No abstract available.
Diaphragm* ; Stomach Volvulus*

No abstract available.
Vascular System Injuries

No abstract available.
Gyeongsangbuk-do* ; Quality Control*

Gastropleural fistula is an uncommon condition which can be induced by a trauma, gastroesophagectomy, subphrenic abscess, malignancy, and or hiatal hernia. In the patient with a predisposing factor, gastropleural fistula must be considered when pneumothorax, pyothorax, hemothorax, or food materials in the chest tube is detected. Diagnosis can be confirmed by an esophagogastrogram or endoscopy. The prognosis is often very poor with conservative care needed, along with a fistulectomy reguiring repair of orifice. We experienced a case of gastropleural fistula treated by endoscopic injection of Histoacryl and report it here with a review of related literature.
Causality ; Chest Tubes ; Diagnosis ; Empyema, Pleural ; Enbucrilate ; Endoscopy ; Fistula* ; Hemothorax ; Hernia, Hiatal ; Humans ; Pneumothorax ; Prognosis ; Subphrenic Abscess

PURPOSE: To determine the characteristic MR imaging findings of Brodie's abscess in pediatric patients. MATERIALS AND METHODS: We retrospectively reviewed 17 pediatric patients with surgically-proven or clinically and radiologically diagnosed Brodie's abscess who had undergone T1- and T2-weighted spin-echo sequences, T2-weighted fast spin-echo sequence and gadolinum enhanced MR imaging. The MR imaging findings were analysed and classified according to the signal characteristics of the abscess and srrounding bone marrow. RESULTS: The MR imaging findings of Brodie's abscess could be classified as one of three types, as follows : Type I (10/17) was seen as a target appearance with four layers ; i.e. a center with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images; an inner rim of high signal intensity, as compared with muscle on both T1- and T2-weighted images with intense contrast enhancement; an outer rim of low signal intensity on both T1- and T2-weighted images, and a peripheral halo of low signal intensity on T1-weighted images and variable signal intensity on T2-weighted images. In type II (4/17), there was no distinction between the center and the inner rim on T1-weighted images, but a clear distinction on contrast enhanced images by intense enhancement of the inner rim. In type III (3/17), there was no distinction between the center and the inner rim on either T1-weighted or contrast enhanced images, due to diffuse enhancement of the lesions. Additional findings of Brodie's abscess include epiphyseal plate violation (8/17), linear or tubular sinus tracts (7/17), inflammatory reaction or edema of surrounding soft tissue (7/17), periosteal reaction (1/17), and pyogenic arthritis (1/17). CONCLUSION: MR imaging is a useful diagnostic tool for the characterization and determination of the extent of Brodie's abscess. Contrast enhanced MR imaging is particularly valuable for the evaluation of type II lesions.
Abscess* ; Arthritis ; Bone Marrow ; Edema ; Growth Plate ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies

PURPOSE: To evaluate the clinical utility of the teleradiology system using the information super highway communication network. MATERIALS AND METHODS: Two radiologists selected 101 cases of pneumothorax and 20 cases ofmiliary tuberculosis. There were scanned and transmitted to our hospital at a speed of 640 Kbps and displayed on avideo monitor with a resolution of 1280 pixels/line x 1024 lines. Four radiologists divided into three groups :read the images group A read the images without image processing ; group B read the images with image processing, group C read the radiographic films on the view box. The authors compared sensitivity and specificity between thegroups and checked their statistical significance using the Chi-square test. According to the location of thepleural line, we divided the pneumothorax into four types : continve on this live type 1, pleural line confined tothe apex ; type 2, to the upper half ; type 3, to the lower half ; type 4, to the upper through lower half. We then compared sensitivity between the Three groups. RESULTS: In the pneumothorax group, the average sensitivity of group A, B and C was 79%, 90% and 96%, and average specificity was 99%, 99% and 94%, respectively. There were statistically significant differences in seasitivity between group A and B and between group B and C (p<0.017). There were no statistically significant difference in specificity between group A and B or between group B and C.In the miliary tuberculosis group, the average sensitivity of group A, B and C was 73%, 78% and 90%, and average specificity was 95%, 95% and 100%, respectively. With regard to sensitivity and specificity, there was no statistically significant difference between group A and B or between group B and C but there was a statistically significant difference between group A and C (p<0.017). According to the location of the pneumothorax, for alltypes, the sensitivity of group A was less than that of group B and group B was less than that of group C. CONCLUSION: All groups showed reduced observer performance in the detection of pneumothorax and miliary tuberculosis when reading a transmitted image on the monitor-workstation compared with reading conventional radiographs on the view box. To improve the clinical utility of the teleradiology system, a higher resolution workstation and adequate image processing are required.
Pneumothorax* ; Sensitivity and Specificity ; Teleradiology* ; Tuberculosis ; Tuberculosis, Miliary* ; X-Ray Film

Although metastasis from cutaneous malignant melanoma to the small intestine is not uncommon, primary small bowel melanoma (SBM) is extremely rare. This case report describes a rare case of primary SBM, diagnosed by single-balloon enteroscopy. A 74-year-old man presented with recurrent melena. Upper endoscopy and colonoscopy were unremarkable. Abdominal computed tomography (CT) revealed an ileal mass with ileo-ileal intussusception. Subsequent single-balloon enteroscopy identified an ileal tumor, which was histologically diagnosed as melanoma. Extensive clinical examination did not reveal any primary cutaneous lesions. To the best of our knowledge, this is the first case of primary SBM in South Korea.
Aged ; Colonoscopy ; Endoscopy ; Humans ; Intestine, Small ; Intussusception ; Korea ; Melanoma* ; Melena ; Neoplasm Metastasis

