PURPOSE: To evaluate the MR image in the differentiation of benign and malignant lesion in compression of the vertebral body. MATERIALS AND METHODS: MR images of 47 benign(acute traumatic within one month:19, chronic traumatic longer than one month or nontraumatic:28) and 21 metastatic compression fractures were respectively reviewed in terms of margin of lesions, signal intensity, paraspinal mass formation, soft tissue change, and involvement of posterior element of vertebra. MR images of TI-(T1WI) and T2*-weighted gradient echo (GE T2WI) sequences were obtained on 0.5T unit in sagittal and axial orientation with 5mm section thickness. RESULTS: The margin of benign compression fracture was usually indistinct (acute fracture:90% (17/19), chronic fracture:68% (19/28)), whereas it was sharply delineated in metastatic compression fracture (92%, (12/13) (p<0.001). Paraspinal mass was seen in both acute traumatic and metastatic compression fractures (acute fracture :26% (5/19), metastatic fracture: 52% (11/21). Soft tissue change was seen only in acute cornpression fractures (58%, 11/19). Involvement of posterior element of vertebra was noted in metastatic fracture (71%, 15/21), acute fracture (32%, 6/19) and chronic fracture (7%, 2/28) CONCLUSION: On MR imaging, involvement of entire portion of a given vertebral body, sharp margin between normal and abnormal areas in partially involved cases, paraspinal mass formation, and posterior element involvement are more frequently seen in metastatic compression fractures, which are considered to be useful in differentiation between benign and malignant causes of compression fracture.
Fractures, Compression* ; Magnetic Resonance Imaging* ; Spine

PURPOSE: To assess the role and efficacy of radiologic intervention in the adult patients with esophagobronchial fistula. MATERIALS AND METHODS: Radiologic intervertion was performed in 4 patients with esophagobronchial fistula. We tried direct occlusion of fistula tract by glue(histoacylate 0.4cc + lipiodol 0.3cc) and coil in 2 patients and performed presurgical wire insertion by using 8F curved catheter via esophageal opening of fistula tract. The latter procedure was carled out to detect the fistula tract easily at operation. RESULTS: Direct occlusions of fistula tract by glue and coil were performed only to fail in 2 patients. Pre-surgical wire incertion by using 8F curred catheter under guidance of fluroscopy in 3 patients were helpful in detecting fistula tract at operation. CONCLUSION: Direct occlusion of the fistulous tract in esophagobronchial fistulas was ineffective. However, presur- gical wire insertion by using cured catheter under fluroscopy guidance is helpful to detect the fistula tract easily at operation.
Adhesives ; Adult* ; Catheters ; Ethiodized Oil ; Fistula* ; Humans

PURPOSE: The chemoembolization with Lipiodol and doxorubicin hydrochloride is used in patients with hepatocellular carcinoma. What condition is the ideal emulsion of Lipiodol and doxorubicin for excellent anticancer effect? METHOD AND MATERIALS: Microscopic evaluation was performed on the emulsions, which were varied with different specific gravities of doxorubicin solutions, degrees in mixing of the emulsion, and amount of Lipiodol. RESULT: 1. Maximal amount of doxorubicin solution was contained in Lipiodol droplets and the release of doxorubicin from the droplets were delayed, when specific gravity of doxorubicin was equal to that of Lipiodol (SG, 1.28). 2. The optimal therapertic ratio of Lipiodol and doxorubicin was 3:2 at least, as in the emulsion less than 3:2, unmixed free forms of doxorubicin solution were increased. 3. The emulsion mixed by pumping 50--100 times had smaller Lipiodol droplets and contained larger amount of doxorubicin solution in the droplets than by pumping 20 times. CONCLUSION: We recommend the emulsion with specific gravity of doxorubicin equal to Lipiodol (SG. 1.28), the ratio of Lipiodol and doxorubicin closo to 3:2, and the mixture prepased with puming 50--100 times.
Carcinoma, Hepatocellular* ; Doxorubicin ; Emulsions ; Ethiodized Oil ; Humans ; Specific Gravity

Rarely, rupture of a cerebral aneurysm causes an acute subdural hematoma(SDH) in addition to subarachnoid hemorrhage(SAH). We report clinical and radiological characteristics of five cases, as well as potential pitfalls in the diagnosis and the treatment of this life-threatening condition. The patients ranged in age from 42 to 76 years. The Hunt-Hess grade on admission was gradeIII in one patient, gradeIV in two, and grade V in two. All five patients underwent one-stage operation (both SDH evacuation and clipping of the aneurysm). The outcome was good recovery in two patients, persistent vegetative state in two, and death in one. Patients with a good outcome had a better Hunt-Hess grade on admission, with less amount of SDH.
Aneurysm* ; Diagnosis* ; Hematoma, Subdural, Acute* ; Humans ; Intracranial Aneurysm* ; Persistent Vegetative State ; Rupture

