No abstract available.
Pulmonary Artery* ; Takayasu Arteritis*

PURPOSE: MRI is known to be an effective imaging modality of the aorta and its role is steadily increasing in the evaluation of acquired aortic diseases including aortic dissections and aortic aneurysms. However, differentiation of the aortic dissections with thrombosed false lumen from the aortic aneurysm with mural thrombus in MRI has not been easy. Therefore, the authors tried to find the characteristic MR featrses which would to differentiate the two diseases. MATERIALS AND METHODS: MR images of 6 patients with thrombosed aortic dissection and 7 patients with thrombosed aortic aneurysms were reviewed retrospectively and compared in regand to shape and extent of thrombus, dimension of aorta, and luminal flow signal. RESULTS: Thrombosed aortic dissections showed sharply demarcated crescent shaped aortic wall thickening of even thickness involving long segment of the aorta, whereas thrombosed aortic aneurysms showed irregular aortic wall thickening of uneven thickness localized in the short dilated segment of the aorta. Characteristically aortic aneurysm with mural thrombus showed eccentric intraluminal slow flow signal. In contrast to the signal void of the true lumen in aortic dissections, the residual lumen of the aortic aneurysm with mural thrombus revealed intraluminal signal due to slow flow. CONCLUSION: Familiarity to these MRI findings of thrombosed aortic dissections and aortic aneurysms may lead to the accurate differential diagnosis in majority of cases.
Aorta ; Aortic Aneurysm* ; Aortic Diseases ; Diagnosis, Differential* ; Humans ; Magnetic Resonance Imaging* ; Phenobarbital ; Recognition (Psychology) ; Retrospective Studies ; Thrombosis

OBJECTIVE: The clinical value of preoperative serum squamous cell carcinoma antigen(SCC) in relation to clinical stage, tumor volume, disease extent and prognosis has already reported in many papers. The aim of this study is to analyse the relationship between preoperative SCC level and pelvic lymph node metastasis. Matrials and METHODS: From March 1995 to December 1998, 157 patients who examined pretreatment SCC levels before undergoing radical hysterectomy for squamous cell carcinoma of uterine cervix were included. The effect of pelvic lymph node status on the SCC level was examined by comparing 125 cases with cancer limited uterus or upper vagina and 32 cases with cancer confined to the uterus (including upper vagina) and pelvic lymph node using multivariate analysis. RESULTS: 90% of patients without pelvic lymph node metastasis showed SCC levels of 2.9ng/ml or below. 60.7% of patients with serum SCC level more than 2.9ng/ml exhibited pelvic lymph node metastasis. The marker values exceeding 2.9ng/ml increased risk of nodal metastasis 5 times compared with serum level 2.9ng/ml or below. Multivariate analysis confirmed that the pelvic lymph node metastasis had a large impact on the marker level than did tumor size or depth of stromal infilteration. CONCLUSION: SCC levels greater than 2.9ng/ml can be considered a high risk zone for nodal metastasis
Carcinoma, Squamous Cell* ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis* ; Prognosis ; Tumor Burden ; Uterine Cervical Neoplasms* ; Uterus ; Vagina

PURPOSE: To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. MATERIALS AND METHODS: We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years). RESULTS: The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CONCLUSION: CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.
Actinomyces ; Diagnosis ; Enterobacter ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Klebsiella ; Male ; Medical Records ; Necrosis ; Nocardia ; Pneumonia* ; Pseudomonas ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. MATERIALS AND METHODS: We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years). RESULTS: The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CONCLUSION: CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.
Actinomyces ; Diagnosis ; Enterobacter ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Klebsiella ; Male ; Medical Records ; Necrosis ; Nocardia ; Pneumonia* ; Pseudomonas ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

