No abstract available.
Adult* ; Fistula* ; Humans

Objectives : 201Tl - chloride, 99mTc - MIBI, 99mTc(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we performed three consecutive SPECT using 201Tl, 99mTc - MIBI, 99mTc(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods : SPECT was carried out at 10min and 3hr for 201Tl after injection of 2 mCi, and 2hr for 99mTc - MIBI and 99mTc(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - bakground(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for 201Tl. Results : The diagnostic sensitivity of 201Tl, 99mTc - MIBI and 99mTc(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer Conclusion : 201Tl and 99mTc - MIBI showed higher sensitivity than 99mTc(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.
Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Succimer* ; Tomography, Emission-Computed, Single-Photon* ; Tuberculosis, Pulmonary

Objectives : 201Tl - chloride, 99mTc - MIBI, 99mTc(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we performed three consecutive SPECT using 201Tl, 99mTc - MIBI, 99mTc(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods : SPECT was carried out at 10min and 3hr for 201Tl after injection of 2 mCi, and 2hr for 99mTc - MIBI and 99mTc(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - bakground(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for 201Tl. Results : The diagnostic sensitivity of 201Tl, 99mTc - MIBI and 99mTc(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer Conclusion : 201Tl and 99mTc - MIBI showed higher sensitivity than 99mTc(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.
Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Succimer* ; Tomography, Emission-Computed, Single-Photon* ; Tuberculosis, Pulmonary

PURPOSE: To evaluate the usefulness of combination therapy composed of percutaneous ethanol injection treatment and subsequent transarterial chemoembolization in the treatment of single nodular hepatocellular carcinoma(HCC). MATERIALS AND METHODS: A total of eight patients with single nodule hepatocellur carcinoma (+/-5cm)were treated with a combination of initial percutaneous ethonol injection therapy(PEIT) and, a week later, transcatether arterial embolization(TAE). CT was performed 3 weeks after TAE to assess whether or not lipidol uptake had occurred. If lipiodol was accumulated in the nodule, the necrotic rate of the tumor was calculated by the following equation: (initially observed tumor volume - volume of nodule in which lipidol uptake occurred)x100/Initially observed tumor volume. Follow-up CT scan was performed every third or fourth month to evaluate tumor growth or recurrence. RESULTS: A nodule in which lipidol uptake occurred was seen in four of the eight patients; in one of these, a tumor-confirmed by angiogaphic examination and laboratory data-recurred twelve months later. The mean necrotic rate of a tumor treated PEIT alone was 83%(range, 37%-100%). CONCLUSION: Although limited in numbers of cases we studied, use of combination therapy composed of PEIT and subsequent TAE, appears to be effective in achieving the high rate of tumor necrosis as well as in the evaluation of the tumor during follow-up.
Carcinoma, Hepatocellular* ; Ethanol* ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Necrosis ; Recurrence ; Tomography, X-Ray Computed ; Tumor Burden

PURPOSE: To compare the ratio of renal cortical thickness to renal parenchymal thickness in early diabetic nephropathy and in normal control group. MATERIALS AND METHODS: We performed spiral CT in 17 patients suffering from diabetic nephropathy without renal failure or renal atrophy. The normal control group consisted of 19 persons who were normal on renal function test and did not show any abnormality of the kidney. Renal cortical and parenchymal thicknesses were measured at renal hilum level perpendicular to the renal surface by electronic caliper on contrast-enhanced transverse scan demonstrating the cortical nephrogram phase. Using student's test, the difference in renal parenchymal and cortical thickness between the two groups was tested for statistical significance. RESULTS: There was no significant difference in renal parenchymal thickness between the two groups(P>0.05) ; the patient group had a thicker renal cortex than the normal control group however (P<0.05). The ratio of renal cortical thickness to parenchymal thickness in early diabetic nephropathy patients(Rt.:0.041+/-0.051, Lt.:0.382+/-0.053) was significantly higher than in the normal control group (Rt.:0.331+/-0.067, Lt.:0.323+/-0.064). CONCLUSION: The kidney of early diabetic nephropathy patients had a thicker renal cortex than normal kidney.
Atrophy ; Diabetic Nephropathies* ; Humans ; Kidney ; Renal Insufficiency ; Tomography, Spiral Computed*

