PURPOSE: To evaluate the role of bile duct obstuction in the development of atrophy of the liver, using ananimal model. MATERIALS AND METHODS: Seven rabbits were divided into two groups : group 1(n=5), in which therewas selective bile duct ligation, and group 2(n=2), which underwent a sham operation. Each group was evaluated using CT for changes in hepatic volume after selective bile duct ligation or a sham operation. In group I, the diameter of dilated bile duct was measured 2, 4, 8, 12 and 16 weeks after bile duct ligation, while gross andhistologic change were evaluated in all cases. RESULTS: In group 1, bile duct dilatation was seen on CT two weeks after selective bile duct ligation, and did not change significantly during follow-up. In four of five cases, CT revealed no evidence of significant atrophy of the involved segment. Pathologic specimens, however, revealed dilatation of the bile duct, periductal fibrosis, infiltration of chronic inflammatory cells, and periportalfibrosis. One of five cases showed segmental liver atrophy after selective bile duct ligation. In addion to the above pathologic findings, there was obstruction of the portal vein by foreign body reaction. In group 2, no evidence of dilated bile duct or liver atrophy was revealed by CT or pathologic specimen after a sham operation. CONCLUSION: During long-term follow-up of 16 weeks, obstruction of the bile duct did not play a major role in the development of lobar atrophy in the rabbit.
Animals ; Atrophy ; Bile Ducts* ; Bile* ; Dilatation ; Fibrosis ; Follow-Up Studies ; Foreign-Body Reaction ; Ligation* ; Liver ; Portal Vein ; Rabbits

PURPOSE: To evaluate the changes in arteriovenous malformation(AVM) of the brain revealed by follow-up MR images after gamma-knife surgery. MATERIALS AND METHODS: In 25 patients with AVM of the brain who had undergone gamma-knife radiosurgery, 39 MR images were obtained during follow-up between 6 and 46 months later, and were reviewed. We evaluated changes volume of the nidus and in its enhancement patterns, changes in T1- and T2-weighted images of the regions in which the nidus had disappeared, and changes in adjacent brain. Conventional follow-up cerebral angiography was performed in seven patients, and the results were correlated with those obtained by M-RI. RESULT: On the MR images obtained as described, disappearance of signal void lesion within the nidus was observed in 16 of the 25 patients. In five of 16, the nidus was obliterated within 1 year of gamma-kinfe radio-surgery, and in the remaining 11 patients this happened after 1 year. In nine cases in which the nidus remained and 16 in which it was obliterated, follow-up examination of MR images revealed spot and mixed spot-nodular enhancement, with signal void lesion. Within the nidus, serial follow-up MR images showed increased enhancement, which was nodule-like. As seen on T1-weighted images, the lesions of obliterated nidus showed slightly lower or iso- signal intensity to gray matter in all 25 cases, while T2-weighted images revealed high signal intensity in 21 cases and iso-signal intensity in four. Abnormal high signal intensity adjacent to the brain was seen on T2 weighted images in nine of 25 cases. In six of seven cases in which cerebral angiography was performed, AVM was obliterated on both MRI and angiography. In one case, however, MR imaging showed that a signal void lesion remained. Cerebral angiography in this case revealed arteriovenous shunting. CONCLUSION: After gamma-knife surgery, early follow-up revealed that in AVM of the brain, a spot and mixed spot and nodular enhancement pattern was visible, with a reduced volume of signal void lesions. During later follow-up, an enhanced nodular pattern was revealed. Nodular enhancement without signal void lesion probably indicates complete regression of the nidus of AVM.
Angiography ; Arteriovenous Malformations* ; Brain* ; Cerebral Angiography ; Follow-Up Studies ; Humans ; Intracranial Arteriovenous Malformations ; Magnetic Resonance Imaging ; Radiosurgery*

PURPOSE: To determine the CT findings and to evaluate the role of CT scanning in adult supraglottitis. MATERIALS AND METHODS: The CT findings of five male patients aged between 29 and 69 (mean, 53) years with adult supraglottitis were reviewed and evaluated. Particular attention was focussed on swelling of epiglottis and laryngeal structures, abscess formation and extension of the inflammatory process to adjacent neck spaces. In addition, the findings of CT were compared with those of plain radiography. RESULTS: In all patients, CT revealed swelling of the epiglottis and aryepiglottic folds, while in four, swelling of the paralaryngeal space was noted. Abscesses in the epiglottis were seen in four patients, and in three of these, small abscesses in the preepiglottic, parapharyngeal, or peritonsillar space or palatine tonsil, were also noted. One patient had an emphysematous epiglottitis, and in three, inflammation extended to adjacent regions of the neck, namely the parapharyngeal, retropharyngeal, submandibular, or peritonsillar space. Plain radiographs gave only restricted information regarding abscess formation and the extension of inflammation to adjacent neck space. CONCLUSION: CT is useful for assessing the extent of adult supraglottitis and for evaluating ensuing complications. It may also be useful for differentiating this condition from other supraglottic diseases, for the planning of treatment, and for evaluating the results of therapy.
Abscess ; Adult* ; Epiglottis ; Epiglottitis ; Humans ; Inflammation ; Male ; Neck ; Palatine Tonsil ; Radiography ; Supraglottitis* ; Tomography, X-Ray Computed

