No abstract available.
Aged* ; Femoral Neck Fractures* ; Femur Neck* ; Humans

To evaluate the results of cardiac anesthesia during open heart surgery using cardiopulmonary bypass, the cases of 100 patients from December 1986 to May 1989 were reviewed. The results were as follows: 1) There were 56 patients with congenital heart disease (male 32, female 24) and 44 patients with acquired heart disease (male 14, female 30). 2) The mean age of patients with congenital heart disease was 17.0+/-10.0 years and the mean age of patients with acquired heart disease was 41.2+/-14.6 years. 3) There were 54 cases of acyanotic heart disease and 2 cases of cyanotic heart disease among congenital heart disease, and 41 cases of valvular heart disease. 4) Glycopyroolate and hydroxyzine were mostly used as premedicants and morphine was used in some cases of acquired heart disease. 5) Anesthesia was induced by morphine and diazepam mostly while ketamine was used in some congenital heart disease. 6) The periods of cardiopulmonary bypass and aortic cross clamp in acquired heart disease were twice as long as in congenital heart disease. 7) The lowest body temperature during cardiopulmonry bypass was 26.7+/-2.5 degrees C in congenital heart disease and 24.1+/-3.6 degrees C in acquired heart disease while mean arterial pressure was maintained between 50-80 mmHg. 8) There were 33 cases of complications in 19 patients in which wound infection and arrythmia were most predominant. Four fatalities resulted from 3 cases of low cardiac output syndrome and 1 case of cerebrovascular disease.
Anesthesia* ; Arrhythmias, Cardiac ; Arterial Pressure ; Body Temperature ; Cardiac Output, Low ; Cardiopulmonary Bypass ; Diazepam ; Female ; Heart Defects, Congenital ; Heart Diseases ; Heart Valve Diseases ; Heart* ; Humans ; Hydroxyzine ; Ketamine ; Morphine ; Thoracic Surgery* ; Wound Infection

No abstract available.
Carcinoma, Hepatocellular*

PURPOSE: To evaluate the usefulness and limitations of power Doppler sonography in determining the tumor vascularity. MATERIALS AND METHODS: Power Doppler sonography was performed on VX2 carcinomas present in rabbit thighs, and the findings were compared with those of microangiography in an almost identical plane. Tumor vascularity was qualitatively analysed on the basis of tumor vessel distribution and density, and the presence of thick and thin vesels ; for a comparison of tumor vascularity as seen on microangiography, tumor blood flow signals shown by power Doppler sonography were graded 3, 2, 1, 0. For quantitative analysis, a comparison was made of the percentage of tumor area occupied by vessels, as shown in each study. Data analysis utilized the Wilcoxon signed-rank test and Spearman correlation test. RESULTS: Mean tumor vascularity scores, as seen on power Doppler sonography and relating to tumor vessel distribution and density, and the presence of thick and thin vessels, were 2.87, 2.73, 2.93 and 2.73, respectively. The means and medians of the percentages of tumor area occupied by vessels were 22.7% & 23.5% and 36.4% & 34.7% on microangiography and power Doppler sonography, respectively. Thus, there was good correlation between these two modes. CONCLUSION: Power doppler sonography could demonstrate the tumor vascularity on microangiography relatively well but tend to overestimate it.
Neoplasms, Experimental ; Statistics as Topic ; Thigh

Dieulafoy's disease of the bronchus is rare but potentially life-threatening, and should be considered in patients with massive hemoptysis, especially from unknown etiology. We report a case of a patient with massive hemoptysis due to bronchial Dieulafoy's disease. He underwent bronchial artery embolization and surgical resection, and the post-operative specimen revealed dilated and tortuous arteries in the submucosa that presented as Dieulafoy's disease of the bronchus.
Arteries ; Bronchi ; Bronchial Arteries ; Hemoptysis ; Humans

Peritoneal calcification, which can lead to intestinal obstruction and potentially lethal hemoperitoneum, is a rare complication of continuous ambulatory peritoneal dialysis. We describe a case in which extensive peritoneal calcification had arisen for this reason. Although the patient was asymptomatic, extensive calcification was present on the parietal and visceral peritoneum, including the hepatic and splenic surface.
Dialysis ; Hemoperitoneum ; Humans ; Intestinal Obstruction ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritoneum ; Rabeprazole

