Clonorchiasis procucts diffuse dilatation of the small and medium sized intrahepatic bile ducts and its cholangiogram shows visualization of many bile ducts, especially, tertiary, quaternary, and more peripheral tributaries up to the 6th tributaries. In an attempt to clarify this cholangiographic sign quantitively, we counted the visualized smaller bile ducts in clonorchiasis and compared the number of visualized ducts in normal cholangiogram, recurrent pyogenic chlangitis and carcinoma of the extrahepatic ducts. In clonorchiasis the number of visualized smaller bile ducts was considerably geater than in normal subjects and recurrent pyogenic cholangitis, but there was no singnificant statistical differences in the number of visualized bile duct tributaries between clonorchiasis and carcinoma of the bile ducts. Thus it is considered that too many ducts sign is not a unique cholangiographic finding of clonorchiasis, but we believe that in the presence of this sign with other we l known cholangiographic findings, diagnosis of clonorchiasis is very easy.
Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangitis ; Clonorchiasis* ; Diagnosis ; Dilatation

No abstract available.
Child* ; Growth Hormone* ; Humans ; Insulin* ; Insulin-Like Growth Factor I*

BACKGROUND: Acute renal failure(ARF) is characterized by rapid decline in glomerular filtration rate and retension of nitrogenous waste products. This syndrome occurs in approximately 5 percent all hospital admissions and up to 30 percent of admissions to intensive care units. ARF is diagnosed when screening of hospital patients reveals a recent increase in serum BUN(blood urea nitrogen) and creatinine. The mortality rate for ARF is approximate 40-60% and has changed little in past three decades. This lack of improvement in outcome, despite significant advances in medicine. The reasons of high mortality rate is not certain. This study intend to identify prognostic risk factors influencing survivals. METHODS: We retrospectively analyzed 60 patients with ARF during 2 years period from Oct. 1996 to Oct. 1998 at chosun university hospital. Multiple factors which may influence mortality were evaluated. RESULTS: 1)Of the 60 patients, 34 were male and 26 were female. The mean age was 55.8+/-15.9 years. 2)The cause of ARF is Drug, toxin, dehydration, infection, trauma, surgery, urinary tract obstruction, HFRS, rhabdomyolysis and bleeding. 3)Underline disease is observed in 52 case. DM, Hypertension, Malignancy, Pulmonary disease, Liver disease, Renal disease 4)The mortality rate is 31.7%. The major cause of deaths is DIC, infection and hepatic failure. 5)Based on the unpaired t-test, chi-squre analysis, albumin, total bilirubin, hemoglobin, thrombocytopenia, APACHE II score, serum sodium, urine creatinine, number of multiple organ failure, cause of acute renal failure, pH, vital sign on admission, sepsis, DIC, oilguria, and hemodialysis were significant factors between survivors and nonsurvivors(p< 0.05). 6)APACHE II score on admission is good prognostic factor for patients with acute renal failure (p<0.001). CONCLUSION: This results suggest that the evaluation of patients symptom, sign, laboratory data, APACHE II score is important for patients with acute renal failure. the discriminant score by multiple analysis and APACHE II score could relatively predict the mortality of ARF patients. however further evaluation and clinical apply of prognostic factors is required to confirm these results.
Acute Kidney Injury* ; APACHE ; Bilirubin ; Cause of Death ; Creatinine ; Dacarbazine ; Dehydration ; Female ; Glomerular Filtration Rate ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Hydrogen-Ion Concentration ; Hypertension ; Intensive Care Units ; Liver Diseases ; Liver Failure ; Lung Diseases ; Male ; Mass Screening ; Mortality ; Multiple Organ Failure ; Nitrogen ; Renal Dialysis ; Retrospective Studies ; Rhabdomyolysis ; Risk Factors* ; Sepsis ; Sodium ; Survivors ; Thrombocytopenia ; Urea ; Urinary Tract ; Vital Signs ; Waste Products

