There are considerable discrepacies between clinical symptoms and imaging diagnosis in the localization of the responsible radiculopathy. The purposes of this study are to analyzed the dynamic alteration of contrast filling of the spinal nerve sleeves during positional changes and to determine how the abnormalities of nerve sleeves no lateral bending A-P views correlate with sciatica. The criteria indicationg the root abnormality in functional myelography were (1) bad filling of ipsilateral root to sciatica and (2) good filling of contralateral root compared with those in neutral A-P view. Of total 77 patients, 67 had radiculopathy and 10 had no radiculopathy. In 23 (34.3%) of 67 patients with radiculopathy and 6 (60%) of 10 patients with no radiculopathy, their clinical symptoms well correlated with conventional myelographic findings. However, in 35 (52.2%) of 67 patients with radiculopathy and 6(60%) of 10 patients with no radiculopathy, their symptoms well correlated with functional myelographic findings. This study suggests that the functional myelogaphy using both lateral bending A-P views can be used as a complementary tool in the evaluation of the radiculopathy.
Diagnosis ; Humans ; Myelography* ; Radiculopathy* ; Sciatica ; Spinal Nerves

Transcatheter embolization was done in 15 patients wtih various diseases at departement of radiology, SeoulNational University Hospital from Sept. 1978 to July 1983 using absolute ethanol, autologous blood clots andgelfoam particles as embolic agents. The results were as follows; 1. Successful embolizations were done in 14 of15 cses. (Success rate:93%). 2. Most of complication was post-embolization syndrome such as fever, nausea, painbut minimal. Serious complicaiton was very little. 3. Transcatheter embolization appears to be highly valuableadjuvant therapy in debulking of preoperative and inoperable hypervascular mass or treatment of bleeding fromvarious etiology.
Ethanol ; Fever ; Hemorrhage ; Humans ; Nausea

Transcatheter arterial embolization was applied in 7 cases of hepatic disease including hemobilia of various causes and malignant tumors at Department of Radiology, Seoul National University Hospital during recent several years. The embolic materials were autologous blood clot and Gelfoam particle. Successful control of bleeding or devascularization of tumor vessel was made in 6 of the 7 patients. There was no serious complications; however, post embolization syndrome was found including pain, fever, nausea and vomiting in all cases and subsided after a few days. Transcatheter hepatic arterial embolization is suggested to be a safe and effective treatment in control of hemobilia and devascularization of malignant hepatic tumors.
Fever ; Gelatin Sponge, Absorbable ; Hemobilia ; Hemorrhage ; Humans ; Nausea ; Seoul ; Vomiting

Though intravenous digital subtraction angiography (IV DSA) has several advantages over conventionalangiography in diagnosis and follow up of various vascular disease, it also has several undesirable problems suchas large volume of the contrast medium and inferior image quality compared to conventional angiography. Sorecently intraarterial digital subtraction angiography (IA DSA) was introduced for better image quality usingsmall amount of contrast medium. The authours had good clinical results IA DSA which were made in 20 patients withour own system, SRM-II, developed by cooperation of Departements of Radiology and Medical engineering, Seoul.National University Hospital. Intraarterial digital substraction angiography was found to have several advantagesover conventional angiography: (a) small amount of contrast medium, (b) reduced need for selective arterialcatheterization,(c) lower film cost, (d) shortened examination time, (e) ability to obtain a “road map”, and (f)easier detection of contrast medium. Also IA DSA has several advantages over IV DSA : (a) less dependency oncardiac output, (b) far less vessel overlapping, (c) reduction in patient motion through less painful procedure byreduced volume of contrast media and shorter imaging time.
Angiography ; Angiography, Digital Subtraction ; Contrast Media ; Diagnosis ; Follow-Up Studies ; Humans ; Vascular Diseases

Lymphangioma occuring in the gastrointestinal tract is a rare benign tumor, which is composed of lymphatic vessels of various size. A sharply demarcated smooth, soft, cystic submucosal tumor which is easily compressible and covered with normal mucosa is a characteristic eadoscapic feature. Recently, we experienced a case of lymphangioma in ascendmg colon and removed it successfully by colonoscopic snare polypectomy.
Colon ; Colonoscopy ; Gastrointestinal Tract ; Intestine, Large* ; Lymphangioma* ; Lymphatic Vessels ; Mucous Membrane ; SNARE Proteins

