BACKGROUND: It is difficult to treat patients with hepatolithiasis because of recurrent or residual stones and serious postoperative complications. This study was done to compare the operation method and postoperative progression related to location of the hepatolithiasis. METHODS: Retrospective analysis was done in 234 patients who underwent operation due to hepatolithiasis from Jan. 1989 to Dec. 1998 in Chonnam University Hospital. RESULTS: The patients with left intrahepatic duct stones were 135, with right intrahepatic duct stones were 30 and with both intrahepatic duct stones were 69. In cases of resection of the liver, left lobectomy, left lateral segmentectomy, right posterior segmentectomy or right lobectomy was done. In a patient with stone in caudate lobe, caudate lobectomy was done. In non-resected group choledocholithotomy was done. Of 135 patients with left intrahepatic stones, 117 patients(86.7%) underwent hepatic resection and 18 patients(13.3%) underwent choledocholithotomy. Of 30 patients with right intrahepatic stones, 6 patients(20.0%) underwent hepatic resection and 24 patients(80.0%) underwent choledocholithotomy. Of 69 patients with both intrahepatic stones, 36 patients(52.2%) underwent resection and 33 patients(47.8%) underwent choledcholithotomy. Overall incidence of remnant stone was 28.2%. In resected group of left intrahepatic stones, the incidence of remnant stones was 8.5% and in non-resected group 33.3%. In resected group of right intrahepatic stones, the incidence of remnant stones was 0% and in non-resected group 37.5%. In resected group of both intrahepatic stones, the incidence of remnant stones was 55.6% and in non-resected group 63.6%. Incidence of postopertive complications was 22.6% and wound complication was most common. There was no postoperative mortality. CONCLUSIONS: Hepatic resection for hepatolithiasis confined to one lobe has an advantage of low incidence of remnant stone without increasing the morbidity and mortality rate. In both intrahepatic stones, the treatment is difficult, but if operation is performed with proper selection of extent of hepatic resection, favorable result would be expected.
Humans ; Incidence ; Jeollanam-do ; Liver ; Mastectomy, Segmental ; Mortality ; Postoperative Complications ; Retrospective Studies ; Wounds and Injuries

PURPOSE: To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. MATERIALS AND METHODS: A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. RESULTS: Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. CONCLUSION: Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group.
Airway Obstruction ; Child ; Cleft Palate* ; Humans ; Incidence ; Infant ; Medical Records ; Pneumonia ; Pneumonia, Aspiration* ; Radiography ; Thorax

PURPOSE: This study examined the clinical outcomes and assessed the average time to return to play following a peroneal tendon repair in Korean athletes. MATERIALS AND METHODS: Between March 2004 and February 2017, a total of 30 athletes underwent peroneal tendon repair for a peroneal tendon tear. The indications of surgical treatment were chronic pain or intractable symptoms after a previous ankle sprain affecting sports activity refractory to conservative treatment for at least six months. The patient underwent tubulization for a longitudinal tendon rupture. Peroneus longus to peroneus brevis tenodesis was performed when tendon repair was impossible due to total rupture or multiple longitudinal rupture. RESULTS: Twenty patients not included in this study were as follows: insufficient follow-up, previous surgery, and additional bone surgery. All 10 patients had a previous ankle sprain history, tenderness and swelling on the retromalleolar area. In the 10 patient population, there were five peroneus brevis tendon tears, three peroneus longus tendon tears, one peroneus longus and brevis tendon tear, and one peroneus brevis and superior peroneal retinaculum tear. In the 10 patients, six cases of peroneal brevis tendon repair and four cases of peroneal longus to brevis tenodesis were performed. The preoperative American Orthopaedic Foot and Ankle Society score was improved from a mean of 60.6 (standard deviation [SD], 8.64) to a mean of 90.2, postoperatively (SD, 4.4; p<0.012). The preoperative visual analogue scale was improved from a mean of 5.43 (SD, 1.2) to 0.5 (SD, 0.16), postoperatively (p<0.023). The mean length of time to return to play was 12.2 weeks (range, 8~16 weeks). CONCLUSION: Peroneal tendon tear can occur due to sports injuries. If there is tenderness at the retromalleolar area, the surgeon should consider a peroneal tendon lesion. Surgical repair of the peroneal tendon can be an effective treatment to help athletes to return to play.
Ankle ; Ankle Injuries ; Athletes ; Athletic Injuries ; Chronic Pain ; Follow-Up Studies ; Foot ; Humans ; Return to Sport ; Rupture ; Sports ; Tears ; Tendon Injuries ; Tendons ; Tenodesis

