PURPOSE: To analyze contrast-enhancement pattern of stomach cancer on dynamic MRI and to verify the efficacy of intravenous contrast agent in the evaluation of stomach cancer. MATERIALS AND METHODS: Twelve patients with proven stomach cancer underwent dynamic MRI, By using 1.0T scanner, we obtained precontrast FLASH images, and 30, 60, 90 second delay FLASH images after intravenous contrast injection. All patients ingested on liter of water and had intramuscluar injection of Buscopan just before MR study. For quantitative analysis we measured signal to noise ratio (S/N) of stomach cancer on each image, and signal difference to noise ratio (SD/N) between cancer and intraluminal fluid, cancer and the pancreas. For qualitative analysis two radiologists evaluated lesion conspicuity on each image by grading system(grade 0, 1, 2, 3: poor, fair, good, excellent). RESULTS: S/N of stomach cancer increased gradually by time(precontrast, 30, 60, 90 second delay:38.7, 42.5, 57.4, 65.7). SD/N between cancer and intraluminal fluid significantly increased after contrast enhancement(1.24, 25.01, 39.30, 45.89). SD/Ns between cancer and the pancreas were 10.5, 9.33, 9.99, 10.66 respectively. In qualitative analysis, precontrast images were better than postcontrast images for delineation of stomach cancer, Postcontrast images showed clear endo-luminal side of stomach cancer, but outer margin of stomach cancer was more distinct on precontrast images. CONCLUSION: Precontrast MR images are better than postcontrast MR images in the depiction of stomach cancer. Intravenous contrast agent is not imperative in the evaluation of stomach cancer.
Butylscopolammonium Bromide ; Humans ; Magnetic Resonance Imaging* ; Noise ; Pancreas ; Signal-To-Noise Ratio ; Stomach Neoplasms* ; Water

Ganglioneruroblastoma and neuroblastoma are among commonest types of childhood malignancy and a number of unique paraneoplastic syndromes have associated with both localized and disseminated neuroblastoma. The coincidence of neuroblastoma and myoclonic encephalopathy or other paraneoplastic syndromes occurs relatively rare, and therefore, failure to recognize this association could result in delays in both diagnosis and treatment, and the result could prove to be unfortunately fatal. The mechanism which underlies the remote damaging effect of neural crest tumor, especially neuroblastoma, on the nervous system resulting in myoclonic encephalopathy is by no means clear. In addition the nature and the extent of the pathologic lesion are inconsistent. We experienced a case of myoclonic encephalopathy associated with an occult mediastinal ganglioneuroblastoma in a 22-month-old girl who was hospitalized for inability to walk without support and tilting of the head to the left side. She became increasingly ataxic, and during the hospitalization myoclonic jerks of upper extremities and head along with chaotic, rapidly flickering, multidirectional spontaneous eye movements, were noted. Laboratory data included normal complete blood count, urinalysis, BUN and creatinine, electrolytes and bone marrow. Chest X-ray and chest CT revealed a relatively well marginated right posterior mediastinal mass. In a 24 hours urine excretion test, VMA and catecholamines were increased. Over the next 2 weeks, a surgical exploration revealed a right posterior mediastinal mass. Microscopically the mass proved to be a ganglioneuroblastoma, extending to right innominate artery and right axillary lymph nodes. Within 2 weeks after the surgery, radiotherapy (2,400 rads) and chemotherapy (CTX, DTIC, VCR) were started, but corticosteroid was not used. She has been free of tumor and abnormal neurological systemic symptoms and signs for 1 1/2 year since the completion of chemotherapy. In the 3 1/2 years follow-up period, her neurologic symptoms has completely resolved by the completion of 2 years chemotherapy. We report a case of mycoclonic encephalopathy associated with hidden ganglioneuroblastoma in 22-month-old girl.
Blood Cell Count ; Bone Marrow ; Brachiocephalic Trunk ; Catecholamines ; Creatinine ; Dacarbazine ; Diagnosis ; Drug Therapy ; Electrolytes ; Epilepsies, Myoclonic* ; Eye Movements ; Female ; Follow-Up Studies ; Ganglioneuroblastoma* ; Head ; Hospitalization ; Humans ; Infant ; Lymph Nodes ; Myoclonus ; Nervous System ; Neural Crest ; Neuroblastoma ; Neurologic Manifestations ; Paraneoplastic Syndromes* ; Radiotherapy ; Thorax ; Tomography, X-Ray Computed ; Upper Extremity ; Urinalysis

