PURPOSE: To correlate SOhographic and pathologic findings of gallbladder adenoma, and to evaluate the clinical significance of sonographic findings. MATERIALS AND METHODS: Ultrasound findings of twenty gallbladder adenomas were retrospectively reviewed to evaluate the size, shape and echogenicity of the adenoma, and was correlated with the pathological finding. RESULTS: Among 14 patients, 11 patients had single lesion and 3 patients had multiple lesions. Three patients showed 2, 3 and 4 adenomas, respectively. Nine of 20 lesions showed focal dysplasia pathologically. Among the nine adenomas with dysplasia, two adenomas showed focal cancerous change. The nine adenomas showing focal dysplasia measured 25.6mm (14-35mm) in mean diameter, while the mean diameter of adenomas without dysplasia was 8.7 mm (3-13mm). The echogenicity of adenoma with focal dysplasia were hyperechoic in 8, isoechoic in 1. The echogenicity of adenomas without dysplasia were hyperechoic in 7, isoechoic in 4. Sessile(7/9) and papillary shape(6/9) were predominant in adenoma with dysplasia, but smooth shape(8/11) and stalked type(9/11) were predominant in adenoma without dysplasia. Two adenomas with focal cancerous change showed histological transition from cancer to dysplasia and to adenomatous tissue. In adenoma with dysplasia, the diameter more than 14 mm on sonography was statistically significant (p<0. 005). Also age of patient was significantly different between the two groups (p<0.01), while echogenicity and associated stone were not statistically significant. CONCLUSION: As gallbladder adenoma more than 14ram in diameter on US is suggestive of dysplasia on pathology, so, close follow up US or surgery is recommended.
Adenoma* ; Follow-Up Studies ; Gallbladder* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography

PURPOSE: The fibrates are ligands for peroxisome proliferator-activated receptor (PPAR) alpha and used clinically as hypolipidemic drugs. The fibrates are known to cause peroxisome proliferation, enhance superoxide dismutase (SOD) expression and catalase activity. The antioxidant actions of the fibrates may modify radiation sensitivity. Here, we investigated the change of the radiation sensitivity in two cervix cancer cell lines in combination with fenofibrate (FF). MATERIALS AND METHODS: Activity and protein expression of SOD were measured according to the concentration of FF. The mRNA expressions were measured by using real time reverse-transcription polymerase chain reaction. Combined cytotoxic effect of FF and radiation was measured by using clonogenic assay. RESULTS: In HeLa cells total SOD activity was increased with increasing FF doses up to 30 microM. In the other hand, the catalase activity was increased a little. As with activity the protein expression of SOD1 and SOD2 was increased with increasing doses of FF. The mRNAs of SOD1, SOD2, PPARalpha and PPARgamma were increased with increasing doses of FF. The reactive oxygen species (ROS) produced by radiation was decreased by preincubation with FF. The surviving fractions (SF) by combining FF and radiation was higher than those of radiation alone. In Me180 cells SOD and catalase activity were not increased with FF. Also, the mRNAs of SOD1, SOD2, and PPARalpha were not increased with FF. However, the mRNA of PPARgamma was increased with FF. CONCLUSION: FF can reduce radiation sensitivity by ROS scavenging via SOD induction in HeLa. SOD induction by FF is related with PPARalpha.
Catalase ; Cell Line ; Fenofibrate ; Fibric Acids ; Hand ; HeLa Cells ; Humans ; Hypolipidemic Agents ; Ligands ; Peroxisomes ; Polymerase Chain Reaction ; PPAR alpha ; PPAR gamma ; Radiation Tolerance ; Reactive Oxygen Species ; RNA, Messenger ; Superoxide Dismutase ; Superoxides ; Uterine Cervical Neoplasms

The pattern of thickening of the extrahepatic bile duct on computed tomography was analysed in 30 cases with recurrent pyogenic cholangitis diagnosed by surgery (n=19) or clinical basis (n=11). The mean wall thickness of the extrahepatic bile duct was 3.3mm (range, 1-6.3mm). Diffuse thickening of the extrahepatic bile ductal wall was demonstrated in 26 of 30 cases. Diffuse thickening of the extrahepatic bile duct in recurrent pyogenic cholangitis may be differentiated from focal thickening of duct in a common duct cancer or pancreatic cancer.
Bile Ducts, Extrahepatic* ; Cholangitis* ; Pancreatic Neoplasms

