PURPOSE: Hepatic atrophy has been recognized as a complication of hepatic and biliary disease but we have often found it in follow up CT after transcatheter arterial embolization {TACE). The purpose of this study is to evaluate the characteristics of hepatic atrophy after TACE. MATERIAL AND METHODS: Of 53 patients who had TACE, We evaluated the relationship between the incidence of hepatic atrophy and the number of TACE, and also evaluated the average number of TACE in patients with hepatic atrophy. Of 20 patients who had received more than average number of TACE for development of hepatic atrophy (2 times with portal vein obstruction, 2.7 times without portal vein obstruction in this study), we evaluated the relationship between the tipiodol uptake pattern of tumor and the incidence of hepatic atrophy. RESULTS: There were 8 cases of hepatic atrophy (3 with portal vein obstruction, 5 without portal vein obstruction), average number for development of hepatic atrophy were 2.5 times. As the number of TACE were increased, the incidence of hepatic atrophy were also increased. Of 20 patients who received more than average number of TACE for development of hepatic atrophy, we noted 6 cases of hepatic atrophy in 11 patients with dense homogenous lipiodol uptake pattern of tumor and noted only 1 case of hepatic atrophy in 9 patient with inhomogenous lipiodol uptake pattern. CONCLUSION: Hepatic atrophy was one of the CT findings after TACE even without portal vein obstruction. Average number of TACE was 2.5 times and risk factors for development of hepatic atrophy were portal vein obstruction, increased number of TACE, and dense homogenous lipiodol uptake pattern of tumor.
Atrophy* ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Incidence ; Portal Vein ; Risk Factors

PURPOSE: The purpose of this study was to compare the marginal fitness and fracture load of the zirconia copings according to the design with different thickness and coloration. MATERIAL AND METHODS: The evaluation was based on 80 zirconia copings. Zirconia copings were fabricated in design with different thicknesses using CAD/CAM system (Everset, KAVO dental GmbH, Biberach, Germany). The designs of copings were divided into four groups. The first group consisted of copings with uniform thickness of 0.3 mm. The thickness in the second group was 0.3 mm on the buccal surface and 0.6 mm on the lingual surface. The third group consisted of coping with uniform thickness of 0.6 mm. The thickness in the fourth group was 0.6 mm on the buccal surface and 1mm on the lingual surface. Each group consisted of 10 colored and 10 uncolored copings. Half of the copings (40) processed with a milling system according to the specific design were sent to be given a color (A3) through saturation in special dye by a manufacturing company. Just after sintering, the marginal discrepancies of copings were measured on the buccal, lingual, mesial and distal surfaces of metal die, under a Video Microscope System (sv-35, Sometech, Seoul, Korea) at a magnification of x100. It was remeasured after the adjusting of the inner surface. Next, all copings were luted to the metal dies using reinforced cement {GC FujiCEM (GC Corp. Tokyo, Japan)} and mounted on the testing jig in a Universal Testing Machine (Instron 4467, Norwood, MA, USA). The results were analyzed statistically using the one-way ANOVA test. RESULTS: The obtained results were as follow: 1. The measured value of marginal discrepancy right after sintering was the greatest in the contraction of the buccal area in all groups, except for group I2. 2. There was no significant difference of marginal fitness among the groups in the colored zirconia group (P<.05). 3. When the marginal fitness among the groups in the uncolored zirconia group was considered, group II2 had the smallest marginal discrepancy. 4. When the colored and uncolored groups with the same design were compared, there was a significant difference between I1 and II1 groups. In group 2, 3, and 4, the uncolored zirconia had the greatest marginal fitness (P<.05). 5. After adjustment of inner surface, there was no significant difference in the marginal fitness in all groups when color and design of the zirconia coping were compared. 6. The fracture load of CAD/CAM zirconia copings showed significant difference in group 1, 2, 3, and 4. I4 and II4 had the strongest fracture load. 7. When groups with different color and same design were compared, all colored groups showed greater fracture load (P>.05), with no significance. CONCLUSION: There was difference in the marginal fitness according to the design and coloration of zirconia copings right after sintering, but it was decided that the copings may well be used clinically if the inner surface are adjusted. The copings should be thick enough for the reinforcement of fracture strength. But considering the esthetics of the visible surfaces (labial and buccal surface), the thickness of copings may be a little thin, without giving any significant effect on the fracture strength. This type of design may be considered when giving priority to preservation of tooth or esthetics.
Ceramics ; Collodion ; Contracts ; Esthetics ; Glass Ionomer Cements ; Reinforcement (Psychology) ; Tokyo ; Tooth ; Zirconium

