To find any specific radiologic findings of skeletal metastases from hepatocellular carcinoma, we analyzed plain radiographs(n=25), CT(n=16) and MRI(n=5)of 25 patients with metastatic bony lesions from hepatocellular carcinoma. Vertebrae(17/25) and rids(16/25)were most frequently involved and 16 cases showed multiple metastases. The size of the lesions was larger than 5cm in 17 cases. Plain radiographs showed osteolytic destruction(2/25). CT(n=16) showed osteolytic destruction with an isodense expansile mass in all cases. Focal low attenuations suggesting necrosis were found in 2 cases. Calcification within the mass was not detected. MRI(n=5) showed a slight hyperintense area on T1WI and a defimte hyperintense mass on T2WI. After gadopentetate dimeglumine enhancement. The mass showed irregular enhancement. We concluded that skeletal metastatic lesions from hepatocellular carcinoma showed relatively large osteolytic destruction accompanying soft tissue mass and minimum central necrosis.
Carcinoma, Hepatocellular* ; Gadolinium DTPA ; Humans ; Necrosis ; Neoplasm Metastasis*

This study was designed to evaluate the potential applicability of magnetic resonance imaging (MRI) for the diagnosis of acute renal vein thrombosis. Renal vein thrombosis was experimentally induced by surgical ligation of the left renal vein in a total of 21 rabbits. MRI was performed with a 0.5 Tesla superconductive magnetic system. Spin echo technique was used with varying TR and TE parameters. Spin echo images of the rabbit kidney were analysed for morphology and signal intensity. T1 and T2 relaxation times of the renal cortex and medulla were calculated from the images. After venous ligation, kidneys became enlarged. Low signal band along the outer medulla in T2 weighted images were characteristically shown from 1 hour to 3 days after ligation, Changes of cortex to medullar contrast (CMC) values were significant (p<0.05) in T1 - and T2- weighted images of the ligated side. T1 and T2 relaxation times were significantly prolonged (p<0.05) on the ligated side, both in the cortex and medulla from 1 hour to 2 weeks after the ligation, while T2 relaxation time on the contralateral side was significantly prolonged both in the cortex and medulla 2 weeks after venous ligation. The most useful MRI criteria for the diagnosis of renal vein thrombosis were enlarged renal size, and the low signal band along the outer medulla of ligated kidney. The relative intensity difference between cortex and medulla (CMC) in T1-and T2-weighted images, and T1 and T2 relaxation times were suggested to be the useful MR parameters for the diagnosis of acute renal vein thrombosis.
Diagnosis ; Kidney* ; Ligation* ; Magnetic Resonance Imaging* ; Rabbits ; Relaxation ; Renal Veins* ; Thrombosis

This study was designed to evaluate the potential applicability of magnetic resonance imaging (MRI) for the diagnosis of acute renal vein thrombosis. Renal vein thrombosis was experimentally induced by surgical ligation of the left renal vein in a total of 21 rabbits. MRI was performed with a 0.5 Tesla superconductive magnetic system. Spin echo technique was used with varying TR and TE parameters. Spin echo images of the rabbit kidney were analysed for morphology and signal intensity. T1 and T2 relaxation times of the renal cortex and medulla were calculated from the images. After venous ligation, kidneys became enlarged. Low signal band along the outer medulla in T2 weighted images were characteristically shown from 1 hour to 3 days after ligation, Changes of cortex to medullar contrast (CMC) values were significant (p<0.05) in T1 - and T2- weighted images of the ligated side. T1 and T2 relaxation times were significantly prolonged (p<0.05) on the ligated side, both in the cortex and medulla from 1 hour to 2 weeks after the ligation, while T2 relaxation time on the contralateral side was significantly prolonged both in the cortex and medulla 2 weeks after venous ligation. The most useful MRI criteria for the diagnosis of renal vein thrombosis were enlarged renal size, and the low signal band along the outer medulla of ligated kidney. The relative intensity difference between cortex and medulla (CMC) in T1-and T2-weighted images, and T1 and T2 relaxation times were suggested to be the useful MR parameters for the diagnosis of acute renal vein thrombosis.
Diagnosis ; Kidney* ; Ligation* ; Magnetic Resonance Imaging* ; Rabbits ; Relaxation ; Renal Veins* ; Thrombosis

