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

PURPOSE: To assess the effects and complications of balloon dilatation in the treatment of postoperative stricture at the gastrointestinal tract. MATERIALS AND METHODS: From February 1991 to July 1993, balloon dilatation was performed under fluoroscopic guidance on 5 patients (age:l month to 64 yrs, male:female=2:3) who previously had undergone abdominal surgery because of stomach cancer (n=2), congenital tracheoesophageal fistula (n=l), lye stricture (n=l), and colon cancer (n=l). Causes of the stricture were all benign (n=4) except for one (recurrence of malignant tumor). We dilatated the stricture site with balloon catheter (8--25 mm in diameter) 3 to 4 times per session which was repeated 1 to 5 times in each patient. Follow-up periods ranged 8 to 15 months after the treatment. RESULTS: Two out of four benign strictures were relieved at one session, and the remaining two needed repeated sessions of balloon dilatation. Symptoms did not improve in the patient with malignant stricture in~pite of balloon dilatation, and feeding jejunostomy was reginred. Partial tear of anastomosis site occurred in one patient, however, it did not require any treatment. CONCLUSION: Balloon dilatation is relatively safe and effective in the treatment of postoperative stricture at the gastrointestinal tract.
Catheters ; Colonic Neoplasms ; Constriction, Pathologic* ; Dilatation* ; Follow-Up Studies ; Gastrointestinal Tract* ; Humans ; Jejunostomy ; Lye ; Stomach Neoplasms ; Tracheoesophageal Fistula

Successful block of the celiac plexus denervates the denervatives of the foregut and therefore can successfully interrupt nociceptive stimuli from the pancreas, stomach, liver, etc. Although permanent neurolytic block is much less successful for malignant chronic pancreatitis syndrome, it is specifically useful for treatment of intractable pain that often accompanies carcinoma of the pancreas or other upper abdominal visceral tumors. This was a case report in which intractable pain due to malignant gastric cancer was successfuly controlled by the permanent neurolytic celiac plexus block.
Celiac Plexus ; Liver ; Pain, Intractable ; Pancreas ; Pancreatitis, Chronic ; Stomach ; Stomach Neoplasms*

Many studies have shown that epidural narcotics produce prolonged analgesic action. We instillated 2mg of morphine on the dura just before wound closure which was exposed for lumbar laminectomy. Sixty patients scheduled for laminectomy were devided into two groups i.e., morphine group (30 patients) and control group(30 patients). The results of this study were as follows: 1) In morphine group, 17 patients (56.6%) tolerated the postoperative pain without narcotic injection for over 20 hours, but 13 patients(43.3%) of the control group required narcotic injection within 5 hours. 2) Severe respiratory depression was noted in two cases from the morphine group. 3) It is a very simple and effective method for postoperative pain control.
Humans ; Laminectomy ; Morphine* ; Narcotics ; Pain, Postoperative* ; Respiratory Insufficiency ; Wounds and Injuries

Peripheral nerve injury occurs mostly in company with tendon and muscle injuries, fractures, or dislocations. Because of the disabilities and socioeconomic loss caused by such injuries, much attention must be paid to the initial treatment, and later to the reconstruction and rehabilitation. At department of Orthopedic Surgery, Seoul National University Hospital, 336 patients of nerve lesion were treated from Jan, 1980 to Dec, 1988. Among them 128 patients were nerve compression syndrome (carpal tunnel 52 patients, cubital tunnel 40 patients, thoracic outlet 16 patients, others 20 patients), and 50 patients were brachial plexus injury, and 168 cases were peripheral nerve injury. 50 patients of the peripheral nerve injury were treated with reconstruction and 118 patients were treatred with neurorrhaphy, nerve graft, and neurolysis. Of the 118 patients, 94 patients were followed up for more than one year, and the results of neurorrhaphy, nerve graft and neurolysis were analyzed. In 46 patients (73.0%) of the patients treated with neurorrhaphy, 7 patients (58.3%) with nerve graft, and 15 patients (78.9%) with neurolysis, good or excellent results were obtained.
Brachial Plexus ; Dislocations ; Humans ; Nerve Compression Syndromes ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rehabilitation ; Seoul ; Tendons ; Transplants

