PURPOSE: To evaluate ethanolamine oleate (EAO)-microfibrillar collagen (MFC) mixture as a new scleroembolic material for the interventions requiring both permanent obliteration of vascular lumen and atrophy of mass, such as for the facial AVM and other hypervascular soft tissue masses. MATERIALS AND METHODS: Twenty-nine transcatheter transarterial embolizations of renal arteries were performed in six groups of rabbits classified by the EAO concentration and the addition of MFC. Postembolization angiography, gross morphological and microscopic examinations of embolized kidneys were performed immediately, 3 days, 2 weeks and 4 weeks after embotization. Analysing points were the usefulness as a scleroembolic material (endovascular retention, thrombogenic-sclerosing effect, perivascular fibrosis and inflammatory reaction), effects of the EAO concentration and the addition of MFC. RESULTS: EAO-MFC mixture satisfied all ideal conditions of scleroembolic agent;persistent endovascular retention, good thrombogenic-sclerosing effect with a mild inflammatory reaction and significant atrophy of kidney. The effect of increasing concentration of EAO was proximal embolization. The effects of MFC were promotion of proximal embolization, endovascular retention and sclerosing effect. CONCLUSION: EAO-MFC mixture can be used as a new effective scleroembolic material for the various hemodynamic situations in which embolic level can be controlled by EAO concentration and the addition of MFC.
Angiography ; Atrophy ; Collagen* ; Ethanolamine* ; Fibrosis ; Hemodynamics ; Kidney ; Oleic Acid* ; Rabbits* ; Renal Artery

No abstract available.

No abstract available.
Spinal Stenosis*

This study was conducted to identify the important research fields and areas for solving current and future health care problems in Korea and to develop priorities in selected research fields and areas. Delphi technique was used to collect expert's opinion. Questionnaire surveys were carried out three rounds, and 29 panel members were invited. From second questionnaire survey, we proposed the median value of score and respondent's score in each item. Prevalence, seriousness and manageability were the main criteria to select the research fields and areas and in priority setting. In health fields, 20 research fields were selected and population, family planning, and environmental pollution were the most important research fields among them. In each research field, several research areas were selected. Because our study had 85 research areas, the priority of research areas was selected in each research fields.
Health Planning/trends* ; Health Priorities/trends* ; Health Services Research/trends* ; Human ; Korea

Colonic lipomas are rare diseases. Incidence of colonic lipomas is only 0.1~4.4%. However, after benign adenomatous polyp, they are the second most common benign disease of the colon. Most colonic lipomas do not require treatment. However, large colonic lipomas or those that cause symptoms require treatment (>2 cm). There are several options for treatment. For example, endoscopic removal, laparoscopic surgery, and open surgery can all be considered. We report on two cases of giant colonic lipomas that caused symptoms. Both were located at the splenic flexure colon, and were safely treated with laparoscopic surgery.
Adenomatous Polyps ; Colectomy ; Colon ; Colon, Transverse ; Incidence ; Laparoscopy ; Lipoma ; Rare Diseases

PURPOSE: To determine differential points, if any, on MR imaging between cerebellar cystic hemangioblastoma and cystic astrocytoma. MATERIALS AND METHODS: MR images of patients with surgically proven cerebellar cystic hemangioblastomas (n=12) and cystic astrocytomas (n=14) were retrospectively reviewed with regard to the following points: size, location and signal intensity of the tumor ; tumor margin; presence, size and location of the enhancing mural nodule; vascular signal voids, internal septations, enhancing feature of the cyst wall, secondary findings (degree of peritumoral edema and presence of hydrocephalus) and the patient's age. RESULTS: The significant (p<0.5) differential points were vascular signal voids, which were the most important clue, as well asthe presence of an enhancing mural nodule, tumor margin, enhancing feature of the cyst wall and the patient's age.If the patient was an adult and presented an enhancing mural nodule with adjacent vascular signal voids and smooth tumor margin, then cystic hemangioblastoma was suggested, While the presence of an irregular-margined thick enhancing cyst wall, mural nodule without adjacent vascular signal voids and pediatric age were suggestive of cystic astrocytoma. CONCLUSION: On MR imaging, there are certain significant differential points between these similar-appearing tumors and these would be useful for a more accurate diagnosis.
Adult ; Astrocytoma* ; Diagnosis ; Edema ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies

PURPOSE: To determine the differential points of hard palate masses, using CT and MR. MATERIALS AND METHODS: MR (N=18) and CT (N=15) findings in 30 patients with pathologically-proven hard palate masses were reviewed. Masses originating in minor salivary glands were the most common (66.7%, N=20), and the remainder were accounted for by squamous cell carcinoma (N=5), lymphoma (N=2), malignant schwannoma (N=1), neurofibroma (N=1), and cholesterol granuloma (N=1). Location and demarcation of the lesions, MR signal intensity, degree of enhancement, internal architecture, and the patterns of adjacent tissue plane invasion were analyzed. RESULTS: The location of lesions originating in minor salivary glauds was as follows: paramedial, 73.7% (14/19); midline, 85.7% (6/7); and marginal,0% (0/4). On MR imaging, signal intensity and degree of enhancement showed no significant differential point except lower T2 signal intensity (3/5) and less enhancement (4/5) in squamous cell carcinoma than in other masses. Necrosiswas seen in 10/21 malignant masses (47.6%), poor demarcation in 10/21 (47.6%), bone invasion in 19/21 (90.5%), and tissue plane invasion in 15/21 (71.4%); in benign masses, the corresponding figures were 4/9 (44.4%), 1/9 (11.1%), 2/9 (22.2%), and 3/9 (33.3%). Two of 21 malignant masses (9.5%) showed none of the above charachteristics. CONCLUSION: Centrally located lesions most probably originate in minor salivary glands. In the hard palate, benign masses can show features which are generally thought to be those of malignant tumors, whereas malignant tumors can be free of such features; in differential diagnosis, caution is therefore required.
Carcinoma, Squamous Cell ; Cholesterol ; Diagnosis, Differential* ; Granuloma ; Humans ; Lymphoma ; Magnetic Resonance Imaging ; Neurilemmoma ; Neurofibroma ; Palate ; Palate, Hard* ; Salivary Glands, Minor