PURPOSE: Recently there have been some reports that percutaneous absces drainage(PAD) was ineffective in treating multiloculated liver abscess. We therefae, reviewed our results of catheter drainage in jultiloculated liver absces. MATERIALS AND METHODS: PADs in 10 cases of multiloculated liver abscesses were performed with 8.5F Pig tail, 12 & 14F Sump cahteters, under ultrasonic & fluoroscopic guidance. RESULTS: All the 10 cases were successfully drained without major complications. Mean drainage duration was 16.3 day and the result was not significantly different from those obtained by draining unilocular pyogenic liver abscess. The success was the result of using large caliber catheter and repetition in insertion of guidewire deeply into abscess cavity to make communications between the Iocules which was proven by abscessogram. CONCLUSION: PAD was safe and effective method for multiloculated abscess as unilocular liver abscess, and it is recommended that the multiloculated liver abscess be draincd.
Abscess* ; Catheters ; Drainage* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Ultrasonics

PURPOSE: To determine the CT factors which predict positive results of bronchoscopic biopsy in cases of lung cancer with CT-bronchus sign. MATERIALS AND METHODS: In 30 patients who on CT showed a lung mass with CT-bronchus sign and who had undergone bronchoscopic biopsy, lung cancer was confirmed histopathologically and/or clinically. The CT findings were evaluated for the location, nature and size of the mass, and the type of CT-bronchus sign, and the diagnostic rate of bronchoscopic biopsy and of CT findings was compared. RESULTS: Seventeen of 30 patients (56.7%) were diagnosed by bronchoscopic biopsy and their diagnostic rates according to the location were as follows: 100% (10/10) in cases involving the lobar bronchus; 60% (6/10) in cases involving the proximal segmental bronchus and 10% (1/10) in cases involving the distal segmental bronchus. In 20 cases of peripheral lung cancer, 16.7% (1/6) of masses with less than 3cm in diameter, 44.4% (4/9) of masses with more than 3cm and less than 6cm, and 40.0% (2/5) of masses with more than 6cm were diagnosed bronchoscopically. In addition, 57.1% (4/7) of cases with abrupt bronchial obstruction, 33.3% (3/9) with a patent bronchus within the mass, 0% (0/3) with bronchial displacement or a marginally located bronchus and 0% (0/1) with tapered bronchial obstruction were diagnosed on bronchoscopic biopsy. One of two cases with perilesional lymphangitic spread and two of four cases with a large cavity were diagnosed bronchoscopically. CONCLUSION: In cases of lung cancer, bronchoscopic biopsy is a useful initial diagnostic method where the mass is located in 1cm proximal to segmental bronchial bifurcation and is more than 3cm in diameter, there is CT-bronchus sign with abrupt bronchial obstruction or a patent bronchus within the mass, and associated perilesional lymphangitic spread or large air-cavity. In most cases where there is peripheral lung mass less than 3cm in diameter, however, bronchoscopic biopsy alone is not adequate, and the use of a further diagnostic modality is required.
Biopsy* ; Bronchi ; Humans ; Lung Neoplasms* ; Lung*

PURPOSE: Glyphosate-surfactant herbicide (GSH) is a widely used herbicide that is generally thought to be safe. When ingested in large quantities, however, it can result in serious toxicity and even lethality. The purpose of this study was to identify predictive factors for early hospital discharge in GSH poisonings. METHODS: GSH poisoning patients were divided into two groups. Group A consisted of patients who were discharged earlier, within 48 hours, without any complication since ED admission. Group B included patients who were admitted to the ED more than 48 hours earlier and/or who died within 48 hours of ED admission. Patient demographics, drug intoxication information, chest X-ray (CXR) findings and laboratory data during the first 24 hours on ED admission were collected. Those data were analyzed for their effect on the two groups. Univariate and odds ratio analysis were done. Predictive factors for early hospital discharge were then determined using logistic regression analysis. RESULTS: Seventy three patients (51 males, 22 females) were enrolled in our study; 39 patients in group A, and 34 patients in group B. By univariate and odds ratio analysis, the following variables showed statistically significant differences between groups A and B: estimated amount of poison ingested?, GSC score, CXR findings, arterial pH, PO2, bicarbonate, BUN, creatinine, amylase and potassium. In the analysis of clinical symptoms and signs, mental change, dyspnea and voice change were the significant findings in group B (p<0.05). In multivariate logistic regression analysis to predict early discharge in GSH poisonings, 3 variables (normal CXR finding, no metabolic acidosis, BUN level < or = 23) were found to be highly associated with early discharge. We established the following multiple logistic regression model: Log(p/1-p) = -3.02+1.85(normal CXR)+1.98(no metabolic acidosis)+1.46(BUN< or =23) CONCLUSION: Although GSH poisoning causes multi-organ toxicity, its mortality rate is relatively low (5.5%). Acid-base status, chest X-ray finding, and serum BUN level during the first 24 hours are useful predictive factors for early discharge from the hospital in GSH poisonings.
Acidosis ; Amylases ; Creatinine ; Demography ; Dyspnea ; Glycine ; Herbicides ; Humans ; Hydrogen-Ion Concentration ; Logistic Models ; Male ; Odds Ratio ; Potassium ; Thorax ; Voice

