract available.
Craniocerebral Trauma*

Spinal extradural angiolipoma is a rare benign tumor containing vascular and mature adipose elements. The most common location of this tumor is the thoracic level with a tendency to involve several spinal segments. Almost all spinal extradural angiolipomas develop on the posterior aspect of the dura. The authors report a case of surgically proven spinal extradural angiolipoma involving the thoracic level and describe its CT findings.
Angiolipoma*

PURPOSE: We reviewed 13 cases of pancreatic pseudocysts treated by percutaneous catheter drainage to determine the value and effectiveness of the procedure. MATERIALS AND METHODS: Sixteen pancreatic pseudocysts(nine infected, seven noninfected) were drained in 13 patients. Access routes were determined by images on CT scan and procedures were performed under fiuoroscopic guidance. Ultrasonogram was used as a guide for drainage when there were bowel loops near the access routes. Various access routes were used for catheter drainage:transperitoneal (10), retroperitoneal (3), transsplenic (2) transhepatic (1). RESULTS: Percutaneous catheter drainage cured 15 of 16 pancreatic pseudocysts(93.8%). No recurrance was encountered in the clinical follow-up of 7 to 69 months(mean 35 months). The mean duration of drainage was 29 days(infected, 24 days; noninfected, 39 days). Five pseudocysts(31%) were communicated with pancreatic duct The mean duration of drainage in these cases was 38 days. Spontaneous of the pancreatic pseudocysts to the gastrointestinal tract was occurred in 3 pseudocysts. Mean duration of drainage in pseudocysts with fistulas was 19 days. CONCLUSION: Percutaneous cather drainage is a safe and effective front-line treatment method in most pancreatic pseudocysts if drainage is done with a adequate follow-up and catheter care.
Catheters ; Drainage* ; Fistula ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Pancreatic Ducts ; Pancreatic Pseudocyst* ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Craniocerebral Trauma* ; Head*

No abstract available.
Fetus* ; Humans*

The central venous catheter(Quinton) was replaced in the right atrium for chemotherapy and blood sampling to a eight-year old girl with acute lymphoblastic leukemia. The catheter was flushed with heparin two times daily and the chemotherapeutic drug regimens by CCSG-105 protocol were vincristine, prednisone, L-asparaginase, daunomycin, methotrexate, cyclophosphamide, cytosine arabinoside, 6-mercaptopurine and adriamycin. On day 31 of catheterization, the lumen for blood sampling was blocked. From day 60 of catheterization, anorexia, nausea, vomiting, abdominal distension and tachypnea were developed. Echocardiogram, lung scan, pulmonary function test(PFT), arterial blood gas analysis (ABGA) were done. Two cemtimeters in diameter of thrombosis was found in the right atrium on echocardiogram. The lung scan showed slight decrease in uptake of Tc-99m on the whole lung fields. Restrictive ventratory impairment on PFT and decreased PaO2(48 mmHg) on ABGA were found. To lysis of thromboembolism, urokinase(4,400 IU/kg for initial 10 minutes and the 4,400 IU/kg for 12 hours) was injected intravenously and aspirin(30 mg/kg/d, po) was given. The thrombosis was disappeared from the atrium on echocardiogram and PaO2 was increased up to 97 mmHg temporary. The catheter was removed but total haziness on the right middle and lower lobes were developed after 5 days. The same dose of urokinase was injected just infront of the embolism through Pitfall catheter for 8 days intermittently as results of pulmonary angiography. Symptoms and PaO2 were alleviated and the lung was expanded with mild atelectasis on day 55 of the first fibrinolytic enzyme therapy. Although the frequent complications of central venous catheter are catheter occlusion and infection, we have to check the development of thromboembolism with echocardiogram periodically or in case of unexplained respiratory symptoms.
6-Mercaptopurine ; Angiography ; Anorexia ; Blood Gas Analysis ; Catheterization ; Catheters ; Central Venous Catheters* ; Cyclophosphamide ; Cytarabine ; Daunorubicin ; Doxorubicin ; Drug Therapy ; Embolism ; Enzyme Therapy ; Female ; Heart Atria ; Heparin ; Humans ; Lung ; Methotrexate ; Nausea ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prednisone ; Pulmonary Atelectasis ; Tachypnea ; Thromboembolism* ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Vincristine ; Vomiting

