No abstract available.
Idiopathic Pulmonary Fibrosis*

A percutaneous nephrostomy tract was used as a conduit to the kidney and upper ureter for extraction of calculi. We have performed percutaneous extraction of renal and upper ureter stones in 52 cases with the use of the percutaneous equipment and ultrasonic lithotrite. Overall success rate was 86.5% and average operating time was 90 minutes and mean hospitalization was 6.9 days. The advantage of this technique are that a skin incision of only 1 cm. is required to remove the stone, hospital days are fewer than with open procedures and postoperative morbidity is minimal. We conclude that percutaneous nephrolithotomy can be the primary choice of treatment in upper urinary tract stones.
Calculi ; Hospitalization ; Kidney ; Nephrostomy, Percutaneous* ; Skin ; Ultrasonics ; Ureter ; Urinary Calculi

PURPOSE: Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament(ACL) injury in MR image. MATERIAL AND METHODS: The knee MR images of 47 patients with ACL injury(complete; 24, partial; 23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament(PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. RESULTS: The means( +/- 2standard errors) of anterior translocation were different significantly in statistical analysis(p<0.001, student t-test) between injury group(7.51 +/- 1.16mm) and normal group(-0.56 +/- 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 +/- 0.02) and normal group(0.17 +/- 0.01)(p<0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear(66%), thirteen lateral meniscus tear(28%), ten medial collateral ligament injury(28%), one PCL injury (2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients {43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients(19%) and avulsion fractures of anterior tibial spine in four patients(9%). CONCLUSION: The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.
Anterior Cruciate Ligament* ; Arthroscopy ; Bone Marrow ; Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Spine ; Tibia

PURPOSE: Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament(ACL) injury in MR image. MATERIAL AND METHODS: The knee MR images of 47 patients with ACL injury(complete; 24, partial; 23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament(PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. RESULTS: The means( +/- 2standard errors) of anterior translocation were different significantly in statistical analysis(p<0.001, student t-test) between injury group(7.51 +/- 1.16mm) and normal group(-0.56 +/- 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 +/- 0.02) and normal group(0.17 +/- 0.01)(p<0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear(66%), thirteen lateral meniscus tear(28%), ten medial collateral ligament injury(28%), one PCL injury (2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients {43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients(19%) and avulsion fractures of anterior tibial spine in four patients(9%). CONCLUSION: The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.
Anterior Cruciate Ligament* ; Arthroscopy ; Bone Marrow ; Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Spine ; Tibia

PURPOSE: To describe MR findings of recurred giant cell tumor of bone. MATERIALS AND METHODS: MR imagings of ten cases of pathologically proven recurrence of giant cell tumor were retrospectively analyzed. Location of recurrence, multiplicity of recurred tumor, signal intensity and homogeneity, pattern of gadolinium enhancement, soft tissue and articular surface involvement were evaluated. RESULTS: Tumors were located in peripheral portion of previous operation site(80%). Six cases recurred as multiple lesions. Tumor showed low signal intensity on T1 weighted images(100%), high signal intensity on T2 weighted images(100%) and inhomogeneous peripheral rim enhancing pattern(75%). Soft tissue and articular surface involvement were also demonstrated. CONCLUSION: We concluded that characteristic MR findings of recurred giant cell tumor could be helpful in early detection and precise evaluation of tumor recurrence.
Gadolinium ; Giant Cell Tumor of Bone ; Giant Cell Tumors* ; Giant Cells* ; Recurrence ; Retrospective Studies

Renal arterial embolization was induced experimentally in rabbits using autologous blood clot, Gelfoam, bariumsulfate, Ivalon(Polyvinyl alcohol)and ethanol. Microvascular changes were studied angiographically,microangiographically and histopathologically. The results were as follows: 1. The microangiographic findings ofrenal artery embolization were arterial occlusion, irregular arrangement, spiralling, dilatation, narrowing andcollateral vessel formation. 2. Recanalization of embolized vessels were noted after injection of autologous bloodclot and Gelforam only. 3. Collateral vessel formations were demonstrated in entire cases of renal arterialembolization (36/37). 4. After injection of Ivalon, recanalization of embolized vessel was not demonstrated butcollateral vessel formation were demonstrated microangiographically in all cases. 5 After injection of ethanol,collateral vessels were poorly developed microangiographically than other groups. 6. Embolic effect of ethanol wasnoted in central vessel but as well as in peripheral vessel. It was considered that ethanol is the most effectiveagent for permanent renal arterial occlusion.
Arteries ; Dilatation ; Ethanol ; Gelatin Sponge, Absorbable ; Rabbits

