Percutaneous drainage of liver abscess is an effective treatment, but the success rate is low for liver abscess that has septa and is multilocular. We experienced one case of successful treatment of multilocular liver abscess using administration of Urokinase into an abscess cavity during the course of percutaneous drainage.
Abscess ; Catheters* ; Drainage* ; Liver Abscess* ; Liver* ; Urokinase-Type Plasminogen Activator*

Percutenous transluminal angioplasty is world wide prevalent method for treatment of vascular occlusivedisease. Its advantage is avoidance of major surgery as well as decreased cost with shortened hospital days. Inrenal arterial stenosis, successful angioplasty produces draumatic reduction of blood pressure in renin dependent hypertension. Even in renin independent hypertension, blood pressure may be easier to control withantihypertensive medication following renal arterial dilatation. We have performed 2 cases of percutaneous transluminal angioplasty in renal arterial stenosis recently. One patient, 58-year-old female, has gained normalblood pressure after angioplasty, while the other showed not very satisfactory blood pressure control because ofchronic bilateral renal parenchymal damage.
Angiography ; Angioplasty ; Blood Pressure ; Constriction, Pathologic ; Dilatation ; Female ; Humans ; Hypertension ; Methods ; Middle Aged ; Renin

The use of intravacular catheterization for both diagnostic and therapeutic purposes increased the incidence of iatrogenic foreign bodies, which might cause many complications such as cardiac arrythmias, perforation of cardiac chamber or blood vessels, sepsis and thromboembolism. The authors experienced 5 cases of successful retrieval of intravascular iatrogenic foreign bodies: three cases of subclavian catheter wire and two cases of subclavian catheter. Subclavian catheter was introduced into right subclavian venous route for hyperalimentation or central venous pressure monitoring. The foreign bodies were located in superior vena cava and inferior vena in four cases and in left main pulmonary artery in the other case. We have successufully removed the foreign bodies by interventional procedures. The loop-snare technique is a safe and effective method for retrieval of iatrogenic foreign bodies in great vessels.
Arrhythmias, Cardiac ; Blood Vessels ; Catheterization ; Catheters ; Central Venous Pressure ; Foreign Bodies* ; Incidence ; Methods ; Pulmonary Artery ; Sepsis ; Thromboembolism ; Vena Cava, Superior

PURPOSE: To evaluate the surface anatomy of the central sulcus(CS), precentral gyrus(PrCG) and postcentral gyrus(PoCG) on the basis of sulci pattern on MR images. MATERIALS AND METHODS: The MR images were obtained in the plane 10 degree angled to the orbitomeatal line. The MR images of 120 subjects(6 months to 79 years) with normal anatomy were analyzed and another four subjects with known space occupying lesions were also reviewed. RESULTS: The identification of gyri was feasible on the axial T1WI from anterior to posterior and from upper to lower images. The STS demonstrated symmetric pattern on both sides in 84 of 120 cases (70%), including two cases of prominent STS pattern. The asymmetric pattern was seen in 36 of 120 cases (30%):14 of 120 cases (12%) on the right and 22 of 120 cases (18%) on the left at 4.5 cm above the level of the splenium of corpus callosum. The PrCG and PoCG and CS were identified well in all cases with the use 'of the sulci pattern. CONCLUSION: The identification of the gyri on the basis of the cerebral sulci pattern on MR images is useful and important when locating the space occupying lesion of the brain.
Brain ; Corpus Callosum ; Magnetic Resonance Imaging*

Thombolytic therapy and placement of vascular metallic stent can be used for the treatment of lilac venous stenosis and thrombosis, but these treatments increase the risk of pulmonary thromboembolism. Inferior vena cava filter was developed for the prevention of recurrent pulmonary thromboembolism due to lower extremity deep vein thrmobosis and has been regarded as relatively safe and effective treatment modality. We experienced good result of combined treatment of inferior vena filter, thrombolytic therapy and placement of right lilac venous metallic stent in a patient with severe stenosis and thrombosis at both common lilac veins.
Constriction, Pathologic ; Humans ; Lower Extremity ; Pulmonary Embolism ; Stents* ; Thrombolytic Therapy ; Thrombosis* ; Veins* ; Vena Cava Filters* ; Vena Cava, Inferior*

Chest CT is the most useful modality in the diagnosis of primary lung cancer, particularly in patients with recurrent pneumonia which are resistant to antibiotic therapy and in high risk age groups for cancer, The purpose of this examination is to assess the usefulness of CT in pneumonia types of lung cancer. The authors retrospectively analyzed 15 histologically proven cases of pneumonic type lung cancer, which had no evidence of primary lung mass, mediastinal lymphadenopathy or other metastatic lesion on piain chest radiography. On CT scan, a primary lung mass was identified in 13 patients(87%, bronchial obstruction was identified in 12 patients(80%), and metastatic foci was found in the bone(one patient), liver(one patient), and spleen(one patients). In Conclusion, CT scan is a useful method to detect the mediastinal lymphadenopathy or pulmonary mass and also should be the initial radiolographic procedure for diagnosis of lung cancer in patients with recurrent pneumonia on simple chest radiography.
Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Lymphatic Diseases ; Methods ; Pneumonia* ; Radiography ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