PURPOSE: CT or MRT is performed in preoperative staging of laryngeal cancer. These methods are used in assessment of the deep tissues and cartilage of the larynx, but cannot compete with laryngoscopy in the evaluation of the laryngeal surface. The purpose of this study is to evaluate feasibilty and clinical value of the 3-D reconstruction of the mucosal surface in laryngeal cancer. METHODS AND MATERIALS: Twenty two patients with laryngeal cancer proved by means of surgical.exploration (pathologic) or clinical examinations including laryngoscope, imaging studies and biopsy underwent preoperative staging with computed tomography(G-P);and three dimensional(3D) CT reconstruction. The TNM classification of the American Joint Committee on Cancer was used to compare the imaging findings with pathologic or clinical staging. RESULTS: When the extension of primary tumor(T staging) was evaluated, the findings at only transaxial CT and those at pathologic or clinical examination were concordant in 8 of 14 cases(57.1%) of supraglottic tumor, and 3 of 6 cases(50%) of glottic tumor. The overall accuracy of CT with additional 3D-reconstruction was 85.7% for assessment of supraglottic tumor, and 66.6% for glottic tumor. CONCLUSION: 3D CT reconstruction after transaxial CT may improve outcome in preoperative staging of laryngeal cancer and has a potential value in guiding management decisions.
Biopsy ; Cartilage ; Classification ; Humans ; Joints ; Laryngeal Neoplasms* ; Laryngoscopes ; Laryngoscopy ; Larynx

Leptin, which is a plasma protein produced by the obese gene, is expressed and secreted by adipocytes. The clearance of lepdn from the circulation is unknown. But, markedly elevated serum leptin concentrations have recently been reported in patients with chronic renal failure. The purpose of the present study was to investigate plasma leptin concentration of patients with chronic renal failure and evaluate the factors affecting plasma leptin levels. Plasma leptin, insulin, and body mass index were determined in 34 patients with chronic renal failure and 55 control subjects. The plasrna leptin concentrations were not significantly different between patients with chronic renal failure and control subjects (9.4+/-11.8 vs 4.9+/-4.2ng/ml, P>0.05). The serum leptin concentrations were not significantly higher in both male and female CRF patients compared with control subjects (3.96+/-5.72 vs 2.48+/-1.65, P=0.1947, 17.07+/-14.02 vs 7.49+/-4.63ng/ml, P=0.07, respectively). And, there was no significant correlation between serum creatinine and plasma leptin. However, there was significant correlation between plasma leptin concentration and insulin level (P<0.05). We fit a multiple linear regre- ssion analysis with plasma leptin level as the dependent variable in CRF. Sex (male vs female) (P< 0.001) and insulin (P=0.004) were independently associated with plasma leptin level in CRF. These results suggested that plasma leptin level was regulated or affected by multiple factors inclu- ding sex and insulin resistance. Additional study is required to evaluate relationship between plasma leptin and insulin resistance in chronic renal failure.
Adipocytes ; Body Mass Index ; Creatinine ; Female ; Humans ; Insulin ; Insulin Resistance ; Kidney Failure, Chronic* ; Leptin* ; Male ; Plasma*

By using antegrade pyelography which was modified from Casey and Goodwin technique, we examined nine patients in whom accurate roentgenographic diagnosis could not be made by excretory or retrograde pyelography. Diagnosis established were three cases of hydronephrosis due to ureteral calculi, three of pyonephrosis due to renal tuberculosis, one of pyonephrosis due to carcinoma of the ureter, one case of pyonephrosis due to carcinoma of the uretero-pelvic junction and one of pyonephrosis due to ureteral obstruction This is the first report of antegrade pyelography in cases of pyonephrotic renal tuberculosis. No complications occurred during or after examinations. In selected cases of hydronephrosis and pyonephrosis, antegrade pyelography is a safe and new diagnostic procedure to other accepted methods of urography.
Diagnosis ; Humans ; Hydronephrosis ; Pyonephrosis ; Tuberculosis, Renal ; Ureter ; Ureteral Calculi ; Ureteral Obstruction ; Urography*