Amiodarone is a potent antiarrhythmic agent that is used to treat ventricular arrhythmias and atrial fibrillation. But it has a wide range of adverse effects, including pulmonary toxicity, thyroid dysfunction, liver toxicity, gastrointestinal events, corneal deposits, peripheral neuropathy and so on. Patients treated with amiodarone should be followed regularly to assess ongoing need for amiodarone, efficacy of the drug, appropriateness of dosage, adverse effects, and potential drug interactions. We experienced a case of severe weight loss due to amiodarone-induced multiple toxicity after a long course of a low dose therapy. So we report this unusual case with literature review.
Amiodarone ; Anorexia ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Drug Interactions ; Humans ; Liver Diseases ; Peripheral Nervous System Diseases ; Thyroid Gland ; Thyrotoxicosis ; Weight Loss

Antitumor effects of Bacillus Calmette-Guerin (BCG) against superficial urinary bladder cancer is known to be strong when BCG is directly infused into the bladder, but its immunological mechanisms are poorly understood. These experiments were performed to elucidate the effects of intralesional or systemic administration of BCG on the antitumor activity in murine transitional cell carcinoma (MBT-2) model and on the production of cytokines by the activated splenocytes or macrophages. ...continue...
Animals ; Bacillus ; Carcinoma, Transitional Cell ; Cytokines ; Immunotherapy* ; Macrophages ; Mice* ; Mycobacterium bovis* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: To determine which CT findings are useful for the early diagnosis of esophageal perforation, and on the basis of these findings, to assess the accuracy of prediction of the perforation site. MATERIALS AND METHODS: A review of medical records indicated that between January 1995 and December 2001, 36 patients with esophageal perforation were admitted to our hospital. Thirteen of these [M:F=8:5; age: 28-69 (mean, 52.4) years], who had undergone CT chest scanning, were included in this study. The causes of esophageal perforation were trauma (n=5), infectious diseases (n=4), Boerhaave syndrome (n=1), lung cancer (n=1), esophageal cancer (n=1), and idiopathic (n=1). Two chest radiologists unaware of the clincal findings reviewed the CT scans and predicted whether the upper or lower esophagus was perforated. RESULTS: The most common CT finding was extraluminal air at the posterior mediastinum (n=11), while other findings included pulmonary consolidation (n=10), pleural effusion (n=7), discontinuity of the esophageal wall (n=6) and subcutaneous emphysema (n=4), fluid collection around the esophagus (n=4), esophageal wall thickening (n=4), pneumothorax (n=2), and lung abscess (n=2). The perforation site was accurately predicted in 76.9% of cases (10/13). CONCLUSION: The CT findings which help the diagnosis of esophageal perforation, and prediction of the sites at which it occurs, are extraluminal air or fluid collection, focal defect of the esophageal wall, and esophageal wall thickening.
Communicable Diseases ; Diagnosis ; Early Diagnosis ; Esophageal Neoplasms ; Esophageal Perforation* ; Esophagus ; Humans ; Lung Abscess ; Lung Neoplasms ; Mediastinum ; Medical Records ; Pleural Effusion ; Pneumothorax ; Subcutaneous Emphysema ; Thorax ; Tomography, X-Ray Computed

PURPOSE: We wanted to investigate the incidence of posterior diaphragmatic defect on chest CT in various age gropus and its lateral chest radiographic appearances. MATERIALS AND METHODS: The chest CT scans of 78 patients of various ages with posterior diaphragmatic defect were selected among 1,991 patients, and they were analyzed for the incidence of defect in various age groups, the defect location and the herniated contents. Their lateral chest radiographs were analyzed for the shape of the posterior diaphragm and the posterior costophrenic sulcus. RESULTS: The patients' ages ranged from 34 to 87 with the tendency of a higher incidence in the older patients. The defect most frequently involved the medial two thirds (n= 49, 50.4%) and middle one third (n=36, 37%) of the posterior diaphragm. The retroperitoneal fat was herniated into the thorax through the defect in all patients, and sometimes with the kidney (n=8). Lateral chest radiography showed a normal diaphragmatic contour (n=51, 49.5%), blunting of the posterior costophrenic sulcus (n=41, 39.8%), focal humping of the posterior diaphragm (n=7, 6.8%), or upward convexity (n=4, 3.9%) of the posterior costophrenic sulcus on the affected side. CONCLUSION: The posterior diaphragmatic defect discovered in asymptomatic patients who are without a history of peridiaphragmatic disease is most likely acquired, and this malady increases in incidence according to age. An abnormal contour of the posterior diaphragm or the costophrenic sulcus on a lateral chest radiograph may be a finding of posterior diaphragmatic defect.
Diaphragm ; Hernia, Diaphragmatic ; Humans ; Incidence* ; Intra-Abdominal Fat ; Kidney ; Radiography ; Radiography, Thoracic* ; Thorax* ; Tomography, X-Ray Computed*