PURPOSE: Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament(ACL) injury in MR image. MATERIAL AND METHODS: The knee MR images of 47 patients with ACL injury(complete; 24, partial; 23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament(PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. RESULTS: The means( +/- 2standard errors) of anterior translocation were different significantly in statistical analysis(p<0.001, student t-test) between injury group(7.51 +/- 1.16mm) and normal group(-0.56 +/- 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 +/- 0.02) and normal group(0.17 +/- 0.01)(p<0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear(66%), thirteen lateral meniscus tear(28%), ten medial collateral ligament injury(28%), one PCL injury (2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients {43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients(19%) and avulsion fractures of anterior tibial spine in four patients(9%). CONCLUSION: The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.
Anterior Cruciate Ligament* ; Arthroscopy ; Bone Marrow ; Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Spine ; Tibia

PURPOSE: Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament(ACL) injury in MR image. MATERIAL AND METHODS: The knee MR images of 47 patients with ACL injury(complete; 24, partial; 23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament(PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. RESULTS: The means( +/- 2standard errors) of anterior translocation were different significantly in statistical analysis(p<0.001, student t-test) between injury group(7.51 +/- 1.16mm) and normal group(-0.56 +/- 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 +/- 0.02) and normal group(0.17 +/- 0.01)(p<0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear(66%), thirteen lateral meniscus tear(28%), ten medial collateral ligament injury(28%), one PCL injury (2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients {43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients(19%) and avulsion fractures of anterior tibial spine in four patients(9%). CONCLUSION: The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.
Anterior Cruciate Ligament* ; Arthroscopy ; Bone Marrow ; Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Spine ; Tibia

OBJECTIVE: To analyze the efficacy of intracytoplasmic sperm injection (ICSI) for totally unfertilized oocytes by the conventional insemination during in vitro fertilization and embryo transfer (IVF-ET) METHODS: From March 1996 to April 1998, 15 couples who experienced total fertilization failure after conventional IVF without severe male factor infertility in semen analysis were evaluated. Fertilization were assessed by the presence of 2 pronucleus (PN) after 14-16 hours of conventional insemination. All unfertilized oocytes were reinseminated by ICSI and checked for signs of fertilization between 6-10 hours after ICSI. The embryos with fertilization and development were transferred to the uterine cavity and the outcome was analyzed. RESULTS: Total numbers of unfertilized oocytes were 120, and total numbers of oocytes injected on day 1 using ICSI were 102. Total numbers of oocytes with normal fertilization after ICSI were 74 and mean fertilization rate of 71.1 +/- 24.0% was obtained. The numbers of embryos transferred was 3.6 +/- 1.7. The biochemical pregnancy rate was 13.3% (2/15) and the clinical pregnancy rate was 6.7% (1/15) per cycle. CONCLUSION: ICSI to totally unfertilized oocytes by conventional insemination technique during IVF-ET on the next day of oocyte retrieval seems to be a relatively successful mean and afford a chance of pregnancy to the infertile couples whom the ET could not perfomed to because of total fertilization failure."
Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Fertilization ; Fertilization in Vitro ; Humans ; Infertility ; Insemination ; Male ; Oocyte Retrieval ; Oocytes* ; Pregnancy ; Pregnancy Rate ; Semen Analysis ; Sperm Injections, Intracytoplasmic*

