With the availability of accurate localizer and markedly improved resolution of CT, precise anatomicalpositioning of the structure of interest, proper gantry angulation, thin slicing and magnification technique of CTimage can be easily achieved. Recently there have appeared many articles on normal and abnormal CT findings of thelumber discs. These articles, however, were concerned with more or less indirect evaluation of the discs byobserving the contour of the posterior margin of the disc, compression or displacement of the adjacent structuresby protruded disc materials and the obliteration of the epidural fat. The present study has been carried out toinvestigated basically the normal internal architectures of the lumbar discs to set up a baseline by which onewell be able to judge abnormality of that structure. The materials consisted of 127 lumbar discs of 30 healthyadult subjects studied by the measure set technique (MST). The subjects were sampled randomly from the individualsundergoing a CT study for the reasons other than spnal diseases. To obviate sample bias the age, sex and disclevels were adjusted so that the uniformity in sample number of each category was maintained. CT scans wereperformed with a Siemens Somatom 2 Scanner immediately after calibration. Technical factors involved were tubevoltage 125 kVp, exposure time 10 seconds, 460 mAs, 256 x 256 matrices, and pixel size 0.4mm. Contiguous2-mm-thick slices of each disc were obtained parallel to the disc plane at 3-mm interval from the lower margin ofthe vertebral body for 5 lumbar discs. Out of multiple scan slices of each disc one image was chosen which hadneither partial volume effect with the adjacent vertebral body nor an out the nucleus pulposus (NP) and annulusfibrosus (AF) clearly. The internal architectures of each disc as revealed by MST were classified arbitrarily into3 types as follows; (1) When AF was discerned distinctly as a “white ring-like” structure from the “black” NP, thedisc was classified as well defined type: (2) When AF appeared as a fairly uniform “white ring-llike” structureand NP appeared as uniformly mottled densities with indistinct demarcation between the two, the disc was classifedas intermediate type ; and (3) When both AF and NP were diffusely mottled without any demarcation, the disc wasclassifed as diffuse type . With age, the internal architectures of the lumbar disc changed from the well-definedthrough intermediate to diffuse type. The relative increase in the density of NP was considered to representdegenerative change characterized by gradual replacement of the gelatinous tissue of NP by a fibrocartilaginoustissue and decrease in the water therein contained. The diffuse type were most frequently seen in the discs ofL4-5 and L5-S1 suggesting the maximum intensity of stress and strain due to weight bearing at these two disclevels.
Bias (Epidemiology) ; Calibration ; Clothing ; Gelatin ; Tomography, X-Ray Computed ; Water ; Weight-Bearing

No abstract available.
Animals ; Immunohistochemistry* ; Neurons* ; Rats* ; Substantia Nigra*

Many procedures of quadricepsplasty were reported by Thompson (1944), Judet (1959), van Nes (1962), Nicoll (1963) and Hesketh (1963) in confining the indication of them for the strictly extra-articular origin of their causes. During the period of January 1979 to August 1979, 5 cases of stiff knee joints were surgically treated by means of arthrolysis and quadriceps release. The result were gratifying. The average gain of flexion was 119 degrees, and extension lag was absent except a case which had compression fracture of femoral condyle.
Fractures, Compression ; Knee Joint ; Knee

We have experienced a case of infantile nephritic syndrome confirmed by renal biopsy in a 13-month-old female patient who showed and develop mental retardation and persistent proteinuria. She revealed mild eyelid edema, joint laxity, delayed speech development and adrenal cortical calcification on the radiologic study. Renal biopsy showed microcystic tubular change, micro-glomeruli and marked mesangial proliferation.
Biopsy ; Edema ; Eyelids ; Female ; Humans ; Infant ; Intellectual Disability ; Joint Instability ; Nephrotic Syndrome* ; Proteinuria

