We observed a significant sign in postenhancement CT of liver cirrhosis, that is visualization of portalvenous branches. During postenhancement CT scanning of liver, the portal vein can not be identifed in liverparenchyme in 84% of patients without known cirrhosis (including chronic active hepatitis). Two have the samehemodynamic changes in that there is diffuse fibrosis and resultant decrease in vascular bed. Visualization ofintrahepatic portal branches in postenhancement CT is because of decreased diffusion ability and portalhypertension.
Diffusion ; Fibrosis ; Hemodynamics ; Humans ; Liver Cirrhosis ; Liver ; Portal Vein ; Tomography, X-Ray Computed

Most of malignant melanoma of skin had occurred in transformation from benign nevi(Webster, 1944), especially most frequently from junctional nevi of them. which was characterized by flat surface, dark-brown color and hairlessness(Ackermen, 1948) Blumberg (1972) introduced five levels of hietologic invasion of malignant melanoma described by Clark et al. Morton(1970) reported various measures of treatment such as surgery combined with radiotherapy or with chemotherapy or with recent immunotherapy with good result. The authors recently experienced 24-yeas old male soldier patient with malignant melanoma on hypothenar region of right palm. The pathologic investigation including electronmicroscopical aspect was carried out and are presented. Treatment consisted of the resections of right axillary lymph nodes and the lesion in situ on the hypotherar region of right hand, pedicle skin graft to right hand from abdomen, and immediate postoperative immunotherapy with intradermal injection of 1.0 cc. of B.C.G. daily on extensor surface of both thighs in turn, which lasted for about 3 months duration to find good result.
Abdomen ; Drug Therapy ; Hand ; Humans ; Immunotherapy ; Injections, Intradermal ; Lymph Nodes ; Male ; Melanoma ; Military Personnel ; Nevus ; Radiotherapy ; Skin ; Thigh ; Transplants

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis* ; Osteotomy*

After the stabilization using unreamed intramedullary interlocking nails for the management of fractures of the tibial shaft, a large percentage of patients whose fractures would proceed to delayed bony union may be subject to secondary surgical procedure. The purpose of this study is to determine whether ultrasound, through its potential early assessment of the presence or absence of callus at the fracture site, can be used to predict the need for secondary surgical procedure. Fourteen tibial fractures (5 open, 9 closed) were treated with unreamed interlocking intramedullary nailing. Radiographs were obtained to monitor the maintenance of reduction and fracture healing. The results of ultrasound studies were obtained at two-week intervals for 10 weeks postoperatively and read by a radiologist. In prospective study of 14 patients, tibial fractures treated with unreamed interlocking intramedullary nailing were analyzed from June 1995 to February 1997 and following results were obtained. 1. Ultrasound correctly predicted fracture healing in all 10 fractures that subsequently progressed to fracture union. 2. Of the 4 fractures that did not heal, ultrasound was able to predict delayed union before it was radiographically evident. 3. Ultrasound predicted fracture healing at an average of 42 days (range, 22-70 days). In comparison, the plain radiographs showed fracture healing at an average of 126 days (range, 70 - 180 days). In conclusion, the tibia was ideal for ultrasound study because of the thin overlying soft tissue. Furthermore, the presence of the intramedullary nail facilitated evaluation of the intervening tissue. And there were several advantages of ultrasound over other imaging modalities. It was noninvasive, easy to use, and painless method of evaluation that does not use ionizing radiation.
Bony Callus ; Fracture Fixation, Intramedullary ; Fracture Healing* ; Humans ; Prospective Studies ; Radiation, Ionizing ; Tibia* ; Tibial Fractures ; Ultrasonography*

We report a case of pulmonary infarction probably related with Henoch-Schönlein purpura, which presented with purpura on both lower extremities in a 27-year-old woman. The purpura had developed 4 days previously and it had no itching or tend'erness. She complained of mild fatigue, chest tightness, but no dyspnea or hemoptysis. On routine examination, chest radiography showed a poorly defined nodular opacity on the left lung field, and it was diagnosed by a follow up chest CT as a pulmonary infarction secondary to pulmonary vasculitis.
Adult ; Dyspnea ; Fatigue ; Female ; Follow-Up Studies ; Hemoptysis ; Humans ; Lower Extremity ; Lung ; Pruritus ; Pulmonary Infarction* ; Purpura* ; Radiography ; Thorax ; Tomography, X-Ray Computed ; Vasculitis