PURPOSE: It is known that due to both their imaging and pathologic features, the accurate differentiation ofchondrosarcoma from chordoma is difficult. Through an analysis of MR and CT findings, this study aims to determinethe differential points between these two tumors. MATERIALS AND METHODS: In 21 patients, CT and MR imagingstudies of chordoma(n=12) and chondrosarcoma(n=9) at the base of the skull were retrospectively reviewed.Diagnosis had been established by histologic examination of surgically removed specimens. Eleven of the chordomaswere subclassified as 'conventional' and one as 'chondroid'; eight chondrosarcoma were 'conventional' andone was 'myxoid'. Four chordoma patients underwent CT and MR ; in six, only MR was performed ; and in two, onlyCT. Eight chondrosarcoma patients underwent both CT and MR, while in one, only CT was performed. All scans wereretrospectively evaluated for the location(midline/off-midline), direction of extension, margin and shape, bonydestruction and calcification, MR signal intensity and enhancement patterns of the tumors. Degree of calcificationwas graded from I to III. RESULTS: The epicenter of the mass of ten chordomas (83%) was midline, in twochondrosarcomas(22%), this was off-midline. Foci of calcification were observed in three of eleven chordomas(27%),and heavy calcification (grade III) was observed in one. In contrast to these findings, foci of calcificationswere observed in eight of nine chondrosarcomas (89%) and grade III calcification was observed in five. In bothtumors, calcification was coarse. Between the two kinds of tumor, there were no significant difference in MRsignal intensity and enhancement patterns, margin and shape, or direction of extension. CONCLUSIONS: Although MRand CT findings were similar in both types of tumor, location and degree of calcification may be features whichusefully distinguish chordoma from chondrosarcoma.
Chondrosarcoma* ; Chordoma* ; Humans ; Retrospective Studies ; Skull Base* ; Skull*

The purpose of this study was to introduce the methodology of intervention analysis with time series data and to investigate the influence of the patient referral system on medical care utilization in Kangwha county. The data were obtained at the Kangwha Medical Insurance Society and we analysed the material based on the outpatient care fee. The results were as follows: 1. The average outpatient care utilization in the hospital decreased by 41.7% due to the patient referral system. 2. The utilization of the health institution increased by 278.8 persons per month due to the patient referral system. 3. The patient referral system did not influence the total outpatient care utilization. The methodology of intervention analysis, which detected the effect of intervention, will be helpful to the study of public health area.
Ambulatory Care ; Fees and Charges ; Humans ; Insurance ; Public Health ; Referral and Consultation*

PURPOSE: It is important to diagnose paragonimiasis in early active stage because it can be dured by chemotherapy. However, it is difficult to make a correct diagnosis of cerebral paragonimiasis in the early active stage, and the radiographic findings of cerebral paragonimiasis have been rarely reported. Thus, this experimental study was designed to produce early active cerebral paragonimiasis and to demonstrate radiologic-pathologic correlations. MATERIALS AND METHODS: In 8 cats, 7-8 metacercariae of Paragonimus westerrnani were directly introduced into the brain parenchyma of each cat's after trephination of the skull. In anogher 16 cats, the juvenile worms and the adult worms that had developed for varying periods (2 weeks, 4 weeks, 6 weeks, 8 weeks and 12 weeks) in the lunges of another cats were introduced into the brain parenchyma of each cat's with the same procedures described above. Follw-up MR images and chest radiographs were obtained at 2 days, 1 weeks, 2 weeks, 4 weeks and 8 weeks after innoculation. The autopsies and histopathological examinations of the cat's brain were undertaken in 22 cats. In 9 cats that were suspected with pulmonary lesions on chest radiograph, the soft tissue radiographs of inflated-fixed lungs were obtained. RESULTS: In one cat with innoculation of adult worm, acute suppurative inflammation of the brain parenchyma was demonstrated. But the other cats with innoculction of adult worm or juvenile worm and the cats with innoulation of metacercaris did not reveal any evidence of acute cerebral paragonimiasis. More than half of the introduced metacercariae(5 out of 8 cats) were found in the lung parenchyma, while only 25%(4 out of 16 cats) of the adult worm innoculated cats were. CONCLUSION: Acute suppurative inflammation suggesting acute stage cerebral paragonimiasis was obtained in one case of adult worm innoculated cat. Most of the innoculated metacercariae and some of the juvenile worms or adult worms were migrated to the lungs.
Adult ; Animals ; Autopsy ; Brain ; Cats* ; Diagnosis ; Drug Therapy ; Humans ; Inflammation ; Lung ; Metacercariae ; Paragonimiasis* ; Paragonimus ; Radiography, Thoracic ; Skull ; Trephining