PURPOSE: To document the radiologic characteristic findings of atypical ductal epithelial hyperplasia, we analyzed film mammographic, ultrasonographic, and MRI findings of our cases. MATERIALS AND METHODS: We analyzed 23 cases of surgically proven ADH, excluding carcinoma in ipsilateral breast. Presence and pattern of neodensity, microcalcification, and architectural distortion were reviewed on mammography. Echo pattern and ductal parenchymal morphology were analyzed on ultrasonography, and enhancement speed and pattern analysis were performed on MRI. RESULTS: On film mammography, ADH showed tendency of neodensity(10 of 23 cases), m icrocalcification(11 of 23 cases), with less parenchymal distortion of surrounding structures(7 of 23 cases). On ultrasonography, ADH was demonstrated as inhomogenous to intermediate echoic nodule(16 of 20 cases) with ragged border(19 of 20 cases), however, its boundary was thin or nearly absent(16 of 20 cases), and showed smooth ductal echography(11 of 20 cases). Gd-DTPA contrast dynamic MR study showed relatively slow and less enhancement in 4 out of 5 cases, with progressive inclination of the speed curve of enhancement in later period of dynamic study. CONCLUSION: Multimodality image approach is needed for better evaluation of ADH, however, excisional biopsy is recommended for confirmative diagnosis and proper treatement.
Biopsy ; Breast* ; Diagnosis ; Gadolinium DTPA ; Hyperplasia* ; Magnetic Resonance Imaging ; Mammography ; Ultrasonography*

No abstract available.
Dermatitis, Contact* ; Prurigo*

PURPOSE: In order to assess the incidence and radiologic findings of herniation pit of the femur neck in Korean. IVlaterials and Methods:In 152 macerated femurs of 88 cadavers, and randomly selected 115 hips of 70 patients, the presence of herniation pit was determi ned by using fluoroscopy and radiography. It was then examined by CT for inspection of overlying surface and its opening was confirmed by inserting thin steal wire under the fluoroscopic guidance. RESULTS: Seventeen herniation pits in 15 macerated femurs of 13 cadavers were noted. (14.8%, 13/88). Two of 13 individuals showed bilaterality. All lesions were found only in males. Six herniation pit in 6 femurs of 6 patients (8.6%, 6/70) were also noted. All lesions were on anterosuperior aspect of. femur neck. Plain radiographs of macerated femurs revealed well marginated and thin sclerosis in 15 lesions. Of all 23 lesions, CTshowed cortical breakdown in 3, and overlying cortical thickening in 8. In 15 macerated femurs, roughed area of cortex was found in anterosuperior aspect of femur in all cases, and tiny openings(diameter less than 1 mm) related to cystic lesions were confirmed in 9 lesions. CONCLUSION: The incidence of herniation pits was 14.8% in 88 cadaver, and 8.6% in 70 patients. All were males.
Cadaver ; Femur Neck* ; Femur* ; Fluoroscopy ; Hip ; Humans ; Incidence* ; Male ; Radiography ; Sclerosis

PURPOSE: To evaluate the optimal pulse sequences in the detection of erosions and for the discrimination of theeffusion from pannus. MATERIALS AND METHODS: MR studies were performed in thirteen patients with clinical diagnosis of rheumatoid arthritis. We used a 1.5T MR unit with single or dual 3 inch coil. We compared coronal images at the same location, obtained with pulse sequences of T2, T2 with fat saturation, and postcontrast T1 with fat suppression. Erosions were assessed by comparing the count of the numbers of erosions depending on each imaging method. A four point scoring systems was used for the comparison of conspicuitof lesion. RESULTS: T2WI with fat suppression and postcontreat T1WI with fat suppresison were better than conventional T2WI in the detection of erosions. The pannus had a heterogeneous signal on T2WI, some of which were enhanced after the intravenous injection of MR contrast a gents. CONCLUSION: We suggest that the fat suppression TIWI with enhacnement or the fat suppression T2WI were better than conventional T2WI for detecting both bone erosion and pannus. The postcontrast MR imaging may often be helpul in distinguishing pannus from the effusion.
Arthritis, Rheumatoid* ; Diagnosis ; Discrimination (Psychology) ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging* ; Wrist*

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.
Angiography* ; Cholangiocarcinoma* ; Connective Tissue ; Hypertrophy ; Portal Vein ; Portography ; Retrospective Studies

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.
Angiography* ; Cholangiocarcinoma* ; Connective Tissue ; Hypertrophy ; Portal Vein ; Portography ; Retrospective Studies