Supracondylar fracture of humerus is the most common fracture about the elbow in children and much has been written about its treatment and the prevention of both Volkmann's ischemia with contracture and cubitus varus deformity. In a retrospective survey of 155 children with supracondylar frscture of the humerus, 63 cases were found to have sufficient clinical and retrospective data to classify the fracture. 1. The average age was 6.5 years ranged from 1 year 3 months to 14 years and sex ratio was 2.2: 1(M:F) 2. 62 cases(98.4%) were extension type and 1 case(1.6%) was flexion type. In extension type, displacement was posteromedial 30 cases(47.6%), posterolatera117 cases(26.9%), posterior 10 cases(15.9%) and undisplaced 5 cases(7.9%). 3. Fracture level was divided into 3 Groups. Trans-olecranon fractures were 47 cases(74.6%), proximal to olecranon fractures were 11 cases(17.5%) and distal to olecranon fractures were 5 cases(7.9%). According to age distribution lower age group involves the distal part and higher age group involves proximal part. 4. Transverse fractures were 39 cases(61.9%) and oblique fractures were 24 cases(38.1%). In oblique fracture, postero-anterial oblique fractures were 19 cases(30.2%), medio-lateral oblique fractures 3 cases(4.8%), and latero-medial 2 cases(3.2%). In oblique fractures redisplacements were more common in P-A oblique csse. 5. In the treatment of fracture, 31 cases(49.2%) were treated with closed reduction and percutaneous pinning, 26 cases(41.3%) were treated with closed reduction and splint immobilization, 3 cases(4.8%) were treated with open reduction and K-wire fixation, 3 cases(4.8%) were treated with skeletal traction. 6. Functional results according to degree of initial displacement was worse in some displaced(Grade II) cases, rather than total displaced (Grade IV) or displaced with rotation (Grade III) cases. 7. Complications in splint immobilzation method were cubitus varus deformity 2 cases, nerve injury 2 case, and in k-wire fixation method, nerve injury 5 cases and pin migration 1 case.
Age Distribution ; Child ; Clinical Study ; Congenital Abnormalities ; Contracture ; Elbow ; Humans ; Humerus ; Immobilization ; Ischemia ; Methods ; Olecranon Process ; Retrospective Studies ; Sex Ratio ; Splints ; Traction

PURPOSE: To compare the suppressive effects in hepatocellular carcinoma patients of transhepatic arterial chemoembolization by the infusion of adriamycin-lipiodol emulsion and of this plus 10ml of cisplatin solution. MATERIALS AND METHODS: In a total of 151 cases, the frequency of intrahepatic recurrence was compared with follow-up angiographic findings after the first and second transhepatic arterial chemoembolization with adriamycin-lipiodol emulsion and adriamycin-lipiodol emulsion plus 10ml of cisplatin solution, respectively. RESULTS: Among 46 patients whose first single infusion was after mean 119 days, the recurrence rate was 22% ; for 42 who were given their first multiple infusion after mean 76 days this rate was 5% ; for 35 whose second single infusion was administered after mean 147 days, the rate was 34%, and among 28 whose second multiple infusion was after mean 110 days, the rate was 43%. CONCLUSION: During the first trial of transcatheter arterial chemoembolization with adriamycin-lipiodol plus cisplatin solution, hepatocellular carcinoma recurred much less frequently, but during the second trial with cisplatin, recurrence was not suppresed.
Carcinoma, Hepatocellular* ; Cisplatin* ; Follow-Up Studies ; Humans ; Recurrence*

No abstract available.

Most insects including the honeybee cause erythema and edema at the site of a sting in non-allergic individuals. This reaction usually resolves within a few days. However, in certain cases, the persistence of inciting materials in the cutaneous tissue may promote a local inflammatory foreign body reaction. Localized nodular lesions were seen in our two patients and erythemstous patches were present in one patient due to rarely encountered complications induced by retained sting materials. In these cases histopathology showed multiple foci of foreign body granuloma containing yellow refraetile material in the center surrounded by histiocytes and foreign body giant cells. The granulomatous skin lesions in these patients were treated with intralesional injections of triamcinolone acetonide and partial excisions of the nodular masses were performed.
Bites and Stings ; Edema ; Erythema ; Foreign-Body Reaction ; Giant Cells, Foreign-Body ; Granuloma* ; Granuloma, Foreign-Body ; Histiocytes ; Humans ; Injections, Intralesional ; Insects ; Skin ; Triamcinolone Acetonide

Thirty three cases of metastatic ovarian carcinoma were analysed cilincopathologically. The patient's age ranged from 20 to 68 years, the average being 44.3. Most ovarian tumors were bilateral and asymmertically enlarged, firm and occsaionally multicystic. Histologic examination revealed adenocarcinoma in 31 cases, of which Krukenberg tumors in 14; squamous cell carcinoma in 2. The most common primary site was gasrtointestinal(75.8%), followed by genital, breast and gallbaldder. Most Krukenberg tumors were originated from poorly differentiated adenocarcinoma of stomach. The ovarian and primary carcinomas were synchronously diagnosed in 15 cases, while in 3 cases the primary carcinoma was not round until the ovarian tumor had been removed.
Adenocarcinoma ; Neoplasm Metastasis