OBJECTIVE: To determine whether the somatostatin analogue, octreotide, given concunently with human menopausal gonadotropin (HMG) affects ovarian response, ovulation induction outcome, and serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) in infertile patients with polycystic ovarian syndrome (PCOS) resistant to clomiphene citrate (CC). METHODS: From August 1996 to June 1998, 42 infertile patients with PCOS urresponsive to CC were enrolled in the present study. Women who had other infertility factors were excluded from this study. Patients were randomly allocated either to combined HMG and octreotide treatment (treatment group) (n=21) or HMG alone (control group) (n=21). In the treatment group, 100 micrograms of octreotide were administered daily concomitantly with HMG from the 3rd day of menstrual cycle to the preceding day of human chorionic gonadotropin (HCG) injection. RESULTS: Patient's characteristics were comparable in both groups. One cycle in the control group was abandoned because of excessive follicular development. However, none of the cycles in the treatment group was abandoned. There were no differences in the number of HMG ampules required and the duration of HMG administration between the two groups. The number of follicles > 14mm diameter on the day of HCG injection was significantly less in the treatment group than that in the control group (p<0.01). The serum estradiol level on the day of HCG injection was also significantly lower in the treatment group, with 1391.0 +/- 695.5 pg/ml compared with 2217.5 +/- 811.6pg/ml in the control group (p<0.001). The incidence of severe ovarian hyperstimulation syndrome seemed to be lower in the treatment group, but the difference did not achieve significance (4.9% vs 23.8%). There were no differences in the clinical pregnancy rate, miscarriage rate and multiple pregnancy rate between the two groups. Although serum GH levels were comparable between the two groups, serum IGF-1 level on the day of HCG injection was significantly higher in the treatment gmup than that in the control group (p<0.001). CONCLUSION: This study suggests that the combined octreotide and HMG treatment could improve hormonal milieu and folliculogenesis compared to HMG alone, and therefore may be effective in ovulation induction for patients with PCOS resistant to CC.
Abortion, Spontaneous ; Chorionic Gonadotropin ; Clomiphene ; Estradiol ; Female ; Gonadotropins ; Growth Hormone ; Humans ; Incidence ; Infertility ; Insulin-Like Growth Factor I ; Menstrual Cycle ; Octreotide ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction* ; Ovulation* ; Polycystic Ovary Syndrome* ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Somatostatin*

No abstract available.
Magnetic Resonance Imaging*

Renal arterial embolization was induced experimentally in rabbits using autologous blood clot, Gelfoam, bariumsulfate, Ivalon(Polyvinyl alcohol)and ethanol. Microvascular changes were studied angiographically,microangiographically and histopathologically. The results were as follows: 1. The microangiographic findings ofrenal artery embolization were arterial occlusion, irregular arrangement, spiralling, dilatation, narrowing andcollateral vessel formation. 2. Recanalization of embolized vessels were noted after injection of autologous bloodclot and Gelforam only. 3. Collateral vessel formations were demonstrated in entire cases of renal arterialembolization (36/37). 4. After injection of Ivalon, recanalization of embolized vessel was not demonstrated butcollateral vessel formation were demonstrated microangiographically in all cases. 5 After injection of ethanol,collateral vessels were poorly developed microangiographically than other groups. 6. Embolic effect of ethanol wasnoted in central vessel but as well as in peripheral vessel. It was considered that ethanol is the most effectiveagent for permanent renal arterial occlusion.
Arteries ; Dilatation ; Ethanol ; Gelatin Sponge, Absorbable ; Rabbits

The hepatic artery was embolized with absolute ethanol in 1 mongrel dogs to evaluate the embolic effect andsafety of this material. Follow up angiography and liver function test were performed at 15 minutes, 1 week and 4weeks after embolization. Retrograde cholangiography, microangiography and pathologic examination were done at 4weeks after embolization. The result was as follows: 1. Sequential angiography showed successful and persistentocclusion of intrahepatic arteries at different levels, and reconstitution of the intrahepatic arterialcirculation via collaterals. 2. Microangiography revealed avascular area in 5 cases. But in incompletely infactedare there showed tortuous hepatic arteries, decreased perfusion of sinusoid and microcolaterals through theinterlobular arteries, capsular arteries and peribiliary vascular plexus. In one case sparse peribiliary plexuswas observed. 3. Retrograde cholangiography revealed findings of cholangitis on involved segment. 4. The absoluteethanol was effective for achieving a permanent occlusion of intraheptaic arteries but caused damage on sinusoidand hepatic parenchyme, and on peribilary vasucular plexus resulting in sclerosing cholangitis. So in furtherclinical application, caution would be necessary to superselect the tumor supplying artery to avoid unnecessaryparenchymal damage.
Angiography ; Animals ; Arteries ; Cholangiography ; Cholangitis ; Cholangitis, Sclerosing ; Dogs ; Ethanol ; Follow-Up Studies ; Hepatic Artery ; Liver Function Tests ; Perfusion