STATEMENT OF PROBLEM: Recently, titanium has become popular as superstructure material in implant dentistry because titanium superstructure can be easily milled by means of computer-aided design and manufacture (CAD/CAM) technique. But retention form such as nail head or bead cannot be cut as a result of technical limitation of CAD/CAM milling and bond strength between titanium and porcelain is not as strong as that of conventional gold or metal alloy. PURPOSE: The objective of this study was to evaluate the shear bond strength of three different materials: heat curing resin, composite resin, porcelain which were bonded to grade II commercially pure Titanium (CP - Ti). MATERIAL AND METHODS: Thirty seven CP - Ti discs with 9 mm diameter, 10 mm height were divided into three groups and were bonded with heat curing resin (Lucitone 199), indirect composite resin (Sinfony), and porcelain (Triceram) which were mounted in a former with 7 mm diameter and 1 mm height. Samples were thermocycled for 1000 cycles at between 5 - 55 degrees C. Shear bond strength (MPa) was measured with Instron Universal Testing Machine with cross head speed of 1 mm/min. The failure pattern was observed at the fractured surface and divided into adhesive, cohesive, and combination failure. The data were analyzed by one-way ANOVA and Scheffe's multiple range test (alpha= 0.05). RESULTS: Lucitone 199 (17.82 +/- 5.13 MPa) showed the highest shear bond strength, followed by Triceram (12.97 +/- 2.11 MPa), and Sinfony (6.00 +/- 1.31 MPa). Most of the failure patterns in Lucitone 199 and Sinfony group were adhesive failure, whereas those in Triceram group were combination failure. CONCLUSION: Heat curing resin formed the strongest bond to titanium which is used as a CAD/CAM milling block. But the bond strength is still low compared with the bond utilizing mechanical interlocking and there are many adhesive failures which suggest that more studies to enhance bond strength are needed.
Acrylic Resins ; Adhesives ; Alloys ; Ceramides ; Collodion ; Computer-Aided Design ; Dental Porcelain ; Dentistry ; Head ; Hot Temperature ; Nails ; Retention (Psychology) ; Titanium

MR imaging was performed in 40 patients of aortic disease from March 1988 to February 1990. Transverse, coronal and oblique sagital views were obtained with ECG gating and even echo technique using 0.5 T and 2.0 T MR systems. In 12 patients of aortic aneurysm, the location, the size and the extent of aneurysm could be assessed in all cases. In the cases of six abdominal aortic aneurysm, the relation of aneurysm to renal arteries was evaluated. In 18 cases of aortic dissection, the extent of involvement as well as associated abnormalities was well evaluated in all cases. In the 8 cases of congenital aortic anomalies, the vascular anatomy was well demonstrated. However, the abnormalities of major branches could not be assessed with MR imaging especially in 2 cases of Takayasu's arteritis. With our experiences, MR imaging is regarded as a primary diagnostic modality for aortic disease and expected to be developed as the alternative measure to the angiography in the future.
Aneurysm ; Angiography ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Aortic Diseases* ; Electrocardiography ; Humans ; Magnetic Resonance Imaging* ; Renal Artery ; Takayasu Arteritis

PURPOSE: To elucidate high-resolution CT(HRCT) findings and their pathologic basis in pulmonary oil embolism induced by LipiodoI-Adriamycin emulsion. MATERIALS AND METHODS: Pulmonary oil embolism was induced by infusing LipiodoI-Adriamycin emulsion through a peripheral vein in twelve Yorkshire pigs. Serial HRCT scans were performed on 2rid, 4th, 7th, 14th, and 28th day after the procedure. The pigs were sacrificed immediately after HRCT and histologic specimens were prepared in the same plane and level with HRCT. RESULTS: The basic pathology was reversible hemorrhagic edema of the lung. On HRCT, intraalveolar hemorrhage and edema in the acute stage manifested as ground-glass opacity or air-space consolidation of the whole secondary Iobule. The lesions were predominantly distributed over the dependent posterior lung fields because the specific gravity of Lipiodol is 1.28. Interlobular septal thickening due to edematous fluid collection was also associated. With the elapse of time, the extent and severity of the acute lesions resolved and, sometimes, changed into small nodular opacities. Pulmonary opacity was most severe on the post-embolization 2nd day and completely resolved within 2 weeks. CONCLUSION: Pulmonary embolization of LipiodoI-Adriamycin emulsion causes reversible hemorrhagic edema of the lung and Lipiodol toxicity seems to play a major role. HRCT findings of pulmonary oil embolism are quite different from those of pneumonia and pulmonary metastasis, which suggests the possibility of clincal application.
Edema ; Embolism* ; Ethiodized Oil ; Hemorrhage ; Lung ; Neoplasm Metastasis ; Pathology ; Pneumonia ; Specific Gravity ; Swine ; Veins

