PURPOSE: We studied to evaluate the effect of percutaneous catheter drainage (PCD) in liver abscess. MATERIALS AND METHODS: We retrospectively analyzed clinical data (presence of fever, WBC count), radiological findings (computed tomography, ultrasonography and abscessogram) and correlated them with treatment period. Percutaneous drainage of liver abscess were performed in 19 patients under fluoroscopy guide during recent three years. RESULTS: Eighteen patients (95%) were cured, and one patient underwent surgery because of peritonitis caused by PCD procedure. Average treatment period was 17 days. CONCLUSION: In the treatment of liver abscess, PCD is thought to be safe and effective.
Catheters* ; Drainage* ; Fever ; Fluoroscopy ; Humans ; Liver Abscess* ; Liver* ; Peritonitis ; Retrospective Studies ; Ultrasonography

Hepatic epithelioid hemangioendothelioma is a rare tumor of vascular origin having a intermediate clinical course between benign cavernous hemangioma and malignant anglosarcoma. Patients present nonspecific clinical signs and symptomas. We experienced a case of surgically proven hepatic epithelioid hemangioen-dothelioma. Computed tomography showed multiple nodules with internal calcifications, chiefly in peripheral portion of both lobes of the liver. Ultrasonography showed hypoechoic nodules and tiny calcific foci in peripheral portion. Open biopsy of the liver and the omenrum confirmed epithelioid hemangioendotheliomas.
Biopsy ; Hemangioendothelioma, Epithelioid* ; Hemangioma, Cavernous ; Humans ; Liver* ; Ultrasonography

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic* ; Salpingectomy*

PURPOSE: To evaluate the severity of tissue necrosis of liver according to various kinds of contrast materials used in percutaneous transhepatic procedure. MATERIALS AND METHODS: Four kinds of commercially available contrast material were used in the this study :meglumine ioxithalamate (ionic monomer, Telebrix 30, Guerbet, France), meglumine ioglicinate (ionic dimer, Rayvist 300, Schering, Germany), iopromide (nonionic monomer, Ultravist 300, Schering, Germany), and iotrolan (nonionic dimer, Isovist 300, Schering, Germany). The same amount(0.1 ml) of each contrast material was directly injected into the liver of Sprongue-Dawley rats. After two days and four weeks, the histopathologic findings of resected liver were assessed and analysed with special emphasis on the difference in the area of tissue necrosis between each group. RESULTS: In the liver resected 48 hours later, the area of necrosis was related to the osmolality and ionicity of contrast material used :the higher the osmolality, the wider the area of necrosis and ionic contrast material exhibited wider area of necrosis than nonionic contrast material. In the liver resected four weeks later, almost complete recovery was seen at the site of necrosis in all groups. CONCLUSION: Nonionic contrast materials caused less tissue necrosis than ionic contrast materials in percutaneous transhepatic procedure because of their lower osmolality.
Animals ; Contrast Media* ; Liver* ; Meglumine ; Necrosis ; Osmolar Concentration ; Rats*

No abstract available.
Transplantation*

PURPOSE: The signal of intracranial calcification on magnetic resonance (MR) imaging has been known to bevariable. The purpose of this study was to evaluate the MR signal of calcifications according to calciumconcentration and compound. MATERIALS AND METHODS: T1-weighted, proton density and T2-weighted images were obtained in phantoms with various conposition of calcium carbonate and calcium phosphate. The signal intensities and T1/T2 relaxation times were measured and analyzed according to calcium concentration and compound. The configurations of calcium particles were evaluated by scanning electron microscopy. RESULTS: The signal intensity of calcium carbonate on T1-weighted images gradually decreased as the concentration increased, while that ofcalcium phosphate showed a biphasic curve with a peak intensity at 0.2 g/ml. The signal intensity of both calcium compounds on T2-weighted images decreased as the concentration increased. The T1 relaxation time of calcium carbonate remained constant with increasing calcium concentration, however, that of calcium phosphate decreased upto 0.2g/ml and then remained constant. The T2 relaxation time of both calcium compounds decreased in a similar fashion with increasing concentration. Calcium phosphate showed larger surface area on scanning electron microscope. CONCLUSION: Calcifications show variable MR signal due to difference of T1 and T2 relaxation times according to calcium concentration and compound. Large surface area of calcium particle might cause shortening of T1 relaxation time leading to high signal on T1-weighted image. Understanding of these findings will help interpretation of MR images more precisely.
Calcium Carbonate ; Calcium Compounds ; Calcium* ; Microscopy, Electron, Scanning ; Protons ; Relaxation

PURPOSE: Most of recent MR imagings of cerebral cortex activation have been performed by using high field magnet above 2-T or echo-planar imaging technique. We report our experience on imaging of cerebral cortex activation with a widely available standard 1.5-T MR. MATERIALS AND METHODS: Series of gradient-echo images (TR/TE/flip angle :80/60/40 degrees64 x 128 matrix) were acquired alternatively during the periods of rest and task in five normal volunteers. Finger movement (n=10 ;5 right, 5 left) and flashing photic stimulation (n=l) were used as a motor task and a visual task to activate the motor cortex and visual cortex, respectively. Activation images were obtained by subtracting sum of rest images from that of task images. Changes of signal intensity were analyzed over the periods of rest and task. RESULTS: Activation images were obtained in all cases. Changes of signal intensity between rest and task periods were 6.5-14.6%(mean, 10.5%) in the motor cortex and 4.2% in the visual cortex. CONCLUSION: Functional imaging of cerebral cortex activation could be performed with a widely available 1.5-T MR. Widespread applications of this technique to basic and clinical neuroscience are expected.
Cerebral Cortex* ; Echo-Planar Imaging ; Fingers ; Healthy Volunteers ; Motor Cortex ; Neurosciences ; Photic Stimulation ; Visual Cortex

