Pecutaneous transhepatic portogram with selective catheterizatio of the portal vein and its tributaries notonly provide information about the status of portal circulation and but can also be used in the treatment ofbleeding esophageal varices by selective embolization with various embolic materials. The authors describe easierand safer modified method of conventional percutaneous transhepatic portogram. We wish to describe our experiencewith the technical aspects and portosystemic collateral patterns in 26 patients with variceal bleeding, from July1985 to July 1986 at Kyungpook National University Hospital. 1. To overcome the difficulties of catheter passageand superselection of variceal supplying vein, we used 7F sheath directly introduced over the ,018″ guide wire.We used coaxial system using 25cm 18G needle within 7F vessel dilator to make the tip of dilator more rigid. 2.Variceal obliteration attempted in 23 patients who showed variceal supplying veins on the protogram, Successfulobilteration was obtained in 20 patients. We used absolute ethanol, stainless steel coil, and Gelfoam cubes withsclerosing and embolica agent of variceal vein. 3. Portosystemic collaterals of 24 patients; Coronary vein;21cases, Inferior mesenteric vein:9 cases, Short gastric vein:7 cases, Umbilical & paraumbilical vein; 6 cases,Gastrorenal: 3 cases, Splenorenal: 2 cases, Splenoretoperitoneal: 1 case. 4. The number of coronay vein were 18cases of single and 4 cases of two. The locations of coronary vein: Splenic vein: 13 cases, Main portal vein: 7cases, Junctional area: 6 cases. 5. Transhepatic obliteration of the gastroesophageal veins is a relatively simpleand usually successful form of palliative treatment for actively bleeding and stable gastroesophageal varices.
Catheters ; Coronary Vessels ; Esophageal and Gastric Varices ; Ethanol ; Gelatin Sponge, Absorbable ; Gyeongsangbuk-do ; Hemorrhage ; Humans ; Methods ; Needles ; Palliative Care ; Portal Vein ; Splenic Vein ; Stainless Steel ; Varicose Veins ; Veins

We retrospectively analyzed 22 patients pelvic CT, in whom the acetabular fracture were suspected in plain film. And compared and analyzed the computed tomogram findings and plain radiographic findings. The results were as follows. CT enables better evaluation of shape, extent, and degree of separation of fragment. CT was helpful in detecting the combined fracture and soft tissue injuries. CT showed intraarticular loose bodies, which were invisible on plain film. In patients with pelvic trauma, no necessary changing position during CT examination. CT was useful demonstrates the remnant of intraarticular osseous fragment and adequacy of reduction after surgery.
Acetabulum* ; Humans ; Retrospective Studies ; Soft Tissue Injuries

No abstract available.
Constriction, Pathologic* ; Decompression* ; Laminectomy*

A case of invasive cribriform carcinoma of the breast is presented with fine need- le aspiration cytologic features. The aspiration was performed from a papable 2.0cm mass in the upper outer quadrant of the right breast in a 53 year-old woman. The aspirate showed cellular smear composed of larger three dimensional tight clusters, smaller monolayered loose clusters, and many individual cells on the clean background. In the clusters, the tumor cells were bordering central lumina, quite similar to the cribriform in histology. The tumor cells in the clusters and individual tumor cells had uniform, small and round nuclei. The chromatin was finely granular, and nuclear membrane was smooth. No discernible nucleoli were present (nuclear grade 1-2). Unless the abundance of individual cells and the cribriform growth pattern are recognized in the smear, the cytologic diagnosis of invasive cribriform carcinoma is difficult.
Female ; Humans ; Biopsy