PURPOSE: To determine whether gadolinium enhancement is helpful in rectal tumor staging determined by MRI and using an endorectal surface coil. MATERIALS AND METHODS: Between January 1995 and July 1996, we studied 17 MRI scans in which the scanning procedure had involved the use of an endorectal coil ; this was a prostate coil in six patients, and a colon coil in eleven. Eight patients were male and nine were female ; they were aged between 39 and 77 (mean, 59) years, and the tumors which had presented were adenocarcinoma (n=15), lymphoma (n=1) and villous adenoma (n=1). Precontrast scanning showing invasion of the rectal wall and perirectal fat were interpreted, and postcontrast T1WI and pathological findings were then compared. Fifteen patients underwent surgical resection but the other two (one adenocarcinoma and one lymphoma) underwent only an endoscopic biopsy. RESULTS: On precontrast scanning with the prostate coil, accurate staging was possible in three cases (one of stage T2, and two of stage T3) ; we overstaged two cases of stage T2 as stage T3. On postcontrast T1WI, however, we additionally understaged one case of stage T3 as stage T2. In a case of adenocarcinoma proven by biopsy, no definite difference was noted between pre- and postenhanced scan. On precontrast scan using a colon coil, accurate staging was possible in six cases (two of stage T1, one of stage T2 and three of stage T3). We overstaged a case of stage T2 as stage T3 and understaged three cases of stage T3 as stage T2. On postcontrast T1WI, however, we accurately diagnosed one additional case of stage T3, not diagnosed on precontrast scan. In one case of bioptically-proven lymphoma, no definite difference was noted between pre- and postenhanced scan. CONCLUSION: In rectal tumor staging, pre- and postenhanced scans are both 60% accurate. In MRI using an endorectal surface coil, gadolinium enhancement is not, therefore significantly helpful.
Adenocarcinoma ; Adenoma, Villous ; Biopsy ; Colon ; Female ; Gadolinium* ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Male ; Prostate ; Rectal Neoplasms*

PURPOSE: To assess the relationship between splenic transient inhomogeneous contrast enhancement(CE) on the arterial phase of spiral CT, and splenic volume, and to classify the CE pattern in liver cirrhosis. MATERIALS AND METHODS: We measured the splenic volume of 120 patients, 60 showed inhomogeneous splenic CE on arterial phase,and 60 showed homogeneous splenic CE. CT scans with intrinsic splenic pathology were excluded. Sixteen patients with clinically confirmed liver cirrhosis were included. Splenic volumes of the inhomogeneous and homogeneous CE group were compared. The inhomogeneous group was divided into three grades according to areas of non-enhanced portion (grade I, focal geographic ; grade II, multifocal patchy, grade III, extensive serpentine inhomogeneous CE) , and these were correlated with splenic volume. RESULTS: Among the 60 inhomogeneous CE scans, 23 cases(38.3%) showed splenomegaly (spleen volume>220cm3); in contrast, this applied to only 8 cases (13.3%) of the 60 homogeneous CE scans. Mean splenic volume in the inhomogeneous CE group (226.74+/-129.78cm3) was greater than in the homogeneous CE group (184.56+/-77.44cm3) (p<0.033). A larger splenic volume and extensive inhomogeneous CE(grade III) were noted, and most liver cirrhosis patients(14/16) were grade III. Three such patients who had shown inhomogeneous splenic CE on arterial phase showed inhomogeneous CE even on portal phase. CONCLUSION: Inhomogeneous splenic CE on arterial phase was more common in cases of an enlarged spleen, and more extensive in liver cirrhosis. These findings suggest hemodynamic change of the spleen may be a contributory factor.
Hemodynamics ; Humans ; Liver Cirrhosis ; Pathology ; Spleen* ; Splenomegaly ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed