The pulmonary aspergillosis is a group of three separate diseases, comprising invasive aspergillosis, aspergilloma, and allergic bronchopulmonary aspergillosis, or a disease process in which one of three entities overlap with another process such as mucoid impaction, pulmonary infil t ration with eosinophilia, bronchocentric granulomatosis, microgranulomatous hypersensitivity, or asthma. The radiological findings of 24 cases of pulmonary aspergilloss diagnosed and treated at Seoul National University Hospital during the past 7 years were analyzed retrospectively. The results were as follows: 1. Final diagnosis of 24 cases of pulmonary aspergillosis was aspergilloma in 16 cases, invasive aspergillosis in 2 cases, variant form of allergic bronchopulmonary aspergillosis in 3 cases, and endobroncnial aspergillosis in 3 cases. 2. The underlying causes of the aspergilloma were healed tuberculous cavity in 6 cases, bronchiectasis in 8 cases, and no underlying cause were found in 2 cases. All the 16 cases of aspergilloma were correctly diagnosed without difficultly by demonstrating the intracavitary mass or air meniscus. 3. Radiological findings of the invasive aspergillosis in kidney transplant patients were multiple round nodules with early cavitation and formation of aspergilloma which shows slowly progressive cavitation over 13 months in one case, and diffusely scattered miliary nodules with occasional cavitation in the other case. 4. Classic allergic bronchopulmonary aspergillosis were not found in our series but variant form of ABPA was found in 3 young female patients. AII the three patients shows some degree of central bronchiectasis and combined aspergilloma was found in 2 cases. 5. Three patients diagnosed as endobronchial aspergillosis-saprophytic infection of aspergillus in the bronchial tree-by bronchoscopic biopsy shows nonspecific radiological findings.
Aspergillosis ; Aspergillosis, Allergic Bronchopulmonary ; Aspergillus ; Asthma ; Biopsy ; Bronchiectasis ; Diagnosis ; Eosinophilia ; Female ; Humans ; Hypersensitivity ; Kidney ; Pulmonary Aspergillosis ; Retrospective Studies ; Seoul

Computed tomographic findings in fifteen cases of anterior mediastinal teratoma are presented and comparedwith radiographic , pathologic findings. Specific CT characteristics of anterior mediastinal teratoma arepredominantly fatty mass with a denser dependent element and globular calcification in a solid protuberance intothe cystic cavity. Six cases presented above described characteristic CT findings. Four cases presented waterdensity mass with surrounding thick wall. Fat and calcific densities were present in nine and seven respectively,so these findings are frequently absent. Thick wall was present in all cases. So thick walled cyst even in theabsence of fatty or calcific densities is highly suggestive of anterior mediastinal teratoma.
Teratoma

35 neurogenic tumors of the thorax were analyzed with plain film and CT scan. Radiological analysis emphasizedshape, location calcification, bone change, pleural change in plain film and calcification, cystic change, bonechange, pleural change, presence of contrast enhancement in CT scan. The results were as follows; 1. Age may bethe most important clinical factor for differential diagnosis. 2. Plain film findings(35 cases); 1) The mostcommon shape in the ganglion series tumor (ganglioneuroma, ganglioneuroblastoma, neuroblastoma), was elongation(80%) and these tumors generally had tapered borders(50%). In contrast with those of the genglion series, nervesheath tumors(schwannoma, neurofibroma, malignant Schwannoma) showed a definite tendency to be roudn (95%) and thesulcus effect was more frequetnly seen(67.5%). Most of the masses were smooth. The lobulated masses were commonlymalignant ganglion series tumors. 2) Though overall incidence of calcification was low(8.6%), it was observed morefrequently in ganglion series tumors(20%). 3) Associated bony abnormality were generally observed in large tumorsabove 5cm in long axis, especially in neuroblastoma and ganglioneuroblastoma. 4) Tumors showed pleural effusionwere all malignant. 3. CT findings (17 cases); 1) The overall incidence of cystic change of the mass was 23.6%. Itwas most common in Schwannoma(60%). 2) The contrast enhancement was noted in 64.7%. It's degree was variable andshowed no predilection to any specific tumors. 3) The incidence of calcification, associated bony abnormality andpleural effusion were similiar to plain film. Confident specific diagnosis can be made in most of the neurogenictumors of the thorax by shape of the mass in plain film and internal architecture in CT combined with patient'sage as clinical information.
Diagnosis ; Diagnosis, Differential ; Ganglion Cysts ; Ganglioneuroblastoma ; Incidence ; Neuroblastoma ; Neurofibroma ; Thorax ; Tomography, X-Ray Computed

