BACKGROUND: Urography(IVU) is considered the best first investigation in patient with suspected urinary calculi, but recently ultrasonography(USG), combined with a plain film of the abdomen, has been suggested as an alternative. METHODS: We undertaken study to see if this approch can be used in emergency patients and outpatients by radiologists with different amounts of ultrasound experence. Some 192 patients with suspected urinary colic presenting to Koo Hospital Emergency Department and Youngnam Universith Hospital outward Department(IM, URO, FM) over 12-month period were studied. They had a plain abdominal film(KUB) and USG examination of the kidney, ureter, bladder following hydration and subsequently underwent IVU. Of these, 22 patients passed a stone before their IVU. The data analysis was performed on the remaining 170 patients. Urography was used as the gold standard. RESULTS: Some 170 patients subsequently underwent IVU at a mean interval of 1.8 days after the ultrasound examination. In 91 of 170 patients the IVU was positive. In 97 of 170 patients the combination of JUB plus USG was positive, leaving three false negative KUB plus USG. Thus the sensitivity of KUB plus USG was 97%, specificity was 89%, positive predictive value was 91%, and negative predictive value was 96%. CONCLUSIONS: Our findings in this study suggest that in the hydrated patient the combination of KUB plus US is a very sensitive and relative specific screening test. Because of the high negative predictive value of KUB plus US, urography is not likely to be helpful when KUB plus US are negative. Urography is indicated only if KUB plus US findings are equivocal or if intervention is necessa.ry.
Abdomen ; Colic ; Emergencies ; Emergency Service, Hospital ; Humans ; Kidney ; Mass Screening ; Outpatients ; Sensitivity and Specificity ; Statistics as Topic ; Ultrasonography* ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urography*

The sonographic features of 23 lymphangiomas (19 pediatric patients) were compared with the pathologic findings. Nineteen lymphangiomas appesred as unicameral (n=2) and multiloculated (n=7) cystic masses. Remaining lesions were inhomogeneously echogenic mass with small cystic portions (n=3) and a mixed pattern (n=1). Fourteen of the multiloculated tumors had thin septa and 6 had solid echogenic foci. The fluid within the majority of the cyst was anechoic in 8 cases and echogenic in 11 cases. Correlation of the sonographic features with the pathologic findings demonstrated that the cystic spaces corresponded to the dilated lymphatic spaces lined with endothelium, separated by septa. Echogenic fluid represented hemorrhage. The echogenic component corres ponded to clusters of very smaller dilated lymphatic channels, thick fibro-fatty septa, or blood clot. The author's experience suggests that the most characteristic sonographic appearance of lymphangioma is a multiloculated cysti mass with thin septa, reflecting the preponderance of fluid-filled spaces. An atypical appearance usually reflects the presence of blood or dominancy of cavernous type. The information obtained with US imaging can help in providing a preoperative diagnosis and in planning surgical resection.
Child* ; Diagnosis ; Endothelium ; Hemorrhage ; Humans ; Lymphangioma* ; Ponds ; Ultrasonography*

Brian Allgood Army Community Hospital (BAACH) is one of the US military General Hospitals in Korea that have blood services. The author of this paper is a civilian employee who has been working in the blood bank for 37 years. Through this experience, a difference between BAACH and the Korean Medical Center has been observed. First, BAACH performs a blood culture for the sterility test upon the receipt of platelets from the Korean Red Cross, and measures the pH at the end of allowable storage. Second, some military facilities use the Frozen Blood Program as the storage/thawing system of Deglycerolized Red Blood Cells (DRBC) and the use of DRBC. Third, most military facilities have a continuous training education program for those working in the blood bank provided by the Armed Service Blood Program.
Arm ; Blood Banks ; Education ; Erythrocytes ; Hospitals, Community ; Hospitals, General ; Humans ; Hydrogen-Ion Concentration ; Infertility ; Korea ; Military Facilities ; Military Personnel ; Red Cross

