Afferent loop syndrome(ALS) is caused by obstruction of the afferent loop after subtotal gastrectomy with Billroth II gastrojejunostomy. Prompt diagnosis of ALS is important as perforation of the loop occurs. The aim of this study is to ascertain the value of sonography and CT to diagnose ALS. We describe the radiologic findings in ten patients with ALS. The causes of ALS, established at surgery, included cancer recurrence (n=4), internal hernia(n=4), marginal ulcer (n=1), and development of cancer at the anastomosis site(n=1). Abdominal X-ray and sonography were performed in all cases, upper GI series in five cases and computed tomography in two cases. The dilated afferent loop was detected in only two cases out of ten patients in retrospective review of abdominal X-ray. ALS with recurrence of cancer was diagnosed in three cases by upper GI series. Of the cases that had sonography, the afferent loop was seen in the upper abdomen crossing transversely over the midline in all ten patients. The causes of ALS were predicted on the basis of the sonograms in three of the five cancer patients. In two cases of computed tomography, the dilated afferent loop and recurrent cancer at the remnant stomach were seen. Our experience suggests that the diagnosis of afferent loop syndrome can be made on the basis of the typical anatomic location and shape of the dilated bowel loop in both sonography and computed tomography.
Abdomen ; Afferent Loop Syndrome* ; Diagnosis ; Gastrectomy ; Gastric Bypass ; Gastric Stump ; Gastroenterostomy ; Humans ; Peptic Ulcer ; Recurrence ; Retrospective Studies

The most common causes of conjugated hyperbilirubinemia after the first or second week of life are neonatal hepatitis and biliary atresia. Since these entities represent variable expressions of same pathologic process and have similar clinical, biochemical, and histologic features, differential diagnosis is extremely difficult. We prospectively studied 28 jaundiced infants by sonography and hepatobiliary scintigraphy. Final diagnoses included 12 biliary atresia and 16 neonatal hepatitis. Visualization of a normal-sized common bile duct or gallbladder was compatible with the diagnosis of neonatal hepatitis. Non-visualized or atrophic gallbladder no sonography coupled with non-visualization of bowel activity on scintigraphy was highly suggestive of biliary atresia. We believe that sonography plays valuable role in the initial evaluation of the infants with persistent neonatal jaundice. The combined use of sonography and hepatobiliary scintigraphy provides the most valuable in formation in suspected biliary atresia for prompt surgical treatment.
Biliary Atresia ; Common Bile Duct ; Diagnosis* ; Diagnosis, Differential ; Gallbladder ; Hepatitis ; Humans ; Hyperbilirubinemia ; Infant ; Infant, Newborn ; Jaundice, Neonatal* ; Prospective Studies ; Radionuclide Imaging*

To assess the pathological basis of the sonographic changes of the gallbladder wall in cholecystitis, thesonographic appearances of the gallbladder wall were analysed in 17 patients with acute cholecystitis and 27patients with chronic cholecystitis, and correlated with pathological specimens removed at surgery. In acutecholecystitis, a thin sonolucent layer within the echogenic gallbladder wall corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration: in chronic cholecystitis it corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration: in chronic cholelcystitis it corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration, in chronic cholelcystitis it corresponds to muscular hypertrophy.Indistinctness and/or a low echogenicity rind along the inner margin reflects mucosal sloughing or obliteration ofthe mucosal folds. Uniformly decreased echogenicity of the wall is caused by severe inflammatory cell infiltrationwith sloughing of the mucosa or obliteration of the mucosal folds. These sonographic singns are considered to bevaluable sings of cholecystitis.
Cholecystitis ; Cholecystitis, Acute ; Gallbladder ; Humans ; Mucous Membrane ; Ultrasonography

Bile duct necrosis and liver abscess are rare complications after transcatheter hepatic arterial embolization (THAE) of hepatocellular carcinoma. Authors report bile duct necrosis and liver abscess occurred in 2 cases as a complication of THAE of hepatocellular carcinoma. In these two patients, lipiodol emulsion mixed with adriamycin and mitomycin was used more than three times as chemoembolic materials.
Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular ; Doxorubicin ; Ethiodized Oil ; Humans ; Liver Abscess ; Mitomycin ; Necrosis

Alterations in the expression of genes that control the cell cycle may be of critical importance in tumorigenesis and malignant transformation. The major regulatory events leading to cell proliferation occur in Gl phase of cell cycle, and the deregulated expression of Gl cyclins is related to oncogenesis. Cyclins Dl and E play important roles in the progression of cell through Gl phase of the cell cycle. Amplification and/or overexpression of the cyclin Dl gene and aberrant expression of cyclin E has been described in various forms of human cancer. However, the role of cyclins Dl and E in cervical cancer has been poorly defined. In this study, we examined the expression of cyclins Dl and E by Northern blot technique and the status of human papil- lomavirus(HPV) type 16 and 18 by polymerase chain reaction in 25 cases of cervical carcinoma to explore the relationship between cyclins Dl and E and cervical cancer. We found cyclin Dl expression showed down-regulated expression in cervical cancer but cyclin E expression was increased in cancer group. Other clinicopathological prognostic factors were not correlated with cyclins D1 and E expression. Further study based on larger numbers of cases with correlation of cyclins D1 and E status and survival data will be needed to elucidate the use of cyclin expressions as prognostic factor.
Blotting, Northern ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Cyclin E ; Cyclins* ; Humans ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

