PURPOSE: To evaluate the relative value of arterial, portal venous and delayed phase images of spiral CT in the detection of metastatic tumor of the liver. MATERIALS AND METHODS: Forty-three metastatic tumors in twelve patients were underwent tri-phasic spiral CT examination with injection of 120 ml ionic contrast material (36 g of iodine) at the rate of 3 ml/sec. Arterial, portal venous and delayed phase CT images were obtained 35, 65, and 360 seconds after the start of contrast injection, respectively. RESULTS: Arterial phase images detected 35(81%), portal venous phase images 43(100%), and delayed phase images 34(79%) lesions, respectively(p<0.05). All masses larger than 2cm(n=23) were detected in all three phases, whereas 60%, 100%, 55%of the masses smaller than 2cm(n=20) were detected in arterial, portal venous and delayed phase CT, respectively. The best contrast between masses and the hepatic parenchyma was in portal venous phase followed by arterial and delayed phase(p<0.01). In two hypervascular masses, the contrast was better in arterial phase. CONCLUSION: Portal venous phase of spiral CT is optimal in the detection of metastatic tumor of the liver. Arterial phase may be helpful for the detection of hypervascular metastasis. Delayed phase should be used restrictively.
Humans ; Liver* ; Neoplasm Metastasis ; Tomography, Spiral Computed*

OBJECTS: Sanjoin, the seeds of Zizyphus vulgaris var. spinosus has been used as the most important hypnotic agent in chinese medicine to treat insomnia. This research was performed in order to examine the effect of betulinic acid and sanjoinine-A which are components of Sanjoin. METHOD: Sleeping time, sleep recordings of EEG, serum serotonin level, and locomotor activity were measured in rats which received betulinic acid and sanjoinine-A as sleep induction material extracted from Sanjoin. RESULTS: 1) Groups received betulinic acid, sanjoinine-A, and lorazepam showed increased sleep time than control group with saline. 2) Groups with betulinic acid, sanjoinine-A, lorazepam and saline recorded beta-wave in sleep recording of EEG. In there was no significant difference among all groups. 3) No significant difference in serum serotonin level among all groups was found. 4) In autonomic activity testing, groups of betulinic acid, sanjoinine-A, and lorazepam showed significantly more decreased in activity than saline group. In comparison of groups of betulinic acid and sanjoinine-A with a group of lorazepam, there was no significant difference. CONCLUSION: These results suggests that betulinic acid and sanjoinine-A have the sedative effect like lorazepam rather than sleep effect.
Animals ; Asian Continental Ancestry Group ; Brain* ; Electroencephalography* ; Humans ; Hypnotics and Sedatives ; Lorazepam ; Motor Activity ; Rats* ; Serotonin* ; Sleep Initiation and Maintenance Disorders ; Ziziphus

PURPOSE: To verify the usefulness of left portal vein angle (LPVA) on CT scan in the diagnosis of liver cirrhosis and to compare its diagnostic value with that of caudate to right lobe ratio (C/RL ratio). MATERIALS AND METHODS: LPVA, an angle formed by a vertical line and a line connecting the center of the vertebral body to the umbilical point of the left portal vein, and C/RL ratio were measured on CT scans of 100 cirrhotic and 100 normal livers. Diagnostic values of LPVA and C/RL ratio were compared statistically. RESULTS: The mean of LPVA was 18.9 degrees(SD; 7.6) for normal livers and 25.8 degreesSD; 8.4) for cirrhotic livers (P<0.001). The mean of C/RL ratio was 0.47(SD; 1.10) for normal livers and 0.58(SD;0.14) for cirrhotic livers (P<0.001). When LPVA was greater than 30 degreesliver cirrhosis was diagnosed with 36% sensitivity and 92% specificity. When C/RL ratio was greater than 0.60, the diagnose of liver cirrhosis was with 41% sensitivity and 90% specificity. There was no significant difference of the diagnostic accuracy between LPVA and C/R L ratio in ROC analysis. CONCLUSION: Both LPVA and C/RL ratio are useful diagnostic indices of liver cirrhosis on CTscan. LPVA is more convenient to measure than C/RL ratio.
Diagnosis* ; Fibrosis ; Liver Cirrhosis* ; Liver* ; Portal Vein* ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

PURPOSE: To compare the efficacy and safety of ultrasound guided automated gun biopsy with fine needle aspiration biopsy of focal liver lesions. MATERIALS AND METHODS: We performed 32 automated gun(19.5G Autovac Biopsy Needle) biopsies and 27 fine needle aspiration(22G Westcott Style Biopsy Needle) biopsies in 48 patients with malignant focal liver lesion under the guidance of ultrasound. We compared the "positive for malignancy rate" and "pathologic diagnosis rate" of both methods with final diagnosis, and the rate of complications. RESULTS: The "positive for maiignancy rate" of automated gun biopsy and needle aspiration are 84.4%(27/32) and 66.7%(18/27) respectively(p=0.11). The "pathologic diagnosis rate" are 84.4%(27/32) and 55.6%(15/27) with significant statistical difference(p<0.05). And there is no difference of the rates of significant complications. CONCLUSION: When compared with the fine needle aspiration biopsy, ultrasound-guided automated gun biopsy is safe and more effective method for malignant focal liver lesion.
Biopsy* ; Biopsy, Fine-Needle* ; Diagnosis ; Humans ; Liver* ; Needles ; Ultrasonography*

