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

PURPOSE: To determine the plain film findings of acute neuropathic joint in diabetic foot. MATERIALS AND METHODS: Acute neuropathic joint in diabetic foot was considered when fragmentation of the articular ends of bone and subluxation of the affected joint developed within eight weeks after clinical onset of diabetic gangrene. Eight toes of six diabetics were satisfactory to our criteria. We analyzed plain radiographic findings of the affected joint and soft tissue, interval changes in follow-up radiographs, and deformities after healing. RESULTS: The time interval between clinical onset of gangrene and bone destruction ranged from 2 weeks to 4 weeks(mean 2.6 weeks). Plain radiographs showed fragmentation of the articular ends, subluxation, and soft tissue swelling of the metatarsophalangeal joint or interphalangeal joint. The significant feature of these patients was rapid progression of the lesions. Clinically, all patients had diabetic gangrene in affected toes, however, there was no evidence of osteomyelitis in our series. Amputation was done in 2 cases, and lesions in 3 of the remaining 4 cases were repaired spontaneously with regression of gangrene, leaving radiological residua such as pointed-end, tapered-end, and ball and socket deformity. CONCLUSION: Rapid disorganization of the joint with associated evidence of soft tissue gangrene in plain radiograph is believed to be valuable for the diagnosis of diabetic osteoarthropathy.
Amputation ; Congenital Abnormalities ; Diabetic Foot* ; Diagnosis ; Follow-Up Studies ; Gangrene ; Humans ; Joints* ; Metatarsophalangeal Joint ; Osteomyelitis ; Toes

No abstract available.
Flow Cytometry* ; Humans* ; Leukocytes* ; Microscopy* ; Phagocytosis* ; Staphylococcus aureus* ; Staphylococcus*

No abstract available.
Flow Cytometry* ; Humans* ; Leukocytes* ; Microscopy* ; Phagocytosis* ; Staphylococcus aureus* ; Staphylococcus*

PURPOSE: We planned to determine the diagnostic capability of focused assessment with sonography for trauma (FAST) in cases of blunt abdominal injury (BAI). METHODS: A retrospective analysis of FAST sheets was performed from April 2002 to December 2004. During the study period, 135 BAI patients were evaluated with FAST at the Emergency Department of Bundang CHA Hospital. Of this group, twenty-eight patients were excluded, leaving 107 patients for analysis. Abdomen CT (computerized tomography) or exploratory laparotomy confirmed the presence of hemoperitoneum. At the secondary survey, patients underwent a three-view FAST examination (LogicQ; General Electric, Waukesha, USA) by an emergency physician, followed within 2 hours by an abdomen CT or exploratory laparotomy. The FAST examination was considered positive if it demonstrated evidence of free intra-abdominal fluid. RESULTS: There were 45 true-positive FAST examination, 57 true-negatives, 1 false-positive, and 4 false negatives (sensitivity 91.8%, specificity 98.3%, positive predictive value 97.8%, negative predictive value 93.4%). The area under the ROC curve was 0.951 for the FAST examination. CONCLUSION: FAST is a highly reliable method for screening patients suspected of having BAI for the presence or absence of hemoperitoneum.
Abdomen ; Abdominal Injuries ; Emergencies ; Emergency Service, Hospital ; Hemoperitoneum ; Humans ; Laparotomy ; Mass Screening ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

PURPOSE: We planned to determine the diagnostic capability of focused assessment with sonography for trauma (FAST) in cases of blunt abdominal injury (BAI). METHODS: A retrospective analysis of FAST sheets was performed from April 2002 to December 2004. During the study period, 135 BAI patients were evaluated with FAST at the Emergency Department of Bundang CHA Hospital. Of this group, twenty-eight patients were excluded, leaving 107 patients for analysis. Abdomen CT (computerized tomography) or exploratory laparotomy confirmed the presence of hemoperitoneum. At the secondary survey, patients underwent a three-view FAST examination (LogicQ; General Electric, Waukesha, USA) by an emergency physician, followed within 2 hours by an abdomen CT or exploratory laparotomy. The FAST examination was considered positive if it demonstrated evidence of free intra-abdominal fluid. RESULTS: There were 45 true-positive FAST examination, 57 true-negatives, 1 false-positive, and 4 false negatives (sensitivity 91.8%, specificity 98.3%, positive predictive value 97.8%, negative predictive value 93.4%). The area under the ROC curve was 0.951 for the FAST examination. CONCLUSION: FAST is a highly reliable method for screening patients suspected of having BAI for the presence or absence of hemoperitoneum.
Abdomen ; Abdominal Injuries ; Emergencies ; Emergency Service, Hospital ; Hemoperitoneum ; Humans ; Laparotomy ; Mass Screening ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

