Acupuncture with gold needle insertion is utilized in Oriental medicine, and the effect of therapy is represented by anti-inflammatory and analgesic function, But sometimes the needle is erroneously inserted into abdominal organs, and then it may cause dangerous complications. We report a case of multiple gold needles in the abdominal organs without having definete clinical symptoms.
Acupuncture* ; Medicine, East Asian Traditional ; Needles* ; Radiography*

No abstract available.
Insulinoma*

Spatial change of craniofacial structures from growth or orthopedic force is usually evaluated by cephalometric superimpositions at different points in time.As the evaluation can be changed according to cephalometric superimposition method,selection for correct superimposition method is very important. Double registration of nineteen pairs of female lateral head films,their growth period is average 3.7 years and age is average 10.7 years, were performed by two observers. Comparisions was made between two methods and the results revealed the following; 1. NS line and ACE superimpositions are not markedly different in reliability due to almost same registration error of them. 2. The investigation was undertaken to examine interobserver difference. In NS line method, there is no significance in all measurements. In ACE method, significant difference was revealed in 4 measurements of 7 measurements was 3. In the investigation of intermethod difference, there is no significance between NS line and ACB superimpositions
Female ; Head ; Humans ; Orthopedics ; Skull Base*

Pancreas lipomatosis is definde as fatty replacement of pancreatic acinar cells. Of the nine cases evaluated, seven cases (77.8%) of lipomatosis were limited inbody and tail, one case (11.1%) showed total lipomatosis excluding uncinate process and the remaining one case (11.1%) only in tail. As to the severity of lipomatosis, complete fat replacement in body and tail was found in four cases (44.4%), incomplete body and complete tail involvement in two (22.2%), incomplete body and tail, complete all except uncinate process, and complete tail involvements were found in one case (11.1%) each. Associated or predisposing factors included three diabetes mellitus (33.3%) combined with pancreas divisum, pancreas lithiasis and cholelithiasis respectively, hepatitis (22.2%) in two, and pseudocyst (11.1%) in one case, but in three cases (33.3%) nothing was found. In conclusion, pancreas lipomatosis was easily diagnosed by the abdominal CT and it was associated or predisposed by several e tities but had no major clinical symptoms, such as pancreatic insufficiency.
Acinar Cells ; Causality ; Cholelithiasis ; Diabetes Mellitus ; Exocrine Pancreatic Insufficiency ; Hepatitis ; Lipomatosis* ; Lithiasis ; Pancreas* ; Tail ; Tomography, X-Ray Computed

Twenty seven patients with known rectal cancer were evaluated with CT and CT findings were correlated with surgical and pathologic results on the aspect of perirectal fat infiltration and lymph node involvement. The accuracy in assessment of perirectal fat infiltration was 77.8% (21 of 27); sensitivity, 73.3% (11 of 13); specificity, 83.3% (10 of 12). In the detection of lymph node involvement, lymph nodes were divided into five groups according to the arterial teritories. Overall accuracy in the evaluation of lymph node involvement was 86.7%. Accuracy of peritumoral lymph node involvement was 51.9% (14 of 27); sensitivity, 42.9%(9 of 21); specificity 83.3% (5 of 6). Accuracy of internal iliac lymph node involvement was 88.9% (24 of 27); sensitivity, 85.7% (6 of 7); specificity, 90.0% (18 of 20). Of the common and external iliac lymph node, accuracy was 100% (27 of 27); sensitivity, 100% (2 of 2); specificity, 100% (25 of 25). Of the aortic bifurcation and mid sacral lymph node, accuracy was 92.6% (25 of 27); sensitivity, 50% (2 of 4); specificity, 100% (23 of 23). In regard to the inferior mesenteric lymph node, no lymphadenopathy was found on CT and pathologic results. In conclusion, CT has limited value in evaluating rectal cancer but with the satisfactory outcome in assessment of perirectal fat infiltration and lymph node, involvement except peritumoral node preoperative CT is useful in the evaluation of rectal cancer.
Humans ; Lymph Nodes* ; Lymphatic Diseases ; Rectal Neoplasms* ; Sensitivity and Specificity

PURPOSE: To determine the value of mammography and ultrasonography in the detection of early breast cancer, and the usefulness of combining the two modalities for the diagnostic study of this condition. MATERIALS AND METHODS: The mammographic and ultrasonographic features of 47 female patients aged 23-68 (average, 46) years with pathologically proven early breast cancer were analyzed retrospectively. Mammography was performed in 46 patients and ultrasonography in 38, and 37 underwent both mammography and ultrasonography. Analysis of the mammographic and/or ultrasonographic features focused on mass, microcalcification, mass with microcalcification, multiple nodules, duct dilatation, and architectural distortion. RESULTS: Mammography revealed microcalcification in 29 (63%) patients, mass in 13 (28%) patients, mass with microcalcification in 8 (17%) patients, multiple nodules in 2 (4%) patients, architectural distortions in 1 (2%) patient, and negative finding in 9 (20%) patients. Ultrasonography revealed mass in 25 (66%) patients, microcalcifcation in 9 (24%) patients, mass with microcalcification in 8 (21%) patients, multiple nodules in 2 (5%) patients, duct dilatation in 3 (8%) patients, and negative finding in 7 (18%) patients. On combined study of mammography and ultrasonography of the 37 patients, mammography or ultrasonography revealed mass in 25 (68%) patients, microcalcification in 20 (54%) patients, multiple nodules in 2 (5%) patients, duct dilatation in 3 (8%) patients, and architectural distortion in 1 (3%) patient. In one (3%) patient among them, both mammography and ultrasonography revealed negative findings. The false negative rate of mammography, ultrasonography or both was 20%, 18%, and 3%, respectively, which was statistically significant difference (p < 0.05). CONCLUSION: Combined study of mammography and ultrasonography is the most useful as a diagnostic study for early breast cancer. So, ultrasonography seems to be the important additional method for detection of early breast cancer.
Breast Neoplasms* ; Breast* ; Dilatation ; Female ; Humans ; Mammography* ; Retrospective Studies ; Ultrasonography*