Wegener's granulomatosis is a small vessel vasculitis characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tracts and kidney. Early diagnosis and immediate treatment are very important for a better prognosis, but the nonspecific, variable clinical manifestations and radiologic findings make the diagnosis difficult. A positive proteinase 3-antineutrophil cytoplasmic antibody test is helpful for the diagnosis of Wegener's granulomatosis. Here, we report a case of Wegener's granulomatosis in 54-year-old man who initially presented with fever and multiple cavitary consolidations on the chest radiograph suggestive of a lung abscess. The final diagnosis of Wegener's granulomatosis was based on the medical history of otitis media, gradually developed microscopic hematuria, necrotizing granulomatous inflammation on lung histopathology, and a positive proteinase 3-antineutrophil cytoplasmic antibody test.
Antibodies, Antineutrophil Cytoplasmic ; Cytoplasm ; Early Diagnosis ; Fever ; Glycosaminoglycans ; Hematuria ; Humans ; Inflammation ; Kidney ; Lung ; Lung Abscess ; Lung Diseases, Interstitial ; Middle Aged ; Otitis Media ; Prognosis ; Respiratory System ; Thorax ; Vasculitis ; Wegener Granulomatosis

PURPOSE: To compare the precise roles of high-resolution computed tomography (HRCT) and fiberoptic bronchoscopy (FOB) in the evaluation of patients presenting with hemoptysis and to determine the optimal timing for HRCT. MATERIALS AND METHODS: The results of HRCT and FOB were compared in 23 patients (15 men, 8 women) presenting with hemoptysis. Etiologies included bronchietasis (n=4), parenchymal pulmonary tuberculosis (n=4), lung cancer (n=4), endobronchial tuberculosis (n=2), and broncholithiasis (n=2). Hemoptysis was proved to be due to miscellaneous causes in an additional three cases and to be cryptogenic in four. The diagnostic results of FOB performed before and after HRCT were compared as were those of HRCT performed within and after the first 48 hours of active bleeding. RESULTS: FOB and HRCT offered a correct diagnosis in 39% and 65% of cases, respectively (p=0.005). HRCT demonstrated three cases of bronchiectasis and three of parenchymal pulmonary tuberculosis which were beyond the range of a bronchoscope. In two of five cases in which HRCT findings were nonspecific, chondromatous hamartoma and lung cancer were confirmed by FOB. In cases where HRCT was performed prior to FOB, the latter demonstrated the location and diagnosis in 82% and 47% of cases, respectively (p=0.303) ; when HRCT was performed after FOB, HRCT was correct in 67% and 17% of cases, respectively (p=0.178). In none of three cases (0%) in which HRCT was performed during the first 48 hours of active bleeding did the procedure allow a specific diagnosis. In 15 of 20 (75%) cases in which HRCT was performed after the first 48 hours, however, the diagnosis provided by CT was correct. CONCLUSION: The results of this study suggest that in patients presenting with hemoptysis, both HRCT and FOB should be used for evaluation, since they are diagnostically complementary. FOB is more useful for the diagnosis of endobronchial lesion, and HRCT for bronchiectasis and parenchymal pulmonary tuberculosis. If, in cases of hemoptysis, initial diagnosis is attempted within the first 48 hours of active bleeding, FOB should be the initial step, and HRCT images should not be obtained until active bleeding has been shown on plain chest radiograph to have abated. If this initial approach takes place after the first 48 hours of active bleeding, FOB and HRCT are equally suitable.
Bronchiectasis ; Bronchoscopes ; Bronchoscopy* ; Diagnosis ; Hamartoma ; Hemoptysis* ; Hemorrhage ; Humans ; Lung Neoplasms ; Male ; Radiography, Thoracic ; Tuberculosis ; Tuberculosis, Pulmonary

Esophageal tubular duplication is a rare congenital anomaly. We experienced a patient with esophageal tubular duplication who presented with a swallowing difficulty which was aggravated after a gastrofiberscopic examination. Preoperative diagnosis was intramural hematoma of the esophagus due to trauma caused by endoscopy. Surgical specimen revealed that hematoma was located within a duplicated lumen of the esophagus. The radiologic and endoscopic findings are discussed in correlation with its pathology.
Aged ; Case Report ; Deglutition Disorders/etiology+ACo- ; Esophageal Diseases/etiology+ACo- ; Esophagus/surgery ; Esophagus/injuries ; Esophagus/abnormalities+ACo- ; Gastroscopy/adverse effects+ACo- ; Hematoma/etiology+ACo- ; Human ; Male