The pattern of thickening of the extrahepatic bile duct on computed tomography was analysed in 30 cases with recurrent pyogenic cholangitis diagnosed by surgery (n=19) or clinical basis (n=11). The mean wall thickness of the extrahepatic bile duct was 3.3mm (range, 1-6.3mm). Diffuse thickening of the extrahepatic bile ductal wall was demonstrated in 26 of 30 cases. Diffuse thickening of the extrahepatic bile duct in recurrent pyogenic cholangitis may be differentiated from focal thickening of duct in a common duct cancer or pancreatic cancer.
Bile Ducts, Extrahepatic* ; Cholangitis* ; Pancreatic Neoplasms

Among the 85 cases of prosthetic replacement of femoral neck fracture which had been operated at Department of Orthopaedic Surgery, Korea Veterans Hospital from January, 1982 to May, 1990, 32 cases (15 unipolar hemiarthroplasty and 17 bipolar hemiarthroplasty) were examined clinically and radiologically at an average 7.7 years postoperatively. And the results were as follows; 1. The group I (Unipolar hip hemiarthroplasty without cement) had Harris hip score - average 79.4. The group II (Unipolar hip hemiarthroplasty with cement) had Harris hip score average 87.3. The group III (Bipolar hip hemiarthroplasty without cement) had Harris hip score average 80.5. The group IV (Bipolar hip hemiarthroplasty with cement) had Harris hip score average 86. 2. There were 2 cases of stem loosening (13%) among 15 cases in unipolar hip hemiarthroplasty and 1 case (6%) among 17 cases in bipolar hip hemiarthroplasty. 3. The movement of two components in bipolar hip hemiarthroplasty was noted in all cases and the movement of the outer bearing joint was more active than that of the inner. And the movement of the two components was not correlated with the use of cement. But Harris hip score was superior cement stem group to noncement stem group. 4. Unipolar hip hemiarthroplasty showed the similar clinical and radiological results with bipolar hip hemiarthroplasty of femoral neck fracture in the elderly. As a result, unipolar and bipolar hip hemiarthroplasty were considered the proper treatment method of the femoral neck fracture in the elderly.
Aged ; Femoral Neck Fractures ; Femur Neck* ; Hemiarthroplasty* ; Hip* ; Hospitals, Veterans ; Humans ; Joints ; Korea

OBJECTIVE: Distance between the active and reference electrodes can affect the waveform configuration and amplitude of sensory nerve action potential (SNAP). This study was purposed to determine the change of SNAP parameters with varying interelectrode distance. METHOD: Median sensory nerve conduction study was performed in the middle finger of 40 young healthy subjects by antidromic method. To ensure firm contact with skin, strip adhesive electrode was used for recording responses. The active electrode was fixed on 1 cm distal to the proximal flexion crease of middle finger and interelectrode separation was increased from 1 to 5 cm by 1.0 cm increments. Bar electrode was fixed 14 cm proximal from active electrode for stimulation in the wrist area. RESULTS: As the interelectrode distance increased from 1 cm to 5 cm, onset latency remained unchanged. The peak latency increased with increasing the distance up to 3 cm but didn't change beyond 3 cm (1 cm: 2.89 0.89 msec, 2 cm: 2.97 0.89 msec, 3 cm: 3.02 0.19 msec, 4 cm: 3.02 0.19 msec, 5 cm: 3.02 0.20 msec). Base-to-peak amplitude significantly increased only up to 3 cm (1 cm: 30.3 6.7 microvolt, 2 cm: 43.7 8.6 microvolt, 3 cm: 50.8 10.4 microvolt, 4 cm: 51.1 10.9 microvolt, 5c m: 51.3 11.4 microvolt) but peak-to-peak amplitude sequentially increased to 5 cm (1 cm: 49.6 12.1 microvolt, 2 cm: 72.8 14.4 microvolt, 3 cm: 83.6 19.4 microvolt, 4 cm: 91.3 22.5 microvolt, 5 cm: 93.4 23.9 microvolt)(p<.05). CONCLUSION: This study showed that changing interelectrode distance altered some parameters of SNAP, especially the peak-to peak amplitude.
Action Potentials* ; Adhesives ; Electrodes ; Fingers ; Neural Conduction ; Skin ; Wrist