Dieulafoy's lesion is a rare distinetive arterial malformation that can cause massive gastrointestinal henorrhage. Although in most cases the lesion is encountered in the proximal stomach within 6 cm of the gastroesophageal junction, similar lesions have been described in the antrum, duodenum, jejunum, colon, and rectum. We report 3 unusually located Dieulafoy-like lesion, two gastric antrum and one jejunum in patient who had gastrojejunostomy for pancreatic caneer. After a year follow up there was no bleeding episode in patient after endoscopic treatment.
Colon ; Duodenum ; Esophagogastric Junction ; Follow-Up Studies ; Gastric Bypass ; Hemorrhage ; Humans ; Jejunum* ; Pyloric Antrum* ; Rectum ; Stomach

To present a rare case of a cystic giant schwannoma of the sacrum mimicking aneurysmal bone cyst (ABC). A 54-year-old man visited our institute complaining left leg weakness and sensory change for several years. Magnetic resonance imaging revealed a large multilocular cystic mass with canal invasion and bone erosion confined to left S1 body. The lesion showed multiple septal enhancement without definite solid component. Initially the tumor was considered as ABC. The patient underwent grossly-total tumor resection with lumbosacral reconstruction via posterior approach. The tumor was proved to be a cystic schwannoma. The postoperative course was uneventful and the patient was relieved from preoperative symptoms. We present a rare case of pure cystic giant schwannoma confined to sacrum mimicking ABC. The surgical treatment is challenging due to the complex anatomy of the sacrum. Schwannoma should be considered in the differential diagnosis of osteolytic sacral cysts.
Aneurysm* ; Bone Cysts* ; Diagnosis, Differential ; Humans ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Neurilemmoma* ; Sacrum

No abstract available.
Rectum*

Objective: : Oblique lumbar interbody fusion (OLIF) is a surgical technique that utilizes a large interbody cage to indirectly decompress neural elements. The position of the cage relative to the vertebral body could affect the degree of foraminal decompression. Previous studies determined the position of the cage using plain radiographs, with conflicting results regarding the influence of the position of the cage to the degree of neural foramen decompression. Because of the cage obliquity, computed tomography (CT) has better accuracy than plain radiograph for the measurement of the obliquely inserted cage. The objective of this study is to find the correlation between the position of the OLIF cage with the degree of indirect decompression of foraminal stenosis using CT and magnetic resonance imaging (MRI). Methods: : We review imaging of 46 patients who underwent OLIF from L2-L5 for 68 levels. Segmental lordosis (SL) was measured in a plain radiograph. The positions of the cage were measured in CT. Spinal canal cross-sectional area (SCSA), and foraminal crosssectional area (FSCA) measurements using MRI were taken into consideration. Results: : Patients’ mean age was 69.7 years. SL increases 3.0±5.1 degrees. Significant increases in SCSA (33.3%), FCSA (43.7% on the left and 45.0% on the right foramen) were found (p<0.001). Multiple linear regression analysis shows putting the cage in the more posterior position correlated with more increase of FSCA and decreases SL correction. The position of the cage does not affect the degree of the central spinal canal decompression. Obliquity of the cage does not result in different degrees of foraminal decompression between right and left side neural foramen. Conclusion : Cage position near the posterior part of the vertebral body increases the decompression effect of the neural foramen while putting the cage in the more anterior position correlated with increases SL.

The spontaneous rupture of the ureter is a rare condition. Two cases are reported with a spontaneous rupture caused by ureteral calculi. The diagnosis was suspected by delayed post-CT KUB and confirmed by ureteroscopy. On the basis of the clinical evolution the authors discuss the diagnosis and pathogenesis of the observed ureteral rupture. Rupture of ureter must be considered as differential diagnosis of acute flank pain, especially when there is change of pain character or severity.
Diagnosis ; Diagnosis, Differential ; Flank Pain ; Rupture* ; Rupture, Spontaneous ; Ureter* ; Ureteral Calculi ; Ureteroscopy ; Urinary Calculi

Many anatomists and clinicians who investigate the peripheral nerve concern about the composition of the spinal roots of each terminal nerve of the brachial plexus. From this viewpoint, the spinal root composition of the ulnar nerve is still unclear. Several anatomy textbooks describe that the ulnar nerve is composed of the ventral rami of the C8, T1 and often C7. There is no literature regarding the frequency and contribution quantity of C7 to the ulnar nerve. The purpose of present study was to determine frequency and contribution quantity of the C7 to the ulnar nerve. Fifty cadavers of brachial plexus were obtained from cadavers of Korean adults. The brachial plexus containing the ulnar nerve were extracted from the axilla and the extracted samples were immersed in Guanidine-HCl (0.2 M) for 2 weeks to soften the connective tissue around the nerve bundles. C7 was contributed to the ulnar nerve in all sides (100%). The numbers of the myelinated axons of C7 participating to the ulnar nerve was 1,452+/-429 (mean+/-S.D.). Thus the C7 can be considered as always participating component of the ulnar nerve, not often participation, although numbers of the myelinated axons of C7 was lesser than those of the C8, but similar to those of the T1. The results of the study provide a reference for accurate diagnosis and treatment regarding ulnar nerve injury due to various accidents.
Adult ; Anatomists ; Axilla ; Axons ; Brachial Plexus ; Cadaver ; Connective Tissue ; Humans ; Myelin Sheath ; Peripheral Nerves ; Spinal Nerve Roots ; Ulnar Nerve