No abstract available.
Neck*

Intracranial tuberculomas have been reported occasionally, especially in Asia, though much decreased in recentyears. Those lesions can be diagnosed more easily and acurately using CT than conventional method, including angiography. Authors analysed CT findings of 21 cases, confirmed as tuberculoma, at Hanyang University Hospital from May 1979 to June 1983. The resuslts were as follows; 1. Of all 21 cases, multiple lesions were seen in 14 cases (67%) and single in 7(33%). 2. Of all 21 cases, lesions located only at supratentorial were in 19 cases(90%) and remained 2(10%) had lesions at both supra and infratentorial area. And temporal and parietal lobes were common location (65%) of all lesions. 3. In precontrast scan, density of tuberculoma showed largely isodense (68%)and others were slight high (29%) and low(3%). 4. All lesions were enhanced showed as homogeneous nodular (68%),ring-shaped(29%) and target shaped(3%). 5. All rings were continuous and thickness was largely uniform(67%), anddensity of center of the ring was mainly low(67%). 6. Edema was seen in 58% of all lesions: comparing with thesize of tuberculoma, edema size was smaller in 50%, lager in 33% and almost the same in 17%.
Angiography ; Asia ; Edema ; Methods ; Parietal Lobe ; Tuberculoma ; Tuberculoma, Intracranial

No abstract available.
Lasers, Gas* ; Lasers, Solid-State*

This study was undertaken to identify the causative factors that predispose to early postoperative intestinal obstructions after the radical resection due to colorectal cancer, and to determine their preventive operative techniques. The records of 722 patients that had undergone radical resection due to colorectal cancer at the Department of General Surgery, Kangbuk Samsung Hospital, between January 1, 1986 and December 31, 1995, were reviewed. Among them, operative treatments due to early postoperative intestinal obstructions were performed in 39 patients(5.4%). The most common cause of intestinal obstruction in early postoperative period was bowel adhesion, that was developed in 20 cases(51.3%), and next common cause was internal herniation of bowel into the space between colostomy loop and lateral peritoneal wall(3 cases, 7.7%), incarcerated herniation of small bowel into the reperitonealized pelvic cavity(3 cases, 7.7%), pelvic abscess(1 case, 2.6%), and unknown causes(9 cases, 23.1%) in descending frequency. Use of closed suction drains was responsible to development of the 3rd and 4th causes. As a result, during the radical resection due to colorectal cancer, meticulous manupulation of bowels not to injure the bowel serosa, reperitonealization of pelvic floor at narrow interval with inversion of its dissected edge, complete closure of the space between colostomy loop and lateral wall of peritoneum, and adequate alternative use of closed suction drain and natural drain according to the operative condition, should be considered. In conclusion, surgeons should pay more attention to the operating procedures to lower the incidence of early postoperative intestinal obstruction.
Colorectal Neoplasms ; Colostomy ; Humans ; Incidence ; Intestinal Obstruction* ; Pelvic Floor ; Peritoneum ; Postoperative Period ; Serous Membrane ; Suction

This study was performed to examine 1) Whether hypothermic cardiac arrest produces myocardial HSP72 expression; 2) And if, whether it serves to protect the heart against the subsequent hypothermic arrest. In the present study, neonatal rats were placed in an icebath to induce hypothermia. To determine whether hypothermic cardiac arrest produces myocardial HSP72, experimental animals were subjected to 10-min hypothermic insult before the extraction of the heart. The intervals between the insult and extraction were 1 (1 HR), 4 (4 HR), 8 (8 HR), 24 (24 HR) or 72 (72HR) hours. A minimal amount of HSP72 was detected in control, 1 HR and 72 HR groups. In contrast, 8 HR and 24 HR groups showed a significant level of HSP72 expressions. To assess the cardioprotective effect of HSP72 against hypothermic cardiac arrest, we compared the proportion of recovery from the arrest between control and preconditioned (PREC) animals. Control animals were subjected to 20-min hypothermic insult, while PREC group was preconditioned by 10-min hypothermic insult 8 hours before the 20-min test hypothermic insult. Resuscitation rate from cardiac arrest induced by the 20-min hypothermic insult in PREC group was significantly higher than that in controls. These results suggest that the cardioprotective effect of hypothermic preconditioning is associated with an increase in HSP72 expression.
Animals ; Heart ; Heart Arrest ; Hypothermia ; Incidence* ; Rats* ; Resuscitation