PURPOSE: We wanted to evaluate the usefulness of three-dimensional reconstructive images using multidetector computed tomography (MDCT) for thoracic traumatic patients visiting emergency room. MATERIALS AND METHODS: 76 patients with fractures of the 105 patients who visited our emergency room with complaints of thoracic trauma were analyzed retrospectively. All the patients had thoracic MDCT performed and the three-dimensional reconstructive images were taken. The fractures were confirmed by axial CT, the clinical information, whole body bone scanning and the multiplanar reformation images. Plain x-ray images were analyzed by the fractured sites in a blind comparison of two radiologists' readings, and then that finding was compared with the axial CT scans and the three-dimensional reconstructive images. RESULTS: The fracture sites were rib (n=68), sternum (n=14), clavicle (n=6), scapula (n=3), spine (n=5) and combined fractures (n=14). Plain x-ray and axial CT scans had a correspondency of 0.555 for the rib fractures. Axial CT scans and the three-dimensional reconstructive images had a correspondency of .952. For sternal fractures, those values were 0.692 and 0.928, respectively. The axial CT scans and three-dimensional reconstructive images showed sensitivities of 94% and 91% for rib and other fractures, respectively, and 93% and 100% for sternal fracture, respectively. Three-dimensional reconstructive image had an especially high sensitivity for the diagnosis of sternal fracture. CONCLUSION: While evaluating thoracic trauma at the emergency room, the three-dimensional reconstructive image was useful to easily diagnose the extent of fracture and it was very sensitive for detecting sternal fracture.
Clavicle ; Diagnosis ; Emergency Service, Hospital ; Humans ; Multidetector Computed Tomography ; Reading ; Retrospective Studies ; Rib Fractures ; Ribs ; Scapula ; Spine ; Sternum ; Tomography, X-Ray Computed

PURPOSE: We wanted to evaluate the usefulness of three-dimensional reconstructive images using multidetector computed tomography (MDCT) for thoracic traumatic patients visiting emergency room. MATERIALS AND METHODS: 76 patients with fractures of the 105 patients who visited our emergency room with complaints of thoracic trauma were analyzed retrospectively. All the patients had thoracic MDCT performed and the three-dimensional reconstructive images were taken. The fractures were confirmed by axial CT, the clinical information, whole body bone scanning and the multiplanar reformation images. Plain x-ray images were analyzed by the fractured sites in a blind comparison of two radiologists' readings, and then that finding was compared with the axial CT scans and the three-dimensional reconstructive images. RESULTS: The fracture sites were rib (n=68), sternum (n=14), clavicle (n=6), scapula (n=3), spine (n=5) and combined fractures (n=14). Plain x-ray and axial CT scans had a correspondency of 0.555 for the rib fractures. Axial CT scans and the three-dimensional reconstructive images had a correspondency of .952. For sternal fractures, those values were 0.692 and 0.928, respectively. The axial CT scans and three-dimensional reconstructive images showed sensitivities of 94% and 91% for rib and other fractures, respectively, and 93% and 100% for sternal fracture, respectively. Three-dimensional reconstructive image had an especially high sensitivity for the diagnosis of sternal fracture. CONCLUSION: While evaluating thoracic trauma at the emergency room, the three-dimensional reconstructive image was useful to easily diagnose the extent of fracture and it was very sensitive for detecting sternal fracture.
Clavicle ; Diagnosis ; Emergency Service, Hospital ; Humans ; Multidetector Computed Tomography ; Reading ; Retrospective Studies ; Rib Fractures ; Ribs ; Scapula ; Spine ; Sternum ; Tomography, X-Ray Computed

Five cases of cerebral arteriovenous malformation(AVM) are presented, which underwent total extirpation using the operating microscope. The following are considerations which favor the total extirpation of AVM and the advantages of using the operating microscope, including the rationale for non-use of hypotensive anesthesia or mannitolization which is commonly used in intracranial aneurysm surgery: 1) Relatively small sized AVMs are found to show a high rate of large intracerebral hematoma, including that the degree of bleeding from the malformed vessels is not related to the size of the AVM. 2) The operating microscope facilitates the following procedures: a) determination of the extent of the malformed vessels. b) clipping feeders. c) identification of red vein and laminar flow. d) preservation of normal brain tissue.
Anesthesia ; Brain ; Hematoma ; Hemorrhage ; Intracranial Aneurysm ; Intracranial Arteriovenous Malformations* ; Mannitol ; Veins

The authors analyzed 174 consecutive shunting procedures for hydrocephalus at Severance Hospital, Yonsei University. There were a total of 65 complications (48.5%) among 134 patients. The most common complications were blockage of the catheters (26.2%) and shunt-related infections (15.4%). Among the different types of shunting technique ventriculoatrial, ventriculoperitoneal and ventriculocisternal routes were most commonly used. The ventriculoatrial route had a greater complication rate (40%) than ventriculoperitoneal shunting (21.8%). Flushing devices are critically reviewed and the disadvantages are discussed. The authors suggested a need for a standardized prospective national data collection system where Procedures and compilations may be assembled in a comparable form.
Bacterial Infections/etiology ; Catheterization/adverse effects ; Cerebrospinal Fluid Shunts*/adverse effects ; Female ; Human ; Hydrocephalus/surgery* ; Infant ; Male