PURPOSE: To determine the usefulness of three-dimensional CT angiography using multidetector-row CT (MDCT) for delineating the arterial anatomy of the liver. MATERIALS AND METHODS: Hepatic arterial three-dimensional CT angiography was performed using MDCT (Lightspeed Qx/I; GE Medical Systems, Milwaukee, Wis., U.S.A.) in 45 patients with HCC undergoing conventional angiography for transcatheter hepatic arterial chemoembolization. The scanning parameters during the early arterial phase were 2.5 mm slice thickness, 7.5 mm rotation of table speed, and a pitch of 3. Images were obtained by one radiologist using maximum intensity projection from axial CT images obtained during the early arterial phase. Two radiologists blinded to the findings of conventional angiography independently evaluated the hepatic arterial anatomy and the quality of the images obtained. RESULTS: Compared with conventional angiography, reader A correctly evaluated the hepatic arterial anatomy depicted at three-dimensional CT angiography. Reader B's evaluation was correct in 40 of 45 patients. Interobserver agreement was good (kappa value, 0.73), and both readers assessed the quality of three-dimensional CT angiography as excellent. CONCLUSION: Three-dimensional CT angiography using MDCT was accurate for delineating the arterial anatomy of the liver, and interobserver agreement was good. The modality may provide, prior to conventional angiography, valuable information regarding a patient's hepatic arterial anatomy.
Angiography* ; Hepatic Artery* ; Humans ; Liver

PURPOSE: The purpose of this study was to evaluate the utility of the CT cholangiography by using helical CT with multiplanar reformation in patients with extrahepatic biliary obstruction. MATERIALS AND METHODS: Helical CT was performed in 36 patients of extrahepatic biliary obstruction confirmed by operation or invasive cholangiography(percutaneous transhepatic cholangiography or endoscopic retrograde cholagiopancreatography). The cause of obstructions were 18 benign diseases(11 common bile duct stones, four choledochal cysts, three pancreatitis) and 18 malignant diseases(seven common bile duct carcinomas, seven pancreatic head carcinomas, three ampullary carcinomas, one periampullary duodenal carcinoma). After helical scanning through the extrahepatic bile duct, retrospective reconstruction of the helical data was performed. And then, CT cholagiogram was obtained with multiplanar reformation. We evaluated the technical success rate and the accuracy in determinating the level and the cause of the obstruction. We compared findings of the CT cholangiogram with that of operation or invasive cholangiography. RESULTS: In 100%(36/36) of cases, CT cholangiography could be obtained successfully. The accuracy of the CT cholangiography in determinating the level of the obstruction was 100%(11 cases of suprapancreatic duct, 13 cases of intrapancreatic duct, 13 cases of infrapancreatic duct and ampulla), and the accuracy in determinating the cause of the obstruction was 91.7%(all cases of 18 benign diseases, and 15 cases of 18 malignant diseases). CONCLUSION: In evaluating the obstruction of extrahepatic bile ducts, the CT cholangiography by using helical CT with multiplanar reformation is an useful noninvasive method in determinating the level.and the cause of biliary obstruction and therefore could replace t~e invasive cholangiography.
Bile Ducts, Extrahepatic ; Cholangiography* ; Choledochal Cyst ; Common Bile Duct ; Head ; Humans ; Retrospective Studies ; Tomography, Spiral Computed*

Background: A decrease in computed tomography (CT)-derived skeletal muscle radiodensity (SMD) reflects age-related ectopic fat infiltration of muscle, compromising muscle function and metabolism. We investigated the age-related trajectory of SMD and its association with vertebral trabecular bone density in healthy adults. Methods: In a cohort of healthy adult kidney donors aged 19 to 69 years (n=583), skeletal muscle index (SMI, skeletal muscle area/height2), SMD, and visceral-to-subcutaneous fat (V/S) ratio were analyzed at the level of L3 from preoperative CT scans. Low bone mass was defined as an L1 trabecular Hounsfield unit (HU) <160 HU. Results: L3SMD showed constant decline from the second decade (annual change –0.38% and –0.43% in men and women), whereas the decline of L3SMI became evident only after the fourth decade of life (–0.37% and –0.18% in men and women). One HU decline in L3SMD was associated with elevated odds of low bone mass (adjusted odds ratio, 1.07; 95% confidence interval, 1.02 to 1.13; P=0.003), independent of L3SMI, age, sex, and V/S ratio, with better discriminatory ability compared to L3SMI (area under the receiver-operating characteristics curve 0.68 vs. 0.53, P<0.001). L3SMD improved the identification of low bone mass when added to age, sex, V/S ratio, and L3SMI (category-free net reclassification improvement 0.349, P<0.001; integrated discrimination improvement 0.015, P=0.0165). Conclusion L3SMD can be an early marker for age-related musculoskeletal changes showing linear decline throughout life from the second decade in healthy adults, with potential diagnostic value for individuals with low bone mass.