We anlized CT of 29 cases of various orbital disease in pediatric age group. Diagnoses were confirmed byeither operation or direct ophthalmoscopy. The patients were examined during the period of last 3 years. Theresults were as follows: 1. Of 29 cases, 21 were male and 8 were female, and the age ranged from 20 days to 15years. 2. Intraorbital tumors were 13 cases consisting of 7 retinoblastoma, 3 pseudotumor, and 1 each ofcongenital teratoma, cavernous lymphanngioma, and optic glioma, Of remaining 16 cases, 6 had orbital fracture, 5persistent hyperplastic primary viterous(PHPV), 3 vitreous opacity, and 2 primary glaucoma. 3. The CT findings ofthe retinoblastoma were a lobulated or oval soft tissue mass denisty (40-60HU) extending into the vitreous wtihoutsignificant enhancement on postcontrast scan. Of 7 cases, 4 had calcifications within the tumors. The extraglobalextension of the tumor was shown in 2 patients demonstrating markedly thickened sclera with enhancement anddilated optic nerve. 4. There were 5 patients with PHPV having a history of white pupil since birth, and all wereaffected unilateraly. Four patients had vitreous opacity and 3 of those showed either linear or branchingtree-like densities within the vitreous on the postcontrast scan. Another one had a lobulated increased densityprotruding into the vitreous which was difficult to differenciate from the similar finding of retinoblastoma.Remaining one case demonstrated a deformed and decreased density in the lesional lens without chaneg in thedensity of the vitreous. This was confirmed to be caused by persistence of the embryonic hyaloid artery attachedto the posterior capsule of the lens. 5. There were 3 patients with vitreous opacity and 2 of them were due toretinal detachment and 1 was caused by retrolental fibroplasia. The CT findings of retinal detachement werehomogenous or heterogenous opacities in the vitreous. In a case of retrolental fibroplasia, irregular, band-likedensity was seen along the posterior wall of the globe bilaterally. 6. Two cases of primary glaucoma showed largeglobe with a widened anterior chamber. 7. Among 6 cases of orbital fractures, 5 were blow-out fracture. Theblow-out fractures showed fractures of the medial orbital wall or orbital floor with herniated intraorbitalcontents into the neighboring ethmoid or maxillary sinus.
Anterior Chamber ; Arteries ; Diagnosis ; Female ; Glaucoma ; Humans ; Male ; Maxillary Sinus ; Ophthalmoscopy ; Optic Nerve ; Optic Nerve Glioma ; Orbit ; Orbital Diseases ; Orbital Fractures ; Parturition ; Posterior Capsule of the Lens ; Pupil ; Retinaldehyde ; Retinoblastoma ; Retinopathy of Prematurity ; Sclera ; Teratoma

CT scan is widely used in the evaluation of hepatobiliary system and contrast study is generally performedwith non-biliary contrast media. Therefore the normal intrahepatic bile ducts are not readily visible and alsoextrahepatic bile ducts are occasinally not discriminated from adjacent structures, in spite of improvedresolution of the CT scanner. This study was performed to evaluate the usefulness of cholangiographic enhancementin biliary CT examination. In the control group (n=5), we measured the CT number of the peripheral hepatic duct,perioportal duct, common bile duct and gall bladder, respectively, at the interval of 30 minutes upto 2 hoursafter intervenous infusion of biliscopin(30ml) and observed time-denstiy relationship of infused biliscopin in thebiliary system. In the patient group (n=23), we observed visualization rate of the bilary system and serumbilirubin level at 30 minutes after infusion of biliscopin(30ml). The results were as follows: 1. The peak densityoccurred at 30 minutes after infusion of biliscopin. 2. Visualization rate was 100% in normal bilirubin groupwhereas it was 91.7% in abnormal bilirubin group. 3. The cholangiographic enhancement of biliary CT scan is usefulin the evaluation of intra-and extraheptaic biliary system.
Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Bilirubin ; Common Bile Duct ; Contrast Media ; Humans ; Tomography, X-Ray Computed ; Urinary Bladder

