PURPOSE: To evaluate the efficacy of the arterial phase of dynamic spiral CT in the detection of pancreatic adenocarcinoma compared with the late phase. MATERIALS AND METHODS: Two phase spiral CT images of seventeen patients with pathologically proven pancreatic ductal adenocarcinomas were compared retrospectively. CT scans were performed with 5mm collimation at 1:1 pitch table speed. Images of arterial and late phases were obtained at 35 seconds and 180 seconds after initiation of administration of 100mL of contrast material(3mL/sec), respectively. Images of the arterial phase were compared with those of the late phase. RESULTS: Images of the arterial phase showed sufficient contrast between the tumor and adjacent pancreatic parenchyma in 12 cases, insufficient in four cases, and no significant contrast in one case. Images of the late phase showed sufficient contrast in five cases, insufficient in five cases, and no significant contrast in seven cases. Images of the arterial phase was superior to that of the late phase in 12 patients(70.6%). In six of the 12 patients, only the images of the arterial phase showed contrast between the tumor and the adjacent parenchyma. The images of late phase showed only one case of three metastasis detected on the images of the arterial phase. CONCLUSION: The arterial phase of spiral CT is superior to the late phase that is comparable with conventional CT in the detection of pancreatic adenocarcinoma.
Adenocarcinoma* ; Humans ; Neoplasm Metastasis ; Pancreatic Ducts ; Retrospective Studies ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

No abstract available.
Antibodies* ; Humans ; Leprosy*

BACKGROUND: Neuropathic pain is part of the symptom complex known as peripheral neuropathy. Sensory loss, muscle weakness, atrophy, and decreased tendon reflexes are more common than pain in neuropathic disease. Recently, Bennett and Xie reported that when the sciatic nerve of a rat is loosely ligated, the rat develops pain syndrome similar to that observed in neuropathic pain states in a human. Anatomical and physiological studies to date indicate that the major pathological finding in large diameter myelinated fibers distal to the ligatures was a complex loss of response while in small myelinated fibers there were was only subtle changes. However, a more extensive analysis of the various nerve fiber groups in the damaged sciatic nerve is required for a better understanding of the pathophysiology of the present neuropathy. METHODS: To evaluate the damage and regeneration of all caliber of peripheral nerve, we performed an electron microscopic analysis of the sciatic nerve after four loose ligatures were applied. Cross- sectional photomicrographies of regions distal to the ligatures were studied. A peripheral mononeuropathy was produced in adult rats by tying 4 ligatures loosely around the common sciatic nerve. The distal part of the ligated common sciatic nerve was severed in 2 rats of each group at 1 day, 3 days, 1 week, 2 weeks and 4 weeks respectively. The severed nerves were prepared for electron microscopic examination and pathologic changes were observed under the electron microscope. RESULTS: The ultrastructural changes after ligature application were as follows: At 1 day, the axon of A-beta fiber was shrunken and detached from the myelin sheath. C-fibers were mildly edematous and A-delta fibers appeared to be normal. On the 3rd day, the axoplasm of A-beta fibers was more shrunken, containing swelling of microorganelles and irregularly thickened myelin sheath. C-fiber showed some degrees of degeneration. A-delta fibers revealed mild degeneration and interstitial edema was also noted. At 1 week, the myelin sheaths of A-beta fibers were severely irregular in appearance with marked axonal loss. Many myelin fragments were phagocytosed in the cytoplasm of adjacent Schwann cells. At 2 weeks, A-beta fibers predominantly disappeared and many fragmented myelin sheaths were ingested in the Schwann cell. In some areas, A-beta fibers partially regenerated, which involved remyelination and an increase in the numbers of microorganelles of the Schwann cells. C-fibers were also regenerated. At 4 weeks after sciatic nerve ligation, A-beta fibers regenerated and myelin ovoids were noted within the axoplasm of the A-beta fibers. Myelin ovoids were found in the Schwann cell cytoplasm. A-delta fibers and C-fibers appeared ultrastructurally well-regenerated and had a relatively normal distribution. CONCLUSIONS: We found that maximal nerve degeneration was observed at 2 weeks after sciatic nerve ligation, thereafter, nerve regeneration was noted at 4 weeks after sciatic nerve ligation.
Adult ; Animals ; Atrophy ; Axons ; Cytoplasm ; Edema ; Humans ; Ligation ; Mononeuropathies ; Muscle Weakness ; Myelin Sheath ; Nerve Degeneration ; Nerve Fibers* ; Nerve Regeneration ; Neuralgia* ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Photomicrography ; Rats* ; Reflex, Stretch ; Regeneration ; Schwann Cells ; Sciatic Nerve

