Hepatic masses show different enhancing patterns in N bolus computed tomography: Hepatocellular carcinoma shows high-attenuation in the early enhancing phase and low-attenuation in the late enhancing phase, hemangioma shows peripheral dot-like high-attenuation in the early enhancing phase and central high-attenuation in the late enhancing phase, and metastatic cancer and cholangiocelluar carcinoma show peripheral high-attenuation rim in the early enhancing phase and central portion gradulally high attenuation in the late enhancing phase. but sometimes enhancing patterns of the hepatic masses are confuse. To evaluate the significance of the AFP level and HBsAg in differentiation of the hepatic masses, we retrospectively analyzed AFP level and HBsAg' in 228 pathologically or radiologically confirmed hepatocellular carcinomas, and 137 pathologically nonhepatocellular cacinomas. The results were as follows In hepatocellular carcinoma, AFP level above 20ng/ml was 77.8% and HBsAg positve was 72.6%. In nonhepatocellular carcinoma, AFP level above 20ng/ml was 3.7% and HBsAg positve was 16.1%. We concluded that AFP level and HBsAg are helpful to distinguish hepatocellular carcinoma from nonhepatocellular carcinoma, when IV bolus computed tomogram finding is uncertain.
Carcinoma, Hepatocellular ; Hemangioma ; Hepatitis B Surface Antigens* ; Retrospective Studies

BACKGROUND: To find out characteristics and classification of toxic agents by clinical analysis of pediatric poisoning and to determine the clinical availability of grading by using MSPC score. METHOD: Subjects were patients under 15 years exposed to toxic agents, who visited Ajou university hospital emergency center from June, 1994 to October, 1997. The study was performed retrospectively. RESULTS: The subjects were 126 cases and male to female sex ratio was 1.2:1. Mean age was 29+/-30 months old. The most common route of exposure was ingestion, following contact, inhalation and bite. The most common reason was mistake by the patient, following mistake by caregiver, suicide attempt and accident. The MSPC score distribution of symptomatic patient was as follows; 1 point: 26 cases(63.4%), 2 point: 12 cases(29.2%), 3 point: 1 case(2.4%), 4 point: 2 cases(4.8%). The classification of exposed poison was as follows; therapeutic drugs: 29 cases(23.0%), non-therapeutic drugs: 97 cases(73.0%). The most common exposed poison was household products: 23 patients(18.3%) were admitted to hospital. CONCLUSION: There was statistically significant difference in the classification of poison, MSPC score, treatment modality at hospital, first follow up period after discharge between admitted group and non-admitted group. There was statistically significant difference in the reason of exposure, route of exposure, MSPC score, admission period according to patient's age. severity grading according to MSPC score is regarded as an available method to determine the modality of management.
Caregivers ; Classification ; Eating ; Emergencies ; Female ; Follow-Up Studies ; Household Products ; Humans ; Inhalation ; Male ; Poisoning* ; Retrospective Studies ; Sex Ratio ; Suicide

No abstract available.

No abstract available.
Liver Abscess, Pyogenic*

No abstract available.
Hemorrhage* ; Hemorrhoidectomy*

No abstract available.
Lupus Nephritis*

No abstract available.
Facial Nerve*

Human Adjuvant Disease(HAD) is a connective tissue disease occuring after cosmetic surgery with a foreign substance. It was first reported by Miyoshi in 1964. There have been specific connective disorders such as systemic lupus erythematosus, rheumatoid arthritis, progressive systemic sclerosis and mixed connective tissue disease. Scleroderma is the single most commonly reported disease. A 55-year-old woman was seen for evaluation of dypnea. Four years previously, she underwent cosmetic surgery with silicone injected directly into eyelid, forehead, both hand and monspubis. The patient presented the classic feature of systemic sclerosis and pericardial effusion. Following pericardiocentesis, she felt somewhat better and became less dyspneic. Seventeen days later, however, she progressively deteriorated and died in spite of intensive medical therapy and supportive care.
Arthritis, Rheumatoid ; Connective Tissue Diseases ; Eyelids ; Female ; Forehead ; Hand ; Humans ; Lupus Erythematosus, Systemic ; Middle Aged ; Mixed Connective Tissue Disease ; Pericardial Effusion ; Pericardiocentesis ; Scleroderma, Diffuse ; Scleroderma, Systemic ; Sclerosis* ; Silicone Gels* ; Surgery, Plastic*

Intrathecal and epidural narcotics have been widely used since 1979 to relieve pain and provide postoperative analgesia. Ketamine hydrochloride, a potent analgesic and anesthetic, has also been studied to its usefulness in epidural administration for postoperative pain relief devoid of the respiratory depression caused by morphine. This study was performed to evaluate whether a large dose of ketamine is effective for postoperative pain relief and the results were compared with those of epidural morphine. Forty patients undergoing lower abdominal and extremity surgery were randomly assigned in two groups of twenty. No patient was receiving narcotics or analgesic at the time of study. The operative anesthesia was provided by continuous epidural anesthesia with 27 ml of 1.5% lidocaine with 1:200,000 epinephrine. Ketamine 30mg or morphine 3-4 mg was administered about 30 minutes before the end of operation through the epidural catheter respectively. Patients were monitored every 15 minutes during the first hour and every hour during first 24 hours. Pain complaint, respiratory rate, heart rate, blood pressure, SaO2 and potential side effects were recorded. The results were as follows; 1) Two cases in the ketamine group and nine cases in the morphine group did not need the additional analgesics after operation. The duration of pain relief in the ketamine group varied from 1.83 hour to over 48 hours (less than 3 hours in 50% of patients). Mean analgesic time in the morphine group was 28.3+/-5.6 hours. 2) Dissociative anesthesia with hypotension (one), sedation (fifteen), dizziness (seven), nausea (six) and vomiting (six) in the ketamine group, whereas nausea (nine), and vomiting (five) in the morphine group were developed. We conclude that ketamine 30 mg administered epidurally, which had a more central actions and less analgesic effect than morphine, is inadequate for postoperative pain relief after lower abdomimal and extremity surgery.
Analgesia ; Analgesics ; Anesthesia ; Anesthesia, Epidural ; Blood Pressure ; Catheters ; Dizziness ; Epinephrine ; Extremities ; Heart Rate ; Humans ; Hypotension ; Ketamine* ; Lidocaine ; Morphine ; Narcotics ; Nausea ; Pain, Postoperative* ; Respiratory Insufficiency ; Respiratory Rate ; Vomiting

No abstract available.
Lupus Erythematosus, Systemic*