No abstract available.

It is thought to be reliable roentgenologic sign of pulmonary plethora that the diameter of anterior segmental artery(d-ASA) is larger than that of anterior segmental bronchus(d-ASB). To evaluate the reliability of this sign, we compared d-ASA with d-ASB on chest rentgenograms of 100 normal adults. Of the total 105 cases. d-ASA was larger than d-ASB in 40 cases (38.1%), smaller than d-ASB in 34 cases(32.4%) and equal to (d-ASA and) d-ASB in 31 cases(29.5%). The ratio(ABR) and difference between d-ASA and d-ASB ranged from 0.70 to 1.58(mean, 1.05±0.30) and from -1.85mm to +2.45mm(mean of absolute value, 0.75mm±0.57). These results showed that the relationships between d-ASA and d-ASB were variable. Conclusively, d-ASA may be larger than d-ASB in even normal adults and mild degree of pulmonary plethora cannot exectly evaluated with this findings only.
Adult ; Arteries* ; Bronchi* ; Humans ; Thorax

Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked giant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46- year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like giant cells and mononuclear cells.
Child ; Male ; Female ; Humans ; Biopsy

Anesthetic experience with unilateral adrenalectomy for two patients (ll-year-old and 19- year-old female) with Cushings syndrome due to adrenocortical carcinoma has been reported. Anesthesia was induced with intravenous thiopental followed by nitrous oxide-oxygen-halothane and Pancuronium (Mioblock) for muscular relaxation. An endotracheal semi-closed circle absorption techniqne with controlled respiration was employed. The Patient tolerated well the anesthesia and surgery with appropriate cardiovascular control using hydrocortisone, whole blood and fluid replacement under continuous monitoring of B.P., E.C.G., C.V.P., and urine output. Importance of optimal preparation of the patient with Cushings syndrome, sufficient sedation, smooth induction, complete analgesia, good mucular relaxation, adequate alveolar ventilation and of proper cardiovascular control has been stressed and discussed together with the hazards of postoperative adrenal insufficiency.
Absorption ; Adrenal Insufficiency ; Adrenalectomy ; Adrenocortical Carcinoma* ; Analgesia ; Anesthesia ; Cushing Syndrome* ; Humans ; Hydrocortisone ; Pancuronium ; Relaxation ; Respiration ; Thiopental ; Ventilation

We have experienced 20 cases of anesthesia for Total Hip Replacement(Charnleys Lov Frictinn Arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. Preoperative diagnosis was, 7 cases of Hip Joint Tuberculosis, 6 cases of Femur Neck Fracture, 5 cases, of Osteoarthritis of Hip Joint, and 2 cases, of Avascular Necrosis. Average blood loss has 1500 ml for one side operation, and 2400 ml for bilateral one. In 12 cases, hypotensive response was occurred during the application of Acrylic bone cement to the medullary canal of femur, however in 4 cases, hypotensive responses was more prominentafter the application of Acrylic bone cement to the Acetabulum fossa and the rest of cases were no changes in blood pressure and pulse rate whatsoever. In two cases, hypotensive range was over 30%(in compare with preoperative one), but recovery was soon after administration of Effortil corticosteroids, volume expanders etc. There was no mortality.
Acetabulum ; Adrenal Cortex Hormones ; Anesthesia* ; Blood Pressure ; Clinical Study* ; Diagnosis ; Etilefrine ; Femoral Neck Fractures ; Femur ; Heart Rate ; Hip ; Hip Joint ; Joints ; Mortality ; Necrosis ; Osteoarthritis, Hip ; Polymethyl Methacrylate ; Tuberculosis ; Wounds and Injuries

