CT has been advocated as an adjunct to conventional radiography in the evaluation of pelvic bone fractures andtraumatic dislocations of the femoral head. Author compared and analysed the CT and plain radiographic findings of3 consecutive adult patients in whom acetabular or femoral head injuries were suspected or demonstrated on initialradiographs. The results were as follows; 1. CT was convenient and precise method in evaluation the patient withhip trauma. 2. CT was helpful in detecting intraaraticular osseous fragment, interposed soft tissue, and wideningof the joint space which was not evident on plain radiographs. 3. CT permitted better evaluation of asociatedinjuries in soft tissue and viscera in the plevic and retroperitoneal cavity, and also gave information aboutother associated fractures. 4. CT was superior for the evaluation of posterior acetabular rim and medial portionof the acetabulum. 5. CT was helpful for evaluating the presence or absence of intraarticular osseous fragmentsafter reduction of the dislocated hip.
Acetabulum ; Adult ; Craniocerebral Trauma ; Dislocations ; Head ; Hip ; Humans ; Joints ; Methods ; Pelvic Bones ; Radiography ; Viscera

CT of the laynx represents a major advance in laryngology, Even in severe injury the larynx can be examinedeasily and conveniently by CT at the same times the brain and facial structures without moving the patient, whoneed only lie down and breathe quietly during the study. CT permitted a much more detailed appraisal of layrngealdysfunction in patients with blunt laryngeal trauma (3 cases) and strangulation injury (2 cases). CT of the larynxundoubtedly played a determinant role in patient management. CT was helpful in evaluating the laryngeal cartilagesand deep spaces of the larynx wthich was difficult to examine by the laryngoscope. Follow-up CT made it possibleto evaluate the postoperative results.
Brain ; Follow-Up Studies ; Humans ; Laryngoscopes ; Larynx ; Otolaryngology

A series of 25 patients with residual, recurrent, and unresectable gastric cancer received various combination of surgery, radiotherapy (RT), chemotherapy (CT), and hyperthermia (HT). They were placed into 7 categories; 1) CT and HT-14 patients; 2) RT and HT-15 patients; 3) surgery, RT and HT-2 patients; 4) surgery, RT, HT and CT-1 patient; 5) RT, HT and CT-1 patient; 6) RT and CT-1 patient; 7) RT alone-1 patient. Three patients had curative resection. 21 patients received irradiation with tightly contoured portals to spare as much small bowel, kidney and marrow as possible. Hyperthermia was applied regionally once or twice a week for 23 patients using 8 MHz radiofrequency capacitive heating device (Thermotron RF-8). HT was given approximately 30 min after RT. 7 patients were treated with CT: 4 patients received HT and concomitant Mitomycin-C; 3 patients received HT and sequential 5-FU+Adriamycin+Mitomycin-C. There was not any treatment related deaths. There was also no evidence of treatment related problems with liver, kidney, stomach, or spinal cord except only one case of transient diabetic ketoacidosis. The tumor response was evaluable in 22 patients. None achieved complete remission. 11(50%) achieved partial remission. The response rate was correlated with total radiation dose and achieved maximum temperature. 9 of 14 (64%) received more than 4000 cgy showed partial remission; especially, all 3 patients received more than 5500 cgy achieved partial response. 8 of the 12 patients (67%) who achieved maximal temperature more than 41degrees C showed partial response in comparing with 25% (2 of 8 patients, below 41degrees C). The numbers of HT, however, was not correlated with the response. 3 of the 25 patients (12%) remain alive. The one who was surgically unresectable and underwent irradiation alone is in progression of the disease with distant metastases. The remaining two patients with curative resection are alive with free of disease, 24 and 35 months, respectively. The median survival by response are11.5 months in responders and 4.6 months in non-responders.
Bone Marrow ; Diabetic Ketoacidosis ; Drug Therapy ; Fever ; Heating ; Hot Temperature ; Humans ; Kidney ; Liver ; Mitomycin ; Neoplasm Metastasis ; Radiotherapy ; Spinal Cord ; Stomach ; Stomach Neoplasms

