The aim of investigation is to calculate the mean value of the acetabular anteversion of normal Korean adult after closure of growth according to different gender and sex age group, to find out any significant difference of the value of acetabular anteversion to some other variables such as age, height, weight and radiographic inclination(abduction angle) of acetabulum. Transverse pelvic computed tomography(CT) scans of 360 right hips with no known pathology were examined. The study population consisted of 12 groups by gender (male and female) and age(from third to eighth decade). The number of each group was thirty. The scanning slice nearest the middle region of the acetabulum (nearest through the center of the femoral head) on the scout film was chosen. A measuring point was assigned at the anterior edge of the acetabulum and second at the posterior edge. The line connecting these points was drawn. The angle formed by this line and the plane sagittal to the pelvis was determined as acetabular anteversion. The data analysis was run on a statistical analysis system(SAS). The mean value of acetabular anteversion 19.8±5.4 degrees(17.1±5.6 in males, 22.2±5.4 in females), it was greater significantly in females than in males (p=0.0001). The mean value of acetabular anteversion in third decade male group than the third, fourth and fifth decade group significantly(p < 0.05). The mean value of acetabular anteversion of Koreans was similar to Caucasians value. The value of acetabular anteversion was relatively releated to age. In conclusion, the acetabular anteversion of Korean females was larger than the Korean males. It was increased with aging. When we perform the total hip arthroplasty and pelvic osteotomy or reorientation procedure, we must consider the acetabular anteversion by different gender and age group.
Acetabulum ; Adult ; Aging ; Arthroplasty, Replacement, Hip ; Female ; Hip ; Humans ; Male ; Osteotomy ; Pathology ; Pelvis ; Statistics as Topic

Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as a result of partial or complete obstruction of the bile duct, and may manifest clinically severe from of disease, rapidly deterioration to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying causes were 12 benign diseases(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis (n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients improvement of general condition and failed in three patients. The procedures were preterminated due to the patient's condition in two and biliary-porto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggests that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment.
Bile Ducts ; Cholangitis* ; Clonorchiasis ; Decompression ; Drainage* ; Emergencies ; Fistula ; Humans ; Sepsis*

We retrospectively evaluated the characteristic computed tomographic (CT) findings in nine patients with exohepatic hepatocellular carcinoma(HCC) pathologically prove by surgery(n=2) or percutaneous needle biopsy(n=7). The CT findings of exohepatic HCC were correlated with clinical findings and compared with those of usual HCC Lesions were in the left lobe lobe(n=7) and right lobe(n=2) of the liver. All lesions showed a well-marginated hypodense mass with capsular enhancement on enhanced CT scan. The patterns of capsular enhancement were complete in five and partial in four cases. The portal vein thrombosis was seen only in one case. There was no difference between exohepatic HCC and usual HCC in clinical findings such as increased α-fetoprotein(α-FP), positive Hepatitis B surface antigen(HBsAg), and underlying liver cirrhosis. In conclusion, the CT findings of exohepatic HCC were a well-defined hypodense mass with complete or partial capsular enhancement and these findings may be useful in differentiation from the tumors of adjacent organs.
Carcinoma, Hepatocellular* ; Hepatitis B ; Humans ; Liver ; Liver Cirrhosis ; Needles ; Retrospective Studies ; Tomography, X-Ray Computed ; Venous Thrombosis

It has been reported that cavernous hemangiomas in the spine are generally located in vertebral bodies. Wereport a case of epidural cavernous hemangioma, a very rare condition, at the C7-T2 level. MR images showed adumbbell-shaped mass, with iso and high signal intensity on T1- and T2-weighted images, respectively. The mass wasintensely enhanced following Gd-DTPA injection.
Gadolinium DTPA ; Hemangioma, Cavernous* ; Spine

The paraumbilical vein is one of the anastomotic channels between the portal and systemic circulatory systems, and rupture of the intra-abdominal varix is an unusual complication of portal hypertension that can lead to life-threatening hemoperitoneum. We experienced a case of hemoperitoneum due to a ruptured paraumbilical vein revealed by ultrasonography (US), computed tomography (CT) and percutaneous transhepatic portography. The last mentioned demonstrated a dilated paraumbilical ve i n draining two branches of the left portal vein into the right external iliac vein, and we performed coil embolization at the site at which the presumed site of paraumbilical vein was presumed to cause hemoperitoneum. We describe this unusual case of hemoperitoneum due to a ruptured paraumbilical vein in a known liver cirrhosis patient in whom portal hypertension was treated by means of coil embolization.
Embolization, Therapeutic* ; Hemoperitoneum* ; Humans ; Hypertension, Portal* ; Iliac Vein ; Liver Cirrhosis ; Portal Vein ; Portography ; Rupture ; Ultrasonography ; Varicose Veins ; Veins*