Self expandable metallic stent is a good alternative of percutaneous transhepatic biliary drainage because it can eliminate numerous problems caused by external drainage catheter, such as tube dislodgement, bile leakage and psychotic problems. Authors analyzed initial results of self expandable metallic stents used in the patients with malignant biliary obstruction to evaluate the efficacy of the procedure and to find the technical problems in the procedure. Self expandable metallic stents were inserted in 14 patients: three with recurrent stomach cancer: there with gallbladder cancer: seven with Klatskin tumor: one with common duct cancer. Gianturco type stent was used in 9 cases ans Wallstent was used in 2 cases. In remaining three cases, both Z-stent and Wallstent were used in the same patient. The average period of follow up was 104 days (4-409). In 13 cases, the patency of the bile duct was restored by the stent (technical success: 92.9%). Occlusions of the stent were found in two cases, after two and 13 months, respectively. Causes of failure and stent occlusion were associated duodenal obstruction, tumor overgrowth and shortening of Wallstent. In remaining 11 patients, one patient was lost to follow up an 10 patients did not show recurrent jaundice until death or last follow up. There was no major complication related to the procedure. The insertion of self expandable metallic stent is a safe procedure and call eliminate major disadvantages of PTBD. Overstenting, overlapping land evaluation of associated GI tract obstruction is crucial for obtaining technical success and long-term patency.
Bile ; Bile Ducts ; Catheters ; Drainage ; Duodenal Obstruction ; Follow-Up Studies ; Gallbladder Neoplasms ; Gastrointestinal Tract ; Humans ; Jaundice ; Klatskin Tumor ; Lost to Follow-Up ; Self Expandable Metallic Stents* ; Stents ; Stomach Neoplasms

Self expandable metallic stent is a good alternative of percutaneous transhepatic biliary drainage because it can eliminate numerous problems caused by external drainage catheter, such as tube dislodgement, bile leakage and psychotic problems. Authors analyzed initial results of self expandable metallic stents used in the patients with malignant biliary obstruction to evaluate the efficacy of the procedure and to find the technical problems in the procedure. Self expandable metallic stents were inserted in 14 patients: three with recurrent stomach cancer: there with gallbladder cancer: seven with Klatskin tumor: one with common duct cancer. Gianturco type stent was used in 9 cases ans Wallstent was used in 2 cases. In remaining three cases, both Z-stent and Wallstent were used in the same patient. The average period of follow up was 104 days (4-409). In 13 cases, the patency of the bile duct was restored by the stent (technical success: 92.9%). Occlusions of the stent were found in two cases, after two and 13 months, respectively. Causes of failure and stent occlusion were associated duodenal obstruction, tumor overgrowth and shortening of Wallstent. In remaining 11 patients, one patient was lost to follow up an 10 patients did not show recurrent jaundice until death or last follow up. There was no major complication related to the procedure. The insertion of self expandable metallic stent is a safe procedure and call eliminate major disadvantages of PTBD. Overstenting, overlapping land evaluation of associated GI tract obstruction is crucial for obtaining technical success and long-term patency.
Bile ; Bile Ducts ; Catheters ; Drainage ; Duodenal Obstruction ; Follow-Up Studies ; Gallbladder Neoplasms ; Gastrointestinal Tract ; Humans ; Jaundice ; Klatskin Tumor ; Lost to Follow-Up ; Self Expandable Metallic Stents* ; Stents ; Stomach Neoplasms