PURPOSE: To identify the four layers based on intranodular vascular nature visible in multiphase incremental bolus dynamic CT and to determine any differential points according to various factors of liver abscess with this vascular nature or not. MATERIALS AND METHODS: We categonized 29 cases of confirmed liver abscess into three different groups according to presence of four layers visible in early phase(arterial phase) of CT. Three groups were compared in regard to the results of antiamebic antibody test and bacteriologic study and presense of cholangitic abscess and internal septation. RESULTS: We could separate four layers, innermost hypodense central cavitary lesion, hyperdense granular tissue, hypodense abscess wall and outermost hyperdense compensatory hypervascular zone in 18 cases(62%), only two layers, cavity and wall in six cases(21%), and characteristically we could find three layers without innermost cavitary lesion in five cases(17%). But we couldn't find significant correlations between various clinical factors of liver abscess and our vascular groups. CONCLUSION: Our method of CT could represent four layers based on vascularity in 62% of cases. And also could find the unusual inflammatory mass containing three layer which must be differentiated from other malignant solid mass. But we couldn't find differential point between various clinical factor of liver abscess and imaging diagnosis. We think that with the improvement of hardware such as spiral CT, identification of four layers will be earier and will be very helpful in early detection and proper treatment planning of liver abscess.
Abscess* ; Diagnosis ; Liver Abscess* ; Liver* ; Tomography, Spiral Computed

Fourty-seven patients with non-aneurysmal spontaneous subarachnoid hemorrhage were reviewed retrospectively. Attention was directed to the distribution and amount of subarachnoid hemorrhage on computerized tomography scans. Though the hemorrhage could be distributed in all cisterns, the frequency and amount of hemorrhage were higher in infratentorial cisterns than in supratentorial cisterns. Among infratentorial cisterns, the hemorrhage was distributed to cisterns around the brain-stem mainly and it had a predilection for interpeduncular cistern. Also the telangiectasia of thalamoperforating artery might be one of the causes of non-aneurysmal spontaneous subarachnoid hemorrhage.
Arteries ; Hemorrhage ; Humans ; Retrospective Studies ; Subarachnoid Hemorrhage* ; Telangiectasis

PURPOSE: To assess the usefulness of CT scanning in the differentiation of stage T3a from T2 in renal cell carcinoma. MATERIALS AND METHODS: Among patients with pathologically proven renal cell carcinoma, 114 at stages T2 and T3a were divided into three groups, as follows: intact capsule (T2) n=40, capsular involvement (T2) n=38, and capsular penetration (T3a) n=36. By referring to contrast-enhanced CT scans, we retrospectively compared the groups in terms of tumor margin, the frequency with which a tumor bulged more than 3 cm beyond the renal contour, the presence or absence of peritumoral collateral vessels, thickening of Gerota 's fascia, and perinephric strands. RESULTS: An irregular margin was more common in the capsular penetration group than in the other two groups (p<0.05). With regard to frequency of tumor bulging, the presence of peritumoral collateral vessels, thickening of Gerota 's fascia, and perinephric strands, these characteristics were more frequently noted in the capsular penetration group (T3a) and capsular involvement group (T2) (p<0.05) than in the intact capsule group. The difference between the capsular penetration group (T3a) and the capsular involvement group (T2) was not significant, however (p>0.05). CONCLUSION: In determining the tumor stage of renal cell carcinoma, CT is not helpful in differentiating between a tumor with capsular penetration (T3a) and one with capsular invasion (T2), though differentiation of the T3a stage from the T2 stage, without capsular invasion, is reliable. When a tumor has an irregular margin, however, the possibility that it is at stage T3a should be considered.
Carcinoma, Renal Cell* ; Fascia ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed*

Amyopathic dermatomyositis is defined by characteristic cutaneous manifestation of dermatomyositis without evidence of muscle involvement. There is no clinical difference between dermatomyositis and amyopathic dermatomyositis. Pulmonary involvement of dermatomyositis is so frequent than aggressive dianostic and therapeutic approach is needed. Early steroid or immunosuppresive treatment in pulmonary involvement of dermatomyositis gets better prognosis. Intravenous immunoglobulin treatment is an effective and safe alternative when the steroid or immunosuppresive treatment is ineffective or intolerable. We are reporting a case of amyopathic dermatomyositis with interstitial lung disease. This patient was improved with intravenous immunoglobulin treatment.
Dermatomyositis* ; Humans ; Immunoglobulins ; Lung Diseases, Interstitial* ; Prognosis

