This study was designed to evaluate the potential applicability of magnetic resonance imaging (MRI) for the diagnosis of acute renal vein thrombosis. Renal vein thrombosis was experimentally induced by surgical ligation of the left renal vein in a total of 21 rabbits. MRI was performed with a 0.5 Tesla superconductive magnetic system. Spin echo technique was used with varying TR and TE parameters. Spin echo images of the rabbit kidney were analysed for morphology and signal intensity. T1 and T2 relaxation times of the renal cortex and medulla were calculated from the images. After venous ligation, kidneys became enlarged. Low signal band along the outer medulla in T2 weighted images were characteristically shown from 1 hour to 3 days after ligation, Changes of cortex to medullar contrast (CMC) values were significant (p<0.05) in T1 - and T2- weighted images of the ligated side. T1 and T2 relaxation times were significantly prolonged (p<0.05) on the ligated side, both in the cortex and medulla from 1 hour to 2 weeks after the ligation, while T2 relaxation time on the contralateral side was significantly prolonged both in the cortex and medulla 2 weeks after venous ligation. The most useful MRI criteria for the diagnosis of renal vein thrombosis were enlarged renal size, and the low signal band along the outer medulla of ligated kidney. The relative intensity difference between cortex and medulla (CMC) in T1-and T2-weighted images, and T1 and T2 relaxation times were suggested to be the useful MR parameters for the diagnosis of acute renal vein thrombosis.
Diagnosis ; Kidney* ; Ligation* ; Magnetic Resonance Imaging* ; Rabbits ; Relaxation ; Renal Veins* ; Thrombosis

This study was designed to evaluate the potential applicability of magnetic resonance imaging (MRI) for the diagnosis of acute renal vein thrombosis. Renal vein thrombosis was experimentally induced by surgical ligation of the left renal vein in a total of 21 rabbits. MRI was performed with a 0.5 Tesla superconductive magnetic system. Spin echo technique was used with varying TR and TE parameters. Spin echo images of the rabbit kidney were analysed for morphology and signal intensity. T1 and T2 relaxation times of the renal cortex and medulla were calculated from the images. After venous ligation, kidneys became enlarged. Low signal band along the outer medulla in T2 weighted images were characteristically shown from 1 hour to 3 days after ligation, Changes of cortex to medullar contrast (CMC) values were significant (p<0.05) in T1 - and T2- weighted images of the ligated side. T1 and T2 relaxation times were significantly prolonged (p<0.05) on the ligated side, both in the cortex and medulla from 1 hour to 2 weeks after the ligation, while T2 relaxation time on the contralateral side was significantly prolonged both in the cortex and medulla 2 weeks after venous ligation. The most useful MRI criteria for the diagnosis of renal vein thrombosis were enlarged renal size, and the low signal band along the outer medulla of ligated kidney. The relative intensity difference between cortex and medulla (CMC) in T1-and T2-weighted images, and T1 and T2 relaxation times were suggested to be the useful MR parameters for the diagnosis of acute renal vein thrombosis.
Diagnosis ; Kidney* ; Ligation* ; Magnetic Resonance Imaging* ; Rabbits ; Relaxation ; Renal Veins* ; Thrombosis

With improvements in diagnostic imaging techniques for the brain, pituitary tumors without neurological signs or symptoms have occasionally been found. To evaluate therapeutic strategy for incidentally found pituitary tumors ("pituitary incidentaloma"), we analyzed the result of magnetic resonance imaging findings and of ophthalmological and endocrinological studies in 3 cases with follow up. Incidentally found functioning tumors were excluded. All of 3 cases is greater than 10mm in tumor size("pituitary macroincidentaloma"). The follow-up period was 49 months, 16 months and 6 months(mean, 25.3 months) in each case. There was no evidence of tumor enlargement, endocrinological problems and visual field defect during follow-up period. Patients with pituitary incidentalomas usually follow a benign course and neurosurgical intervention is not initially required in the management even those greater than 10mm in diameter. Observation over time may be good approach to the patient with a pituitary macroincidentaloma to avoid the unnecessary risk for surgery in a patients with a stable mass.
Brain ; Diagnostic Imaging ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Pituitary Neoplasms ; Visual Fields

PURPOSE: The purpose is to correlate computed tomographic findings classified according to the degree of disease severity(grading A-E) with clinical course of acute pancreatitis. MATERIALS AND METHODS: in a retrospective review of 42 patients with acute pancreatitis, computed tomographic scans were classifed according to the degree of disease severity, and were correlatd with the clinical course. RESULTS: Pancreatic abscesses were seen in 14.3% and occured in 35.7% of grade D and E patients. Three patients with abscess died. Fatty infiltration of the liver was noted in 16.7%, pleural effusion in 21.4%.. stones and thickened wall of the gallbladder were present in 7.1% and in 9.5%, respectively. CONCLUSION: Our data indicate that phlegmonous extrapancreatic spread on initial CT scan had a high predictive value of the patients, prognosis.
Abscess ; Cellulitis ; Gallbladder ; Humans ; Liver ; Pancreatitis* ; Pleural Effusion ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

