PURPOSE: To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. MATERIALS AND METHODS: Sixteen patients with avascular necrosis of femoral head were examined with MRI. Tl-weighted and T2-weighted images and contrast-enhanced Tl-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. RESULTS: Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on Tl-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the portions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. CONCLUSION: Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease.
Head* ; Humans ; Joints ; Magnetic Resonance Imaging* ; Necrosis* ; Synovial Membrane

No abstract available.
Gram-Positive Cocci*

No abstract available.
Lung*

The authors have experienced 9 cases of postgastrectomy efferent loop obstruction during the past 16 months' period and analyzed the clinical features, radiological findings, causes, and types of obstruction. The incidence of efferent loop obstruction was 1.3%(9/673). Among the 9 cases, eight patients were male and one patient was female. Median age was 60 years and more than half(5 out of 9 cases) of the patients were obese(defined by more than 110% of ideal body weight). None of the cases showed signs of strangulation, including persistent pain, fever, focal abdominal tenderness, and/or leukocytosis. Gastrointestinal anastomoses were done using a GIA stapler in 6 cases, and manually in 3 cases. The diagnoses were made on the basis of clinical symptoms and signs, further supported by radiologic contrast studies. All the patients were initially treated with conservative measures, including nasogastric drainage and fluid therapy for about 2 weeks in average. 7 cases underwent re-laparotomy using separate left subcostal incisions as conservative management had failed. Among the relaparotomy cases, adhesiolysis and side to side jejunojejunostomy were performed in 5 patients, Roux-en-Y gastrojejunostomy in 1 patient, and gastrojejunostomy revision in 1 patient. Causes of the obstruction in the seven re-opened cases were confirmed as postoperative adhesion. The authors have analyzed the pattern of obstruction and classified the patterns into 4 types. One of the remaining two patients underwent balloon dilatation successfully and the other was managed with prolonged nasogastric decompression. The average hospital stay was 32 days. Adequate omentectomy, gentle tissue handling during dissection, avoidance of ischemia along the suture line of anastomosis, and the use of biologically inert suture material would prevent this kind of postoperative adhesive obstruction.
Adhesives ; Decompression ; Diagnosis ; Dilatation ; Drainage ; Female ; Fever ; Fluid Therapy ; Gastric Bypass ; Humans ; Incidence ; Ischemia ; Length of Stay ; Leukocytosis ; Male ; Stomach Neoplasms ; Sutures

PURPOSE: The increased expression of cyclooxygenase (COX)-2 has been implicated in the development and progression of human cancers. We investigated COX-2 expression in normal, gastric adenomas and adenocarcinomas. MATERIALS AND METHODS: COX-2 protein was assayed in gastrectomy and biopsy specimens, from 68 gastric adenocarcinomas, 40 gastric adenomas and 35 normal gastric tissues, by immunohistochemistry, and 32 specimens of normal and adenocarcinomas by western blot analysis. Correlation between COX-2 expression and various clinicopathological factors were studied in the gastric adenocarcinoma. RESULTS: COX-2 protein expression in epithelial cells was increased in 6/40 (15%) of the adenomas and 55/68 (80.9 %) of the adenocarcinomas, while normal mucosa was not expressed. COX-2 expression was increased in differ-entiated gastric carcinomas compared with those in the undifferentiated group (p<0.05). The expression of COX-2 protein was unrelated to tumor size, depth of tumor invasion and the presence of lymphatic or vascular invasions. Western blot analysis showed the enhanced expression of the COX-2 protein (23 out of 32)(71%) in gastric carcinomas compared to that of normal gastric mucosal epithelium. CONCLUSION: The above results indicated that the expression of COX-2 protein occurs in dysplastic epithelium and gastric carcinomas, which suggests COX-2 expression may contribute to tumor formation.
Adenocarcinoma ; Adenoma ; Biopsy ; Blotting, Western ; Carcinogenesis* ; Cyclooxygenase 2* ; Epithelial Cells ; Epithelium ; Gastrectomy ; Humans ; Immunohistochemistry ; Mucous Membrane ; Prostaglandin-Endoperoxide Synthases ; Stomach Neoplasms

