PURPOSE: To evaluate surface configuration of intervertebral disc on three dimensional CT. MATERIALS AND METHODS: Three dimensional surface images reconstructed from CTscans(1 mm thick) of 20discs in 14 healthy adults were reviewed. Disc surface was classified into peripheral and central zones in contact with consecutive peripheral ring and central endplate. Local irregularity incidence, pattern in radial, concentric, or mixed form, size, location, and extension were observed. Incidence and severity ranges in 4 grades of general irregularity, and peripheral width relative to central radius were evaluated. RESULTS: Normal disc mostly showed smooth surface with few display of small local irregularity(6/20) which was mainly radial in pattern(4/5), posterolaterally located(4/6), and confined within peripheral zone(5/6). General irregularity displayed(5/20) was all grade I and peripheral width was 0.82 of central radius. CONCLUSION: Normal disc shows smooth surface but few may display small local irregularity maybe due to very early degenerative change.
Adult ; Humans ; Incidence ; Intervertebral Disc* ; Radius

No abstract available.
Aorta* ; Endothelium-Dependent Relaxing Factors*

Intravascular injection of hydrogen peroxide produces oxygen microbubbles suitable for echocardiographic contrast enhancement. To evaluate the effect of a method of myocardial contrast 2-D-echocardiographic delineation of myocardium during acute coronary occlusion, injection of a fresh mixture of 2ml of 0.2% H2O2 and 1ml of heparinized dog blood into aortic root were made in 12 poenchest dogs 10 minutes after occlusion of left anterior descending coronary artery distal to the first diagonal branch and left ventricular short axis 2-D echocardiographic images at the midpapillary muscle level were obtained. On injection of H2O2 blood mixture normally perfused myocardium was enhanced in echodensity but the area of malperfusion did not change in echodensity. The borderlines between the area of normal perfusion and malperfusion was well delineated. The malperfused area measured at mid papillary muscle level by planimetry area method was 29.7+/-6.0% and 32.6+/-6.7% by endocardial circumferential length method. There was a linear correlation between planimetric estimate of area of malperfusion by H2O2 contrast echocardiography and visual determination of regional wall motion abnormality by 2-D echocardiography(r=0.93, P<0.001). There was no change in heart rate before, during and after H2O2 injection. Infection of H2O2 blood mixture caused bradycardia(8.3%), second degree A-V block(16.6%) and ventricular fibrillation(8.3%). H2O2 clearance was achieved in 3-10 minutes. These findigs suggest that H2O2 enhanced myocardial contrast ehocargiography using 2ml of 0.2% H2O2 and 1ml of blood muxture is an accurate, reproducible, real-time in vivo method of quantifying the extent of myocardial perfusion defect during acute coronary occlusion in dog.
Animals ; Axis, Cervical Vertebra ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Echocardiography* ; Heart Rate ; Heparin ; Hydrogen Peroxide* ; Hydrogen* ; Microbubbles ; Myocardium ; Oxygen ; Papillary Muscles ; Perfusion*

Benign symmetric lipomat,osis is a rare disease of undetermined cause characterized by symmetric deposits of adipose tissue o:n the neck, upper trunk and abdomen. We report three cases of kienign symmetric lipomatosis, one of which is associated with alcoholic liver disease and the patient complained of a diffieulties in neck motion, All of them are about sixty year old men with history of frequent alcohol consumption. In histopathologic findings, the reticular dermis was completcly replaced by mature fat cells and there was a slight increase in vascular and fibrous elements.
Abdomen ; Adipocytes ; Adipose Tissue ; Alcohol Drinking ; Dermis ; Humans ; Lipomatosis* ; Liver Diseases, Alcoholic ; Male ; Neck ; Rare Diseases

