PURPOSE: To evaluate the normal variations in the origin of the right gastric artery (RGA), as seen on abdominal angiogram. MATERIALS AND METHODS: Four hundred and twenty-six patients underwent celiac and superior mesenteric arteriogram, and in 154, the origin of the RGA was identified (M:F=116:38 ; mean age, 56 years ; range, 6-84 years). Digital subtraction angiography were performed in 101 patients, and conventional angiography in 53 ; we thus evaluated the origin of the RGA, normal variation of the hepatic artery, and the relationship between them. RESULTS: The origin of the RGA was the proper hepatic artery (PHA) in 43% of cases (n=67), the left hepaticartery (LHA) in 41% (n=63), the common hepatic artery (CHA) in 9% (n=14), the right hepatic artery (RHA) in 4% (n=6),and the gastroduodenal artery (GDA) in 3% (n=4). of these 154 patients, 126 (82%) showed a normal hepatic artery branching pattern, with both hepatic arteries arising from the PHA ; in 18 patients (12%), the RHA arose from the superior mesenteric artery (SMA), and in 6 patients (4%), the LHA arose from the left gastric artery (LGA). In 4 patients (3%), other branching patterns of the hepatic artery were noted. In 16 of 18 patients (89%) whose RHA arose from the SMA, the RGA originated in the LHA ; in the other two, the RGA arose from the GDA and CHA, respectively. CONCLUSION: In 43% of cases, the main site from which the RGA originated was the PHA, and in 41%, the LHA, as seen on abdominal angiogram. Where the RHA arose from the SMA, its most frequent site of origin, seen in 89% of cases, was the LHA. The exact recognition of the origin of the RGA, as seen on abdominal angiogram, could lead to a reduction of transarterial chemoembolization-related gastric complications.
Angiography ; Angiography, Digital Subtraction ; Arteries* ; Hepatic Artery ; Humans ; Mesenteric Artery, Superior

To study the possibility of attraction magnetic forces to expand maxillary arch, we used 2 big adult dogs, 2 small puppies, 1 small adult dog as experiments, and 1 small adult dog as a control. We measured the intercanine width and intermolar width and histologically observed in the suture and cervical and apex region of teeth and took occlusal X-rays to observe separation of suture line in the maxilla. The results were as follows: 1. Expansion velocities of intercanine (0.25mm/day) and intermolar widths (0.23mm/day) in puppies were faster than those (0.135mm/day, 0.09mm/day) in adults. 2. In all experiments in adults (0.135mm/day) and puppies (0.25mm/day), expansion velocity of intercanine widths were faster than those (0.09mm/day, 0.23mm/day) of intermolar width. 3. In all experiments ectatic changes were observed and cellularities of fibroblast increased in the suture line. Only in adults dogs the separations of palatal suture were observed in the occlusal X-ray view. 4. In the puppies bony deposition was particularly observed in the suture line and micro-bony fragments were often observed. 5. In the all experiments no root resorption was observed in the cervical and root area, but normal root resorption due to eruption of permanent teeth was observed in the puppies.
Adult ; Animals ; Dogs ; Fibroblasts ; Humans ; Maxilla ; Palatal Expansion Technique* ; Root Resorption ; Sutures ; Tooth

PURPOSE: To evaluate the postoperative changes occurring in the patellar tendon after reconstruction of the anterior cruciate ligament (ACL) using the central one-third of the patellar tendon together with patellar and tibial bony plugs. MATERIALS AND METHODS: Ten patients with ACL injury underwent sagittal and coronal T1-weighted MR imaging of both postoperative and normal knee joints. In all cases, reconstruction of the ACL was performed using the central one-third of the patellar tendon, together with patellar and tibial bony plugs. During the follow-up period of 6-27 months, patient were clinically stable. We compared the length, signal intensity and contour of both patellar tendons, as seen on MR images. RESULTS: No defects was found in harvested patellar tendons, and MR images showed high signal intensity within harvested tendons in six of the ten patients. In seven of ten, patellar tendons had irregular margins and were poorly delineated from adjacent tissue. The mean length of patellar tendons was 44.2+/-2.9 mm in normal knee and 43.9+/-3.1mm in postoperative knee, while their mean thickness in postoperative knee, measured at mid-portion, averaged 4.3+/-1.2 mm. There were no statistically significant differences (p>0.05). The greatest mean thickness of patellar tendon was 6.9+/-1.2 mm and 4.3+/-0.5mm in normal and postoperative knee, respectively. Thus, on average, postoperative patellar tendon was 161% thicker than normal tendon (p<0.05). CONCLUSION: In clinically stable patients, patellar tendons after graft harvesting had a higher signal intensity, worse-defined margins and a greater thickness than normal. We suggest that these are the normal postoperative findings.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Magnetic Resonance Imaging* ; Patellar Ligament* ; Tendons ; Transplants

