No abstract available.
Magnetic Resonance Imaging* ; Stomach Neoplasms*

It is well known that double contrast knee arthrography is useful in diagnosis of meniscal lesions and other knee pathology, But intra-articular structures become less well delineated shortly after injection into the kneejoint with water soluble contrast media because of rapid absorption and dilution of the injected media. This limits the time when sharply detailed arthrograms are obtainable and precludes repeat delayed arthrogram withougreinjection of contrast media. In order to overcome this major disadvantage, the authors used epinephrine which has vasoconstrictive effect and is expected to reduce fluid movement across the synovial membrane temporarily. The authors attempted to compare epinephrine inhanced double contrast arthrographic group, einephrine(+) group, to thedouble contrast arthrographic group withoug epinephrine, epinephrine(-) group, by statistical evaluation. Eachgroup consisted of 35 cases and 7 lateral films of knee joint were taken sequentially 2,6,10,15,10,20,30, and 60 minutes after injection of contrast media, and were assessed by 5 certified radiologists. The resuls were as follows; 1. The difference of mean score of quality between epinephrine(+) group and epinephrine(-) group was statistically significant at every time interval (p value<0.01 at 2 minutes, p<0.01 at all other time intervals).Epinephrine(+) group was superior to the epinephrine(-) group in quality of film. 2. Numbers of cases above scoreof 2 which was considered to be of diagnostic quality in evaluating meniscal lesions were larger in epinephrine(+)group than epinephrine(-) group in quality of film. 3. Only 43% of cases was above score of 2 at 10 minutes inepinephrine (-) group, but 97% at 10 minutes and 80% at 20 minutes respectively in epinephrine(+) group. Therefore duration for adequate study of arthrogram is prolonged more than two times in epinephrine(+) group. 4. At 30 minuts, 57% of cases was above score of 2 in epinephrine(+) group while at 15 minuts, 80% of cases was below scoreof 2 in epinephrine(-) group. This makes it possible to repeat study without additional injection of contrast media or postponing of the examination in half of cases, if necessary. 5. The use of epinephrine in kneearthrography results in significant enhancement of radiographic quality initially (p<0.01). Therefore we can fluoroscope in good condition and obtain films of fine quality.
Absorption ; Arthrography ; Contrast Media ; Diagnosis ; Epinephrine ; Knee Joint ; Knee ; Pathology ; Synovial Membrane ; Water

With the availability of accurate localizer and markedly improved resolution of CT, precise anatomicalpositioning of the structure of interest, proper gantry angulation, thin slicing and magnification technique of CTimage can be easily achieved. Recently there have appeared many articles on normal and abnormal CT findings of thelumber discs. These articles, however, were concerned with more or less indirect evaluation of the discs byobserving the contour of the posterior margin of the disc, compression or displacement of the adjacent structuresby protruded disc materials and the obliteration of the epidural fat. The present study has been carried out toinvestigated basically the normal internal architectures of the lumbar discs to set up a baseline by which onewell be able to judge abnormality of that structure. The materials consisted of 127 lumbar discs of 30 healthyadult subjects studied by the measure set technique (MST). The subjects were sampled randomly from the individualsundergoing a CT study for the reasons other than spnal diseases. To obviate sample bias the age, sex and disclevels were adjusted so that the uniformity in sample number of each category was maintained. CT scans wereperformed with a Siemens Somatom 2 Scanner immediately after calibration. Technical factors involved were tubevoltage 125 kVp, exposure time 10 seconds, 460 mAs, 256 x 256 matrices, and pixel size 0.4mm. Contiguous2-mm-thick slices of each disc were obtained parallel to the disc plane at 3-mm interval from the lower margin ofthe vertebral body for 5 lumbar discs. Out of multiple scan slices of each disc one image was chosen which hadneither partial volume effect with the adjacent vertebral body nor an out the nucleus pulposus (NP) and annulusfibrosus (AF) clearly. The internal architectures of each disc as revealed by MST were classified arbitrarily into3 types as follows; (1) When AF was discerned distinctly as a “white ring-like” structure from the “black” NP, thedisc was classified as well defined type: (2) When AF appeared as a fairly uniform “white ring-llike” structureand NP appeared as uniformly mottled densities with indistinct demarcation between the two, the disc was classifedas intermediate type ; and (3) When both AF and NP were diffusely mottled without any demarcation, the disc wasclassifed as diffuse type . With age, the internal architectures of the lumbar disc changed from the well-definedthrough intermediate to diffuse type. The relative increase in the density of NP was considered to representdegenerative change characterized by gradual replacement of the gelatinous tissue of NP by a fibrocartilaginoustissue and decrease in the water therein contained. The diffuse type were most frequently seen in the discs ofL4-5 and L5-S1 suggesting the maximum intensity of stress and strain due to weight bearing at these two disclevels.
Bias (Epidemiology) ; Calibration ; Clothing ; Gelatin ; Tomography, X-Ray Computed ; Water ; Weight-Bearing