Three siblings with congenital dilatation of the intrahepatic bile ducts (Caroli's disease) are presented. Bile duct pathology was associated with congenital hepatic fibrosis and polycystic renal disease in all three patients. On color Doppler imaging (CD imaingl, multiple small color Doppler signals were observed in or near the vascular radicles within the dilated bile ducts, besides other well-known sonographic findings such as bile duct dilatations, biliary calculi. Dopper frequency spectral analysis confirmed all these color Doppler signals as arterial origin in all patients, showing pulsatile wave pattern. Although portal venous radicles are well known in conventional sonograms or computed tomotraphy(CT), continuous wave patterns were not detected in all patients. In addition to previously reported sonographic findings about Caroli's disease, color Doppler signals showing arterial wave pattern in or around the portal venous radicles within dilated duets are another helpful diagnostic criteria and these findings are easily depicted on routine sonograms with color mapping.
Bile Ducts* ; Bile Ducts, Intrahepatic ; Bile* ; Caroli Disease* ; Dilatation ; Fibrosis ; Gallstones ; Humans ; Pathology ; Polycystic Kidney Diseases ; Siblings ; Ultrasonography

BACKGROUND: Pulmonary complications following bonemarrow transplantation(BMT) are common and associated with a high mortality rate, We investigated the yield, safety, and impact of fiberoptic bronchoscopy(FOB) for diagnosis of postBMT pneumoniae. METHODS: From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with repiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL(bronchoalveolar lavage), TBLB(transbronchial lung biopsy), PSB(protected specimen brush). RESULTS: The characteristics of the subjects were as follows:37 males, 15 females, mean age of 31.3 years(17-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following:12 cytomegalovirus(CMV) (21.4%), 7 pneumocystis carinii(PC) (12.5%), 11 CMV with PC (19.6%), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases(23.2%), 13 died of CMV pneumoniae(n=2), PCP(n=2), mixed infection with CMV and PC(n=3), underlying GVHD(n=1), underlying leukemia progression(n=1), or respiratory failure of unknown origin(n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleedig and 1 episode temporary hypoxemia. CONCLUSION: Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.
Anoxia ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchoscopy* ; Coinfection ; Diagnosis* ; Female ; Glass ; Humans ; Leukemia ; Lung ; Male ; Mortality ; Pneumocystis ; Pneumonia* ; Respiratory Insufficiency ; Siblings ; Streptococcus ; Tissue Donors ; Tuberculosis

Reports of bowing and pseudarthrosis of the humerus and clavicle are rare. Most patients with congenital pseudoarthrosis of the clavicle involving the right side and midportion of clavicle tended to heal better than congenital pseudoarthrosis of the tibia. We experienced a patient who had special features in terms of location, pseudoarthrosis pattern, and neurofibromatosis, and report on this case here.
Clavicle* ; Humans ; Humerus ; Neurofibromatoses* ; Pseudarthrosis* ; Tibia

BACKGROUND: Transcatheter closure of patent ductus arteriosus, using the Rashkind double umbrella occluder system, had been attempted in mulitcenter since non-surgical closure of patent ductus arteriosus by Rashkind. METHODS: Between July 1991 and June 1993, transcatheter closure of patent ductus arterious was attempted in 20 adult patients(21 trials). RESULTS: Seventeen female and 3 male patients was consisted of the study. The patient age ranged from 17 to 54 years(mean 30+/-9 years). Mean pulmonary artery pressure before closure was 18.5+/-6.0mmHg(range from 10mmHg to 30mmHg). The diameter of ductus ranged from 3.5mm to 8.0mm(mean 5.2+/-1.5mm), as determined by contrast injection through 11F Mullin sheath or 7F catheter. There was significant decrease of Qp/Qs from 2.6+/-1.1 to 1.5+/-0.4 immediately after transcatheter closure of ductus(p<0.01). There was significant decrease of left ventricular end-diastolic dimension by echocardiogram from 58.7+/-7.6mm to 53.6+/-6.5mm after transcatheter closure of ductus(p<0.01). Among the 21 cases, 16 cases(76.2%) had the clinical improvement without the support of surgical closure. One 17mm Rashkind umbrella was retrieved because of position and problem of deployment. There was no device embolic experience in 21 cases. There were 2 cases of hemolytic anemia during the follow-up period ; one case was surgically ligated and another 17mm device was implanted in the other case. CONCLUSIONS: Transcatheter closure of patent ductus arteriosus in adult patients can replace the surgical correction in selected patients.
Adult* ; Anemia, Hemolytic ; Catheters ; Ductus Arteriosus, Patent* ; Female ; Follow-Up Studies ; Humans ; Male ; Pulmonary Artery