BACKGROUND: International consensus guidelines have recently been developed to improve the assessment and management of asthma. One of the major recommendations of these guidelines is that asthma severity should be assessed through the recognition of key symptoms, such as nocturnal waking, medication requirements, and objective measurements of lung function. Differential classification of asthma severity would lead to major differences in both long term pharmacological management and the treatment of severe exacerbation. METHODS: This study examined the relationship between the symptom score and measurements of FEV1 and PEF when expressed as a percentage of predicted values in asthmatics(n=107). RESULTS: The correlation of FEV1% with PEFR% was highly significant(r=0.83, p<0.01). However, there was agreement in terms of the classification of asthma severity in 76.6% of the paired measurements of FEV1% and PEFR%. Agreement in the classification of asthma severity was also found in 57.1% of the paired analysis of FEV1% and symptom score. 39% of the patients classified as having moderate asthma on the basis of FEV1% recording would be considered to have severe asthma if symptom score alone were used. Low baseline FEV1 and high bronchial responsiveness were associated with a low degree of perception of airway obstruction. CONCLUSION: The relationships between the symptom score, PEFR and FEV1 were generally poor. When assessing asthma severity, age, duration, PC20, and baseline FEV should be considered.
Airway Obstruction ; Asthma* ; Classification ; Consensus ; Humans ; Lung ; Peak Expiratory Flow Rate

MRI findings of extramedullary hematopoiesis of the spleen have not been described in the literature. Wereport the MRI features of this condition, as seen in two patients and confirmed by fine needle biopsy. Threesmall masses(< or =3cm) were isointense on T1WI, hyperintense on T2WI, and enhanced after the injection of gadolinium.Two 6cm-sized masses were hypointense on both T1WI and T2WI, and showed no contrast enhancement.
Biopsy, Fine-Needle ; Hematopoiesis, Extramedullary* ; Humans ; Magnetic Resonance Imaging* ; Primary Myelofibrosis* ; Spleen*

PURPOSE: To determine by quantitative evaluation of pancreatic and adjacent vascular enhancement during spiral CT, the ideal scan delay for examination of the pancreas. MATERIALS AND METHODS: Dual (n=90) and triple (n=90) phase spiral CT scans of patients whose pancreas showed no pathologic condition were retrospectively evaluated. Dual-phase scans were performed at 43 seconds (early), and 5-6 minutes (delayed) after the injection of 120ml of contrast material at an injection rate of 3ml/sec ; triple-phase scans were performed at 25 seconds (arterial), 60-65 seconds (portal) and 5-6 minutes (delayed) after the injection of 120-140ml of contrast material at an injection rate of 2-4ml/sec, and ten patients also underwent precontrast scanning. CT attenuation values (HU) were measured in the head, body and tail of the pancreas, aorta, and main portal vein during each phase of all scans. Triple-phase protocol was used to measure the effect of different total volumes and injection rates on enhancement of the pancreas and adjacent vessels. RESULTS: There was no significant difference in the degree of enhancement of the pancreas head, body and tail during each phase (p>0.05). The pancreas was maximally enhanced on 43 second delayed scan (132+/-20 HU)(p<0.05), and the aorta, on 25-second delayed scan (269+/-74 HU), but there was no significant difference between this enhancement and that seen at 43 seconds(p>0.05). The main portal vein showed maximum enhancement on 43-second delayed scan (207+/-44 HU)(p<0.05). Different total volume of contrast material did not change the enhancement of the pancreas and adjacent vessels. At an injection rate of 2ml/sec, peak enhancement of the pancreas, aorta and portal vein was obtained on 60-65 second delayed scan, and at 4ml/sec, peak enhancement was obtained on 25 second delayed scan(p<0.05). CONCLUSION: Observing the usual protocols for abdominal spiral CT scanning, the pancreas was most effectively evaluated using a 43-second delayed scan. An increased injection rate resulted in earlier enhancement of the pancreas, aorta and portal vein.
Aorta ; Evaluation Studies as Topic* ; Head ; Humans ; Pancreas* ; Portal Vein ; Retrospective Studies ; Tomography, Spiral Computed*