PURPOSE: The purpose of this study was to evaluate the high-resolution CT(HRCT) appearance of abnormalities of small airways and lung parenchyma associated with bronchiectasis and to correlate HRCT appearance and the results of pulmonary function tests. MATERIALS AND METHODS: The author retrospectively reviewed medical recordsand HRCT scans of 33 patients with bronchiectasis. Abnormalities of small airways and lung parenchyma in lobeswith bronchiectasis were assessed on HRCT scan. The findings on HRCT were correlated with the results of pulmonary function tests in 20 patients. In two specimens obtained at lobectomy, histologic examinations were conducted to determine the pathologic basis for CT findings of disease of small airways. RESULTS: Patchy areas of low attenuation(n=27), centrilobular nodules or branching opacities(n=20), irregular hyper attenuation(n=16), and areasof ground-glass attenuation(n=4) were observed on HRCT scans. In the lobar evaluation, areas of low attenuation were observed in 66(76%) of the 87 lobes with bronchiectasis. Areas of low attenuation were also identified inseven(9%) of the 75 lobes without bronchiectasis. On expiratory HRCT, the lung parenchyma with areas of low attenuation did not show a normal increase in CT attenuation and remained more lucent than surrounding normallung, which suggested that air was trapped in the lung parenchyma. Of the 20 patients who underwent pulmonary function tests, six showed an obstructive pattern. These six had more lobes with bronchiectasis and with areas oflow attenuation than the other 14 patients, who did not have an obstructive pulmonary function pattern(p<.01). Intwo patients who had undergone lobectomy, pathologic examination showed bronchiolities obliterans in small airway speripheral to the dilated bronchi. CONCLUSION: In bronchiectasis, areas of low attenuation and centrilobular nodules or branching opacities are commonly observed in the lung parenchyma peripheral to the dilated bronchi on HRCT. These HRCT findings correspond pathologically to bronchiolitis obliterans and to lung parenchyma with trapped air. The number of loves with bronchiectasis and with areas of low attenuation correlate significantly with an obstructive pattern on pulmonary function tests.
Bronchi ; Bronchiectasis* ; Bronchiolitis ; Bronchiolitis Obliterans ; Humans ; Love ; Lung ; Respiratory Function Tests* ; Retrospective Studies

PURPOSE: The purpose was to compare the marginal fidelity and the fracture resistance of the zirconia crowns according to the various coping designs with different thicknesses and cement types. Material and METHODS: Zirconia copings were designed and fabricated with various thicknesses using the CAD/CAM system (Everest, KaVo Dental GmbH, Biberach., Germany). Eighty zirconia copings were divided into 4 groups (Group I: even 0.3 mm thickness, Group II: 0.3 mm thickness on the buccal surface and the buccal half of occlusal surface and the 0.6 mm thickness on the lingual surface and the lingual half of occlusal surface, Group III: even 0.6 mm thickness, Group IV: 0.6 mm thickness on the buccal surface and the buccal half of occlusal surface and the 1.0 mm thickness on the lingual surface and the lingual half of occlusal surface) of 20. By using a putty index, zirconia crowns with the same size and contour were fabricated. Each group was divided into two subgroups by type of cement: Cavitec(R) (Kerr Co, USA) and Panavia-F(R) (Kuraray Medical Inc, Japan). After the cementation of the crowns with a static load compressor, the marginal fidelity of the zirconia crowns were measured at margins on the buccal, lingual, mesial and distal surfaces, using a microscope of microhardness tester (Matsuzawa, MXT-70, Japan, x100). The fracture resistance of each crown was measured using a universal testing machine (Z020, Zwick, Germany) at a crosshead speed of 1 mm/min. The results were analyzed statistically by the two-way ANOVA and oneway ANOVA and Duncan's multiple range test at alpha= .05. RESULTS: Group I and III showed the smallest marginal fidelity, while group II demonstrated the largest value in Cavitec(R) subgroup (P < .05). For fracture resistance, group III and IV were significantly higher than group I and II in Cavitec(R) subgroup (P < .05). The fracture resistances of Panavia-F(R) subgroup were not significantly different among the groups (P > .05). Panavia-F(R) subgroup showed significantly higher fracture resistance than Cavitec(R) subgroup in group I and II (P < .05). CONCLUSION: Within the limitation of this study, considering fracture resistance or marginal fidelity and esthetics, a functional ceramic substructure design of the coping with slim visible surface can be used for esthetic purposes, or a thick invisible surface to support the veneering ceramic can be used depending on the priority.
Cementation ; Ceramics ; Collodion ; Crowns ; Esthetics ; Japan ; Zirconium

