Twenty two cases of extraarticular skeletal tuberculosis which showed unusual radiological features arereported and classifed into several categories with discussion on the differential diagnosis. Radiologicalpatterns of skeletal tuberculosis is so variable that with any kind of skeletal changes the possibility of theskeletal tuberculosis should not be excluded because of lack of its classical patterns.
Classification ; Diagnosis, Differential ; Tuberculosis

Isolated situs in versus of the stomach with otherwise normal position of the thoracic and abdominal vescera isan extremely rare anomaly occurring in two distinct forms. Majority of cases are associated with eventration of the diaphragm and are reported as being confused with spontaneous pneumothorax of pyopneumothorax at base of the right lung. The right sided stomach may produce interesting and confusing changes in liver scan. We have experienced 2 cases of the isolated dextrogastria.
Diaphragm ; Liver ; Lung ; Pneumothorax ; Stomach

BACKGROUND: Vascular endothelial growth factor (VEGF) plays a role in the development of cancer and the progression of liquid tumors such as chronic lymphatic leukemia, non-Hodgkin lymphomas, and multiple myeloma. VEGF also triggers endothelial cells to secrete hematopoietic growth factors such as interleukin-6 (IL-6); this in turn promotes further leukemia growth, thereby contributing to a paracrine loop between the leukemia and the endothelial cells. METHODS: We transfected a small interfering RNA (siRNA) targeting VEGF into K562 cells in order to investigate the role of VEGF in the development of leukemic cancer. After the conditioned media (CM) of the K562 was cells added to the human umbilical endothelial cell (HUVEC) culture media, we compared the proliferation and tube formation of the HUVECs. Recombinant human prothrombin kringle2 (K2), which is a known angiogenic inhibitor, was also treated onto the HUVECs, and we then examined the level of IL-6 to determine the paracrine interaction between the leukemic and endothelial cells. RESULTS: RT-PCR and western blot analysis demonstrated that the siRNA efficiently down regulated the expression of VEGF in the K562 cells. When the CM of the K562 cells was added to the HUVEC culture, the proliferation of the HUVECs was stimulated. The proliferation of the HUVEC induced by the CM from the siRNA-VEGF K562 cells was diminished, compared with that of the vector control K562 cells. K2 reduced not only the proliferation of the HUVECs, but also the secretion of IL-6 by the HUVEC. CONCLUSION: The siRNA strategy is an alternative tool for inhibiting leukemia-induced angiogenesis. A combinated therapy with angiogenesis inhibitor K2 increases the efficiency. K2 modulates the production of IL-6, which may affect the paracrine interaction between leukemia and endothelial cells.
Blotting, Western ; Culture Media ; Culture Media, Conditioned ; Endothelial Cells ; Humans* ; Intercellular Signaling Peptides and Proteins ; Interleukin-6 ; K562 Cells ; Kringles* ; Leukemia ; Lymphoma, Non-Hodgkin ; Multiple Myeloma ; Prothrombin* ; RNA, Small Interfering* ; Vascular Endothelial Growth Factor A*

Cerebrovascular accident (CVA) is the most common cause of neurologic disorder accompanying grave prognosisand its mortality above 50%. Prior to introduction of the CT, the diagnosis have been depended on clinicalfindings and spinal puncture. Radiologic diagnostic methods, such as angiography, ventriculography andradioisotope scanning are invasive and less sentitive in diagnosis of CVA than CT. The size, location andextension of the intracranial pathology and ventricular penetration are accureately and rapidly portrayed by CT.Consequently, CT plays impotant role in effective tratement and evaluation of prognosis in CVA. Authors analyzed63 cases of diagnosed CVA who were performed CT scan in Korea General Hospital from November 1981 to April 1982.The results were as follows. 1. The most prevalent age group of CVA was 6th decade, and then 7th and 5th decadesin decreasing order. The sex ration between male and female was 1.2:1. 2. The causes of CVA were hypertensivehemorrhage (50.8%), vascular occlusive disease(22.2%), anurysm ruture (4.8%), arteriovenous malformation (3.2%)and hemorrhage of unknown etiology (19.0%). 3. The most common site of hemorrhage was basal ganglia (34.6%) andthen thalamus(21.8%) and cerebral lobes(20.5%). In infarction, the common sites were the lobes(64.7%) and thebasal ganglia (35.3%) 4. Round or oval shaped hematomas of high density (85.9%) were frequent findings ofhemorrhage and mass effect occured in 75.6%. 5. All infarctions were low in density ; Most of the lesion wasinhomogeneous(70.6%) and the rests were homogeneous. Mass effects were seen in 29.4%.
Angiography ; Arteriovenous Malformations ; Basal Ganglia ; Diagnosis ; Female ; Ganglia ; Hematoma ; Hemorrhage ; Hospitals, General ; Humans ; Infarction ; Korea ; Male ; Mortality ; Nervous System Diseases ; Pathology ; Prognosis ; Spinal Puncture ; Stroke ; Tomography, X-Ray Computed

Over a period of recent 3 years, the 5 cases of polyostotic fibrous dysplasia were proven histologically atNational Medical Center, and they were evaluated and analysed radiologically and clinically. The results were asfollows; 1. The age of 5 patients ranged from 12 to 21. 2. In general, clinical symptoms of thses patients werepain of affected sites and swelling, fracture, walking disturbance of lower extremities. 3. The order of frequentsite of polyostotic fibrous dysplasia was skull (4 cases), femur( 3 cases), maxilla (2 cases), humerus, tibia,rib, radius, metacarpal bone and phalanx. 4. The characteristic radiological findings of polyostotic fibrousdysplasia were multicystic lesions with ground glass appearance, osteoslcerosis, cortical thinning and pathologicfracture and deformity of long bones. Particularly, in the extremities, multicystic radiolucencies, groud glass appearance, shepherd's crook and coxa vara deformities were noticed, and in teh skull and maxilla, sclerotic changes wee principally demonstrated.
Congenital Abnormalities ; Coxa Vara ; Extremities ; Fibrous Dysplasia, Polyostotic ; Glass ; Humans ; Humerus ; Lower Extremity ; Maxilla ; Radius ; Skull ; Walking

BACKGROUND: Combined spinal epidural anesthesia (CSE) often produces a more extensive spinal block than expected. This study was designed to evaluate the effects of CSE on subarachnoid block in patients undergoing lower extremity surgery. METHODS: Thirty-three patients who undergone lower extremity surgeries were randomly allocated to three groups of 11 patients each. Using needle through needle technique, all patients received a subarachnoid injection of hyperbaric 0.5% bupivacaine 1.6~2.0 ml through a 25G Whitacre spinal needle. Group 1 received no extradural injection for 25min, but group 2 and 3 received extradural saline 10 ml and bupivacaine 10 ml 5min after the subarachnoid injection, respectively. Levels of sensory and motor block were assessed at 4, 6, 8, 10, 15, 20, and 25 min after subarachnoid injection. RESULTS: The median values of maximum sensory block level were T7 in all groups. Levels of sensory blockade and the time to onset of maximum sensory blockade were similar among the three groups. There was no significant difference in the degree of motor block among three groups. CONCLUSIONS: This study suggests that extradural saline 10 ml or 0.5% bupivacaine 10 ml which injected 5min after subarachnoid injection does not significantly influence the level of subarachnoid block in lower extremity surgical patients. However, further study is required to declare the safety or optimal dose of extradural injection during CSE.
Anesthesia, Epidural* ; Bupivacaine ; Humans ; Injections, Epidural ; Lower Extremity* ; Needles

CT is the most accurate and reliable method for the diagnosis of intracerebral and intraventricularhemorrhage. The precise anatomic extent of the hematoma, associated cerebral edema, ventricular deformity anddisplacement, and hydrocephalus are all readily assessed. Aside from head trauma, the principal cause ofintracerbral hematoma is hypertensive vascular disease. Although hematomas from various causes may present similarCT appearances frequetnly the correct etiology may be suggested by considereation of patient's age, clinicalhistory, and the location of the hematoma. The analytical study was performed in 180 cases of intracerebralhamorrhages by CT from Oct. 1981 to Jan. 1983. The results were as follows; 1. The most prevalent age group was6th decade(37.2%) Male was prevalent to female at the ration of 1.6 to 1. 2. The most common symptom and sign wasmental distrubance (48.7%), motor weakness(23%), headache(10.6%), nausea and vomiting (9.8%). 3. The causes ofhemorrhage were hypertension (53.9%), head trauma (30.6%), aneurysm(6.1%) and A-V malformation (7.2%). 4. Thefrequent locations of hemorrhage were basal ganglia and thalamus(40.4%), lobes(35%), ventricles(21.8%). 5. Thedistribution of hemorrhage was intracerebral hemorrhage(65.6%), intracerebral and intraventricularhemorrhage(30.3%), intraventricular hemorrhage(4.4%).
Basal Ganglia ; Brain Edema ; Cerebral Hemorrhage ; Congenital Abnormalities ; Craniocerebral Trauma ; Diagnosis ; Female ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Male ; Methods ; Nausea ; Vascular Diseases ; Vomiting