PURPOSE: Drug-induced liver injury (DILI) is a serious issue often leading to discontinuation of the proper regimen of antituberculosis drugs (ATD). Previous studies have suggested that antioxidant enzymes play an important role in DILI. METHODS: We explored whether polymorphisms in superoxide dismutase genes, including Cu/Zn superoxide dismutase (SOD1), manganese superoxide dismutase (SOD2) and extracellular superoxide dismutase (SOD3) are associated with ATD-induced hepatitis. Genotype distributions of four single nucleotide polymorphisms (SNPs) in three genes (rs2070424, SOD1; rs4880, SOD2; rs2536512, and rs1799895, SOD3) were compared between 84 patients with ATD-induced hepatitis and 237 patients tolerant to ATD. RESULTS: Intron SNP rs2070424 of SOD1 showed a significant association with ATD-induced hepatitis. The frequency of genotypes carrying minor alleles (GA or GG) was significantly higher in the case group than that of controls (P=0.019, OR=2.26, 95% CI 1.14-4.49). For the other SNPs of SOD2 and SOD3, there were no differences in genotype frequencies between ATD-induced hepatitis and ATD-tolerant controls. CONCLUSIONS: These findings suggest that rs2070424 of SOD1 is significantly associated with ATD-induced hepatitis. This genetic variant may be a risk factor for ATD-induced hepatitis in individuals from Korea.
Alleles ; Drug-Induced Liver Injury* ; Genotype ; Hepatitis ; Humans ; Introns ; Korea ; Polymorphism, Single Nucleotide ; Risk Factors ; Superoxide Dismutase*

Tuberculous pericarditis is a rare form of tuberculosis usually presenting as pericardial effusion or constrictive pericarditis. But rarely it may present as pericardial mass. We experienced a case of tuberculous pericarditis presenting as pericardial mass which was confirmed by open thoracotomy. The patient was 34-year-old female, who was previously treated for tuberculous pleurisy. She admitted for dyspnea on exertion and imaging study including chest CT and echocardiography showed pericardial mass. Open thoracotomy showed hard adhesive mass lesion around pulmonary artery and pathology showed chronic granulomatous inflammation with caseation necrosis. We report a rare case of tuberculous pericarditis presenting as pericardial mass.
Adhesives ; Adult ; Dyspnea ; Echocardiography ; Female ; Humans ; Inflammation ; Necrosis ; Pathology ; Pericardial Effusion ; Pericarditis, Constrictive ; Pericarditis, Tuberculous* ; Pulmonary Artery* ; Thoracotomy ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pleural

Tuberculous pericarditis is a rare form of tuberculosis usually presenting as pericardial effusion or constrictive pericarditis. But rarely it may present as pericardial mass. We experienced a case of tuberculous pericarditis presenting as pericardial mass which was confirmed by open thoracotomy. The patient was 34-year-old female, who was previously treated for tuberculous pleurisy. She admitted for dyspnea on exertion and imaging study including chest CT and echocardiography showed pericardial mass. Open thoracotomy showed hard adhesive mass lesion around pulmonary artery and pathology showed chronic granulomatous inflammation with caseation necrosis. We report a rare case of tuberculous pericarditis presenting as pericardial mass.
Adhesives ; Adult ; Dyspnea ; Echocardiography ; Female ; Humans ; Inflammation ; Necrosis ; Pathology ; Pericardial Effusion ; Pericarditis, Constrictive ; Pericarditis, Tuberculous* ; Pulmonary Artery* ; Thoracotomy ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pleural

BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is an operator-dependent procedure and has significant procedure-related morbidity and mortality. Magnetic resonance cholangiopancreatography (MRCP) is a safe noninvasive method for pancreatobiliary imaging. The aims of this study were to evaluate the potential impact of MRCP on performing ERCP and to evaluate the decision-making value of MRCP in patients suspicious for pancreatobiliary diseases. METHODS: Two hundreds twelve patients (M:F 108:104, mean age 59.3+/-13.7) who underwent MRCP due to clinical or sonographic suggesting pancreatobiliary disease were included. We divided patients into four groups according to their presumptive diagnosis: biliary stone (group 1), biliary tumor (group 2), gallstone pancreatitis (group 3) and other biliary diseases (group 4). RESULTS: Numbers of cases in group 1, 2, 3 and 4 were 145, 43, 17 and 7, respectively. In 144 cases (67.9%), ERCP was unnecessary and 76 cases (35.8%) required neither ERCP nor any other treatment. Thereafter, these cases were thought to be a patient group in whom the workload of performing ERCP could be reduced. CONCLUSIONS: MRCP can reduce the number and efforts doing ERCP and is helpful in decision-making for the treatment of pancreatobiliary disease. Therefore, MRCP could be the primary diagnostic tool before choosing ERCP.
Aged ; Biliary Tract Diseases/*diagnosis ; Cholangiopancreatography, Endoscopic Retrograde ; *Cholangiopancreatography, Magnetic Resonance ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Diseases/*diagnosis