OBJECTIVES: The aim of this study is to evaluate the practical role of 3D-CTA in planning the surgery for intracranial aneurysm from a viewpoint of operator. METHODS: Since May 1997 to April 1998, a total of 65 patients who were suspected to have intracranial aneurysms were studied with 3D-CTA using a General Electric Hispeed Advantage helical scanner. Conventional intraarterial digital subtraction angiographies(IA-DSAs) were performed in all patients except four who were in urgent situation. With the images obtained from the 3D-CTA, we performed preoperative assessments for the targeted aneurysms and evaluated its usefulness for planning the aneurysm surgery. RESULTS: 3D-CTA revealed 69 intracranial aneurysms in 55 patients and the size of aneurysms detected were 2-17mm in diameter. The sensitivity of 3D-CTA(95.8%) which was based on the comparison with IA-DSA and supplemented by microsurgical finding was similar to that of IA-DSA(94.1%) and its specificity(81.8%) was lower than that of IA-DSA(100%). Time consuming for getting images from 3D-CTA was no more than 20 minutes and this rapidity was very useful in the emergent situation such as cases of large intracerebral hematoma or massive intraventricular hemorrhage. 3D-CTA proffered various perspective views including surgical view, which were valuable to estimate the degree of head rotation and the direction of clip insertion and to determine the permanent clip type preoperatively. Careful reviewing of 3D-CTA made it possible to minimize surgical procedures. We could omit routine rectus gyrus resection in twelve of 16 surgeries for A-com aneurysm and could operate sixteen of 19 ICA aneurysms successfully without routine extracranial carotid artery preparation. On the basis of 3D-CTA, we could select the appropriate surgical approach in cases of ophthalmic aneurysm or posterior circulation aneurysm. Moreover, in cases of bilateral multiple aneurysms, 3D-CTA was helpful for evaluating the possibility of visualizing contralateral aneurysm through unilateral approach. The extent of bone work could be determined preoperatively through reviewing the 3D-CTA images and possible rupture of MCA aneurysm during bone work could be avoidable. However, 3D-CTA had some limitations for the describing fine vascular architecture such as the teat of aneurysm, a clue for the ruptured aneurysm in multiple aneurysms and most of fine caliber vessels such as hypoplastic posterior communicating artery or anterior choroidal artery was missed on the 3D-CTA. 3D-CTA lacked description for the hemodynamics of cerebral circulation. CONCLUSIONS: Although the 3D-CTA is still insufficient to be the complete substitute for conventional intraarterial digital subtraction angiography, it may be excellent adjunctive tool in planning the surgery of intracranial aneurysm considering that understanding the exact relationship of aneurysm with surrounding structure is mandatory for minimizing the possible risk during surgery.
Aneurysm ; Aneurysm, Ruptured ; Angiography* ; Angiography, Digital Subtraction ; Arteries ; Carotid Arteries ; Choroid ; Head ; Hematoma ; Hemodynamics ; Hemorrhage ; Humans ; Intracranial Aneurysm* ; Rupture

Type IV spinal cord arteriovenous malformation is a spinal vascular anomaly supplied by the anterior spinal artery and drained directly into an enlarged venous outflow. Direct fistula lies completely outside the spinal cord and pia mater. We report a case of intradural perimedullary arteriovenous fistula in 58-years-old man who presented with progressive paraparesis. Angiographically single fistulous perimedullary communication with moderate-sized abnormal venous engorgement was demonstrated through anterior spinal artery. Direct surgical obliteration of the fistulous site was performed. Spinal angiographic evaluation and recognition of their exact pathophysiology according to individual types of spinal AVMs is the most important in successful execution of planned surgery and to achieve the good outcome.
Arteries ; Arteriovenous Fistula* ; Arteriovenous Malformations ; Fistula ; Hyperemia ; Paraparesis ; Pia Mater ; Spinal Cord*

