Six patients with twenty histologically proven neurilemmomas of the extremities were studied using magnetic resonance(MR) imaging. The size, number, signal intensity on spin-echo T1WI(TR 500-650ms/TE 14-25ms)and gradient -echo (TR 200-600ms/TE 14-20ms; flip angle 25-30)image, enhancement pattern, detectability of nerve of origin, nerve-lesion relationship, and presence of a capsule were analyzed. The masses ranged from 1 to 12cm in longitudinal diameter and originated from the median nerve, ulnar nerve, sciatic nerve, radial nerve, and tibial nerve. All the nerve tracts except for those of 5 lesions, which could not be detected due to their small diameter, were visualized as low intensity tubular structures. All visible nerve tracts were situated along the periphery of the lesion and this finding was considered to be specific for neurilemmona. All neurilemmomas were isointense with the surrounding muscle on spin-echo T1WI and hyperintense on gradient-echo image. After a GD-DTPA injection, all masses showed moderate or marked enhancement and more prominent inhomogeneity than that on nonenhanced scan. In 19 out of 20 lesions(95%), a low signal intensity capsule surrounding the masses could be seen. Four of the six patients showed multiple masses, which was unusual as neurilemmoma usually arises as a solitary mass. In conclusion, the MR findings, especially the eccentric location of the mass lesion from the nerve of origin and the presence of a capsule, were useful in making a diagnosis of neurilemmoma of the extremity and that multiple neurilemmomas were not uncommon.
Diagnosis ; Extremities* ; Gadolinium DTPA ; Humans ; Median Nerve ; Neurilemmoma* ; Radial Nerve ; Sciatic Nerve ; Tibial Nerve ; Ulnar Nerve

To verify the accuracy and reproducibility of corneal thickness measurements obtained with Orbscan (Orbtek, Inc., Salt Lake City, USA), the measurements were compared with those taken with an ultrasound pachymeter (Omega Compuscan, Storz). Central corneal thickness was measured by each method in 100 eyes of 50healthy subjects. The averages by the two methods were compared. One examiner took the measurements twice by each method in 20 eyes of 10 subjects, and intraexaminer reproducibility was evaluated. Two examiners measured the thickness in 20 eyes of 10 subjects and interexaminer reproducibility was assessed. The average corneal thickness was 550.27+/-3.56 micrometer in the Orbscan measurements and 526.62+/-3.70 micrometer in the ultrasound pachymetry: There was a statistically significant difference between the two methods. Significant difference was noticed but this showed a constant corresponding correlation with the Orbscan showing a 4.4%lower average. The intraexaminer and interexaminer reproducibility showed high reliability(Guttman split-half point<0.99). The Orbscan pachymetry is a highly reliable method and may be widely used in clinical practice.
Corneal Pachymetry* ; Lakes ; Ultrasonics* ; Ultrasonography

On video fluorescein angiogram, it is known that arm-to-retinal circulation(ART)influences retinal macrocirculation and arterio-venous passage time(AVP)influences microcirculation.In diabetic retinopathy(DR), midperiphery involved earlier than posterior pole.However, there has been no study on the circulation of the entire retinal circulation including the peripheral retina. The authors conducted a prospective study by performing fluorescein angiography on 19 controls and 19 DR patients in order to measure the ART, AVP and venous filling time(VFT). The VFT correspond to the circulation of the peripheral retina. In the DR group, the retina circulation time was compared with the existence of proliferative diabetic retinopathy(PDR), distribution of nonperfusion area and beading vessels. There was no significant difference between diabetic group and the control group in the ART.AVP was 1.8+/-0.7sec in the control group and 2.5+/0.7sec(p=0.04)in the DR group and venous filling time was 6.4+/-2.4sec and 8.9+/-1.5sec(p=0.006)respectively. Patients with PDR showed prolongation only in VFT compared to patients with non-proliferative diabetic retinopathy(NPDR). In addition, patients presenting with nonperfusion areas and beading of vessels showed longer prolongation of VFT than of AVP. In conclusion, the VFT is delayed in DR compared to control group and in PDR compared to NPDR. The VFT can be utilized as an indicator of DR to measure the retinal circulation including the peripheral retina.
Diabetic Retinopathy* ; Fluorescein Angiography* ; Fluorescein* ; Humans ; Microcirculation* ; Prospective Studies ; Retina ; Retinaldehyde*

