No abstract available.
Plasma Exchange* ; Plasma*

In the treatment of an infected ununited fractures of a long bone, it often is difficult to achieve union and eradicate the infection. Over the past two decades, the electrical behaviour of bone has been studied with increasing interest and several reports reveal that electricity can stimulate osteogenesis. We have experienced 11 cases of infected non-union who were treated by immobilization plus direct current stimulation from January, 1980 to July, 1982. In all cases satisfactorv union occurred within averaging 8.1 months. The results obtained are as follows: 1. The direct current stimulation has revealed to be effective with antibiotics and some kinds of immobilization in treatment of infected non union. 2. If bone graft is combined with electrical stimulation, time from beginning of electrical treatment to union is shortened, as compared with cases of electrical stimulation alone. 3. The electrical stimulation is preferable to other surgeries in treatment of infected non-union due to its effectiveness and simplicity. 4. It is considered treatment of chronic osteomyelitis with silver anode is not due to electrically generated silver ion but its electricity per se. 5. To prevent refracture and assure complete healing, continued immobilization such as cast brace, walking cast, or conventional brace is necessary after electrical stimulation for the time being.
Anti-Bacterial Agents ; Braces ; Electric Stimulation ; Electricity ; Electrodes ; Fractures, Ununited ; Immobilization ; Osteogenesis ; Osteomyelitis ; Silver ; Transplants ; Walking

PURPOSE: The aim of this study is to correlate the non-characteristic dual-phase CT imaging findings of hepato-cellular carcinoma with the observed characteristics of surgical specimens. MATERIALS AND METHODS: We studied four cases in which homogeneous low attenuation was observed during the arterial and delayed phases of dynamic CT scanning and in which hepatocellular carcinoma with coagulation necrosis above 95% was pathologically confirmed. We compared the findings of dual phase CT scanning, ultrasonography, angiography and Lipiodol CT scanning with the observed features of surgical specimens. RESULTS: Nodules were 30-50 (mean, 41) mm in size, and were round in three cases and oval in one. In all four cases, a low density lesion was observed during the arterial and delayed phases of dual-phase CT scanning. Ultrasonography demonstrated internal echo and the presence of a hypoechoic halo, implying that in all cases a capsule was present. At angiography and LiCT, minimal peripheral and central tumor staining or lipiodol up-take was observed. In all surgical specimens a complete capsule was visible, and histologic structures were mainly of the trabecular type, Edmondson grade II or III was recorded, and the mass had undergone extensive coagulation necrosis (above 95%). CONCLUSION: In cirrhotic liver which is hepatitis B-antigen positive, clear sonographic findings of internal echo and a capsule, rather than a simple cyst, indicate the possibility of hepatocellular carcinoma with extensive coagulation necrosis. This is so even if the arterial and delayed phases of dual-phase CT scanning indicate the presence of a low-density lesion, and in such cases additional work-up is therefore required.
Angiography ; Carcinoma, Hepatocellular* ; Diagnosis* ; Ethiodized Oil ; Hepatitis ; Liver ; Liver Neoplasms ; Necrosis* ; Tomography, X-Ray Computed ; Ultrasonography

Primary serous papillary carcinoma of the peritoneum is a rare neoplasm arising from the mesothelium. Histologically it is indistinguisable from ovarian serous papillary carcinoma, but it should be free of tumor or involved only superficially with the ovary. Radiologically its common findings are peritoneal and omental masses with ascites, and it is indistinguisable from peritoneal carcinomatosis or malignant mesothelioma. We report a case of surgically proven primary serous papillary carcinoma of the peritoneum in a 63-year-old woman.
Ascites ; Carcinoma ; Carcinoma, Papillary* ; Epithelium ; Female ; Humans ; Mesothelioma ; Middle Aged ; Ovary ; Peritoneum*

PURPOSE: To compare the mammographic features and histologic subtypes of ductal carcinoma in situ(DCIS) of the breast. MATERIALS AND METHODS: Mammograms of 34 patients with DCIS of the breast detected between January 1992 and November 1998 were retrospectively analyzed. Histologic subtypes were classified as either comedo or noncomedo. Mammographic findings were classified in one of four ways : microcalcification only, microcalcification with mass, mass or asymmetrical density only, or normal. Microcalcifications was classified as either predominantly casting or granular. We also determined whether microcalcification was multifocal. RESULTS: Histologic examination revealed the comedo type in eight patients and the noncomedo type in 26. Among the eight comedo-type cases, mammography demonstrated microcalcification only in five and micro-calcification with mass in three. Among 26 noncomedo-type cases, microcalcifications only was seen in ten, microcalcification with mass in two, mass or asymmetrical density only in six, and normal features in eight. Six of the comedo type were predominantly casting and two were predominantly granular. Predominantly casting calcification was present in four of 12 cases of the noncomedo type and predominatly granular was in eight. Multifocality was seen in four comedo-type cases, but in none of those that were of the noncomedo type. CONCLUSION: We conclude that the comedo subtype of DCIS of the breast is more likely than the noncomedo subtype to be accompanied by microcalcification of the predominantly casting type. Multifocally located microcalcification is a more frequent feature of the comedo subtype than of the noncomedo subtype.
Breast ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Mammography ; Retrospective Studies

Calcifying Fibrous Pseudotumor of the Retroperi We report a case of calcifying fibrous pseudotumor in theretroperitoneum. This is a rare soft tissue mass le-sion with specific radiologic and pathologic findings, and itis the first reported case arising in the retroperi-toneum. The CT, MR and angiographic findings are described.