PURPOSE: To evaluate the prevalence and the patterns of sterile gas shown at computed tomography(CT) after transarterial embolization(TAE) for primary hepatic tumor. MATERIALS AND METHODS: Among 102 patients who performed TAE for hepatoma, thirty-four in whom follow-up CTwas underwent constituted the basis of our study. At CT, we evaluated the patterns and locations of intratumoral gas. We also reviewed the clinical data to exclude an infectious origin of intratumoral gas. RESULTS: Of 34 patients, intratumoral gas was detected in 11 patients(32%), in all of whom Gelfoam was used as an embolic material. The initial tumor size measured at pre-TAE CT was larger in patients with intratumoral gas than in patients without it(p < 0.005). No specific patterns or locations of intratumoral gas were noted on CT scans. No patients had clinical signs and symptoms that suggested infection. CONCLUSION: Intratumoral gas formation without clinical evidence of infection is not an infrequent finding after TAE for hepatoma, especially when Gelfoam is used and when the tumor is large in size. This finding may be a part of postinfarction syndrome and should not be misinterpreted as an postprocedural abscess formation.
Abscess ; Carcinoma, Hepatocellular ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Humans ; Prevalence ; Tomography, X-Ray Computed

BACKGROUND: It was recognized that the intake of the whole cow's milk(WCM) early (before 1 year old of age) and large amount in early childhood is related to the iron deficiency, sometimes the iron deficiency anemia in advanced state. To verify the relationship between the variables in the WCM intake and the iron status, we carried out this study. METHODS: Thirty subjects(1 year to 3 years old of age) were classified as a WCM large intake group and a WCM small intake group. The relationship between the WCM commencing age and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large intake group was evaluated and analyzed by the linear regression. Futhermore, the relationship between the value of WCM intake amountxduration/10 and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large and small intake groups was evaluated and analyzed by the linear regression. RESULTS: As the WCM commencing age was earlier, the values of serum ferritin, transferrin saturation and hemoglobin decreased significantly(P<0.05). The values of serum ferritin and transferrin saturation decreased significantly as the value of WCM intake amountxduration/10 increased(P<0.05). But the value of hemoglobin decreased insignificantly as the value of WCM intake amountxduration/10 increased(P>0.1). CONCLUSION: The variables in the intake of WCM influence upon the iron status in early childhood. The early commencing of the WCM(before 1 year old of age) is the worst variable that influences adversely upon the iron status in early childhood. The amount of WCM intake and the duration influence upon the storage iron(serum ferritin and transferrin saturation), but not hemoglobin. In this regard, it is necessary to inform the parents of the correct WCM intake ways to avoid the irreversible recognition impairment and behavioral change.
Anemia, Iron-Deficiency ; Child, Preschool ; Ferritins ; Humans ; Iron* ; Linear Models ; Milk* ; Parents ; Transferrin

This is a retrospective clinical analysis of 27 cases of pancreatic pseudocysts that were treated at the Department of Surgery, Chung Goo Sung Sim Hospital, from 1988 to 1996. The results are as follows:1) The ratio of males to females was 12.5 :1, and the highest incidence was in the 4th decade. 2) Acute & Chronic Pancreatitis was most frequently associated with pancreatic pseudocysts (72.4%). 3) The most frequent symptom of patients with a pancreatic pseudocyst was abdominal pain (92.5%), and the most common site of the pancreatic pseudocyst was the tail of the pancreas (55.6%). 4) Of the 7 cases involving pseudocysts of less than 5 cm, 6 cases were managed conservatively and 1 case surgically . In the 15 cases with sizes from 5 cm to 10 cm, percutaneous catheter drainage was performed in 7 cases, with sizes larger conservative management in 5 cases and surgical management in 4 cases. In the 5 cases with sizes larger than 10 cm, percutaneous catheter drainage was performed in 3 cases and surgical management in 1 case. 5) Cases involving conservative management and percutaneous drainage (average:31 & 34 days), respectively had shorter hospital stays than surgical menagement (42 days). 6) Complications of pancreatic pseudocysts, such as intra-abdominal abscesses, cutaneous fistulas, pulmonary complications, wound infection, leakage or rupture, etc, were relatively common after surgery. In conclusion, we propose that conservative management and percutaneous catheter drainage are first-line treatment modalities for pancreatic pseudocysts if the clinical conditions of the patient can tolerate them.
Abdominal Abscess ; Abdominal Pain ; Catheters ; Cutaneous Fistula ; Drainage ; Female ; Humans ; Incidence ; Length of Stay ; Male ; Pancreas ; Pancreatic Pseudocyst* ; Pancreatitis, Chronic ; Retrospective Studies ; Rupture ; Wound Infection