BACKGROUND/AIMS: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrast-enhanced magnetic resonance imaging (MRI). METHODS: Fifteen patients with hepatic NET (n=128) underwent enhanced MRI and DWI with multiple-b values. We analyzed three different sets: Precontrast set; DWI set (added DWI); combined set (added enhanced image). Two reviewers rated possibility of NET using a 5-point scale for each image set. Their diagnostic performance was compared using Jackknife alternative free-response ROC (JAFROC). RESULTS: Diagnostic performance was better on the combined set (figure of merit [FOM]=0.852, 0.761) than the precontrast set (FOM=0.427, 0.572, P〈0.05) and the DWI set (FOM=0.682, 0.620, P〈0.05). However, DWI improved performance compared with precontrast set without statistical difference. In small NETs (〈1 cm), all sets showed low sensitivity (10.7-65.9%) with high specificity (95.4-100%). Interobserver agreement was moderate in all image sets (k=0.521 to 0.589). CONCLUSIONS: Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.
Humans ; Magnetic Resonance Imaging* ; Neuroendocrine Tumors* ; Sensitivity and Specificity

PURPOSE: p53 is one of the most commonly mutated genes in human tumors. The aim of this study was to analyze p53 mutation in gastric cancer and its correlations with the clinicopathologic variables to clarify the usefulness of p53 mutation as a prognostic factor. MATERIALS AND METHODS: Specimens from 331 patients with gastric cancer who underwent a gastrectomy between March 1999 and April 2001 at the Kyungpook National University Hospital were used. p53 gene mutations were assessed by using a polymerase chain-reaction single-strand conformation polymorphism (PCR-SSCP) analysis. The correlations between p53 gene mutation and clinocopathologic parameters were analyzed. RESULTS: p53 mutations were found in 66 (19.9%) tumors. Among those 66 cases, mutations were seen in 23 tumors at exon 5, in 8 at exon 6, in 21 at exon 7, and in 17 at exon 8. Two mutations were shown in 3 tumors. Thirty-six (23.1%) of 156 intestinal-type tumors and 19 (13.1%) of 145 diffuse-type tumors showed p53 gene mutation (P=0.007). The frequency of p53 gene mutation didn't show any significant differences according to age, sex, stage, location, or gross type. Exon 5 mutations showed more frequently in intestinal-type tumors than in diffuse-type tumors (9.7% vs. 2.8%, P=0.024), and p53 mutation were more frequent in lymph nodes metastasis group than lymph nodes non-metastasis group with statistical significance (25.0% vs 15.6%, P=0.034). The five-year survival rate showed no statistically significant difference with p53 mutation (P=0.704). CONCLUSION: p53 mutations assessed by PCR-SSCP had little value as a prognostic factor after gastrectomy in patients with gastric cancer.
Exons ; Gastrectomy ; Genes, p53* ; Gyeongsangbuk-do ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms* ; Survival Rate

PURPOSE: Variable changes occur in the progression from normal gastric epithelium to cancer, including many tumor, tumor suppressor and DNA repair genes, as well as growth factor and its receptors. The mutation and protein expression of the p53 gene may be useful prognostic factors, but their significance is still uncertain. METHODS: Specimens from 296 gastric cancer patients, treated by a curative gastrectomy, between March 1999 and April 2001, at Kyungpook National University Hospital, were used. The p53 gene mutation was assessed using a polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis, and the overexpression of tumor p53 protein using immunohistochemistry. The correlation between the results and clinicopathological parameters were then analyzed. RESULTS: The mutation and protein overexpression of the p53 gene were shown in 61 (20.6%) and 124 (41.9%) tumors, respectively. Of the 61 cases with a p53 mutation, 43 (70.5%) showed overexpression of the p53 protein, and of the 235 without mutation of the p53 gene, 81 (34.5%) had no overexpression of the p53 protein, and also showed statistical significance (P< 0.001). The mutation and protein overexpression of the p53 gene showed no significant differences according to age, gender, stage, location and gross type, but of the 138 intestinal and 128 of the diffuse types, 33 (23.9%) and 18 (14.1%) cases, respectively, showed p53 mutation (P=0.027); whereas, of the 150 well differentiated and 142 poorly differentiated tumors, 75 (50%) and 18 (33.8%), respectively, showed overexpression of the p53 protein. Also, of the 138 intestinal and 128 diffuse types, 71 (51.4%) and 43 (33.6%) showed overexpression of the p53 protein. There were no significant differences in the 5 year survival according to the mutation and protein overexpression of the p53 gene. CONCLUSION: The mutation and protein overexpression of the p53 gene, as assessed by PCR-SSCP and immunohistochemistry, respectively, showed a statistically significant correlation, but had little value as prognostic factors following a curative gastrectomy.
DNA Repair ; Epithelium ; Gastrectomy ; Genes, p53 ; Genes, vif ; Gyeongsangbuk-do ; Humans ; Immunohistochemistry ; Stomach Neoplasms*

