CT scan is widely used in the evaluation of hepatobiliary system and contrast study is generally performedwith non-biliary contrast media. Therefore the normal intrahepatic bile ducts are not readily visible and alsoextrahepatic bile ducts are occasinally not discriminated from adjacent structures, in spite of improvedresolution of the CT scanner. This study was performed to evaluate the usefulness of cholangiographic enhancementin biliary CT examination. In the control group (n=5), we measured the CT number of the peripheral hepatic duct,perioportal duct, common bile duct and gall bladder, respectively, at the interval of 30 minutes upto 2 hoursafter intervenous infusion of biliscopin(30ml) and observed time-denstiy relationship of infused biliscopin in thebiliary system. In the patient group (n=23), we observed visualization rate of the bilary system and serumbilirubin level at 30 minutes after infusion of biliscopin(30ml). The results were as follows: 1. The peak densityoccurred at 30 minutes after infusion of biliscopin. 2. Visualization rate was 100% in normal bilirubin groupwhereas it was 91.7% in abnormal bilirubin group. 3. The cholangiographic enhancement of biliary CT scan is usefulin the evaluation of intra-and extraheptaic biliary system.
Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Bilirubin ; Common Bile Duct ; Contrast Media ; Humans ; Tomography, X-Ray Computed ; Urinary Bladder

BACKGROUND: We studied the incidence of trauma caused by alcohol related accidents, and the effects that has on the occurrence, the extent, and the outcome to the patient. METHODS: In our study we studied trauma patients excluding pediatric patients(15 years old and under) who came to the Emergency department of Korea University Medical School Anam Hospital from the 1st of january 1996 to 30th of June 1996, looked into their medical records, and studied the records in a retrospective manner. The trauma patients were divided into two groups, a) alcohol-related and b) alcohol-non-related. The two groups were then subdivided according to their sex, age, the time they came in, the anatomical part of the trauma, the mechanism of their injury, the extent of the injury, the length of their hospital stay, the length of their ED stay and were seperately compared and analysed. Statistically, ANOVA and logistic regression analysis using SAS were used in the study and then was assessed in Chi-square analysis methods. RESULTS: The total of the trauma patients, added up to 832 people, 577: male and 255: female. Among this sum, 16 trauma patients were alcohol related(male:127 & female 36). 115 people were in the age group of 21-40. Compared to the non-alcohol related trauma group, the alcohol-related group had more facial & scalp injuries and tended to come in the hours between 0-6 AM. The cause of the injuries were mossy by fast-fighting and suicide, compared to mostly accidental-slipping injuries in the non alcohol-related group. There were no difference in the degree of the injury(ISS) and the length of hospital stay between the two groups, whereas the length of the stay at the ED was longer alcohol-related trauma patients. CONCLUSION: Alcohol related trauma patients were mostly in their 20s and 30s, came to the hospital at a late time it the reason for their visit were mossy because of fist fighting. In the Emergency department, because prompt and correct diagnosis is quite difficult to make in this group, their ED stay tended to be longer. We can conclude that measuring the blood alcohol level of these patients, continuing the psychological therapy and educating people is needed.
Diagnosis ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Korea ; Length of Stay ; Logistic Models ; Male ; Medical Records ; Retrospective Studies ; Scalp ; Schools, Medical ; Suicide

PURPOSE: This study examined 50 cases of laparoscopic cholecystectomy performed by a single inexperienced surgeon to determine the usefulness of a hepatobiliary scan with 99mTc-DISIDA as the contributing factor related to the conversion to an open cholecystectomy. METHODS: From July 2004 to June 2005, 34 patients, who underwent a laparoscopic cholecystectomy by an inexperienced surgeon, were evaluated. The effectiveness of a hepatobiliary scan with 99mTc-DISIDA as preoperative evaluation was also examined. The patients were divided into 3 groups according to the hepatobiliray scan findings: group A had normal findings, group B had decreased gallbladder contraction and group C had gallbladder nonvisualization. The patients' charts, age, gender, previous history of abdominal operation, preoperative laboratory data, preoperative ultrasound findings, pathologic findings, conversion rate to open cholecystectomy, surgical complication and hospital stay were reviewed. RESULTS: The mean age was 52.7 years and the male-to- female ratio was 1 : 1.3. All 34 were diagnosed with a gallbladder stone in the preoperative ultrasound. The number of patients in group A, B, and C was 11, 15, and 8, respectively. The conversion rate was 0%, 0%, and 37%, respectively. The mean length of hospital stay was 5.5, 5.5, and 8 days in group A, B and C, respectively. CONCLUSION: The conversion rate and hospital stay decreased in laparoscopic cholecystectomy as the surgical experience increased with the increasing number of cases. However, the conversion rate was still high in the inexperienced surgeon. A preoperative hepatobiliary scan with 99mTc- DISIDA allows inexperienced surgeons to predict the thickening of the gallbladder wall, inflammation and the anatomic conditions of the gallbladder, and discuss the high risk of conversion preoperatively.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Female ; Gallbladder ; Humans ; Inflammation ; Length of Stay ; Technetium Tc 99m Disofenin ; Ultrasonography