PURPOSE: To compare image quality of storage phosphor digital radiography(DR) with film-screen radiography in portable chest imaging, and to assess the minimum X-ray dose that can be applied to DR in adults without image degradation, and also to compare image qualities of low dose and standard dose DR. Materials and Methalos: A geometrical phantom similar to the human thorax was imaged by a portable radiographic unit with fixed kVp and variable m^s in both film-screen and DR systems. Three radiologists scored the images by four grades in four categories of 1) contrast between mediastinum and lung, 2) definition of the nodule in the lung, 3) definition of another nodule through the mediastinal shadow, and 4) grainess(noise : assessed only in DR). Additionally, portable chest images were obtained in 10 patients in a intensive care unit by film-screen, standard dose and half dose DR in consecutive days. The same readers scored the images by four grades in six categories of 1) the lungs and hila, 2) the mediastinum, 3) subphrenic area. 4) musculoskeletal shadow, 5) tubes and lines, and 6) grainess (only in DR). The images with superior quality were assessed by paired t-test. RESULTS: In phantom study, the minimum dose of digital images scored 3 or more by all readers was 39% of the standard dose. In patient study, DR was superior to film-screen radiography in all categories except tube and line. Low dose DR was not inferior to standard dose DR in five categories other than grainess to two readers or more. CONCLUSION: In portable chest imaging, storage phosphor DR image was superior to conventional film-screen radiography and half dose DR was comparable to standard dose DR despite of more noise.
Adult ; Humans ; Intensive Care Units ; Lung ; Mediastinum ; Noise ; Radiographic Image Enhancement* ; Radiography ; Thorax*

PURPOSE: To compare image quality of storage phosphor digital radiography(DR) with film-screen radiography in portable chest imaging, and to assess the minimum X-ray dose that can be applied to DR in adults without image degradation, and also to compare image qualities of low dose and standard dose DR. Materials and Methalos: A geometrical phantom similar to the human thorax was imaged by a portable radiographic unit with fixed kVp and variable m^s in both film-screen and DR systems. Three radiologists scored the images by four grades in four categories of 1) contrast between mediastinum and lung, 2) definition of the nodule in the lung, 3) definition of another nodule through the mediastinal shadow, and 4) grainess(noise : assessed only in DR). Additionally, portable chest images were obtained in 10 patients in a intensive care unit by film-screen, standard dose and half dose DR in consecutive days. The same readers scored the images by four grades in six categories of 1) the lungs and hila, 2) the mediastinum, 3) subphrenic area. 4) musculoskeletal shadow, 5) tubes and lines, and 6) grainess (only in DR). The images with superior quality were assessed by paired t-test. RESULTS: In phantom study, the minimum dose of digital images scored 3 or more by all readers was 39% of the standard dose. In patient study, DR was superior to film-screen radiography in all categories except tube and line. Low dose DR was not inferior to standard dose DR in five categories other than grainess to two readers or more. CONCLUSION: In portable chest imaging, storage phosphor DR image was superior to conventional film-screen radiography and half dose DR was comparable to standard dose DR despite of more noise.
Adult ; Humans ; Intensive Care Units ; Lung ; Mediastinum ; Noise ; Radiographic Image Enhancement* ; Radiography ; Thorax*

No abstract available.
Drug Therapy* ; Fistula*

Fourty one cases of open fractures of tibial shaft complicated with varying degrees of soft tissue injuries were trested by one-plane unilateral external fixation with AO fixator. In seventeen csses among them, interfragmental lag screw fixation was applied in addition, for more rigidity and stability of the fixation. All of thern were followed up at least for one year and we obtained the following results. 1. Rigid stable external fixation provided by additional minimum internal fixation may not increase the rate of infection but rather enhance prompt primary bone healing. 2. One-plane unilatersl external fixation may facilitate good access to the wound for subsepuent reconstructive procedures, and enhance pain-free early full range of joint motion, thus promote early bone union. 3. Comparing with bilsteral fixation, there wss almost no difference in the union time of the fracture even with one-plsne unilatersl fixation.
Clinical Study ; External Fixators ; Fractures, Open ; Joints ; Soft Tissue Injuries ; Tibia ; Wounds and Injuries