Galeazzis frature has been described as a fracture of the radius complicated by a dislocation of the distal radioulnar joint. This fracture, with angulation of the distal radius and dislocation of the distal radioulnar joint, shows the tendency to redisplacement after reduction due to a variety of factors including the brachioradialis muscle, the pronator quadratus muscle and the thumb abductors and extensors. Because of these factors, this fracture may rarely be treated by manipulation and plaster immobilization alone. The treatment of choice for Galeazzis fracture is open reduction and internal fixation. The author reviewed the cases of 28 patients with Galeazzis fracture who had been treated at the Department of Orthopedic Surgery, Yonsei University Wonju College of Medicie from January 1978 to December 1986. This study emphasized the nature of the injury, the level of the radial fracture, treatment and results. The results were as follows ; 1. The subjects included 2 children and 26 adults. Males were affected more frequently than females, and the sex ratio was 6: 1 2. The causes of injury included car accidents in ten cases(36%), falls in eight cases(29%), injuries from machinery in five cases(18%), direct blows in four cases(14%) and explosion in one case(3%). 3. The fracture occured most often at the junction of the middle and distal thirds of the radial shaft in thirteen cases(47%), and less often in the middle third of the radial shat, eitht cases(29%). Infrequent sites of fracture included the junction of the proximal and middle thirds in four cases(14%), the distal third in two cases(7%) and the proximal third of the radius in one case(3%). 4. Twenty-two cases(78%) experienced fracture composed of only two fragmented, but six cases(22%) were multifragment fractures. The frature was oblique and in one case, spiral. In twenty-two cases, the fractures were closed and in six cases, open. Three cases of open fractures had grade III soft tissue injuries. 5. Roentgenograpghic diagnosis of the distal radioulnar joint disruption was possible in 82% of the cases. 6. Associated injuries were noted in 57% of the cases including six cases of head injuries, four cases of head injuries, two cases of injury to the lower extremities, two cases of spinal injury, one cases of a fractured humerus. 7. Conservative treatment was given in five cases and operative treatment twenty-two cases. Conservative treatment gave excellent results in one case, fair results in two cases, while operative treatment resulted in an excellent outcome in thirteen cases, a fair outcome in eight cases and poor in one case. 8. Six cases experienced complications including delayed union in two cases, subluxation of the distal radioulnar joint in two cases, ahgulation in one case and infection in one case.
Accidental Falls ; Adult ; Child ; Clinical Study ; Craniocerebral Trauma ; Diagnosis ; Dislocations ; Explosions ; Female ; Fractures, Open ; Gangwon-do ; Humans ; Humerus ; Immobilization ; Joints ; Lower Extremity ; Male ; Orthopedics ; Radius ; Sex Ratio ; Soft Tissue Injuries ; Spinal Injuries ; Thumb

It is the purpose of this article to determine various normal anatomic measurements of temporomandibular joint and normal range of condylar movement using relatively simple X-ray equipment and radiographic technique in consideration of popular clinical application. Author's cases condisted of 100 clinically normal adult males and temporomandibular joint radiographs of 3 serial position so condylar head were taken by transcranial obliquelateral pojection in each case. The serial positions are centric occlusion, 1 inch opening and maximal opening position. The results were as follows; 1. In cetric occlusion, the length between the condylar head and glenoidfossa was 2.23±0.58mm in anterior part, 3.55±0.80mm in upper part and 2.76±0.72mm in posterior part. 2. Incentric occlusion, the angle (alpha) between the horizontal standard line(AB) and anterior slope (BC) was 37.22±3.87 degrees. 3. In 1 inch opening position, the distance between the summit of condylar head from thestandard point of articular eminence (B) was
Adult ; Head ; Humans ; Male ; Mandible ; Reference Values ; Temporomandibular Joint