PURPOSE: To compare the image quality and diagnostic efficacy of turbo spin-echo (TSE) T2WI with breath-holdturbo SE T2WI and to evaluate the clinical usefulness combined breath-hold turbo SE T2WI with FLASH(fast low-angleshot) MR imaging for the evaluation of focal hepatic lesions. MATERIALS AND METHODS: A total of 47 patients with known or suspected hepatic mass were prospectively evaluated using a commercially available 1.5-T MR system. All patients were examined with conventional spin-echo T1WI, TSE T2WI, breath-hold TSE T2WI, and T1-weighted FLASHwith and without Gd-DTPA. The images were compared quantitatively (liver-lesion C/N ; CNR [contrast-to-noiseratio] and lesion detectability) and qualitatively (sharpness of anatomic structure, artifact, and overall imagequality). RESULTS: A total of 69 hepatic lesions were detected in 47 patients. Sixty-seven lesions (97.1%) were detected with Gd-FLASH, 66 (95.7%) with TSE T2WI, 65 (94.2%) with breath-hold TSE T2WI, 62 (89.9%) withnon-enhanced FLASH, and 55 (79.7%) with conventional SE T1WI. The CNR of cysts and hemangiomas was significantly greater on turbo SE T2WI and breath-hold TSE T2WI than on other sequences, but there was no significant difference between turbo SE T2WI and breath-hold TSE T2WI. For solid lesions, CNR was greatest on turbo SE T2WI and was similar on breath-hold TSE T2WI and Gd-FLASH without statistical significance, but was significantly higher than conventional SE T1WI. Breath-hold TSE T2WI and Gd-FLASH were qualitatively superior to other sequences except the vascular pulsation artifact of FLASH. Non-enhanced FLASH was also superior to conventional T1WI for CNR, lesion detectability, sharpness, respiratory motion artifact, and overall image quality. CONCLUSION: Breath-hold TSET2WI may replace turbo SE T2WI, and as well as conventional SE T1WI, FLASH with or without Gd-DTPA may be used for the evaluation of focal hepatic lesions. The combination of FLASH and breath-hold TSE T2WI may be an excellent technique that can be used to rapidly evaluate liver lesions, and at the same time offer superior overall imagequality.
Artifacts ; Gadolinium DTPA ; Hemangioma ; Humans ; Liver ; Magnetic Resonance Imaging* ; Prospective Studies

PURPOSE: To assess the usefulness of breath-hold fast MR imaging of liver with fat suppression (FS) by application of chemical saturation technique in the diagnosis of regional fatty changed suspected in sonography. MATERIALS AND METHODS: Thirteen patients who had focal lesions with diffuse, homogeneous signal changes after FS through chemical saturation technique without additional changes of imaging parameter during MR imaging of liver were selected. T1-weighed fast low-angle shot and T2-weighted turbo spin-echo sequences were obtained with or without FS during each single breath-holding session. Subjective changes of signal intensity between the pre-FS and the FS images were compared with the sonographic findings in each lesion. RESULTS: Seven lesions of decreased signal intensity after FS on T1 or T2-weighted images, including three lesions only at FS T1 images, were regarded as focal fat infiltration. All seven lesions had compatible sonographic findings as homogenously echogenic areas. Another six lesions of subjectively increased signal intensity including two lesions only at FS T2 images were regarded as focal fat sparing. All six lesions had sonographic findings as homogenous echo poor areas suggesting focal fat sparing. In cases regarded as fat infiltration, score changes were more prominent at FS T1 images than FS T2 images(p=0.0002). In cases regarded as fat sparing, score changes were more prominent at FS T2 images than FS T1 images(p=0.042). CONCLUSION: Breath-hold fast T1 and T2-weighted MR imaging with and without chemical saturation pre-pulse may be sufficient for characterization of regional fatty changes in the different ferential diagnosis of focal hepatic lesion found at sonography.
Diagnosis ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Ultrasonography

