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*

The CD8(+)CD28(+) T cells have known to mediate major histocompatibility complex class I-restricted cytolysis and to secret an HIV-1 inhibitory factor. As HIV infection lead to dramatic changes within the cellular immune system, the cellular cytotoxicities decrease in the duration of the HIV infection. To determine the importance of the cellular cytotoxicities in long-term nonprogression, we tried to compare CD28 expression on total T, CD4(+) T, and CD8(+) T cells as one of methods for cellular cytotoxicity measurements between long-term nonprogressor and normal person or between long-term nonprogressor and rapid progressor. The median percentages and counts of CD4(+) T cells of the norrnal, the long-term nonprogressor, and the rapid progressor groups were 39.9 and 0.96 * 10(9) cells/L, 24.6 and 0.58 * 10(9) cells/L, 9.9 and 0.15 * 10 cells/L, respectively. As a result of comparison of the cells having CD28 surface molecules on CD8(+) T cells in the long-term nonprogressor and the rapid progressor group, they showed over 5 times lower than that in the normal group. Especially, the long-term nonprogressor regarded to the healthy HIV-infected patient showed much lower CD28 expression on total T, CD4(+) T, and CD8(+) T cells than those of the normal person. The proportions of CD4'CD28 T and CD3CD28 T cell subsets showed the significant difference between the LTNP and the RP group. In conclusion, although HIV-infected patients were LTNPs having the steady CD4(+) T cell counts and no clinical symptoms, we suggested that HIV led to abnormality within the lymphocyte subsets such as the altered expression of CD28 molecules on various T cell subsets and this result would cause deficiency of host immune function and failure of control of HIV replication by anergy in T cell subsets.
Cell Count ; HIV ; HIV Infections ; HIV-1 ; Humans ; Immune System ; Lymphocyte Subsets ; Major Histocompatibility Complex ; T-Lymphocyte Subsets* ; T-Lymphocytes

So-called sclerosing hemangioma of the lung is a rare benign neoplasm which usually presents with a coin lesion detected through routine chest X-ray. We report two cases showing characteristic cytologic appearances which have been rarely reported. Both cases were young females with coin lesions in the lung. Fine needle aspiration of each case revealed unique but some different cytologic features. Case 1 showed bland-looking polygonal epithelial cells resembling bronchioloalveolar cells having pre- dominantly papillary configurations with loosely arranged solid sheets or isolated cells. Cytoplasms were plump, cyanophilic, and finely granular, with eccentric nuclei, The nuclei were usually monotonous, round-to-ovoid, and vesicular with a small but conspicuous nucleolus. In comparison to case 1, case 2 revealed largely loose pavement-like solid sheets or clusters rather than papillary patterns in the hemorrhagic background. The size of tumor cells were a little smaller than that of case 1. Bronchioloalveolar carcinoma and papillary adenocarcinoma of metastatic origin were considered to be one of the important differential diagnoses with these cytologic features. Histologically, both cases exhibited findings compatible with so-called sclerosing hemangioma of the lung.
Adenocarcinoma, Bronchiolo-Alveolar ; Adenocarcinoma, Papillary ; Biopsy, Fine-Needle ; Cytoplasm ; Diagnosis, Differential ; Epithelial Cells ; Female ; Humans ; Kidney* ; Lung ; Numismatics ; Pulmonary Sclerosing Hemangioma ; Renal Insufficiency* ; Thorax

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

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

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

No abstract available.
Humans ; Infant, Newborn*

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