PURPOSE: A study was performed to compare the detectability of extrahepatic duct stones between nonenhanced and enhanced computed tomography(CT). MATERIALS AND METHODS: Consecutive 30 patients with extrahepatic duct stones were analyzed with special attention to the detectability of stones between nonenhanced and enhanced CT. The extrahepatic duct was further divided into two segments, one above(suprapancereatic) and the other in(intrapancreatic) the head of the pancreas. Conspicuity of the stone was graded as "visible", "suspicious", and "invisible". Three radiologists reviewed the CT images without prior information and determined the location of stone and grade of their conspicuity. RESULTS: The stones were located at the suprapancreatic common duct in 5 patients, intrapancreatic common duct, in 15 patients and both portion of the duct in 10 patients. There was no difference in the detection rate of stones between the two images at suprapancreatic common duct, and was 93%, However, the rate at intrapancreatic common duct was 95% and 64% on nonenhanced and enhanced CT scans, respectively. The overall detection rate was 95% on nonenhance CT and 75% on enhanced CT. CONCLUSION: We concluded that nonenhanced CT was prerequisite to evaluate the extrahepatic duct stones in addition to enhanced CT.
Head ; Humans ; Pancreas ; Tomography, X-Ray Computed

We investigated the question of whether 7-oxygenated cholesterol derivatives could affect inflammatory and/or immune responses in atherosclerosis by examining their effects on expression of IL-23 in monocytic cells. 7alpha-Hydroxycholesterol (7alphaOHChol) induced transcription of the TLR6 gene and elevated the level of cell surface TLR6 protein in THP-1 monocytic cells. Addition of an agonist of TLR6, FSL-1, to TLR6-expressing cells by treatment with 7alphaOHChol resulted in enhanced production of IL-23 and transcription of genes encoding the IL-23 subunit alpha (p19) and the IL-12 subunit beta (p40). However, treatment with 7-ketocholesterol (7K) and 7beta-hydroxycholesterol (7betaOHChol) did not affect TLR6 expression, and addition of FSL-1 to cells treated with either 7K or 7betaOHChol did not influence transcription of the genes. Pharmacological inhibition of ERK, Akt, or PI3K resulted in attenuated transcription of TLR6 induced by 7alphaOHChol as well as secretion of IL-23 enhanced by 7alphaOHChol plus FSL-1. Inhibition of p38 MAPK or JNK resulted in attenuated secretion of IL-23. These results indicate that a certain type of 7-oxygenated cholesterol like 7alphaOHChol can elicit TLR6-mediated expression of IL-23 by monocytic cells via PI3K/Akt and MAPKs pathways.
Atherosclerosis ; Cholesterol ; Interleukin-12 ; Interleukin-23* ; Macrophages ; p38 Mitogen-Activated Protein Kinases ; Toll-Like Receptor 6

OBJECTIVES: The objective of this study is to clarify the family environments, parent-adolescent communication, family violence, parental conflict, parental alcohol drinking that contribute to internet use of adolescent. METHODS : Subjects were middle and high school students in Gang-seo gu, Seoul city (N=998). Self-rating questionnaire included demographic data, internet addiction scale, family adaptability cohesion evaluation scale III, parent-adolescent communication inventory, conflict tactics scales 2 and children of alcoholics screening test. RESULTS : 1) There were statistically significant differences in CAST, family violence, communication between family members and family adaptability cohesion scale between addicted group and non-addicted group. 2) Most significantly correlated variants for internet addiction were problematic communication of parents and psychological aggression. 3) Multiple regression analysis showed that problematic communication of parents, psychological aggression and CAST could explain 10.1% of internet addictions. CONCLUSION : This study was designed specifically to focus on the various domains of adolescents' family environment that may influence the overuse of internet. It proved that moderate level of adaptability, cohesion and open communication in a parentchild relationship can prevent the overuse of internet. On the other hand, aggressive language spoken between the two parents and their alcohol abuse can aggravate the overuse of internet.
Adolescent* ; Aggression ; Alcohol Drinking ; Alcoholics ; Alcoholism ; Child ; Domestic Violence ; Family Conflict ; Hand ; Humans ; Internet* ; Mass Screening ; Parents ; Surveys and Questionnaires ; Seoul ; Weights and Measures

