Pulmonary aspergilloma may usually demonstrate the classic "air-crescent sign" in the conventional radiograph. However, this lesion is often seen as a pulmonary nodule or is obscured by the surrounding scarred and fibrotic lung tissue, which may limit the value of the conventional techniques and hinder the diagnosis. We retrospectively analysed the plan film findings of 44 lesions of 40 patients and CT findings of 29 lesions of 26 patients with pulmonary aspergilloma with special emphasis upon the atypical manifestation. The cases with classic "air-meniscus sign" in conventional radiograph accounted for 50%, while 30%, presented with a pulmonary nodule and 20% were unrecognized forms due to surrounding parenchymal lesion. CT findings of 28 aspergillomas were analyzed according to the shape of the intracavitary space(space between the cavity wall and the fungal ball) and the fungal ball itself. The intracavity space showed "air-meniscus sign" (62%), filling cavity (28%), peripheral air bubble (3%) and high density due to hemorrhage (3%), in descending order of frequency, The shape of the fungal ball itself showed homogeneous low density mass (62%) and spongeform or irregular air bubble contained mass (34%), CT was more accurate than conventional radiograph in the diagnosis and evaluation of number and location of atspergilloma, particularly in the case of atypical presentaion and was useful to assess the associated disease and to predict postoperative outcome.
Cicatrix ; Diagnosis ; Hemorrhage ; Humans ; Lung ; Retrospective Studies

PURPOSE: The aim of this study was to compare conventional scissors and Harmonic Scalpel(R) hemorrhoidectomy. METHODS: Two hundred and five patients were prospectively assigned to two groups in the consecutive order. The group was divided into Group A (Harmonic Scalpel(R) excision; n=101) and Group B (conventional scissor excision; n=104). All other aspects of surgery and anesthesia were standardized. Intramuscular opiate was available on demand during the postoperative period, and analgesic requirements were also recorded. All patients noted their pain on a daily basis using a visual analogue scale (0=no pain; 10=worst pain). The length of hospitalization, operative time and postoperative complications were also analyzed. RESULTS: The operative time was 16.6 +/- 0.9 minutes 25.3 +/- 0.8 minutes in Group A and B, respectively (p<0.01). Length of hospital stay was 4.1 +/- 0.1 and 4.5 +/- 0.1 days (p<0.05). Pain scores in the group A were significantly lower than in the group B (p<0.01). Analgesic requirements were also significantly less in group A (p<0.05). Postoperative complications, such as urinary retention, fecal impaction and skin tags were rarer in group A. One patient in group A and two patients in group B developed secondary hemorrhage, but no patient had anal stricture. CONCLUSIONS: The Harmonic Scalpel(R) excision significantly shortens the operative time for hemorrhoidectomy with less blood loss and postoperative pain without remarkable early or late postoperative complications.
Anesthesia ; Constriction, Pathologic ; Fecal Impaction ; Hemorrhage ; Hemorrhoidectomy* ; Hospitalization ; Humans ; Length of Stay ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Skin ; Urinary Retention

Constrictive pericarditis is caused by fibrosis of the pericardium leading to decrease in ventricular compliance. The diagnosis is often delayed due to nonspecific signs and symptoms. The authors experienced eight cases of constrictive pericarditis detected on chest CT scan while being treated for considerable length of time under the clinical impressions of intrathoracic tumor, tuberculous pleural effusion, liver cirrhosis, etc. Constrictive hemodynamics of these patients were confirmed by echocardiogram and cardiac catheterization. Among them five cases were due to tuberculosis. In four cases with pathologically proven tuberculous granuloma, the pericardium was markedly thickened and intensely enhanced. Associated pericardial effusion (n=3), and mediastinal lymphadenitis (n=3) were present, but pericardial calcifications were not seen. On the other hand, the fibrosis group (n=3) displayed mild pericardial thickening. All the three patients showed pericardial calcifications, mild or absent enhancement of pericardium, but no mediastinal lymphadenitis. The cardiovascular changes such as inferior or superior vena caval distension, left ventricular deformity, interventricular septum angulation, and biatrial enlargements were more severe than those in patients with active granuloma. In patients with constrictive pericarditis with nonspecific signs and symptoms, CT scan is very helpful in making the diagnosis and can give informations about the evolution of the disease.
Cardiac Catheterization ; Cardiac Catheters ; Compliance ; Congenital Abnormalities ; Diagnosis* ; Fibrosis ; Granuloma ; Hand ; Hemodynamics ; Humans ; Liver Cirrhosis ; Lymphadenitis ; Pericardial Effusion ; Pericarditis, Constrictive* ; Pericardium ; Pleural Effusion ; Tomography, X-Ray Computed ; Tuberculosis

