PURPOSE: The purpose of this study was to analyze the MR findings of childhood adrenoleukodystrophy regarding the extent of white matter degeneration and the pattern of enhancement, and to correlate these findings with clinical manifestations. MATERIALS AND METHODS: Six male patients (5-13 years old;mean age, 8.7 years) of biochemically confirmed adrenoleukodystrophy were included in this study. We evaluated the extent of white matter degeneration which was shown as high signal intensity on T2-weighted image, and the pattern of enhancement. Also we correlated the MR findings with clinical manifestations of symptoms and the results of evoked potential studies. RESULTS:The most common sites of predominant involvement were occipital deep white matter, optic radiation, and splenium of corpus callosum (n = 4, 66.7%). The other sites of predominant involvement were frontal deep white matter (n = 1, 16.7%) and pyramidal tract with cerebellum (n = 1, 16.7%). After contrast enhancement, there was peripheral rim enhancement surrounding the most severely affected areas in five cases (83. 3%). These findings were consistent with clinical symptoms in five cases (83.3%), but the results of evoked potential studies were consistent with clinical symptoms in only two cases (33.3%). CONCLUSION:In childhood adrenoleukodystrophy, MRI can clearly demonstrate specific tracts of involvement and these findings were well correlated with clinical manifestations.
Adrenoleukodystrophy* ; Cerebellum ; Corpus Callosum ; Evoked Potentials ; Humans ; Magnetic Resonance Imaging* ; Male ; Pyramidal Tracts

PURPOSE: To assess the incidence and causes of pseudohydronephrosis in the abdominal two-phase (arterial and portal) spiral CT. MATERIALS AND METHODS: This study included 115 renal pelvises of 62 patients (hepatocellular carcinoma in 36, gastric carcinoma in 10 and others in 16 patients) whose entire renal pelvises were imaged in both phases of abdominal spiral CT. Arterial and portal phase scans were obtained 30 and 65-70 seconds after the injection of 100 mL of non-ionic contrast media (370mg I/mL) at a rate of 2.5 mL/sec, respectively. The renal pelvis was considered to be dilated when the shortest diameter of renal pelvis exceeded 1cm as seen on CT. In each patient, a plain film was obtained 5-10 minutes after the injection of contrast media for CT to confirm the hydronephrosis. RESULTS: Seven renal pelvises were dilated on spiral CT. All of them were pseudohydronephrosis with prominent renal pelvis and two of them were extrarenal pelvises. In 115 renal pelvises, there was one case of true hydronephrosis due to a ureteral stone not suspected clinically. CONCLUSION: A 6% incidence of pseudohydronephrosis due to prominent renal pelvis should be considered in interpreting the abdominal two-phase spiral CT.
Abdomen* ; Contrast Media ; Humans ; Hydronephrosis ; Incidence ; Kidney Pelvis ; Pelvis ; Tomography, Spiral Computed* ; Ureter

In portal hypertension, hepatopetal flow is rerouted away from the liver through collateral pathways to low pressure systemic vessels. Information about collateral pathways is relevant, especially when interventional procedure or surgery is contemplated, because inadvertent disruption of these veins can cause significant bleeding. Dynamic CT and spiral CT with a bolus injection of contrast material have to a significant extent recently replaced angiography. The porto-systemic collateral pathways have, however, been classified and described according to location or frequency in a majority of previous reports. This essay illustrates variable porto-systemic collateral blood flow pathways, with CT and angiography correlation.
Angiography* ; Hypertension, Portal* ; Liver ; Portasystemic Shunt, Surgical ; Portography ; Tomography, Spiral Computed ; Veins