PURPOSE: To verify the usefulness of left portal vein angle (LPVA) on CT scan in the diagnosis of liver cirrhosis and to compare its diagnostic value with that of caudate to right lobe ratio (C/RL ratio). MATERIALS AND METHODS: LPVA, an angle formed by a vertical line and a line connecting the center of the vertebral body to the umbilical point of the left portal vein, and C/RL ratio were measured on CT scans of 100 cirrhotic and 100 normal livers. Diagnostic values of LPVA and C/RL ratio were compared statistically. RESULTS: The mean of LPVA was 18.9 degrees(SD; 7.6) for normal livers and 25.8 degreesSD; 8.4) for cirrhotic livers (P<0.001). The mean of C/RL ratio was 0.47(SD; 1.10) for normal livers and 0.58(SD;0.14) for cirrhotic livers (P<0.001). When LPVA was greater than 30 degreesliver cirrhosis was diagnosed with 36% sensitivity and 92% specificity. When C/RL ratio was greater than 0.60, the diagnose of liver cirrhosis was with 41% sensitivity and 90% specificity. There was no significant difference of the diagnostic accuracy between LPVA and C/R L ratio in ROC analysis. CONCLUSION: Both LPVA and C/RL ratio are useful diagnostic indices of liver cirrhosis on CTscan. LPVA is more convenient to measure than C/RL ratio.
Diagnosis* ; Fibrosis ; Liver Cirrhosis* ; Liver* ; Portal Vein* ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

BACKGROUND: Knowledge of bile duct anatomy is largely obtained through cholangiography. However, it is sometimes difficult to follow the intrahepatic segmental bile ducts and to define the extent of pathology precisely. Basically, the images on cholangiography are projected ones, so they do not provide the spatial concept. In contrast, sequential slices of CT contain information on the threedimensional structure. Purpose : We aimed to assess the intrahepatic bile duct anatomy by examining the CT. METHODS: The spiral CT images of 42 patients with bile duct dilatation were examined serially from above downward. Intrahepatic bile ducts were followed up to the third-order branches, classified according to the level of branching and compared with those on cholangiography. Further, the relationship between the segmental bile ducts and portal veins were evaluated. RESULTS: At or below the level of convergence of the ventral(V) and dorsal(D) branches of VIII segment, the posterior bile duct(Bp) arises from right or common hepatic duct(VDP, or VD-P). Below this level, the Bp descends more than 8mm and branches into VI segmental branch(B6) and the posterior trunk(Pr), or it branches directly into B6 and Pr without definite descending portion(Pd). VDP-Pd- Pr,B6(high level of branching of Bp with Pd) was observed in 22, VDP-Pr,B6(high level of branching of Bp without Pd) in 3, VD-P-Pd-Pr,B6(low level of branching of Bp with Pd) in 12, and VD-P-Pr,B6(low level of branching of Bp without Pd) in 4. These findings were closely correlated with those on cholangiography. Regarding the relationship of the segmental bile ducts and portal veins(PV), all right anterior bile ducts were located superior-medial to the PV, and the trunk of right posterior bile duct(Pr) ran superior-lateral to PV in 38 and superior-medial in 4 patients. Most segmental branches of VI and VII segments ran anterior-lateral-superior to PV(VI:39/40, VII:17/18). The Bp coursed above(and behind) the right anterior portal vein(APV) in 39, and below(and in front of) the APV in 3, of which 2 cases had separate and low origin of Bp from common hepatic duct. CONCLUSION: CT was useful to understand intrahepatic bile duct anatomy.
Bile ; Bile Ducts ; Bile Ducts, Intrahepatic* ; Cholangiography ; Dilatation ; Hepatic Duct, Common ; Humans ; Pathology ; Portal Vein ; Tomography, Spiral Computed

