Pseudoaneurysm or false aneurysm is one of the late complication of a missed or untreated arterial injury. Most traumatic aneurysms in the extremities are false, and they are usually caused by penetrating trauma. The diagnosis of pseudoaneurysm is suggested by the presence of one or more of the followings: an expanding ill defined mass with or without pulsation, a bruit, pain, paresthesia or paralysis due to nerve compression, an absent peripheral pulse, or signs of ischemia. Although plain radiographs may demonstrate a nonspecific soft tissue mass, arteriography is essential in defining the false aneurysm or aneurysms and differentiating them from other soft-tissue masses. We are reporting the case of a patient who had a false aneurysm of the posterior tibial artery after open fracture of tibial shaft.
Aneurysm ; Aneurysm, False* ; Angiography ; Diagnosis ; Extremities ; Fractures, Open ; Humans ; Ischemia ; Paralysis ; Paresthesia ; Tibial Arteries*

No abstract available.
Family Practice* ; Humans ; Outpatients* ; Thyroid Diseases* ; Thyroid Gland*

BACKGROUND & OBJECTIVES: Although thalamic stroke is the most frequent cause of pure sensory stroke, non-thalamic strokes have been also occasionally reported to produce pure sensory stroke(PSS). We attempt to characterize the clinical and radiological features of 11 patients with PSS due to brainstem stroke. SUBJECTS AND METHODS: There were eight men and three women and their age ranged from 50 to 71 years. Their risk factors included hypertension in 10, diabetes mellitus in 2, hyperlipidemia in 3, alcohol drinking in 3 and cigarette smoking in 2. All underwent brain computed tomography(n=11) and/or magnetic resonance imaging(n=8). RESULTS: Five patients presented with pure lemniscal sensory deficits(position and vibration sensation); two presented with abnormalities in all sensory modalities but dominantly involving lemniscal sensation; remaining 4 presented with numbness only. Four patients had cheiro-oral syndrome with bilateral perioral involvement. Imaging studies showed that 6 patients had a small infarct in the paramedian pontine tegmentum, which was thought to be caused by small vessel(lacunar) inclusion. One patient had a small infarct in the lateral part of the midbrain which was probably caused by artery-to-artery embolism originated from mid-basilar stenosis. In addition, four patients had small hypertensive hemorrhage affecting the pontine tegmentum. CONCLUSION: Our result confirms that PSS can be caused by small brainstem stroke of various etiopathology, frequently involving the paramedian pontine tegmentum PSS due to braimtem stroke may be characterized by predom inant lemniscal sensory involvement and occasional bilateral perioral symptoms.
Alcohol Drinking ; Brain ; Brain Stem Infarctions ; Brain Stem* ; Constriction, Pathologic ; Diabetes Mellitus ; Embolism ; Female ; Hemorrhage ; Humans ; Hyperlipidemias ; Hypertension ; Hypesthesia ; Male ; Mesencephalon ; Risk Factors ; Sensation ; Smoking ; Stroke* ; Vibration

No abstract available.
Female ; Fetal Heart* ; Heart Rate, Fetal* ; Meconium* ; Pregnancy

The chest radiographs and angiograms were retrospectively evaluated in 47 patients with pulmonary atresia (PA) and ventricular septal defect (VSD) to determine the characteristic findings of major aortopulmonary collateral arteries (MAPCSs) on the chest radiographs. Of 47 patients, 23 had MAPCAs and 24 had only PDA for blood supply of whole right and left lung. Chest radiographs enabled identification of 16 of 23 patients with MAPCAs. The most common finding of MAPCAs was inappropriately large peripheral pulmonary vasculature (n=16, 69.6%). The other findings were tortuosity of pulmonary vasculature (n=12, 52.2%), focal unevendistribution of pulmonary vasculature (n=12, 52.2%), and two descending pulmonary arteries (n=4, 17.4%). When chest radiographs showed two or more findings of MAPCAs, MAPCAs could be differentiated from PDA with statistical significance (p<0.005). It is concluded that chest radiographs may help to identify MAPCAs before angiography if two-dimensional echo ardiography suggests PA with VSD.
Angiography ; Arteries* ; Heart Septal Defects, Ventricular* ; Humans ; Lung ; Pulmonary Artery ; Pulmonary Atresia* ; Radiography, Thoracic ; Retrospective Studies ; Thorax*