Buerger's disease was first identified in 1908 by Leo Buerger as a distinct clinicopathological entity, which causes severe pain and necrosis on distal parts of the extremities and occurs especially in young male adults. In spite of many treatment modalities, it is not completely cured but results in amputation in the long run. So, we studied a total of 120 cases of Buerger's disease, who were admitted at Yonsei University, Severance Hospital from Jan., 1975 to June, 1985 and we obtained the following results. 1. All the patients were male and majority of them were under 40 years of age (69.2%). 2. 118 cases were smokers and 2 cases were non-smokers. 3. The initial symptoms were resting pain, necrosis, and color change in descending order of frequency. 4. Diagnoses were made mainly by angiogram(75.8%) and most common site of obstruction was popliteal artery (49.4%). 5. After sympathectomy and angioplasty, there was temporary relief of symptoms, but none showed good results after long term follow up. As a result, amputations were performed after sympathectomy in 47 cases(39.2%), of which 36 cases(76.6%) received that surgery within 2 yeas after sympathectomy. 6. The pressure index not only helps diagnose the disease but also is a very useful method to objectively assess the severity of the initial symptoms and postoperative results.
Adult ; Amputation ; Angioplasty ; Clinical Study ; Diagnosis ; Extremities ; Follow-Up Studies ; Humans ; Male ; Methods ; Necrosis ; Popliteal Artery ; Sympathectomy ; Thromboangiitis Obliterans

The clinical value of CT in the diagnosis of pelvic bone fractures is being explored. Conventional radiographic projections, including internal and external oblique views, although very helpful, often cannot provide sufficent jnformation to give a true sense of the fractures. CT conversely displays the anatomy in an axial plane, thereby providing the missing pieces of information and fascilitating classification of these fractures. From January 1983 to June 1986, 34 patients with pelvic bone fractures, admitted to Department of Orthopedic Surgery, Severance Hospital, were given both CT and conventional radiographs. Comparing the conventional radiographic findings with those of CT, the following conclusions were obtained. 1. For patients with multiple trauma who necessitate position changes during conventional radiography, no further change in position was required during CT. 2. CT clearly showed intraarticular loose bodies, anterior wall fractures of the acetabulum, and separations of the saicroiliac joint which were hardly detected on conventional radiographs. 3. CT permitted a better evaluation of the shape, extent, and degree of separation of fracture fragment, so it was very helpful in formulating the treatment plan. 4. Follow-up CT was helpful in evaluating the effectiveness of treatment.
Acetabulum ; Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Joints ; Multiple Trauma ; Orthopedics ; Pelvic Bones ; Radiography

We report a case of metastatic carcinoma of the skin in 62-year-old male who showed multiple nodules on the anterior chest, scalp, face and left axilla for 2 months duration. He suffered from lower abdominal discomfortness for 6 months. Histopathologic findings revealed atypical cell nests and some tubular or glandular formation in the dermis and subcutaneous fat tissue. Material in the lumen showed diastase resistant and PAS positive, and alcian blue positive at pH 2.4, but negative pH 0.4. So it represented sialomucin. We did not find primary site of malignant tumor. In view of clinical and histopathological findings, it was considered to be originated from the large intestine.
Alcian Blue ; Amylases ; Axilla ; Dermis ; Humans ; Hydrogen-Ion Concentration ; Intestine, Large ; Male ; Middle Aged ; Scalp ; Sialomucins ; Skin* ; Subcutaneous Fat ; Thorax

The present study has been carried out to enhance the specificity of computed tomography (CT) in diagnosing herniated nucleus pulposus (HNP) of the lumbar spine by the application of measure-set (MS) technic. MSCT scans of 20 patients with proven diagnosis of HNP were reviewed prospectively to sort out features of diagnostic value. Eleven were men and 9 were women with the mean age being 40 years. MSCT scan revealed dislocation of the center of the nucleus pulposus (NP) in direction of herniation in 75%, "permeation" of the annulus fibrosus (AF) by HNP material and a clear disruption of the outermost layer of AF in all patients. The site and grade of the protrusion of HNP beyond the normal saliancy of AF could be easily evaluated in 90%. The present study saliancy of AF could be easily evaluated in 90%. The present study revealed that MSCT can demonstrate four characteristic findings of HNP enabling one to directly and semiquantitatively assess the pathologic changes of NP.
Adult ; Female ; Humans ; Male ; Spinal Diseases/diagnosis/*radiography ; *Tomography, X-Ray Computed