This dealt with the 23 cases of giant cell tumor of femur and tibia who were treated with curettage and cementation of the lesion, over 14 year period. Cement by virtue of it's heat of polymerization may “sterilize” the wall upto 3-5mm in depth. Authors adoped cement treatment as an effective adjuvant after intra-lesional surgery(curettage). Curettage was indicated in all stage I lesions; most stage 2 and some stage 3 lesions, provided the residual bone stock were sufficient to make it oncologically and mechanically effective. The follow-up period ranged from 3 to 14 years(oaverage 8 years and 6 months). The sites of the lesions were proximal tibia in 8, dital femur in 13, proximal femur in one, and distal tibia in one. Among these cases, 3(13.0%) cases(two grade 1 and one grade 2) of stage II(To: active), and 2(8.7%) of stage III(grade 2) (Tl or T2: aggressive). Utmost attention was paid to nulify or to reduce the local seeding of the tumor cell during aggressive curettage, which was followed by electrical cautery of the cavitey wall, and lastly by the cavity obliteration with bone cement. None of the cases had lung metastasis. Only in a stage III GCT case(4.3%) of local recurrence after curettage and bone and artificial bone graft, recurettage and cementation brought the successful outcome. Through this study, it was reconfirmed that with correct indications the use of cement as a local adjuvant in conjuction with curettage was effective method in treating GCT without any side effects.
Cautery ; Cementation ; Curettage ; Femur ; Follow-Up Studies ; Giant Cell Tumors ; Hot Temperature ; Lung ; Methods ; Neoplasm Metastasis ; Polymerization ; Polymers ; Recurrence ; Tibia ; Transplants ; Virtues

Subperiosteal Cortical Defect is a symptomless rarefaction of cortical bone which begins most often on the external surface of the medial and posterior cortical walls of the lower end of the femur in children between the ages of 3 and 6 years. The name of Subperiosteal Cortical Defect was first used by Aegerter who differentiated it from non-osteogenic fibroma. The authors found out 5 positive cases of incidental findings among 62 cases of both knee joint X-ray of which 3 was male and 2 was female. Also we experienced 3 cases which necessiat d a correct diagnosis and differential diagnosis. Because this is a common lesion, it frequently accompanies more serious bone conditions, and because this is self-limited disease, treatment is not necessary. It was emphasized that its nature should be understood by all those dealing with bone disease lest it be overdiagnosed and overtreated.
Bone Diseases ; Child ; Diagnosis ; Diagnosis, Differential ; Female ; Femur ; Fibroma ; Humans ; Incidental Findings ; Knee Joint ; Male

After extensive studies of the regenerated meniscus, most of authors believe that newly replaced meniscus completely consisted of fibrous connective tissue Instead of forming fibrocartilaginous tissue. This experiment was planned to investigate the chronological effect on the normal menisci and replaced one which formed after meniscectomy In rabbits knees. Total meniscectomy was performed on the medial menlsci of both knee joints of the 40 young rabbits (5 weeks old), weighting from 300 to 400 gm and 40 adult rabbits weighting from 1800 to 2200gm. In both groups, meniscal specimens were obtained from medial area of both knee joints 3,5, 12,24 and 48 weeks following meniscectomy respectively. Medlcal meniscl of normal 5,12,24 and 48 weeks old rabbits were used as control. Each specimen was examined grossly and histologically. Serial histological sections were cut at 6um and stained with hematoxylin and eosin for the histological examination and Safranln-0 fast green Iron hematoxylin for the histochemical examination. The result obtained were as follows: 1. Macroscopically all regenerated meniscl were less shlny and smaller than normal. Its margin was blunt shaped and completely connected with synovial membrane. 2. The meniscus, at 5 weeks after birth was composed with flbroblast and flbrocyte without cartilage cells. At 12 weeks after birth, In 2 out of 4 menisci flbrocytes were transformed with round oval shaped cells with lacunae and they looked Immature cartilage cells and Iightly stained with Safranin-O. 3. In young experimental rabbits, cartilage cells were found in one out of 14 regenerated meniscl at 12 weeks after meniscectomy while in mature rabbits cartilage cells were found in 2 out of 13 regenerated meniscl at 24 weeks after meniscectomy and newly formed 3 menlsci were strongly stained with Safranin-0. Mean rate of cartilage transformation of regenerated meniscl was 10.6% in young rabbits and 8.1% In adult rabbits without much difference in Incidence of transformation rate. Cartilagenous transformation in the small area of regenerated menlscus was found In 10% of cases. It ls summarized from the result that regenerated meniscl firstiy composed with fibrous tissue, but later on regenerated meniscus partiy transforms Into cartllage cells but not entirely. It is speculated that this cartllaginous transformation is due to adaptive metaplasia.
Adult ; Cartilage ; Connective Tissue ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Incidence ; Iron ; Knee ; Knee Joint ; Metaplasia ; Parturition ; Rabbits ; Synovial Membrane

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
Audiometry ; Carpal Tunnel Syndrome* ; Condoms* ; Diagnosis ; Hand ; Mass Screening ; Median Nerve ; Neural Conduction ; Occupations ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Ulnar Nerve ; Vibration ; Wrist