PURPOSE: The correlation between radiation dose and loco-regional control (LRC) was evaluated in patients with stage II-III esophageal cancer treated with definitive concurrent chemoradiotherapy (CRT). MATERIALS AND METHODS: Medical records of 236 stage II-III esophageal cancer patients treated with definitive CRT at Yonsei Cancer Center between 1994 and 2013 were retrospectively reviewed. Among these, 120 received a radiation dose of < 60 Gy (standard-dose group), while 116 received ≥ 60 Gy (high-dose group). The median doses of radiation in the standard- and high-dose groups were 50.4 and 63 Gy, respectively. Concurrent 5-fluorouracil/cisplatin chemotherapy was administered to most patients. RESULTS: There were no differences in patient characteristics between the two groups except for high Karnofsky performance status and lower-thoracic lesions being more prevalent in the standard-dose group. The median progression-free survival (PFS) and overall survival (OS) times were 13.2 months and 26.2 months, respectively. Patients in the high-dose group had significantly better 2-year LRC (69.1% vs. 50.3%, p=0.002), median PFS (16.7 months vs. 11.7 months, p=0.029), and median OS (35.1 months vs. 22.3 months, p=0.043). Additionally, LRC exhibited a dose-response relationship and the complete response rate was significantly higher in the high-dose group (p=0.006). There were no significant differences in treatment-related toxicities between the groups. CONCLUSION: A higher radiation dose (> 60 Gy) is associated with increased LRC, PFS, and OS in patients with stage II-III esophageal cancer treated with definitive CRT.
Chemoradiotherapy* ; Disease-Free Survival ; Dose-Response Relationship, Radiation ; Drug Therapy ; Esophageal Neoplasms* ; Humans ; Karnofsky Performance Status ; Medical Records ; Retrospective Studies

The elderly people are often afflicted with chronic illnesses of which depression and dementia comprise substantial proportion. The authors tried to figure out the impact of depression and dementia on the quality of life of elderly. 1,300 community residents over 65 years of age were selected by random sampling. Using Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy, the authors selected 3 groups of subjects, namely dementia group (N=113), depression group (N=157), normal control group (N=289). The 3 groups of subjects were examined with General Health Questionnaire 12-Quality of Life, Geriatric Depression Scale, Mini-Mental State Exam-K, and Physical Self-Maintenance Scale. The results were compared between groups and the correlations of each scales were examined. The quality of life was lower in the older, female, lower educational groups. The quality of life was significantly lower in dementia group and depression group than in normal elderly group. The subjective quality of life of depressed elderly got lower with increasing severity of depression. Demented elderly had low quality of life but no correlation was found between subjective quality of life and severity of depression. The score of Mini-Mental State Exam-K was found to have significant correlation with the quality of life in demented group. The quality of life of normal elderly and those with dementia had significant correlation with Physical Self-Maintenance Scale. Conclusively, the quality of life was decreased in both normal elderly group and dementia group. The severity of depressive symptoms were correlated with the decrease of quality of life in depression group, whereas the degree of cognitive impairment had significant correlation with quality of life in dementia group. Therefore, the subjective quality of life must be considered in the treatment of the depression and dementia, and further study about the relation between psychopathology and the various aspects of living and the quality of life in the elderly is needed.
Aged* ; Chronic Disease ; Classification ; Dementia ; Depression ; Female ; Humans ; Psychopathology ; Quality of Life* ; Surveys and Questionnaires ; Weights and Measures

BACKGROUND/AIMS: We aimed to evaluate the long-term outcome of patients with MALT lymphoma in respect to various treatment modalities and clinicopathologic characteristics, including endoscopic findings. We also tried to deduce suitable strategic guideline to treat MALT lymphoma. METHODS: We retrospectively studied 55 patients (24 males and 31 females) aged 23 to 74 years who had primary low-grade gastric MALT lymphoma that were diagnosed between May 1992 and August 2002. RESULTS: The majority of endoscopic findings showed lesions with ulceration or with color and surface change of mucosa. All but one was H. pylori positive when tested. Treatment modalities included anti H. pylori treatment, radiation, surgery and/or chemotherapy. Eradication was successful in all the 29 patients associated with H. pylori infection. Complete remission was obtained in 24 patients (82.8%). Only one patient suffered a relapse after 28 months during the follow up (2~74 months). The duration to reach complete remission was 12 months (85 percentile, 2~33 months). Six patients showed complete remission with radiation therapy. Two of them were H. pylori treatment failure cases. One of 14 patients treated by surgery displayed relapse during follow-up (12~20 months). Endoscopically, the ulcerative and/or the protruding type showed unfavorable response to anti H. pylori treatment. CONCLUSION: H. pylori eradication alone should be considered as an initial treatment for MALT lymphoma and radiation therapy could be preferred in patients with no evidence of H. pylori infection or who do not response to H. pylori eradication therapy 12 months after successful eradication.
Drug Therapy ; Endoscopes ; Follow-Up Studies* ; Humans ; Lymphoma, B-Cell, Marginal Zone* ; Male ; Mucous Membrane ; Recurrence ; Retrospective Studies ; Treatment Failure ; Ulcer