PURPOSE: To evaluate the usefulness in diagnosing the gallbladder perforation MATERIALS AND METHODS: CT scans of surgically proved 11 cases of gallbladder perforation were retrospectively reviewed. CT findings analyzed were iuminal diameter of GB, GB wall thickness and configuration, presence or absence of fluid collection in the pericholecystic or intraperitoneal space, and observation of pericholecystic anatomic structures. All patients underwent cholecystectomy, and surgical findings were also compared. RESULTS: The GB was distended in 6 cases(55% with a range of 4.0-7.5cm, mean :5.2cm). GB wall was thickened in most cases(9/11,82%) with homogeneous(n=7) or inhomogeneous(n=2) enhancement. At the sites of perforation, focal defect or contour bulging was seen in the GB wall in 3 cases. in 2 cases with gangrene, GB wall showed loss of normal contour with mottled contrast enhancement. Pericholecystic or intraperitoneal fluid co11ection was noted in 9 cases(82%), especially in the region of perforation. In all cases, there was evidence of diffuse infiltration in the pericholecystic space, omenturn or mesentery. Other findings included cholecy-stoenteric fistula in 1 case, and intrahepatic or intraperitoneal abscess formation in 2 cases. CONCLUSION: CT is useful in correct diagnosis of gallbladder perforation.
Abscess ; Cholecystectomy ; Diagnosis ; Fistula ; Gallbladder* ; Gangrene ; Humans ; Mesentery ; Retrospective Studies ; Tomography, X-Ray Computed

Endometrial carcinoma usually occurs in postmenopausal women ; less than 5% occurs in women under the age of40. Up to one quarter of endometrial carcinoma patients below this age have PCO(polycystic ovary disease, Stein-Leventhal syndrome). The increased incidence of endometrial carcinoma in patients with PCO is related to chronic estrogenic stimulation. We report MR imaging in one case of endometrial carcinoma occuring in a 23 yearold woman with PCO and had complained of hypermenorrhea for about three years. On T2-weighted MR image the endometrial cavity was seen to be distended with protruded endometrial masses of intermediate signal intensity, and the junctional zone was disrupted beneath the masses. Both ovaries were best seen on T2-weighted MR imagingand showed multiple small peripheral cysts and low signal-intensity central stroma.
Endometrial Neoplasms* ; Estrogens ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging ; Menorrhagia ; Ovary*

Hereditary hemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu disease is an autosomal dominant disorder characterized by repeated episodes of bleeding. Multiple telangiectases consisting of thin-walled, dilated vascular channels with arteriovenous communication may involve, for example, mucocutaneous tissue, the gastrointestinal tract, and the liver, lung, and brain. We report the imaging findings of two cases of HHT involving arteriovenous malformation of both the lungs and liver, a rare condition. Chest radiography revealed a round mass, while helical CT showed a feeding artery and draining vein with arteriovenous malformation in the lung. Color Doppler sonography revealed an enlarged and tortuous hepatic artery with high systolic velocity. CT demonstrated an enlarged hepatic artery, arteriovenous shunt, and early draining hepatic vein in the liver. Celiac angiography showed arteriovenous malformation.
Angiography ; Arteries ; Arteriovenous Malformations* ; Brain ; Gastrointestinal Tract ; Hemorrhage ; Hepatic Artery ; Hepatic Veins ; Liver* ; Lung* ; Radiography ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis ; Thorax ; Tomography, Spiral Computed ; Veins

