Authors performed angio-CT(portal &/or arterial CT) in 35 patients with various hepatic masses. We obtained portal CT in 32 and arterial CT in 13 patients. The contrast material was injected into superior mesenteric artery for portal CT and into hepatic artery for arterial CT after transfemoral cathetrization of these arteries. We concluded that portal CT was superior to other imaging modalities highly sensitive in detecting hepatic masses, especially, early hepatocellular carcinomas, daughter nodules, and subclinical metastatic hepatic malignancy, With this method, detection rate of early hepatocelluar carcinomas improved 62% in number of patients and 90% in number of masses. Detection rate of subclinical hepatic metastases improve 60% each in number of patients and in number of masses. It was also useful for the detection of portal vein invasion. Arterial CT was useful in differential of masses and in defining the characteristics of entire or part of the masses because this method revealed hemodynamic patterns more definitely.
Arteries ; Carcinoma, Hepatocellular ; Hemodynamics ; Hepatic Artery ; Humans ; Mesenteric Artery, Superior ; Methods ; Neoplasm Metastasis ; Nuclear Family ; Portal Vein

No abstract available.
Electrocardiography* ; Inferior Wall Myocardial Infarction*

No abstract available.
Cardiomyopathy, Hypertrophic* ; Hypertrophy, Left Ventricular*

Experinece in the management of 74 patients with delayed traumatic intracranial hemorrhage(DTICH) of 474 head injury from January 1996 to December 1996 is poresented with emphasis on the incidence, occurring time, risk factors and outcome. The incidence of DTICH was 15.6% of all hospitalized head-injury patients. After an injury, every patient had an immediate computerized tomography(CT) scan to diagnose intracranial pathology and then CT follow-up was carried out according to intial CT finding and reurological deficit. The lesion was almost occurred in patients with initial abnormal CT finding(85.1%). 82.4% of DTICH were noted within 72 hours after injury. The delayed epidural hematoma and intracerebral hemorrhage were almost noted in first 72 hours(>90%), but the delayed subdural hemorrhage was found after a time interval varying from 6 hours to 10 days. So we strongly recommend CT follow-up in 4-8hour, 24-72hour, and then 7th day after head injury, especially in patients with initial abnormal CT findings. The risk factor of the delayed lesion was not hypotension, hypoxia, and consciousness level, but age of patients and the initial CT finding. The development of DTICH was not heralded by neurological deterioration. The prognosis of DTICH was not worse than non-DTICH. The patient with delayed subdural hemorrhage was better than the patient with non-delayed lesion(including hemorrhage and normal CT finding).
Anoxia ; Cerebral Hemorrhage ; Consciousness ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Intracranial Hemorrhages* ; Pathology ; Prognosis ; Risk Factors

BACKGROUND: The patients with traumatic brain injury showed ischemia due to increased intracranial pressure. This study evaluated the relationship of pre-anesthetic serum lactate level with in-hospital mortality. METHODS: The archived medical records of 121 patients were retrospectively reviewed. Demographics and preoperative serum lactate level were analyzed. RESULTS: Of the 121 patients, 32 patients expired in the hospital after decompressive craniectomy. Preoperative serum lactate levels were 3.2 +/- 2.2 mmol/L in the survivors and 5.4 +/- 3.0 mmol/L in the dead (P = 0.001), and the receiver operating characteristic curve revealed that a cut off value of 3.60 mmol/L was reasonable for predicting mortality. CONCLUSIONS: Preoperative serum lactate level is highly correlated with in-hospital mortality after decompressive craniectomy in traumatic brain injury.
Brain Injuries* ; Decompressive Craniectomy* ; Demography ; Hospital Mortality* ; Humans ; Intracranial Pressure ; Ischemia ; Lactic Acid* ; Medical Records ; Mortality ; Retrospective Studies ; ROC Curve ; Survivors

To evaluate the cerebral blood flow in feline hydrocephalic brain, this study was designed to measure the regional cerebral blood flow(rCBF;frontal and periventricular area) by the hydrogen clearance method in different stages of the kaolin-induced hydrocephalus and the postshunt status. The results were as follows: 1) A reduction of rCBF was detected in the left periventricular area at two weeks after kaolin injection. A significant reduction of rCBF was revealed in the left periventricular area at two and four weeks after kaolin injection. However, the rCBF of the left frontal cortex was significantly decreased at four weks after kaolin injection. 2) At one week after shunt operation, the significant restroration of rCBF was found in the left frontal cortex and the left periventricular area.
Brain ; Hydrocephalus* ; Hydrogen ; Kaolin