The incidence of contralateral reflux after unilateral reimplantation in children with primary unilateral vesicoureteral reflux(VUR) is reported to be 0.8-32%. We evaluated the characteristics of contralateral reflux after endoscopic or open surgical correction of primary unilateral VUR in children. 30 children who underwent unilateral reimplantation by Paquin (25pts) and submucosal Macroplastique injection(5pts) were evaluated. The association between postoperative contralateral reflux and age, sex, ipsilateral implant side, postoperative urinary tract infection, and surgical method were evaluated. There were 18 male and 12 female patients. Initial reflux was observed in the right in 18 and 12 in left. The initial reflux grades were II, III, IV, and V in 2, 11, 14, and 3 patients, respectively. Postoperative urinary tract infection was observed in 4 patients of whom 1 had contralateral reflux. In conclusion, there was no single factor that could predict the development of contralateral reflux after unilateral correction of unilateral primary VUR. Furthermore, the fact that contralateral reflux occurred even after submucosal Macroplastique injection suggests that the method of surgery is not related to the subsequent development of contralateral reflux.
Child* ; Female ; Humans ; Incidence* ; Male ; Replantation ; Ureter ; Urinary Bladder ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

88 workers exposed to cadmium were examined at the 12 factories using or producing cadmium in order to know the present state of cadmium exposure and renal dysfunction in 1992. Cadmium in blood and in urine were measured and compared by the 3 exposure level of cadmium in air. Cadmium in blood of low, moderate and high exposure group were 2.5, 3,8 and 7.6 microgram/L, respectively. Cadmium in urine were 1.8(1.3), 3.8(2,6) and 7.9 microgram/L(6.1 microgram/g creatinine) , resrectively. However, there was no relationship between Urinary cadmium and beta(2)-microglobulin. Cumulative exposure estimate (CEE) was calculated by multiplying the mean ambient cadmium level of the factory and working duration. CEE has a high correlation with cadmium in blood and urine, but no relation to beta(2)-microglobulin. Because working durations were relatively shorter than European workers', the highest CEE was just 300 microgram. year/m(3), which was not enough to induce renal tubular dysfunction. This study, however, suggested the possibility that renal tubular dysfunction caused by cadmium could be happened in Korea in the near future.
Cadmium* ; Korea ; Occupations*

BACKGROUND: Eosinophilic pustular folliculitis (EPF) is characterized by erythematous patches of follicular papules and pustules that mainly involve the face. Although various treatments have been attempted for EPF, including systemic and topical steroids, dapsone and indomethacin, there is no consensus on the first choice for treatment. OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy and safety of naproxen treatment for EPF patients. METHODS: We retrospectively reviewed the clinical records of 16 biopsy-proven EPF patients who were treated with naproxen. Initial dose of oral naproxen was 500 mg to 1,000 mg. Therapeutic effects were evaluated by 3 grades: NR (no response), PR (partial remission, >50% improvement), CR (complete remission). RESULTS: Of the 16 EPF patients, 11 patients (69%) showed either complete remission (50%) or partial remission (19%). The median time to response for good responders (CR+PR) was 1.5 weeks. Two patients (13%) had mild gastrointestinal side effects, such as indigestion, but the symptoms disappeared soon after use of a gastrointestinal protectant. CONCLUSION: Oral naproxen may be an effective and safe treatment modality for EPF.
Consensus ; Dapsone ; Dyspepsia ; Eosinophilia ; Eosinophils ; Folliculitis ; Humans ; Indomethacin ; Naproxen ; Retrospective Studies ; Skin Diseases, Vesiculobullous ; Steroids

BACKGROUND: During coronary angiography, some electrocardiographic changes occured due to contrast media, which do life threatening influences. METHODS: We compared the electrocardiographic changes which were induced by injection of three radiopaque contrast media during selective coronary angiography in 49 patients with chest pain. One of the contrast media was high osmolar ionic(Urografin_76) and the another was low osmolar ionic(Hexabrix) and the last was non-ionic(Ioversol). Electrocardiograms were obtained before, during and after selective coronary angiography. RESULTS: The changes of S-T segment or T were decreased in non-ionic group rather than high osmolar or ionic group. And there was significant Q-Tc interval prolongation among all three groups except comparision of low osmolar ionic contrast dye and non-ionic contrast dye in left coronary angiography. CONCLUSION: Non-ionic low osmolar contrast media was safer than high osmolar or ionic contrast medial because of lesser change of Q-Tc interval during selective coronary angiography.
Chest Pain ; Contrast Media* ; Coronary Angiography* ; Diatrizoate Meglumine ; Electrocardiography* ; Humans ; Ioxaglic Acid ; Osmolar Concentration