Background and Objective : Dural sinus thrombosis(DST) is a rare disorder with many etiologies and unpredictable clinical courses. The optimal mode of treatment has not been well established. With the advent of neuroradiological intervention, we have successfully performed the direct infusion of t-PA into the venous sinus for the prompt Iysis of thrombosis and subsequent clinical Improvement. METHODS: Three patients, presented with headache, vomiting or focal neurological deficits, were diagnosed as having dural sinus thrombosis by MRI. After the confirmation by angiogram with a superselective transfemoral catheter, a bolus of t-PA was injected into the thrombosed portion of the dural sinuses, followed by a continuous t-PA infusion at a rate of 40mg/hr. Result : All three patients were clinically improved. Follow-up angiogram on the next day demonstrated recanalization of the thromboses venous sinus. Two patients developed non-life threatening extracranial hemorrhage as a complication. Conclusion : Authors suggest that direct thrombolysis with t-PA is a very effective method of treatment in the early phase of DST. Further study is needed to decide the appropriate t-PA dosage to minimize the complication.
Catheters ; Follow-Up Studies ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Plasminogen* ; Sinus Thrombosis, Intracranial* ; Thrombosis ; Vomiting

No abstract available.
Antiemetics* ; Cisplatin* ; Dexamethasone* ; Humans ; Lorazepam* ; Metoclopramide* ; Ondansetron*

Creutzfeldt-Jakob disease(CJD) is characterized clinically by rapidly progressive dementia with pyramidal, extrapyramidal, and cerebellar symptoms and signs, and histologically by spongiform change, neuronal loss and reactive gliosis. We have experienced 2 cases of CJD. Case 1 was a 36-year-old male who had suffered from myoclonus and cerebellar symptoms including sluggish speech, gait and balance disturbance. Case 2 was a 70-year-old female who had showed cognitive dysfunction, ataxic gait and disturbance of extraocular movement. Both patients, underwent brain biopsy. Case 1 revealed marked cortical atrophy, 2mm in thickness, with neuronal loss and astrocytic proliferation extending into white matter. The spongiform change, made up of many small, usually rounded or oval, vacuoles was noted mainly in the neuropil. Case 2 revealed remarkable spongiform change throughout the cortex and cytoplasmic vacuoles compressing the nuclei of neuronal cells were numerous. Neuronal loss and gliosis were also found without considerable change in the white matter. On double immunostaining against GFAP and PrP(Prion Protein), there was a weak positive reaction for PrP in the perinuclear cytoplasm in case 1, and a strongly positive reaction in case 2. The electron microscopic examination showed numerous membrane-bound vacuoles in neuropil and perikarya of neurons. The majority of the vacuoles were multiseptated by thin membranous structures. They demonstrated curled, or disrupted membrane, that had foldings and protrusions into the vacuolar clear spaces. There were neither identifiable virus-like particles nor amyloid deposition.
Female ; Male ; Humans

PURPOSE: For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. METHODS: The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. RESULTS: The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastro intestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum(21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. CONCLUSION: The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.
Abdomen, Acute ; Abdominal Pain* ; Diagnosis ; Duodenitis ; Duodenum ; Early Diagnosis ; Endoscopy ; Exanthema* ; Gastrointestinal Hemorrhage ; Hemorrhage ; Nephritis ; Purpura* ; Recurrence ; Sigmoidoscopy ; Skin* ; Ulcer ; Ultrasonography

Endodermal sinus tumor of the mediastinum is a very rare malignant tumor, usually affecting young adolescents, and its histologic findings are characteristic as that of gonadal germ cell origin. We describe the cytologic finding of fine needle aspiration of mediastinal endodermal sinus tumor in a 19-year-old male patient, comparing with tissue section. The tumor cells in smears were usually in tight clusters with large overlapping cells, which were arranged in a papillary or microacinar pattern, suggesting carcinoma. The tumor cells were large, round or oval with a small amount of cytoplasm which was occasionally vacuolated and had indistinct border. The nuclei were large, pleomorphic, and vesicular with large promi- nent nucleoli. The tissue sections showed typical findings of endodermal sinus tumor. Careful correlation of cytological findings and the serum alpha-fetoprotein level would be helpful to confirm the diagnosis.
Adolescent ; alpha-Fetoproteins ; Biopsy, Fine-Needle ; Biopsy, Needle ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Child* ; Clonorchiasis ; Cytoplasm ; Diagnosis ; Dietary Proteins* ; Endodermal Sinus Tumor ; Female ; Germ Cells ; Giant Cells ; Gonads ; Humans ; Kidney Failure, Chronic* ; Male ; Mediastinum ; Middle Aged ; Thyroid Gland ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux* ; Young Adult

No abstract available.
Humans ; Infant, Newborn*