Isolated heaptic tuberculous granuloma with no coexistent tuberculosis elsewhere in the body is extremely rare. We report a case of pathologically proven tuberculous granuloma in the liver followed with both IV bolus and portal CT scans. The lesion on preenhanced CT scan showed undefinable isodensity. After IV bolus injection, it showed poor enhancement with central low-density and surrounding hyperdenity due to compensatory hypervascularity of the left lobe of liver in early phase. It showed peripheral rim enhancement in late phase and in delayed phase showed relatively homogeneous but slightly decreased contract enhancement. On portal CT scan, it showed a hypodense portal defect similar to other hepatic mass lesions. During follow-up studies, it was a slowly growing mass which was more easily detectable by prtal CT scans than bolus CT scans.
Follow-Up Studies ; Granuloma* ; Liver ; Tomography, X-Ray Computed ; Tuberculosis

No abstract available.
Focal Nodular Hyperplasia*

No abstract available.
Hearing*

Requirement of blood transfusion has been progressively increased and supplements by volunteer donor are not sufficient to their requirements. Moreover homologous blood transfusion are not supplied without risks, espcially the transmission of the serum hepatitis. Twenty procedures, including two total hip replacement arthroplasty, were carried out with acute hemodilutional autotransfusion. The results of this study show that autotransfusion is a safe method without difficulty of blood replacement in elective orthopedic procedures.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Blood Transfusion ; Blood Transfusion, Autologous ; Clinical Study ; Hepatitis ; Humans ; Methods ; Orthopedic Procedures ; Orthopedics ; Tissue Donors ; Volunteers

Pellegrini-Stieda's disease is a post-traumatic disorder of the knee. It is characterized by a crescentric-like bony formation in the region of the medial condyle of the femur, which usually makes its appearance upon roentgenographic examination three or more weeks after injury to the knee. During the three and a half years from January 1979 to July 1982, eleven patients were treated by conservative method and only one patient was treated by operation. The results were as follows; l. All give a history of trauma. 2. The major findings in this disease were pain in motion, local tenderness, and limitation of motion. 3. In roentgenographic findings of these cases, we noted the followings: 1) The most common site of the calcification was the proximal area of the tibial collateral ligament. 2) In seven cases (58%), the evidence of calcification was noted in 4 weeks to 12 weeks following original trauma. 3) Eight cases (67%) showed a radiolucent area from 0.5 to 3mm in thickness between the bony shadow and the femur. 4) Eight cases (67%) showed a crescentric shape of calcified area. 5) In seven cases (58%), the size of calcified mass was 1.5 to 3.5cm in length and 1 to 3mm in width. The mean size of calcified mass about 3cm in length and about 2.5mm in width. 4. Eleven cases were treated conservatively and one case was treated operatively. The results were satisfactory, and all patients were able to return to their works.
Clinical Study ; Femur ; Humans ; Knee ; Medial Collateral Ligament, Knee ; Methods

Fractures involving joints and about the joints provide complex problems with small comminuted fractures, surrounding soft tissue injuries and articular cartilage damage. Various problems are also encountered on the weight bearing surface, especially on the convex side of the distal Femur. Even though many auther had recommended kinds of management upto now, operative methods are more suggested in order to get good results regarding with the accurate anatomical reduction, rigid internal fixation and early joint motion. The clinical analysis of rnanagements of 20 cases of distai femoral fracture demonstrate that seperate dual incision-bilateral or right angle plane-to originate fracture site, and anatomical reduction & rigid internal fixation, early non-weight bearing ROM exercise of joint were sometimes mandatory to treat the displaced, comminuted fracture.
Cartilage, Articular ; Femoral Fractures ; Femur ; Fractures, Comminuted ; Joints ; Soft Tissue Injuries ; Weight-Bearing