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

As transplantation for end-stage renal disease has become more common, avascular necrosis has become a major cause of disability after a successful transplantation. We studied the relationship between development of avascular necrosis of bone and the administration and dosage of steroid, cholesterol level and triglyceride level after transplantation in 909 patients who received kidney transplantation from March 1969 until August 1994 at Catholic University, Medical College. These patients were compared against 60 patients who received kidney transplantation and steroid therapy without developing osteonecrosis. Osteonecrosis was observed in 62 of the patients (6.8 per cent) from 3 to 37 months (mean 10) after the transplant operation. The average age was thirty-eight years (range, twenty to sixty-three years). A single bone was involved in 28 patients, while in the rest of the patients there were between two and four different sites. Altogether 109 bones were affected, 102 of them being weight-bearing. The most common sites were the femoral heads, with 32 patients having bilateral involvement. There was no association between the cumulative dosage of prednisone and the development of avascular necrosis. Although the post renal transplant cholesterol and triglyceride level were significantly elevated compared to the pre-renal transplant state, there were no significantly difference between the avascular group and control group.
Cholesterol ; Head ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Necrosis* ; Osteonecrosis ; Prednisone ; Triglycerides ; Weight-Bearing

Among patients scheduled for elective thoracic surgery at the Medical Center of Kyung Hee University, 15 patients undergoing lobectomy or pneumonectomy were selected. Three different ventilatory modes were employed and compared to the two-lung ventilation with 50% oxygen (control). First, patients were ventilated with 50% oxygen and left the unventilated lung to deflate during one lung ventilation (test 1). Second, continuous positive airway pressure (CPAP) of 10 cmH2O was applied to the ventilated lung while patients were under one lung ventilation with 50% oxygen (test 2). Lastly, patients were ventilated with 100% oxygen and unventilated lung was left to deflate during one lung ventilation (test 3). PaO2, A-aDO2 and Qsp/QT of three different ventilatory modes were observed and compared to that of control, and that of test 2 to test 1. The results were as followed: 1) Mean PaO2 in test 1 and test 2 were 98+/-24.0 mmHg and 126+/-34.8 mmHg, respectively and were significantly decresed as compared to the PaO2 of control, 234+/-21.4 mmHg. Comparing the PaO2 of test 1 and test 2, there was statistically significant increase in test 2 (P<0.01). 2) Comparing with A-aDO2 of control (68+/-22.5 mmHg), A-aDO2 in both test 1 and test 2 were significantly increased to 210+/-24.3 mmHg and 184+/-33.4 mmHg, respectively. there was significantly decreased in test 2 as compared to test 1 (P<0.01). 3) Shunt percentages (Qsp/QT) were measured as 8.3+/-2.3% in control, 25.4+/- 6.7% in test 1, 19.8+/-3.2% in test 2. Shunt percentages of test 1 and test 2 were increased significantly as compared to the control. Comparing the shunt percentages of test 1 and test 2, there was decreased in test 2 (P<0.01). Based on the above results, the application of appropriate CPAP to the unventilated lung during one lung ventilation is thought to be very effective in preventing hypoxemia. But, vigorous and meticulous monitoring, surveilance of patients and one lung ventilation with 100% oxygen are essential depending on the conditions of ventilated lung and long duration of one lung ventilation.
Anoxia ; Continuous Positive Airway Pressure ; Humans ; Lung* ; One-Lung Ventilation* ; Oxygen* ; Pneumonectomy ; Thoracic Surgery ; Ventilation