Therapeutic Efficacy of Balloon-Occluded Retrograde Transvenous Obliteration in the Treatment of Gastric Varices in Cirrhotic Patients with Gastrorenal Shunt / 대한소화기학회지

BACKGROUND/AIMS: Rupture of gastric varices was one of the most dreadful complications of cirrhosis. Recently, a new interventional procedure, balloon-occluded retrograde transvenous obliteration (B-RTO) was introduced for the treatment of gastric variceal bleeding. This study was performed to evaluate the therapeutic efficacy of B-RTO in the treatment of gastric varices with gastro-renal shunts. METHODS: From March 2000 to June 2003, we performed B-RTO in 17 patients with gastric varices and gastrorenal shunts. All patients had history or high risk factors of gastric variceal bleeding. For the evaluation of therapeutic efficacy, we performed esophagogastroduodenoscopy (EGD) and computed tomography (CT) at 1, 6 and 12 months after B-RTO. Successful B-RTO was judged by combined CT findings and EGD findings (disappearance of gastric varices or markedly reduced gastric variceal size or bleeding risk) during follow-up periods (1-14 months, mean:6.18). We analyzed the clinical factors related to clinical success of B-RTO. RESULTS: Technical success were achieved in all patients except one (94.1%). Gastric varices were disappeared or decreased after B-RTO in 13 patients (81.2%). Complications related to procedure included transient hematuria (n=5), puncture site oozing (n=1) and partial splenic infarction (n=1), and all were conservatively managed. During the follow up periods, neither significant hepatic nor renal functional damages occurred. Statistically, no significant factors related with B-RTO success. CONCLUSIONS: B-RTO is effective and safe in the management of gastric varices in cirrhotic patients with gastrorenal shunt.

Squamous Cell Carcinoma Arising from SecondBranchial Cleft Cyst: Case Report

Primary branchiogenic carcinoma is a rare malignant tumor resulting from the malignant transformation of a branchial cleft cyst. In the case we describe, CT scanning and ultrasonography demonstrated the characteristic findings of a second branchial cleft cyst located in the anterior triangle of the neck, along the anterior margin of the sternocleidomastoid muscle. This lesion presented as a well-defined cystic mass with a thick irregular inner wall and central septa, and associated multiple neighboring necrotic lymph nodes. Microscopic examination revealed a transition zone from squamous epithelium to squamous cell carcinoma.

Testicular Microlithiasis: Clinical Features in 18 Cases / 대한남성과학회지

PURPOSE: Testicular microlithiasis (TM) is an uncommon benign condition characterized by calcium deposits in the lumen of the seminiferous tubules. It may be associated with testicular malignancies and infertility. MATERIALS AND METHODS: We performed a retrospective review of clinical charts and scrotal ultrasound findings of 18 patients who were found to have TM. Scrotal ultrasound scans were performed using 5- to 10-mHz high-resolution transducers. The indication for ultrasonography was an abnormal scrotal examination. RESULTS: The mean age at presentation was 39.9 years (range 14 to 70 years). Most (15; 83.3%) of the patients had bilateral TM. There were no differences in the sonographic patterns and appearance according to patient age. A third of the patients (7; 38.9%) had benign epididymal lesions. Two with bilateral TM had unilateral testicular malignancy. A varicocele was identified in two men, who demonstrated normal semen parameters. A 16-year-old boy showed no interval sonographic changes at 1-year follow-up. CONCLUSIONS: Testicular microlithiasis usually affects both testes. The association between TM and progres sion of cancer is unclear.

