PURPOSE: In order to help identifying the subgroups of primary megaureter who neck operation, we retrospectively reviewed the clinical records of the patients who had primary megaureters without vesicoureteral reflux. MATERIALS AND METHODS: We analyzed the initial differential renal function, UTI rate and the incidence of breakthrough infection of each group. Every patient had abdominal renal ultrasonograms and diuretic renograms during his/her follow-up period and the calyceal changes and differential renal functions were assessed. RESULTS: Those who underwent operation in their neonatal period did not have considerable postoperative problems. Those with primary obstructive megaureters who underwent operation had severe calyceal dilatation at the initial evaluation. However, there were severe calyceal dilatation in the nonobstructive-nonrefluxing group, too. Those who had poor differential renal function at the initial evaluation had a greater chance to have surgical correction. Those who were classified as primary obstructive megaureter and underwent operation had a higher rate of urinary tract infection than the counterpart who had consevative care. CONCLUSIONS: In order to differentiate those who need operation, we think that the differential renal function, the calyceal morphology, The diuretic renogram curve and urinary tract infection all act as combined factors altogether and not a single factor acts as a contributing factor. That is, if the diuretic renogram cutie is obstructive and there is urinary tract infection in the initial evaluation or if there is severe calyceal dilatation and decline of the differential renal function, we think that surgical correction should be under consideration. In contrast, if the diuretic renogram cutie is not obstructive and there are other factors combined, we think that conservative treatment should be the choice only if there is no breakthrough infection.
Dilatation ; Follow-Up Studies ; Humans ; Incidence ; Neck ; Retrospective Studies ; Ultrasonography ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

Pulmonary artery sling is a rare congenital condition in which the left pulmonary artery arises from the right pulmonary artery forming a sling around the trachea. This causes tracheal compression with the resulting respiratory symptoms. Most cases are associated with cardiovascular and tracheobronchial abnormalities. Some cases present incidentally without respiratory symptoms in adolescents and adults. We report a case with double left aberrant pulmonary artery associated with multiorgan anomalies which was incidentally found.
Adolescent ; Adult ; Humans ; Pulmonary Artery* ; Trachea

No abstract available.
Teratoma*

PURPOSE: To evaluate lung parenchymal change as seen on chest radiographs and high-resolution CT (HRCT) afterthe resolution of adenovirus pneumonia (a common cause of lower respiratory infection in infants and children),and the usefulness of HRCT during follow-up. MATERIAL AND METHODS: Four to 13(mean, 8) months after recovery, tenpatients infected with adenovirus pneumonia underwent HRCT and chest radiographs. Eight were boys and two weregirls, and their mean age was 26(range, 14-45) monthes. Adenovirus pneumonia had been confirmed by viral isolationin culture or serologic test. CT scanning was performed during quiet breathing ; collimation was 2mm and theinterval from apex to diaphragm was 5-10mm. Lung settings were 1600 HU (window width) and -700 HU(level). CTfindings were assessed and compared with chest radiographs by two chest radiologists, who reached a consensus. Thepatients were clinically followed up for one year. RESULT: On chest radiographs, hyperlucent lung was seen in 8of 10 patients (80%) ; in one other there was partial collapse, and in one, findings were normal. The most commonHRCT finding was a mosaic pattern of lung attenuation with decreased pulmonary vascularity in the area of lowerattenuation ; this was seen in 8 of 10 patients (80%). Other findingss were partial collapse, bronchiectasis, andbronchial wall thickening, each seen in two patients, and reticulonodular density, seen in one. In two patientsHRCT findings were normal ; in one of these, chest findings were noraml but a mosaic pattern of lung attenuationwas found in all lobes. During follow-up, three patients wheezed continously. CONCLUSION: In cases of adenoviruspneumonia, HRCT demonstrated more specific parenchymal change than did chest radiographs ; a mosaic pattern oflung attenuation was seen, with decreased pulmonary vascularity in areas of lower attenuation ; bronchiectasis,bronchial wall thickening, and reticulo-odular density were also noted. These findings were presumably due tobronchiolitis obliterans, a well known complication of adenovirus pneumonia, and are prognostically helpful.
Adenoviridae* ; Bronchiectasis ; Bronchiolitis Obliterans ; Consensus ; Diaphragm ; Follow-Up Studies ; Humans ; Infant ; Lung* ; Lung, Hyperlucent ; Pneumonia* ; Radiography, Thoracic* ; Respiration ; Serologic Tests ; Thorax* ; Tomography, X-Ray Computed

A 24 year old man visited our hospital, because an intrapulmonary foreign body had been found incidentally. Simple chest X-ray showed a 5 cm sized foreign body of metallic density, and chest CT confirmed the foreign body, which was like a sewing needle, in the left upper lobe. We performed a simple extraction of the foreign body using VATS (Video Assisted Thoracic Surgery). After the operation, the patient was discharged without any complications.
Foreign Bodies ; Humans ; Needles* ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed ; Young Adult

A 24 year old man visited our hospital, because an intrapulmonary foreign body had been found incidentally. Simple chest X-ray showed a 5 cm sized foreign body of metallic density, and chest CT confirmed the foreign body, which was like a sewing needle, in the left upper lobe. We performed a simple extraction of the foreign body using VATS (Video Assisted Thoracic Surgery). After the operation, the patient was discharged without any complications.
Foreign Bodies ; Humans ; Needles* ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed ; Young Adult