BACKGROUND: Sexual dysfunction such as erectile dysfunction (ED) may be a hidden agenda, but, it should be dealt with by family physicians in primary care. We investigated the prevalence of ED and utilization of sexual consultation practice among community family physicians. METHODS: We analyzed the subjects who were males aged over 30 and married who visited 10 community family clinics around Seoul, Korea and completed questionnaires related to erectile function and utilization of sexual consultation service from May 9 to 28 2009. ED was designated if the 5-item version of international index of erectile dysfunction (IIEF-5) scores were less than 17. RESULTS: The average age of the responders was 45.6 years. The prevalence of ED was 43.3% and increased according to age, chronic disease, low educational history and low family income. Almost all of the mild ED patients answered that they needed sexual consultation. But, half of them had no plan to have a sexual consultation. Odds ratios (ORs) with 95% confidence intervals (CIs) for having a sexual consultation or not according to variables were calculated with logistic regression. More severe ED (OR = 0.875; 95% CI, 0.827 to 0.926), existence of chronic disease (OR = 1.828; 95% CI, 1.026 to 3.260), inferior education (OR = 0.395; 95% CI, 0.196 to 0.796), and lower income (OR = 0.326; 95% CI, 0.124 to 0.857) were the factors which influenced to have a sexual consultation with a family physician. CONCLUSION: The prevalence of ED in family clinic was over 40%, but the utilization of sexual consultations was under 50%. We need to develop intervention strategies for more sexual counseling practice according to educational history, family incomes and status of ED in community family medicine clinics.
Aged ; Chronic Disease ; Counseling ; Erectile Dysfunction ; Humans ; Korea ; Logistic Models ; Male ; Odds Ratio ; Physicians, Family ; Prevalence ; Primary Health Care ; Referral and Consultation ; Sex Counseling

BACKGROUND: The abnormal barrier function in atopic dermatitis(AD) is caused by a reduction in the amounts of ceramides in the intercellular lipids in the stratum corneum(SC). Replenishing the SC via the topical application of ceramides and pseudoceramides leads to effective recovery of the barrier function of skin. OBJECTIVES: An open clinical crossover evaluation was conducted to investigate the effects in AD of a multi-lamellar emulsion(MLE) that contained pseudoceramide(PC-9s). METHODS: The study group included 30 AD patiendaverage age: 4.4 yr, range: 1-8 yr), who applied MLE or a commercial moisturizing cream(CMC, 5% urea) alternately for four weeks each. We divided the subjects into two subgroups and started with different treatments in each subgroup. Treatment efficacy was evaluated using the average subjective satisfaction scores for each symptom and the global clinical response. In addition, the SCORAD(Scoring AD) index was adopted to evaluate the severity of AD as objectively as possible. The patients were evaluated using this index every other week. RESULTS: Although the SCORAD improved in both subgroups, the patients had better results (p<0.05) when applying MLE(31-35% decrease) than CMC(13% increase to 14% decrease). The subjective satisfaction scores of the symptoms and signs of patients, including itching, erythema, and dry skin, were higher in the MLE group than in the CMC group, and the global response to treatment was also better in the MLE group. During the follow-up period, AD improved in all patients. MLE was more effective than CMC in our patients. CONCLUSIONS: The topical application of a multi-lamellar emulsion containing pseudoceramide is an effective regimen for improving symptoms of AD.
Ceramides ; Cross-Over Studies* ; Dermatitis, Atopic* ; Erythema ; Follow-Up Studies ; Humans ; Pruritus ; Skin ; Treatment Outcome