We retrospectively analysed plain radiographs and MR imaging of 16 conventional osteosarcoma cases(8 children, 8 adults) which underwent amputations or limb salvage operations. Pathologic correlation was performed with gross and microscopic sections to evaluate 1) whether the open epiphyseal plate can function as a barrier against transphyseal spread of osteosarcoma and 2) the diagnostic value of MR imaging for the detection of the detection of the epiphyseal involvement of osteosarcoma. In children with open epiphyseal plates, conventional radiographs suggested transphyseal tumor growth in one of eight cases(12.5% and MR imaging in seven cases(87.5%). Pathologic examination confirmed epiphyseal involvement in six of seven cases noted with MR imaging(75%). On the the other hand, in adult patients with closed epiphyseal plates, conventional radiographs showed transphyseal tumor growth in six of eight cases(75%), while MR imaging and pathologic exam demonstrated tumor invasion in all cases(100%). We conclude that open epiphyseal plate does not function as and effective barrier against tumor extension, and MR imaging is an excellent method in detecting the extent of transphyseal tumor growth.
Adult ; Amputation ; Child ; Growth Plate ; Hand ; Humans ; Limb Salvage ; Magnetic Resonance Imaging* ; Methods ; Osteosarcoma* ; Retrospective Studies

To evaluate the reliability of MR imaging in tissue characterization and depiction of tumor boundaries, we performed MR-pathologic correlation using parosteally implanted VX-2 carcinoma in 17 rabbit thighs. T1-weighted, T2-weighted and Gd-DTPA enhanced T1-weighted axial images were obtained 10-30 days after tumor implantation. After the animals were killed, frozen and sectioned along the MR imaging planes, and histopathologic examinaton were done. For accurate MR-pathologic correlation, rabbits were fixed on the cardboard plate to minimize position change during the procedures. Tumor boundaries depicted on MR images were larger than those depicted on the specimen. Small tumors were surrounded by capsule-like loose connective tissue. Loose connective tissue became compact with tumor growth. This connective tissue showed high signal intensity on both T2-weighted and Gd-DTPA enhanced T1-weighted images. Muscle atrophy with fatty tissue accumulation around the tumor also contributed to the high signal intensity on MR images. Peritumoral edema and inflammatory reaction were not remarkable. Six of 8 cases with bone marrow fibrosis were detected on MR images. We concluded that peritumoral loose connective tissue and muscle atrophy exaggerated the size of experimentally induced malignant musculoskeletal tumors on MR images.
Adipose Tissue ; Animals ; Connective Tissue ; Edema ; Gadolinium DTPA ; Magnetic Resonance Imaging ; Muscular Atrophy ; Primary Myelofibrosis ; Rabbits ; Thigh

Ketamine, a dissociative anesthetic, produces an increase in heart rate and blood pressure, but the precise mechanism of the cardiovascular stimulating affects of ketamine is not understood clearly. Clonidine, an antihypertensive agent, is an alpha-2 agonist that appears to act primarily on the CNS, where it apparently produces a decrease in the sympathetic outflow from the brain. Prazosin is antihypertensive agent that appears to evert its vasodilator action through the blockade of postsynaptic alpha-1 receptors. In order to investigate the effects of clonidine and prazosin on the heart rate and blood pressure increased by ketamine, ketamine was administered intravenously following administration of clonidine or prazosin in conscious patients. The results were as follows : 1) Intravenous ketamine (2 mg/kg) produced significant increases in heart rate and blood pressure by as much as 25%. 2) Intravenous clonidine (1.25 ug/kg) produced a decrease in the heart rate by 5 beats per minute and decreased blood pressure significantly. 3) In the clonidine pretreated group (1.25 ug/kg, lV), intravenous ketamine (2 mg/kg/kg, lV) produced significant increases in the heart rate and blood pressure without attenuation with clonidine 4) In the prasosin pretreated group (2 mg/kg~70 kg, PO), ketamine (2 mg/kg, lV) produced increases the in heart rate and blood pressure without attenuation with prasosin. From the above results, it was inferred that the action site of the cardiovascular stimulating effect of ketamine isn't a postsynaptic alpha-1 receptor and is different from the action site of clonidine.
Blood Pressure* ; Brain ; Clonidine* ; Heart Rate* ; Heart* ; Humans ; Ketamine* ; Prazosin*