No abstract available.
Esophagus* ; Numismatics*

BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

The hyperosinophilic syndrome (HES) commonly involves liver and spleen but only a few literature has reported the imaging features. In this article, we present the imaging features of the liver and spleen in HES patients together with clinical and laboratory features. This study included 5 HES patients with hepatic involvement. Extensive laboratory tests including multiple hematologic, serologic, parasitologic, and immunologic examinations were performed. Imaging studies included CT, ultrasound (US) of upper abdomen and hepatosplenic scintigraphy. All patients were periodically examined by laboratory and imaging studies for 4 to 24 months. The common clinical presentations were weakness, mild fever, and dry cough. All patients revealed leukocytosis with eosinophilia of 40 to 80% and benign eosnophilic hyperplasia of the bone marrow. The percutaneous biopsy of the hepatic focal lesions performed in 2 patients showed numerous benign eosinophilic infiltrates and one of them revealed combined centrilobular necrosis of hepatocytes. All cases revealed hepatomegaly with multiple focal lesions on at least one of CT, US, or scintigraphy. These findings completely disappeared in 2 To 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphy. These findings completelydisappeared in 2 to 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphic studies showed hepatic multifocal lesions with hepatomegaly. Differential diagnoses of these findings should include metastatic disease, lymphoma, leukemia. candidiasis or other opportunistic infections.
Abdomen ; Biopsy ; Bone Marrow ; Candidiasis ; Cough ; Diagnosis, Differential ; Eosinophilia ; Eosinophils ; Fever ; Hepatocytes ; Hepatomegaly ; Histamine Antagonists ; Humans ; Hypereosinophilic Syndrome* ; Hyperplasia ; Leukemia ; Leukocytosis ; Liver ; Lymphoma ; Necrosis ; Opportunistic Infections ; Radionuclide Imaging ; Spleen ; Ultrasonography

The hyperosinophilic syndrome (HES) commonly involves liver and spleen but only a few literature has reported the imaging features. In this article, we present the imaging features of the liver and spleen in HES patients together with clinical and laboratory features. This study included 5 HES patients with hepatic involvement. Extensive laboratory tests including multiple hematologic, serologic, parasitologic, and immunologic examinations were performed. Imaging studies included CT, ultrasound (US) of upper abdomen and hepatosplenic scintigraphy. All patients were periodically examined by laboratory and imaging studies for 4 to 24 months. The common clinical presentations were weakness, mild fever, and dry cough. All patients revealed leukocytosis with eosinophilia of 40 to 80% and benign eosnophilic hyperplasia of the bone marrow. The percutaneous biopsy of the hepatic focal lesions performed in 2 patients showed numerous benign eosinophilic infiltrates and one of them revealed combined centrilobular necrosis of hepatocytes. All cases revealed hepatomegaly with multiple focal lesions on at least one of CT, US, or scintigraphy. These findings completely disappeared in 2 To 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphy. These findings completelydisappeared in 2 to 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphic studies showed hepatic multifocal lesions with hepatomegaly. Differential diagnoses of these findings should include metastatic disease, lymphoma, leukemia. candidiasis or other opportunistic infections.
Abdomen ; Biopsy ; Bone Marrow ; Candidiasis ; Cough ; Diagnosis, Differential ; Eosinophilia ; Eosinophils ; Fever ; Hepatocytes ; Hepatomegaly ; Histamine Antagonists ; Humans ; Hypereosinophilic Syndrome* ; Hyperplasia ; Leukemia ; Leukocytosis ; Liver ; Lymphoma ; Necrosis ; Opportunistic Infections ; Radionuclide Imaging ; Spleen ; Ultrasonography