This study was performed to develop a new method, fluorecent leukocyte angiography(FLAG), to measure retinal circulation. Fluorescein-stained leukocytes can be seen in all the retinal vessels during fluorescein angiography using Scanning Laser Ophthalmoscope(SLO FAG) and retinal blood flow can be measured by using leukocyte velocities in the retinal vessels. Methods were followings. Firstly, blood was withdrawn from vein, mixed with fluorescein(10%) and anticoagulant and then centrifuged. The yellowbrown coat layer containing fluorescin-stained leukocytes was selected and injected into the vein while performing SLO FAG. The image of FLAG displayed circulating hyperfluorescent leukocytes clearly in all retinal vessels, and allowed the measurement of leukocyte velocities. In conclusion, FLAG is a new method to measure blood flow in all the retinal vessels simultaneously and can be a useful tool for studying animal and human retinal circulation.
Angiography* ; Animals ; Fluorescein Angiography ; Humans ; Leukocytes* ; Retinal Vessels ; Retinaldehyde* ; Veins

To evaluate the reproducibility in measuring the velocities of perifoveal hyperfluorescent dots, we analyzed fluorescein angiographs of 24 eyes[24 patients]which had central serous retinopathy. Fluorescein angiography was performed with a scanning laser ophthalmoscope[SLO, Rodenstock, Mnchen, Germany]Distances between 5 moving hyperfluorescent dots in a perifoveal capillary were measured at each consecutive frame[interval 1/30 sec]. And then velocities of 5 fluorescent dots were measured with image analysis program by converting the distances to real retinal size using the Littmann's curve in 20 eyes. In the other 4 eyes, the velocities between 5 fluorescent dots of each 2 to 4 capillaries were measured. Perifoveal capillary mean blood flow velocity and standard deviation were 2.08 +/-0.36 mm/sec, and mean coefficient of variation of the velocities measured in a vessel of one patient was 12.58%. However, reliability of the velocities of 2 to 4 capillaries on the 4 eyes was relatively low. In conclusion, the measurement of velocities between perifoveal fluorescent dots with scanning laser ophthalmoscope may be a reproducible method for a perifoveal capillary. However, reliability of measuring velocities was not sufficient enough to use the velocity of one perifoveal capillary as macular blood flow.
Blood Flow Velocity ; Capillaries ; Central Serous Chorioretinopathy ; Fluorescein Angiography* ; Fluorescein* ; Humans ; Ophthalmoscopes* ; Retinaldehyde

To investigate the retinal hemodynamics in chronic primary open angle glaucoma (POAG), high-quality video fluorescein angiograms using a scanning laser ophthalmoscope(SL0 101, Rodenstock, Munich, Germany) were obtained from 22 eyes of 16 patients with POAG and 14 eyes of 14 healthy subjects. From these angiograms, the arm to retinal time (ART), arteriovenous passage time (AvFT), venous fulling time(VFT) and arteriovenous fulling time (AvFT) were quantified. And these parameters of retinal circulation of the group of patients with POAG were compared with those of the age-matched group of healthy subjects. There were no significant differences in the ART between two groups (p=0.09). But significant prolongations of the AvPT, VFT and AvFT of the group of patients with POAG(2.5 +/- 1.1, 8.4 +/- 1.8 and 10.9 +/- 2. sec, respectively) were observed compared to the values (1.8 +/- 0.7, 6.4 +/- 2.2 and 8.1 +/- 2. 4 sec, respectively) obtained among the healthy subjects (p=0.04, p=0.007 and p=0.0008, respectively). These results indicate that a significant retinal microcirculatory deficit exists in the eyes of POAG, and the VFT and AvFT may be good indices of retinal microcirculatory deficit in the eyes of POAG.
Arm ; Fluorescein ; Glaucoma, Open-Angle* ; Hemodynamics ; Humans ; Retinaldehyde

