A clinical observation was made on the bladder tumors of the inpatients in the Department of Urology, Seoul National University Hospital during the period January. 1957 through June, 1967. During the period, of 1.836 cases (1,372 males and 464 females) hospitalized, 99 cases had bladder tumors, giving a rate of 5.3%. Among the 99 cases, 88 cases could be studied and the following results were obtained. 1. Among the 88 cases, 68 cases were male and 20 cases were female with ratio of 3.4 to 1. 2. Age distribution ranged from 22 years to 79 years, 70.5% of cases were in the age group of 4o~69. 3. Hematuria which occurred in 80 cases is the most common initial disturbance. The other common manifestations are frequency, dysuria and urinary retention as in order. 4. 54 cases or 61.5% of the cases visited to hospital within one year after the occurrence of initial disturbance. 5. 37.8% of the cases involved in the lateral wall, 30.7% in the posterior wall, 12.1% in the entire wall and 7.9% in the trigone. 6. As the methods of treatments, T.U.R. was performed 43 times, 29 time of electrocoagulation through suprapubic cystotomy and 12 times of partial resection of the bladder were done. 7. Among 88 cases, pathologic diagnosis was made in 72 cases. Transitional cell carcinoma is observed in 62 cases, adenocarcinoma in 4 cases, metastatic carcinoma in 3 cases and squamous cell carcinoma in 1 case. 8. 27 (30.7%) cases had had follow-up studies one or more times for 2 months to six and half years. At the first follow-up study 6 cases were tumor free and 21 cases had recurrent tumors.
Adenocarcinoma ; Age Distribution ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Cystotomy ; Diagnosis ; Dysuria ; Electrocoagulation ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Inpatients ; Male ; Seoul ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Retention ; Urology

It is well known that high energy X and r-ray have high penetration power in tussue, but have lower survacedose which is called the “skin sparing effect”. However, the surface dose can be increased significantly by excessive electron contamination and it is an important factor intreatment planning in the presence of a blocktray, especially in isocentric set-up. So relaltive surface doses for 10MV-X-ray and Co-60 r-ray were measuredwith various field sizes and SSD with or withoug 1/4" lucite shadow tray, present in the beams, using pancakechamber and polystylene phantom. The results obtained are as follows. 1. A rapid increase in surface dose isapparant with increasing field size in 10MV X-ray and Co-60 r-ray. 2. high surface dose is evident for smallerdistance from the tray, so at least 25cm of skin shadow tray distance for 10MV X-ray and 20cm for Co-60 are desirable. 3. Utilization of either bolus for treatment field or electron boost should be considered in treatmentof superificial nodal disease. 4. A tray using an intermediate or high z No. filter can be reduced the surfacedose significantly.
Polymethyl Methacrylate ; Silver Sulfadiazine ; Skin

The retrospective analysis on the clinical utility and side effects of the metrizamide myelography andmetrizamide CT-cisternography were made in 292 patients. Metrizamide CT proved valuable in the diagnosis ofintraspinal neoplasms with total block in myelography, demonstrating the upper margin of the neoplasms in a largenumber(75%) of the cases with neoplasm. Metrizamide study also clearly showed the nature and extent of thesyringomyelia, and arachnoid cyst. Metrizamide CT was also helpful in the diagnosis of spinal stenosis, spinaltrauma and infectious disease of the spine. The most common side effects were transient minor meningealirritations (headache, nausea, vomiting and dizziness)which persisted no more than 48 hours in most of thepatients. Five patients developed major complications such as grand mal seizure, toxic psychosis or asepticmeningits.
Arachnoid ; Communicable Diseases ; Diagnosis ; Humans ; Metrizamide ; Myelography ; Nausea ; Psychotic Disorders ; Retrospective Studies ; Seizures ; Spinal Stenosis ; Spine ; Vomiting

Eleven magnetic resonance(MR) and CT imagings were performed in nine patients with mild to moderate degree oddelayed neuropsychiatric symptoms following acute carbon monoxide(CO) poisoning, to evaluate the capability of MRin demonstrating any additional finding to CT. The MR images were obtained using 0.15 Tesla resistive system withvariuos combination of three pulse sequences, including partial saturation recovery, T2-weighted spine echo andinversion recovery. Bilateral white matter abnormalities suggesting demyelination were demonstrated in 4 patientswith MR and in only 2 patients wtih CT. The contrast discrimination between normal and abnormal white matterproved to be better with T2-wieghted spin echo and inversion recovery than with partial saturation recovery andCT. But necrosis of the globus pallidus(1 patient) and diffuse atrophy(3 patients) were equally demonstrated onboth MR and CT. It is suggested that MR be used as a initial imaging method in the evaluation of the delayedencephalopathy following acute CO poisoning, especially for the detection of the possible white matter lesions.
Brain Diseases ; Carbon Monoxide Poisoning ; Carbon Monoxide ; Carbon ; Demyelinating Diseases ; Discrimination (Psychology) ; Humans ; Methods ; Necrosis ; Poisoning ; Spine ; White Matter