Multiple primary tumors are defined as cases involving primary malignant tumors of different histologic origins in one person. Recently, the number of reports dealing with multiple primary tumors has been increasing due to more developed diagnostic procedures and patients with longer survival rates. Both the occurrence of multiple primary tumors and the primary adenocarcinoma of the duodenum are infrequent, accounting for less than 1% of all carcinoma of the gastrointestinal tract. Also, It has been reported that duodenal bulb cancer combined with early gastric cancer is extremely rare. One case was experienced involving duodenal bulb cancer combined with early gastric carcinoma, and is herein reported with a review of related literatures.
Adenocarcinoma* ; Duodenum ; Gastrointestinal Tract ; Humans ; Stomach ; Stomach Neoplasms* ; Survival Rate

PURPOSE: The usefulness of fast spin-echo MR imaging for the diagnosis of meniscal tear of the knee is amatter of debate. The purpose of this study was to evaluate the accuracy of diagnosis of meniscal tears by fastspin-echo MR imaging and the role of gadolinium enhancement. MATERIALS AND METHODS: Between October 1994 andDecember 1996, 68 consecutive patients with arthroscopically proven meniscal tears participated in this study. AllMR examinations performed on a 1.5-T MR imager with an extremity knee coil. All patients underwent sagittal andcoronal MR imaging, using a fast spin-echo sequence with echo train length(ETL) 8. Sagittal and coronal fatsuppressed T1-weighted MR images were obtained after gadolinium infusion. RESULTS: In 68 cases ofarthroscopically-proven meniscal tears, MR sensitivity to tear was 93% (63/68) for fast spin-echo alone and 96%(65/68) for combined fast spin-echo and fat-suppressed gadolinium enhanced T1-weighted MR images. MR sensitivityto medial meniscus tear was 98% (40/41) for fast spin-echo alone and 98% (40/41) for combined fast spin-echo andfat-suppressed gadolinum-enhanced T1-weighted MR images. MR sensitivity to lateral meniscus tear was 85% (23/27)for fast spin-echo alone and 93% (25/27) for combined fast spin-echo and fat-suppressed gadolinium-enhancedT1-weighted MR images. CONCLUSION: Fast spin-echo MR imaging with adequate imaging parameters is suitable for thediagnosis of meniscal tears, and additional fat-suppressed gadolinium-enhanced T1-weighted MR imaging may increasediagnostic sensitivity to such tears.
Diagnosis* ; Extremities ; Gadolinium ; Humans ; Knee* ; Magnetic Resonance Imaging* ; Menisci, Tibial

