The authors analysed retrospectively 56 cases of bile duct cancer, which were confirmed by histologically in47 cases and highly suuspected by clinically and radiologically in 9 cases. The resutls were as follows: 1. Themost prevalent age groups were 5th decade and a male to female ratio is 2.7:1. 2. The location of bile ductcarcinomas were common bile duct in 36%, common hepatic duct in 25%, junction in 13%, porta haptis in 11% anddiffuse involvement in 5%. 3. The accuracy of predicting obstruction is by ultrasonography was 76%. 4. Correctdiagnosis as bile duct carcinoma was made in 29 cases(43%). 5. The echogenicity of bile duct carcinoma compare toliver parenchyme was hyperechoic in 10 cases(34.5%), isoechoic in 14 cases(48.3%) and hypoechoic in 5cases(17.2%). 6. Posterior acoustic shadowing was seen in 5 cases. 7. The shape of obstruction site was abruptcut-off in 12 cases(41%), funnel shape in 7 cases(24%) and indistinct in 10 cases(35%).
Acoustics ; Bile Duct Neoplasms ; Bile Ducts ; Bile ; Biliary Tract ; Common Bile Duct ; Female ; Hepatic Duct, Common ; Humans ; Male ; Retrospective Studies ; Shadowing (Histology) ; Ultrasonography

Duodenal diverticulum is commonly found at 2nd portion of duodenum undergoing duodenal procedure. It is generally asymptomatic and not harmful. But occasionally it causes massive upper gastrointestinal bleeding. Bleeding from duodenal diverticulum is very difficult to diagnose and manage since vision of the lesion by conventional direct endoscope is limited. Recently, emphasis has been placed on aggressive and careful endos- copic diagnosis and hemostasis with hemoclip or local injection. We report a case of massive duodenal diverti- cular bleeding on a senile patient which was treated successfully by endoscopic hemoclip therapy.
Diverticulum ; Duodenal Diseases ; Duodenum ; Endoscopes ; Gastrointestinal Hemorrhage ; Hemorrhage ; Hemostasis ; Humans ; Vision, Ocular

Pancreatic acinar cell carcinoma is an uncommon malignancy of the exocrine pancreas. Because of a higher recurrence rate and frequent metastases, this tumor, generally, has a poor prognosis. We report a case of pancreatic acinar cell carcinoma in a 60-year-old man. His chief complaint was jaundice. Abdominal CT revealed a heterogeneous enhancing mass in the pancreatic head measuring 8.2x7.5cm. After receiving the Whipple procedure, acinar cell carcinoma was diagnosed by pathological examination. Liver metastasis was found at one year after the curative resection.
Acinar Cells ; Carcinoma, Acinar Cell ; Head ; Humans ; Jaundice ; Liver ; Middle Aged ; Neoplasm Metastasis ; Pancreas ; Pancreas, Exocrine ; Prognosis ; Recurrence

It was already reported in else where that a standard linear accelerator, with only slight modification can function in a manner similar to Leksell's Gamma unit device in the treatment of inoperable deep seated intracranial lesions. Using collimated narrow beams, a localization system and special computer programs for precise patient positioning and a high concentration of irradiation dose within the lesions, eleven patients with AVMs and brain tumor have now been treated since 1988. The 6 MeV linear accelerator and Hitchcock stereotactic frame was used of the all procedures. In 10 of the 11 patients, no side effects occurred. The first 7 patients, who could be observed 3 months or longer have been studied radiologically and clinically. In 6 patients marked decrease in contrast enhancement and sometimes dramatic clinical improvement was achieved. In one case a marked increase of the surrounding brain edema occurred 7days after radiosurgery, who was operated on. The radiantion dose was based on the volume, location and radiosensitivity of the lesion which ranged 15-40 Gy.
Brain Edema ; Brain Neoplasms ; Humans ; Particle Accelerators* ; Patient Positioning ; Radiation Tolerance ; Radiosurgery*