Syphilitic involvement of the stomach often takes the appearance of neoplastic conditions. We describe the radiological findings of syphilitic gastritis. A 36-year-old man was diagnosed with gastric cancer by upper GI and CT, but syphilitic gastritis was confirmed by endoscopy and upper GI series performed after penicillin therapy, We report a case of syphilitic gastritis presented as advanced stomach cancer by clinical, endoscopic and radiological study.
Adult ; Endoscopy ; Gastritis* ; Humans ; Penicillins ; Stomach ; Stomach Neoplasms

PURPOSE: To verify the value of CT in the diagnosis of cirrhosis, CRL ratio was measured in 225 Koreans who had and evidence of cirrhosis both clinically and radiologically. MATERIALS AND METHODS: The mean value of CRL ratio was 0.68+/-0.21 which was significant difterent from the published value of normal person(0.45+/-0.07). The difference of CRL ratio between men and women and that among different age groups were found to be not statistically signficant. RESULTS: CRL ratio of virus- related group(N:149) was 0.64+/-0.18, whereas that of virus-nonrelated group (N=76) was 0.76+/-0.23. There was a statistically significant difference of CRL ratio between virus-related group and virus-nonrelated group. CRL ratio of hepatoma-related group(N:113) was 0.71+/-0.22 whereas that of heparoma-nonrelated group(N:112) was 0.66+/-0.19. There was no statistically significant difference of CRL ratio between hepatoma-related group and hepatoma-nonrelated group. CONCLUSION: Measurement of CRL ratio by CT is a useful method in assessing cirrhosis of the liver.
Diagnosis ; Female ; Fibrosis ; Humans ; Liver Cirrhosis* ; Liver* ; Male

Membranous obstruction of the hepatic inferior vena cava(MOVC)is one of the common causes of Budd-Chiari syndrome. The aim of this study is to ascertain and compare the characteristic sonographic and CT findings of Budd-Chiari syndrome caused by MOVC. We studied 10 patients of Budd-Chiari syndrome caused by MOVC through sonography and CT. MOVC was confirmed by operation and/or inferior vena cavography. The cases included 9 men and one woman. With sonography. IVC obstruction was diagnosed in 9 cases. The cause of IVC obstruction was web in 5 cases and fibrous cord in 3 cases. The cause was unspecified in on case. Obliteration of the hepatic veins and intrahepatic collateral vessels were delineated in 9 cases. With color doppler sonography, the directions of blood flow of the hepatic veins through the intervenous communication were fairly well demonstrated in all 5 cases. With CT, IVC obstruction was diagnosed in 7 cases. The obliteration of the hepatic segment of the IVC were segmental in 6 cases and diffuse in one case. Ct demonstrated communicating vessels between the hepatic veins in 3 cases. Furthermore. Systemic collateral vessls(azygos and hemiazygos veins. Veins along the abdominal wall, and internal mammary veins)were demonstrated in all cases. Liver cirrhosis was combined in all cases and hepatoma developed in 4 cases. Sonography is useful to detect the MOVC and to demonstrate hepatic venous obstruction and intrahepatic collateral vessels. Color doppler sonography is easily performed to show the direction of the blood flow through interconnecting vessels. CT shows the obliterated segment of the IVC clearly and multiple prominent systemic coliaterals. In conclusion, and Budd-Chiai syndrome caused by MOVC is accurately diagnosed by combined color doppler sonography and CT.
Abdominal Wall ; Budd-Chiari Syndrome* ; Carcinoma, Hepatocellular ; Female ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Male ; Ultrasonography ; Veins ; Vena Cava, Inferior*

Each Disease affecting the bile ducts tends to produce characteristic pattern of billiary dilatation: recurrent pyogenic cholangitis causes dilatation and straightening of the larger(central) intrahepatic ducts ; clonorchiasis causes dilatation of the smaller (peripheral) intraahepatic ducts; and carcinoma along the extrahepatic ducts causes (proportional) dilatation and tortuosity of both larger and smaller intrahepatic ducts. To evaluate the specificity of the pattern and morphology of the dilated biliary tree on CT scancs (CT characterization) three independent radiologists who were unfamiliar with the cases were asked to classify 62 CT scans in patients with obstructive jaundice. The case population consisted of 14 cases with recurrent pyogenic cholangitis, 18 cases with clonorchiasis and 30 cases with carcinoma along the extrahepatic ducts, which were intermixed randomly. Classification was made only on the basis of CT characterization: those scans showing primary lesions i.t., stone, aggregate of flukes, or tumor mass were excluded or masked. All the scans of every case showing the extrahepatic bile duct were masked. Radiologists correctly classified 54 of the 62 cases (87%): ten of the 14 patients with recurrent pyogenic cholangitis(71%), 17 of the 18 patients with clonorchiasis(94%) and 27 of the 30 patients with carcinoma along the extrahepatic bile cucts(90%). We believe that CT characterization of bile duct dilatation is useful in the differential diagnosis of obstructive jaundice, especially when a primary pathologic lesion is not depicted in CT scans.
Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Biliary Tract ; Cholangitis ; Classification ; Clonorchiasis ; Diagnosis, Differential ; Dilatation* ; Humans ; Jaundice, Obstructive* ; Masks ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Trematoda

No abstract available.
Hypereosinophilic Syndrome*