Type IV spinal cord arteriovenous malformation is a spinal vascular anomaly supplied by the anterior spinal artery and drained directly into an enlarged venous outflow. Direct fistula lies completely outside the spinal cord and pia mater. We report a case of intradural perimedullary arteriovenous fistula in 58-years-old man who presented with progressive paraparesis. Angiographically single fistulous perimedullary communication with moderate-sized abnormal venous engorgement was demonstrated through anterior spinal artery. Direct surgical obliteration of the fistulous site was performed. Spinal angiographic evaluation and recognition of their exact pathophysiology according to individual types of spinal AVMs is the most important in successful execution of planned surgery and to achieve the good outcome.
Arteries ; Arteriovenous Fistula* ; Arteriovenous Malformations ; Fistula ; Hyperemia ; Paraparesis ; Pia Mater ; Spinal Cord*

Anterior temporal lobectomy is the most popular surgical method for mesiobasal temporal lobe epilepsy. The key point in anterior temporal lobectomy is to resect lateral neocortex as little as possible, and mesiobasal structures as much as possible without surgical complication. We analyzed surgical anatomy on MRI scans of 20 persons to evaluate the relationships of anatomical structures related with surgical steps in anterior temporal lobectomy. On the oblique axial scan, the distance from temporal pole to anterior margin of hippocampus was 29.8+/-1.5mm. The length of hippocampus to the level of posterior margin of cerebral peduncle was 25.6+/-2.4mm. On the oblique coronal image through hippocampal head, the distance between the surface of superior temporal sulcus and lateral margin of temporal horn roof was 32.5+/-2.2mm. The angle between middle fossa base line and the line connecting superior temporal sulcus and lateral margin of temporal horn roof was 33.6+/-5.2 degree. The distance between lateral temporal surface and brain stem, and that between lateral temporal surface and collateral sulcus was 49.9+/-1.9mm and 40.6+/-3.3mm, respectively. The distance between collateral sulcus and lateral margin of temporal horn roof was 14.2+/-1.8mm, and the angle between middle fossa base line and the line connecting lateral margin of temporal horn roof and collateral sulcus was 60.4+/-7.4 degree. On the sagittal image, the angle between superior temporal sulcus and hippocampal axis was 18.8+/-1.1 degree. In conclusion, surgical complication of anterior temporal lobectomy can be reduced by careful consideration of anatomical relationships between anatomical structures encountered in each surgical steps in anterior temporal lobectomy.
Animals ; Anterior Temporal Lobectomy ; Axis, Cervical Vertebra ; Brain Stem ; Epilepsy, Temporal Lobe* ; Head ; Hippocampus ; Horns ; Humans ; Magnetic Resonance Imaging* ; Neocortex ; Tegmentum Mesencephali ; Temporal Lobe*

PURPOSE: The aim was to assess how the background site affects the Gates' glomerular filtration rate (GFR) measurement using Tc-99m-DTPA in correlation with GFR by I-125-iothalamate method. MATERIAL AND METHODS: The study populations were 63 adults with 39 men and 24 women aged from 20 to 59 yrs (mean = 37.9 yrs). The following five background regions of interest were used in measurement of GFR using Gates' method: 1) lower side of each kidney (subrenal), 2) around each kidney (circumferential), 3) upper side of each kidney (suprarenal), 4) lateral side of each kidney (lateral), 5) between the two kidneys (inter-renal). We also measured GFR using I-125-iothalamate in each subject. The two studies were separated by 1 to 3 weeks. The subjects were divided into two groups by renal depth. Group 1 with renal depth> or=7cm and group 2 with renal depth < 7 cm. We calculated the means and standard deviations of the GFRs measured by two studies. And we statistically analyzed the correlation and differences among GFRs by Gates' method and the GFR by iothalamate method with correlation analysis. RESULTS: The GFRs by Gates' method using suprarenal and inter-renal background correction showed better correlation with the GFR measured by I-125-iothalamate. And GFRs measured by Gates' method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth < 7cm. But GFRs measured by Gates' method did not show statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth > or=7cm. CONCLUSION: GFRs measured with Gates' method showed higher correlation with the GFR measured by I-125-iothalamate when the regions of interest were placed over the suprarenal and inter-renal backgrounds. And GFRs measured with Gates method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth < 7cm.
Adult ; Female ; Glomerular Filtration Rate ; Humans ; Iothalamic Acid ; Kidney ; Male