PURPOSE: An oblique interface in the right cardiophrenic angle, extending superomedially from rightretrocardiac or supradiaphragmatic region inferolaterally to peridiaphragmatic region, is occasionally observed onposteroanterior chest radiograph. The aim of this study was to evaluate the frequency of visualization of the interface on chest radiographs and to elucidate its nature on radiographic-CT correlation. MATERIALS AND METHODS: Posteroanterior chest radiographs from 300 consecutive subjects were analyzed to evaluate the frequency and demographic data about an oblique interface in the right cardiophrenic angle. Thin-section CT scans(1-mmcollimation and 5-mm intervals) were obtained from the subjects with positive interface on chest radiograph for assessment of the nature of the interface. The demographic data in the subjects with and without the interface were tested statistically to note any difference between two groups. RESULTS: Oblique interface in the right cardiophrenic angle was present in 29 subjects(9.7%) on chest radiograph. The age of the subjects with positive interface(13 men and 16 women) ranged from 19 to 70 years(mean +/-SD, 47+/- 12.7 years) whereas the age of thesubijects without the interface from 16 to 82 years (mean +/-SD, 50+/-9.1 years)(p>0.1). The body weight of thesubjects with the interface ranged from 41 to 72 Kg(mean +/-SD, 60 +/- 8.0Kg) whereas the body weight of thesubjects without the interface from 41 to 85 Kg(mean +/-SD, 63+/-10.1Kg)(p>0.1). On CT scan, it was formed due tocontact between the epipericardial fat and the right middle lobe of the lung in 27 subjects(93%) and between the inferior vena cava and the medial basal segment of the right lower lobe of the lung in two(7%). CONCLUSION: Oblique interface in the right cardiophrenic angle is occasionally visualized on chest radiograph. It is formed due to contact between the right middle lobe of the lung and pericardial fat in most cases. The frequency of visualization of the interface has no relationship to age and body weight of the subjects.
Body Weight ; Humans ; Lung ; Male ; Radiography, Thoracic ; Thorax* ; Tomography, X-Ray Computed

PURPOSE: To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. MATERIALS AND METHODS: Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. RESULTS: The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheters were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted , namely the one case of thrombophlebitis. CONCLUSION: Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein.
Azygos Vein ; Catheter-Related Infections ; Catheters* ; Central Venous Catheters ; Constriction, Pathologic ; Embolism, Air ; Follow-Up Studies ; Humans ; Incidence ; Jugular Veins* ; Thrombophlebitis ; Thrombosis ; Venous Thrombosis

PURPOSE: To evaluate a recently developed technique to place a medium-duration(weeks to months) central venous access. MATERIALS AND METHODS: Within three-year period, 635 patients were referred to interventional radiology suite for placement of peripherally inserted central catheter(PlCC). Contrast medium was injected into the peripheral intravenous line and a puncture was made into the opacified vein near the junction of the middle and upper thirds of the upper arm, either the brachial or basilic vein under fluoroscopic guidance. A 5.5-French peel-away sheath was inserted into the vein and a 5- French silicone catheter was introduced with its distal tip to the junction of the right atrium and superior vena cava. RESULTS: Catheter placement was successful in all patients unless there was a central venous obstruction. Catheters were maintained from 2 days to 5 months with a mean of 3 weeks. Complications included infection requiring removal of the PICC in 16 patients(2.5%), acute thrombosis of the subclavian vein in 3(0.5%). Occluded catheters in 4 patients were easily cleared with urokinase in place. CONCLUSION: The PICC system is an excellent option for medium-duration cen- tral venous access. Patients were able to carry on normal activities with the catheters in place.
Arm* ; Catheters* ; Heart Atria ; Humans ; Ocimum basilicum ; Punctures ; Radiology, Interventional ; Silicones ; Subclavian Vein ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Superior