Twenty-four factories registered at the Ministry of Labor as factories using or producing cadmium in 1991 were investigated to know the present state of occupational exposure to cadmium in 1992. Nine factories among 24 stopped using or changed to other substances and 1 factory didn't produce any more, but delivered it to other factories through imports. Therefore, only 14 factories were producing or using cadmium. But, alloying materials were uspplied to about 20 and more factories, however, they couldn't be investigated because of limited information. Three factories had less than 50 workers were 3, 6 had 50-300 and 5 had more than 300. About 167 workers were exposed to cadmium. According to the classification by process, there were 4 alloy processes, 2 refinary, 2 elctroplating, 2 dry cell making, 1 industrial battery and 1 copper refinary. 8 factories used metal cadmium, 3 cadmium oxide, 2 cadmium sulfide, and 1 cadmium hyroxide. One factory was importing cadmium stearates only and supplying them to the PVC making factories. The amount of metal cadmium producing in 2 refinary factories was about 50-65 ton per month. The other cadmium compounds were imported. According to exposure level of cadmium in air of the 10 factories examined, each factory could be divided into high, moderate and low exposure groups. 1 battery recycling factory and 3 alloy factories were in the high exposure group and their mean air concentrations were 0.06679, 0.05481, 0.02492, and 0.003mg/m3, respectively. Refinary and industrial battery making factories were in the middle exposure group and their mean air concentrations were 0.00773 and 0.00613 mg/m3, respectively. Finally, low exposure group were copper smelting, dry cell case making, duplicator drum making and electroplating factory and their mean air concentrations were 0.00096, 0.00071, 0.00057 and 0.00054 mg/m3 respectively.
Alloys ; Cadmium Compounds ; Cadmium* ; Classification ; Copper ; Electroplating ; Korea* ; Occupational Exposure* ; Osmeriformes ; Recycling ; Stearates

PURPOSE: To analyze, using finite element model analysis, the causes of postoperative pain in patients who had arthroscopic treatment for femoroacetabular impingement (FAI). MATERIALS AND METHODS: Ten patients with FAI treated by arthroscopic surgery between July 2004 and July 2007 were selected. Five cases whose condition improved to a pain score of 3 postoperatively were assigned to comparative group A and 5 cases who had a second operation done due to a pain score of 1 were assigned to experimental group B. Finite element model analysis was done for the impingement test position. Femoral offset and alpha angle were measured to compare with contact pressure or von Mises stress. RESULTS: Preoperative von Mises stress and contact pressure were all higher in group B than group A. Maximal stress and pressure location was the anterolateral surface of the femoral head and neck, and this location was removed more accurately in group A. CONCLUSION: Finite element model analysis of FAI indicated that incomplete removal of a bump was the cause of pain, and that accurate location of the lesion and adequate bump removal are the definitive factors in reducing pain.
Arthroscopy ; Femoracetabular Impingement ; Head ; Hip ; Humans ; Neck ; Pain, Postoperative

PURPOSE: To report the clinical and radiological outcomes of a mid-term follow-up of patients with femoroacetabular impingement treated using an arthroscopic method. MATERIALS AND METHODS: Of the patients who underwent an arthroscopic labrectomy (91 cases), femoroplasty (82 cases) or acetabuloplasty (9 cases) after a diagnosis of femoroacetabular impingement, 82 patients (91 cases) who had been followed up were examined. The preoperative and postoperative clinical outcomes were evaluated using the Modified Harris hip score, Hip Outcome Score, pain score and patient's satisfaction. The radiological assessment was performed by measuring the alpha angle, femoral offset, and center edge angle using simple radiographs and computed tomography. RESULTS: The patients consisted of 63 men and 19 women, whose mean age was 33.5 years (range, 15-70 years). The mean follow-up period was 42.2 months (range, 25-60 months). On the clinical results, the mean pain score improved from 0.72 points preoperatively to 2.02 points at the final follow-up. The Modified Harris hip score improved from 61.4 preoperatively to 83.4 at the final follow-up. The median patient satisfaction was 8.2 (range,0-10 points). On the radiological assessment, the alpha angle decreased from 60.9degrees to 40.4degrees, and the femoral offset recovered from 4.9 mm to 10.0 mm. CONCLUSION: The arthroscopic treatment of femoroacetabular impingement could be an excellent modality to prevent osteoarthritis of the hip. However, recovery of clinical results by arthroscopic treatment is not expected in elderly patients or those with developed osteoarthritis, a low preoperative Modified Harris hip score and concurrent degenerative disease.
Aged ; Arthroscopy ; Female ; Femoracetabular Impingement ; Follow-Up Studies ; Hip ; Humans ; Male ; Osteoarthritis ; Patient Satisfaction