PURPOSE: To compare the ratio of renal cortical thickness to renal parenchymal thickness in early diabetic nephropathy and in normal control group. MATERIALS AND METHODS: We performed spiral CT in 17 patients suffering from diabetic nephropathy without renal failure or renal atrophy. The normal control group consisted of 19 persons who were normal on renal function test and did not show any abnormality of the kidney. Renal cortical and parenchymal thicknesses were measured at renal hilum level perpendicular to the renal surface by electronic caliper on contrast-enhanced transverse scan demonstrating the cortical nephrogram phase. Using student's test, the difference in renal parenchymal and cortical thickness between the two groups was tested for statistical significance. RESULTS: There was no significant difference in renal parenchymal thickness between the two groups(P>0.05) ; the patient group had a thicker renal cortex than the normal control group however (P<0.05). The ratio of renal cortical thickness to parenchymal thickness in early diabetic nephropathy patients(Rt.:0.041+/-0.051, Lt.:0.382+/-0.053) was significantly higher than in the normal control group (Rt.:0.331+/-0.067, Lt.:0.323+/-0.064). CONCLUSION: The kidney of early diabetic nephropathy patients had a thicker renal cortex than normal kidney.
Atrophy ; Diabetic Nephropathies* ; Humans ; Kidney ; Renal Insufficiency ; Tomography, Spiral Computed*

Charcot-Marie-Tooth disease (CMTD) is a hereditary neuropathy with slow progression, whereas Guillain-Barre syndrome is an acute acquired neuropathy of immunopathogenesis. A 17 year-old girl with hammertoes and pes cavus developed an acute quadriparesis. The duplication of PMP-22 exons in 17p12-p11.2 was confirmed by genetic study. After Intravenous ingection of immunoglobulin, she recovered to normal activity within one month with improvement of nerve conduction study. We should be concerned with the possibility of Guillain-Barre syndrome if there is rapidly progressive exacerbation on CMTD.
Adolescent ; Charcot-Marie-Tooth Disease* ; Exons ; Female ; Foot Deformities ; Guillain-Barre Syndrome* ; Humans ; Immunoglobulins ; Neural Conduction ; Quadriplegia

PURPOSE: The aneurysmal aortitides could be classified into 4 categories by clinical features, and each category has a different principle of treatment and prognosis. The purposes of this study were 1) to classify the CT findings of the aneurysmal aortitides by the 4 categories-aortic aneurysm, aortic dissection, penetrating atheromatous aortic ulcer, and annuloaortic ectasis, and 2) to evaluate the complications of each category. MATERIALS AND METHODS: We reviewed the CT findings of 33 cases of aneurysmal aortitides, and classified them into the above-mentioned 4 categories. Thirty-two patients were examined with CT with or without ultrasound, angiography, echocardiography, or MRI. Among them, 15 cases were confirmed with operation and the rest were diagnosed with radiologic and clinical findings. RESULTS: There were 17 aortic aneurysms, 9 aortic dissections, 4 penetrating atheromatous aortic ulcers, and 3 annuloaortic ectases. Aortic rupture, the most serious complication of aortitides, occurred in 9 cases. The causes of the rupture were aortic dissection, aneurysm, and penetrating aortic ulcer in descending order of frequency. The most frequent site of rupture was retroperitoneum. CONCLUSION: Using CT with or without other diagnostic tools, we could classify the aneurysmal aotitides into 4 categories and evaluate the complications.
Aneurysm* ; Angiography ; Aortic Aneurysm ; Aortic Rupture ; Aortitis* ; Classification* ; Echocardiography ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Rupture ; Ulcer ; Ultrasonography