Development of acetabulum and epiphysis of the femoral head following reduction in seventy-four patients with ninty-one congenitally dislocated hips were assessed radiologically. Acetabular index, CE angle of Wiberg, neck-shaft angle of the femur and overgrowth of the pelvis and femur were measured according to the various treatment. To evaluate results, the method of treatment was divided into four groups; closed reduction, open reduction, open reduction combined with pelvic osteotomy and modified Klisic operation (open reduction, pelvic osteotomy, femoral osteotomy and so on). Each treatment was compared with three subgroups according to ages; first subgroup was belong to patients under one year of age, second from one year to three years, third over three years. This paper agrees to Harris (1976) and Lindstrom (1979) about improvement of acetabular index and CE angle of Wiberg that showed a rapid rate of repair in the first 6 months and thereafter slowly progressed to normal range of degree. Overgrowth of pelvis and femur was also noticed in cases of hips treated pelvic and/or femoral osteotomy, moreover even in cases of open reduction only. The goal of this preliminary investigation may be supposed to propose the idea which method of treatment to the first visiting patient will approach the most satisfactory final result.
Acetabulum ; Dislocations ; Epiphyses ; Femur ; Head ; Hip ; Humans ; Methods ; Osteotomy ; Pelvis ; Reference Values

Brunner's gland adenoma is characterized by benign proliferation of the normal Brunner's gland, and is a relatively rare disease that accounts for only 10% of benign duodenal tumors. It is usually found in the bulb and second portion of the duodenum, but is rarely found in the pylorus. The clinical manifestations vary from non-specific upper abdominal symptoms to obstruction, intussusception and gastrointestinal hemorrhage. It is a benign lesion but rarely undergoes malignant transformation. Management of Brunner's gland adenoma involves complete removal of the lesion. We experienced a 43-year-old man who had complained of melena and dyspnea on exertion. An esophagogastroduodenoscopy and computed tomography of the upper gastrointestinal tract demonstrated the presence of a 5.5x4.0 cm sized hyperemic and lobulated large mass with hemorrhage that originated from the pylorus and was intussuscepted into the duodenum. Resection of the tumor revealed that it was a Brunner's gland adenoma on a histological examination.
Adenoma* ; Adult ; Anemia* ; Duodenum ; Dyspnea ; Endoscopy, Digestive System ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intussusception* ; Melena ; Pylorus* ; Rare Diseases ; Upper Gastrointestinal Tract

Brunner's gland adenoma is characterized by benign proliferation of the normal Brunner's gland, and is a relatively rare disease that accounts for only 10% of benign duodenal tumors. It is usually found in the bulb and second portion of the duodenum, but is rarely found in the pylorus. The clinical manifestations vary from non-specific upper abdominal symptoms to obstruction, intussusception and gastrointestinal hemorrhage. It is a benign lesion but rarely undergoes malignant transformation. Management of Brunner's gland adenoma involves complete removal of the lesion. We experienced a 43-year-old man who had complained of melena and dyspnea on exertion. An esophagogastroduodenoscopy and computed tomography of the upper gastrointestinal tract demonstrated the presence of a 5.5x4.0 cm sized hyperemic and lobulated large mass with hemorrhage that originated from the pylorus and was intussuscepted into the duodenum. Resection of the tumor revealed that it was a Brunner's gland adenoma on a histological examination.
Adenoma* ; Adult ; Anemia* ; Duodenum ; Dyspnea ; Endoscopy, Digestive System ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intussusception* ; Melena ; Pylorus* ; Rare Diseases ; Upper Gastrointestinal Tract

Dissociated vrtical deviation(DVD) is frequently associated with infantile esotropia. It is hard to find DVD before surgery for esodeviation, and usually found after surgery. We studied the occurrence of DVD in 176 patients who had had horizontal rectus muscle surgery for the correction of infantile esotropia and followed up for 6 months or more. DVD was seen in 78 patients(44.3%), preoperatively in 27 patients(34.6%) and postoperatively in 51 patients(65.4%). Among 51 patients with DVD after surgery, DVD occurred in 24.0% of patients with preoperative angle of esodeviation less than 50 PD and in 44.6% of patients with preoperative angle of esodeviation more than 51 PD(P<0.01). Most of them(25 of 51 patients) developed DVD within 6 months after esodeviation surgery, however, 12 patients were noted to develop even after 2 years. This shows that we need long term follow-up for the detection of DVD. The occurrence of DVD was not influenced by the time of surgery for esodeviation(P>0.05). Inferior oblique overaction(IOOA) was accompanied with DVD in 71.8% and occurred without DVD in 28.6%. This study revealed postoperative DVD developed more in large angle esotropia such as deviation angle greater than 51 PD, and IOOA was frequently accompanied. The result suggests that in large angle infantile esotropia with mild IOOA and DVD or fundus extorsion we may need the preventive correction of DVD and IOOA.
Esotropia* ; Follow-Up Studies ; Humans