PURPOSE: To document the radiologic characteristic findings of atypical ductal epithelial hyperplasia, we analyzed film mammographic, ultrasonographic, and MRI findings of our cases. MATERIALS AND METHODS: We analyzed 23 cases of surgically proven ADH, excluding carcinoma in ipsilateral breast. Presence and pattern of neodensity, microcalcification, and architectural distortion were reviewed on mammography. Echo pattern and ductal parenchymal morphology were analyzed on ultrasonography, and enhancement speed and pattern analysis were performed on MRI. RESULTS: On film mammography, ADH showed tendency of neodensity(10 of 23 cases), m icrocalcification(11 of 23 cases), with less parenchymal distortion of surrounding structures(7 of 23 cases). On ultrasonography, ADH was demonstrated as inhomogenous to intermediate echoic nodule(16 of 20 cases) with ragged border(19 of 20 cases), however, its boundary was thin or nearly absent(16 of 20 cases), and showed smooth ductal echography(11 of 20 cases). Gd-DTPA contrast dynamic MR study showed relatively slow and less enhancement in 4 out of 5 cases, with progressive inclination of the speed curve of enhancement in later period of dynamic study. CONCLUSION: Multimodality image approach is needed for better evaluation of ADH, however, excisional biopsy is recommended for confirmative diagnosis and proper treatement.
Biopsy ; Breast* ; Diagnosis ; Gadolinium DTPA ; Hyperplasia* ; Magnetic Resonance Imaging ; Mammography ; Ultrasonography*

Focal nodular hyperplasia is a benign hepatic tumor mainly composed of nodules of hepatocytes and Kupffer cells separated by fibrous septa. In general, it is difficult to differentiate focal nodular hyperplasia and hepatocellular carcinoma on ultrasonography, conventional CT(computerized tomography), and angiography. But IV bolus CT is of particular value in the diagnosis of focal nodular hyperplasia because it can divide enhanced CT into early and late phase and can characterize tumor vascularity and analyze any intratumoral elements. In our case, it was seen as a hypoechoic mass lesion on ultrasonograpl'hy and hyperdense mass lesion on early-phase IV bolus CF and isodense mass, lesion on late-phase IV bolus CT. On angiography, hypertrophy of the feeding artery and tumor staining were well visualized. The patient underwent operation and the mass was pathologically confirmed to a focal nodular hyperplasia. We report the first case of focal nodular hyperplasia on IV bolus CT in Korea.
Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis ; Focal Nodular Hyperplasia ; Hepatocytes ; Humans ; Hypertrophy ; Korea ; Kupffer Cells ; Liver* ; Ultrasonography

No abstract available.
Peptic Ulcer Perforation* ; Peptic Ulcer*

A 76-years old man with a ruptured abdominal aortic aneurysm underwent an emergency abdominal aortic replacement with artificial graft. The patient developed abdominal compartment syndrome at the day of the operation and he received secondary decompression operation the next day. At 45 hours after the second operation the patient was returned to operation room to close the abdominal fascia, and sigmoid colon necrosis was found so we performed sigmoid colectomy with colostomy. After 22 days from the last operation, the abdominal wound was closed completely and the patient was discharged at the 42nd postoperative day with a colostomy state. We report here on this complex case together with a review of the recent articles.
Aged ; Aortic Aneurysm, Abdominal* ; Colectomy ; Colon* ; Colon, Sigmoid ; Colostomy ; Compartment Syndromes ; Decompression ; Emergencies ; Fascia ; Humans ; Intra-Abdominal Hypertension* ; Ischemia* ; Necrosis ; Transplants ; Wounds and Injuries

No abstract available.
Daegu* ; Humans ; Infant, Newborn* ; Sex Ratio*

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging

BACKGROUND: A lots of fires were happened every years. And then, the many peoples have died because of foe. It is important to plane for initial field emergency management that the major cause of death and injury type is analysed by large scaled fire. METHOD: We have analysed the fire victims by large scaled fire from Jan. 1995 to Dec. 1995 in Korea. We analysed systemic factors, environmental factors, patient factors which was acquired from medical records and interviews with victims, victim's famaly, rescuer. RESULT: The total number of victims are 130 and the mortality rate is 61.5% (80 patients). The major injury and cause of death were inhalation injury and trauma. The injury type of fire victims are 19 cases of inhalation injury, 13 cases of laceration,5 cases of burn,5 cases of contusion,4 cases of blephaloconjunctivitis. In fire deaths, the 78 victims (97.5%) were death associated with the gas inhalation, and the only 2 fire deaths were due to trauma. This result of the cause of death was higher inhalation injury than previously reported literature because most fires of our study was happened at the closed-maze area. CONCLUSION: When the fee was happened at closed-maze area, many victims foiled to escape the space because of smoke, toxic inhalants from combustible interior decoration, and then were death.
Cause of Death ; Emergencies* ; Emergency Treatment* ; Fees and Charges ; Fires* ; Humans ; Inhalation ; Korea ; Medical Records ; Mortality ; Smoke ; United Nations