BACKGROUND: Lung-to-heart uptake ratio (LHR) in (201) Tl-chloride myocardial perfusion scan is believed to be a reliable marker for left ventricular (LV) dysfunction, but the clinical value of LHR is controversial for 99mTc-MIBI imaging. Furthermore, most of results suggesting lung uptake of 99mTc-MIBI as a potential marker for LV dysfunction used immediate post-stress images, instead of routine images acquired 1 hour after tracer injection. The goal of our study was to investigate whether LHR evaluated with routine gated 99mTc-MIBI imaging can reflect the degree of perfusion defect or left ventricular performance. SUBJECTS AND METHODS: 241 patients underwent exercise 99mTc-MIBI myocardial SPECT were classified into normal myocardial perfusion (NP, n=135) and abnormal myocardial perfusion (AP, n=106) group according to the presence of perfusion defect. LHR was calculated from anterior projection image taken at 1-hour after injection. Two regions of interest (ROIs) were placed on left lung above LV and on myocardium showing the highest radioactivity. Subjects were classified by left ventricular ejection fraction (LVEF), as Gr-I: > 50%, Gr-II: 36-50%, Gr-III: < 36% and by summed stress score (SSS), as Gr-A: < 4, Gr-B: 4-8, Gr-C: 9-13, Gr-D: > 13, LHR was compared among these groups. RESULTS: In NP group (n=135), LHR, were higher in men than women (men: 0.311+/-0.03, women: 0.296+/-0.03, p< 0.05). Significant difference, in LHR were found between NP and AP groups both for men and women (men: 0.311+/- 0.03 vs. 0.331+/- 0.06, women: 0.296+/-0.03 vs. 0.321+/-0.07, p< 0.05). There were weak negative correlation between LHR and LVEF (r=-0.342, p< 0.05) and weak positive correlation between LHR and SSS (r=0.478, p< 0.05) in men, but not in women (LVEF: r=-0.279, p=0.100, SSS: r=0.276, p=0.103). Increased LHR was defined when for more than mean + 2SD value (men> or = 0.38, women> or = 0.37) of the LHR of the subject with normal perfusion. Increased LHR were observed more frequently in subjects with lower LVEF (Gr-I: 11.1%, Gr-II: 27.0%, Gr-III: 36.4%, p< 0.05) and higher SSS (Gr-A: 14.0%, Gr-B: 6.7%, Gr-C: 18.2%, Gr-D: 40.7%, p< 0.05). CONCLUSIONS: LHRs obtained from routine 99mTc-MIBI gated SPECT images were weakly correlated with LVEF and perfusion defect. Although significant overlaps were observed between normal and abnormal perfusion group, LHRs could be used as an indirect marker of severe perfusion defect or reduced left ventricular function.
Female ; Humans ; Lung* ; Male ; Myocardium ; Perfusion* ; Radioactivity ; Stroke Volume* ; Technetium Tc 99m Sestamibi* ; Tomography, Emission-Computed, Single-Photon* ; Ventricular Function, Left

PURPOSE: The purpose of this study was to develop a large animal (rabbit) model which has a proper solitary intrahepatic tumor with lower leakage rates through less traumatic methods. Consequently, we evaluated tumor progression following the intrahepatic inoculation of VX2 cells into New Zealand white rabbits to acquire baseline data on the progression of a VX2 tumor. MATERIALS AND METHODS: Twenty New Zealand white rabbits, each weighting 2.5-3 kg, were selected for this study. A 1 mm3 VX2 tumor fragment was created and then minced to enable the particles to pass through a 21 G needle mounting in a tuberculin syringe with 0.1 ml of normal saline. The minced VX2 tumor particles were injected into the subcapsular parenchyma of the left hepatic lobe. A 21 G needle was used to avoid penetrating large hepatic vessels. In order to prevent hemorrhage or leakage of the VX2 tumor cells through the injection route, a purse-string suture around the puncture site was made using black silk 4-0. The tumor particles were then injected through the center of the suture. While removing the needle, the suture was tightened to prevent hemorrhage or leakage of the VX2 tumor cells through the injection route. Finally, the injection site was covered with a Surgicel(R) patch. The inoculated intrahepatic VX2 tumors were then imaged with a 16 channel multidetector CT every week for the duration of the study. The CT images covered from the lung apex to the pelvic floor. Two radiologists evaluated the size, location, and peritoneal seeding of the tumors as well as metastasis of other organs. Three rabbits were sacrificed at random beginning in the second week, and this process continued on a weekly basis for the duration of the study. The CT images and pathologic findings for the sacrificed rabbits were correlated. RESULTS: The inoculated intrahepatic VX2 tumors were not visible in the first week. By the second week 66.7% were visible on CT images and by the third week all tumors were visible. Of the twenty rabbits, three (15%) had tumor growth both in the liver and the peritoneal cavity, suggesting tumor leakage from the injection site into the peritoneal cavity. The remaining rabbits (n=17) had successful inoculation in the liver parenchyma as a solitary mass. Three of twenty rabbits (15%) showed tumor regression after successful inoculation. Tumor metastasis in extratumoral regions, including the liver and peritoneal seeding, increased beginning in the fourth week and more than 12x103 mm3 in volume after the initial inoculation of the VX2 tumors. CONCLUSION: This new technique using innoculated intrahepatic VX2 tumor particles seems to be a simple and effective method for obtaining a solitary hepatic tumor in animal models. Results of this study suggest that a solitary intrahepatic tumor model without metastasis can be maintained. However, the evaluation of any therapeutic effects or any planned intervention should not occur until the fourth week following innoculation or less than 12x103 mm3 in volume after the inoculation of the VX2 tumor. The second highlighted section does not seem to fir with the rest of the sentence. Consider rephrasing the last part of the sentence.
Animals* ; Hemorrhage ; Liver ; Lung ; Models, Animal* ; Needles ; Neoplasm Metastasis ; Pelvic Floor ; Peritoneal Cavity ; Punctures ; Rabbits ; Silk ; Sutures ; Syringes ; Tuberculin