PURPOSE: This study aimed to evaluate the relationships between 99mTecnicium-dimercaptosuccinic acid (DMSA) scan findings and clinical parameters including age and fever duration. METHODS: The positive rates for abnormal DMSA scans were analyzed according to the age of patients, fever duration prior to admission, and total fever duration. DMSA scan findings were divided into 3 categories: single defect, multifocal defects, and discrepant defects. We evaluated the detection rates of vesicoureteral reflux according to DMSA scan lesions. RESULTS: Among a total 320 cases, 141 (44.1%) had abnormal DMSA scans. The infant group (0-1 year of age) had a shorter total fever duration, and a lower C-reactive protein (CRP) value and DMSA positive rate (39.8% vs. 60.6%, P=0.002) compared to children group (2-15 years of age). Patients with abnormal scans had a longer total fever duration and higher CRP compared to those with normal scans. The positivity rate of abnormal scans did not differ between the patients with a short fever duration prior to admission of ≤2 days and those with longer fever duration of ≥3 days. However, patients with longer total fever duration had a higher rate of abnormal DMSA scans (P=0.02). Among cases with a single defect, multifocal defects, and discrepant defects, vesicoureteral reflux was observed in 22.4%, 60% and 70.6% of cases, respectively (P=0.004). CONCLUSION: Although DMSA scan has limitations in early diagnosis, DMSA scan findings may aid in the prediction of the severity of systemic inflammation and detection of vesicoureteral reflux.
C-Reactive Protein ; Child ; Early Diagnosis ; Fever ; Humans ; Infant ; Inflammation ; Pyelonephritis* ; Succimer* ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: This study aimed to evaluate the relationships between 99mTecnicium-dimercaptosuccinic acid (DMSA) scan findings and clinical parameters including age and fever duration. METHODS: The positive rates for abnormal DMSA scans were analyzed according to the age of patients, fever duration prior to admission, and total fever duration. DMSA scan findings were divided into 3 categories: single defect, multifocal defects, and discrepant defects. We evaluated the detection rates of vesicoureteral reflux according to DMSA scan lesions. RESULTS: Among a total 320 cases, 141 (44.1%) had abnormal DMSA scans. The infant group (0-1 year of age) had a shorter total fever duration, and a lower C-reactive protein (CRP) value and DMSA positive rate (39.8% vs. 60.6%, P=0.002) compared to children group (2-15 years of age). Patients with abnormal scans had a longer total fever duration and higher CRP compared to those with normal scans. The positivity rate of abnormal scans did not differ between the patients with a short fever duration prior to admission of ≤2 days and those with longer fever duration of ≥3 days. However, patients with longer total fever duration had a higher rate of abnormal DMSA scans (P=0.02). Among cases with a single defect, multifocal defects, and discrepant defects, vesicoureteral reflux was observed in 22.4%, 60% and 70.6% of cases, respectively (P=0.004). CONCLUSION: Although DMSA scan has limitations in early diagnosis, DMSA scan findings may aid in the prediction of the severity of systemic inflammation and detection of vesicoureteral reflux.
C-Reactive Protein ; Child ; Early Diagnosis ; Fever ; Humans ; Infant ; Inflammation ; Pyelonephritis* ; Succimer* ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients. METHODS: Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204). RESULTS: The mean fever duration was 6.6±2.3 days, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other. CONCLUSION: The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.
C-Reactive Protein ; Coronary Vessels ; Diagnosis ; Early Diagnosis* ; Fever ; Humans ; Inflammation ; Lymphocytes ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils

Central catheterization for temporary vascular access in hemodialysis patients may cause serious catheter-related infection such as bacteremia, osteomyelitis, and septic shock. We here report a case of unusual complication of catheter-related infection in a hemodialysis patient with internal jugular catheter. A 44-year old man was admitted due to intermittent fever and right chest discomfort. Five weeks ago, right internal jugular catheter was inserted for hemodialysis. Three weeks ago, He stopped hemodialysis treatment and exit site skin care of the catheter by himself. Chest X-ray showed massive right pleural effusion. But the catherter was normally positioned in superior vena cava. Both blood and pleural fluid cultures demonstrated Staphylococcus aureus. After prompt removal of the catheter and drainage of the pleural fluid, and adequate antibiotic treatment, catheter-related bacteremia and pleural effusion improved.
Male ; Humans

Direct approach of technically difficult or inoperable intracranial aneurysms many become possible using complete circulatory arrest with extracorporeal circulation and profound hypothermia and barbiturate cerebral protection. To avoid difficulties associated with closed chest method, open chest method was used by direct cannulation of the right atrium and aorta through the chest. 3 patients with posterior circulation aneurysms operated on with these techniques;1 large basilar bifurcation aneurysm and 1 irregular shaped vertebro-basilar junction aneurysm and 1 posterior cerebral artery aneurysm were operated on and all had excellent results. Careful attention was needed to the depth of hypothermia, duration of total circulatory arrest, and hemostasis which important factors in the success of these methods.
Aneurysm* ; Aorta ; Catheterization ; Extracorporeal Circulation ; Heart Atria ; Hemostasis ; Humans ; Hypothermia* ; Intracranial Aneurysm ; Thorax