No abstract available.
Osteoblastoma* ; Spine*

No abstract available.
Animals ; Rats* ; Vitamin A* ; Vitamins* ; Wounds and Injuries*

PURPOSE: To determine the hemodynamics of the pancreas by investigating the enhancement patterns of pancreaticparenchyma, as seen on spiral CT, after the administration of various amounts of contrast medium, and to determineoptimal scan time by knowing the peak time of normal pancreatic parenchyma. MATERIALS AND METHODS: Between January1995 and April 1997 55 cases of normal abdominal CT with dynamic enhancement study on pancreas, the subject were38 cases(28 persons) with good image, aged 21-65 years, men were twenty-one and women were seven. Non-ioniccontrast medium, 30ml(n=15), 60ml(n=9), 990ml(n=7), and 120ml(n=7) were injected at a rate of 3ml/sec. From 20sec. after the start of injection, 15 images were obtained at 3-sec intervals. Before and after injection, R.O.I.was applied to each image, and for the aorta and pancreatic parenchyma, Hounsfield units(H.U.) were measured; timeof enhancement and maximal H.U. were also measured. RESULTS: After 30, 60, 90, and 120ml of contrast mediuminjection, mean maximal H.U. of pancreatic parenchyma was 36+/-7, 54+/-6, 68V13, and 92+/-8, respectively; mean valueat peak parenchymal enhancement of the pancreas was 27+/-3, 32+/-3, 42+/-3, and 52+/-3, respectively. Time intervalsof maximal enhancement of aorta and pancreatic parenchyma could not be obtained in 30ml injection, but 5,4+/-2.5,4.2+/-1.6, and 6.0+/-2.1sec in 60, 90, and 120ml injection, respectively. CONCLUSION: Maximal H.U. of parenchymalenhancement of the pancreas is directly proportional to the amount of injected contrast medium and the peak timeof parenchymal enhancement was 12sec after the injection of contrast material. Time interval of maximalenhancement of aorta and pancreatic parenchyma was 5.2+/-2.1sec.
Aorta ; Contrast Media ; Female ; Hemodynamics ; Humans ; Male ; Pancreas* ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

PURPOSE: To evaluate the enhancement patterns of nodular and massive hepatocellular carcinoma (HCC), with or without portal vein thrombosis, on three-phase spiral CT. MATERIALS AND METHODS: Contrast enhancement patterns in 61 patients with HCC were retrospectively analysed. Three-phase spiral CT images of the hepatic arterial dominant phase, portal dominant phase, and delayed phase were obtained 30, 60-70, and 360 seconds after the injection of contrast material was initiated. Tumors were divided into grossly nodular and massive type and enhancement patterns of HCC, with and without portal vein thrombosis, were compared. These patterns were divided into three groups, as follows: High/High/Low; High/Low/Low; Low/Low/Low. HCC with portal vein thrombosis was found in 21 of 61 cases ; this carcinoma without portal vein thrombosis was found in 40 cases. The nodular type accounted for 39 cases, and the massive type for 22. RESULTS: In 21 cases of HCC with portal vein thrombosis, the most common enhancement pattern was L/L/L, and was seen in 13 cases (62%); H/L/L was seen in eight (38%), but H/H/L was not seen. In 40 cases of HCC without portal vein thrombosis, the most common enhancement pattern was H/L/L, seen in 25 cases (63%) ; this was followed by L/L/L (11 cases ; 27%), and H/H/L (4 cases ; 10%). In the arterial dominant phase, among cases of HCC with portal vein thrombosis, low attenuation was more common (13/21) than high (8/21);among cases of HCC without portal vein thrombosis, high attenuation was more common (29/40) than low (11/40). Among 39 nodular-type cases, HCC with portal vein thrombosis was found in six (H/H/L and L/L/L: three each), and HCCwithout portal vein thrombosis was seen in 33 (H/L/L: 22; L/L/L: 7; H/H/L; 4). Among 22 cases of the massive type, HCC with portal vein thrombosis accounted for 15 (L/L/L: 10, H/L/L: 5), and seven cases without portal vein thrombosis were seen (L/L/L: 4 ; H/L/L : 3). CONCLUSION: On Three-phase spiral CT, HCC showed different enhancing patterns according tumor type and the presence of portal vein thrombosis.
Carcinoma, Hepatocellular* ; Humans ; Retrospective Studies ; Tomography, Spiral Computed* ; Venous Thrombosis

