PURPOSE: To evaluate the relative value of arterial, portal venous and delayed phase images of spiral CT in the detection of metastatic tumor of the liver. MATERIALS AND METHODS: Forty-three metastatic tumors in twelve patients were underwent tri-phasic spiral CT examination with injection of 120 ml ionic contrast material (36 g of iodine) at the rate of 3 ml/sec. Arterial, portal venous and delayed phase CT images were obtained 35, 65, and 360 seconds after the start of contrast injection, respectively. RESULTS: Arterial phase images detected 35(81%), portal venous phase images 43(100%), and delayed phase images 34(79%) lesions, respectively(p<0.05). All masses larger than 2cm(n=23) were detected in all three phases, whereas 60%, 100%, 55%of the masses smaller than 2cm(n=20) were detected in arterial, portal venous and delayed phase CT, respectively. The best contrast between masses and the hepatic parenchyma was in portal venous phase followed by arterial and delayed phase(p<0.01). In two hypervascular masses, the contrast was better in arterial phase. CONCLUSION: Portal venous phase of spiral CT is optimal in the detection of metastatic tumor of the liver. Arterial phase may be helpful for the detection of hypervascular metastasis. Delayed phase should be used restrictively.
Humans ; Liver* ; Neoplasm Metastasis ; Tomography, Spiral Computed*

The detection of the tubercle bacilli is absolutely necessary to make definite diagnosis of patients with genitourinary tuberculosis. Recently it has been reported that the detection rate of tubercle bacilli from the patient's urine is decreasing because of abuse of the anti-tuberculous drugs and the resistance developed in the experimental animals such as mouse and guinea pig (Marks, 1972). Therefore the necessity of the development of better diagnostic methods has been mandatory. Recently it was reported that the Korean chipmunks(Tamias sibiricus asiaticus. Gmelin) are highly susceptible to tubercle bacilli (Chang et al., 1971). The specific objection of this study is to pursue the possibility of using the chipmunks for the early diagnosis of genitourinary tuberculosis. Twenty-four hour urines of 34 patients with suspected genitourinary tuberculosis were tested for tubercle bacilli with smear, culture, and inoculation ink chipmunks and mice intraperitoneally. The results are briefly summarized as follows: 1. 18 cases out of 34 patients with suspected genitourinary tuberculosis were confirmed to be positive by any means of stained smear, culture and animal inoculation. Of 18 proved genitourinary tuberculosis. 12 cases were confirmed by smear, culture and mouse inoculation, and on the other hand. 14 cases by chipmunks inoculation. 2. In the group of chipmunks inoculation, 8 cases were found to be positive on the 10th day and 14 cages on the 20th day. 3. These findings suggest that the period required for the detection of tubercle bacilli was shorter and the positive rate was higher than that of other animals and other methods. For the clinical applications of the Korean chipmunks as a diagnostic tools, further effort is considered to be necessary.
Animals ; Diagnosis ; Early Diagnosis ; Guinea Pigs ; Hand ; Humans ; Ink ; Mice ; Sciuridae* ; Tuberculosis*

PURPOSE: To report a case of primary extramedullary plasmacytoma which is rare in the orbit. METHODS: A 72 year-old man was referred for the evaluation of a slowly developing proptosis in the right eye. A CT scan revealed the orbital mass which involved optic nerve and surrounding tissues. Incisional biopsy via lower lid was performed. RESULTS: Histopathologic examination confirmed the findings of plasmacytoma. Systemic evaluation including bone marrow biopsy, clinical and radiologic evaluation showed no evidence for multiple myeloma. Taken together we diagnosed the orbital lesion as a primary extramedullary plasmacytoma. He was treated with radiation therapy and followed for 6months without evidence of new lesion or systemic disease. CONCLUSIONS: We experienced a case of primary extramedullary plasmacytoma which is rare in the orbit. Continuing careful observation is warranted because of its variable natural course and prognosis.
Aged ; Biopsy ; Bone Marrow ; Exophthalmos ; Humans ; Multiple Myeloma ; Optic Nerve ; Orbit* ; Plasma Cells ; Plasmacytoma* ; Prognosis ; Tomography, X-Ray Computed

Most patients who have spondylolysis dont's need surgical treatment. However, for the patients who have no response to conservative treatment, surgical treatment may be indicated. In 1970, Buck reported the operative technique that the used two screws between the pars defect and lamina followed by bone graft. In patients who have spondyloysis, pain in the back seems to be due to instability and irritation of nerve root by the abnormal motion of the loose neural arch and granulation tissue. For period of 7 years from May, 1984 to March, 1991, twelve patients with spondyloysis who had no response to conservative treatment were treated with Buck's operation and were analyzed. Following results were obtained: 1. The age of the patients was 24 years in average ranging from 14 to 40 years. 2. The level of the lesion was L5 in 10 cases, L4 in 2 cases. 3. Preoperative clinical feature included low back pain in 12 cases, refered pain in 2 cases. 4. Clinical sympotoms were improved in 83%, and the follow up result of the operation: excellent 16.7%, good 66.6% and poor 16.7%.
Follow-Up Studies ; Granulation Tissue ; Humans ; Low Back Pain ; Spondylolysis ; Transplants