Eighteen cases of osteonecrosis of the femoral head associated with macromolecular polyvinylpyrrolidone (PVP) deposition were analysed on the basis of clinical, radiologic and pathologic features. The cases were observed during 8 years period from January, 1974 to December, 1981. The pathogenesis of the osteonecrosis of the femoral head due to PVP storage in reticuloendothelial system were discussed in detail. Parenteral administration of high-molecular PVP in repeated, long duration led to osteonecrosis of the femoral head. Storage of PVP in the histiocytes of the bone marrow resulted in osteonecrosis of the femoral head followed by microciculation disturbance. PVP-induced osteonecrosis were manifested as multiple foci of necrosis involving not only the femoral head, other long bones around joints, but also the visceral reticuloendo-thelial system characterized by infiltrates of histiocytes laden with PVP. The patients with PVP induced osteonecrosis complianed multiple joint pain in their early course of the disease. On roentgenogram, osteonecrosis were often noted in the hip, shoulder, knee, and ankle in order or frequency. Foamy histiocytes laden with PVP were characteristic on hematoxylin-eosin stain diagnostic on Weigert's elastica, phosphotungstic acid hematoxylin, and Congo red stains. As far as rationale of the treatment concerning a number of staging systems for Osteonecrosis, the choice of surgical procedures were similar to those given by W.F. Enneking et al. In the series, we have performed two hips in total surface replacement, 26 hips in total hip replacement mostly for 3rd generation-configuration of Charnley prosthesis. In addition, one case for free vascularized fibula graft and trans-trochanteric rotational osteotomy after Sugioka were also included for this study. The result of treatment was rather optimistic. However, complications have occured in 4 hips of 3 patients which required removal of whole prosthetic components. Therefore, we underwent revisional surgery in three out of four hips subsequently during the short post-poerative follow-up. These will be published in the future.
Ankle ; Arthralgia ; Arthroplasty, Replacement, Hip ; Bone Marrow ; Coloring Agents ; Congo Red ; Fibula ; Follow-Up Studies ; Head ; Hematoxylin ; Hip ; Histiocytes ; Humans ; Joints ; Knee ; Mononuclear Phagocyte System ; Necrosis ; Osteonecrosis ; Osteotomy ; Phosphotungstic Acid ; Povidone ; Prostheses and Implants ; Rubber ; Shoulder ; Transplants

PURPOSE: To describe MR imaging features of hypoxic brain damage in relation to time elapse and prog-nosis of patients. MATERIALS AND METHODS: We reviewed 19 MR studies of 18 patients with hypoxic brain damage. MR imaging studies were performed between 1 to 20 days after the hypoxic insults (mean 8.6 days). MR images were analyzed with regard to the locations of abnormal signal intensities, the presence of brain edema. And imaging findings were correlated with the time elapse after the insults and the prognosis of patients. RESULTS: On 19 cases of MR studies, abnormal high intensities on T2-weighted images were found in the basal ganglia (15, 78.9%), cerebral cortex (13, 68.4%), white matter (9, 47.4%), thalamus (6, 31.6%), cerebellum (4, 21.1%) and brainstem (1, 5.3%), respectively. Cerebral cortical involvement was typically bilateral and diffuse, but sometimes limited to the parieto-occipital area. The brainstem and cerebellar involvement was rare and in all cases, cerebral cortical lesions accompanied. Most of the white matter lesions were accompanied with cortical and deep gray matter lesions and found in subacute period(>6 days). The cortical high signal intensity lesions on T1-weighted image were found mostly in subacute stage, but in some cases involvement was also found in acute stage (< or =6 days). The cortical edema is found on 11 cases in acute and subacute stages. In cases of recovered consciousness, cortical involvement and edema on MR were rare. CONCLUSION: MR findings of hypoxic brain damage were various, but diffuse bilateral involvement of cortex and/or deep gray matter was found in most of the cases. White matter involvement was rarely found in acute stage and usually found in subacute stage. In cases of good pronosis, cortical involvement and edema were rare.
Anoxia ; Basal Ganglia ; Brain ; Brain Edema ; Brain Stem ; Cerebellum ; Cerebral Cortex ; Consciousness ; Edema ; Humans ; Hypoxia, Brain* ; Magnetic Resonance Imaging ; Prognosis* ; Thalamus