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

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

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*

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*

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*

Congential bile duct cysts, the so called "choledochal cysts" occur at all levels of the biliary tree and may be of saccular, diverticular, or fusiform configuration. There are 6 types of choledochal cysts proposed by todani et al based on roentgenologic and operative findings. This disease is usually diagnosed at the childhood or early adult life and predilection for orientals. Clinical manifestations are usually jaundice, right upper quadrant abdominal pain and abdominal mass. Here we are reporting a case of choledochal cyst, type IV-A diagnosed by abdominal ultrasonogram. 99mTc-DISIDA hepatobiliary scan and endoscopic retrograde cholangiopancreatogram.
Abdominal Pain ; Adult ; Biliary Tract ; Choledochal Cyst* ; Humans ; Jaundice ; Technetium Tc 99m Disofenin ; Ultrasonography

Authors report a case with recurrent epigastric pain who revesled to have chronic pancreatitis due to impaction of Ascaris lumbricoides into the pancreatic duct. She was a 41-year-old female who favored raw meat. ERCP revealed a living round worm in the pancreatic duct which was also showed by ultrasonegraphy and computed tomography. She underwent distal pancreatectomy and developed glucose intolerance but was well controlled.
Adult ; Ascaris lumbricoides* ; Ascaris* ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Glucose Intolerance ; Humans ; Meat ; Pancreatectomy ; Pancreatic Ducts* ; Pancreatitis, Chronic*

Authors came acoss a case of Behcet's syndrome involving cecum. The patient was a 33-year-old female. Her chief complaint was right lower quadrant pain, Colonoscopy revealed several ulcerations the base of which was covered by thick whitish coat, They were surrounded by mulitiple nodular masses. Endoscopic biopsy showed noaspecific ulceration. The patient had a history of aphthous ulceration of mouth and external genitalia. So she was diagnosed to have Behcets syndrome. She underwent right hemicolectomy with tetminal ilectomy. We report this case with literiature review.
Adult ; Behcet Syndrome* ; Biopsy ; Cecum* ; Colonoscopy ; Female ; Genitalia ; Humans ; Mouth ; Stomatitis, Aphthous ; Ulcer

No abstract available.
Cardiomyopathy, Hypertrophic* ; Hypertrophy, Left Ventricular*