To compare the diagnostic yields and complication rates of transthoracic fine needle aspiration cytology(FNAC) and gun biopsy in the diagnosis of pulmonary mass, a retrospective review was performed in 125 cases. Under the fluoroscopic guide, FNAC was performed by 20G Chiba needle in 91 cases, core biopsy was done by 18.5 G vaccum needle attached with automated biopsy gun in 74 cases and both procedures were done together in 37 cases. Overall sensitivity was 88.4% in FNAC and 87.5% in gun biopsy. For malignant pulmonary tumors, correct type correlation with final diagnosis was obtained in 33(76.7%) out of 43 cases by FNAC and 30(75.0%) out of 40 cases by gun biopsy. For benign pulmonary lesions, there were correct type correlation in 14(35.0%) out of 40 cases by FNAC and 14(53.8%) out of 26 cases by gun biopsy. The complication was pneumothorax and hemoptysis. Pneumothorax occured in 11.1% of FNAC, 10.9% of gun biopsy and 10.9% of both technique, among which chest tube drainages were necessary in one patient by gun biopsy and in three patients by both technique. Although no significant difference of diagnositc accuracy and complication rate was found between FNAC and gun biopsy, gun biopsy was more helpful in the diagnosis of pulmonary benign lesions than FNAC.
Biopsy* ; Biopsy, Fine-Needle* ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Needles ; Pneumothorax ; Retrospective Studies

In an attempt to clarify the protective action of an antioxidant agent against acute toxicity of thioacetamide (TAA) and in order to throw some light on an satisfying concept of the mechanism of its action, a single dose of alphatocopherol (200 mg per kg) was given orally by stomch tube to male mice prior to the administration of thioacetamide in a dose of 200 mg per kg of body weight. Sections of liver samples, obtained from the mice which were sacrificed at intervals of 3, 6, 9, or 12 hours after TAA administration, were stained using the methyl green-pyronin technique. At 3 hours following TAA administration, the pretreatment with alpha-tocopherol inhibited almost completely such alterations of the hepatocytes in the animals given TAA alone, as revealed by loss and clumping of cytoplasmic pyroninophilic granules in the periportal zone of the lobule. At 6, 9, and l2 hours, the prevention of alpha-tocopherol was incomplete in degree and extent. The changes of the hepatocytes were more intense and extensive in the TAA-treated 6 to 12 hour-groups than in the 3 hour-group of TAA-treated ones. Some discussion is given of the mechanism of TAA toxicity, with respect to the microsoma1 lipid peroxidation.
Acetamides/poisoning* ; Animal ; Hepatitis, Toxic/pathology* ; Hepatitis, Toxic/prevention & control ; Liver/pathology* ; Male ; Mice ; Vitamin E/pharmacology* ; Vitamin E/therapeutic use

Carney complex is an autosomal dominant disease that displays such characteristic features as cardiac and cutaneous myxomas and spotty pigmentation of the skin. We report here on a case of Carney complex that was accompanied by increased myxoid fibroadenomas in the breast and multiple intracranial aneurysms.
Adult ; Breast Neoplasms/*complications/diagnosis ; Female ; Fibroadenoma/*complications/diagnosis ; Humans ; Intracranial Aneurysm/*complications ; Magnetic Resonance Imaging ; Pigmentation Disorders/*complications ; Syndrome

BACKGROUND: Intravenous patient controlled analgesia (IV-PCA) is a most common used delivery system for intravenous administration of opioids during acute post operative pain management. The objective of this study is to compare the rate of opioid induced adverse reactions and effectiveness among two IV-PCA opioids, morphine, fentanyl, in laparoscopic cholecystectomy pain management. METHODS: Sixty patients in ASA physical status 1 and 2 scheduled for laparoscopic cholecystectomy were allocated randomly to either morphine IV-PCA used (n = 30, Group M) group or fentanyl IV-PCA used (n = 30, Group F) group. In each group, numerical rating scale (NRS) score, sedation score and incidence of side effect were checked. RESULTS: NRS score of Group F showed lower than that of Group M during PACU and 3 hrs after the recovery room (P < 0.05). There were no significant differences in sedation score among two groups. The incidences of adverse reactions were similar in the two groups, though the incidence of nausea and pruritus were higher in the Group M. CONCLUSIONS: Fentanyl IV-PCA is more advantageous than morphine IV-PCA for laparoscopic cholecystectomy in view of early pain control and adverse reaction incidences.
Administration, Intravenous ; Analgesia, Patient-Controlled ; Analgesics, Opioid ; Cholecystectomy, Laparoscopic ; Fentanyl ; Humans ; Incidence ; Morphine ; Nausea ; Pain Management ; Pruritus ; Recovery Room