The severe form of chronic periodontitis(CP) has been reported to be strongly associated with the presence of allele 2 of composite IL-1B(+3954) and IL-1A(+4845) genetic polymor- phisms(genotype positive). However, other studies have reported conflicting findings. These might have resulted from differences in ethnic background and disease entities. The aim of this study was to determine the distribution of IL-1A(+4845), IL-1B(+3954), IL-1B(-511), and IL-1 RN(VNTR) genetic polymorphisms in children as a future Korean population. The study population consisted of 92 children from the Dept. of Pediatric Den- tistry, Chonnam National University Hospital. Genomic DNA was obtained from buccal swab. The IL-1A(+4845), IL-1B(+3954), and IL-1B(-511) genes were genotyped by amplifying the polymorphic region using multiplex polymerase chain reaction(PCR), followed by restriction enzyme digestion and gel electrophoresis. IL-1 RN(VNTR) polymorphism were then evaluat- ed by PCR amplification and fragment size analysis in agarose gel. The allele 2 frequency was 41.3%, 4.3%, 47.8%, and 9.9% for IL-1A(+4845), IL-1B(+3954), IL-1B(-511), and IL-1 RN respectively. The frequency of genotype with allele 2 carriage for IL-1A(+4845), IL-1B(+3954), IL-1B(-511), and IL-1 RN was 77.1%, 7.6%, 63.0%, and 15.2% respectively. The allele 2 frequency in IL-1B(+3954) was significantly higher in female than in male population(p<0.05). The negative association was shown between the presence of allele 2 in IL-1B(-511) and in IL-1B(+3954), and the carriage rate of IL-1B(+3954) allele 2 tended to lower in IL-1B(-511) allele 2(P=0.056). Only 7.3% of children carried the composite genotype of IL-1A(+4845) and IL-1B(+3954). These results suggest that the polymorphism of IL-1B(+3954) and the positive composite genotype was relatively rare in Korean population.
Alleles ; Child* ; Digestion ; DNA ; Electrophoresis ; Female ; Genotype ; Humans ; Interleukin-1* ; Jeollanam-do ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Sepharose

No abstract available.

Pigmented villonodular synovitis(PVNS) is a synovial lesion of joints or tendon sheaths, characterized by villous and nodular overgrowth of the synovial membrane. It commonly occurs in synovial joints of the appendicular skeleton, particularly those of the knee and hip, but rarely affecting those of the spine. We report a case of PVNS of the lumbar spine mimicking epidural mass.
Hip ; Joints ; Knee ; Skeleton ; Spine* ; Synovial Membrane ; Synovitis ; Synovitis, Pigmented Villonodular* ; Tendons

The triclosan was shown to have anti-microbial and anti-inflammatory effect with inhibition of inflammatory mediators such as prostaglandin E2 (PGE2). The purpose of this study was to elucidate whether and how PGE2 could be inhibited by triclosan in human gingival fibroblast. Human gingival fibroblast-1 cells (ATCC CRL2014) were pre-treated for 1 hour with triclosan (0.001 microgram/ml~ 10 microgram/ml) and then stimulated with TNF-alpha(1.0 ng/ml). PGE2 synthesis was evaluated by ELISA and gene expression of COX-1 and COX-2 was evaluated by RT-PCR after TNF-alpha, triclosan, and NS-398 (COX-2 inhibitor, 5 micrometer) and/ or cycloheximide (protein synthesis inhibitor, 2 microgram/ml). Triclosan was cytotoxic to human gingival fibroblasts in the concentration higher than 1.0 microgram/ml for longer than 24 hours in tissue culture. The PGE2 synthesis was inhibited by triclosan in dose-dependent manner. Greater COX-2 mRNA suppression was observed with triclosan (0.1 microgram/ml) than with TNF-alphaalone, without change in COX-1 gene expression. Inhibitory effects of triclosan on PGE2 synthesis disappeared in presence of cycloheximide. This study suggests that triclosan inhibit prostaglandin E2 at the level of COX-2 gene regulation and require de novo protein synthesis.
Cycloheximide ; Dinoprostone* ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts* ; Gene Expression ; Humans* ; RNA, Messenger ; Triclosan* ; Tumor Necrosis Factor-alpha