This study was designed to evaluate the potential applicability of magnetic resonance imaging (MRI) for the diagnosis of acute renal vein thrombosis. Renal vein thrombosis was experimentally induced by surgical ligation of the left renal vein in a total of 21 rabbits. MRI was performed with a 0.5 Tesla superconductive magnetic system. Spin echo technique was used with varying TR and TE parameters. Spin echo images of the rabbit kidney were analysed for morphology and signal intensity. T1 and T2 relaxation times of the renal cortex and medulla were calculated from the images. After venous ligation, kidneys became enlarged. Low signal band along the outer medulla in T2 weighted images were characteristically shown from 1 hour to 3 days after ligation, Changes of cortex to medullar contrast (CMC) values were significant (p<0.05) in T1 - and T2- weighted images of the ligated side. T1 and T2 relaxation times were significantly prolonged (p<0.05) on the ligated side, both in the cortex and medulla from 1 hour to 2 weeks after the ligation, while T2 relaxation time on the contralateral side was significantly prolonged both in the cortex and medulla 2 weeks after venous ligation. The most useful MRI criteria for the diagnosis of renal vein thrombosis were enlarged renal size, and the low signal band along the outer medulla of ligated kidney. The relative intensity difference between cortex and medulla (CMC) in T1-and T2-weighted images, and T1 and T2 relaxation times were suggested to be the useful MR parameters for the diagnosis of acute renal vein thrombosis.
Diagnosis ; Kidney* ; Ligation* ; Magnetic Resonance Imaging* ; Rabbits ; Relaxation ; Renal Veins* ; Thrombosis

This study was designed to evaluate the potential applicability of magnetic resonance imaging (MRI) for the diagnosis of acute renal vein thrombosis. Renal vein thrombosis was experimentally induced by surgical ligation of the left renal vein in a total of 21 rabbits. MRI was performed with a 0.5 Tesla superconductive magnetic system. Spin echo technique was used with varying TR and TE parameters. Spin echo images of the rabbit kidney were analysed for morphology and signal intensity. T1 and T2 relaxation times of the renal cortex and medulla were calculated from the images. After venous ligation, kidneys became enlarged. Low signal band along the outer medulla in T2 weighted images were characteristically shown from 1 hour to 3 days after ligation, Changes of cortex to medullar contrast (CMC) values were significant (p<0.05) in T1 - and T2- weighted images of the ligated side. T1 and T2 relaxation times were significantly prolonged (p<0.05) on the ligated side, both in the cortex and medulla from 1 hour to 2 weeks after the ligation, while T2 relaxation time on the contralateral side was significantly prolonged both in the cortex and medulla 2 weeks after venous ligation. The most useful MRI criteria for the diagnosis of renal vein thrombosis were enlarged renal size, and the low signal band along the outer medulla of ligated kidney. The relative intensity difference between cortex and medulla (CMC) in T1-and T2-weighted images, and T1 and T2 relaxation times were suggested to be the useful MR parameters for the diagnosis of acute renal vein thrombosis.
Diagnosis ; Kidney* ; Ligation* ; Magnetic Resonance Imaging* ; Rabbits ; Relaxation ; Renal Veins* ; Thrombosis

The incidence of thyroid cancer has been rapidly increased in Korea. Although fine needle aspiration cytology is recommended for diagnosis of cancer, there are some limitations. Patients with indeterminate or suspicious cytology category in which malignancy cannot be ruled out usually undergone a thyroidectomy, however, only 10~25% of them finally diagnosed as cancer. According to the progress in understanding molecular mechanism, some mutations or other molecular alterations have been studied for the diagnostic and prognostic markers for thyroid cancer. The majority of papillary thyroid cancers have BRAF and RAS mutations or RET/PTC rearrangement, and approximately 80% of follicular thyroid cancers harbor a RAS mutation or PAX8/PPARgamma rearrangement. These genetic alterations are mostly studied and current clinical guidelines suggested that these molecular markers may help management for patients with indeterminate cytology. In addition, recent studies demonstrated the high sensitivity and specificity of thyroid-stimulating hormone receptor mRNA in diagnosing cancer in patients with indeterminate cytology. For the detection of recurrent or residual thyroid cancer, serum thyroglobulin is the only circulating marker in clinical practice. However, it lacks sensitivity and is unreliable specifically in the presence of antibodies to thyroglobulin. Recent studies demonstrated a significant role of measuring the mRNA of thyroglobulin, thyroid peroxidase, thyroid-stimulating hormone receptor, and sodium/iodine symporter in peripheral blood for monitoring of the recurrence of thyroid cancer.
Antibodies ; Biopsy, Fine-Needle ; Humans ; Incidence ; Iodide Peroxidase ; Ion Transport ; Korea ; Recurrence ; RNA, Messenger ; Sensitivity and Specificity ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin

No abstract available.
Ammonium Compounds* ; Corpus Callosum

OBJECTIVES: The dopamine-blocking effects and the associated side effects(amenorrhea, lactation, sexual dysfunct of classical antipsychotics in schizophrenic patients have been studied for a long time. The purpose of this study to find out these effects of new antipsychotics(risperidone, olanzapine) in schizophrenic patients treated with clinical relevant doses. METHOD: Plasma levels of both prolactin and testosterone were measured in 91 schizophrenic patients(28 taking haloperidol, 4-20mg/day ; 31 taking risperidone, 2-6mg/day/ 32 taking olanzapine, 5-20mg/day). RESULTS: In male schizophrenic patients, the prolactin levels of risperidone group(76.44+/-38.85ng/ml) and haloperidol group(60.26+/-20.74ng/ml) had no significant difference, but were significantly higher than that of olanzapine(26.90+/-5.36ng/ml). In female, the prolactin level of olanzapine group(36.66+/-17.55) was significantly lower than those of risperidone(121.7+/-.33) and haloperidol group(161.66+/-37.53). And prolactin level of risperdone group was lower than that of haloperidol group. While the testosterone plasma level of risperidone, haloperidol and olanzapine in both male and female schizophrenic patients had no significant difference. CONCLUSIONS: At doses known to be effective in popular clinical setting, prolactin level in patients taking risperidone we higher than that of haloperidol, while olanzapine showed no significant difference in terms of prolactin plasma level haloperidol. New antipsychotics may not influence the testosterone plasma level.
Antipsychotic Agents* ; Female ; Haloperidol ; Humans ; Lactation ; Male ; Plasma ; Prolactin* ; Risperidone ; Testosterone*

OBJECTIVE: Nonstress test(NST) has become an important method of antepartum evaluation of fetal well-being. The fetal heart rate(FHR) testing is used frequently as a nonstress test(NST). However, NST highly depends on whom to interpret the result of FHR testing. Recently, for interpretation of FHR, objective decision methods using softwares have been introduced. In this study, we aim to analyse the correlation between each variable affecting FHR and fetal outcome using objective decision basis with principal component analysis and multiple regression analysis. MATERIALS AND METHODS: The clinical observation was made on 5,314 data from pregnant women who took a NST which had been collected from 1989 to 1997 at Hanyang University Hospital. For collection of data and values of each variable, we used our own FHR interpretation softwares, HYFM-I(DOS version, 1989) and HYFM-II(Window-version, 1998). Then, the principal component analysis is performed to find significant variable and multiple regression analysis using these variables. RESULTS: Each groups were divided and classified as followings ; 1 minute Apgar score-normal, 1 minute Apgar score-abnormal, 5 minute Apgar score-nomal, 5 minutes Apgar score-abnormal; there is significant difference between signal loss and 1 minute Apgar score only. And significant difference was shown between mean baseline FHR, FHR variability-amplitude, FHR variability-MMR, and fetal outcomes(body weight of newborn & Apgar score). The FHR variability-amplitude, FHR variability-MMR, and weight of baby were important values in predict of fetal well-being. CONCLUSIONS: In conclusion, there are close relation in each variable of FHRand fetal outcome. The result of this study would be useful background data in the development of objective and automated FHR analysis software, especially in the computerized FHR analysis system.
Apgar Score ; Female ; Fetal Heart* ; Heart Rate, Fetal* ; Humans ; Infant, Newborn* ; Pregnancy ; Pregnant Women ; Principal Component Analysis