OBJECTIVE: Many studies have investigated paraspinal muscle changes after posterior lumbar surgery, including lumbar fusion. However, no study has been performed to investigate back muscle changes after pedicle based dynamic stabilization in patients with degenerative lumbar spinal diseases. In this study, the authors compared back muscle cross sectional area (MCSA) changes after non-fusion pedicle based dynamic stabilization. METHODS: Thirty-two consecutive patients who underwent non-fusion pedicle based dynamic stabilization (PDS) at the L4-L5 level between February 2005 and January 2008 were included in this retrospective study. In addition, 11 patients who underwent traditional lumbar fusion (LF) during the same period were enrolled for comparative purposes. Preoperative and postoperative MCSAs of the paraspinal (multifidus+longissimus), psoas, and multifidus muscles were measured using computed tomographic axial sections taken at the L4 lower vertebral body level, which best visualize the paraspinal and psoas muscles. Measurements were made preoperatively and at more than 6 months after surgery. RESULTS: Overall, back muscles showed decreases in MCSAs in the PDS and LF groups, and the multifidus was most affected in both groups, but more so in the LF group. The PDS group showed better back muscle preservation than the LF group for all measured muscles. The multifidus MCSA was significantly more preserved when the PDS-paraspinal-Wiltse approach was used. CONCLUSION: Pedicle based dynamic stabilization shows better preservation of paraspinal muscles than posterior lumbar fusion. Furthermore, the minimally invasive paraspinal Wiltse approach was found to preserve multifidus muscles better than the conventional posterior midline approach in PDS group.
Humans ; Muscles ; Psoas Muscles ; Retrospective Studies ; Spinal Diseases

Thoracic outlet syndrome (TOS) is an uncommon condition which is caused by compression of subclavian artery, vein or brachial plexus in the region of thoracic outlet area, which is composed by the first rib, clavicle, anterior and middle scalene muscles and other connective tissue. In arterial TOS, chronic arterial compression causes arterial stenosis, poststenotic dilatation, aneurysm formation, intramural thrombus and peripheral arterial embolism. We present herein a case of arterial TOS patient with multiple distal embolization. The patient was 43-year old male with crutch ambulation because of sequelae of polioviral infection in his youth. His chief complaint was discoloration and gangrenous change of five right digits for 1 month. A rudimentary first right rib was found in simple chest X-ray. Angiographic findings were stenosis and poststenotic dilatation of right subclavian artery, multiple peripheral arterial embolic obstructions and numerous collateral vessel formation. Right thoracoscopic sympathectomy (T2), resection of the abnormal first rib and the abnormal axillary arterial segment was performed through the supraclavicular and transaxillary incision, then interpositional graft with saphenous vein was done for arterial reconstruction. A minor lymphatic fluid collection around the area of operation occurred, but it was easily controlled by percutaneous drainage. The gangrenous wounds of digits were improved after restoration of blood circulation.
Adolescent ; Adult ; Aneurysm ; Blood Circulation ; Brachial Plexus ; Clavicle ; Connective Tissue ; Constriction, Pathologic ; Dilatation ; Drainage ; Embolism ; Humans ; Male ; Muscles ; Ribs ; Saphenous Vein ; Subclavian Artery ; Sympathectomy ; Thoracic Outlet Syndrome* ; Thorax ; Thrombosis ; Transplants ; Veins ; Walking ; Wounds and Injuries

PURPOSE: To evaluate the prevalance of morphological variation of the kidney secondary to junctional parenchyma, as well as to analyze the ultrasonographic features of junctional parenchyma. MATERIALS AND METHODS: Two hundred and eighty two kidneys of 141 patient without clinical or radiologic evidence of renal disease were prospectively analysed using ultrasound. In all patients, ultrasonograms were obtained in sagittal, coronal and transaxial planes. The kidney was considered to have morphological variation if the ulrasonogram demonstrated junctional parenchymal defect or line ; those showing such variation were classified as one of three types :continuous, discontinuous, or junctional parenchymal line or defect without junctional parenchyma. The prevalance and ultrasonographic features of the kidneys were evaluated. RESULTS: Morphological variation was noted in 71 cases(25%). the continuous type accounted for 54% of these, the discontinuous type for 38%, and junctional parenchymal defect or line without junctional parenchyma for 8%. In all cases, junctional parenchyma was located approximately at the junction of the upper and middle third of the kidny, and had the same echogenecity as the renal cortex. CONCLUSION: An understanding of the morphological variation of the kidney resulting from junctional renal parenchyma would be helpful in differentiating pseudo tumor from true renal neoplasm.
Humans ; Kidney Neoplasms ; Kidney* ; Ultrasonography*