A retrospective study was conducted to evaluate the clinical outcomes of midtrimester emergency cervical cerclage in patients with painless cervical dilatation with/without prolapsed amniotic sac, including cases of no previous history of cervical incompetence. 10 patients including 1 twin pregnancy were teviewed for study, All had received emergency cervical cerclage with Macdonald operation or Shirodka operation at 18 to 31 weeksgestation. The procedures were carried out without serious complication except for one patient who had received re-operation 3 days after Macdonald operation because of re-protrusion of amniotic sae. The mean procedure to delivery internal was 8.9+/-5.3 (range 1 to 17) weeks. The mean gestational age at delivery was 32.4+/-5.6 (range 22 to 39+6) weeks for the entire group, 36.1+/-2.6 (range 32+4 to 39+6) weeks for the 6 who achived viability, and 27.6+/-5.0 (range 22 to 29+4) weeks for the 3 who died during the neonatal period. 1 died during gestation and was delivered at 33+6 weeksgestation. The mean birthweight was 2181.6+/-971.6 (range 498 to 3500)g for the entire group, and 2712.9+/- 571.5 (range 1860 to 3500)g for the 7 infants who lived until after neonatal period. The total survival rate for 11 babies was 64%. This study demonstrates that midtrimester emergency cervical cerclage for the patients who have dilated cervix with/without prolapsed amniotic sac is valuable method to try in the cases predicted they would lost the baby with conservative treatment only.
Cerclage, Cervical* ; Cervix Uteri* ; Dilatation* ; Emergencies* ; Female ; Gestational Age ; Humans ; Infant ; Labor Stage, First ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy, Twin ; Retrospective Studies ; Survival Rate

Endoscopic retrograde cholangiopancreatography (ERCP)-related complications should be promptly and properly managed in accordance with the type and severity of the complication and the comorbidity of the patient. Neurologic complications occur very rarely, but despite of the prompt management, the patient status can severely deteriorate and sometimes result in fatality. A female patient visited SAM Medical Center for abdominal pain and yellow skin. She has taken a current medication for essential hypertension since 10 years ago. Initial laboratory findings showed obstructive jaundice and abdominal computed tomography (CT) showed two common bile duct stones with moderate dilation of bile duct. Her vital sign with oxygen saturation was stable until the first attack of seizure 12 hours later after removal of stones through the ERCP. Emergent brain CT and magnetic resonance imaging revealed multiple cerebral infarctions of both hemispheres with right predominance of middle cerebral artery territory and no evidence of air emboli. She died four days later despite of intensive care including high oxygen therapy and intravenous broad spectrum antibiotics with antiplatelet drug. We report a rare, delayed occurrence of a fatal multiple cerebral infarctions 12 hours after ERCP.
Abdominal Pain ; Anti-Bacterial Agents ; Bile Ducts ; Brain ; Cerebral Infarction* ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Comorbidity ; Female ; Humans ; Hypertension ; Critical Care ; Jaundice, Obstructive ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Oxygen ; Seizures ; Skin ; Vital Signs

Among 202 aneurysmal patients with SAH who were admitted to Kyungpook National University Hospital from Jan. 1984 through Jan. 1988, the incidence of ventricular dilatation confirmed by postoperative follow-up brain CT scannings was 32.2%(65 cases). And 33 cases(19.3%) was in mild ventricular dilatation, 9 cases(4.5%) was in moderate and 23 cases(11.4%) in severe who needed the shunting procedure were analysed. The incidence of ventricular dilatation to the site of aneurysm was highest in A-com A. aneurysm(42.2%), followed by P-com A. aneurysm(36.4%) and MCA aneurysm(11.3%). The incidence of ventricular dilatation and the need for shunting was higher in multiple bleeding patients than the single. The good risk patients had meaningfully lower incidence of ventricular dilatation than the poor risk group. In the delayed surgical group showed significantly more numbers of ventricular dilatation needing the shunt than the cases in early group.
Aneurysm* ; Brain ; Dilatation* ; Follow-Up Studies ; Gyeongsangbuk-do ; Hemorrhage ; Humans ; Incidence ; Tomography, X-Ray Computed

A case of an epidural abscess, a rare but possibly devastating complication of epidural instrumentation and catheterization, which occurred in a cancer pain patient with an epidural port connected to the epidural catheter, is described. Although cases of a catheter related epidural abscess have been intermittently reported, those following epidural port implantation are very rare, with no case having been reported in Korea. Herein, the case of a 31-year-old man, who developed an epidural abscess 54 days after subcutaneous implantation of an epidural port connected to an epidural catheter, is reported. Methicillin-sensitive staphylococcus aureus was detected in a culture of the purulent discharge. Magnetic resonance imaging was essential, not only for the diagnosis of the epidural abscess, but also for determining the extent of spread. The patient refused further evaluation and treatment, and expired 22 days later.
Adult ; Catheterization ; Catheters ; Diagnosis ; Epidural Abscess* ; Humans ; Korea ; Magnetic Resonance Imaging ; Staphylococcus aureus