PURPOSE: The aims of this study were to review the clinical characteristics of midgut volvulus and recognize the importance of the early diagnosis and treatment of midgut volvulus. METHODS: The medical records of 10 patients with midgut volvulus, diagnosed at the Dankook University Hospital, between May 1995 and May 2001, were retrospectively reviewed. RESULTS: There were 6 male and 4 female subjects. 80% of the patients were younger than 1 month old. The most common symptom was bilious vomiting. A simple abdominal X-ray was performed in 8 cases, with five of these 8 showing positive findings, such as a gasless abdomen or stomach dilatation. Ultrasonography was performed in all 10 cases. The sensitivity of the ultrasonography was 70%. UGI series was performed in 9 cases, and showed 100% sensitivity. Eight patients underwent surgical treatment. Seven infants in the early-diagnosis group had a Ladd operation performed, but only one patient whose diagnosis was delayed underwent a small bowel resection. The 7 patients that had undergone a Ladd operation showed good results after surgery. However, the one whose diagnosis had been delayed developed severe complications and mortality. CONCLUSION: The early diagnosis and adequate intervention for midgut volvulus can prevent life threatening complications. If the ultrasonographic findings are uncertain, especially when the midgut volvulus is untwisted after attack, UGI series or a barium enema should be performed to confirm the diagnosis.
Abdomen ; Barium ; Diagnosis ; Early Diagnosis ; Enema ; Female ; Gastric Dilatation ; Humans ; Infant ; Infant, Newborn ; Intestinal Volvulus* ; Male ; Medical Records ; Mortality ; Retrospective Studies ; Ultrasonography ; Vomiting

Twenty-six patients with chief complaint of shoulder pain who underwent both ultrasonographic examination and arthrography of the shoulder were analyzed. Ten out of 12 cases with clinical impression of frozen shoulder, showed normal findings on the ultrasonographic examination of the shoulder. Among these ten cases, nine cases showed abhesive capsulitis and one case showed rotator cuff tear on arthrography. Among six cases with the clinical impression of rotator cuff tear, five cases showed rotator cuff tear and one case showed combined calcific tendinitis and adhesive capsulitis on ultrasonographic examination. In arthrography, four cases of rotator cuff tear, one case of calcific tendinitis and biceps tendinitis and one case of normal findings were diagnosed. For the remaining eight cases in the ultrasonographic examination, normal finding or biceps tendinitis were found and for the remaning of the cases in arthrography adhesive capsulitis were found. With the above results, we recommend that the shoulder ultrasonography as the first line diagnostic modality for a patients with chief complaint of shoulder pain.
Arthrography* ; Bursitis ; Humans ; Rotator Cuff* ; Shoulder ; Shoulder Pain ; Tears ; Tendinopathy ; Ultrasonography*

No abstract available.
Humans ; Pregnancy, Twin*

No abstract available.
Abscess* ; Drainage*

No abstract available.
Aortic Aneurysm* ; Humans ; Rupture*

BACKGROUND: Multi-loculated empyema makes treatment difficult, and more so when thoracentesis or chest tube drainage fails. MATERIALS AND METHODS: From December 1991 to December 1997, we performed closed rib resectional drainage for 18 cases of loculated empyema on the fibrinopurulent or early chronic phase. RESULTS: Surgery was performed on patients with loculated empyema complaining of persistent symptoms due to failure of treatment by thoracentesis (8 cases) or chest tube drainage (10 cases). Predisposing factors of empyema were pneumonia in 13 cases, clotted hemothorax in 3 cases, cholecystectomy, and tuberculous pleurisy in 1 case. Causal organisms were cultured in 8 cases (42.1%), and methicillin-resistant staphylococcus aureus was found in 3 cases, pseudomonas aeruginosa in 2 cases, and enterococcus aerogens, alpha-hemolytic streptococcus, and acinetobacter baumannii were found in 1 case. Size of loculations was various, and computed chest tomogram showed multiple loculations of empyema numbering 1~4 (mean 1.78+/-1.00). Operating time was relatively short, about 55~140 mins (mean 102.8+/-30.8). All toxic symptoms including fever disappeared postopratively and general conditions improved very quickly in all patients. Length of chest tube indwelling time and hospital stay after surgery were 3~42 days (mean 11.4+/-11.5) and 6~36 days (mean 12.9+/-8.1), respectively. Complications of prolonged drainage occurred in 2 cases and no death occurred. There were no recurrences and chest x-rays taken 3~6 months after surgery showed normal findings in 14 cases and slight pleural thickening in 4 cases. CONCLUSIONS: Closed rib resectional drainage requires very simple techniques and has excellent outcomes and little complications, therefore, we think that it is the choice of operation for patients with loculated empyema on the fibrinopurulent or early chronic phase.
Acinetobacter baumannii ; Causality ; Chest Tubes ; Cholecystectomy ; Drainage* ; Empyema* ; Enterococcus ; Fever ; Hemothorax ; Humans ; Length of Stay ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pseudomonas aeruginosa ; Recurrence ; Ribs* ; Streptococcus ; Thorax ; Tuberculosis, Pleural