The advent of computerized cranial tomography made a greater advance in the diagnosis of very wide variety of intracranial lesions. Authors analyzed 58 pathologically proven sellar and parasellar tumors examined at Kyung Hee Un-iversity Hospital from Oct. 1977 to Jun. 1981 and the results were as follows; 1. The distribution of the tumors is 28 pituitary adenomas, 18 craniopharyngiomas, 5 meningiomas, 4 germinomas, 2 astrocytomas, and 1 sphenoid mucocele. 2. In pituitary adenoma, the precontrast CT scan of tumors appeared as isodensity in 11 cases, mixed density in 8 cases, high density in 6 cases, and low density in 3 cases, and associated with destruction of sellar turcica in 15 cases, calcification in 3 cases, and hydrocephalus in 2 cases. The postcontrast CT scan study revealed 24 cases of contrast enhancement, including 17 cases of homogenous and 7 cases of ring or rim enhancement. 3. In craniopharyngioma, the precontrast CT scan of tumors appeared as low density in 12 cases, isodensity in 4 cases and high density in 2 cases and associated with calcification in 16 cases, hydrocephalus in 15 cases and destruction of sellar turcica in 2 cases. The postcontrast CT scan study revealed no enhancement in 10 cases and contrast enhancement in 8 cases including 6 of ring enhancement and 2 heterogenous enhancement.
Astrocytoma ; Craniopharyngioma ; Diagnosis ; Germinoma ; Hydrocephalus ; Meningioma ; Mucocele ; Pituitary Neoplasms ; Tomography, X-Ray Computed

PURPOSE: The purposes of this study were to analyze the MR findings of medulloblastoma, and to evaluate the subarachnoid dissemination and the significance of contrast enhanced MR of brain and spine for tumor.. MATERIALS AND METHODS: The preoperative brain MR studies of 18 patients (9 males, 9 females;mean age, 9.4 years) with surgically proved medulloblastomas were retrospectively reviewed to characterize these neoplasms with regard to their location, size, MR signal intensity, appearance after contrast enhancement, presence of cyst and necrosis, subarachnoid dissemination, and other associated findings. In 14 patients postoperative spine MR studies were evaluated for staging and therapeutic planning. RESULTS: The most frequent location of medulloblastoma was the inferior vermis and the mean tumor size was 4.1 x 3.6 x 3.9 cm. On Tl-weighted image, medulloblastomas generally had low to intermediate signal, predominantly hypointense relative to white matter. On T2-weighted image, medulloblastomas showed modetately high signal, hyperintense relative to white matter. Inhomogeneous contrast enhancement was demonstrated in 13 patients(72.2%) after injection of gadopentetate dimeglumine(Gadolinium). Cyst and necrosis within the tumor were visualized in 15 patients(83.3%). Subarachnoid disseminations of medulloblastomas were noted in 11 patients(61.1%), of which 6 demonstrated intracranial and 2 intraspinal dissemination. Three had both intracranial and intraspinal dissemination. In nine cases with intracranial lesions, there were intraparenchymal mass formation(7), subarachnoid nodules(5), infundibular lesions(2) and diffuse gyral enhancement(I). In five cases with intraspinal lesions, there were extramedullary intradural small nodules(3), central canal nodules(2), intradural masses(I)and fine nodular and sheet-like leptomeningeal enhancement(1). Other associated findings included intratumoral hemorrhage(11.1%), per/tumoral edema(44.4%), tonsillar herniation(44.4%), hydrocephalus(88.9%) and calcification(44.4%). CONCLUSION: Medulloblastomas revealed low to intermediate signal intensity on Tl-weighted image and intermediate to moderately high signal intensity on T2-weighted image, relative to cerebellar white matter. Medulloblastomas were solid tumors with cystic necrosis, which showed inhomogeneous enhancement and subarachnoid disseminations to the intracranial and intraspinal spaces after Gd-DTPA enhancement. Gd-enhanced MR of brain and spine was an useful diagnostic modality in preoperative diagnosis and in staging of postoperative cases of medulloblastomas, which was superior to postcontrast CT or precontrast MR.
Brain* ; Diagnosis ; Gadolinium DTPA ; Humans ; Male ; Medulloblastoma ; Necrosis ; Retrospective Studies ; Spine*

A Tc-99m sulfur colloid hepatic scintigraphy is often the first imaging modality empolyed in the evaluation ofthe patient with suspected liver disease,since the hepatic scintigraphy is not only highly sensitive, low expenseand easy of performance but also provides both structural and functional information of the liver. The authoranlayzed the scintigraphic findings in 304 patient proven various hepatic disease and 58 normal liver, and alsoretrospectively analyzed the result of hepatic scintigraphy and ultlrasonography of the liver in 117 patients. Theresults were as follows; 1. The overall sensitivity and specificity of hepatic scintigraphy in the liver diseaseis 91% and 67%, respectively. 2. On the evaluation of the diffuse parenchymal parenchymal disease of liver, thescintigiraphy was found to be highly sensitive (88%) and also specific image patterns were found in cirrhosis. 3.The hepatic scintigraphy was highly sensitive (92%) in the detection of the focal lesions of liver. 4. Theultrasonography was capable of differentiating solid and cystic masses which were detected on scintigraphy, whilescintigraphy was more sensitive in detection of hepatocellular disease. 5. Tc-99m sulfur colloid imaging reminedthe preferred inital screening method in patients with suspected liver disease, while ultrasonography should bedone for those patients with prior suspicious findings.
Fibrosis ; Humans ; Liver Diseases ; Liver ; Mass Screening ; Methods ; Radionuclide Imaging ; Sensitivity and Specificity ; Technetium Tc 99m Sulfur Colloid ; Ultrasonography

