Percutaneous transhepatic cholangiography(PTC) is of value in differential diagnosis of cholestatic diseases. Authors had performed PTC in 120 patients with flexible needle of 23 gauge at the Department of Radiology, KangNam St, Mary's Hospital and Myung Dong St. Mary's Hospital during the period from Jan. 1976 to April 1980. PTC was accomplished successfully in 112 of 120 patients. Diagnoses included cholangiocarcinomas (27 cases), arcinomas ofpancreas head (21 cases), ampullary carcinomas (4 cases), metastatic carcinomas(4 cases), metastatic carcinomas (5cases), bile duct stones(27 cases), sclerosing cholangitis(6 cases), hepatitis(6 cases), liver cirrhosis(6 cases), post operative adhesions(5 cases), chronic pancreatitis(3 cases), stomach carcinomas(3 cases), clonorchiasis(2cases), blood clot (1 case), and remaining normal 4 cases. Some characteristic PTC findings were (1) segmentalannular narrowing and abrupt complete obstruction and polypoid filling defects of the bile duct incholangiocarcinoma, (2) typical nipple or rat-tail appearance of the distal commmon bile duct in pancreatic headcarcinoma, (3) single or multiple sharply and smoothly outlined filling defects whthin bile duct in all cases ofstones, (4) complete obstruction with shallow concavity in ampullary carcinoma, (5) diffuse or segmental narrowingof the intrahepatic bile duct and common bile duct in sclerosing cholangitis, (6) multiple tiny polypoid fillingdefects of gallbladder, common hepatic duct, and common bile duct in clonorchiasis, (7) normal appearance inhepatitis. The overall diagnostic accuracy of PTC in 66 operated cases was 89.4%, and complications following the examination were signficantly reduced by using a fine flexible needle(23 gauge). From the present study it is concluded as follows; 1. To evaluate obstructed or stenosed site accurately, aspiration of bile juice must bepreceded by a 23 gauge needle connected to either 10mo or 5ml syringe. 2. To diagose carcinoma of hte ampullaryportion, serial spot filmings were indispensible ot demonstrated modified appearance of obstructive lesions due tocontraction of Oddi sphincter. 3. In contrast to other reports, the most common site of cholangiocarcinomas wasthe common hepatic duct (12 of 27 cases) in our series. Rat-tail appearance was seen in both pancreatic headcarcinoma and carcinoma involving the distal end of the common bile duct. 4. PTC was a more valuable method for diagnosis of clonorchiasis.
Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangiography ; Cholangitis, Sclerosing ; Clonorchiasis ; Common Bile Duct ; Diagnosis ; Diagnosis, Differential ; Gallbladder ; Head ; Hepatic Duct, Common ; Humans ; Liver ; Methods ; Needles ; Nipples ; Sphincter of Oddi ; Stomach ; Syringes

The diagnostic importance of finding an appendicolith in the plain x-ray of the abdomen has been well documented. However, most of the papers so far published have stressed x-ray findings of the preoperative abdomenin acute appendicitis. In the present study we have attempted to correlate incidences of appendicoliths insurgical specimen and plain x-ray of the abdomen. The materials were 37 surgical specimens of the appendix removed for acute appendicits at St. Mary's Hospital, St. Paul's Hospital, Kang Nam Hospital, Holy Family Hospital and Our Lady of Mercy Hospital of Catholic Medical College during the period of 6 months from August 1980. Each surgical specimen was subjected to soft tissue radiography to detect calcified appendicolith. Then the preoperative x-raysof abdomen were retrospectroscopically analysed for the presence of radiographically demonstrable appendicoliths.Our study revealed that in as many as 32% of 37 surgical specimens one or more calcified appendicoliths were demonstrated radiographically whereas only one of these was identified as such in the preoperative x-ray film ofthe abdomen. Such a great discrepancy between the incidences of appendicoliths in the surgical specimen andpreoperative x-ray films of the abdomen are ascribed to (1) relative smallness of appendicoliths (87% of the stones measured less than 1cm in diameter in radiographs of surgical specimen in our series), (2) overlapping of these small stones on the right iliac bone and (3) underpenetrating of the iliac bone area in x-ray films of theabdomen. For improving detctability of appendicoliths therefore it is recommended that the technique of radiography of plain abdomen should be such that a small appendicolity overlying the iliac bone can be brought outof trabecular shadows.
Abdomen ; Appendicitis ; Appendix ; Humans ; Incidence ; Radiography ; X-Ray Film

PURPOSE: The aim of this study was to determine the role of the CT scan in blunt hepatic injury and the significance of CT degree of hepatic injury in the decision making of treatment plan. MATERIALS AND METHODS: We retrospectively analysed the CT findings of 22 patients with hepatic injury. We graded hepatic injury on CT scan into five according to the severity. Clinical records, type of management and clinical outcome of the patients were also reviewed. RESULTS: Of the 22 patients, 17 had conservative treatment and five had surgery. The numbers of patients treated conservatively were 0, 4, 11, 2 and 0 in the grade 1, 2, 3, 4 and 5, respectively and the numbers of surgically treated cases were 0, 0, 3, 2 and 0 respectively. There was no significant statistical difference between surgically and conservatively treated groups(p-value > 0.05). All patients with conservatively treated group were hemodynamically stable and had no complication during hospitalization. Hemoperitoneum was observed in 11 of 22 patients. CONCLUSION: In blunt hepatic injury, CT plays an important role in the demonstration of location and extent of the hepatic injury, size of hemoperitoneum and the post operative course. However, we believe that physiologic status of the patients may be more important than the extent of CT based hepatic injury for determining a mode of treatment.
Decision Making ; Hemoperitoneum ; Hospitalization ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.

OBJECTIVE: Cadaver's sectioned images with high resolution and real color could be used as the source of realistic three-dimensional images. If the sectioned images are registered to a patient's MRIs, three-dimensional images with high resolution and real color that fit the patient, can be produced; the three-dimensional images enable realistic virtual surgery for the patient. The objective of this study was to verify the registration of a cadaver's sectioned images to a patient's head MRIs. METHODS: The sectioned images of the heads of cadaver were associated with segmented images selected at 3 mm intervals. The patient had his head MR scanned at 3 mm intervals; the MRIs were segmented. Software to register the cadaver's sectioned images to the patient's MRIs was developed. On this software, the corresponding dots were identified on both the sectioned images and the MRIs either manually or automatically using segmented images. RESULTS: The registered sectioned images corresponded to the patient's MRIs. Both manual and automatic registrations were satisfied. CONCLUSION: Further study is needed for registering sectioned images to actual patients.
Cadaver ; Head ; Humans ; Imaging, Three-Dimensional

OBJECTIVE: After drawing and stacking contour of structures, which are identifed in the serially sectioned images, three-dimensional (3D) images can be made by surface reconstruction. The 3D images can be selected and rotated in a real time. The purpose of this research is to compose software of automatic surface reconstruction for making 3D images. METHODS: Contours of 55 structures in the 613 magnetic resonance images of whole body were drawn to make segmented images. We composed automatic software for stacking contours of a structure, for converting the contours into polygons, and for connecting vertices of the neighboring polygons to fill gaps between polygons with triangular surfaces. The surface reconstruction software was excuted to make 3D images of 55 structures. RESULTS: Virtual dissection software, on which 3D images could be selected and rotated, was composed. CONCLUSION: For other research, this like program can be composed for automatic surface reconstruction; several kinds of commercial software can be used for manual or automatic surface reconstruction. Investigators might choose one of the methods in consideration of their only circumstances.
Humans ; Imaging, Three-Dimensional ; Research Personnel

BACKGROUND AND OBJECTIVES: External ear resonance (EER) can normally increase the sound pressure level at the tympanic membrane by as much as 20 dB at the frequency between 2 and 4 kHz. Perforation of tympanic membrane (TMP) may alter the resonance characteristics. Surgical modifications of the external auditory canal by tympanoplasty may also change the EER features. We aimed to analyze the EER of patients with the TMP before and after surgery. MATERIALS AND MEHTOD: This study comprised of 130 patients (135 ears) with chronic otitis media. We checked EERs before and after the surgery. The preoperative group was divided into two groups according to perforation size. Postoperatively, the EER was checked at 3, 6, 9, 12 months or after 15 months. We compared these data with the control group which comprised of 96 adult ears. RESULTS: In the preoperative group, the peak resonant gain and the frequency were not different from the control's and the peculiar negative peaks appeared around 1500 Hz in half of the cases. No significant differences were found in the first peak gains according to the perforation size. The negative peaks appeared deeper in the larger perforation group. After tympanoplasty, the gain markedly increased. As time passed, the gain tended to decrease, but did not equalize with the control's data. CONCLUSION: Additional gain should be considered in the frequency of around 1 kHz for hearing aid users with the TMP. We could expect alterations of EER after tympanoplasty, suggesting that these changes should be considered at the time of fitting hearing aids.
Adult ; Ear ; Ear Canal ; Ear, External* ; Hearing Aids ; Humans ; Otitis Media* ; Otitis* ; Thymidine Monophosphate ; Tympanic Membrane ; Tympanic Membrane Perforation ; Tympanoplasty