PURPOSE: Lymphoma is considered when multiple, nonnecrotic lymph nodes are present in the superficial and deep lymphatic chains, especially if they are large and bilateral, on CT scan. It is reported that combined nodal and extranodal presentation of HD is uncommon. However, we found central low density in involved lymph node of NHL, and combined nodal and extranodal disease in HD, not infrequently. The purpose of this study is to ascertain whether our findings may be characteristics of NHL and HD. MATERIALS AND METHODS: CT findings with contrast enhancement were reviewed in 23 patients with untreated neck lymphoma:18 NHL and 5 HD. The followings were analyzed in each case: nodal or extranodal involvement; unilateral or bilateral involvement; presence or absence of central low density with peripheral enhancement in nodal lesion ;infiltration into adjacent structures. Nodal and extranodal lesions were confirmed by pathologic studies. RESULTS: Of 18 patients with NHL, nine cases had nodal disease and the rest had combined nodal and extranodal disease. Lymphadenopathy was bilateral in ten cases and unilateral in eight. Five cases with HD were composed of three combined nodal and extranodal diseases and two nodal diseases. Central low density of involved lymph node was shown in eight cases of 18 NHL and in one case of five HD. CONCLUSION: Central low density with peripheral enhancement was not uncommon in NHL, in contrast to HD. Hence, it is suggested that in case of nodal necrosis, NHL be also considered, besides tuberculous lymphadenitis and metastatic lymphadenopathy. It is not considered that nodal or extranodal disease, and unilateral or bilateral involvement are of high significance in differentiation of NHL from HD.
Hodgkin Disease* ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Neck* ; Necrosis ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

PURPOSE:To evaluate the factors influencing the prognosis in avascular necrosis(AVN) of the femoral head by MR. MATERIALS AND METHODS:Radiographic and MRI findings of twenty-three patients(30 cases, aged 23-67 years) with AVN identified clinically and radiologically were evaluated. The radiography included follow up study for at least 6 months. The mean age of these patients was 43 years and M: F ratio was 20: 3. MR imaging was performed at 1. 5T unit using T1- and T2-weighted coronal and Tl-weighted sagittal and axial spin echo sequences. We categorized the changes of the femoral head on radiographic follow-ups to three grades of mild, moderate and severe. We also analyzed the changes of the signal intensity and sizes of the lesion at sagittal and coronal MR images. On MR imaging we classified the extent of AVN of the fernoral head to 2 grades according to the size of lesion. RESULTS:In the cases of mild changes in fernoral head on radiography, the mean age of the patient was 37 years and the extent of AVN was below 1/2 in eleven out of seventeen cases. In the cases of moderate changes, the mean age was 43 years and the extent was above 1/2 in five out of seven cases. In the cases of severe changes, the mean age was 60 years and the extent was above 1/2 in all 6 cases. With 95% confidence coefficient, comparisons in the age and necrosis extent revealed statistical significance in severe versus moderate changes and in severe versus mild changes. Comparisons in the change of signal intensity on T1 and T2 weighted images showed no statistical relationship between each other. CONCLUSION: We conclude that if patient is younger and has smaller extent of the AVN, bone destruction is slower that these factors may be helpful in predicting the prognosis of AVN. However, the modes of the changes of the signal intensity on T1- and T2- weighted images may not be useful in predicting the prognosis of AVN.
Follow-Up Studies ; Head* ; Humans ; Magnetic Resonance Imaging* ; Necrosis* ; Prognosis ; Radiography

No abstract available.

PURPOSE: To evaluate the difference in each procedure time and complication rates related to percutaneous transhepatic biliary drainage(PTBD) via the right and the left hepatic lobe. MATERIALS AND METHODS: We performed PTBD in 120 patients with biliary obstruction below both main hepatic ducts. Of the 120 catheters, 54 were introduced via a left lobe approach and 66 through the right lobe. All procedures were performed under fluoroscopic guidance by the same operator. For each patient, procedure time was recorded prospectively. PTBD related complications were classified as either early(up to 30 days after procedure) or late(after 30 days), and each complication graded as major, or minor according to its intensity. RESULTS: The difference in the mean procedure time(28.8min versus 36.2rain, left versus right approach group) and that in complication rates (37% versus 58%) were statistically significant(p<0.05). Concerning major complications(bile peritonitis, sepsis, massive hemobilia, liver abscess, pyothorax), the percentages related to left and right lobe approach were 1.8% and 10.6%, and concerning minor complications(catheter obstruction or dislodgement, transient hemobilia, persistent fever or pain), the percentages were 36%and 51%respectively. CONCLUSIONS: PTBD via the left lobe approach was superior with short procedure time and low complication rates than the right approach.
Catheters ; Fever ; Hemobilia ; Hepatic Duct, Common ; Humans ; Liver Abscess ; Peritonitis ; Prospective Studies ; Sepsis