PURPOSE: To compare the accuracy of computed tomography (CT) with that of digital subtraction angiography (DSA) in predicting the resectability of Klatskin tumor on the basis of vascular invasion. MATERIALS AND METHODS: Twenty-five patients with Klatskin tumor who had undergone laparotomy were in-cluded in this study. In order to assess the surgical resectability of their tumors, the preoperative CT scans and DSA of these patients were retrospectively assessed in terms of vascular invasion. The criteria of unresectability were tumoral invasion of the proper hepatic artery or main portal vein, or simultaneous invasion of the hepatic artery on one side and the other side portal vein. RESULTS: Tumors were unresectable in 13 cases, and resectable in 12. CT and DSA predicted nine and three tumors as unresectable ones, respectively. The sensitivity, specificity, positive predictive value, negative predic-tive value and accuracy of CT in determining whether a tumor was unresectable were 61.5 %, 91.7%, 88.9 %, 6 8 .8 % and 76.0 %, respectively. For DSA, the respective figures were 23.1 %, 100 %, 100 %, 54.5 % and 6 0 .0 %. For the detection of vascular invasion without diameter change, CT was superior to DSA; for the evaluation of vascular anatomy, it was, however, less effective. CT failed to detect small hepatic metastasis (n=2), lymph node metastasis (n=1), variation of the bile duct (n=1), and the distal extent of tumor in the bile duct (n=1), factors which precluded surgical resection. CONCLUSION: CT is a reliable method for the detection of vascular invasion and tumor unresectability. For the detection of vascular anatomic variation, the combined use of CT and DSA would be helpful.
Anatomic Variation ; Angiography ; Angiography, Digital Subtraction* ; Bile Ducts ; Hepatic Artery ; Humans ; Klatskin's Tumor* ; Laparotomy ; Lymph Nodes ; Neoplasm Metastasis ; Portal Vein ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Because US plays a key role in the initial evaluation of hepatic hemangiomas,knowledge of the entire spectrum of US appearances of these tumors is impor-tant. Most hemangiomas have a distinctive US appearance, and even with those with atypical appearances on conventional gray-scale US, specific diagnoses can be made using pulse-inversion harmonic US with contrast agents. In this essay,we review the spectrum of US appearances of hepatic hemangiomas on conven-tional gray-scale, power Doppler, and pulse-inversion harmonic US with contrast agents.
Adult ; Aged ; Contrast Media ; Female ; Hemangioma/*ultrasonography ; Human ; Liver Neoplasms/*ultrasonography ; Male ; Middle Age ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color

We report a case with low-grade MALT lymphoma of the rectum in a 32-year-old man. Primary lymphoma of thecolon is rare and comprises less than 1 % of large bowel malignancies. Recently, large part of colonic lymphomahave been shown to be MALT lymphoma, which is a distinct type of B-cell lymphoma. The radiologic findings of thiscase are mucosal nodularity with shallow ulcers in the rectum, as seen on bar-ium enema, and rectal wallthickening, as seen on CT. There was no evidence of intra-abdominal lym-phadenopathy nor hepatosplenomegaly. Suchradiologic findings are rather similar to the findings in cases of inflammatory bowel disease, rending thedifferential diagnosis difficult.
Adult ; Colon ; Diagnosis ; Enema ; Humans ; Inflammatory Bowel Diseases ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone* ; Rectum* ; Ulcer

PURPOSE: To describe the radiologic features of computed tomography(CT) in hepatocelluar carcinoma(HCC) with bile duct involvement. MATERIALS AND METHODS: We retrospectively analyzed the two phase spiral CT findings of 31 patients in whom HCC with bile duct invasion (n=28) or compression (n=3), was diagnosed. Eight of these underwent follow-up CT after transarterial chemoembolization. We analyzed the size, type, location, enhancement pattern, and lipiodol retention of parenchymal and intraductal masses, as well as their and lymphadenopathy. RESULTS: In all patients with bile duct invasion, single or multiple masses were demonstrated in the bile ducts. Intraductal masses showed the same enhancement characteristics as the parenchymal mass (kappa 0.550, p < .001), and were contiguous to this mass. In 14 of 28 patients, intraductal masses filled the peripheral intrahepatic bile ducts and extended to the common bile ducts. In the other 14, the parenchymal mass extended to the area of the porta hepatis and then directly invaded the large ducts. In nine of the 28 patients, there was a hypoattenuated cleft between the intraductal mass and ductal wall. In six, a parenchymal mass was not apparent (n = 2), or was smaller than 2cm (n = 4). In five of eight patients (62.5%), follow-up CT after transarterial chemoembolization showed compact or partial lipiodol retention within the intraductal mass. In patients with bile duct compression, perihilar lymph nodes were noted along with the dilated intrahepatic duct but no intraductal mass was demonstrated in the duct. CONCLUSION: Hepatocellular carcinomas cause bile duct dilatation either by direct invasion or by extrinsic compression of the bile duct with surrounding enlarged nodes. For the diagnosis of this condition, CT is helpful.
Bile Ducts* ; Bile Ducts, Intrahepatic ; Bile* ; Carcinoma, Hepatocellular* ; Common Bile Duct ; Diagnosis ; Dilatation ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Retrospective Studies ; Tomography, Spiral Computed