The authors report clinical results of 6 myopic patients(6 eyes) who showed undercorrection following keratomileusis-in-situ and then underwent radial keratotomy to correct the residual myopia. The mean age of patients was 39.2 years, and the mean interval between keratomileusis and radial keratotomy was 19.8 months. The mean refractive error was changed from -7.0D preoperatively to -3.23D after radial keratotomy. 'The average difference of refractive error between treated eye and untreated fellow eye was changed from 5.12D to 1. 63D after radial keratotomy. The mean visual acuity was changed from 0.15 preoperatively to 0.33 after radial keratotomy. In conclusion, radial keratotomy is an useful procedure for correcting undercorrected myopia after keratomileusis in situ.
Humans ; Keratotomy, Radial* ; Myopia* ; Refractive Errors ; Visual Acuity

This is a study to determine if there is a significant relationship between eye movement and alcohol intake at and below the legal limit of 0.05% blood alcohol concentration [BAC], and to identify the minimal BAC that causes significant change in eye movement. Twenty healthy males were orally given 0.57g/kg alcohol. After the alcohol intake, the BAC was measured at 10 minute intervals along with measurements of saccadic velocity, latency, and gain of pursuit movement of the eye. Linear regression analysis between BAC < or =0.05%and saccadic velocity and latency resulted in correlation coefficients of 0.258 and 0.306 respectively[p<0.005], while gain of pursuit movement had no relation to BAC.The latency at 0.05~0.06%BAC interval increased compared with the values before alcohol intake, with statistical significance [p<0.05 ]. Although there existed variations among subjects, a significant functional change of eye movement developed at 0.05%BAC, the legal limit of alcohol.Eye movement is thought to be a valuable indicator of CNS depression by alcohol and prolonged latency of saccadic eye movement by alcohol may be the explanation for increased risk of traffic accidents after alcohol intake.
Accidents, Traffic ; Depression ; Eye Movements* ; Humans ; Linear Models ; Male ; Saccades

Dissociated horizontal deviation(DHD) is a rare type of dissociative strabismus. It dose not obey the Hering`s law of equal innervation and is expressed in associated with dissociated vertical deviation or asymmetrical nystagmus blockage syndrome. We observed 6 cases of DHD among the patients with refractive accommodative esotropia associated with amblyopia. The mean age of the patients was 3.6 years and the average refractive error was +5.35D in the dominant eyes and +6.29D in the amblyopic eyes. The average visual acuity was 0.38 with the dominant eyes and 0.17 with the amblyopic eyes. The average angle of deviation was 40.0delta with fixation in the dominant eyes and 24.3delta in the amblyopic eyes. The authors speculate that this difference of angle deviation was caused by the weaker accommodative convergence at the time of fixation by the amblyopic eye that appeared to have decreased accommodative amplitudes.
Amblyopia* ; Esotropia* ; Humans ; Jurisprudence ; Refractive Errors ; Strabismus ; Visual Acuity

Endpgenous bacterial endophthalmitis develops mainly in a extremely ill patient or a immunologically compromised patient. As reported earlier, early suspicion and careful diagnostic evaluation and early aggressive treatment are important to treat endophthalmitis and prevent poor visual acuity. The authors experienced a case of endogenous endophthalmitis developed from pneumonia in chronic alcoholics patient. The pathogen was proved to be a Staphylococcus aureus by the culture of specimen obtained from the aqueous. Systemic, topical, subconjunctival and intravitreal antibiotic therapy were done, but the patient's eye progressed to phthisis state.
Alcoholics* ; Endophthalmitis* ; Humans ; Pneumonia ; Staphylococcus aureus ; Visual Acuity