BACKGROUND: To decrease the risk of pulmonary aspiration of gastric contents, patients are routinely asked not to eat or drink anything for at least 6 to 8 hours before surgery. We studied to evaluate whether the volume and pH of gastric fluid immediately after induction of anesthesia is correlated with water ingestion. METHODS: Fifty patients, scheduled for elective surgery, were randomly divided into two groups. Control group(n=25) were fasted overnight and received no water. Experimental group(n=25) were fasted overnight and received 150 ml water approximately 2 hours before the induction of anesthesia. Gastric fluid was obtained via multiorifice gastric tube with the patient in three different positions. The volume of gastric fluid was recorded and its pH was measured. RESULTS: The gastric volumes were no differences between the two groups. The gastric pH values were significant differences. The incidence of patients with the high risk factors of gastric volume greater than 25 ml and pH less than 2.5 was decreased in experimental group. CONCLUSIONS: We concluded that surgical patients could be permitted to ingest 150 ml water approximately 2 hours before the induction of anesthesia.
Adult* ; Anesthesia ; Eating* ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Risk Factors ; Water*

OBJECTIVE: The lateral extracavitary approach(LECA) to the thoracolumbar spine is known as one of procedure which allows not only direct vision of pathologic lesion, but also ventral decompression, and dorsal fixation of the spine through the same incision. However, some drawbacks of LECA, including the technically- demanding, time-consuming, unfamiliar surgical anatomy and excessive blood loss, make surgeons to hesitate to use this approach. This study is to provide the surgical anatomy of LECA using cadavers, for detailed informations when LECA is considered for the surgery. METHODS: We performed the 10 cadaveric studies, 7 male and 3 female, and careful dissection was carried out on right side of thoracolumbar region, except one for thoracic region. The photographs with micro-lens were taken to depict the close-up findings and for demonstrating detailed anatomy. RESULTS: The photographs and hand-drawings demonstrated the relationships among the musculature, segmental vessels and nerve roots seen during each dissection plane. The lateral branches of dorsal rami of spinal nerve and the transverse process were confirmed to be the most important landmark of this approach. CONCLUSION: We concluded that detailed anatomical findings for LECA through this step-by-step dissection would be useful during operative intervention to reduce the intraoperative complications in LECA.
Cadaver* ; Decompression ; Female ; Humans ; Intraoperative Complications ; Male ; Spinal Nerves ; Spine*

In various autopsy series, overdiagnosis as well as underdiagnosis of pulmonary embolism has been reported. During the past decade, mortality rate has not declined despite advances in diagnostic methods. To evaluate the hypothesis that changes of hemodynamic parameters responded by mean pulmonary arterial pressure differences are of paramount importance to guide prognosis, experimental model of anesthetized dogs was used. Six dogs were anesthetized with 15 milligrams per kilogram of pentobarbital sodium, given intravenously and paralyzed with 2 milligrams of pancuronium bromide. 0.3 to 0.8 gram per kilogram of autologous blood clot was infused into the right atrium through a left external jugular vein. The dogs after embolization were divided into group A(mean pulmonary arterial pressure 33mmHg) and group B(mean pulmonary arterial pressure 43 mmHg). Each group of three dogs was monitored for a total of 4.5 hours. A 7F Swan-Ganz catheter was positioned and used to measure with fluid-filled transducer pulmonary capillary wedge pressure, mean pulmonary arterial pressure and mean right atrial pressure. Cardiac ouput was measured in triplicate by thermodilution and divided by weight to obtain the cardiac index. Blood gases, pH and saturation of arterial blood were measured. White blood cell and platerlets were counted in arterial blood. The results are as follows : 1) Changes in mean arterial pressure showed no significant differences between group A and group B following embolization. 2) Changes in mean pulmonary arterial pressure showed significant differences between group A and group B(p<0.05). 3) Changes in cardiac index showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 4) Changes in total pulmonary resistance showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 5) PaO2 showed significant differences between group A and group B after one hour following embolization(p<0.05), but arterial pH showed no significant difference. 6) Changes in mean pulmonary capillary wedge pressure, mean right atrial pressure and heart rates showed no significant differences between group A and group B following embolization. In conclusion, changes in mean pulmonary arterial pressure, cardiac index, total pulmonary resistance and PaO2 showed significant differences between group A and group B following embolization.
Animals ; Arterial Pressure ; Atrial Pressure ; Autopsy ; Catheters ; Dogs* ; Gases ; Heart Atria ; Heart Rate ; Hemodynamics ; Hydrogen-Ion Concentration ; Jugular Veins ; Leukocytes ; Models, Theoretical ; Mortality ; Pancuronium ; Pentobarbital ; Prognosis ; Pulmonary Artery* ; Pulmonary Embolism* ; Pulmonary Wedge Pressure ; Thermodilution ; Transducers