PURPOSE: To evaluate the CT findings of pulmonary tuberculosis in patients with diabetes mellitus (MD),according to the diabetic control state. MATERIALS AND METHODS: We retrospectively studied 34 cases of pulmonarytuberculosis accompanied by DM. We divided the right lung three lobes and ten segments and the left into two lobesand eight segments and analyzed CT findings of bronchogenic spread, cavitary lesion, ill-defined nodule, lobularconsolidation, lobar and segmental consolidation, atelectasis, interlobular septal thickening, fibrotic band, andassociated findings such as lymph node enlargement, pleural effusion and empyema. We also tried to determine thetypical CT findings of pulmonary tuberculosis according to diabetic duration and controlled state of DM focusingby FBS 160 and HbA1C 8.0. RESULT: Among 34 CT scans, bronchogenic spread was seen on 29 (85.3%), cavitary lesionon 26 (76.5%), ill-defined nodules on 11 (32.4%), lobular consolidation on 14 (41.2%), lobar and segmentalconsolidation on 12 (35.3%), atelectasis on four (14.7%), and fibrotic band on eight (23.5%). Multiple cavitieswere present in 76.9% of total cavitary lesions, and consolidation with bronchogenic spread in 75%; associatedfindings were as follows: lymph node enlargement (n=1), pleural effusion (n=10), empyema (n=2), and pericardialeffusion (n=2). In 46.7% of cases, general tubercular lesions were in an unusual location, but among cases ofsecondary pulmonary tuberculosis, 73.9% of lesions were in the usual location. More lobular consolidation was seenin patients with less than FBS 160 on admission, and this result was statistically significant (p<0.05); CTfindings did not, however, differ according to diabetic duration and HbA1C. CONCLUSION: In patients with DM,general fubercular lesions were found infrequently, but in secondary tubereulosis, multiple cavitary lesions-inthe usual location-were very frequent. In patients with DM, CT findings of pulmonary tuberculosis did not varyaccording to the diabetic control state, except that in patients with less than FBS 160 on admission, there was agreater degree of lobular consolidation.
Diabetes Mellitus* ; Empyema ; Humans ; Lung ; Lymph Nodes ; Pleural Effusion ; Pulmonary Atelectasis ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary*

BACKGROUND/AIMS: Little information is available on the rate and predictive factors of rebleeding of unknown cause, which is very important in deciding further investigations on obscure-overt gastrointestinal bleeding. The aim of this study was to evaluate the rebleeding rate and related factors in obscure-overt gastrointestinal bleeding patients who revealed normal gastroscopic and colonoscopic findings. METHODS: A total of 69 patients with negative first-line gastroscopy and colonoscopy were enrolled in this study as obscure-overt gastrointestinal bleeding cases. The relationships between rebleeding and clinical characteristics were analyzed retrospectively. RESULTS: The causes of obscure-overt gastrointestinal bleeding were confirmed in 30 cases among the 69 cases. Small bowel tumors (14 cases) were the most common cause, followed by vascular lesions (6 cases). The mean follow-up period was 28 months and rebleeding was noticed in 19 patients (27.5%). Among these rebleeding patients, 14 cases (73.7%) occurred within 6 months. The past experience of previous bleeding was significantly related with rebleeding (p=0.0009). CONCLUSIONS: Close observation and detailed investigations are needed for obscure-overt gastrointestinal bleeding patients with bleeding history, especially during 6 months follow-up.
Adult ; Aged ; Angiodysplasia/complications/diagnosis ; Female ; Gastrointestinal Hemorrhage/diagnosis/*etiology ; Gastrointestinal Neoplasms/complications/diagnosis ; Humans ; Intestinal Diseases/complications/diagnosis ; Male ; Middle Aged ; Recurrence ; Risk Factors

