To investigate the diagnostic accuracy of ERCP in pancreatobiliary disease, the authors analysed the 1,244 cases of ERCP. The success rate of ERCP was 91.5%. The diagnostic accuracy of ERCP was 93.6% and complications occurred in 2.1%. Complications included pancreatitis,cholangitis and drug reactions. Among the biliary tract disease diagnosed, by ERCP, biliary tract stone was the most common finding. Compared with operative diagnosis of biliary tract stones,the sensitivity of ERCP diagnosis was 92.7% while that of sonographic diagnosis was 81.4%. The specificity of ERCP diagnosis was 94.4% while that of sonagraphic diagnosis was 80.9%. ln the diagnosis of common bile duct stones, ERCP was more accurrate than sonographic diagnosis. The results show that ERCP was a safe and effective diagnostic tool in the assessment of pancreatobiliary tract disease.
Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Diagnosis ; Sensitivity and Specificity ; Ultrasonography

To investigate the diagnostic accuracy of ERCP in pancreatobiliary disease, the authors analysed the 1,244 cases of ERCP. The success rate of ERCP was 91.5%. The diagnostic accuracy of ERCP was 93.6% and complications occurred in 2.1%. Complications included pancreatitis,cholangitis and drug reactions. Among the biliary tract disease diagnosed, by ERCP, biliary tract stone was the most common finding. Compared with operative diagnosis of biliary tract stones,the sensitivity of ERCP diagnosis was 92.7% while that of sonographic diagnosis was 81.4%. The specificity of ERCP diagnosis was 94.4% while that of sonagraphic diagnosis was 80.9%. ln the diagnosis of common bile duct stones, ERCP was more accurrate than sonographic diagnosis. The results show that ERCP was a safe and effective diagnostic tool in the assessment of pancreatobiliary tract disease.
Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Diagnosis ; Sensitivity and Specificity ; Ultrasonography

Since 1974, we had performed five cases of total elbow replacement; four cases of Coonrad type and one case of Stanmore type. There were done In three cases of comminuted fracture and dislocation of the elbow and two cases of ankylosis of the elbow. We could obtain useful range of motion in three cases and good stability without pain in all the cases. In one case of Coonrad type total elbow, we removed the prosthesis at five years and three months later due to infection of the Joint. In another case of Coonrad type total elbow, there was transitory tourniquet palsy of the arm.
Ankylosis ; Arm ; Arthroplasty, Replacement, Elbow ; Dislocations ; Elbow ; Fractures, Comminuted ; Joints ; Paralysis ; Prostheses and Implants ; Range of Motion, Articular ; Tourniquets

In recent years, with increased number and higher speed of the automobiles, the incidence of the so-called whiplash injury has been increasing. The author had studied the clinical symptoms and signs, roentgenographic findings, associated injuries and treatment of the sixty four patients who had admitted to the Yonsei Medical Center under the diagnosis of the whiplash injury excluding the patients who had sustained an associated injuries those may cause neurologic symptoms and signs during the period of eight years from January, 1972 to December, 1979. and sumnerized the results as followings. 1. Among the sixty four patients, thirty one (48.4%) were male and thirty three (51.6%) were female. The most prevalent age were third and fourth decades (62.5%). 2. The causes were rear-end collision, falling of a car, front-end collision, falling of an airplane in an air-pocket and sudden deceleration of a car in the order of frequency. 3. The admission period were longest in the cases of falling of a car (13.3 days) and shortest in the cases of sudden deceleration of a car (9.4 days). 4. Fifty one (79.7%) were returned to the general activity in two weeks and fifty seven (89.1%) were out of the hospital in three weeks. 5. On admission. the patients were suffered from the symptoms and signs as followings, headache, limitation of the motion in neck, neckache, paresthesia, dizziness and dysphagia in the order of frequency. 6. Roentgenograms show loss of lordotic curve in twenty eight (43.7%) and prevertebral swelling in seven (10.3%). 7. Thirty six (56.3%) were associated with other injuries as followings; multiple contusion, teeth injuries, scalp laceration. There were thirteen cases (36.1%) of cerebral concussion. 8. In all the cases, we used analgegics and muscle relaxants until the neck pain subsided. We had performed cervical traction, hot packs in selected cases. Twelve (18.8%) needed cervical braces or Thomas collar at discharge.
Accidental Falls ; Aircraft ; Automobiles ; Braces ; Brain Concussion ; Clinical Study ; Contusions ; Deceleration ; Deglutition Disorders ; Diagnosis ; Dizziness ; Female ; Headache ; Humans ; Incidence ; Lacerations ; Male ; Neck ; Neck Pain ; Neurologic Manifestations ; Paresthesia ; Scalp ; Tooth Injuries ; Traction ; Whiplash Injuries

The appendiceal mucocele is a rare disease and very difficult to get the diagnosis preoperatively because of the rartity of classical symptoms. With progress in diagnostic procedures such as colonofiberscopy, preoperative diagnosis of appendiceal mucocele has become possible. We experienced a case of appendiceal mucocele in 50 years old male who was admitted due to vague RLQ discomfort, and was diagnosed by colonofiberscopy and surgical specimen obtained by right hemicolectomy. So we present this case with a review of literatures.
Appendix ; Diagnosis ; Humans ; Male ; Middle Aged ; Mucocele* ; Rare Diseases