OBJECTIVE: To assess several variables that are known as the risk factor of preeclampsia. METHODS: We have studied with 279 pregnant women who were diagnosed with preeclampsia and went through delivery in Chungnam University from January, 1998 to December, 2002. For control group, we chose 364 non-hypertensive pregnant women who went through delivery from January, 2002 to December, 2002 through random process. Through reviewing each patient's chart, we collected data regarding age, parity, past medical history, past obstetric history, family history, presence of gestational diabetes, height, body weight, before and at the time of delivery, delivery mode and neonatal outcomes. Statistical analysis was performed using x2-test, Student t-test. A value of p below 0.05 was considered to show statistical significance. RESULTS: During the study period, 298 women had preeclampsia so that the incidence of preeclampsia was 6.0%. Age and past medical history were not related to preeclampsia. The primiparous women in this study are likely to show a higher incidence of preclampsia (OR 1.35, 95% CI 1.16-1.5, p=0.017). In addition, women whose BMI are ranged from 25.0 kg/m2 to 30.0 kg/m2 (p=0.027), and ranged from 30.0 kg/m2 to 40.0 kg/m2 (p=0.027) had a higher incidence of preeclampsia. By using a multiple logistic regression analysis about the BMI changes, we found out that there was a higher rate of preeclmapsia among pregnant women with over 7.11 kg/m2 BMI increasement compared with BMZ before pregnancy (OR=2.97, 95% CI 2.22-3.99, p<0.05). Finally, women who had previous preeclmapsia were in a higher reoccurrence. According to the study, those who have hypertensive family history and twin gestation showed significantly higher risk in the incidence of preeclampsia as 1.92 fold (95% CI 1.38-2.66 and 2.61 fold (95% CI 1.29-5.29) retrospectively. CONCLUSION: Women with primiparity, BMI>or=25.0 kg/m2, previous preeclampsia, family history of chronic hypertension, twin gestation showed an increased risk of preeclampsia.
Body Height ; Case-Control Studies* ; Chungcheongnam-do ; Diabetes, Gestational ; Female ; Humans ; Hypertension ; Incidence ; Logistic Models ; Parity ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Risk Factors*

Blood flow restoration to ischemic zone of the heart is essential to salvage of ischemic tissue. However, there is a large body of evidence documenting that the reperfusion can induce reperfusion injury like reperfusion-induced malignant arrhythmias. In the present study, employing a cat model of regional cardiac ischemia, we examined if reperfusion rendered in a gradual fashion could lower the incidence of reperfusion-induced ventricular fibrillation (VF), which usually precipitated within a few to several tens of seconds after abrupt reperfusion. The experiments were conducted with male mongrel cats (n=46, 2.5-5 kg). The animals in the control and 30 MIN groups were subjected to an episode of 20- and 30-min left anterior descending coronary artery occlusion, respectively, followed by abrupt reperfusion. The animals in 5 G and 10 G groups received gradual reperfusion over a 5- and 10-min period, respectively, following a 20-min occlusion. The proportion of animals that exhibited VF during the reperfusion phase was 11/15 in the control, 7/10 in the 30 MIN, 5/10 in the 5 G and 2/11 in the 10 G groups. The incidence of VF in the 10 G group was significantly lower than that in the control or 30 MIN group subjected to abrupt reperfusion. These results suggest that the gradual reperfusion is a useful procedure against reperfusion-induced VF.
Animals ; Arrhythmias, Cardiac ; Cats* ; Coronary Vessels ; Heart ; Humans ; Incidence* ; Ischemia* ; Male ; Reperfusion Injury ; Reperfusion* ; Transcutaneous Electric Nerve Stimulation ; Ventricular Fibrillation*

