Pedunculated hepatocellular carcinoma was first described by Roux in 1987, and Goldberg and Wallerstein presented a case with pathological description in 1934. Since then 37 cases have been reported in the world literature. A pedunculated hepatocellular carcinoma, occurred in a 69-year-old woman, was encountered. It was attached to the Glission's capsule of the right lobe of liver inferiorly, and was connected to the porta hepatis bt a mesenteric pedicle containing arteries, veins, bile ducts and nerve bundles. The tumor mass was completely encapsulated, and measured 8.5x8x6 cm and 255 gm. It was composed of hepatocellular carcinoma of a well-differentiated, acinar type. Tumor cells were positive for HBsAg, but negative for alpha-fetoprotein on peroxidase-antiperoxidase staining. The liver exhibited macronodular cirrhosis on gross examination. This tumor is thought to have on in the supernumerary lobe of liver.
Female ; Humans ; Carcinoma, Hepatocellular

The primary malignant melanoma arising in the leptomeninges of the central nervous system is extremely rare. We report a case of malignant melanoma, apparently thought to be originated from leptomeninges, with diffuse neoplastic process widely spreaded over the leptomeninges of 42 years old man, who had suffered severe headache, nausea and left hemiparesis. This patient is free of the symptoms for six months after operation. The literature on this subject is briefly reviewed.
Adult ; Central Nervous System ; Headache ; Humans ; Melanoma* ; Nausea ; Paresis

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

We performed IV bolus CT scan in 40 patients with final diagnosis of various hepatic masses in order to evaluate hemodynamic changes and differentiating characters of the lesions. Preenhanced, early and late phase post enhanced, and delayed CT scans were obtained with rapid IV bolus injection of contrast materials and table sliding method for pertinent scans. In hepatomas, early enhanced CT scan directly showed hypervascular change and active viable portion of the mass and late phase CT scan showed capsular enhancement. In addition, extracapsular invasion and post-embolization recurrence were more easily visualized. In hemangiomas, early and late enhancing types could be categorized according to the time of maximal enhancement. In metastatic liver malignancies and cholangiocarcinomas, specific findings were seen in early phase and delayed CT scans and not in conventional CT scan. In conclusion, IV bolus CT scan is a very useful CT method in demonstrating the characteristic hemodynamic patterns and in differential diagnosis of the hepatic masses.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Contrast Media ; Diagnosis ; Diagnosis, Differential ; Hemangioma ; Hemodynamics ; Humans ; Liver ; Methods ; Recurrence ; Tomography, X-Ray Computed*

Isolated heaptic tuberculous granuloma with no coexistent tuberculosis elsewhere in the body is extremely rare. We report a case of pathologically proven tuberculous granuloma in the liver followed with both IV bolus and portal CT scans. The lesion on preenhanced CT scan showed undefinable isodensity. After IV bolus injection, it showed poor enhancement with central low-density and surrounding hyperdenity due to compensatory hypervascularity of the left lobe of liver in early phase. It showed peripheral rim enhancement in late phase and in delayed phase showed relatively homogeneous but slightly decreased contract enhancement. On portal CT scan, it showed a hypodense portal defect similar to other hepatic mass lesions. During follow-up studies, it was a slowly growing mass which was more easily detectable by prtal CT scans than bolus CT scans.
Follow-Up Studies ; Granuloma* ; Liver ; Tomography, X-Ray Computed ; Tuberculosis

A case of fibroepithelial polyp with stromal atypia in a 25-year-old female is described. The tumor arose from the vaginal wall and measured 3.5 cm in maximal diameter. It was composed of hypercellular connective tissue stroma and focal myxoid area containing numerous atypical mono- and multinucleated stromal cells. These cells may mislead to make a diagnosis of sarcoma, particulary of botryoid rhabdomyosarcoma.
Adult ; Connective Tissue ; Diagnosis ; Female ; Humans ; Polyps* ; Rhabdomyosarcoma ; Sarcoma ; Stromal Cells* ; Vagina*