MR Findings of Brainstem Injury

PURPOSE: To analyze the characteristies of traumatic brainstem injury by CT and MR MATERIALS AND METHODS: CT and MR studies of 10 patients with traumatic brainstem lesion in MR were retrospectively reviewed, particularly attended to location, signal intensity and associated lesions. RESULTS: CT failed to depict 8 of 10 brainstem lesions. All lesions were detected in MR images with T2-weighted images showing higher detection rate (n=10) (100%) than Tl-weighted images (n=3) (30%) or CT (n=2) (20%). The brainstem lesions located in the dorsolateral aspects of the rostral brainstem(mid brain and upper pons)in 7 (70%) cases, in ventral aspects of rostral brain in 2 (20%) cases and in median portion of pons in 1 (10%) case. Corpus callosal (n=5), Iobar white matter(n=5) diffuse axonal injury, and 2 hemorrhagic lesions in basal ganglia were the associated findings. CONCLUSION: MR imaging is more helpful than CT in the detection of brainstem injury, especially T2 weighted images. Primary brainstem lesions were typically located in the dorsolateral aspect of rostral brainstem(midbrain and upper pons). Corpus callosum and white matter lesions were frequently associated.

Etiology and Radiologic Findings of Anoxia Occured at Dan-IVlu-Ji(Salted Radish in Rice Bran) Manufacture: A Case Report and Results of Gas Analysis

PURPOSE:To identify the main toxic gas released from salted radish in rice bran(Dan-Mu-Ji) and to introduce the radiological findings of the patient who was exposed to the gas. MATERIALS AND METHODS: Chest radiographs and CT scans of one survivor among three men who were exposed to the gas from Dan-Mu-Ji were reviewed. Gas obtained from the closed bottle containing Dan-Mu-Ji was analized by using the gas chromatography. RESULTS: The radiographic examinations of the survivor were suggestive of pulmonary edema with it's rapidly improving consolidations in both lung. The headspace gas within the bottle containing Dan-Mu-Ji was mainly composed with carbon dioxide, ethyl alcohol and hydrogen sulfide, of which hydrogen sulfide was considered the main toxic gas released. CONCLUSION: Under the anaerobic condition, Dan-Mu-Ji released toxic hydrogen sulfide. Inhalation of hydrogen sulfide might produce non-cardiogenic pulmonary edema.

An experimental study about efficacy of drain catheters

Although percutaneous abscess drainage has become and accepted alternative from of therapy for selected patients with abscess, it is well known that there are several factors in the failure of adequate drainage such as pre-and post- procedural management, technique itself, various features of abscess, and selection and application of catheters. Among these factors, we made an experiment about drain efficacy of commonly used various catheters with different viscosities of water-glycerin solution under the two different pressure gradients. The experimental values of flow rate were lower than than the calculated values. An efficacy of experimental value was 4-14%. Because the inner diameter of fittings and stopcocks was usually smaller than the inner diameter of catheters, these factors also affected the drain efficacy. Finally, we though that it will be very helpful to the treatment of patients as well as to study about the catheter drainage, if the drain efficacy of individual catheters has been notified.

Chronic mercury vapor poisoning of the lung plain radiograph and high resolution CT

Authors analyzed the findings of findings of chest radiographs and high-resolution CT(HRCT) of chronic mercury vapor poisoning in 12 patients who were diagnosed by previous working history for mercury-thermometer and high level of mercury in blood and urine. The purpose of this paper is to introduce the HRCT findings of chronic mercury vapor poisoning. Duration of mercury exposure was ranged from 10 to 41 months(mean, 21.8 months). Estimated value of serum mercury was ranged from 3.6 to 8.7µg/dl(mean, 5.3 µg/dl: normal value is less than 0.5µg/dl). Estimated value of mercury in urine was ranged from 104 to 482µg/1(mean, 291.4µg/1: normal value is less than 20µg/1). Chest radiographs showed positive findings such as ground-glass opacities and peribronchial cuffings in only 2 out of 12 patients, but HRCT showed positive findings such as ground-glass opacities in 8 patients, peribronchial cuffings in 7 patients, centrilobular abnormalities in 5 patients, interface sign in 4 patients, interlobular septal thickening with intralobular lines in 2 patients and lobular consolidation in one patient. In conclusion, chest HRCT is superior to chest radiograph to show the pulmonary manifestation of chronic mercury vapor poisoning. In patients with chronic mercury vapor poisoning, HRCT findings of centrilobular distributed ground-glass opacities and peribronchial cuffinges are characteristic.

Characteristic angiographic findings of thromboangiitis obliterans

No abstract available.