BACKGROUND: Mitral valve prolapse(MVP) is now recognized as noe of the most common cardiovascular disorders, particularly in young women with a slender body habitus. However, there is little clinical information about young men with mitral valve prolapse. The purpose of this study was to evaluate the physical and echocardiographic characteristics of young men about 20 years old with mitral valve prolapse. METHOD: Twenty young men with mitral valve prolapse(MVP graoup, mean age ; 19.9±2.4 years) and twenty healthy volunteers(control group, mean age ; 19.9±3.2 years) were examined using physical examination, chest X-ray, computed thoracic tomography and two dimensional and Doppler echocardiography. RESULTS: Compared with control group, MVP group had a smaller chest circumference(p < 0.001), a larger height-arm span difference(p < 0.01), smaller anteroposterior chest diameters(by chest X-ray ; p < 0.001 and computed tomography ; p < 0.01) and smaller anteroposterior/transverse chest diameter ratio(chet X-ray ; p < 0.01 and computed tomography ; p < 0.05). In MVP group, mitral regurgitation was noted 15 men(75%), those had posteriorly directed jets suggesting anterior mitral leaflet anomalies. CONCLUSION: Healthy young men having mitral valve prolapse had narrow chest and slender physical characteristics and anterior mitral leaflet abnormalities.
Clinical Study ; Echocardiography ; Echocardiography, Doppler ; Female ; Humans ; Male ; Methods ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Mitral Valve ; Physical Examination ; Thorax

Despite recent advances in nutritional support, patient monitoring, and surgical intensive care, as well as some improvement in surgical techniques, post-operative fistulas have been regarded as one of the most serious complications in abdominal surgery. The present study was undertaken to evaluate the effectiveness of treatment with total parenteral nutrition (TPN) alone (group A, n=26) or with TPN combined with octreotide, a long-acting analog of somatostatin (group B, n=20) in post-operative enterocutaneous fistulas. In group A, we treated 2 biliary, 10 pancreatic and 14 intestinal cutaneous fistulas with total parenteral nutrition. In group B, we treated 6 biliary, 8 pancreatic and 6 intestinal cutaneous fistulas with octreotide. The results obtained from the analysis are as follows: 1) The spontaneous closure of the fistulas was 69.2% in group A and 75.0% in group B. 2) The mean interval of time to achieve the healing of the fistula was 30.44 days in group A and 14.53 days in group B. 3) The mean interval of time to achieve a fistula output reduction of 50% was 6.44 days in group A and 2.44 days in group B. 4) In patients with low-output fistulas, the spontaneous closure of the fistula was 81.8% in group A and 80.0% in group B. In patients with high-output fistulas, the spontaneous closure of the fistula was 60.0% in group A and 73.3% in group B. 5) In patients with low albumin (< 3.0 g/dl), the spontaneous closure of the fistula was 54.5% in group A and 50.0% in group B. In patients with high albumin (> or = 3.0 g/dl), the spontaneous closure of the fistula was 80.0% in group A and 85.7% in group B. 6) In patients with an abdominal abscess, the spontaneous closure of the fistula was 40.0% in group A and 40.0% in group B. In patients without an abdominal abscess, the spontaneous closure of the fistula was 87.5% in group A and 86.7% in group B. 7) As compared with TPN, the spontaneous closure of the fistulas treated with octreotide was increased in the gastroduodenum and the external biliary system, was similar in the small bowel and the pancreas, but was decreased in the colon. We conclude that octreotide is a useful therapeutic complement in the conservative treatment of selected patients with post-operative cutaneous fistulas, especially fistulas in the external biliary system and the gastroduodenum.
Abdominal Abscess ; Biliary Tract ; Critical Care ; Colon ; Complement System Proteins ; Cutaneous Fistula ; Fistula ; Humans ; Intestinal Fistula* ; Monitoring, Physiologic ; Nutritional Support ; Octreotide ; Pancreas ; Parenteral Nutrition, Total ; Somatostatin

A renal arteriovenous fistula and arterial aneurysm are congenital or acquired in origin. Treatment has consisted of partial or total nephrectomy and ligation of branch artery traditionally. Recently the development of transcatheter arterial embolization technique has afforded a new therapeutic alternative Selective embolization using a embolic agent was found useful in management of arteriovenous fistula and aneurysm. With brief review of literatures, we report 5 cases treated successfully by selective transcatheter embolization.
Aneurysm* ; Arteries ; Arteriovenous Fistula* ; Kidney ; Ligation ; Nephrectomy

BACKGROUND: Burn is one of the most common illness in primary care. Most burns are partial skin thickness burns. The purpose of this study was to evaluate the use ofSilvadene (silver sulfadiazine) ointment (antibacterial agent) and DuoDERMR (artificial syntheticmaterial). METHODS: The subjects of this study were 46 patients with partial skin thickness burns who had visited a general hospital burn clinic from May 1, 2002 to June 30, 2002. They were randomly assigned to the silvadine ointment or DuoDERMR group. The patients were evaluated for pain, the number of dressing change, the ease of dressing application and removal, limitation of activity, comfortableness, satisfaction with the appearance, sleep disturbance, treatment cost, and the number of days for complete epithelialization. RESULTS: DuoDERMR treated burns had a fewer dressing change (3.19 times vs 5.36 times), less time for dressing change (4.13 min vs 6.26 min) and less cost (P<0.01). But there was no statistical difference in the number of days for complete epithelialization (P=0.197) and it depended on the size of the wounds (P=0.005). The cost of treatment was related with the number of dressing change (P=0.000). CONCLUSION: Treatment methods had no effect on duration of treatment but artificial synthetic material was shown to reduce the time for dressing and the cost.
Bandages ; Burns* ; Health Care Costs ; Hospitals, General ; Humans ; Primary Health Care ; Skin* ; Wounds and Injuries