BACKGROUND AND PURPOSE: We performed this study to explore the various diagnostic roles of video-EEG monitoring (VEM) and to assess the outcome after VEM. METHODS: 1749 patients who underwent VEM in the adult epilepsy section were included. We classified purposes of VEM and assessed outcome after VEM or epilepsy surgery guided by VEM. The outcome was assessed according to seizure frequency during the previous 12 months from the day of follow-up evaluation. RESULTS: The purposes of VEM were presurgical evaluation (68.5%), confirmation of epilepsy (15%), classification of seizures (9.4%), diagnosis of pseudoseizures (5.5%), and detection of nonconvulsive status epilepticus (1.7%). The efficiency of VEM was 89.2%, highest for presurgical evaluation (97.1%) and lowest for confirmation of seizures (66.0%). The number of events detected and the number of days needed differed according to the purposes of VEM. Epilepsy surgery was performed in 629 patients. The outcome of patients with epilepsy surgery was significantly better compared with patients without surgery despite presurgical evaluation (p<0.0001). Various other illnesses with transient symptoms as well as various epileptic syndromes were diagnosed by VEM. Better outcomes were observed in patients in whom VEM was used for classification and confirmation of seizures compared with patients in whom VEM was used for presurgical evaluation. CONCLUSIONS: VEM is a useful tool for various purposes. The efficiency, number of events and days of VEM differed according to the purposes. Patient outcome was also dependent on the purpose of the VEM as well as on treatment modalities.
Adult ; Epilepsy ; Follow-Up Studies ; Humans ; Seizures ; Status Epilepticus

BACKGROUND: Perindopril. a new second-generation angiotensin converting enzyme inhibitor developed by Servier Research, was administered in essential hypertensive patients in order to observe the clinical effects. METHOD: The changes of blood pressure, heart rate, quality of life, clinical laboratory examinations, side effects, electrocardiogram and echocardiographic left ventricular mass were evaluated before and after 4-12mg of perindopril 12 weeks' administration in 25 essential hypertensive patients(mild 10, moderate 8, severe 5, very severe 2 : male 7, female 18 ; mean age 53.1+/-8.9 years). RESULT: 1) After treatment with perindopril alone, blood pressures were lowered markedly in 17(68%), moderately in 5(20%) and mildly in 2(8%) cases. The average of blood pressures of 25 subjects were systolic 173.1+/-22.8mmHg and diastolic 105.9+/-9.5mmHg before treatment, which were lowered to 125.2+/-14.9mmHg and 83.2+/-9.0mmHg respectively after 12 weeks(p<0.0001). 2) Quality of Life improved markedly in 11(44%) and slightly in 9(36%) cases after perindopril administration. 3) On electrocardiographic follow-up study, three out of five left ventricular hypertrophy with strain, seven out of 13 left ventricular hypertrophy, two out of three ST segment and T wave change and two sinus tachycardia were improved. Echocardiographic left ventricular mass was reduced significantly form 249.4+/-72.7g to 202.9 56.3g after 12 weeks perindopril treatment(p<0.0001). 4) Side effects were 5 cases of dry cough and 3 facial flushing. 5) Final Assessment of perindopril effect including hypotensive effect, quality of life, left ventricular mass regression and side effect showed very useful in 16(64%) and useful in 6(24%) out of 25 subjects. CONCLUSION: Perindopril may be an effective initial single antihypertensive agent for the treatment of varying degree of hypertension, especially with left ventricular hypertrophy.
Blood Pressure ; Cough ; Echocardiography ; Electrocardiography ; Female ; Flushing ; Follow-Up Studies ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Peptidyl-Dipeptidase A ; Perindopril ; Quality of Life ; Tachycardia, Sinus

BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) was initially applied in patients with proximal, discrete, single vessel disease, but complex multivessel PTCA has become feasible with increased operator experience and instrumental development. The authors analyzed the predictive factors concerning the success rate of multivessel PTCA. METHODS: To evaluate the predictive factors of the successful PTCA in multivessel disease, clinical and angiographic findings of 39 patients (male 31, female 8, age 58.4 9.9) with 84 multiple lesions, who admitted to Chonnam National University Hospital between January 1991 and December 1992, were analyzed. RESULTS: Overall success rate of 84 attempted lesions was 92.9%. Success rate of old aged group 65 years or older was 89.5% and that of below 65 years was 93.8%. Success rate in acute myocardial infarction was 80% and significantly lower than those of old myocardial infarction, unstable and stable angina. Success rate of AHA type C lesion was 75.0% and significantly lower than those of type A(100%), type B1(96.7%) and type B2(95.2%). Success rate according to target vessels was not significantly different. Angiographic findings including calcification, lesion length, angulation, TIMI flow grade, left ventricular function and left ventricular aneurysm didn't affect the success rate of multivessel PTCA significantly. CONCLUSION: Overall success rate of multivessel PTCA was 92.9%. The negative predictive factors affecting the success rate of multivessel PTCA were the acute myocardial infarction out of clinical factors and the AHA type C lesion out of angiographic factors.
Aneurysm ; Angina, Stable ; Angioplasty, Balloon, Coronary* ; Female ; Humans ; Jeollanam-do ; Myocardial Infarction ; Ventricular Function, Left

BACKGROUND: Angina with normal coronary angiogram has been called syndrome X or microvascular angina, but pathophysiologic mechanisms for chest patin in this group of patients are not known exactly. To observe the changes of left ventricular function in patients with angina and normal coronary angiogram, the authors analyzed the left ventricular systolic and diastolic function with echocardiogram and cardiac catheterization. METHODS: The authors performed resting and treadmill exercise electrocardiogram, 201TI dipyridamole scan, M-mode and Doppler echocardiogram, cardiac catheterization and coronary angiogram in patients with angina and normal coronary angiogram. The systolic and diastolic left ventricular function indices from M-mode and Doppler echocardiogram, left ventricular catheterization and coronary angiogram were analyzed in 12 patients excluding diabetes, hypertension, cardiomyopathy and esophageal motility disorders among 1626 patients who underwent coronary angiogram between Jan. 1991 and Aug. 1992 in Chonnam University Hospital. RESULTS: 1) Studied subjects were 12 patients, 5 male and 7 female, mean age was 51+/-9.4 year-old. Resting electrocardiograms were normal in 8 cases and ST-T changes in 4 cases. Ischemic ST-T changes were observed in all cases during treadmill exericise test and perfusion defects in 3 cases out of 8 cases during 201TI dipyridamole scan. 2) On echocardiogram, ejection fraction(EF) was 68.9+/-4.5%, fractional shortening(FS) 37.4+/-4.4%, ratio of left atrial to aortic root dimension(LAD/AOD) 1.2+/-0.1, OR slope 3.8+/-0.8c,/sec, mitral valve Doppler E/A velocity ratio[E/A(V)] 0.9+/-0.2, mitral valve Doppler E/A area ratio[E/A(a)]1.3+/-0.3, early diastolic deceleration rate(EDDR) 4.3+/-1.3m/sec2, isovolumic relaxation time(IVRT) 96.2+/-15.7msec, isovolumic contraction time(IVCT) 38.1+/-9.1 msec and aortic valve Doppler peak flow velocity[Ao(V)] 0.8+/-0.2m/sec. EF, FS, IVCT and A(V) were normal. LAD/AOD and IVRT were increased, but E/A(V), E/A(a), OR slope and EDDR were decreased compared to normal subjects. 3) On cardiac catheterization and angiogram, mean left ventricular end-diastolic pressure was 15.3+/-5.1mmHg and ejection fraction by left ventriculogram 78.2+/-7.4%. There was no regional wall motion abnormality. CONCLUSION: Above results suggest that angina with normal coronary angiogram may be associated with impaired left ventricular diastolic function.
Aortic Valve ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathies ; Catheterization ; Catheters ; Deceleration ; Dipyridamole ; Electrocardiography ; Esophageal Motility Disorders ; Female ; Humans ; Hypertension ; Jeollanam-do ; Male ; Microvascular Angina ; Mitral Valve ; Perfusion ; Relaxation ; Thorax ; Ventricular Function, Left*