Constrictive pericarditis is caused by fibrosis of the pericardium leading to decrease in ventricular compliance. The diagnosis is often delayed due to nonspecific signs and symptoms. The authors experienced eight cases of constrictive pericarditis detected on chest CT scan while being treated for considerable length of time under the clinical impressions of intrathoracic tumor, tuberculous pleural effusion, liver cirrhosis, etc. Constrictive hemodynamics of these patients were confirmed by echocardiogram and cardiac catheterization. Among them five cases were due to tuberculosis. In four cases with pathologically proven tuberculous granuloma, the pericardium was markedly thickened and intensely enhanced. Associated pericardial effusion (n=3), and mediastinal lymphadenitis (n=3) were present, but pericardial calcifications were not seen. On the other hand, the fibrosis group (n=3) displayed mild pericardial thickening. All the three patients showed pericardial calcifications, mild or absent enhancement of pericardium, but no mediastinal lymphadenitis. The cardiovascular changes such as inferior or superior vena caval distension, left ventricular deformity, interventricular septum angulation, and biatrial enlargements were more severe than those in patients with active granuloma. In patients with constrictive pericarditis with nonspecific signs and symptoms, CT scan is very helpful in making the diagnosis and can give informations about the evolution of the disease.
Cardiac Catheterization ; Cardiac Catheters ; Compliance ; Congenital Abnormalities ; Diagnosis* ; Fibrosis ; Granuloma ; Hand ; Hemodynamics ; Humans ; Liver Cirrhosis ; Lymphadenitis ; Pericardial Effusion ; Pericarditis, Constrictive* ; Pericardium ; Pleural Effusion ; Tomography, X-Ray Computed ; Tuberculosis

No abstract available.

In the neonatal diseases of pediatric surgery, a congenital duodenal obstruction is an important part of congenital disease. Between March 1994 and December 1996, 15 cases of congenital duodenal obstruction were experienced and treated at St. Francisco's General Hospital. The following results were obstained: 1) The types of congenital duodenal obstruction were 5 malrotations, 4 atresia, 3 webs, 2 annular pancreases, and 1 obstruction due to an ectopic pancreas. 2) There were 8 males and 7 females; the male to female ratio was 1.14 : 1. 3) The age on admission was 1 to 7 days in 13 cases (87%), and all cases were admitted within 1 month after birth. 4) The birth weight below 2500 gm in only 2 cases (13%). 5) The main clinical symtom was vomiting (93%). 6) Associated anomalies were found in 11 cases (73.3%): 4 cases of congenital heart disease, 3 of Down's syndrom, 2 of malrotations, 2 of urogenital anmalies, and 1 each of jejunal atresia, midgut volvulus, and polydactyly. 7) Postoperative complications occurred in 4 cases (27%), but there was no deaths.
Birth Weight ; Duodenal Obstruction* ; Female ; Heart Defects, Congenital ; Hospitals, General ; Humans ; Infant, Newborn ; Intestinal Atresia ; Intestinal Volvulus ; Male ; Pancreas ; Parturition ; Polydactyly ; Postoperative Complications ; Vomiting

No abstract available.
Esophageal Atresia* ; Tracheoesophageal Fistula*

Adalimumab (Humira(TM)) is the first fully humanized monoclonal TNF-alpha antibody that antagonizes the effects of TNF-alpha. Its use has been found in the treatment of various rheumatologic disorders, namely rheumatoid arthritis, Crohn's disease, and ankylosing spondylitis, as well as for various skin conditions such as psoriasis. As the use of this particular biologic agent is becoming more widespread, cutaneous adverse effects of the drug is now being reported at a steady rate. The authors herein report a case of 32 year-old female who presented with multiple psoriasiform eruptions on her trunk, back and lower extremities. She had a four-year history of ankylosing spondylitis, for which she was started on subcutaneous adalimumab injection monthly, three and a half years prior to her initial visit.
Antibodies, Monoclonal, Humanized ; Arthritis, Rheumatoid ; Crohn Disease ; Dermatitis ; Female ; Humans ; Lower Extremity ; Psoriasis ; Skin ; Spondylitis, Ankylosing ; Tumor Necrosis Factor-alpha ; Adalimumab

No abstract available.
Hydroxyurea ; Hyperpigmentation*

D variant of encephalomyocarditis (EMC-D) virus causes diabetes in susceptible mice by direct infection and cytolysis of pancreatic beta cells. cDNA covering the major outer capsid protein (VP1) of EMC-D virus was cloned into Mycobacterium bovis bacillus Calmette-Guerin (BCG). None of the SJL/J male mice, immunized with live recombinant BCG-VP1, became diabetic when challenged with highly diabetogenic EMC-D virus. But the control mice inoculated with normal BCG or rBCG transformed with vector alone developed diabetes in the same challenge. VP1-specific antibodies including neutralizing antibodies were markedly increased as time went on and reached to the maximum titer at week 10 after a single immunization. The plateau of the titer lasted longer than following 4 weeks. Guinea pigs immunized with the live rBCG-VP1 showed strong delayed type hypersensitivity (DTH) to the VP1of EMC-D virus. It means that the live rBCG-VP1 elicit efficient humoral and cell-mediated imrnune responses against EMC-D virus, resulting in prevention of virus-induced diabetes in susceptible mice.
Animals ; Antibodies ; Antibodies, Neutralizing ; Bacillus ; Capsid Proteins ; Clone Cells ; DNA, Complementary ; Guinea Pigs ; Humans ; Hypersensitivity ; Immunization* ; Insulin-Secreting Cells ; Male* ; Mice* ; Mycobacterium bovis*