Fifty-one consecutive 186 patients with aneurysmal subarachnoid hemorrhage were treated from the day of admission with nimodipine which was given first as an IV infusion at 30ug/kg/hr for 1 week and then orally in a dose of 360mg/day for 2 weeks and compared with 135 patients which were treated without nimodipine for the past 2 years. A comparision based on clinical and radiological variables influencing both the coruse and the outcome of the disease showed no significant difference between the nimodipine treated group and the control group except the delayed timing of surgery in the control group. There was no significant difference in the outcome between the nimodipine treated patients and the patients treated without nimodipine, however in Hung & Hess grade IV patients nimodipine treatment was associated with a significantly better outcome. Nimodipine treatment reduced the occurrence of delayed ischemic deficts(DID) in grade III, IV patients. Significant improvement in the outcome occurred in the nimodipine treated patients with subarachnoid hemorrhage of large amount(Fisher classification III).
Aneurysm* ; Classification ; Humans ; Intracranial Aneurysm ; Nimodipine* ; Subarachnoid Hemorrhage*

Myositis ossificans progressiva is a rare disease characterized by the formation of areas of calcification in the interstitial connective tissue of muscles, tendons, ligaments, fascia, and aponeuroses. There may be exacerbations and remissions of the disease, but the general course is an insidious loss of body motion, affecting especially the neck, spine and upper extremities and, rarely, the hips and lower extremities. It is commonly associated with various congenital anomalies. The cause is unknown and there is no known effective treatment. Myositis ossificans progressiva associated with brachydactyly of both great toes, in a 34 year old femaIe, is presented with a review of the literature. Chief complaints were ankylosis of the left knee and hip of 9 years duration. We performed biopsy of tubular bone which is placed antero-lateral side of the left knee.
Ankylosis ; Biopsy ; Brachydactyly ; Connective Tissue ; Fascia ; Hip ; Knee ; Ligaments ; Lower Extremity ; Muscles ; Myositis Ossificans ; Myositis ; Neck ; Rare Diseases ; Spine ; Tendons ; Toes ; Upper Extremity

Adenocarcinoma of the urinary bladder, including urachal carcinoma, is a rare tumor with incidence in the range between 0.5% and 2.2% of all epithelial bladder neoplasms. Ten cases of adenocarcinoma of the urinary bladder(eight cases of primary adenocarcinoma and two cases of urachal carcinoma)are presented. We described the computed tomography(CT)appearances of adenocarcinoma of the urinary bladder and tried to find out the characteristic CT findings of urachal carcinoma. CT scan were evaluated for the location of the tumors, presence of calcification in the tumor, and the tumor extension. Seven tumors were located at the dome of the bladder(70%0, two were at lateral walls, and one was at anterior wall. Seven were single mass and three were multicentric masses in the bladder. Fine punctate calcifications scattered within the tumors were detected in four cases(40%); three of the eight, primary adenocarcinoma, and one of the two, urachal carcinoma. Two urachal carcinomas were characterized by midline position and predominantly extravesical growth along the urachus. Gross extravesical extension with distant metastasis were presented in seven cases(70%) at the time of initial diagnosis. CT may be useful in evaluating the adenocarcinoma of the urinary bladder and differentiating urachal carcinoma from bladder cancer.
Adenocarcinoma* ; Diagnosis ; Incidence ; Neoplasm Metastasis ; Tomography, X-Ray Computed ; Urachus ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: To evaluate the usefulness of percutaneous catheter drainage (PCD) in patients who have abdominal abscesses or fluid collections. MATERIALS AND METHODS: We performed PCD for 165 abscesses and fluid collections in 148 patients. The follow-up periods in these patients ranged from 15 days to 42 months (mean, 274 days). The lesion sites were subphrenic space in 46 cases, liver in 33, perihepatic space in 20, pancreas or peirpancreatic space in 14, pelvic cavity in 13, and retroperitoneum in 13. We evaluated the success, failure, and recurrence rates, the causes of failure or recurrence, the mean duration of drainage, and the complications of PCD. RESULTS: Of the 165 cases, one hundred-fifty nine(96.5%) were successfully cured, Although a partial success could be achieved, 2(1.2%) cases were failed and 4(2.4%) were recurred. Multiloculation or fistula formation were the main causes of the unsullessful cases. The duration of drainage rainged from 2 to 605 days (mean, 1 days). Complications occured in 12 cases(7%) during or after procedures, which included fever and chill in 7, transgression of pleura in 2, bowel perforation in 2, and bleeding through catheter in 1. CONCLUSION: PCD is an effective and safe method for various abdominal abscesses or fluid collections.
Abdominal Abscess* ; Abscess ; Catheters* ; Drainage* ; Fever ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Pancreas ; Pleura ; Recurrence