PURPOSE: We report a case of neuromyelitis optica (Devic's syndrome) with hepatocellular carcinoma. CASE SUMMARY: A 70-year-old male with hepatocellular carcinoma presented with bilateral visual loss. A relative afferent pupillary defect was not observed in either eye due to bilateral mydriasis. On brain MRI, there was no specific finding, however, on spine MRI, multiple and severe myelopathies were observed. After high-dose methylprednisolone pulse therapy, the visual acuity was 0.03 in the right eye and counting fingers at 30 cm in the left eye. CONCLUSIONS: We encountered a case of neuromyelitis optica involving bilateral optic neuropathy in hepatocelluar carcinoma. Therefore, in patients with an optic neuropathy of uncertain etiology, clinicians should consider performing a systemic evaluation.
Aged ; Brain ; Carcinoma, Hepatocellular* ; Eye ; Fingers ; Humans ; Male ; Methylprednisolone ; Mydriasis ; Neuromyelitis Optica* ; Optic Nerve Diseases ; Optic Neuritis ; Paraneoplastic Syndromes* ; Pupil Disorders ; Spinal Cord Diseases ; Spine ; Visual Acuity

Arthroplasty ; Facial Asymmetry ; Humans ; Hyperplasia ; Mandible ; Mandibular Osteotomy ; Osteotomy

PURPOSE: The aim of our study was to identify the CT features helpful in the differential diagnosis of Iobar consolidation. MATERIALS AND METHODS: We evaluated the CT findings in 52 consecutive patients with Iobar consolidation which were proved to be pulmonary tuberculosis(n=24), malignant obstructive pneumonitis due to bronchogenic carcinoma(n=21), and lung abscess(n=7). We retrospectively reviewed CT scans with respect to 1) number of cavities or low attenuation area suggesting necrosis(we described these as cavity), 2) the contour of cavity, 3) enhancement of the cavity wall, 4) enhancement of pleura, 5) small nodules adjacent to the consolidation, 6) similar lesion in other location in lung, 7) air-bronchogram 8) mediastinal lymph node enlargement, and 9) extrapleural change. RESULTS: The helpful CT fingings in the patients with pulmonary tuberculosis were multiple cavities(more than three;79.2%), small nodules adjacent to the Iobar consolidation(75.0%), similar lesion in another lobe or lung(91.7%), air-bronchogram(91.7%), and mediastinal lymph node enlargement(58.3%). Although extrapleural change had low sensitivity it was highly specific for pulmonary tuberculosis(sensitivity, 43.5%;specificity, 91. 7%). Multiple cavities(61.9%) and mediastinal lymph node enlargement(52.4%) were common findings of malignant obstructive pneumonitis. In the patients with lung abscess, the common findings were small number of cavities(one or two, 85.7%) and air-bronchogram(85.7%). However, other findings of pulmonary tuberculosis were rarely seen in the patients with malignant obstructive pneumonitis or lung abscess. CONCLUSION: The CT findings of Iobar consolidation may be used as useful adjuncts in the differential diagnosis of Iobar consolidation.
Diagnosis, Differential ; Humans ; Lung Abscess* ; Lung* ; Lymph Nodes ; Pleura ; Pneumonia* ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary

The antihypertensive effect and side reactions of perdipine were evaluated in 30 patients with essential hypertension. The results were as follows; 1) Before medication and after 2, 4, 5 and 8 weeks of medication, the over all average systolic and diastolic blood pressure were 170+/-13/104+/-7, 152+/-13/93+/-6, 146+/-11/91+/-6, 143+/-9/90+/-7, and 141+/-10/89+/-7mmHg, respectively. In 89% of all cases, marked or moderate degree of antihypertensive effect was observed. 2) There were no significant changes in heart rates before and after treatment. 3) In 83% of all cases, improvement of symptoms were observed. 4) The side reactions of oral perdipine were mild constipation, anorexia, facial flushing, dizziness, and headache, respectively one case. but there were no side reactions which required discontinuing the treatment, except 1 case which discontinued the medication because of severe bradycardia and dizziness.
Anorexia ; Blood Pressure ; Bradycardia ; Constipation ; Dizziness ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension ; Nicardipine*

No abstract available.
Thymus Neoplasms*