No abstract available.

PURPOSE: To determine the value of Gd-DTPA enhanced fat-suppression(GEFS) MR imaging in the characterization and differentiation of benign from malignant ovarian tumors. MATERIALS AND METHODS: MRI findings of thirty-seven patients with surgically proved 44 ovarian tumors (30 benign, 14 malignant) were studied retrospectively. MR imaging with conventional spin echo (CSE;Tl-weighted image TR/TE 450/20, T2-weighted image TR/TE 3500/30, 90) and GEFS were performed with a 1.5T GE signa. MRI findings of tumors including cystic or solid, wall and septal thickness, necrosis, invasion to adjacent organ, ascites and lymphadenopathy were assessed separately by using CSE and GEFS images, and then tumors were characterized as benign or malignant. RESULTS: Compared with CSE image, GEFS MR image showed better visualization of solid component in 5 malignant lesions, wall thickness in 5 malignant and 1 benign lesions, septal thickness in 3 malignant and 1 benign lesions, necrosis in 1 malignant lesion, and adjacent soft tissue invasion in 5 malignant lesions. Correct characterization of malignant tumors was increased from 71% on CSE image to 93% on GEFS image. However, correct characterization of benign tumors was 93% on both images. CONCLUSION: GEFS MR imaging could be useful for characterization of ovarian tumors, especially in malignant cases, and employed for differentiation of benign from malignant tumors.
Ascites ; Gadolinium DTPA* ; Humans ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Necrosis ; Retrospective Studies

BACGROUND: The purpose of this study was to evaluate the efficacy of caudal epidural steroid injection with local anesthetic for chronic lower back pain patients. METHODS: The 152 patients with lower back pain were selected for the study. The patients were treated with the caudal injections of steroid (triamcinolone acetate 40 mg) and local anesthetics (1% lidocaine 17 ml). The efficacy of caudal injections was assessed with the visual analogue scale (VAS) before procedure and at 8 weeks following procedure. RESULTS: The VAS scores of 'Before procedure' group and '8 weeks after procedure' group were 62 23 and 31 15, respectively. The caudal steroid injections provided effectiveness in treating various lower back pain diseases except postlaminectomy syndrome. CONCLUSION: We consider that caudal epidural injections of steroid and local anesthetics are effective for patients with chronic lower back pain in the short term.
Anesthetics, Local ; Humans ; Injections, Epidural ; Lidocaine ; Low Back Pain*

The computed tomographic(CT) findings of fourteen patients with inflammatory disease and 28 with neoplasm who had an abnormal colonic wall thickening, were retrospectively studied to establish CT criteria for each disorder in differentiating inflammatory from neoplastic lesions. According to homogeneity, density and contour of mural thickening and pericolic inflammatory change in enhanced CT scans, we classified colonic wall abnormalities into 6 patterns: I) multilayering with inner and outer hyper- and middle hypodensities, II) homogeneously hyperdense with pericolic inflammatory change, III) heterogeneously hyperdense with pericolic inflammatory change, IV) homogeneously heperdense with lobulated contour, V) heterogeneously hypodense with lobulated contour and VI) heterogeneously mixed densities with irregular lobulated contour. Type I, II and III were distinctively identified in inflammatory disease, type IV, V in neoplasm, and type VI in boty diseases. We conclude that enhanced CT could be helpful in the initial diagnosis and/or suggestion of abnormal colonic wall disease and differentiation of inflammatory from neoplastic diseases.
Colon* ; Diagnosis ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To determine the usefulness of three-dimensional CT angiography using multidetector-row CT (MDCT) for delineating the arterial anatomy of the liver. MATERIALS AND METHODS: Hepatic arterial three-dimensional CT angiography was performed using MDCT (Lightspeed Qx/I; GE Medical Systems, Milwaukee, Wis., U.S.A.) in 45 patients with HCC undergoing conventional angiography for transcatheter hepatic arterial chemoembolization. The scanning parameters during the early arterial phase were 2.5 mm slice thickness, 7.5 mm rotation of table speed, and a pitch of 3. Images were obtained by one radiologist using maximum intensity projection from axial CT images obtained during the early arterial phase. Two radiologists blinded to the findings of conventional angiography independently evaluated the hepatic arterial anatomy and the quality of the images obtained. RESULTS: Compared with conventional angiography, reader A correctly evaluated the hepatic arterial anatomy depicted at three-dimensional CT angiography. Reader B's evaluation was correct in 40 of 45 patients. Interobserver agreement was good (kappa value, 0.73), and both readers assessed the quality of three-dimensional CT angiography as excellent. CONCLUSION: Three-dimensional CT angiography using MDCT was accurate for delineating the arterial anatomy of the liver, and interobserver agreement was good. The modality may provide, prior to conventional angiography, valuable information regarding a patient's hepatic arterial anatomy.
Angiography* ; Hepatic Artery* ; Humans ; Liver