Congenital self-healing reticulohistiocytosis (CSHR) is a rare variant of cutaneous reticulohistiocytosis. We report a newborn who had about 25 reddish brown papulonodular lesions on whole body at birth. No extracutaneous involvement was found. All skin lesions involuted within 4 months spontaneously. Biopsy of a skin lesion showed marked aggregated histiocytic infiltration with some eosinophils. S-100 protein and lysozyme were positive. Electron microscopy revealed numerous dense bodies, often with a myelin-like core and some Birbeck granules. We described a detailed clinical features of this case and reviewed the literatures.
Biopsy ; Eosinophils ; Humans ; Infant, Newborn ; Microscopy, Electron ; Muramidase ; Parturition ; S100 Proteins ; Skin

PURPOSE: This study was carried out to elucidate the effects of nitric oxide synthase(NOS) inhibitor, NG-monomethyl-L-arginine(L-NMMA) and nitric oxide precursor, L-arginine(L-Arg) on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion(RR) after hypoxia-ischemia(HI) in newborn piglets. METHODS: Twenty-eight newborn piglets were divided into 4 groups; Sham normal control(NC), experimental control(EC), L-NMMA(HI & RR with L-NMMA), and L-Arg(HI & RR with L-Arg) groups. HI was induced by occlusion of bilateral common carotid arteries and simultaneously breathing with 8 percent oxygen for 30 mins, and followed RR by release of carotid occlusion and normoxic ventilation for one hour. All groups were monitored with cerebral hemodynamics and cytochrome aa3 (Cyt aa3) using near infrared spectroscopy(NIRS). Na+, K(+)-ATPase activity, lipid peroxidation products, and tissue high energy phosphate levels were determined biochemically in the cerebral cortex. RESULTS: In experimental groups, mean arterial blood pressure, PaO2, and pH decreased, and base excess and blood lactate level increased after HI compared to NC group(P<0.05). These variables subsequently returned to baseline after RR except pH. There were no differences among the experimental groups. In NIRS, oxidized hemoglobin(HbO2) decreased and hemoglobin(Hb) increased during HI(P<0.05) but returned to base line immediately after RR; 40 min after RR, the HbO2 had decreased significantly compared to NC group(P<0.05). Changes of Cyt aa3 decreased significantly compared to NC after HI and recovered at the end of the experiment. Significantly reduced cerebral cortical cell membrane Na+, K(+)-ATPase activity and increased lipid peroxidation products(P<0.05) were not improved with L-NMMA or L-Arg. CONCLUSION: These findings suggest that NO is not involved in the mechanism of HI and RR brain damage during the early acute phase of RR.
Anoxia ; Arginine* ; Arterial Pressure ; Brain ; Carotid Artery, Common ; Cell Membrane ; Cerebral Cortex ; Electron Transport Complex IV ; Energy Metabolism* ; Hemodynamics* ; Humans ; Hydrogen-Ion Concentration ; Hypoxia-Ischemia, Brain* ; Infant, Newborn* ; Ischemia ; Lactic Acid ; Lipid Peroxidation ; Nitric Oxide ; omega-N-Methylarginine* ; Oxygen ; Perfusion ; Respiration ; Ventilation

PURPOSE: The prevalence of intoxication and toxidromes, such as altered mental status, from Sedatives/hypnotics is high. Many patients have been transferred to a higher-level emergency center. This study was designed to analyze the clinical features of these patients and to compare patients transferred from a regional hospital with patients who directly visited a higher-level emergency center. METHODS: A retrospective study was conducted on 298 sedative/hypnotic intoxication patients examined from January 2008 to December 2012. After excluding patients intoxicated from other category medications and missing data on medical records, 158 acute intoxication patients were enrolled in the study and divided into transferred and direct-visit groups. Gastric lavage patients (n=108) were also subdivided into two groups by irrigation site. Clinical features, treatments, and complications were investigated. RESULTS: There were no significant differences between the two groups in initial clinical manifestations, laboratory data, and toxicological information, except for charcoal treatment and complications from pneumonia. The use of charcoal was significantly lower in the group transferred from a regional medical center. The transferred group showed a higher incidence of pneumonia than the direct-visit group (10/54(18.5%) vs. 5/104(4.8%), respectively, p=0.007). In the subgroup analysis of gastric lavage patients, there was also a higher incidence of pneumonia in the regional hospital lavage group compared to the higher-level emergency center lavage group (8/32(25.0%) vs. 5/76(6.6%), respectively, p=0.011). From a comparative analysis of pneumonic complications and mental status, pneumonia patients showed a higher incidence of painful responses and unresponsive mentality (6(40.0%) and 4(26.7%), respectively, p<0.001). CONCLUSION: In acute sedative/hypnotic intoxication patients, transferred patients, including regional hospital gastric lavage patients, showed a higher incidence of pneumonia. Pneumonic complication patients showed a higher incidence of a decreased mentality. Therefore, for patients transferred or treated for an altered mental status, precautions for complications from pneumonia must be considered.
Charcoal ; Emergencies* ; Gastric Lavage ; Humans ; Hypnotics and Sedatives ; Incidence ; Medical Records ; Pneumonia ; Poisoning ; Prevalence ; Retrospective Studies ; Therapeutic Irrigation