We report a case of gastric pseudoterranoviasis proven by gastrofiberscopy on Dec. 13, 1994. The 34-year-old male patient, residing in Chungju-shi, was admitted to Konkuk University Hospital complaining of prickling epigastric pain. The symptoms suddenly attacked him two days after eating raw marine fish at Chonan-shi. By the gastrofiberscopic examination, a long white-yellowish nematode was found from the fundus region of stomach. The worm was 34.50 x 0.84 mm in size, and was identified as a 3rd stage larva of Pseudoterranova decipiens judging from the position of the intestinal cecum. This is the 12th confirmed case of human pseudoterranoviasis in Korea.
Adult ; Animals ; Anisakiasis/*parasitology ; Ascaridoidea/*isolation & purification ; Gastric Mucosa/parasitology ; Gastroscopy ; Human ; Korea ; Larva ; Male ; Stomach Diseases/*parasitology

The concept of using high-dose immunosuppressive treatment (HDIT) with autologous stem cell transplantation (ASCT) to treat patients with refractory rheumatoid arthritis has been provided by animal studies and anecdotal case reports. Over the past five years, an increasing number of patients with refractory rheumatoid arthritis have received HDIT with ASCT as an adjunct to intense immunosuppression. Here, we present a case of refractory rheumatoid arthritis in a 54-yr-old woman using HDIT with ASCT. Peripheral blood stem cells were mobilized with cyclophosphamide (4 g/m(2)) followed by G-CSF (5microgram/kg/day). Leukapheresis continued daily until the number of harvested progenitor cells reached 2 x 10(6) CD34+ cells/kg after CliniMax(R) CD34+ positive selection. For HDIT, high-dose cyclophosphamide (total dose 200 mg/kg) and antithymocyte globulin (total dose 90 mg/kg) were administered and CD34+ cells were infused 24 hr after HDIT. The patient tolerated the treatment well but experienced an episode of neutropenic fever. She achieved an early dramatic improvement of joint symptoms during therapy. Fifty percent of improvement of rheumatoid arthritis by the American College of Rheumatology (ACR 50) preliminary definition was fulfilled during the 6 months following ASCT. Although further long-term follow-up is required, the patient's activity of arthritis has been stable since receiving HDIT with ASCT.
Antilymphocyte Serum/*therapeutic use ; Arthritis, Rheumatoid/*drug therapy/physiopathology ; Combined Modality Therapy/methods ; Cyclophosphamide/*therapeutic use ; Female ; *Hematopoietic Stem Cell Transplantation ; Humans ; Immunosuppressive Agents/*therapeutic use ; Middle Aged ; Transplantation, Autologous ; Treatment Outcome

PURPOSE: To evaluate the diagnostic accuracy of CT in the differential diagnosis of tuberculous and malignant pleural effusion whether or not lung lesions are present, and to investigate the CT findings used for this differential diagnosis. MATERIALS AND METHODS: This study involved 30 patients with tuberculous pleural effusion (mean age, 44.6 years; M:F=19:11) and 20 with malignant pleural effusion (mean age, 57.2 years; M:F=10:10). All 50 patients underwent enhanced CT chest scans, and the respective conditions were pathologically confirmed. Two radiologists unaware of the pathologic results and distribution of patients reviewed these scans retrospectively and independently. They recorded the presence or absence of helpful lung lesions, CT findings of pleural effusions, their diagnoses, and the degree of confidence of their diagnoses. RESULTS: Among the total of 100 answeres, helpful long lesions were found in 57 cases. Fifty-three of 57 diagnoses (93%) were correct and 26 cases (46%) were diagnosed with a high degree of confidence. Thirty-two of 43 cases (74%) without helpful lung lesions were correct and 11(26%) were diagnosed with a high degree of confidence. All diagnoses made with a high degree of confidence were correct, even in cases without helpful lung lesions. Frequent CT findings in tuberculous pleural effusion included diffuse pleural thickening, enhancement of pleura, deposition of extrapleural fat, and pleural calcification; in malignant pleural effusion, nodular pleural thickening, pleural thickening over 1cm and associated lymphadenopathy were frequent. Mediastinal and circumferential pleural, as well as fissural involvement, were seen in both effusions; there were no statistical differences. CONCLUSION: In most cases, CT provided correct differential diagnosis between tuberculous and malignant pleural effusion. It can help determine the nature of associated lung and pleural lesions, and specific findings of the latter, and can accurately differentiate tuberculous and malignant pleural effusion.
Diagnosis ; Diagnosis, Differential* ; Humans ; Lung ; Lymphatic Diseases ; Pleura ; Pleural Effusion* ; Pleural Effusion, Malignant* ; Retrospective Studies ; Thorax