PURPOSE: To assess the usefulness of cardiac MR imaging (MRI) in the diagnosis of acute myocardial infarction and in the assessment of myocardial viability in comparision with Tl-201 SPECT. MATERIALS AND METHODS: We retrospectively studied 17 patients who complained of chest pain and dyspnea with cardiac MRI . The patients were evaluated for the presence or absence of high signal intensity on T2-weighted image (T2WI), abnormal wall motion on 2D - FIESTA, perfusion defect on Gd-DTPA enhanced T1WI, and delayed myocardial enhancement on 15-minutes delay Gd-DTPA enhanced T1WI. The results were correlated with the images on Tl-201 SPECT, taken at rest and stress, through which reversibility of perfusion defect was assessed. RESULTS: Both cardiac MRI and Tl-201 SPECT proved to be useful methods for diagnosing acute myocardial infarction. In order of decreasing correspondence, T2WI, Tl-201 SPECT, delayed enhancement study, and wall motion images all showed significant statistical correlation with the clinical diagnosis of myocardial infarction. Perfusion MRI, on the other hand, showed no significant statistical difference was found between Tl-201 SPECT and cardiac MRI. The results on T2WI showed high accordance with those on Tl-201 SPECT, while delayed myocardial enhancement and wall motion studies showed no agreement with Tl-201 SPECT. CONCLUSION: Cardiac MRI is useful method for diagnosis of acute myocardiac infarction. With respect to the assessment of myocardial viability, the results obtained on cardiac MRI showed high agreement with those on Tl-201 SPECT. However, further study is necessary at this point for standardization and establishment of the methods for assessing myocardial viability on cardiac MRI.
Chest Pain ; Diagnosis ; Dyspnea ; Gadolinium DTPA ; Hand ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Myocardial Infarction* ; Perfusion ; Retrospective Studies ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: The purpose of this study was to describe the clinical and imaging features of metastatic bone tumors with sunburst periosteal reaction and to define the characteristic findings which would be helpful for differentiating metastatic bone tumors from primary malignant bone tumors. MATERIALS AND METHODS: The authors retrospectively reviewed the cases of nine patients with pathologically confirmed metastatic bone tumors with sunburst periosteal reaction, for which imaging studies (plain radiographs [n=9], radioisotope [RI] scans [n=4], magnetic resonance [MR] images [n=6], and computed tomographic [CT] scans [n=4]) were performed. The imaging studies of each lesion were analyzed by two musculoskeletal radiologists focusing on the metastatic site, patterns of bone response, signal intensity characteristics and pattern of contrast enhancement on MR. The clinical records of the patients were reviewed with regard to the age and sex of the subjects, the clinical presentation, and the origin of the primary tumors. RESULTS: The cases consisted of six men and three women, whose mean age was 62 years (age range, 50-88 years). The primary tumors were adenocarcinoma of the stomach [n=4], adenocarcinoma of the lung [n=2], adenocarcinoma of the prostate [n=1], hepatocellular carcinoma of the liver [n=1], and adenocarcinoma of unknown origin [n=1]. The sites of metastatic involvement exhibiting sunburst periosteal reaction were the scapula [n=2], proximal humerus [n=2], rib [n=1], iliac bone [n=1], tibia [n=1], spine [n=1], and proximal phalanx [n=1]. In all patients, the imaging findings showed osteolytic [n=3] or osteoblastic [n=6] lesions with sunburst periosteal reaction. In six cases, the lesions were iso-intense on the T1-weighted images and heterogeneously hyperintense on the T2-weighted images. The gadolinium-enhanced T1-weighted images showed a nearly homogenous enhancement of the lesions without any central necrotic portion. CONCLUSION: Although metastatic bone tumor exhibiting sunburst periosteal reaction is rare, it should be included along with primary malignant bone tumors in the differential diagnosis of bone lesions with sunburst periosteal reaction, especially in older patients with or without a known primary malignancy.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Diagnosis, Differential ; Female ; Humans ; Humerus ; Liver ; Lung ; Male ; Osteoblasts ; Prostate ; Retrospective Studies ; Ribs ; Scapula ; Spine ; Stomach ; Tibia

PURPOSE: Peritoneal metastasis is a crucial factor for the prognosis in gastric cancer, but its diagnosis is difficult before laparotomy. This study analyzed the usefulness of diagnostic imaging and various tumor markers in the detection of peritoneal metastasis in gastric cancer. MATERIALS AND METHODS: The sera from 768 patients with gastric cancer were measured for CEA, CA19-9 and CA125 levels using a commercial immunoradiometric assay. All the patients underwent diagnostic imaging with computed tomography (CT) and ultrasound (US) before laparotomy. RESULTS: Preoperative levels of CEA, CA19-9 and CA125 were above the cut-off levels in 15.4%, 8.7% and 5.7% of all cases, respectively. Eighty-eight patients were diagnosed with peritoneal metastasis by laparotomy. CT and US revealed peritoneal dissemination in 15 of 88 patients (17%). Among the three tumor markers, CA19-9 and CA125 showed similar detection rates of peritoneal metastasis (37.5% and 38.6%, respectively). In particular, the serum CA125 levels showed the best sensitivity (38.6%), specificity (98.4%), and diagnostic accuracy (91.5%), and the highest odd ratio (24.46, 95% CI: 11.17~53.57) for predicting peritoneal metastasis among the markers tested. CEA did not add significant predictive information (p=0.471). CONCLUSION: Preoperative serum CA19-9 and CA125 levels may provide a predictable value in determining peritoneal metastasis in patients with gastric cancer.
Diagnosis ; Diagnostic Imaging ; Humans ; Immunoradiometric Assay ; Laparotomy ; Neoplasm Metastasis* ; Prognosis ; Sensitivity and Specificity ; Stomach Neoplasms ; Biomarkers, Tumora ; Ultrasonography