PURPOSE: To determine the frequency, level, distribution, onset, and pattern of progression of bone resorption that occurring around pedicle screws after pedicle screw plate fixation. MATERIALS AND METHODS: Bone resorption around 902 pedicle screws was analyzed in post-operative, and follow-up radiographs obtained from 156 patients who underwent pedicle screw plate fixation. To determine the resorption degree, categorized arbitrarily as grade 1 (less than 1 mm), grade 2 (1 mm or more, but less than 2 mm), or grade 3 (2 mm or more), the width of radiolucent zones was measured. In 39 patients in whom resorption was graded 1, 2, or 3, the pattern of progression of 78 screws was evaluated. RESUTLS: Resorption occurred around 78 (8.6%) screws in 39 (25%) patients, 26 of whom had more than one lesion. For 99% of screws, there was evidance of resorption within 12 weeks of pedicle screw plate fixation. During follow-up, 61.5% of screws (48/78) remained stable, while 38.5% (30 screws) showed progression to higher grades. The possibility of progression to a higher grade is less when the initial grade is lower. CONCLUSION: An understanding of the radiographic patterns of bone resorption is useful for monitoring a patient after pedicle screw plate fixation.
Bone Resorption* ; Follow-Up Studies ; Humans

PURPOSE: To assess the postoperative CT findings of aortic aneurysms or dissections treared by resection- and-graft replacement or continuous-suture graft-inclusion technique MATERIALS AND METHODS: We reviewed postoperative follow-up CT findings of 14 patients, 19 cases. There were 8 patients(10 cases) of aortic aneurysm and 6 patients(9 cases) of aortic dissecton which involved the thoracic aorta in 9 patients(13 cases) and abdominal aorta in 5 patients(6 cases). The interval of follow-up after operation was from 9 days to 2 year 9 months. On CT scans, we analyzed the appearance of graft materials, differences of CT findings between two surgical techniques, and normal or abnormal postoperative CT findings. RESULTS: Most of grafts appeared as hyperdense ring on precontrast scan, and all of them were not seperated from aortic lumen on postcontrast scan. On CT findings of patients who were operated by continuous-suture graft-inclusion technique, perigraft thrombus was concentrically located with sharp demarcation by native aortic wall and its density was homogeneous, but in cases of those operated by resection-and-graft replacement, perigraft hematoma was eccentrically located with indistinct margin and its density was heterogeneous and native aortic wall could not be delineated. In patients without complication, perigraft thrombus or hematoma(15 cases), perigraft calcification(11 cases), residual intimal flap(6 cases), graft deformity(4 cases), perigraft air(2 cases) and reconstructed vessels(1 case) were noted. And in one patient with complication, perigraft flow was noted with more increased perigraft hemaroma. CONCLUSION: Precise knowledge of the differences of CT findings between two surgical techniques and nor- mal postoperative CT findings is crucial to evaluate the postoperative CT findings in aortic aneurysm and dissection.
Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm* ; Follow-Up Studies ; Hematoma ; Humans ; Thrombosis ; Tomography, X-Ray Computed ; Transplants

Here we report a case of ruptured dissecting aneurysm of the posterior inferior cerebellar artery(PICA) treated with proximal PICA coil occlusion using an endovascular technique. A 28-year-old man presented with acute severe headache and vomiting followed by seizure. At admission, he was drowsy, with diplopia and right ankle hypesthesia. Computed tomographic scans demonstrated a subarachnoid hemorrhage. Cerebral angiography demonstrated a dissecting aneurysm of the left proximal PICA. One day after the bleeding episode, he was undergone proximal PICA coil occlusion using an endovascular technique. The patient's postoperative course was uneventful. The decision that led to the choice of treatment is discussed.
Adult ; Aneurysm, Dissecting* ; Ankle ; Arteries* ; Cerebral Angiography ; Diplopia ; Endovascular Procedures ; Headache ; Hemorrhage ; Humans ; Hypesthesia ; Pica ; Seizures ; Subarachnoid Hemorrhage ; Vomiting