PURPOSE: To evaluate the air contamination of the gelfoam in the angio-intervention room. MATERIALS AND METHODS: After exposing four groups of gelfoam(group A1 : gelfoam fragment, group A2 : gelfoam fragment+ saline +contrast media, group B1 : gelfoam powder, group B2 : gelfoam powder + saline + contrast media) to air in the angio-intervention room, we inoculated gelfoam in each group to 30 agar plates each at every fifteen minutes for one hour with aseptic cotton buds. Cultivating them in the incubator for one day, we evaluated the growth of bacteria or fungus. RESULTS: Out of 480 inoculated agar plates, the growth of coagulase(-) staphylococci was visible in 14 ; in group A1, two at 30 minutes, three at 45 minutes, and four at 60 minutes ; in group A2, one at 45 minutes and two at 60 minutes ; in group B1 and B2, one each at 45 minutes. The stastical analysis on bacterial contamination according to time sequence and group revealed no significance(p<0.05). CONCLUSIONS: If gelfoam is exposed to room air for less than 30 minutes, it is possible to reduce contamination by air-borne bacteria. Since coagulase-negative Staphylococci resistant to commonly used antibiotics, it is ideal to reduce exposure of gelfoamto room air for less than 30 minutes.
Agar ; Anti-Bacterial Agents ; Bacteria ; Fungi ; Gelatin Sponge, Absorbable* ; Incubators

PURPOSE: The purpose of this study is to evaluate the MR images of solitary cerebral metastasis and glioblastoma multiforme to determine the differential findings. MATERIALS AND METHODS: Ten cases of solitarycerebral metastasis and 14 cases of glioblastoma multiforme were retrospectively reviewed, all of which were proved by pathologically. The MR findings were compared in regard to tumor size and location, degree of edema, enhancement pattern, and shape of rim enhancement. RESULTS: Mean maximum diameter of solitary cerebral metastasis was 3.85cm(s.d. 1.47). Metastatic lesions were located in corticomedullary junction(70%) with cerebellum in 2cases. The locations of glioblastoma multiforme were white matter(64%) without cerebellar involvement and the mean maximum diameter was 5.43cm(s.d. 0.99). In solitary cerebral metastasis, the size of edema was larger than thetumor diameter in 50%, but glioblastoma multiforme did not show severe degree of edema. Rim enhancement seen in 7cases of solitary cerebral metastasis showed unilocular shape and complete rim in 6 cases, and even thickness and smooth inner margin in 5 cases. Howevere, rim enhancement seen in 11 cases of glioblastoma multiforme showed multilocular appearance with septa in all cases, incomplete rim in 5 cases, and uneven thickness and irregular inner margin in 10 cases. CONCLUSION: Tumor location, degree of edema, and rim enhancement pattern on Gd-enhanced MR may be useful in differentiation between solitary cerebral metastasis and glioblastoma multiforme.
Cerebellum ; Edema ; Glioblastoma* ; Neoplasm Metastasis* ; Retrospective Studies

PURPOSE: This study was conducted to describe the postopertive MRI findings with contrast enhancement following anterior cervical fusion(ACF). MATERIALS AND METHODS: Thirteen patients after anterior cervical fusionsfor disc herniation or traumatic injury were studied with MRI 1 month to 10 months after operation. MRI findings were analysed with attention to the remained vertebral body, disc material, retropharyngeal soft tissue, grafted bone fragment, and biological orthopedic prosthesis(BOP). RESULTS: In 8/13 cases(62%), enhancement of the retropharyngeal soft tissue was seen with good demarcation between soft tissue and surrounding vertebra or disc.In 9/13 cases(69%), grafted bone or BOP was well defined by intersurface with low signal intensity. In 4 cases ofACF with bone graft, 2 cases(50%) showed heterogeneous or homogeneous enhancement of grafted bone fragments. Remained vertebral bodies and discs showed enhancements in 8/13 cases(62%). CONCLUSION: Postoperative MR findings after ACF included good margination of enhanced retropharyngeal soft tissue, grafted bone, and remained vertebral bodies/discs. The MRI could be a useful study to differentiate findings after ACF from posoperative inflammations such as spondylitis or discitis, and be a good imaging modality for follow up of grafted bony fragment or BOP.
Discitis ; Humans ; Magnetic Resonance Imaging ; Orthopedics ; Spine ; Spondylitis ; Transplants