We compared the production of three chemokines; interferon-gamma-inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1) and growth-related onco-gene-alpha(Gro-alpha) that attracts monocytes or neutrophils, or both, in peripheral blood at acute stage of Kawasaki disease (n=29), Henoch-Schonlein purpura (n=15) and acute febrile illnesses (n=12). The production of the chemokines was assayed by ELISA. The plasma levels of IP-10 were markedly elevated in Kawasaki disease (538.6 +/-336.4 pg/mL) and acute febrile illnesses (417.1 +/-262.2 pg/mL) compared with in Henoch-Schonlein purpura (58.7 +/-95.7 pg/mL) (p<0.05). The MCP-1 levels were elevated in Kawasaki disease (443.0 +/-473.1 pg/mL) and acute febrile illnesses (328.6 +/-261.1 pg/mL) compared with in Henoch-Schonlein purpura (82.9 +/-79.0 pg/mL) (p<0.05). The Gro- levels were elevated only in acute febrile illnesses (134.3 +/-153.6 pg/mL) compared with in Kawasaki disease (31.8 +/-22.1 pg/mL) or Henoch-Schonlein purpura (29.4 +/-53.3 pg/mL) (p<0.05). According to these results, monocytes may play an important role in Kawasaki disease. In acute febrile illness-es, both monocytes and neutrophils may play an important role. By contrast, Henoch-Schonlein purpura may not be associated with the role of monocytes and neutrophils. Further studies using a larger number of cases are needed.
Acute Disease ; Adolescent ; Chemokines/*blood ; Child ; Child, Preschool ; Comparative Study ; Female ; Fever/*blood/*epidemiology ; Humans ; Infant, Newborn ; Korea/epidemiology ; Male ; Mucocutaneous Lymph Node Syndrome/*blood/*epidemiology ; Purpura, Schoenlein-Henoch/*blood/*epidemiology ; Research Support, Non-U.S. Gov't ; Risk Assessment/methods ; Risk Factors

Authors had prepared the high-quality sectioned images of a cadaver head. For the delineation of each cerebral gyrus, three-dimensional model of the same brain was required. The purpose of this study was to develop the segmentation protocol of cerebral gyri by referring to the three-dimensional model on the personal computer. From the 114 sectioned images (intervals, 1 mm), a cerebral hemisphere was outlined. On MRIcro software, sectioned images including only the cerebral hemisphere were volume reconstructed. The volume model was rotated to capture the lateral, medial, superior, and inferior views of the cerebral hemisphere. On these four views, areas of 33 cerebral gyri were painted with colors. Derived from the painted views, the cerebral gyri in sectioned images were identified and outlined on the Photoshop to prepare segmented images. The segmented images were used for production of volume and surface models of the selected gyri. The segmentation method developed in this research is expected to be applied to other types of images, such as MRIs. Our results of the sectioned and segmented images of the cadaver brain, acquired in the present study, are hopefully utilized for medical learning tools of neuroanatomy.
Aged ; Cerebrum/*anatomy & histology ; Humans ; Imaging, Three-Dimensional ; Male ; *Models, Anatomic ; Software

BACKGROUND AND OBJECTIVES: The vestibuloautonomic reflex controls respiration and blood pressure during locomotion. The purpose of this study was to investigate the role of the peripheral vestibular receptor in the control of blood pressure in sinoaortic denervated (SAD) rats. MATERIALS AND METHODS: The baroreceptor reflex was removed by SAD in labyrinthectomized rats. The expression of c-Fos protein in the vestibular nuclear complex, and other nuclei related to control of blood pressure, was measured following the induction of acute hypotension using sodium nitroprusside (SNP). RESULTS: The SNP induced acute hypotension, in intact labyrinthine rats, increased the expression of c-Fos protein in the supraoptic nucleus, paraventricular nucleus, rostral ventrolateral medulla, solitary nucleus, and vestibular nuclear complex. The expression of c-Fos protein, following the SNP induced acute hypotension in the SAD rats, increased the expression of c-Fos protein in the paraventricular nucleus, rostral ventrolateral medulla, and medial and inferior vestibular nuclei. The acute hypotension induced by SNP in a unilateral labyrinthectomy, with SAD, increased the expression of c-Fos protein in the contralesional vestibular nuclear complex, but decreased its expression in the ipsilesional vestibular nuclear complex. The acute hypotension induced by SNP in a bilateral labyrinthectomy, with SAD, showed only slight expression of c-Fos protein in the bilateral vestibular nuclear complex. CONCLUSION: These results suggest that the acute hypotension induced by SNP activates the vestibular nuclear neurons by decreasing the blood flow in the peripheral vestibular receptors, and that these in turn modulate blood pressure through activation of the catecholaminergic nervous system and neuroendocrine reflex.
Animals ; Baroreflex ; Blood Pressure* ; Hypotension ; Locomotion ; Nervous System ; Neurons ; Nitroprusside ; Paraventricular Hypothalamic Nucleus ; Pressoreceptors ; Rats* ; Reflex ; Respiration ; Solitary Nucleus ; Supraoptic Nucleus ; Vestibular Nuclei