PURPOSE: To determine the usefulness of cerebral perfusion computed tomography (CT) in patients with acute cerebral ischemic infarction. MATERIALS AND METHODS: Twelve patients with acute middle cerebral artery infarction underwent conventional CT and cerebral perfusion CT within 25 hours of the onset of symptoms. For each patient, perfusion CT scans were obtained at the levels of the basal ganglia and 1 cm caudal to them. Using special imaging software, perfusion imaging maps for cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to peak (TTP) were created, and the infarcted lesion was evaluated on each map. MTT and TTP delay times were measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Lesion size on each perfusion map was determined and compared with the value obtained by diffusionweighted MR imaging (DWMRI). RESULTS: In all patients, perfusion CT maps depicted the perfusion defect lesion, for which the MTT and TTP delay was remarkable. A comparison of lesion size between each perfusion map and DWMR images showed that the closest correlation involved CBF maps (8/12, 67%). On MTT maps, the lesion was larger than at DWMRI, suggesting that MTT mapping can be used to evaluate ischemic penumbra. CONCLUSION: Perfusion mapping facilitates the evaluation not only of the ischemic core and ischemic penumbra, but also of hemodynamic status in the area of the perfusion defect. This finding demonstrates that perfusion CT can be useful for the diagnosis and treatment of patients with acute cerebral ischemic infarction.
Basal Ganglia ; Blood Volume ; Cerebrum ; Diagnosis ; Hemodynamics ; Humans ; Infarction* ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Perfusion Imaging ; Perfusion* ; Tomography, X-Ray Computed

Chylous ascites in neonates is an unusual and etiologically poor understood entity. We report a male newborn who suffered from abdominal distension and respiratory distress after birth. Paracentesis was performed and ascitic fluid was obstained. Analysis of the fluid revealed cell count (RBC 10,000/mm3, WBC 800/mm3: segmented form-72%, lymphocyte form- 28%), protein 4,100 mg/dl, glucose 57 mg/dl, cholesterol 53 mg/dl, triglyceride 28 mg/dl. Culture of ascitic fluid grew no bacteria. A plain film of abdomen and abdominal sonogram showed massive ascites. On the 4th hospital day, gastrografin enema showed microcolon and ileal atresia. On the 6th hospital day, ileocolostomy has been performed and operative findings sho- wed blind pouch in terminal ileum, massive inflammation and extensive adhesion on peritoneum. After operation, he gained weight by continuous gavage feeding. He discharged on the 36th hospital day.
Abdomen ; Ascites ; Ascitic Fluid ; Bacteria ; Cell Count ; Cholesterol ; Chylous Ascites* ; Diatrizoate Meglumine ; Enema ; Glucose ; Humans ; Ileum ; Infant, Newborn ; Inflammation ; Lymphocytes ; Male ; Paracentesis ; Parturition ; Peritoneum ; Triglycerides

This study aimed to investigate the analgesic effect of substance P (SP) in an animal model of neuropathic pain. An experimental model of neuropathic pain, the chronic constriction injury (CCI) model, was established using ICR mice. An intravenous (i.v.) injection of SP (1 nmole/kg) was administered to the mice to examine the analgesic effects of systemic SP on neuropathic pain. Behavioral testing and immunostaining was performed following treatment of the CCI model with SP. SP attenuated mechanical allodynia in a time-dependent manner, beginning at 1 h following administration, peaking at 1 day post-injection, and decaying by 3 days post-injection. The second injection of SP also increased the threshold of mechanical allodynia, with the effects peaking on day 1 and decaying by day 3. A reduction in phospho-ERK and glial fibrillary acidic protein (GFAP) accompanied the attenuation of mechanical allodynia. We have shown for the first time that i.v. administration of substance P attenuated mechanical allodynia in the maintenance phase of neuropathic pain using von Frey’s test, and simultaneously reduced levels of phospho-ERK and GFAP, which are representative biochemical markers of neuropathic pain. Importantly, glial cells in the dorsal horn of the spinal cord (L4–L5) of SP-treated CCI mice, expressed the anti-inflammatory cytokine, IL-10, which was not seen in vehicle saline-treated mice. Thus, i.v. administration of substance P may be beneficial for improving the treatment of patients with neuropathic pain, since it decreases the activity of nociceptive factors and increases the expression of anti-nociceptive factors.
Administration, Intravenous* ; Animals ; Behavior Rating Scale ; Biomarkers ; Constriction ; Glial Fibrillary Acidic Protein ; Humans ; Hyperalgesia* ; Interleukin-10 ; Mice ; Mice, Inbred ICR ; Models, Animal ; Models, Theoretical ; Neuralgia ; Neuroglia ; Spinal Cord ; Spinal Cord Dorsal Horn ; Substance P*

