Staging of carcinoma of the urinary bladder is important for the choice of therapy and also has prognostic implications. Hitherto the staging has been based upon cystoscopy with bio psy, transurethral resection , and palpation with complementary radiographic examlnations such as cystography, urography, lymphangiography, ultrasound and angiography. However, with all these methods, the staging of bladder carcinomas still uncertain and inferior to CT. Authors analyzed CT staging of bladder cancers and compared with pathologic staging of laparotomy results. The results are as follows: 1. Overall accuracy of CT staging in bladder carcinoma was 72 percent. 2. Overstaging was 20 percent (5/25) and understaging was 8 percent (2/25). 3. All of CT stage B cancers were proven to be stage B, pathologlcally. 4. In 6 cases of CT stagec cancers,only one was correct,3 were overstaged and 2 were understaged. 5. In 7 cases of CT stage D cancers, 5 were correct and 2 were overstaged. 6. CT detected only 2 cases of pelvic Iymph node involvement in 4 of pathologically proven Iymphadenopathy.
Angiography ; Cystoscopy ; Laparotomy ; Lymphography ; Palpation ; Ultrasonography ; Urinary Bladder Neoplasms ; Urinary Bladder ; Urography

9 cases of criss-cross heart anomaly, diagnosed by angiography from April, 1979 to Feb. 1985 at Seoul National University Hospital were reviewed. The results were as follows: 1. Of 9 cases, 6 cases were male and 3 cases werefemale and the age ranged from 2 months to 16 years of age. 2. Of 9 cases, 7 cases were concordant (D-loop) and 2cases were discordant (L-loop). segmental approaches are 2 cases of SDD(TGV) and each one case of SLD(TGV),SDD(DORV), SDL(DORV), SDD(DOLV), SLL(corrected TGV), and normal one. 3. Associated anomalies are small sized rightventricle (7 cases), especially inflow tract and sinus portion, pulmonary outflow tract obstruction(5 cases),VSD(9 cases), ASD( 7 cases), PDA(2 cases) and visceroatrial situs solitus was observed in all 9 cases but 1dextrocardia.
Angiography ; Crisscross Heart ; Humans ; Male ; Seoul

No abstract available.
Liver* ; Neoplasm Metastasis*

CT scans of 21 patients(intrathoracic goiter=7. Castleman disease=6, pulmonary carcinoid tumor=3, parathyroid adenoma=1, thyroid carcinoma=1, paraganglioma=1, benign pleural mesothelioma=1, sclerosing hemangioma=1) with mediastinal tumors that are known to be enhanced with intravenous injection of contrast media, were studied retrospectively to investigate the enhancing capabilities f those tumors and to describe their CT findings. The degree of enhancement was estimated by visual inspection with a grading system. All but one case of cystic parathyroid adenoma showed enhancement on post-contrast scan. The degree of enhancement was not helpful in differentiating these tumors. Characteristic location and pattern of tumor extension were found in cases of intrathoracic goiter, parathyroid adenoma, thyroid carcinoma and paraganglioma. Calcifications were found in intrathoracic goiter(5/7). Castleman disease(2/6). Pulmonary carcinoid(1/3), thyroid carcinoma. Necrotic low-attenuation areas were in intrathoracic goiter(7/7), parathyroid adenoma, thyroid carcinoma and paraganglioma. In conclusion, mediastinal tumors that are known to be enhanced in the literature were enhanced with rare exception, and if we consider the predilection site of those tumors, the scope of differential diagnosis can reasonably be narrowed.
Carcinoid Tumor ; Contrast Media ; Diagnosis, Differential ; Goiter, Substernal ; Injections, Intravenous ; Paraganglioma ; Parathyroid Neoplasms ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Tomography, X-Ray Computed

Double outlet left ventricle (DOLV), even defined as origins of both great vessels from left ventricle,implies varieties of morphology in concern with loop pattern, location of ventricular septal defect, conotruncalanatomy, and presence or adsence of pulmonary stenosis. With the improvement of surgical tenchnique, correctivesurgery of DOLV became possible, and preoperative diagnosis and determination of the accurate anatomicalrelaltionship between great vessels, ventricular septal defect, and ventricles is very important in surgicalimplication. Authors have recently experienced two cases of DOLV. The one is with subpulmonic conus, subpulmonicventricular septal defect, patent ductus arteriosus, and preductal type coarctation of aorta. The other is withbilateral coni and subaortic ventricular septal defect. Loop patterns are [S,D,D] in both cases.
Aortic Coarctation ; Conus Snail ; Diagnosis ; Ductus Arteriosus, Patent ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Pulmonary Valve Stenosis

Ultrasonography of rabbit kidney was erformed after induction of simple and infected hydronephrosis toevaluate the sequential sonographic changes in 27 rabbits. Simple hydronephrosis was induced by ligation of thedistal ureter and infected hydronephrosis by ligation of the distal ureter and ureteral inoculation of Escherichiacoli. Ultrasonography was performed daily during the first week and weekly during the following 5 weeks afterinductin of simple and infected hydronephrosis. The results are as follows; 1. In simple hydronephrosis, theearliest abnormal ultrasonographic finding was splitting of central renal echo complex, which appeared within 1day after ureteral ligation in all cases. 2. In simple hydronephrosis, complete loss of central renal echo complexand cystic dilatation of pelvis were seen with in 5 days after ureteral ligation in all cases. 3. In infectedhydronephrosis, the earliest abnormal ultrasonographic finding was appearance of internal lapse of time and theentire pelvis was filled with internal echoes within 2 weeks after inoculation in all cases. 5. In infectedhydronephrosis, echogenecity of internal echoes within the pelvis was similar to that of renal parenchma in thefirst week after inoculation, however was weaker than that of renal parenchyma 2 weeks after inoculation in all cases.
Dilatation ; Hydronephrosis ; Kidney ; Ligation ; Pelvis ; Pyonephrosis ; Rabbits ; Ultrasonography ; Ureter