To identify the relation between simple reaction time and height and arm length, simple reaction time was performed to medical students with measurement of height, and arm length. Participants should answer questions about Smoking, drinking, sleep deprivation, history of diseaseand drug, whether to use computer or hot Mean height of men(n=98) was 173.0+/-4.79 cm, that of women (n-22) 161.7+/-4.33 cm. Mean arm length of men was 73.5+/-3.09 cm, and that of women 68.0+/-2.93 cm respectively. Height and arm length were statistically significantly different between-men and women (plt;0.01). Mean simple reaction time of men was 265.4+/-25.03 msec, that of women 286.8+/-28.48 msec. Mean simple reaction time was also statistically significantly different(p<0.01). As a result of correlation analysis, for men. None was significant. However, for women, height and arm length showed statistically significant, correlation with mean reaction time. Correlation coefficient of height and arm length were 0.45 (p<0.05) and 10.57 (p<0.05) respectively.
Arm* ; Drinking ; Female ; Humans ; Male ; Reaction Time* ; Sleep Deprivation ; Smoke ; Smoking ; Students, Medical

PURPOSE: To evaluate changes in the spinal canal in cases of L5 spondylolysis, as seen on sagittal MR images. MATERIALS AND METHODS: We retrospectively analysed the MR findings of 27 patients suffering from L5 spondylolysis without spondylolisthesis and compared them with 100 control subjects. Spondylolysis had been confirmed by conventional radiography. On midsagittal MR images, sagittal canal ratio (SCR) was defined as midsagittal canal diameter at L5 devided by that at L1. We analysed the frequency of posterior epidural fat deposition (posterior epidural fat between the posterior margin of the dural sac and the anterior cortical margin of the spinous process on the midsagittal line), and compared this with the frequency in 100 control subjects. RESULTS: Mean SCR value in 27 patients with L5 spondylolysis (1.22) was significantly greater than 100 control subjects (0.96, p<0.001). Mean SCR value in 17 patients with L5 spondylolysis and posterior epidural fat deposition (1.27) was significantly higher than in nine control subjects with posterior epidural fat deposition (0.97). Posterior epidural fat deposition was more frequently indentified in patients with L5 spondylolysis (63%) than in control subjects (9%). CONCLUSION: The possibility of L5 spondylolysis is suggested when on midsaggital MR imaging, the anteroposterior diameter of the L5 spinal canal is seen to be widened and posterior epidural fat deposition is noted.
Humans ; Magnetic Resonance Imaging ; Radiography ; Retrospective Studies ; Spinal Canal* ; Spondylolisthesis ; Spondylolysis*

No abstract available.
Drug Therapy, Combination* ; Epirubicin* ; Fluorouracil*

PURPOSE: Ultrafiltration (UF) failure is one of the most important causes of CAPD withdrawal accounting for up to 20% of CAPD catheter removal. Factors contributing to UF failure are; severe and multiple peritonitis, continuous exposure to nonphysiologic dialysis solution, and use of beta-blockers. We evaluated clinical features of patients with UF failure and assessed the risk factors for UF failure in CAPD patients. METHODS: CAPD data of our institution from Jan 1990 to Dec 2000 were analyzed and a subgroup of 191 patients whose CAPD catheters were removed were collected. Nineteen patients, whose CAPD catheters were removed due to UF failure, were selected from the subgroup as the case group. Seventy-six hospital controls without ultrafiltration failure matched for age, sex, and time of CAPD initiation who were currently maintained on CAPD were selected as the control group. Peritoneal equilibration test (PET) was done within 3 months of initiation of CAPD and at the diagnosis of UF failure, respectively. Peritoneal glucose load was estimated for the first two years. Incidence of peritonitis, accumulated days of peritoneal inflammation (APID), causative organisms of peritonitis, and history of beta-blocker use were evaluated. Peritoneal function was determined by daily net ultrafiltration and mass transfer area coefficient (MTAC) for creatinine. Serum albumin, normalized protein catabolic rate (nPCR) and Kt/Vurea were also evaluated. RESULTS: There was no difference between cases and controls in etiology of ESRD, peritonitis incidence, APID and causative organisms of peritonitis. The case group included more high transporters at the time of the diagnosis of UF failure. The patients with UF failure showed lower nPCR and higher CRP than controls. Serum albumin level was similar at start of CAPD, but decreased faster in UF failure group. Use of beta-blockers and decline in RRF were not different between the two groups. UF fail ure group had higher MTAC for creatinine and more peritoneal glucose load compared to control group. By logistic regression analysis, peritoneal glucose load and increment in glucose load were independent factors associated with UF failure. CONCLUSION: Peritoneal glucose load and increment of glucose load were found to be important risk factors for UF failure in our study. Therefore, various efforts to reduce peritoneal glucose load in CAPD patients are needed for prevention of UF failure.
Case-Control Studies* ; Catheters ; Creatinine ; Diagnosis ; Dialysis ; Glucose ; Humans ; Incidence ; Inflammation ; Kidney Failure, Chronic ; Logistic Models ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Risk Factors* ; Serum Albumin ; Ultrafiltration*