PURPOSE: To evaluate a recently developed technique to place a medium-duration(weeks to months) central venous access. MATERIALS AND METHODS: Within three-year period, 635 patients were referred to interventional radiology suite for placement of peripherally inserted central catheter(PlCC). Contrast medium was injected into the peripheral intravenous line and a puncture was made into the opacified vein near the junction of the middle and upper thirds of the upper arm, either the brachial or basilic vein under fluoroscopic guidance. A 5.5-French peel-away sheath was inserted into the vein and a 5- French silicone catheter was introduced with its distal tip to the junction of the right atrium and superior vena cava. RESULTS: Catheter placement was successful in all patients unless there was a central venous obstruction. Catheters were maintained from 2 days to 5 months with a mean of 3 weeks. Complications included infection requiring removal of the PICC in 16 patients(2.5%), acute thrombosis of the subclavian vein in 3(0.5%). Occluded catheters in 4 patients were easily cleared with urokinase in place. CONCLUSION: The PICC system is an excellent option for medium-duration cen- tral venous access. Patients were able to carry on normal activities with the catheters in place.
Arm* ; Catheters* ; Heart Atria ; Humans ; Ocimum basilicum ; Punctures ; Radiology, Interventional ; Silicones ; Subclavian Vein ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Superior

PURPOSE: To evaluate the safety and efficacy of Hickman catheter placement via the subclavian vein under fluoroscopic guidance with intravenous contrast injection. MATERIALS AND METHODS: During an eleven-month period, 187 Hickman catheters were percutaneously placed in 167 consecutive patients in an interventional radiology suite. Subclavian venous puncture was made with injection of contrast medium into the peripheral venous line. After subclavian venous access had been obtained, a subcutaneous tunnel was created using a peel-away sheath or a tunneler. The Hickman catheters were inserted through a peel-away sheath, the distal tip of which was at the junction of the right atrium and the superior vena cava. RESULTS: One hundred and eighty-six Hickman catheters were successfully placed; the one failure was due to an atomical tortuosity of the vein(0.53%). Complications included one case of subclavian vein occlusion (0.53%); three of line occlusion by thrombus (1.6%); one of oozing at the suture site (0.53%); six of infection or inflammation (3.2%); eight of natural removal (4.2%); one case of air embolism (0.53%) and two of malposition (0.1%). Major complications such as pneumothorax or arterial puncture leading to mediastinal hemorrhage did not, however, occur. CONCLUSION: The authors concluded that radiologic Hickman catheter placement offers advantages over traditional approaches in terms of safety, convenience, and time and cost savings.
Catheters ; Cost Savings ; Embolism, Air ; Heart Atria ; Hemorrhage ; Humans ; Inflammation ; Pneumothorax ; Punctures ; Radiology, Interventional ; Subclavian Vein* ; Sutures ; Thrombosis ; Vena Cava, Superior

PURPOSE: To determine the usefulness of microbubble contrast enhanced power Doppler ultrasonography (PDUS)for the detection of residual tumor in hepatocellular carcinomas (HCCs) treated by transcatheter arterialchemoembolization (TACE). MATERIALS AND METHODS: Fourteen nodular HCCs (size range: 1 - 7.3 cm, mean: 3.5) intwelve patients treated by TACE, and on the basis of follow-up liver CT, thought to have a residual tumor, wereincluded in this study. Between July 1997 and April 1998, PDUS examinations were performed with a 2-4 MHz convextransducer before and after intravenous injection of a microbubble contrast agent (Levovist(, Schering AG, Berlin,Germany). Real-time power Doppler ultrasonographic images were recorded on videotape and representative imageswere color-printed. Tumor vascularity was analyzed on real-time images with regard to its presence or absence, andchanges, and two observers reached a consensus. The results were compared with those of other diagnostic tests(three-phase helical CT, conventional angiography, percutaneous biopsy, and/or surgical pathology). RESULTS: Contrast-enhanced PDUS revealed intratumoral vascularity in ten of 14 tumors, none of which showed vascularity onunenhanced PDUS. In the remaining four tumors, both unenhanced and enhanced PDUS showed intratumoral tumorvascularity, which in all cases was more pronounced on enhanced than on unenhanced PDUS. Other diagnostic testsrevealed residual tumors in eleven lesions. CONCLUSION: Microbubble contrast-enhanced PDUS was more sensitivethan non-enhanced PDUS in depicting vascularity within a residual tumor and could be a useful method for thedetection of residual tumor in HCCs treated by TACE.
Angiography ; Biopsy ; Carcinoma, Hepatocellular* ; Consensus ; Follow-Up Studies ; Humans ; Injections, Intravenous ; Liver ; Microbubbles ; Neoplasm, Residual ; Tomography, Spiral Computed ; Ultrasonography, Doppler* ; Videotape Recording