OBJECTIVE: To introduce the technique of the ultrasound-guided selective nerve root injection in the lower cervical spine and to evaluate its accuracy and distribution patterns of injections. METHOD: Thirty-one patients with the cervical radiculopathies (C5 to C7) from cervical disc herniation were enrolled in this study. Targeted nerve root image was obtained and the needle was introduced to its dorsal surface under the ultrasound guidance. Then 2 ml of contrast media was injected which was followed by fluoroscopic image. The accurate injection was defined as the contrast media placed over the neural foramen along the targeted nerve root. RESULTS: 24 of 31 (77.4%) procedures were assesed to be accurately placed and there was no significant complication. The accuracy of injection was lower at the C7 nerve root (70.0%) than other nerve roots. In all cases, large amount of back flow to the brachial plexus and spread to the adjacent nerve roots were observed. CONCLUSION: In the lower cervical spines, ultrasound-guided selective nerve root injections might be considered as a radiation free, safe and available method.
Brachial Plexus ; Contrast Media ; Equidae ; Humans ; Needles ; Radiculopathy ; Spine

OBJECTIVES: This study aimed to analyze the relationship between clinical status and work characteristics of firefighters and other public officers who engaged on collection duties in the site of the hydrogen fluoride spill that occurred on September 27, 2012, in Gumi City, South Korea. METHODS: We investigated the clinical status, personal history, and work characteristics of the study subjects and performed physical examination and several clinical examinations, including chest radiography, echocardiography, pulmonary function test, and blood testing in 348 firefighters, police officers, volunteer firefighters, and special warfare reserved force who worked at the hydrogen fluoride spill area. RESULTS: The subjects who worked near the accident site more frequently experienced eye symptoms (p = 0.026), cough (p = 0.017), and headache (p = 0.003) than the subjects who worked farther from the accident site. The longer the working hours at the accident area, the more frequently the subjects experienced pulmonary (p = 0.027), sputum (p = 0.043), and vomiting symptoms (p = 0.003). The subjects who did not wear respiratory protective devices more frequently experienced dyspnea than those who wore respiratory protective devices (p = 0.013). In the pulmonary function test, the subjects who worked near the accident site had a higher decease in forced vital capacity than the subjects who worked farther from the site (p = 0.019); however, no statistical association was found between serum calcium/phosphate level, echocardiography result, chest radiographic result, and probation work characteristics. CONCLUSIONS: The subjects who worked near the site of the hydrogen fluoride spill, worked for an extended period, or worked without wearing respiratory protective devices more frequently experienced upper/lower respiratory, gastrointestinal, and neurological symptoms. Further follow-up examination is needed for the workers who were exposed to hydrogen fluoride during their collection duties in the chemical plant in Gumi City.
Chemical Hazard Release ; Cough ; Dyspnea ; Echocardiography ; Firefighters* ; Gyeongsangbuk-do ; Headache ; Hematologic Tests ; Humans ; Hydrofluoric Acid* ; Hydrogen* ; Physical Examination ; Plants ; Police ; Radiography ; Radiography, Thoracic ; Republic of Korea ; Respiratory Function Tests ; Respiratory Protective Devices ; Sputum ; Thorax ; Vital Capacity ; Vomiting

Head trauma has been mentioned as an uncommon cause of secondary Parkinsonism. We report a 68-year-old woman who developed a rapidly evolving post-traumatic encephalopathy with predominant akinetic-rigid syndrome. The clinical manifestations were mainly bradykinesia, rigidity, cognitive dysfunction and emotional lability. Brain SPECT showed perfusion defect in the left basal ganglia and thalamus. The parkinsonian symptoms improved moderately with levodopa.
Aged ; Basal Ganglia ; Brain Injuries* ; Brain* ; Craniocerebral Trauma ; Female ; Humans ; Hypokinesia ; Levodopa ; Parkinson Disease, Secondary ; Parkinsonian Disorders ; Perfusion ; Thalamus ; Tomography, Emission-Computed, Single-Photon*

Cytomegalovirus(CMV) infections are common in immune compromised situations such as human immunodeficiency virus infection and organ transplantation. However CMV colitis had been rarely found in immunocompetent individuals. We experienced a case of an 83-year-old female patient, initially immune competent, who developed a massive lower gastrointestinal bleeding caused by CMV colitis. Previously, multiple antibiotics were used for nontuberculous Myco- bacterium and other bacterial infections after total knee arthroplasty. Colonoscopy revealed multiple ulcerations and mucosal congestion with hemorrhage. In spite of ganciclovir therapy, our patient did not recover.
Aged, 80 and over ; Anti-Bacterial Agents ; Arthroplasty ; Bacterial Infections ; Colitis ; Colonoscopy ; Cytomegalovirus ; Estrogens, Conjugated (USP) ; Female ; Ganciclovir ; Hemorrhage ; HIV ; Humans ; Knee ; Mycobacterium Infections, Nontuberculous ; Nontuberculous Mycobacteria ; Organ Transplantation ; Transplants ; Ulcer