Splenoportography has been proved as a useful method for the evaluation of circulatory distrubances in portalhypertension. Authors analyzed the various aspects of these disturbances on splenoportography in 22 cases thatwere performed under the clinical suspicion of portal hypertension during recent 6 years, from May, 1976 to July,1982 at the Department of Radiology, National Medical Center. The results were as follows; 1. Liver cirrhosis wasthe most frequent cause of intrahepatic obstruction type in portal hypertenstion (86%). 2. The portal pressure wasmore than 400 mmH2O in 67% of the cases (range; 300-540 mmH2O). 3. In the majority of the cses, the higher theportal pressure was, the more dilated splenic and portal veins were. The diameter of portal vein was more than15mm in 79%, more than 21 mm in 47% of the cases (range; 10-26mm). The diameter of splenic vein was more than 15mmin 48% of the cases (range; 7-23mm). Especially the diameter of splenic vein was larger than that of portal veinin 20% of the cases. 4. There was no definite correlation between the development of collateral circulation andthe diameter of splenic and portal veins. 5. The filling of collateral circulation was definite sign of portalhypertenstion, though not regular. In portal hypertension, the collateral circulation was formed via coronary vein(91%), short gastric vein (64%), inferior mesenteric vein(36%). 6. Splenic-hilum time was delayed in 64% of thecases. Intrahepatic portal vein emptying time was more than 6 seconds in all the cases. 7. Most of the cases (91%)could be diagnosed as portal hypertension with vasculogram and hepatogram.
Collateral Circulation ; Hypertension, Portal ; Liver Cirrhosis ; Methods ; Portal Pressure ; Portal Vein ; Portography ; Splenic Vein ; Veins

Twenty cases of pulmonary metastases from pathologically proven stomach carcinoma were studies with specialreference to the clinico-radiological findings and the grades of cell-differentiation of stomach carcinoma. Theywere calssifed into five types based on the pattern of chest X-ray findings according to the reportedclassifications of metastatic pulmonary carcinoma. The radiological appearance of pulmoanry metastases formstomach carcinoma was didffferent from that of usual pulmonary metastatic cancers. The Type IV metastatic form(Type IV-Progressive increasing interstitial lung markings and then infiltration of pulmonary parenchyme with orwithout evidence of pleural effusion.) was most commonly seen in stomach carcinoma particularly in poorlydifferentiated cell type and more associates with respiratory symptoms than others.
Lung ; Neoplasm Metastasis ; Stomach ; Thorax

Ultrasonograhy, it's excellent ability of differentiating cystic from solid lesion and depicting detailedarchitecture, proved itself useful in the diagnosis of thyroid pathologies. Adanced high resolution equipmentsmade hidden small lesion detected and finer structure clearly seen. They seemed to throw light on the histologicaldiagnosis of thyroid diseases, especially differentiation of benignancy and malignancy. Author reviewed picturesof high-resolution ultrasonography of thyroid disease(24 ases0 and correlated them witn proven pathologicalfindings. The results were as follows: 1. Multiplicity of lesion favors benignancy(4 cases). 2. Well definedmargin favors benignancy(14/17), while ill defined margin favors malignancy(3/4), and lesion of no margin favorsthyroiditis(3/3). 3. Surrounding halo favors benignancy(7 cases). 4. Hypoechogenicity were found in most ofmalignancy and thyroiditis. Cystic components in solid nodule were common findings in bening and malignantlesions. Calcification was not found in malignancy.
Diagnosis ; Pathology ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Ultrasonography