PURPOSE: This study was performed to evaluate prognostic factors for survival from first relapse (SFFR) in stage I-III breast cancer patients. MATERIALS AND METHODS: From June 1994 to June 2008, 3,835 patients were treated with surgery plus postoperative radiotherapy and adjuvant chemotherapy for stage I-III breast cancer at Samsung Medical Center. Among them, a total of 224 patients died by June 2009, and 175 deaths were of breast cancer. Retrospective review was performed on medical records of 165 patients who met the inclusion criteria of this study. Univariate and multivariate analysis were done on survivals according to variables, such as age, stage, hormone status of tumor, disease-free interval (DFI), sites of first failure, number of organs involved by recurrent disease (NOR), application of salvage treatments, and existence of brain or liver metastasis (visceral metastasis). RESULTS: Patients' median overall survival time was 38 months (range, 8 to 123 months). Median SFFR was 17 months (range, 5 to 87 months). Ninety percent of deaths occurred within 40 months after first recurrence. The patients with SFFR < or =1 year had tendency of triple-negativity, shorter DFI (< or =2 years), larger NOR (>3), visceral metastasis for first relapse than the patients with SFFR >1 year. In multivariate analysis, longer DFI (>2 vs. < or =2 years), absence of visceral metastasis, and application of salvage treatments were statistically significant prognosticators for longer SFFR. CONCLUSION: The DFI, application of salvage treatments, and visceral metastasis were significant prognostic factors for SFFR in breast cancer patients.
Brain ; Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Humans ; Liver ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Recurrence* ; Retrospective Studies

URPOSE: To evaluate using spiral CT the effect of spleen size on blood flow in the portal venous system andto know the usefulness of this evaluation. MATERIALS AND METHODS: Fifty-one patients without evidence on spiralCT scan of abnormality thought to affect portal venous flow presented between December 1994 and June 1995. We measured spleen size and Hounsfield units of portal vein in dual-phase, and calculated the ratio of the unit inthe portal phase to that in the arterial phase. Spleen size was measured, using the length of X-axis by that of Z-axis on spiral CT scan. We then measured the correlation between the two values. CT was performed with a Somatom Plus-S scanner(Siemens, Erlangen, Germany). A total dose of 120ml of non-ionic contrast material(Ultravist) was administered at a rate of 3ml/sec. Arterial and portal phase were obtained after 30 seconds and 60 seconds fromthe beginning of the contrast agent injection. RESULTS: The correlation between spleen size and contrast enhancement of the portal vein was relatively significant(Pearson's correlation coefficient(r)=0.41801). CONCLUSIONS: Spleen size significantly affects portal venous flow on spiral CT scan. The evaluation of spleensize and contrast enhancement of the portal vein could be useful in the differential diagnosis of diseases which affect portal venous flow.
Diagnosis, Differential ; Humans ; Portal Vein* ; Spleen* ; Tomography, Spiral Computed*

PURPOSE: We analyzed the association of lymph node ratio (LNR) wth locoregional control (LRC) in breast cancer patients with ≥10 involved axillary lymph nodes who underwent multimodality treatment. METHODS: We retrospectively analyzed 234 breast cancer patients with ≥10 involved axillary lymph nodes between 2000 and 2011. All patients received adjuvant chemotherapy and radiotherapy (RT) after radical surgery. The cutoff value of LNR was obtained using receiver operating characteristic curve analysis. The majority of patients (87.2%) received chemotherapeutic regimen including taxane. RT consisted of tangential fields to the chest wall or intact breast, delivered at a median dose of 50 Gy, and a single anterior port to the supraclavicular lymph node area, delivered at a median dose of 50 Gy. For patients who underwent breast-conserving surgery, an electron boost with a total dose of 9 to 15 Gy was delivered to the tumor bed. RESULTS: Within a median follow-up period of 73.5 months (range, 11-183 months), locoregional recurrence (LRR) occurred in 30 patients (12.8%) and the 5-year LRC rate was 88.8%. After multivariate analysis, LNR ≥0.7 was the only independent factor significantly associated with LRC (hazard ratio, 2.06; 95% confidence interval, 0.99-4.29; p=0.05). CONCLUSION: An aggressive multimodal treatment approach showed favorable locoregional outcome in patients with ≥10 involved axillary lymph nodes. However, patients with a high LNR ≥0.7 still had an increased risk for LRR, even in the setting of current local treatments.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Mastectomy, Segmental ; Multivariate Analysis ; Radiotherapy ; Recurrence* ; Retrospective Studies ; Risk Factors* ; ROC Curve ; Thoracic Wall