PURPOSE: The purpose.of this study was to characterize the enhancing patterns of hepatocellular carcinoma (HCC) on two-phase dynamic incremental liver scan with spiral CT. MATERIALS AND METHODS: Two-phase dynamic incremental liver scan using spiral CT was performed on 230 lesions in 107 patients with HCC. CT scanning was performed with a table speed of 13mm/sec and a section thickness of 10 mm;120 mL of contrast medium was injected intravenously with a automatic injector at the rate of 3mL/sec. CT scans were started 35 sec(early phase) and 3 min(delayed phase) after beginning injection of contrast medium. The tumors were divided into 2 groups according to size(< or = 3cm and > 3cm), the contrast enhancement patterns of HCCs and capsules in the early and delayed phases were analyzed in each group. RESULTS: Most of HCCs appeared as high-attenuating lesions in the early phase(75% in tumors smaller than 3cm and 61% in tumors larger than 3cm), and as low-attenuating lesions in the delayed phase(68% in tumors smaller than 3cm and 90% in tumors larger than 3cm). Forty-eight percent of HCCs smaller than 3cm and 58% of HCCs larger than 3cm were high-attenuating in the early phase and low-attenuating in the delayed phase. Thirty-two percent of capsules were low- or iso-attenuating in the early phase and high-attenuating in the delayed phase. Capsules were demonstrated in 22% in HCCs smaller than 3cm and 67% in HCCs larger than 3 cm(p <. 01). CONCLUSION: Two-phase dynamic scan with spiral CT is useful in the diagnosis of HCC because of a precise display of hemodynamic characteristics of HCCs.
Capsules ; Carcinoma, Hepatocellular* ; Diagnosis ; Hemodynamics ; Humans ; Liver ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

No abstract available.
Intracranial Arteriovenous Malformations* ; Risk Factors*

PURPOSE: We evaluated the clinical, plain radiographic, and anglographic findings of congenital vascular malformation of the soft tissue. METHODS AND MATERIALS: Retrospective analysis was performed in 36 patients. Pathological diagnosis was done in 25 patients by surgery and the others were clinically and anglographically diagnosed. On the basis of anglographic findings, we classified the lesions to three groups as arteriovenous malformation(AVM), hemangioma, and venous malformation. In pathologically proven 25 cases, we compared the anglographic diagnosis with the pathologic diagnosis. RESULTS: By anglographic classification, AVM was 13 cases, hemangioma 16 cases, and venous malformation 7 cases. The locations of the lesions were upper extremities in 14 cases, lower extremities in 20 cases, both extremities in 1 case, and back in 1 case. Clinical findings were bruit and thrill in 13 cases(12 AVMs, 1 hemangioma) and varicosities in 16 cases(11 AVMs, 3 hemangiomas and 2 venous malformations). The varicosities in AVM were pulsating nature, but not in hemangioma and venous realformation. The concordance rate of the anglographic and pathologic diagnosis was 100%(6/6) in AVM, 71%(10/14) in hemangioma and 60% (3/5) in venous malformation. CONCLUSION: We think that angiography is an essential study for accurate diagnosis and appropriate treatment of congenital vascular malformation.
Angiography ; Classification ; Diagnosis ; Extremities ; Hemangioma ; Humans ; Lower Extremity ; Retrospective Studies ; Upper Extremity ; Vascular Malformations*

The authors analyzed 30 patients whose celiac artery or its branches were dissected during the procedure of transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) and were followed up angiographically. The incidence of arterial dissection was 1.25%. The dissection occurred most frequently in the celiac artery (40% 12/30) and the proper hepatic artery(28% 7/30). The frequency of arterial dissection was affected by the status of the vessel and the experience of the operator. The follow-up angiography revealed complete recanalization in 40% (12/30), irregularity and narrowing of the lumen in 23% (7/30), pseudoaneurysm formation in 23%(7/30), and complete obstruction in 13% (4/30) of the cases. The rate of recanalization in the celiac artery was lower than that of any other arteries in our series. Recamalization to a certain degree without therapeutic intervention was observed in 72% of the dissected arteries enabling and contributing to subsequent successful TAE within 2 months in 78% of the patients with the dissection.
Aneurysm, False ; Angiography ; Arteries ; Carcinoma, Hepatocellular ; Celiac Artery* ; Follow-Up Studies* ; Humans ; Incidence

No abstract available.
Leiomyosarcoma* ; Uterine Inversion*

We report an autopsy case of the brain stem glioma that extended extensively in the brain stem itself and cephalad. This 18-year-old boy first presented with dizziness, vomiting and left side weakness with left facial palsy. Brain MRI revealed a diffusely infiltrative tumor involving whole medulla, pons and lower midbrain. A total of 4000 R was given with some alleviation of respiratory difficulty. He died one year after the onset. Autopsy revealed the tumor involving pons, a portion of medulla oblongata, and cerebellum. The tumor showed diffusely infiltrative pattern and extended along the periventricular area to the thalamus and corpus callosum. The cut surface was grayish white and solid. It also showed areas of myxoid degeneration and necrosis probably related to radiation therapy. Microscopically the tumor was a cellular and pleomorphic glioma that showed some astrocytic differentiation. It was diffuse without geographic necrosis.