BACKGROUND: The maintenance of low central venous pressure (LCVP) induced by fluid restriction and nitroglycerin administration reduces the overall blood loss during major hepatic resections. We studied the postoperative renal function in hepatectomized patients under LCVP maintenance with nitroglycerin. In addition, the renal effect of low dose dopamine combined with nitroglycerin was evaluated. Methods: A total of 60 patients were randomly divided into two groups: a nitroglycerin group (n = 30), and a nitroglycerin and dopamine group (n = 30). During the Pringle maneuver the central venous pressure (CVP) was maintained at < 5 mmHg in both groups. The nitroglycerin group received 0.5-1microgram/kg/min nitroglycerin before and during the Pringle maneuver, but in nitroglycerin and dopamine group, 3microgram/kg/min dopamine was administered with nitroglycerin. Mean arterial pressure, CVP, and urine output were measured before, during, and after the Pringle maneuver. BUN and serum creatinine were measured on postoperative days 1 and 3. Results: No significant differences were observed between the mean arterial pressures, CVPs, or urine outputs of the two groups. In both groups, urine output reduced after the Pringle maneuver but increased more in the nitroglycerin and dopamine group than in the nitroglycerin control group after anesthesia. There was no overall statistical change in either BUN or creatinine in either group. Conclusions: We conclude that LCVP induced by nitroglycerin with the Pringle maneuver during hepatectomy does not cause postoperative renal dysfunction, and that the use of low dose dopamine with nitroglycerin has no meaning in terms of preventing renal dysfunction in this situation.
Anesthesia ; Arterial Pressure ; Central Venous Pressure* ; Creatinine ; Dopamine* ; Hepatectomy* ; Humans ; Nitroglycerin

BACKGROUND: Glucocorticoids have anti-inflammatory effects and have been used to treat many types of nerve injury- associated chronic pain conditions. A randomized double-blind study was performed to determine if methylprednisolone could prevent the development of neuropathic pain after a peripheral nerve injury in rats. METHODS: Two groups of rats, one group (n = 50) injected intraperitoneally with methylprednisolone (100 mg/kg/day, for 7 days starting from 3 days prior to the nerve injury) and the other (n = 58) treated with saline with same manner, were compared in terms of the incidence and intensity of allodynia after a superior caudal trunk transection at the level between the 3rd and 4th sacral spinal nerves. The tail-flick responses to normally innocuous mechanical and thermal stimuli applied to the tail were observed as the behavioral signs of neuropathic pain. RESULTS: The proportions of rats exhibiting tail-flick responses to the mechanical (but not thermal) stimuli 7, 14 and 21 days after the nerve injury were significantly smaller in the methylprednisolone-treated group (2, 3 and 4 of 50 rats, respectively) than in the saline-treated, control group (11, 14 and 15 of 58 rats, respectively) (P = 0.009). However, the pain intensity was similar in mechanical allodynia developed rats of the two groups (P > 0.05), which was estimated based on the frequency and latency of the tail-flick responses after applying mechanical and thermal stimuli, respectively. CONCLUSIONS: These results suggest that a pre-emptive treatment with high methylprednisolone doses may be used to prevent the development of mechanical allodynia following peripheral nerve injuries.
Animals ; Axotomy ; Chronic Pain ; Double-Blind Method ; Glucocorticoids ; Hyperalgesia* ; Incidence ; Methylprednisolone* ; Neuralgia ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; Spinal Nerves