PURPOSE: To evaluate the MR imaging findings and gadolinium enhancing patterns of Kienboeck's disease. MATERIALS AND METHODS: Thirteen patients with Kienb ck's disease were included in this study. T1 and T2 or T2*weighted images(WI) were taken in all patients and gadolinium enhancement was performed in six patients. We compared MR signal intensity of lunates with that of normal bone marrow. MR imaging findings and stages accordingto Lichtman's classification were correlateds and we evaluated the enhancing patterns of the lunates and synovia. RESULTS: Stage II was found in five patients, stage III in seven, and stage IV in one. T1WIs showed low or focaliso signal intensity in all patients. T2WI showed low signal intensity in three patients and focal iso or focal high signal intensity in ten. There were no significant correlations between the signal intensity of lunates and stages. Synovial enhancement was detected in five patients. In four, the areas of focal iso or high signal intensity on T2WI were the enhanced areas of lunates. CONCLUSION: Kienb ck's disease showed low signal intensityon T1WI in all patients and variable signal intensity on T2WI. There was no significant correlation between MRsignal intensity and Lichtman's stage. Synovia and the areas of focal iso or high signal intensity on T2WI were frequently enhanced.
Bone Marrow ; Classification ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Necrosis ; Osteonecrosis* ; Synovial Fluid

PURPOSE: To demonstrate CT findings of malignancies occurring in choledochal cysts focusing on the differential points with benign inflammation. MATERIALS AND METHODS: The CT findings of seven patients with malignancies occurring in choledochal cysts(six cholangiocarcinomas and one cholangiohepatoma) and three with benign inflammatory wall thickening were reviewed. Six were studied with two-phase(arterial and portal) CT(threethe malignancies and all benign inflammations) and the remainder with conventional CT in the late portal or equilibrium phase. Spiral dynamic CT scans were performed in all two phase CT, except in the case of onemalignancy. The study was focused on the shape and enhancement pattern of the lesions and the presence of localinvasion or distant metastasis. RESULTS: Three of seven associated malignancies showed concentric wall thickening(mean wall thickness=11.3mm), two eccentric, wall thickening and two polypoid masses. Two of three arterial phase CT scans showed tumor enhancement and one showed low attenuating concentric wall thickening, well delineated from a strongly enhanced pancreas. In portal or delayed phase CT scans, all masses were isodense orslightly hypodense compared with the liver or pancreas. Extensive regional lymphadenopathy or distant metastasis was present in six patients at the time of diagnosis. Three cases of benign inflammatory wall thickening showed athinner wall(mean thickness=5mm), and two showed arterial enhancement of the inner wall with only, a diffuse and even pattern. On preoperative CT diagnosis, two cases of benign inflammatory wall thickening were misdiagnosed as malignancies. CONCLUSION: Concentric wall thickening type was the most difficult to differentiate from benign wall thickening. Irregular wall thickening of more than 10mm and enhancement of the whole thickeness of the wall is a reliable sign of malignancy. Dynamic spiral CT is essential for this evaluation.
Cholangiocarcinoma ; Choledochal Cyst* ; Diagnosis ; Humans ; Inflammation* ; Liver ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreas ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

To see the usefulness of CT in evaluation of response to treatment in patients with mediastinal tuberculous lymphadenitis (MTL), we analyzed the initial CT patterns and follow-up CTs or serial plain radiographs during 18 months antituberculous chemotheraphy in 58 consecutive patients. CT patterns of MTL at the beginning of treatment were categorized into solid type (n=8), low density with peripheral rim enhancement type (n=36), extranodal extension type (n=9) and calcified type (n=5). According to the response to treatment, each patients was categorized into prompt response group (response within the first three months and no residual lymph node after one year), slow response group (response after three months but residual lesion after one year), no response group (no change in size during 18 months treatment) and temporal increase group (temporal increase in size during the treatment but ultimately improved with chemotheraphy). Among 29 cases of prompt response group, 20 cases had large low-density areas, 6 cases had diffuse or extensive node involvement with extranodal extension or tracheal compression. Two patients with acquired immune derfciency syndrome belonged to this group. Fifteen cases of slow response group had low-density nedes in 7 patients and small solid or extranodal-extension nodes in 6 patients. They were associated with disseminated pulmonary tuberculosis, generalized lymphadenopathy or other organ(pericardium, brain, bone or abdomen) involvement. In 5 cases of no response group, there were 3 cases of calcified node and 2 cases of small solid nodes. Nine cases of temporal increase group included low density type of MTL only. And they were associated with disseminated pulmonary of endobronchial tuberculosis. In conclusion, response to antituberculous chemotherapy could be predicted in patients with MTL on the basis of CT findings before treatment.
Brain ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Tuberculosis ; Tuberculosis, Lymph Node* ; Tuberculosis, Pulmonary

