Percutaneous biopsy is the most frequent interventional radiographic procedure. Its increased use is relatedto new imaging techniques facilitating needle placement, greater safety of fine needle and advances in cytology.CT because of its characteristic high spatial and density resolution, permits the accurate localization of anylesion in the body. Because of the ability of CT scans to precisely localize lesions and biopsy needle, along withthe delineation of adjacent structure, it is widely used in percutaneous biopsy. Sixty-six cases of CT-guidedpercutaneous fine-needle biopsy were performed in order to diagnose suspected malignant or infectious disease(49malignant and 17 infectious) over a 7-month period(June 1984 through Dec. 1984). Most of these procedures wereperformed on, but not limited to, the lung(21), liver(20), and pancreas(7). The spine and nasopharynx could alsosafely be biopsied. 4 cases of hepatic abscesses were successfully drained following insertion of drainingcatheter under the CT-guidance. The overall accuracy of both suspected malignant and infectious disease was 82%.Complication rate was low as 6%(4 cases only in thorax). Neither complication require any further intervention.Three were self-limited pneumothoraces and one was minimal hemorrhage around the needle tract.
Biopsy ; Biopsy, Fine-Needle ; Communicable Diseases ; Hemorrhage ; Liver Abscess ; Nasopharynx ; Needles ; Spine ; Tomography, X-Ray Computed

The Ewing's sarcoma comprises approximately less than 10 percent of malignant bone tumors and 5 percent of allbone tumors, occures in almost all bones of the body, and presents a widely divergent roentgenographicmanifestations. The tarsal bones are involved only 2 percent in the Ewing's sarcoma. Two cases experienced byauthors and ten cases published in literatures of Ewing's sarcoma of the tarsal bone were analizedretrospectively. The result were as follows; 1. Of tarsal bones, the calcaneus was 7 cases, the talus 4 cases,cuneiform 1 case. 2. Female was affected more commonly than male, the ratio being 4 to 1 in the tarsal bones. 3.About sixty percent of total case in the tarsal bones had evidence of diffuse sclerotic pattern. All the cases ofthe talus had evidence of diffuse sclerotic pattern. 4. The diseases to be considered in differential diagnosisare as follows: avascular necrosis, tuberculous osteomyelitis, osteosarcoma, and pyogenic osteomyelitis. 5. Thediffuse sclerosis radiographically showed a close relation with dead bone resulting from avascular necrosis due totumor infiltration histologically. Periosteal reactive new bone and osteoid deposition on the dead bone were alsocorrelated with diffuse sclerosis. 6. Because it is difficult to differentiate sclerotic lesions in the tarsalbones by radiographic methods alone, all such lesions should be subject to biopsy as early as possible.
Biopsy ; Calcaneus ; Female ; Humans ; Male ; Necrosis ; Osteomyelitis ; Osteosarcoma ; Sarcoma, Ewing ; Sclerosis ; Talus ; Tarsal Bones

Biliary endoprosthesis could provide permanent internal biliary drainage inpatient with obstructive jaundicewith advantages of absence of troublesome external catheter and no loss of fluid, bile and electrolytes overexternal drainage. Incidence of sepsis and cholangitis may be lowered. Endoprosthesis was performed in 18 patientsof obstructive jaundice from January, 1985 to december, 1985 at Department of Radilogy, Kyungpook NationalUniversity Hospital. The results are as follows: 1. The cases of obstructive jaundice included bile duct cancer in11, stomach ca. metastasis in 3, ca. of ampulla of Vater in 1, ca. of head of pancresas in 1, CBD cancer withpostop. recurrenced in 1, and impacted CBD stone in 1 case. 2. The levels of obstruction were at the trifurcationin 8, CHD in 5, proximal CBD in 3, and distal CBD in 2 cases. 3. Decline of serum bilirubin level was noted in 15cases with the most rapid decline wihtin 1 week after the procedure. 4. The complication occurred in 5 cases. Thethree cases were recovered spontaneously, but one died of bile peritonitis, another experienced obstrution ofendoprosthesis. 5. The endoprosthesis is benificial intreatment of obstructive jaundice for which surgery is notindicated, and saving expensive abdominal surgery and less advantageous percutaneous external drainage, henceenhancing life quality.
Ampulla of Vater ; Bile ; Bile Duct Neoplasms ; Bilirubin ; Catheters ; Cholangitis ; Drainage ; Electrolytes ; Gyeongsangbuk-do ; Head ; Humans ; Incidence ; Inpatients ; Jaundice, Obstructive ; Neoplasm Metastasis ; Peritonitis ; Quality of Life ; Sepsis ; Stomach

Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 μg/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 μg/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 μg/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 μg/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

Diagnosis of knee jont pathology has been mainly dependent on clinical manifestations and invasive proceduressuch as arthrography and arthroscopy etc. However, these procedures are invasive. Arthroscopy is perfromed undergeneral anesthesia. Recently, with development of high resuloution CT with thin slices and multiplanarreconstructions capability, CT could be used to verify the internal structures of knee joint in noninvasive orless invasive way. From June ot December 1985, authors have experienced 19 cases of the knee joint CT. Among them,13 cases were operated and confirmed. We concluded as follows. 1. The diagnostic accuracy of the knee CT was 100%in lateral meniscal tearing, 92.3% in medial meniscal tearing, 92.3% in detachment of lateral collateral ligament,92.3% in medial collateral ligament, 100% in tearing of cruciate ligaments. 2. CT could be considered as a primarydiagnostic procedure in the knee pathology rather than more invasive arthrocopy or arthrography. 3. For theaccurate diagnosis of knee joint pathology, CT which can obtain thin slies, high resolution, multiplanarreconstructions is indispensable.
Anesthesia ; Arthrography ; Arthroscopy ; Collateral Ligaments ; Diagnosis ; Knee Joint ; Knee ; Ligaments ; Pathology ; Tears

PURPOSE: The purpose of this study was to analyze the radiologic findings of primary epiploic appendagitis, with particular attention to the correlation of ultrasonographic, clinical, CT, MR and surgical findings. MATERIALS AND METHODS: Among 14 patients with primary epiploic appendagitis who presented with the rapid onset of a very localized pain and tenderness, we performed ultrasonography in all, CT in eight, and MRI in four of these eight. Surgery was performed in two patients. Follow-up examinations were performed using US, CT and MRI (n=2), US and CT (n=2), US alone (n=2), and with regard to clinical features (n=12). RESULTS: US performed in 14 patients revealed the presence in all of small, well-defined, ovoid, noncompressible hyperechoic (n=12) or isoechoic (n=2) solid masses attached to the colonic wall, without bowel wall change and without communication with bowel lumen. CT performed in 8 patients showed varying hyperattenuating fatty lesions in the same location in the abdomen, without other inflammatory process. MRI findings of four patients were helpful for further evaluation of internal architecture. CONCLUSION: In primary epiploic appendagitis, US findings were sufficiently characteristic to allow accurate diagnosis and valuable for the differential diagnosis of other acute conditions of the abdomen.
Abdomen ; Colon ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

Myotubular or centronuclear myopathy(MTM) is a rare congenital myopathy, which is characterized by predominance and atrophy of type 1 fibers and centrally located nuclei in muscle pathology. The clinical features and severity are quite variable. MTM is classified as three forms according to the inheritance pattern : autosomal dominant, autosomal recessive and X-linked recessive. The authors present familial myotubular myopathy, suggestive of X linked, occurred in a sibling with intrafamilial clinical variability.
Atrophy ; Humans ; Inheritance Patterns ; Muscular Diseases ; Myopathies, Structural, Congenital* ; Pathology ; Siblings*