PURPOSE: The purpose of this study was to evaluate the usefulness of single photon emission computed tomography (SPECT) of bone using Tc-99m MDP in the diagnosis of osteoporotic vertebral fractures. MATERIALS AND METHODS: Thirty two patients with osteoporotic vertebral fracture were included in this study (mean age: 67 +/- 8, male: 5, female: 27). Seventy nine vertebral fractures were detected (38 thoracic/thoracolumbar lesions and 41 lumbar lesions), which were classified by type of deformity (wedge, biconcave or compression). The patterns and locations of increased uptakes were examined and analyzed. RESULTS: Forty seven wedge fractures, 20 biconcave fractures and 12 compression fractures were found. Diffuse and asymmetric uptakes were common in fractured bodies. More than one uptake were examined in 69 posterior elements of fractured vertebrae (87.3%) including 40 of 47 wedge fractures (85.1%), 17 of 20 biconcave fractures (85.0%) and 12 of 12 compression fractures (100%). Wedge fractures were predominant fracture in thoracic/thoracolumbar spine whereas incidence of biconcave or compression type was similar to that of wedge fracture in lumbar spine (p=0.04). Spinous process uptake was more frequently seen in lumbar lesions than thoracic/thoracolumbar lesions (p=0.009). Facet joint uptake in biconcave fracture was more common in lumbar spine (92.3%) than thoracic/thoracolumbar spine (57.1%). Spinous process uptake in biconcave fracture was also more frequently detected in lumbar spine (p=0.043). CONCLUSION: Bone SPECT was useful in the evaluation of osteoporotic vertebral fracture, especially posterior elements of vertebrae.
Congenital Abnormalities ; Diagnosis ; Female ; Fractures, Compression ; Humans ; Incidence ; Male ; Osteoporosis ; Spine ; Technetium Tc 99m Medronate ; Tomography, Emission-Computed, Single-Photon* ; Zygapophyseal Joint

Background: The incidence of colic and the outcomes of colic surgery have not been surveyed in racetracks in Korea. Objectives: This study examined the incidence, mortality, and case fatality of colic and investigated the effects of age and sex after an exploratory celiotomy on the long-term survival rate (return to racing), subsequent racing performance, and career longevity. Methods: The incidence, mortality, and case fatalities of colic were examined over an 11-year period. The records of 40 horses that had undergone a celiotomy, after participating in at least one race and 75 race-matched control horses were analyzed. The racing performance and career length of the horses that returned to racing post-surgery were compared with a control group. Results: The annual incidence, fatality rate of colic, and annual mortality rate at Seoul Racecourse were 6.5, 2.8 per 100 horse-years, and 0.2 deaths cases per 100 horse-years, respectively. Of the 40 horses that underwent colic surgery, 26 (65%) returned to racing. The likelihood of returning to racing decreased with increasing age of the horses, and geldings had a lower probability of returning. While the performance in the five preoperative races between the two groups was not significantly different, a significant decrease in racing performance was observed after the surgery date (p < 0.01). Horses that underwent colic surgery did not show a significant decrease in career length. Conclusions Surgical treatment for colic at the age of three and four years had a negative impact on the racing performance. On the other hand, there was no significant difference in career longevity between the two groups.