No abstract available.
Embolism, Air* ; Humans ; Infant, Newborn*

No abstract available.
Embolism, Air* ; Humans ; Infant, Newborn*

OBJECTIVE: The aim of this study was to evaluate the clinical effectiveness and safety of vaginal myomectomy via colpotomy with analyzing clinical course and postoperative complication. METHODS: A retrospective study was performed in 59 patients, who underwent vaginal myomectomy between November 1997 and July 2006 in department of gynecology, Chonnam National University Hospital. Operating time, hemoglobin change, postoperative pain, perioperative complication, and days of hospital stay were recorded. RESULTS: Fifty-nine patients were evaluated, mean age of patients was 41.54+/-5.8 years. Mean diameter of the uterine myoma was 6.79+/-1.75 cm. Mean operating time was 66.69+/-34.49 minute. Mean hemoglobin loss was 2.67+/-1.26 g/dL, and mean days of hospital stay was 4.91+/-1.25 days. One patient had febrile morbidity. Only one patient had suffered from retroperitoneal bleeding enough to get on operation. CONCLUSION: Vaginal myomectomy seems to be a feasible and safe surgical procedure. Further randomised studies are needed to compare this procedure with laparotomy and laparoscopy, and vaginal myomectomy is expected to be more effective and generalized surgical procedure.
Colpotomy ; Gynecology ; Hemoglobins ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Leiomyoma ; Length of Stay ; Myoma ; Pain, Postoperative ; Retrospective Studies

OBJECTIVE: To investigate the lipid peroxide levels and protein carbonyls levels in the amniotic fluid of pregnant women with preterm premature rupture of membranes (PPROM). METHODS: The lipid peroxide levels in the amniotic fluid of normal pregnancy (n=20) and pregnant women with PPROM (n=20) were measured by thiobarbituric acid reaction. The protein carbonyl contents in the amniotic fluid of normal pregnancy (n=20) and pregnant women with PPROM (n=20) were determined by the 2,4-dinitrophenylhydrazine method. After amniotic fluid of them were mixed and incubated up to 5 hours with 0.2 mL of 1mM moxalactam, cefodizime, amoxacillin, erythromycin, the lipid peroxide levels and protein carbonyl contents in them were measured. RESULTS: 1. The lipid peroxide levels in the amniotic fluid of pregnant women with PPROM was significantly higher than that of normal pregnancy (9.74+/-0.48 vs. 7.20+/-0.38 nmol/mg protein, P<0.01). 2. The protein carbonyl levels in the amniotic fluid of pregnant women with PPROM was significantly higher than that of normal pregnancy (13.0+/-0.33 vs. 11.27+/-0.17 nmol/mg protein P<0.01). 3. The lipid peroxide levels and protein carbonyls formation by moxalactam in the amniotic fluid of pregnant women with PPROM was significantly higher than basal level (12.08+/-0.81 vs. 9.74+/-0.48 nmol/mg protein, 20.08+/-0.66 vs. 13.0+/-0.33 nmol/mg protein, P<0.01). 4. The lipid peroxide levels and protein carbonyls formation by cefodizime in the amniotic fluid of pregnant women with PPROM was significantly lower than basal level (5.04+/-0.33 vs. 9.74+/-0.48 nmol/mg protein, 9.76+/-0.35 vs. 13.0+/-0.33 nmol/mg protein, P<0.01). 5. There were no significant differences in the levels of lipid peroxide and protein carbonyls by amoxacillin and erythromycin in the amniotic fluid of pregnant women with PPROM between antibiotics-induced and basal levels. CONCLUSION: The lipid peroxidation and the protein carbonyls formation were increased in the amniotic fluid of pregnant women with PPROM. Antibiotics-induced lipid peroxide and protein carbonyl levels were changed in the amniotic fluid of pregnant women with PPROM. Further studies on our results may be beneficial in the selection of antibiotics for pregnant women with PPROM.
Amniotic Fluid ; Anti-Bacterial Agents ; Cefotaxime ; Erythromycin ; Female ; Humans ; Lipid Peroxidation ; Membranes ; Moxalactam ; Phenylhydrazines ; Pregnancy ; Pregnant Women ; Protein Carbonylation ; Rupture ; Thiobarbiturates