We anlized CT of 29 cases of various orbital disease in pediatric age group. Diagnoses were confirmed byeither operation or direct ophthalmoscopy. The patients were examined during the period of last 3 years. Theresults were as follows: 1. Of 29 cases, 21 were male and 8 were female, and the age ranged from 20 days to 15years. 2. Intraorbital tumors were 13 cases consisting of 7 retinoblastoma, 3 pseudotumor, and 1 each ofcongenital teratoma, cavernous lymphanngioma, and optic glioma, Of remaining 16 cases, 6 had orbital fracture, 5persistent hyperplastic primary viterous(PHPV), 3 vitreous opacity, and 2 primary glaucoma. 3. The CT findings ofthe retinoblastoma were a lobulated or oval soft tissue mass denisty (40-60HU) extending into the vitreous wtihoutsignificant enhancement on postcontrast scan. Of 7 cases, 4 had calcifications within the tumors. The extraglobalextension of the tumor was shown in 2 patients demonstrating markedly thickened sclera with enhancement anddilated optic nerve. 4. There were 5 patients with PHPV having a history of white pupil since birth, and all wereaffected unilateraly. Four patients had vitreous opacity and 3 of those showed either linear or branchingtree-like densities within the vitreous on the postcontrast scan. Another one had a lobulated increased densityprotruding into the vitreous which was difficult to differenciate from the similar finding of retinoblastoma.Remaining one case demonstrated a deformed and decreased density in the lesional lens without chaneg in thedensity of the vitreous. This was confirmed to be caused by persistence of the embryonic hyaloid artery attachedto the posterior capsule of the lens. 5. There were 3 patients with vitreous opacity and 2 of them were due toretinal detachment and 1 was caused by retrolental fibroplasia. The CT findings of retinal detachement werehomogenous or heterogenous opacities in the vitreous. In a case of retrolental fibroplasia, irregular, band-likedensity was seen along the posterior wall of the globe bilaterally. 6. Two cases of primary glaucoma showed largeglobe with a widened anterior chamber. 7. Among 6 cases of orbital fractures, 5 were blow-out fracture. Theblow-out fractures showed fractures of the medial orbital wall or orbital floor with herniated intraorbitalcontents into the neighboring ethmoid or maxillary sinus.
Anterior Chamber ; Arteries ; Diagnosis ; Female ; Glaucoma ; Humans ; Male ; Maxillary Sinus ; Ophthalmoscopy ; Optic Nerve ; Optic Nerve Glioma ; Orbit ; Orbital Diseases ; Orbital Fractures ; Parturition ; Posterior Capsule of the Lens ; Pupil ; Retinaldehyde ; Retinoblastoma ; Retinopathy of Prematurity ; Sclera ; Teratoma

CT scan is widely used in the evaluation of hepatobiliary system and contrast study is generally performedwith non-biliary contrast media. Therefore the normal intrahepatic bile ducts are not readily visible and alsoextrahepatic bile ducts are occasinally not discriminated from adjacent structures, in spite of improvedresolution of the CT scanner. This study was performed to evaluate the usefulness of cholangiographic enhancementin biliary CT examination. In the control group (n=5), we measured the CT number of the peripheral hepatic duct,perioportal duct, common bile duct and gall bladder, respectively, at the interval of 30 minutes upto 2 hoursafter intervenous infusion of biliscopin(30ml) and observed time-denstiy relationship of infused biliscopin in thebiliary system. In the patient group (n=23), we observed visualization rate of the bilary system and serumbilirubin level at 30 minutes after infusion of biliscopin(30ml). The results were as follows: 1. The peak densityoccurred at 30 minutes after infusion of biliscopin. 2. Visualization rate was 100% in normal bilirubin groupwhereas it was 91.7% in abnormal bilirubin group. 3. The cholangiographic enhancement of biliary CT scan is usefulin the evaluation of intra-and extraheptaic biliary system.
Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Bilirubin ; Common Bile Duct ; Contrast Media ; Humans ; Tomography, X-Ray Computed ; Urinary Bladder