Alcoholic celiac plexus blocks have been used to relieve intractable upper abdominal cancer pain. Various techniques have been proposed including the use of the X-ray and CT scanner to improve results and to avoid complications. We used the CT scanner and the X-ray fluroscope for 36 cases of alcoholic celiac plexus blocks to determine the depth and position of the needle without previous diagnostic blocks. Good to excellent pain relief occurred in more than 72% of the patients and the advantages of the use of the CT scanner showed that 1) placement of the needle tip is easily established according to the surrounding anatomical structures. 2) the operator can introduce the needle without anxiety. 3) the time required for block are saved.
Alcoholics ; Anxiety ; Celiac Plexus* ; Humans ; Needles

No abstract available.
Oocytes* ; Pregnancy* ; Spermatozoa*

No abstract available.
Pulmonary Atelectasis*

Two strains of vancomycin-resistant Leuconostoc species were isolated from blood cultures in two compromised patients. The isolates produced gas from Lactobacillus MRS booth, hydrolysed esculin, and produced no ammonia from arginine, thus fulfilling the major criteria as Leucorostoc spp. We recommend that clinical laboratories should perform susceptibility test to vancomycin for clinical isolates (especially from cerebrospinal fluid and blood) which resemble streptococci so as not to confuse Leuconostoc spp. with more commonly isolated pathogens such as streptococci.
Ammonia ; Arginine ; Bacteremia* ; Cerebrospinal Fluid ; Esculin ; Humans ; Lactobacillus ; Leuconostoc* ; Vancomycin

The CT digital radiography is a new accurate technique for measuring the long bone length. Authors performed acomparative study on accuracy, time and film consumption and radiation dose between conventional spot scanogramand CT scanogram. We used two femur and two tibia specimen for materials, the Somatom II(Siemens) for CTscanogram, and Rad Check(Voctoreen) for radiation dosimetery. There was no significant difference in accuracybetween direct measurement, conventional scanogram and CT scanogram(lesser than 1% difference). The examinationtime of conventional scanogram was about 35 minutes, CT was 15 minutes, and the film consumption of spot scanogramwas 3 of 14x17'' size, but the CT scanogram need only one 8x10'' film for completion of study. The radiation doseof hip, knee and ankle joint were 220 mRad, 365 mRad, respectively, in spot scanogram, but it was lesser than 5mRad in all joints in CT scanogram. The advantages of the CT scanogram are simple, rapid and reduced radiation.
Ankle Joint ; Femur ; Hip ; Joints ; Knee ; Radiographic Image Enhancement ; Tibia

PURPOSE: To evaluate the effect of gadoxetic acid on the measurement of the stiffness value of MR elastography (MRE) used to evaluate hepatic fibrosis (HF). MATERIALS AND METHODS: MRE was obtained in 32 patients with clinically suspected chronic liver disease, both before and after injection of gadoxetic acid. Two independent reviewers measured the stiffness values of the liver parenchyma on elastograms. The mean liver stiffness values were compared in the pre- and post-contrast MREs using the paired t-test. Intra-rater and inter-rater correlation was assessed using the intraclass correlation coefficient (ICC). The accuracy, sensitivity, and specificity of both pre- and post-contrast MREs was evaluated for the diagnosis of significant HF (> or = F2) using cut off value of 3.1 kPa. RESULTS: There were no significant differences in the stiffness values of the liver parenchyma on pre- and post-contrast MREs (p = 0.15 and 0.38 for each reader, respectively). Regarding intra-rater correlation, excellent agreement was noted on rater 1(ICC = 0.998) and rater 2 (ICC = 0.996). Excellent correlation regarding the measured stiffness values was noted on both pre- and post-contrast MREs (ICC = 0.988 for pre-contrast, ICC = 0.993 for post-contrast). The accuracy, sensitivity, and specificity of the pre- and post-contrast MREs for differentiating significant HF (> or = F2) from < or = F1 were same as 71%, 60%, and 100%, respectively. CONCLUSION: As there was no significant difference in the stiffness measurements seen on MREs before and after administration of gadoxetic acids, it is therefore acceptable to perform MRE after contrast injection in order to evaluate HF.
Elasticity Imaging Techniques ; Fibrosis ; Gadolinium DTPA ; Humans ; Liver ; Liver Diseases ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Sensitivity and Specificity