PURPOSE: The objective of this study was to translate the obesity-related problems (OP) scale for Koreans and to validate it for use in Korean populations. METHODS: Translation and back-translation of the OP scale was performed and a pilot test was conducted. Following this, patients who had received treatment at the Obesity Center of Inha University Hospital were selected for participation in the field test. Cronbach's alpha (alpha) was used for assessment of the internal consistency of the OP scale. Spearman's correlation coefficients were used to assess the concurrent validity between the OP scale, the EuroQoL-5D (EQ-5D), and the Beck depression inventory (BDI) scale. One-way analysis of variance and t-test were used to assess the factors associated with the OP scale. RESULTS: A total of 67 individuals participated in the field study. The standardized Cronbach's alpha of the OP was 0.913. A significant negative correlation was observed between the OP scale and the EQ-5D and a positive correlation was observed between the OP scale and the BDI (the correlation coefficient with EQ-5D = -0.316, and the BDI = 0.305, P < 0.05). CONCLUSION: The results of this study prove that the Korean version of the OP has been translated and adapted correctly in order to meet the standard of its use.
Depression ; Humans ; Obesity ; Quality of Life ; Surveys and Questionnaires

Acute gastric anisakiasis is occurred when men intake a raw or inadequate cooked anisakis infected fish. The clinical symptoms are severe cramping abdominal pain, nausea, vomiting, and epigastric fulling sensation. It is well known that the whale is final host and man is opportunistic host. Recently, we experienced three cases of acute gastric anisakiasis. We think that acute gastric anisakiasis is probably rather undetected than rare disease. So through immediate gastrofiberscopy of patients with severe cramping epigstric pain occuring after ingestion of raw fish,we can find more cases of the anisakis larvae. In is adequate to abstract of larvae by biopsy forceps through gastrofiberscopy.
Abdominal Pain ; Anisakiasis ; Anisakis* ; Biopsy ; Eating ; Humans ; Larva ; Male ; Muscle Cramp ; Nausea ; Rare Diseases ; Sensation ; Surgical Instruments ; Vomiting ; Whales

The clinical review was done on 15 cases with the foreign body in the upper gastrointestinal tract who visited and underwent endoscopic removal of foreign body at department of lnternal Medicine of Chonnam University Hospital and Namkwang Hospital from June 1982 to August 1987. The results are as follows: 1) The age distribution varied from 32 yeara to 83 years of age, being most prevalent at 6th decade, The ratio between male and femaie was 4:1, more prevelant in male. 2} Among 15 eases, 8 cases were lodged in the esophagus and 7 cases in the stomach. The foreign bodies in the esophagus were meat, pressure-through package, food materials and bone in order of frequency and those in the stomach were bezoar, persimmon seed, brown seaweed, tooth brush and suture materials. 3) Cambined diseases of upper gastrointetinal passage disturbance were 1 case of esophageal cancer and 3 cases of gastric outlet obstruction caueed by duodenal ulcers and gastric malignancy. Other combined diseases were schizophrenia, chronic alcoholism, diabetes mellitus and gastrie polyp. 4) Complications by foreign body were retropharyngeal abscess and phlegmonous esophagitis with esophageal ulcer.
Age Distribution ; Alcoholism ; Bezoars ; Cellulitis ; Diabetes Mellitus ; Diospyros ; Duodenal Ulcer ; Esophageal Neoplasms ; Esophagitis ; Esophagus ; Foreign Bodies* ; Gastric Outlet Obstruction ; Humans ; Jeollanam-do ; Male ; Meat ; Polyps ; Retropharyngeal Abscess ; Schizophrenia ; Seaweed ; Stomach ; Sutures ; Tooth ; Ulcer ; Upper Gastrointestinal Tract*