No abstract available.
Stents

From January 198e to September 1990,7 patients with carcinoma of the extrahepatic biliary system received external radiaiton therapy combined with hyperthermia. of the 3 patients with extrahepatic bile duct cancer, two were primary cholangiocarcinoma and one was metastatic peripancreatic carcinoma. Of the 4 patients with carcinoma of the gallbladder, two were locoregionally advanced and unresectable carcinoma and the remaining two were local-regional recurrence after cholecystectomy. They were all pathologicallly proven adenocarcinoma. The radiation dose received ranged from 3000 cGy/2weeks to 5040 cGy/ 7weeks. The hyperthermia was done once or twice a week and 4 to 12 sessions in total. The tumor response was confirmed by T-tube cholangiography, percutaneous transhepatic cholangiography and CT scan. 6 out of 7(86%) showed partial regression of the tumor. The median survival time was 7 months (range 4~11 Months). 6 out of 7 patients were dead : one died of septicemia, 4 of primary disease, one of distant metastases. Only one out of 7 patients is still alive but new metastatic lesion was found. There was not any treatment related deaths. There was also no evidence of treatment related problems with liver, stomach and duodenum, although the observation period was short.
Adenocarcinoma ; Bile Duct Neoplasms ; Bile Ducts, Extrahepatic* ; Cholangiocarcinoma ; Cholangiography ; Cholecystectomy ; Duodenum ; Fever* ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Liver ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Sepsis ; Stomach ; Tomography, X-Ray Computed

This experimental study was conducted to evaluate the effect of indomethacin and methylprednisolone on PAN-induced nephrosis in rats. Sprague-Dawley rats weighing 150~200gm were used and divided into controls, group I (PAN intraperitoneally), group II(PAN intraperitoneally, followed by indomethacin peritoneally for 12 days), group III (PAN intraperitoneally, followed by methylprednisolone peritoneally for 12 days) and group IV (PAN intraperitoneally, followed by cyclosporin subcutaneously for 12 days). Twenty four-hour urinary protein excretion was measured on day 0, 5, 10 and 17. On the 17th day, rats were sacrificed for the determination of total serum protein, albumin and cholesterol levels. Foot process widths of glomerular epithelial cells were measured, and anionic sites of lamina rara externa were determined by using PEI as cationic probes. The following results were obtained. Twenty four-hour urinary protein excretion (mg/day) of group I was significantly increased to 455.7+/-188.8 on the 5th day compared to 15.2+/-3.7 on day 0 (p<0.01), and increased gradulally to 525.6+/-203.5 on the 10th day, then decreased to 280.6+/-25.2 on the 17th day. In group III, 24 hr urinary protein excretion on 17 th day (180.7+/-64.5) was significantly lower than that of group I (280.6+/-25.2). Total serum protein of group III was significantly lower than that of group I, and serum albumin and cholesterol did not show any significant difference among Group I, II, III and IV. Foot process widths (nm) of glomerular epithelial cells in group I, II, III and IV were 409.5+/-15.2, 387.8+/-49.2, 279.9+/-36.9 and 398.3+/-38.3, respectively. And the value of group of group III was significantly lower than that of group I (p<0.01). The number of anionic sites per 1micrometer length of glomerular basement membrane in Group I, II, III and IV were 10.3+/-1.3, 10.1+/-1.6, 12.5+/-1.5and 10.2+/-1.5, respectively. And the value of group III was significantly lower than that of group I (P<0.01). In conclusion, cyclosporin and indomethacin did not show any significant effect on PAN nephrosis in rat. However, methylprednisolone reduced the urinary protein excretion and showed significant recovery of foot process widths and number of anionic sites of glomerular basement membrane.
Animals ; Cholesterol ; Cyclosporine* ; Epithelial Cells ; Foot ; Glomerular Basement Membrane ; Indomethacin* ; Methylprednisolone* ; Nephrosis* ; Nephrotic Syndrome ; Rats* ; Rats, Sprague-Dawley ; Serum Albumin

The effect of local hyperthermia of 41 to 43degree C for 30 minutes on radiosensitivity of normal tissue was studied utilizing jejunal crypt microcolony assay. Hyperthermia of this range enhanced the radiation effect and the effect was mainly additive without significant effect on the slopes of cell survival curves. At the isoeffect level of 20 microcolony formation, the thermal enhancement ratio was 1.02, 1.10 and 1.39 for 41degree 42degreeand 43degree C, respectively. The distribution of microcolony formation along the circumference of jejunum was not uniform, having more colonies around the mesenteric border, and this suggests the effect of uneven cooling by blood circulation.
Animals ; Blood Circulation ; Cell Survival ; Fever* ; Hyperthermia, Induced ; Jejunum* ; Mice* ; Radiation Effects ; Radiation Tolerance