No abstract available.
Humans ; Immunoglobulin G* ; Immunoglobulins* ; Pneumonia*

Cancer of the gastric stump, first described by Balfour in 1922, is defined as the cancer detected more than 5 years after surgery for a benign disease. We experienced a case of cancer found at the gastric stump after gastrojejunostomy in a 53 years old male patients, proven pathologically as a early cancer. He visited to our hospital with the chief complaint of epigastric pain and indigestion for 1 Months. On past history, he has been received gastrojejunostomy due to duodenal ulcer obstruction, 23 years ago, Gastrofiberscopy was done, and we could find the early gastric cancer lesions at the anterior wall of gastric angle as type Ilc+III and antrum as type IIa. The microscopic finding of the multiple endoscopic biopsies at the gastic angle and antrum revealed the adenocarcinoma of signet ring cell type infiltrated to the level of submucosa. And so, we could diagnose these lesions as a early gastric cancer in the gastric stump after gastrojejunostomy. He was treated with subtotal gastrectomy and discharged with cured condition. Therefore, we report this case with a literature review.
Adenocarcinoma ; Biopsy ; Duodenal Ulcer* ; Dyspepsia ; Gastrectomy ; Gastric Bypass* ; Gastric Stump* ; Humans ; Male ; Middle Aged ; Stomach Neoplasms

OBJECTIVES: About 60% of all deaths due to acute pancreatitis occur within the first 7 days of onset and associated with acute lung injuries. Lung injury include pulmonary infiltration, pulmonary edema, pleural effusion, and adult respiratory ditress syndrome. But it is unclear whether the acute lung injury is related with severity of pancreatitis. In this study, we have evaluated the association between acute lung injury and severity of pancreatitis in experimental acute pacreatitis. METHODS: Twenty-one male Sprague-Dawley rat (200-250 g B.wt) were used. There were three groups: control (group 1, n=7), edematous pancreatitis (group 2, n=7), and necrotizing pancreatitis (group 3, n=7). For inducing a edematous pancreatitis, rat was received a 4 hour intravenous infusion of cerulein (5micro/kg/hr). For a necrotizing pancreatitis, rat was received intraductal injection of taurocholate (5%, 0.1ml/100 g B.wt). After pancreatitis was induced, the pancreas, lung and blood were prepared for biochemical and histologic changes each other. Bronchoalveolar lavage (BAL) was also taken. RESULTS: Cerulein induced edematous pancreatitis and taurocholate induced necrotizing pancreatitis. Amylase was significantly increased in edematous and necrotizing pancreatitis. BAL findings showed that neutrophil was increased from 2% to 49% in necrotizing pancreatitis. The severity of lung injury was more severe in necrotizing pancreatitis than edematous pancreatitis. CONCLUSION: These observations suggest that the lung injury was strongly associated with severity of acute pancreatitis and neutrophil may be capable of important role in the development of lung injury.
Acute Lung Injury* ; Adult ; Amylases ; Animals ; Bronchoalveolar Lavage ; Ceruletide ; Humans ; Infusions, Intravenous ; Lung ; Lung Injury ; Male ; Neutrophils ; Pancreas ; Pancreatitis* ; Pleural Effusion ; Pulmonary Edema ; Rats ; Rats, Sprague-Dawley ; Taurocholic Acid

We have experienced six new cases of mucinous ductal ectasia of the pancreas. Muci-nous ductal ectasia is characterized by mucin secretion and dilatation of the main pancreatic duct. These tuinors have been reported with increasing frequency, especially in Japan, where in 1982, it was advocated that they represent a new clinical entity. ERCP revealed a dilated pancreatic duct in the absence of obstructing ductal strictures and amorphous filling defects in the main pancreatic duct. Endoscopic findings included a patulous ampullary orifice, bulging ampulla of the Vater and mucin secretion from an orifice. We reviewed a total of twenty six cases including our six, of mucinous ductal ectasia, which were reported in various Korean literature. Clinical and radiologic studies of the twenty six cases were performed. They included nineteen men and seven women, 40-79 years of age. Twelve patients had symptoms of epigastric pain. From endoscopic retrograde pancreatography, twenty four patients showed mucin secretion from an orifice, twenty three patients showed a patulous arnpullary orifice, and twenty four patients showed dilatation of the main pancreatic duct. Pathological examination showed fifteen intraductal papillary mucinous hyperplasias, seven adenocarcinom-as, and four adenomas.
Adenoma ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Dilatation ; Dilatation, Pathologic* ; Female ; Humans ; Hyperplasia ; Japan ; Male ; Mucins* ; Pancreas* ; Pancreatic Ducts

Ultrasound scanning of a peripheral nerve along its expected course is a simple and useful method for determining the cause of peripheral neuropathy. We present 3 cases of peripheral neuropathy in which the pathology was detected by simple ultrasound scanning of the affected nerve. There were 2 cases of entrapment neuropathy due to mucoid cyst and 1 case of nerve sheath tumor. All lesions were visualized by simple ultrasound scanning of the involved peripheral nerve. Our results suggest that if a lesion affecting the peripheral nerve is suspected after history and physical examination or electrophysiologic studies, ultrasound scanning of the peripheral nerve of interest throughout its course is very helpful for identifying the causative lesion.
Nerve Compression Syndromes ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Physical Examination