STUDY DESIGN: Thirteen patients with cervical interlocked facets dislocation in whom closed reduction by skull traction was failed were evaluated about the patterns of ruptured disc fragment. Objects : To evaluate the causes of failure at closed reduction, and the relation between ruptured discs and interlocked facets, and the treatment results through an anterior approach. SUMMARY OF LITERATURE REVIEW: In traumatic dislocation of the cervical facet joints, spinal cord or nerve roots injury associated with the ruptured disc fragment has been reported. However, there is few report evaluating the patterns of ruptured disc fragment as a cause of reduction failure. MATERIALS AND METHODS: Between 1988 and 1997, thirteen patients were treated by anterior fusion with plate after complete removal of the intervertebral disc through anterior approach and reduction of interlocked facets by O1iveira method. They have been followed for an average of 36 months(range : 12-96 months). The interlocking was bilateral in seven cases and unilateral in six cases. We assessed the types of ruptured disc fragment by preoperative MRI and CT and the clinical and radiological results. RESULTS: Ruptured disc fragment was found in all thirteen patients with interlocked facets dislocation. The patterns of ruptured discs were within the uncovertebral joints in 5 cases, posterioly under the posterior longitudinal ligament in 3 cases, anteriorly under intact anterior longitudinal ligament in 3 cases and combined under the anterior and posterior longitudinal ligament in 2 cases. The displacement of ruptured disc fragment were seemed to be the cause of failure in closed reduction. CONCLUSIONS: Intervertebral disc injury should be evaluated carefully with MRI and CT in the lower cervical interlocked facet dislocations before trial of reduction or decision makings of treatment.
Dislocations* ; Humans ; Intervertebral Disc ; Joints ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Skull ; Spinal Cord ; Spine* ; Traction ; Zygapophyseal Joint

For the elucidation of a possible pathogenetic mechanism of fatty accumulation by the orotic acid in the liver, male Sprague-Dawley rats were fed on semisynthetic diet containing 1 per cent orotic for a week, and followed by the morphological examination on the rat livers. The experimental animals were sacrificed on the 1st, 2nd, 3rd, and the 7th days of orotic acid feeding and daily sacrifice was performed after conversion to normal diet feeding during the performed after conversion to normal diet feeding during the period of successive 7 days. The control group animals were fed on normal regular diet, or semisynthetic diet without orotic acid. The liver tissues were examined by the light ad electron microscopy, together with electron microscopic cytochemical study for glucose-6-phosphatase and thiamine pyrophosphatase. On the light microscopy, the lipid droplets began to appear in the 3rd day of orotic acid feeding and then occupy through the all hepatic lobules in the 7th day of orotic acid feeding. On the electron microscopy in the 3rd day of orotic acid administraion, the endoplasmic rdticulum were fragmented and vesiculated, and vesicles containing VLDL particles were demonstrated closely around the Golgi complex. In the 7th day, Golgi complex were increased in numbers. The limiting membrances of lipid vacuoles were regarded to originated from rough-surfaced endoplasmic reticulum of account of demonstration of glucose-6-phospatase in them. In the Golgi complex the activity of thyamine pyprophosphatase were markedly decreased in the 1st day of orotic acid feeding, and then the activity of this enzyme is failed to present afterthat. On the above findings it is assumed that orotic acid depresses the function of trans aspect of Golgi stack and the VLDL is interrupted and followed by the retrograde accumulation of VLDL. The cis aspect of Golgi stack and rough-surfaced endoplasmic reticulum were accumulated with VLDL particles, and eventually coalesced vesicles of VLDL with become lipid vacuole. The sequential alteration of endoplasmic reticulum and Golgi complex is supporting the concept of conformational change of membranes in cytocavitary net-work.
Male ; Humans ; Rats ; Animals

For the elucidation of a possible pathogenetic mechanism of fatty accumulation by the orotic acid in the liver, male Sprague-Dawley rats were fed on semisynthetic diet containing 1 per cent orotic for a week, and followed by the morphological examination on the rat livers. The experimental animals were sacrificed on the 1st, 2nd, 3rd, and the 7th days of orotic acid feeding and daily sacrifice was performed after conversion to normal diet feeding during the performed after conversion to normal diet feeding during the period of successive 7 days. The control group animals were fed on normal regular diet, or semisynthetic diet without orotic acid. The liver tissues were examined by the light ad electron microscopy, together with electron microscopic cytochemical study for glucose-6-phosphatase and thiamine pyrophosphatase. On the light microscopy, the lipid droplets began to appear in the 3rd day of orotic acid feeding and then occupy through the all hepatic lobules in the 7th day of orotic acid feeding. On the electron microscopy in the 3rd day of orotic acid administraion, the endoplasmic rdticulum were fragmented and vesiculated, and vesicles containing VLDL particles were demonstrated closely around the Golgi complex. In the 7th day, Golgi complex were increased in numbers. The limiting membrances of lipid vacuoles were regarded to originated from rough-surfaced endoplasmic reticulum of account of demonstration of glucose-6-phospatase in them. In the Golgi complex the activity of thyamine pyprophosphatase were markedly decreased in the 1st day of orotic acid feeding, and then the activity of this enzyme is failed to present afterthat. On the above findings it is assumed that orotic acid depresses the function of trans aspect of Golgi stack and the VLDL is interrupted and followed by the retrograde accumulation of VLDL. The cis aspect of Golgi stack and rough-surfaced endoplasmic reticulum were accumulated with VLDL particles, and eventually coalesced vesicles of VLDL with become lipid vacuole. The sequential alteration of endoplasmic reticulum and Golgi complex is supporting the concept of conformational change of membranes in cytocavitary net-work.
Male ; Humans ; Rats ; Animals