INTRODUCTION: The fixation strength of transpedicular screw system in the vertebral hody relied on bone quality and anatomical characteristics of vertebral pedicle, designs of screw and types of connection(rod or plate) with screw. The purpose of this study is to verify the biomechanical nature of the transpedicular fixation in spine under various conditions with porcine vertebrae. MATERIAL AND METHOD: Fresh porcine vertebrae and the custom-made screws were used in this experiment. To reduce the errors caused by vertebral bodies of different size and quality, vertebral bodies having regular range of pedicular width(10.0 to 11.5mm) and hone density(more than 1.0 gm/cm2) were used. The pedicle screws were inserted in the same procedure and axial pull out test was performed with using the Material Testing System(lntron8511, Canton, USA). The experiments were performed in four types to assess the difference of strength accroding to designs of the screw hy using two group of screws. The first group of screw was designed according to the outer and inner diameter and the second group was designed according to the shape, pitch, and thread profile of screw. Experiment I was perfomed to evaluate the effect of screw diameters on the biomechanical pull-out strength hy using the first group of custom-made pedicle screw which fixed all other factors except the diameter of screw. Experiment I was to verify the effect of screw shape, experiment III to verify the effect of pitch and experiment IV to verify the effect of thread profile. RESULTS: The results of experiments were summarized as follows: Experiment I showed that the screw of larger outer diameter had greater holding strength. Experiment II showed that the holding strength of cylindrical shaped screw is superior to that of conical shaped screw. Experiment III showed that there is no statistical significance between different modes of pitch. Experiment IV showed that the holding strength of buttress shape of thread profile is superior to that of V-shape. CONCLUSION: It seemed that the fixation strength of the screw was more powerful with 1 mm increment of outer diameter in 4-7mm of outer diameter, 3mm of pitch and buttress shape of thread of the screw with the same operation technique.
Spine

PURPOSE: Bone graft is essential for successful spinal fusion. So, we clinically assessed the effect of uniting grafted autologous bone. MATERIALS AND METHODS: Retrospective analysis is performed on 46 patients who had grade I or II, one segmental, degenerative spondyloiisthesis according to Meyerding classification and treated operatively by posterolateral fusion with posterior decompression and autologous iliac bone graft from January 1991 to June 1996. We got the data from simple anteroposterior, lateral, flexion- extension X-ray film at preoperative, postoperative and last follow-up period, and from clinical results at last OPD follow-up according to Kirkaldy-Willis criteria. We compared the union of grafted autologous bone with clinical results using X2-test. We also compared preoperative spinal instability, with/without instrumentation and intraoperative reduction with the union of grafted autologous bane and clinical results. RESULTS: There was high significant correlation (P=0.000) between the union of grafted autologous bone and clinical results statistically, CONCLUSIONS: This results suggest that the union of grafted autologous bone was an important factor in determing clinical results.
Classification ; Decompression ; Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Fusion ; Spondylolisthesis* ; Transplants* ; X-Ray Film

No abstract available.
Humans ; Infant, Newborn* ; Rhabdomyoma*

No abstract available.

OBJECTIVE: Recently, there are many reports that glutamate receptors have close relationships with a pathophysiology of schizophrenia. The purpose of this study was to assess the effects of D-cycloserine, which is glycine site partial agonist in NMDA receptor on psychopathologic symptoms and cognitive functions. METHODS: This study was done for chronic schizophrenic inpatients taking typical antipsychotics for more than 4 months. Exclusion criteria were patients with over 8 points according to Simpson-Angus scale for EPS or those with over 17 points of Hamilton Depression Scale. Patients were randomized to classify into two groups; D-cycloserine group (n=13) and placebo group (n=13). Each group received D-cycloserine 100 mg or placebo separately for 8 weeks. Psychopathology was evaluated with PANSS at baseline, 2nd week, fourth week and eighth week. Cognitive function was evaluated with KWIS at baseline and eighth week. RESULTS: Total 26 patients completed this trial. The average period of morbidity was 10.39+/-3.87 years and the average doses of antipsychotic was 1228.35+/-720.30 mg based on chlorpromazine equivalent. In positive subscale, negative subscale, general psychopathology subscale, total PANSS scale and KWIS, there were no significant differences between D-cycloserine and placebo groups. However, negative subscale scores had decreased from 24.92+/-3.64 (Baseline) to 23.46+/-3.41 (week 8) (p=0.077). CONCLUSION: There were no clear changes in positive symptom, negative symptom, memory, language function, and performance intelligence when D-cycloserine 100 mg was given with antipsychotic medication. However, some patients showed clear improvement in negative symptom, especially blunted affect. Therefore, D-cycloserine combination therapy could be effective for negative symptom. In future, study that can show effectiveness in psychopathology and cognitive function according to drug dosage is needed.
Antipsychotic Agents ; Chlorpromazine ; Cognition* ; Depression ; Glycine ; Humans ; Inpatients ; Intelligence ; Memory ; N-Methylaspartate ; Psychopathology ; Receptors, Glutamate ; Schizophrenia*

We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*

No abstract available.