PURPOSE: To analyse the MR imaging characteristics of the soft tissue hemagiomas of the extremity. MATERIALS AND METHODS: We retrospectively reviewed histopathologically proven 18 cases of hemangiomas of the extremity including 15 cavernous hemangiomas, 2 venous hemangiomas and 1 capillary hemangioma. The lesions were frequent in female and low extremity. We analyzed the site, extent, margin, signal intensity, enhancement pattern, the homogeniety of internal architecture, and abnormal vessels near the lesion. RESULTS: The extensive lesions involving multiple muscle and tissue layers were more frequent than localized lesions (12/18). Twelve cases had ill defined margin. In most cases, the lesion was heterogeneous mass composed of nodular and septal components. The nodular component showed intermediate signal intensity in T1WI and hign signal intensity in T2WI. The setal component showed mixed inconstant signal intensity. One case of capillary hemangioma showed relatively homogeneous signal intensity than cavernous hemangioma and the main portion of 2 venous hemangiomas had mutilple tubular signal voids. At least some portion of the lesion was enhanced in all enhanced cases. CONCLUSION: The soft tissue hemangiomas of the extremity showed characteristic MR findings and MRI would be an useful method in the diagnosis of the soft tissue hemangiomas of the extremity.
Diagnosis ; Extremities* ; Female ; Hemangioma* ; Hemangioma, Capillary ; Hemangioma, Cavernous ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies

PURPOSE: To analyse the MR imaging characteristics of the soft tissue hemagiomas of the extremity. MATERIALS AND METHODS: We retrospectively reviewed histopathologically proven 18 cases of hemangiomas of the extremity including 15 cavernous hemangiomas, 2 venous hemangiomas and 1 capillary hemangioma. The lesions were frequent in female and low extremity. We analyzed the site, extent, margin, signal intensity, enhancement pattern, the homogeniety of internal architecture, and abnormal vessels near the lesion. RESULTS: The extensive lesions involving multiple muscle and tissue layers were more frequent than localized lesions (12/18). Twelve cases had ill defined margin. In most cases, the lesion was heterogeneous mass composed of nodular and septal components. The nodular component showed intermediate signal intensity in T1WI and hign signal intensity in T2WI. The setal component showed mixed inconstant signal intensity. One case of capillary hemangioma showed relatively homogeneous signal intensity than cavernous hemangioma and the main portion of 2 venous hemangiomas had mutilple tubular signal voids. At least some portion of the lesion was enhanced in all enhanced cases. CONCLUSION: The soft tissue hemangiomas of the extremity showed characteristic MR findings and MRI would be an useful method in the diagnosis of the soft tissue hemangiomas of the extremity.
Diagnosis ; Extremities* ; Female ; Hemangioma* ; Hemangioma, Capillary ; Hemangioma, Cavernous ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

One fullterm infant whose clinical feature initially was that of necrotizing enterocolitis eventually developed intussusception. The symptomatology of these two conditions is strikingly similar, and when they coexist, recognition of a complicating intussusception is difficult. The pathogenic relationship between necrotizing enterocolitis and intussusception remains obscure. When a presumptive diagnosis of necrotizing enterocolitis is made but the infant's clinical course varies from that expected, other diagnoses, such as intussusception, must be considered.
Diagnosis ; Enterocolitis, Necrotizing* ; Humans ; Infant* ; Intussusception*

PURPOSE: The purpose of this study is to evaluate the effect of applying Silano-pen to feldspathic porcelain and zirconia on shear bond strength with composite resin. MATERIALS AND METHODS: Feldspathic porcelain and zirconia specimens were produced into 30 per each 2 mm thick and 12 mm in diameter and their surface was made smooth and even and then embedded in acrylic resin. The specimens were divided into each Group F (Feldspathic porcelain) and Group Z (Zirconia), (1) Hydrofluoric acid etching and silane (F1 & Z1), (2) Silano-pen and silane (F2 & Z2), (3) Hydrofluoric acid etching and Silano-pen, silane (F3 & Z3). After surface conditioning, substrate surfaces of the specimen were examined by SEM. Composite resin cylinders (2 mm high, 3 mm in diameter)were bonded to specimen and shear bond strength between ceramic and composite resin was measured by using universal testing machine. The measured values were statistically analyzed by using two way ANOVA and Tukey's multiple comparison test (alpha=.05). RESULTS: In the scanning electron micrograph of the treated ceramic surface, Group F2 and F3 appeared the high roughness and Group Z3 appeared the highest density of silica particle. In Feldspathic porcelain, the result of measuring shear bond strength showed that Group F3 was measured to be highest and Group F1 was measured to be lowest but there was no statistical significance among Groups. In zirconia, Group Z3 was measured to be highest and Group Z1 was measured to be lowest and there was statistical significance among Groups (P<.05). CONCLUSION: In zirconia, applying hydrofluoric acid etching and then Silano-pen and silane is effective for composite resin adhesion.
Ceramics ; Dental Porcelain* ; Hydrofluoric Acid ; Silicon Dioxide