Twenty patients with congenital aortic stenosis excluding valvular stenosis were studied beween April 1980 and April 1984 at Seoul National University Hospital. The clinical and radiologic findings with the emphasis on the cineangiographies were analyzed separately according to the type of aortic stenosis as subaortic and supravalvular aortic stenosis. The summaries of the analysis are as follows: 1. Among the 20 cases, 12 cases were subaorticstenosis and 8 cases were supravalvular stenosis. 2. The anatomic types of subaoritc stenosis were the discrete membranous type (8 cases), the fibromuscular type (2 cases) and the tunnel type (2 cases). 3. The obstruction of subaoritic types was usually severe, and the median left ventricular to aortic systolic pressure gradient was 60mmHg, and associated cardiac defects were found in 10 cases (84%), an incidence greater than that reported in mostother large series. 4. The anatomic types of 8 cases of supravalvular aortic stenosis were mainly focal type (7cases ) and 1 case of diffuse hypoplastic type. 5. The median left ventricular to aortic systolic pressure gradient of supravalvular stenosis was 75mmHg, and associated anomalies were seen in 6 cases(75%) with 3 cases of suspected mental retardation and facial abnormalities without definite hypercalcemia. 6. For accurate diagnosis of congenital aortic stenosis, retrograde left ventricular angiograms obtainend in axial pojections are of crucial importance in demonstration of anatomic types of stenosis and associated anomalies. And supravalvular aortic injection is sometimes helpful to outline the anatomy of the valve and to evaluate the degree of aortic regurgitation.
Aortic Stenosis, Supravalvular ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Blood Pressure ; Cineangiography ; Constriction, Pathologic ; Diagnosis ; Humans ; Hypercalcemia ; Incidence ; Intellectual Disability ; Seoul

Hyposexuality after stroke has been frequently observed, but hypersexuality as a sequela of stroke has not been commonly documented. We report a patient who exhibited hypersexuality and obsessive-compulsive behaviors after stroke in the region of the left mesial frontal cortex and both basal ganglia. At 2 months after stroke, he visited psychiatric unit due to these symptoms. His motor function was almost full recovered. He was treated with fluvoxamine and perphenazine, With two-month medication, his hypersexuality and obsessive-compulsive behavior disappeared. This case may indicate that basal ganglia-thalamocortical circuit plays an important role in the mediation of sexual behavior and obsessive-compulsive behavior. Since changes in sexual activity may not be spontaneously reported, a systemic inquiry into patient's sexual functioning after infarction in frontal lobe or basal ganglia is warranted.
Basal Ganglia* ; Depression ; Fluvoxamine ; Frontal Lobe ; Humans ; Infarction ; Negotiating ; Perphenazine ; Sexual Behavior ; Stroke*

Cervical disc arthroplasty (CDA) has become more widespread and diverges from the conventional technique used in anterior cervical fusion for cervical degenerative disc disease. As arthroplasty has become a popular treatment option, few complications have been reported in the literature. These include subsidence, expulsion, posterior avulsion fractures, heterotopic ossification, and osteolysis. One of the critical complications is osteolysis, but current studies on this subject are limited in terms of not elucidating the incidence, etiology, and consequences. The authors present two cases, who presented with clinical signs of gradually worsening myelopathy induced by posterior vertebral body osteolysis, 2 years after CDA. Subsequently, the patient underwent posterior decompression and fusion without prosthesis removal. Postoperatively, the clinical symptoms gradually resolved, with no severe deficits. The present rare cases highlight the osteolysis that occurs after CDA, which can cause cervical myelopathy, and suggest spine surgeons to be alert to this fatal complication.

Adenocarcinoma of the urinary bladder, including urachal carcinoma, is a rare tumor with incidence in the range between 0.5% and 2.2% of all epithelial bladder neoplasms. Ten cases of adenocarcinoma of the urinary bladder(eight cases of primary adenocarcinoma and two cases of urachal carcinoma)are presented. We described the computed tomography(CT)appearances of adenocarcinoma of the urinary bladder and tried to find out the characteristic CT findings of urachal carcinoma. CT scan were evaluated for the location of the tumors, presence of calcification in the tumor, and the tumor extension. Seven tumors were located at the dome of the bladder(70%0, two were at lateral walls, and one was at anterior wall. Seven were single mass and three were multicentric masses in the bladder. Fine punctate calcifications scattered within the tumors were detected in four cases(40%); three of the eight, primary adenocarcinoma, and one of the two, urachal carcinoma. Two urachal carcinomas were characterized by midline position and predominantly extravesical growth along the urachus. Gross extravesical extension with distant metastasis were presented in seven cases(70%) at the time of initial diagnosis. CT may be useful in evaluating the adenocarcinoma of the urinary bladder and differentiating urachal carcinoma from bladder cancer.
Adenocarcinoma* ; Diagnosis ; Incidence ; Neoplasm Metastasis ; Tomography, X-Ray Computed ; Urachus ; Urinary Bladder Neoplasms ; Urinary Bladder*