PURPOSE: To assess the value of MR imaging compared to CT for the staging of gastric carcinoma when body-wrap-around surface coil, intravenous glucagon, motion suppression technique and effervescent granules are used. MATERIAL AND METHOD: CT and MRI were performed for thirty-five patients with gastric carcinoma. Postcontrast CT scan was performed immediately after oral effervescent granules and Buscopan were given. Before MR imaging, BWA surface coil was wrapped around the upper abdomen. T1 coronal, sagittal and axial SE images (TRITE=400/15 msec) were obtained immediately after oral effervescent granules and glucagon were given. Respiratory compensation and presaturation techniques were used for each imaging. Three radiologists evaluated independently for randomly mixed 70 sets of CT and MR images. The signal intensity of gastric mass and enlarged lymph nodes were compared to the signal intensity of the adjacent pancreas, liver and spleen to evaluate any discriminating features between them. RESULTS: The accuracy in the diagnosis of pancreatic invasion was 83.8% on MRI and 74.3% on CT (p < 0.05). The accuracy of MRI and CT was 77.1% and 72.4% in detecting of gastric tumor respectively (p > 0.05), 73.3% and 68.6% in gastric serosal invasion (p> 0.05), 50.5% and 42.9% in lymph node metastasis (p > 0.05). The gastric mass and enlarged lymph nodes were hypointense to the intensity of pancreas and liver in more than 78% of cases. CONCLUSION: MRI was comparable to CT scan for the staging of gastric carcinoma. Therefore, MRI could be used as an alternative or adjunctive diagnostic modality in the staging of gastric carcinoma.
Abdomen ; Butylscopolammonium Bromide ; Compensation and Redress ; Diagnosis ; Glucagon ; Humans ; Liver ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pancreas ; Spleen ; Tomography, X-Ray Computed

Amyloidosis is a rare systemic disease caused by extracellular deposition of insoluble protein. Systemic amyloidosis is subclassified into idiopathic primary and secondary form. The cause of secondary amyloidosis includes tuberculosis, familial Mediterranean fever, rheumatoid arthritis and multiple myeloma. We report a case of tuberculosis-related, secondary systemic amyloidosis which involved liver, spleen, kidneys, stomach, urinary bladder and lymph nodes.
Amyloidosis* ; Arthritis, Rheumatoid ; Familial Mediterranean Fever ; Kidney ; Liver ; Lymph Nodes ; Multiple Myeloma ; Spleen ; Stomach ; Tuberculosis* ; Urinary Bladder

The obliteration of a fat plane between the gastric carcinoma and the pancreas is a major criterion on CT scan for pancreatic invasion of gastric carcinoma. However, this sign is not always a reliable indicator of invasion, as the patients with gastric carcinoma are often emaciated. Producing a false positive CT findings. The purpose of our study is to improve the diagnostic accuracy of pancreatic invasion of gastric carcinoma in cases which the fat plane between the gastric carcinoma and the pancreas is obliterated in conventional CT scan. The authors performed lateral decubitus as well as supine CT scans and upper gastrointestinal series(UGIS) in 49 pathologically proven cases in which the fat plane was obliterated between the gastric carcinoma and the pancreas on conventional supine CT scan. Pancreatic invasion was suggested when the fat plane was obliterated persistently in the lateral decubitus view as well as the supine CT images and the involved gastric wall and adjacent pancreas maintained constant approximation despite postural change(CT+), and when the gastric tumor moved downward on the erect view of the UGIS no more than 1.5 time the height of the first lumbar vertevral body(UGIS+). Among 49 cases in which the fat plane between the gastric carcinoma and the pancreas was obliterated on supine CT scan, pancreatic invasion was confirmed pathologically in 11 cases(22.4%). Eight of 11 cases proven as pancreatic invasion were correctly diagnosed as pancreatic invasion by this combined analysis (CT+/UGIS+, 72.7%). Twenty seven of 38 cases proven as no pancreatic invasion were correctly diagnosed as no pancreatic invasion(CT-/UGIS-, 71.1%). Twelve cases showed CT +/UGIS-or CT-/UGIS+, so it was inconclusive whether there was invasion or not. The overall diagnostic accuracy was 71.4%. In conclusion, combined analysis with supine and lateral decubitus CT and UGIS is useful for improving diagnostic accuracy for pancreatic invasion by gastric carcinoma in patients of which the fat plane between the gastric carcinoma and the pancreas is obliterated on conventional supine CT.
Humans ; Pancreas ; Tomography, X-Ray Computed