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

BACKGROUND: The high concentration of plasma total homocysteine is recently considered an independent risk factor for atherosclerosis. The purpose of this study was to provide reference ranges for plasma homocysteine levels and to investigate the relationship between plasma homocysteine and cardiovascular risk factors in healthy Korean men. METHODS: Anthropometric parameters, alcohol intake, cigarette use and nutrient intake were determined in 166 healthy men within a wide age range(30-69 yr). Serum levels of lipids, glucose and insulin levels during oral glucose tolerance test(OGTT), plasma amino acid concentrations and levels of antioxidant nutrients and enzymes were also measured. Hyperhomocysteinemia was defined as plasma homocysteine levels above the 90th percentile(> or =15micromol/L) of respective plasma homocysteine distribution in study subjects. Characteristics of hyperhomocysteinemic men(n=16) were compared to normohomocys- teinemic men(n=16) matched for age and body mass index. RESULTS: Plasma total homocysteine values ranged from 2.4 to 38.1micromol/L, a skewed, right-tailed distribution. The homocysteine levels of 25th, 50th and 75th percentile were 7.02, 9.61 and 12.4micromol/L, respectively. The mean concentration of plasma total homocysteine was 10.7micromol/L. Plasma total homocysteine level was positively correlated to body mass index, serum cholesterol and triglyceride levels and alcohol intake, but negatively correlated to serum bata-carotene concentration. In multivariate analysis, serum triglyceride level was the strongest determinant of plasma total homocysteine concentration. There were no significant differences between two groups in waist to hip ratio, alcohol intake, cigarette use, blood pressure and serum levels of glucose and insulin during OGTT. Hyperhomocysteinemic men had significantly higher mean values of serum triglyceride(258mg/dl), total cholesterol(226mg/dl), and LDL-cholesterol(140mg/dl) than normohomocysteinemic men. Hyperhomocysteinemic men showed a decrease in lipid corrected values of serum bata-carotene and alpha-tocopherol and plasma concentrations of serine and taurine, when compared to normohomocysteinemic men. The mean intakes of vitamin B6, folate, vitamin B12 and bata-carotene tended to decline by 25-30% in hyper- homocysteinemic group, when compared to normohomocysteinemic group. CONCLUSION: Our results indicate that healthy Korean men with hyperhomocys- teinemia show signs of hyperlipidemia and decreased antioxidants nutrients and these factors increase risk for coronary artery disease. In addition, hyperhomocysteinemia may affect amino acid metabolism related to homocysteine.
alpha-Tocopherol ; Antioxidants ; Atherosclerosis ; Blood Pressure ; Body Mass Index ; Cholesterol ; Coronary Artery Disease ; Folic Acid ; Glucose ; Glucose Tolerance Test ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hyperlipidemias ; Insulin ; Male ; Metabolism ; Multivariate Analysis ; Plasma* ; Reference Values ; Risk Factors* ; Serine ; Taurine ; Tobacco Products ; Triglycerides ; Vitamin B 12 ; Vitamin B 6 ; Waist-Hip Ratio

No abstract available.
Child* ; Humans ; Rhabdomyosarcoma*

No abstract available.
Nasal Bone*

Owing to the advancement of imaging techniques which include the CT scan, it became easier to evaluate fracture patterns of calcaneal fractures accurately. Moreover, it is possible to obtain good results with operative treatment as a consequence of the development of good operative equipment and new operative technique. In 1988, Regazzoni and Benirschke in 1990, recommended L-shaped extensive lateral approach for calcaneus which provide extensive exposure of calcaneus and so allow easier reduction and fixation. We carried out L-shaped extensive lateral approach in 11 cases from June, 1993 to April, 1994. This approach did not produce any skin problems and allowed excellent anatomical reduction and fixation. But we experienced some severe causalgia on the heel region in several cases. We tried to analyse the cause of pain and concluded that it was the damage to the lateral calcaneal branch of the sural nerve. We are reporting the problems of tbis approach.
Calcaneus ; Causalgia ; Heel ; Skin ; Sural Nerve ; Tomography, X-Ray Computed

No abstract available.
Animals ; Rats*

No abstract available.
Animals ; Rats* ; Reperfusion*

Authors analyzed the post-operative subdural hygroma using radioisotope(RI) cisternography in 30 cases following aneurysmal surgery with pterional approach from October, 1995 to March, 1996. Age, CSF flow from basal cisterns, and etent of opening of Liliequist's membrane during operation were significantly related to the development of post-operative subdural hygroma. Computed tomography(CT) scan of brain and RI cisternography were performed in all patients at three weeks following operations. RI diffusion time from the interpeduncular cistern to the cerebral convexity of ipsilateral side with surgically opened Liliequist's membrane was compared with contralateral nonoperated normal side. Diffusion time of ipsilateral side(mean 5.2+/-8.4hr) was faster than that of contralateral one. Age, cerebrospinal fluid(CSF) from basal cistern, and extent of opening of Liliequist's membrane during operation were significantly related to development of post-operative subdural hygroma. Development of subdural hygroma after pterional approach for aneurysmal operations in our series is believed to be caused by stagnation of CSF in the convexity until its absorption into the arachnoid villi. Increased CSF flow from the infratentorial space to the supratentorial space through extensively opened Liliequist's membrane is considered to contribute development of its formation.
Absorption ; Aneurysm* ; Arachnoid ; Brain ; Diffusion ; Humans ; Membranes ; Subdural Effusion*