PURPOSE: The purpose of this study is to determine the detection rate of early gastric cancer and to measure the focal gastric wall thickening in computed tomography. MATERIALS AND METHODS: From November 1991 to November 1993, 19 patients (age;33--76 years, male ;female:4;5) with surgically proven early gastric cancer were examined by upper gastrointestinal series and abdominal computed tomography. Twenty lesions in these patients were included in this study. Computed tomography was performed with conventional technique using gastrografinR (17 cases) or water filling (2 cases) method in supine position. Additional scans were obtained either in right down decubitus (15 cases) or supine position (4 cases) with an ingestion of gas forming agent. We determined the detection rate of early gastric cancer at computed tomography and measured the maximum thickness of the lesion. RESULTS: The pathologic types of the early gastric cancer were type lib + IIc in 5 cases, type IIc in 6, type III in 3 and type I, I + IIc, Ila, lib, lib + III and IIc + III in one, respectively. Seventy-five percent (15 cases) of early gastric cancer was detected at upper gastrointestinal series and fifty percent (10 cases) at computed tomography. Computed tomography could detect 100% of elevated carcinomas (3/3) and 41% of depressed carcinomas (7/17). The maximum thickness of the lesion ranged from 7 mm to 11 mm (mean ;8mm). CONCLUSION: In a well-distended stomach, CT could detect focal gastric wall thickening (mostly, less than 1 cm) caused by early gastric cancer in half of the cases.
Eating ; Humans ; Male ; Stomach ; Stomach Neoplasms* ; Supine Position ; Water

BACKGROUND: Tuberculous cervical lymphadenitis is a granlomatous lymphadenitis which is the most common extra-plumonary tuberculosis in Korea. There are several controversies about the methods and the duration for the treatment of the disease. METHODS: We have studied 208 cases of tuberculous cervical lymphadenitis which were treated at Chung-Goo Sung-Shim Hospital from January 1992 to December 1996. RESULTS: The result of the study are as follows: The most prevalent age group was the third decade followed by the fourth decade. For the sexual distribution, females predominated over males by 1.9 to 1. the unilateral location was the most common one (76.2%). The most frequent lesion was on the anterior cervical triangle (28.6%) Simple excision was performed in 194 cases and incision plus drainage in 14 cases. Antituberculous medication was applied to the patients in two different groups. Isoniazid, Rifampin and Ethambutol were administered every day to the patients in one of the groups. To the other group, Pyrazinamide was additionally administered - Isoniazid, Rifampin, Ethambutol, and Pyrazinamide were administered every day. The average duration of medication for the former group was 13 months, and that for the latter group was 11 months. We experienced 17 cases of recurrence in both groups. The recurrence rate was 3.7% (4 cases) for the group with Pyrazinamide included and 13.0% (13 cases) for the other. For the patients with recurrence who were treated with the pyrazinamide, extending the medication from 6 to 12 months brought about a complete treatment for all cases. However, for the cases of recurrence in the other group, in which Pyrazinamide were not applied, only 8 cases were treated completely by 12 months after the additional administration of Pyrazinamide. Surgical treatment was performed for the remaining 5 cases, and all 5 cases were cured completely after additional antituberculous medication for 6 months. CONCLUSIONS: We conclude that the best choice for the treatment of tuberculous cervical lymphadenintis is the use of both surgical excision and antituberculous medication. In addition, the use of Pyrazinamide is recommended for the antituberculous medication.
Drainage ; Ethambutol ; Female ; Humans ; Isoniazid ; Korea ; Lymphadenitis* ; Male ; Pyrazinamide ; Recurrence ; Rifampin ; Tuberculosis