No abstract available.
Peripheral Vascular Diseases*

PURPOSE: To evaluate the effect on surface dose due to Aquaplast used for immobilizing the patients with head and neck cancers in photon beam radiotherapy. MATERIALS AND METHODS: To assess surface and buildup region dose for 6MV X-ray from linear accelerator(Siemens Mevatron 6740), we measured percent ionization value with the Markus chamber model 30-329 manufactured by PTW Frieburg and Capintec electrometer, model WK92. For measurement of surface ionization value, the chamber was embedded in 25 X 25 X 3 cm3 acrylic phantom and set on 25 X 25 X 5 cm3, polystyrene phantom to allow adequate scattering. The measurements of percent depth ionization were made by placing the polystyrene layers of appropriate thickness over the chamber. The measurements were taken at 10 cm SSD for 5 X 5 cm2 , 10 X 10 cm2 , and 15 X 15 cm2 field sizes, respectively. Placing the layer of Aquaplast over the chamber, the same procedures were repeated. We evaluated two types o Aquaplast: 1.6mm layer of original Aquaplast(manufactured by WFR Aquaplast Corp.) and transformed Aquaplast similar to moulded one for immobilizing the patients practically. We also measured surface ionization values with blocking tray in presence or absence of transformed Aquaplast. In calculating percent depth dose, we used the formula suggested by Gerbi and khan to correct overresponse of the Markus chamber. RESULTS: he surface doses for open fields of 5 X 5 cm2 , 10 X 10 cm2 , 15 X 15 cm2 were 7.9%, 13.6%, and 18.7% respectively. He original Aquaplast increased the surface doses upto 38.4%, 43.6% and 47.4% respectively. There were little differences in percent depth dose values beyond the depth of Dmax. Increasing field size, the blocking tray caused increase of the surface dose by 0.2%, 1.7%, 3.0% without Aquaplast, 0.2%, 1.9%, 3.7% with transformed Aquaplast, respectively. CONCLUSION: The original and transformed Aquaplast increased the surface dose moderately. The percent depth doses beyond Dmax, however, were not affected by Aquaplast. In conclusion, although the use of Aquaplast in practice may cause some increase of skin an dbuildup region dose, reduction of skin-sparing effect will not be so significant clinically.
Carboxymethylcellulose Sodium* ; Head ; Humans ; Neck ; Polystyrenes ; Radiotherapy ; Silver Sulfadiazine ; Skin

PURPOSE: To determine the MR findings of cervical lymphadenopathy which distinguish tuberculouslymphadenitis(TL) from metastatic lymphadenopathy(ML). MATERIALS AND METHODS: We retrospectively analyzed the MRfindings of 14 patients with TL and 19 with ML. Thirty-nine lesions in 14 patients with TL and 80 lesions in 19with ML were classified into three categories: conglomerate lesion (TL, 7; ML, 8); discrete lesion withoutnecrosis (TL, 3; ML, 15); and discrete lesion with necrosis (TL, 29; ML, 57). Between TL and ML, we compared age,sex, bilaterality, multiplicity, associated pulmonary tuberculosis, infiltration of adjacent fat, muscle, skin andsubcutaneous tissue, margin, and signal intensities on T1- and T2-weighted images. In discrete lesion, we alsocompared the minimal to maximal dimension ratio, and in discrete necrotic lesion, the thickness and evenness ofrim enhancement, and the location and extent of necrosis. RESULTS: There were statistically significantdifferences between TL and ML in age(34.7+/-13.1 years; 56.1+/-14.3 years), male to female ratio(3:11; 13:6),bilaterality(1/14; 10/19), multiplicity(5/14; 14/19), and associated active pulmonary tuberculosis(7/14; 1/19). OnT2-weighted images, TL showed predominantly homogeneous (30/39) or high (20/39) signal intensity, similar to thatof cerebrospinal fluid, but the signal inteusity of ML was predominantly heterogeneous(58/80), or lower than orsimilar to that of fat(41/80). Between TL and ML, however, there were no statistically significant differences ininfiltration of adjacent tissue, margin, signal intensity and its heterogeneity on T1-weighted image, minimal tomaximal dimension ratio, thickness and evenness of rim enhancement, or the location and extent of necrosis. CONCLUSION: In cervical lymphadenopathy, the existence of TL rather than ML is suggested by single or unilaterallesion in a young woman, by associated active pulmonary tuberculosis, or by homogeneous high signal intensity onT2-weighted MR images.
Cerebrospinal Fluid ; Female ; Humans ; Lymphatic Diseases* ; Male ; Necrosis ; Neoplasm Metastasis* ; Population Characteristics ; Retrospective Studies ; Skin ; Tuberculosis* ; Tuberculosis, Pulmonary