We evaluated the effectiveness of Tc-99m labeled antigranulocyte antibody immunoscintigraphy in differentiating the causes of vertebral compression fracture. This study involved 16 patients with vertebral compression fracture; 8 were due to trauma or osteoporosis, 3 were due to metastasis and 5 were due to tuberculous spondylitis. We retrospectively analyzed the location and the extent of decreased tracer uptake in tomographic images of Tc-99m labeled antigranulocyte antibody immunoscintigraphy. Eight patients had a 16 vertebral compression fractures due to trauma or osteoporosis , three patients had a 3 vertebral compression fractures due to metastasis and 5 patients had a 6 vertebral compression fractures due to tuberculous spondylitis. Sixteen vertebral compression fractures by trauma or osteoporosis showed a normal tracer uptake in pedicle, laminar and spinous process, but there was noted with 6 decreased uptake, 8 absence of tracer uptake and 2 normal tracer uptake in the vertebral body. Two vertebral compression fractures by metastasis showed the absence of uptake in vertebral body, pedicle, laminar and spinous process, and one showed an absence of vertebral body and spinous process. Six vertebral compression fractures by tuberculous spondylitis showed the absence of uptake in six compression fractures, the absence of pedicle in five compression fractures. We concluded Tc-99m labeled antigranulocyte antibody immunoscintigraphy may be helpful to differentiate the causes of vertebral compression fractures.
Fractures, Compression* ; Humans ; Neoplasm Metastasis ; Osteoporosis ; Retrospective Studies ; Spondylitis

BACKGROUND: Changes in body fat distribution and antioxidant status can be shown in patients with coronary heart disease (CHD) and these changes may be more pronounced in CHD patients with than those without diabetes. This study was undertaken to determine the discrimination of body fat distribution, hormones and antioxidants among healthy male and CHD male patients with and without diabetes. METHODS: An oral glucose tolerance test was performed in 64 healthy males and 56 CHD male patients. CHD group was subdivided into patients with and without diabetes. Adipose tissue and muscle areas were calculated from computed tomography scans made at four body levels, L1, L4 and mid portion of thigh and calf. Fasting serum levels of lipids, hormones and antioxidants and plasma level of homocysteine were determined. RESULTS: 28% of healthy males, 33% of CHD patients without diabetes and 15% of CHD patients with diabetes were current smokers. 56% of healthy males, 30% of CHD patients without diabetes and 46% of CHD patients with diabetes supplemented their diet with synthetic vitamin preparation. There were no differences among groups in means of age, body mass index and blood pressure. While CHD patients without diabetes showed an increase in visceral fat area at only L1 level, CHD patients with diabetes showed an increase at both L1 and L4 levels, compared with healthy males. CHD patients with diabetes showed the lowest mean value of HDL-cholesterol and testosterone. The mean response areaof insulin and C-peptide during OGTT was higher in CHD patients without diabetes than healthy males. CHD patients with and without diabetes showed higher plasma level of homocysteine and lower serum levels of IGF-1, superoxide dismutase (SOD) and beta-carotene, compared with healthy males. Serum levels of cryptoxanthin and lycopene were lower in CHD patients with diabetes than healthy males. CONCLUSION: Visceral fat accumulation, an increase in insuline and homocysteine levels and a decrease in IGF-1, SOD and beta-carotene levels in CHD patients indicate a difference in body fat distribution, hormones and antioxidant systems between CHD patients and healthy males. In addition, a further increase in visceral fat and a decrease in the serum levels of HDL-cholesterol, testosterone and carotenoids in CHD patients with diabetes show the increased risk in the simultaneous presence of CHD and diabetes. Thus, the lifestyle modification of these CHD patients such as quitting smoking, reducing abdominal fat and taking antioxidant-rich foods is recommended.
Abdominal Fat ; Adipose Tissue* ; Antioxidants ; beta Carotene ; Blood Pressure ; Body Fat Distribution* ; Body Mass Index ; C-Peptide ; Carotenoids ; Coronary Disease* ; Diet ; Discrimination (Psychology) ; Fasting ; Glucose Tolerance Test ; Homocysteine ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Intra-Abdominal Fat ; Life Style ; Male ; Plasma ; Smoke ; Smoking ; Superoxide Dismutase ; Testosterone ; Thigh ; Vitamins