OBJECTIVE: Appropriate antituberculosis chemotherapy may not prevent occurrence or progression of tracheobronchial stenosis and obstruction in the patients with endobronchial tuberculosis. The effect of corticosteroid treatment combined with antituberculosis chemotherapy was inconclusive. We evaluated prospectively the effect of corticosteroid treatment. METHODS: We diagnosed endobronchial tuberculosis by bronchoscopic examination and bronchial biopsy in the patients of tuberculosis within one month of antituberculosis chemotherapy. After randomization, we prescribed isoniazid, rifampin, ethambutol, and pyrazinamide with or without prednisolone 40 mg for 4 weeks. We carried out bronchoscopy in second month and ninth month of treatment. RESULTS: Edematous endobronchial tuberculosis showed significant improvement of bronchial stenosis after corticosteroid treatment(p<0.05). Corticosteroid treatment did not have advantage of improvement of bronchial stenosis in the patients with infiltrative endobronchial tuberculosis. CONCLUSION: Corticosteroid is effective in the treatment of bronchial stenosis when endobronchial tuberculosis is edematous type, in the early period of antituberculosis chemotherapy.
Biopsy ; Bronchoscopy ; Constriction, Pathologic ; Drug Therapy ; Ethambutol ; Humans ; Isoniazid ; Prednisolone ; Prospective Studies ; Pyrazinamide ; Random Allocation ; Rifampin ; Tuberculosis*

OBJECTIVES: This research attempts to investigate the relationship between health risk factors and workers'behavioral changes based on individual worker's characteristics to allow the development of more effective health promotion programs in businesses places. METHODS: A questionnaire survey was conducted with 282 workers employed in small to medium sized enterprises in the Kyong-in area of Korea. The questionnaire was composed of general characteristics, a health risk assessment and an evaluation of the stage of behavior change for health promotion strategy in the workplace. RESULTS: The health risk assessment revealed that 65.7 % of male workers smoke, 70.5% of male workers do not exercise on a regular basis, 86.1 % of female workers do not exercise at all, and 78.6 % of male workers and 50 % of female workers drink alcohol. In addition, the survey identified that 29.5% of male workers are addicted to excessive drinking, as are 11.1% of female workers. Based on the four stages of behavioral changes that lead to health, the pre-contemplation stage, contemplation stage, action stage, and maintenance stage, 40.5 %, 23.7 %, 12.1 % and 23.7 % of workers are in these stages, respectively, with regards to quitting smoking. As for regular exercises, 18.4 %, 37.6 %, 17.7 %, and 26.3 % of workers belong to each stage, respectively. As for moderation in drinking, 20.9 %, 15.4 %, 10.0 %, and 53.7 % are in each stage, respectively. The rate of health managers in the active stage of quitting smoking is significantly higher than that of general workers. Among the workers who do not exercise on a regular basis, workers over 50 years-old and blue color workers are more common in the precontemplation stage than any other worker groups. CONCLUSIONS: The results of this study suggest that the stages of behavioral change vary with worker characteristics. An awareness of the effects of the high risk factors is essential for promoting workers'attendance in health promotion programs.
Commerce ; Drinking ; Exercise ; Female ; Health Promotion ; Humans ; Korea ; Male ; Middle Aged ; Questionnaires ; Risk Assessment ; Risk Factors ; Smoke ; Smoking

Hypercalcemia is a relatively common complication of cancer that is clinically important because, left unattended, it is associated with symptomatic deterioration and even death. So hypercalcemia can afflict the quality of life and complicate management of the cancer patients with anorexia, lethargic, stuporous mentality, and severely dehydrated. Nonetheless, most cancers are at an advanced stage by the time hyperclacemia develops, many clinicians share doubts about the role of antihypercalcemic therapy in this situation. Furthermore, because the symptoms of hypercalcemia may mimic that of progressive malignant disease or the toxic effects of chemotherapy and radiation therapy, this may not always be recognized. So concerns are needed for active management of patients with malignant hypercalcemia. The authors reviewed the morbidity and mortality in 20 patients with malignant hypercalcemia out of 219 patients with bone metastasis, who were treated at the department of orthopaedic surgery, Catholic University Medical College from January 1989 through December 1992. The results were as follows. 1. The overall incidence of malignant hypercalcemia was 8.6% of bone metastases (20 out of 219 cases).: lung cancer 11.2% (10 out of 89 cases), breast cancer 22.5% (7 out of 31 cases), stomach cancer 6.3% (3 out of 47 cases). 2. The underlying diseases associated with hyprecalcemia were 10 cases of lung cancer(50%), 7 cases of breast cancer(35%) and 3 cases of stomach cancer(15%). Out of lung cancers, 8 cases were squamous cell cancers, the other 2 cases were oat cell cancers. 3. Only 7 out of 20 patients were treated with hydration, diuretics, steroid, calcitonin and mithramycin. And the mean survival duration after recognition of hypercalcemia was 11.3 weeks independent of treatment. In conclusion, the authors emphasize that inspite of grave prognosis, when treated actively, calcium lowering therapy may allow patients to be discharged during terminal period of their illness.
Anorexia ; Avena ; Breast ; Breast Neoplasms ; Calcitonin ; Calcium ; Diuretics ; Drug Therapy ; Humans ; Hypercalcemia ; Incidence ; Lung ; Lung Neoplasms ; Mortality ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Plicamycin ; Prognosis ; Quality of Life ; Stomach ; Stomach Neoplasms ; Stupor