PURPOSE: To identify the four layers based on intranodular vascular nature visible in multiphase incremental bolus dynamic CT and to determine any differential points according to various factors of liver abscess with this vascular nature or not. MATERIALS AND METHODS: We categonized 29 cases of confirmed liver abscess into three different groups according to presence of four layers visible in early phase(arterial phase) of CT. Three groups were compared in regard to the results of antiamebic antibody test and bacteriologic study and presense of cholangitic abscess and internal septation. RESULTS: We could separate four layers, innermost hypodense central cavitary lesion, hyperdense granular tissue, hypodense abscess wall and outermost hyperdense compensatory hypervascular zone in 18 cases(62%), only two layers, cavity and wall in six cases(21%), and characteristically we could find three layers without innermost cavitary lesion in five cases(17%). But we couldn't find significant correlations between various clinical factors of liver abscess and our vascular groups. CONCLUSION: Our method of CT could represent four layers based on vascularity in 62% of cases. And also could find the unusual inflammatory mass containing three layer which must be differentiated from other malignant solid mass. But we couldn't find differential point between various clinical factor of liver abscess and imaging diagnosis. We think that with the improvement of hardware such as spiral CT, identification of four layers will be earier and will be very helpful in early detection and proper treatment planning of liver abscess.
Abscess* ; Diagnosis ; Liver Abscess* ; Liver* ; Tomography, Spiral Computed

BACKGROUND: It has been reported that heart disease is the most common cause of sudden death in children. There have been relatively few studies concerning heart disease screening of school children in Korea. This study was to evaluate the usefulness of 12-lead ECG for mass screening of heart disease in elementary school children. METHODS: Mass screening of heart disease with 12-lead ECG was done in 17,343 first grade elementary school children(male 8,948, female 8,395) in Kwangju area during 4 months period since September 1992. Among 200 children(male 135, female 65) who showed abnormal electrocardiographic findings, 128 were referred to pediatric cardiologist for detection of heart diseases by thorough examinations including 24-hour ECG, echordiography, cardiac catherization and angiocardiography. RESULTS: 1) The incidence of 12-lead ECG abnormalities was 1.2%. Male outnumbered female in the incidence of abnormalities(0.8% vs 0.4%). 2) Incomplete right bundle branch block was the most frequent ECG abnormality with the incidence of 5.3 among 1,000, followed by right ventricular hypertrophy and premature ventricular contraction, both of them stand the next common abnormalities with the same incidence of 1.6 among 1,000. 3) Out of 39 cases undergoing echocardiography, seven were found to have structual heart abnormalities : 6 atrial defects and one ventricular septal defect. 4) All patients having structual defects but one with atrial septal defect underwent open heart surgery without problems. CONCLUSION: These results suggest that routine 12 lead ECG be one of the useful methods for mass screening of heart disease and imply that establishment of heart disease screening system is necessary for the health promotion of the school chidren with heart disease.
Angiocardiography ; Bundle-Branch Block ; Child* ; Death, Sudden ; Echocardiography ; Electrocardiography ; Female ; Gwangju ; Health Promotion ; Heart Defects, Congenital ; Heart Diseases* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Korea ; Male ; Mass Screening* ; Thoracic Surgery ; Ventricular Premature Complexes

Essential hypertension is an important public health problem in Korea-being common, asymptomatic, easily treatable, and often leading to lethal complication in left untreated. The number of patients with hypertension has been significantly increased, and this factor may be an importnat one responsible for the increase in cardivascular mortality during past 20 years in Korea. As the drug therapy for hypertension needs longer period, it is very important to evaluate the efficacy and the adverse effects. Thirty patients(17 men and 13 womon) with essential hypertension were evaluated in this study. All patients had received oral Isradipine 1.25~2.5mg b.i.d. for 8 weeks. 1) The systolic and diastolic pressure were decreased significantly(166.8+/-9.0mmHg vs 147.3+/-12.0mmHg, p<0.001 and 100.3+/-4.0mmHg vs 90.3+/-6.1mmHg, p<0.001, respectively) 2) Heart rate, body weight, laboratory tests, chest X-ray, ECG studies were not changed significantly. 3) The systolic pressure was lowered by 20mmHg or more in 17 cases(56.7% of total), and the diastolic pressure was lowered by 10mmHg or more in 20 cases(66.7% of total) at 8 weeks after Isradipine administration. 4) The adverse effects of Isradipine were edema in 3(10%), constipation in 2(6.7%), headache in 2(6.7%), and insomnia, dizziness and dry mouth in 1 patient respectively, and none of them discontinued Isradipine administration due to adverse effects. In many patients with essential hypertension there is an effective response to Isradipine, even though there may be some mild adverse effects.
Blood Pressure ; Body Weight ; Constipation ; Dizziness ; Drug Therapy ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension ; Isradipine ; Korea ; Male ; Mortality ; Mouth ; Public Health ; Sleep Initiation and Maintenance Disorders ; Thorax

Ex.traosseous osteogenic sarcoma is exceedingly rare although bone formation occurs commonly in different reactive processes or neoplasms. Most of this tumors occurred in the lower extremities of middle aged people. The overall prognosis is grave and local recurrence following simple local excision possibly contributes to the poor prognosis. An agressive surgical approach including major amputation is recommended as the primary form of treatment. We have experienced a case of extraosseous osteogenic sarcoma of left gluteal region at the site of therapeutic irradiation for cervical carcinoma 16 years previously.
Amputation ; Buttocks ; Humans ; Lower Extremity ; Middle Aged ; Osteogenesis ; Osteosarcoma ; Prognosis ; Recurrence