A pathologic splenic rupture is rare, occurring primarily in a spleen affected by infective, hematological, and neoplastic disease. To the best of our knowledge, no prior reports of a pathologic splenic rupture due to scrub typhus exist. Intrasplenic pseudoaneurysms and focal infarctions are visible on an initial CT scan. Moreover, the spontaneous splenic rupture occurred a week later. We report a case of nontraumatic-splenic rupture in a patient with scrub typhus.
Aneurysm, False ; Humans ; Infarction ; Rupture ; Scrub Typhus ; Spleen ; Splenic Rupture ; Typhus, Endemic Flea-Borne

PURPOSE: To determine the findings of diffusion-weighted magnetic resonance (MR) imaging of acute and chronic benign compression fracture, metastatic compression fracture, and spondylitis, and to differentiate between them. MATERIALS AND METHODS: Forty-nine cases with vertebral compression fractures (17 metastatic, 16 acute osteo-porotic, 11 old osteoporotic, 5 acute traumatic) and seven with spondylitis (4 tuberculous, 3 pyogenic) underwent MR imaging. All cases were classified as belonging to one of four groups: A: acute osteoporotic and traumatic, B: metastatic, C: old osteoporotic, or D: spondylitic. For MR imaging, a 1.5-T scanner (Magnetom Vision, Siemens, Erlangen, Germany) was used, and the diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession (PSIF) and a relatively low b value of about 150 sec/mm 2. Signal intensity characteristics were evaluated in terms of the contrast ratio (CR) and signal-to-noise ratio (SNR) of bone marrow. RESULTS: Diffusion-weighted MR imaging showed that signal intensity in group A was hypointense to adjacent normal vertebral bodies, but in group B, hyperintensity was noted. In group C, signal intensity was variable, while in group D, hyperintensity was again noted. Diffusion-weighted imaging revealed that in group A, bone marrow CR had a negative value, while in groups B and D, this value was positive (p < .01). The SNR of group D was lower than that of group B, but the difference was not statistically significant (p > .01). CONCLUSION: Diffusion-weighted MR imaging revealed that the signal intensity of metastatic compression fracture and spondylitis was hyperintense to adjacent normal vertebral bodies, that of acute benign compression fracture was hypointense, and that of chronic benign compression fracture was variable. This modality is therefore useful for differentiating between metastatic compression fracture, spondylitis and acute benign compression fracture.
Bone Marrow* ; Fractures, Compression* ; Magnetic Resonance Imaging* ; Signal-To-Noise Ratio ; Spine* ; Spondylitis*

PURPOSE: We attempted to evaluate the relationship between transarteiral chemoembolization (TACE) and injury to the peribiliary plexus by evaluating the number of microvessels in the peribiliary plexus of surgical specimen. MATERIALS AND METHODS: Surgical specimens were obtained from 78 hepatocellular carcinoma patients and 22 patients with liver metastases. They were divided into 4 groups (Group 1; hepatocellular carcinoma without TACE [n=30], Group 2; hepatocellular carcinoma receiving preoperative TACE once [n=37], Group 3; hepatocellular carcinoma receiving preoperative TACE more than two times [n=11] and Group 4; metastatic carcinoma of the liver patients without a history of liver disease [n=22]). Immunohistochemical staining for factor VIII-related antigen was performed in all the specimens and the number of microvessels in the inner capillary layer and the outer venous layer of the bile duct (> 200 micrometer in diameter) was counted. RESULTS: The mean numbers of microvessels in the inner capillary layer were 4.50, 4.08, 1.64 and 2.05, and those in the outer venous layer were 25.23, 20.00, 18.36 and 12.32 for the 4 groups, respectively. The number of microvessels in group 4 was statistically fewer than that of group 1 (p<0.01). In the hepatocellular carcinoma patients, the number of microvessels was decreased as the number of TACE sessions was increased. CONCLUSION: The number of microvessels in the peribiliary plexus is increased in chronic liver disease patients. It may be from the increased portal pressure and flow stagnation in the sinusoidal and portal venules. TACE can have an effect on microvascular injury of the peibiliary plexus, and this can be a cause of bile duct necrosis and biloma.
Bile Ducts ; Capillaries ; Carcinoma, Hepatocellular ; Humans ; Liver ; Liver Diseases ; Microvessels ; Necrosis ; Neoplasm Metastasis ; Portal Pressure ; Venules ; von Willebrand Factor

Nitric oxide (NO) is mainly involved in brain ischemic damage to elucidate the protective mechanism of NO pretreatment on ischemic-induced cytotoxicity. This study was investigated whether NO pretreatment inhibits the increase of iNOS expression by lipopolysaccharide (LPS) combined phorbol 12-myristate 13-acetate (PMA) via regulating NF-kB activation in C6 glial cells. C6 glial cells with LPS and PMA for 72 hours markedly induced NO, but sodium nitroprusside (SNP) (100 nM) pretreatment before exposure of LPS and PMA significantly supressed NO production, iNOS expression and NF-kB activation by LPS and PMA. In addition, LPS and PMA treatment for 72 hours induced severely cell death and LDH release from cell into media in C6 glial cells. However SNP pretreatment before treatment of LPS and PMA significantly protected LPS and PMA induced cytotoxicity. Treatment with LPS and PMA induced caspase 3 activation follewed by chromosomal condensation, and fragmentation of nuclei in C6 glial cells. SNP pretreatment before exposure to LPS and PMA supressed caspase 3 activation and inhibited chromosomal condensation and fragmentation of nuclei. From these above results, it is suggest that the protective effects of SNP pretreatment against LPS and PMA induced cytotoxicity may be mediated by inhibiting the expression of iNOS via regulating NF-kB activation.
Brain ; Caspase 3 ; Cell Death ; Neuroglia ; NF-kappa B ; Nitric Oxide* ; Nitroprusside