PURPOSE: The administration of 5-fluorouracil (5-FU) by protracted intravenous infusion is an alternative to the bolus administration of 5-FU in patients with advanced colorectal cancers. This study was performed to evaluate the response rate and toxicities of protracted infusion of 5-FU in patients with advanced or recurrent colorectal cancers who had been treated with 5-FU by bolus or shortterm continuous administration. MATERIALS AND METHODS: Between March 1995 and June 1997, twenty-eight patients with advanced colorectal cancer previously exposed to 5-FU based chemotherapy were enrolled in this triaL Patients received 5-FU (250 mg/m(2)/day days 1-28) or 5-FU plus leucovorin (5-FU; 200 mg/m/day days 1-28, leucovorin; 20 mg/m IV days 1, 8, 15, 21) by ambulatory infusion pump. Treatment course was repeated every 42 days until disease progression. RESULT: Twenty-eight patients entered. All 28 patients were assessable for response and toxicity. Five (19%) patients achieved a partial response, with the median response duration of 15 weeks (range; 7-22 weeks), and median survival time of entire patients was 54 weeks (range 7-151+ weeks). Gastrointestinal toxicity, specifically stomatitis was a major toxicity (grade 2, 12%; grade 3, 4%), but hand-foot syndrome was less frequent (5%) compared with other trials with protracted infusion of 5-FU reported in the literature. Hematologic toxicity was generally of low grade. CONCLUSION: Prolonged intravenous infusion of 5-FU can produce a response rate of 19% with low toxicity among patients refractory to bolus or short-term infusion of S-FU.
Colorectal Neoplasms* ; Disease Progression ; Drug Therapy* ; Fluorouracil* ; Hand-Foot Syndrome ; Humans ; Infusion Pumps ; Infusions, Intravenous ; Leucovorin ; Stomatitis

PURPOSE: Colorectal cancer is believed to progress through an adenoma-carcinoma sequence. However, recent evidence increasingly supports the existence of an alternative route for colorectal carcinogenesis through a serrated adenoma, which combines the architectural features of hyperplastic polyps with the cytological features of traditional adenomas. We assessed the characteristics and the endoscopic features of serrated adenomas and compared them with those of hyperplastic polyps and traditional adenomas in Korea. METHODS: The medical records of 344 consecutive patients who underwent a colonoscopic biopsy or polypectomy from January 2003 through August 2004 at Gyeongsang National University Hospital were analyzed retrospectively. RESULTS: Serrated adenomas were seen in 12 cases (3.4%), and the most common site was the rectum (50%). Endoscopically in most cases, the serrated adenomas had small diameters (< or = 0.5 cm) and were single polyps. Morphologically, the serrated adenomas were flat and non-pedunculated. The coincidental rate of the carcinomas was 8.3%. CONCLUSIONS: According to this study, serrated adenomas are generally single, sessile adenomas with diameters less than 5 mm, and they are commonly observed in the left colon, especially in the rectum.
Adenoma* ; Biopsy ; Carcinogenesis ; Colon ; Colorectal Neoplasms ; Humans ; Korea ; Medical Records ; Polyps ; Rectum ; Retrospective Studies

BACKGROUND/AIMS: Perioperative endoscopic retrograde cholangiopancreatography (ERCP) and en copic sphincterotomy (EST) offer the ability to remove common bile duct (CBD) stones and it ean make laparoscopic cholecystectcqny possible instead of open cholecystectomy. Although ERCP accurately detects CBD stones, the associated financial costs and potential morbidity argue against its indiscriminate use. Thus, we undertook the current retrospective study to analyze our own experience in the identification of preoperative indicators of CBD stones in patients managed by laparoscopic cholecystectomy. METHODS: Between October 1994 and October 1996, 503 laparoscopic cholecystectomy were performed at Samsung Medical Center. We analyzed the value of serum biochemical tests and findings of ultrasonography in patients ted by laparoscopic cholecystectomy. RESULTS: A total of 117 patients underwent perigperative ERCP; 113 patients underwent preoperative ERCP with 2/113 (1.8%) failing to cannulate the ampulla; 21 patients (18.0%) had choledocholithiasis; and all patients with CBD stones were cleared by EST without major complications. The indication of ERCP for prediction of CBD stones were categorized as 4 groups; abnormal liver function tests (LFT) and duct dilatation in ultrasonography 61.9% (13/22), only abnormal liver function tests 13.6% (6/44), only duct dilatation in ultrasonography 5,9% (1/17), and normal liver function tests with normal findings in ultrasonopaphy 2.9% (1/35) in this study. In patients with CBD stones, there was no significant difference to predict CBD stones in total bilirubin, alkaline phosphatase, and alanine aminotransferase. Gallstone pancreatitis patients who had hyperamylasemia and abnornal LFT that were resolved or resolving before ERCP revealed no CBD stones (0/10, 0%). CONCLUSIONS: ERCP before laparoscopic cholecystectomy is needed in selected patients who have abnormal liver function and/or CBD dilatation on ultrasonography. Gallstone pancreatitis that is resalving or resolved clinically may not require preoperative ERCP. ERCP with EST and laparoscopic cholecystectomy is a safe and effective method for the management of symptomatic eholelithiasis and choledocholithiasis.
Alanine Transaminase ; Alkaline Phosphatase ; Biliary Tract* ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Choledocholithiasis ; Common Bile Duct ; Dilatation ; Gallstones ; Humans ; Hyperamylasemia ; Liver ; Liver Function Tests ; Pancreas* ; Pancreatitis ; Retrospective Studies ; Ultrasonography