Despite recent advances in the care of such patients, subarachnoid haemorrhage(SAH) due to ruptured intracerebral aneurysm continues to carry a high rate of morbidity and mortality. During the acute phase of SAH, various factors can aggravate a patients initial good neurological state, and every effort should thus be made to prevent such occurrences. Although not a major problem, seizure is a well known factor influencing the course of the disease. The authors studied 476 cases of SAH occurring during the preceding eight-year period and reported the incidence of seizure, the risk factors which evoke it, and the optimal time required to prevent it. The incidence was 11%, and 48% of seizures occurred within three days of SAH. The risk factors were Hunt-Hess grade at admission, degree of neurologic deficit, and the presence and timing of rebleeding. Regardless of initial grade, seizure led to a poorer outcome. We conclude that seizure in aneurysmal subarachnoid hemorrhage occurs during the early stage of the disease and aggravates the prognosis. The recognition of risk factors and early prevention of seizure are thus necessary.
Aneurysm ; Humans ; Incidence ; Intracranial Aneurysm* ; Mortality ; Neurologic Manifestations ; Prognosis ; Risk Factors ; Seizures* ; Subarachnoid Hemorrhage

PURPOSE: We explored the relationship between the use of each medical intervention and the length of time between do-not-resuscitate (DNR) consent and death in Korea. MATERIALS AND METHODS: A total of 295 terminal cancer patients participated in this retrospective study. Invasive interventions (e.g., cardiopulmonary resuscitation, intubation, and hemodialysis), less invasive interventions (e.g., transfusion, antibiotic use, inotropic use, and laboratory tests), and the time interval between the DNR order and death were evaluated. The subjects were divided into three groups based on the amount of time between DNR consent and death (G1, time interval ≤ 1 day; G2, time interval > 1 day to ≤ 3 days; and G3, time interval > 3 days). RESULTS: In general, there were fewer transfusions and laboratory tests near death. Invasive interventions tended to be implemented only in the G1 group. There was also less inotrope use and fewer laboratory tests in the G3 group than G1 and G2. Moreover, the G3 group received fewer less invasive interventions than those in G1 (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.03 to 0.84; 3 days before death, and OR, 0.16; 95% CI, 0.04 to 0.59; the day before death). The frequency of less invasive interventions both 1 and 3 days before death was significantly lower for the G3 group than the G1 (p ≤ 0.001) and G2 group compared to G1 (p=0.001). CONCLUSION: Earlier attainment of DNR permission was associated with reduced use of medical intervention. Thus, physicians should discuss death with terminal cancer patients at the earliest practical time to prevent unnecessary and uncomfortable procedures and reduce health care costs.
Cardiopulmonary Resuscitation ; Health Care Costs ; Humans ; Intubation ; Korea* ; Resuscitation Orders ; Retrospective Studies ; Terminal Care

In recent years, digital technology has been developed in dentistry, which denture frameworks can be manufactured using DMLS (Direct Metal Laser Sintering) technique. A traditional impression method can be replaced by oral scanning and wax pattern production process can be achieved by the use of CAD/CAM techniques. The designed STL files can be sent to DMLS devices to fabricate final components of removable partial dentures (RPD). The advantages of digital dentistry are concision and precision. In this case study, a fracture of occlusal rests providing support and indirect retention was repaired by DMLS and laser welding techniques. It shows satisfactory results in adaptation accuracy and functional properties of the repaired denture.

Anatomical changes in the facial and alveolar bones occur after multiple teeth are extracted. In the maxilla, the alveolar bone is absorbed in the direction and inclination of the root, and the remaining alveolar bone becomes shorter, reducing the diameter of the arch. In addition, as the nasolabial angle increases, the support of the lips and the aesthetics of the face are lost. This case reports a functional and aesthetically satisfactory results of full mouth rehabilitation with the implant-supported fixed prosthesis using a zirconia framework.

Patients with multilevel atherosclerotic disease represent a difficult surgical challenge. In the 5 decades that have relapsed since the introduction of initial methods of revascularization, a wide variety of the therapeutic options have been developed and advocated for management of aortoiliac disease. With the aid of dramatic advance of endovasular technique, various nonoperative catheter based endoluminal therapies have been accentuated in recent years by the explosive growth in vascular surgical procedures. A combination of iliac PTA and distal surgical revascularization would appeal to be a logical and potentially advantageous methods of revascularization in selected patients. This report is a retrospective review of 20 patients who were treated using a combination of lilac transluminal angioplasty and/or stent and infrainguinal reconstruction. They were 19 males and 1 female with an average of 69 years (range : 48 to 74 years). Follow-up period ranged from 1 month to 92 months( median : 28 months). These patients had cormorbid disease including heart disease (35%), hypertension(35%), diabetes mellitus(15%), hyperlipidemia(15%); 90% of the patients were smokers. Ten patients were treated for rest pain or tissue loss, while ten were treated for moderate or severe claudication. Distal operation included 7 femorofemoral bypass, 11 femoropopliteal(AK) bypass, 4 femoropopliteal(BK) bypass, 1 pop-tibial bypass. A mean resting iliac artery pressure gradient of 27.6+/-22.8 mmHg pre-PTA was reduced to 3.1+/-4.3 post PTA. Mean pretreatment ankle/brachial index of 0.36+/-0.28 increased to 0.80+/-0.16 after operation(P<.001). By Kaplan-Meier method, the 5-year primary patency rate of the distal surgical procedures was 72%. The procedures were well tolerated with no mortality and two complication occurred, but all were sucessfully corrected by stent insertion for intimal dissection and Urokinase infusion for thrombosis. Two patients underwent amputation due to preoperative wide skin ulcer and knee joint infection. We conclude that in selected patients, combined use of iliac PTA or stent insertion and distal surgical reconstructions is safe and effective modality for managing the patients with severe multilevel occlusive disease.
Amputation ; Angioplasty ; Angioplasty, Balloon ; Catheters ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Iliac Artery ; Knee Joint ; Logic ; Male ; Mortality ; Retrospective Studies ; Skin Ulcer ; Stents ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Vascular Surgical Procedures