PURPOSE: To analyze angiearchitecture of arteriovenous malformations(AV malformation) in order to clarify the angiegraphic risk factors for intracerebral hemorrhage and other nonhemorrhagic symptoms. MATERIALS AND METHODS: Eighty-five patients with angiegraphically-proved brain arteriovenous malformation were included in this study. Retrospective review of clinical history and angiography was done. Topographic analysis and evaluation of 17 angiearchitectural characteristics were conducted. RESULTS: Deep-seated and cortico-callosal type, small nidus size, intranidal pouch, one draining vein, deep venous drainage only venous stenosis and venous aneurysm were the most discriminating or predictive characteristics of hemorrhage in brain arteriovenous malformation. And those with large nidus size, dural supply and venous hypertension were correlated with nonhemorrhagic symptoms such as seizure, headache and neurologic deficit. CONCLUSION: Detailed analysis of the angiearchitecture of brain arteriovenous malformations is needed to identify the features that are correlated with prognostic implications for the treatment of patients with ^V malformations.
Aneurysm ; Angiography ; Arteriovenous Malformations* ; Brain* ; Cerebral Hemorrhage ; Constriction, Pathologic ; Drainage ; Headache ; Hemorrhage ; Humans ; Hypertension ; Neurologic Manifestations ; Retrospective Studies ; Risk Factors ; Seizures ; Veins

No abstract available.
Anemia, Hemolytic, Autoimmune* ; Kidney Transplantation*

No abstract available.
Anemia, Hemolytic, Autoimmune* ; Kidney Transplantation*

No abstract available.
Humans ; Kidney* ; Living Donors* ; Transplants*

BACKGROUND: We performed a prospective, randomized, and controlled trial to evaluate the effect of an intravenous fentanyl and propofol on the variation in BIS level associated tracheal suction. METHODS: Thirty ICU patients intubated or tracheostomized were randomly allocated to control and experimental groups. Control group was received saline and experimental groups were received propofol with or without fentanyl intravenously prior to tracheal suction. And then we monitored BIS index, blood pressure, heart rate and SpO2 before, during and after tracheal suction. RESULTS: BIS index was significantly lower in propofol plus fentanyl group than others during experiment (P < 0.05). Heart rate and blood pressure in propofol plus fentanyl group also less increased than those in control or propofol group during tracheal suction (P < 0.05). CONCLUSIONS: These results suggest that co-administration of propofol and fentanyl has more effective than propofol alone in sedation and analgesia of ICU patients during tracheal suction.
Analgesia ; Blood Pressure ; Fentanyl* ; Heart Rate ; Humans ; Propofol* ; Prospective Studies ; Suction*

BACKGROUND: Many liver transplant surgeons think that portal vein cold perfusion is essential during liver procurement. However, it may limit the perfusion to the pancreas and small intestine and may lengthen the procedure. If visceral arteries are not ligated, perfusates passing the spleen and the small intestine can eventually cool the liver. Aorta only perfusion is rapid and easy and can be performed with the better perfusion of the pancreas and small intestine than with conventional perfusion. However, it may delay the cooling of the liver. The purpose of this study was to evaluate the feasibility of aorta only perfusion compared with conventional perfusion as an alternative method for multiorgan procurement. METHODS: Male mongrel dogs of 16-18 kg were used. In the control group (n=5), standard multiorgan procurement method, including portal vein perfusion, was performed. In experimental group (n=4), aorta only perfusion without superior mesenteric artery ligation was performed. An isotonic citrate solution was used as a perfusate. In the control group, a total amount of 800 to 1000 ml of the perfusate was used to each portal vein and aorta perfusion. In the experimental group, 1500 to 2000 ml of the perfusate were infused only to aorta. After donor liver procurement, 200 to 300 ml of the perfusate was added to the portal vein and the hepatic artery at a ratio of 8:2. Core temperature changes of the liver during perfusion with preservation solution were checked at 5-second intervals. Standard orthotopic liver transplantation was performed. Wedge liver biopsies were performed after procurement and 1 hour after reperfusion. A liver function test was performed, and the hematologic features, and the coagulation profiles were measured preoperatively and one hour after reperfusion. In histologic examination, injuries of hepatic vessel endothelia and hepatocytes were evaluated semiquantitatively under light microscopic and electron microscopic exams. RESULTS: A comparion of the two groups showed no differences in operation time, anhepatic time, and ischemic time. The values of the leukocyte count, the hemoglobin, hematocrit, the prothrombin time,the partial thromboplastin time, the total protein/albumin, bilirubin, ALT/AST and alkaline phosphatase were not different between two groups. Falling of liver core temperature during perfusion was slightly delayed in experimental group. However the delayed time was less than 2 minutes until to reach the temperature of 10oC. The histological grading scores of hepatocytes and endothelial damage determined from light microscopic and electron microscopic examinations were not different from each other. CONCLUSIONS: There was no difference between aorta only perfusion group and portal vein perfusion group, including the severity of liver damages. Therefore, liver procurement without in situ portal perfusion may be a reasonable alternative to combined portal and aorta perfusion on the background of rapid procurement and benefit to the pancreas and small intestine procurement.
Alkaline Phosphatase ; Animals ; Aorta ; Arteries ; Bilirubin ; Biopsy ; Citric Acid ; Dogs ; Hematocrit ; Hepatic Artery ; Hepatocytes ; Humans ; Intestine, Small ; Leukocyte Count ; Ligation ; Liver Function Tests ; Liver Transplantation* ; Liver* ; Male ; Mesenteric Artery, Superior ; Pancreas ; Partial Thromboplastin Time ; Perfusion* ; Portal Vein ; Prothrombin ; Reperfusion ; Spleen ; Tissue Donors

No abstract available.
Animals ; Heart* ; Rats*