Long intergenic non-coding RNAs (lincRNAs) have historically been ignored in cancer biology. However, thousands of lincRNAs have been identified in mammals using recently developed genomic tools, including microarray and high-throughput RNA sequencing (RNA-seq). Several of the lincRNAs identified have been well characterized for their functions in carcinogenesis. Here we performed RNA-seq experiments comparing gastric cancer with normal tissues to find differentially expressed transcripts in intergenic regions. By analyzing our own RNA-seq and public microarray data, we identified 31 transcripts, including a known expressed sequence tag, BM742401. BM742401 was downregulated in cancer, and its downregulation was associated with poor survival in gastric cancer patients. Ectopic overexpression of BM742401 inhibited metastasis-related phenotypes and decreased the concentration of extracellular MMP9. These results suggest that BM742401 is a potential lincRNA marker and therapeutic target.
Animals ; DNA, Intergenic/genetics ; Expressed Sequence Tags/*metabolism ; Extracellular Space/metabolism ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Genetic Predisposition to Disease ; Humans ; Male ; Matrix Metalloproteinase 9/metabolism ; Mice ; Mice, Inbred C57BL ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Phenotype ; Proportional Hazards Models ; RNA, Long Noncoding/*genetics/metabolism ; RNA, Messenger/genetics/metabolism ; Reproducibility of Results ; Stomach Neoplasms/*genetics/*pathology ; Survival Analysis

An association of hepatolithiasis and cholangiocarcinoma is thought to be rare, with a rate reported to be 2.36%-10%. Most of the cholangiocarcinomas concurrent with intrahepatic stones are found in the vicinity of the hepatolithiasis, and the diagnosis of intrahepatic cholangiocarcinoma in cases with hepatolithiasis is very difficult to detect preoperatively in spite of recent developments in techniques of imaging studies. Recently, the development of cholangiocarcinoma was reportd even after the complete removal of the hepatic stones. Thus, bile stasis and bacterial infecton appear to be important causative factors causing cholangiocarcinoma rather than the stone itself. A rare case is reported on intrahepatic cholangiocarcinoma developed in a remote region from the site of the hepatolithiasis. Therefore, the possible presence of cholangiocarcinoma should always be considered and sought during the diagnosis and treatment of hepatolithiasis.
Bile ; Cholangiocarcinoma* ; Diagnosis ; Cholangiocarcinoma

BACKGROUND AND OBJECTIVES: The impact for recannulation of an artery, where a vascular closure device had been used following percutaneous coronary intervention (PCI), has not been evaluated. The aim of this study was to determine the feasibility and safety of recannulation of the femoral artery following the use of an Angioseal(r) following PCI. SUBJECTS AND METHODS: Between February 2002 and June 2004, 110 patients (Group I: 60.0+/-9.0 years, 84 male), who underwent a 6-month follow-up coronary angiography (CAG) following PCI and the use of an Angioseal(r) closure device, were compared with a further 110 randomly assigned patients (Group II: 61.4+/-9.2 years, 78 male), who received manual compression for femoral artery hemostasis following PCI during the same period. The occurrence of femoral puncture site complications, the time to active ambulation following PCI and procedural difficulties for recannulation during the follow-up CAG were analyzed. RESULTS: The baseline clinical characteristics and procedure related factors were similar between the two groups. No major complications were noted in either group. There were no differences in the incidence of minor complications, including puncture site oozing or hematoma, between the two groups. The time to active ambulation was significantly shorter in group I than II (7.2+/-2.7 vs. 17.3+/-4.2 hours, p=0.001). At the 6-month follow-up CAG, no major complications associated with re-puncture at the same site of the femoral artery were noted, and there were no differences in the incidence of minor complications between the two groups. CONCLUSION: An Angioseal(r) was a convenient method of hemostasis, which promoted early ambulation without difficulties in the reuse of the femoral artery.
Angioplasty ; Arteries ; Coronary Angiography ; Early Ambulation ; Femoral Artery* ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Hemostasis ; Humans ; Incidence ; Methods ; Percutaneous Coronary Intervention* ; Punctures ; Walking