BACKGROUND: The Sampung Collapse took place at 17:55 June 29, 1995. The rescue operation encountered 458 dead and 477 multiply traumatized patients and 464 non traumatized peoples. We wanted to present basic data for disaster planning for example of Sampung Collapse. METHODS: We made a survey of accident field immediately after accident and interviewed with victims, victim's famaly, and rescuer. We analysed the medical record and SCL-9 (Hopkins symptom check list 90R) which was checked several list with victims, victim's family and control group. RESULT: The mean RTS was 11.9 and the mean ISS was 4.3.96 long bone fractures occurred in 76 patients. 127 case of vertebral injury occurred in 63 patients. Total number of surgical operations were 237. There are also many crushing injury and acute post-traumatic stress diseases. CONCLUSION: There are many injury types which are crushing injury, vertebral injury, blunt trauma and acute PTSD(post traumatic stress diseases). Thus, The field management, especially field triage, is very important. And, the urgent patients were 72 patients, about 5% of total patients, witch needed intensive care in tirtiary hospital. Therefore, we need to plan out the expeditious proper management. and prevention of disaster propagation.
Disaster Planning ; Disasters ; Fractures, Bone ; Humans ; Critical Care ; Medical Records ; Triage ; Wounds, Nonpenetrating

Clinical observation was made on 272 cases of urolithiasis who admitted in the department of Urology, Seoul Adventist Hospita1, during the period from Jan. 1976 to Dec. 1980. The results of this observation may be summarized as follows: 1. Among total admissions (969 cases), those with urolithiasis were 272 cases (28.2%) and the sex ratio of male and female was about 9.2 : 5.9. 2. The highest incidence on age distribution showed in 20 to 40 years (61.0%). 3. On seasonal distribution, occurence was prevalent in summer (3O.8%). 4. The ureter was he most favored predilection site of urinary stone (84.9%) and upper urinary stones were almost noted (95.6%). The most common location of ureteral stones was lower third of ureter (60.2%). 5. In the aspect of number of urinary calculi, the single was in 257 cases (91.8%) and the most common size was below 1.0cm in diameter (64.8%), weight in 0.6-1.0gm (38.4%). In shape, round or oval stones were more prevalent (38.9%) and the 2 cases of staghorn calculi were noted in renal region. 6. The clinical symptoms of upper urinary tact showed flank pain in 91.8%, nausea & vomiting: etc. in 57.8%. hematuria in 47.8% but in lower urinary tract, hematuria was in 83.3%, vesica1 irritability in some cases. 7. Microscopic hematuria showed in 88.8% and pyuria in 65.3% Positive urine cultures above ever 100,000 colony/ml were obtained in 158 cases (58.O%) and most common organisms were E. coli (56.8%), staphylococcus aureus (21.5%), Proteus mirabilis (8. 2%). 8. It upper urinary stones, hydronephrosis with or without functional deterioration were detected in 91% on excretory urogram or other X-ray films, Among them, moderate hydronephrosis showed in 34.9% 9. The 142 cases of urolithiasis (58.0%) were treated with surgical intervention. Among them, ureterolithotormy was made in 40.7%. 10. On chemical analysis of urinary calculi (107 cases), calcium phosphate and calcium oxalate in mixed type was most common (39.8%). On the chemical component of urinary calculi, most prevalent types were phosphate stone (72.2%). oxalate stone (61.7%), etc.
Age Distribution ; Calcium ; Calcium Oxalate ; Calculi ; Female ; Flank Pain ; Hematuria ; Humans ; Hydronephrosis ; Incidence ; Male ; Nausea ; Proteus mirabilis ; Pyuria ; Seasons ; Seoul ; Sex Ratio ; Staphylococcus aureus ; Ureter ; Urinary Calculi ; Urinary Tract ; Urolithiasis* ; Urology ; Vomiting ; X-Ray Film