No abstract available.
Fontan Procedure* ; Heart Ventricles*

Most stress urinary incontinence require a surgical correction for stabilizing the urethrovesical junction Many procedures had been applied for the treatment of stress urinary incontinence. Recently we experienced two cases of stress urinary incontinence, corrected by endoscopic suspension of bladder neck with percutaneous nephrostomy needles, ang good results were obtained. Herein we reported a more simple and safe modified procedure with some literatures.
Neck ; Needles ; Nephrostomy, Percutaneous ; Urinary Bladder ; Urinary Incontinence*

OBJECTIVES: Polycystic ovary syndrome (PCOS) has the feature of excessive LH, hyperandrogenism and disturbance of folliculogenesis. Also, insulin, IGF-I and IGFBP-1 are involved in the pathogenesis of PCOS. Various surgical and medical therapies have been used and the action mechanisms are related to the endocrine effect. Laparoscopic ovarian electrocautery or laser vaporization is effective in the restoration of ovulation and normal menstrual cycle with minimal invasive procedure especially in the patients resistant to medical therapy. Clomiphen citrate (CC) is used for the ovulation induction in PCOS and the resistance is known to be related to insulin, IGF-I, IGFBP-1 levels. This study was performed to evaluate the effect of the laparoscopic laser vaporization on the levels of LH, FSH, testosterone, IGF-I and IGFBP-1 and on the ovarian response to clomiphen citrate in patients with CC-resistant PCOS. MATERIALS AND METHODS: The fasting basal serum LH, FSH, testosterone, IGF-I and IGFBP-1 level were measured in 10 PCOS patients with CC-resistance and 7 normal controls with regular menstrual cycle. In PCOS, after laparoscopic CO2 laser vaporization, endocrine levels were measured in 1 week interval for 4 weeks and then compared with preoperative levels. RESULTS: In PCOS group, mean serum LH/FSH ratio, testosterone, IGF-I levels were higher and IGFBP-1 level was lower than control. LH/FSH ratio decreased from 2.51+/-0.67 to 1.7+/-0.6 (p<0.05) in 2 weeks, to 0.56+/-0.2 (p<0.01) in 3 weeks and to 1.41+/-0.3 (p<0.01) in 4 weeks after operation. Testosterone level decreased from 1.51+/-0.82 ng/ml to 0.65+/-0.34 ng/ml (p<0.05) in 2 weeks, to 0.56+/-0.67 ng/ml (p<0.01) in 3 weeks after operation. IGF-I level also decreased from 436+/-47.5 microgram/l to 187+/-38 microgram/l (p<0.01) in 1 week, to 167+/-42 microgram/l (p<0.01) in 2 weeks, 179+/-55 microgram/l (p<0.01) in 3 weeks and to 120 +/-43 microgram/l (p<0.01) in 4 weeks after operation. IGFBP-1 level showed no significant change. In 8 of 10 PCOS patients, ovulation was induced with low dose clomiphen citrate. CONCLUSION: Laparoscopic CO2 laser vaporization restores normal menstrual cycle and ovulation through endocrine effect of decreasing LH/FSH ratio, testosterone and IGF-I level and increases the response to CC. Therefore it is useful for restoration of normal menstruation and induction of ovulation in CC resistant PCOS patients.
Citric Acid ; Electrocoagulation ; Fasting ; Female ; Humans ; Hyperandrogenism ; Insulin ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor I ; Laser Therapy* ; Lasers, Gas ; Menstrual Cycle ; Menstruation ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Testosterone ; Volatilization

No abstract available.
Glycogen Storage Disease Type I*

No abstract available.

PURPOSE: To verify the usefulness of left portal vein angle (LPVA) on CT scan in the diagnosis of liver cirrhosis and to compare its diagnostic value with that of caudate to right lobe ratio (C/RL ratio). MATERIALS AND METHODS: LPVA, an angle formed by a vertical line and a line connecting the center of the vertebral body to the umbilical point of the left portal vein, and C/RL ratio were measured on CT scans of 100 cirrhotic and 100 normal livers. Diagnostic values of LPVA and C/RL ratio were compared statistically. RESULTS: The mean of LPVA was 18.9 degrees(SD; 7.6) for normal livers and 25.8 degreesSD; 8.4) for cirrhotic livers (P<0.001). The mean of C/RL ratio was 0.47(SD; 1.10) for normal livers and 0.58(SD;0.14) for cirrhotic livers (P<0.001). When LPVA was greater than 30 degreesliver cirrhosis was diagnosed with 36% sensitivity and 92% specificity. When C/RL ratio was greater than 0.60, the diagnose of liver cirrhosis was with 41% sensitivity and 90% specificity. There was no significant difference of the diagnostic accuracy between LPVA and C/R L ratio in ROC analysis. CONCLUSION: Both LPVA and C/RL ratio are useful diagnostic indices of liver cirrhosis on CTscan. LPVA is more convenient to measure than C/RL ratio.
Diagnosis* ; Fibrosis ; Liver Cirrhosis* ; Liver* ; Portal Vein* ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed