No abstract available.
Gonadotropin-Releasing Hormone* ; Gonadotropins*

PURPOSE: Three-dimensional(3D) magnetic resonance(MR) projection imaging was evaluated as a noninvasive alternative to direct cholangiography for the assessment of its reliability in patients with obsructive jaundice. METHODS AND MATERIALS: A heavily T2-weighted gradient-echo sequence(PSIF) was used for 3D MR projecion imaging of the biliary system in five healthy volunteers and 25 patients with obstructive jaundice. The 3D images of the bile ducts were formed by stacking consecutive coronal MR images obtained with a fast imaging method to a maximum-intensity projection algorithm. RESULTS: In the volunteers, MR cholangiography could demonstrate the anatomy of the biliary tract in only two subjects. The extrahepatic and intraheparic bile ducts were well visualized in 23 patients with obstructive jaundice. The leve of obstruction and the grade of dilatation were dipicted with MR cholangiography in all cases. And the cause of obstruction could be determined with MR cholangiography in 18 cases, MR cholangiography was successful in two patients in whom ERCP failed. The gallbladder or dilated pancreatic duct not demonstrated by means of direct cholangiography was demonstrated with MR cholangiography in six cases.
Bile Ducts ; Biliary Tract ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Dilatation ; Gallbladder ; Healthy Volunteers ; Humans ; Jaundice ; Jaundice, Obstructive* ; Pancreatic Ducts ; Volunteers

No abstract available.
Skin*

No abstract available.
Animals ; Embryonic Structures* ; Female ; Follicular Fluid* ; Humans* ; Mice*

No Abstract Available.

PURPOSE: MR findings of the spinal metastasis and the tuberculosis are well known, but sometimes it might be difficult to differentiate these lesions. Therefore we reviewed and analyzed the MR findings which would be useful for the differentiation. MATERIALS AND METHODS: T1- and T2-weighted spin echo images and gadolinium-enhanced Tl-weighted images were obtained with 1. 5T and 1. 0T superconductive MR imager. We reviewed MR findings in 16 cases of spinal metastases and 24 cases of spinal tuberculosis in terms of signal intensity, contrast enhancement pattern, disc space involvement, spinal canal compressing feature and paraspinal soft tissue mass. RESULTS: The signal intensities of both lesions were hypointense on T1WI and hyperintense on T2WI except those of the metastatic lesions from the prostatic carcinoma. Heterogeneous enhancement was noted in 63% of metastasis, whereas peripheral rim enhancement was noted in 83% of spinal tuberculosis(p (.001). Spinal canal compression by collapsed vertebra was only noted in spinal metastasis, and that by paraspinal soft tissue was noted in both spinal metastasis and tuberculosis(p (.001). Disc space invasion was noted in 19% of spinal metastasis and 88% of spinal tuberculosis. Spinal tuberculosis was common at lower thoracic spine(T10) and typically involved two or more adjacent vertebral bodies(96%). CONCLUSION: The important differential point between spinal metastasis and tuberculosis was the enhancement pattern, involvement of two or more contiguous vertebral bodies and the feature of spinal canal compressing. The secondary importance was the disc space involvement pattern.
Neoplasm Metastasis* ; Spinal Canal ; Spine ; Tuberculosis ; Tuberculosis, Spinal*

BACKGROUND/AIMS: A laparoscopic cholecystectomy (LC) has many clinical advantages and is now recognize as the choice of treatment for gallstones. However a laparoscopic cholecystectomy is often not feasible or is converted to the conventional open method in patients with acute cholecystitis because of inflammation around the gallbladder, adhesion, unclear anatomy, or intraoperative complications. Recent studies recommended that acute cholecystitis patients or gallbladder empyema patients undergo a percutaneous transhepatic GB drainage (PTGBD) first and a laparoscopic cholecystectomy later because PTGBD can be very helpful for improving the patient's state. METHODS: This study was carried out on 99 patients with acute cholecystitis or GB empyema who underwent a laparoscopic cholecystectomy after PTGBD at Eulji University School of Medicine from January 1996. These cases were compared with a control group of 41 patients who showed similar symptoms, ultrasonographic finding, operative finding, and pathologic results. RESULTS: There were no differences in the age and the sex distributions, the symptom duration, laboratory finding except alkaline phosphatase and leucocytosis. Among PTGBD group, a successful laparoscopic cholecystectomy was possible in 63 patients (63.6%), the other 36 patients were converted to open cholecystectomy. In control group, only 15 patients (36.6%) out of 41 underwent a successful laparoscopic cholecystectomy. This difference was statistically significant (P= 0.003). We analyze two groups about factors that can affect open conversion during laparoscopic cholecystectomy. In multivariate analysis, preoperative PTGBD and degree of wall thickening are the independent risk factors that can convert LC into open cholecystectomy. CONCLUSION: We think that a laparoscopic cholecystectomy performed some time after PTGBD to improve the patient's condition by eliminating acute inflammation or decompressing the gallbladder may be recommended for management of acute cholecystitis patients with severe clinical symptoms and ultrasonographic findings of marked gallbladder dilatation or pericholecystic fluid collection.
Alkaline Phosphatase ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute* ; Dilatation ; Drainage ; Empyema ; Gallbladder ; Gallstones ; Humans ; Inflammation ; Intraoperative Complications ; Multivariate Analysis ; Risk Factors ; Sex Distribution

PURPOSE: The purpose of this study to access MR findings of the lipomatous soft tissue tumor based on histopathologic correlation and its predictability of the histopathologic diagnosis. MATERIALS AND METHODS: We retrospectively analyzed the MR findings and photomicrographs of 9 patients with histopathologically proven lipomatous soft tissue tumors as follows;classic lipoma(4), fibrolipoma(1), lipoblastoma(2), atypical l ipoma(1) and well-differentiated liposarcoma(1). RESULTS: All cases of lipoma showed the same signal intensities as subcutaneous fat which is composed of mature fat cells. Linear low signal intensity lesions corresponded to fibrous connective tissues within lipomas. Two cases of lipoblastoma showed heterogeneous signal intensity with areas of high signal intensity brighter than subcutaneous fat on T2WI, corresponding to myxoid matrix of cytoplasm of immature lipoblasts, and the areas of myxoid degeneration within tumors. Both atypical lipoma and liposarcoma showed heterogeneous signal intensity with ill-defined margins due to presence of lipoblasts and infiltration to adjacent muscle bundles. CONCLUSION: MR image findings were well correlated with histopathologic findings of lipomatous soft tissue tumor, especially with maturity of fat cells and the signal intensity of mesenchymal components within the tumors. MR may predict the pathologic diagnosis of lipoblastoma by presence of myxoid degeneration within Ihe tumor, but atypical lipoma and liposarcoma revealed similar MR findings.
Adipocytes ; Connective Tissue ; Cytoplasm ; Diagnosis ; Humans ; Lipoblastoma ; Lipoma ; Liposarcoma ; Magnetic Resonance Imaging* ; Retrospective Studies ; Subcutaneous Fat

PURPOSE: Spirometry, because of its simplicity and reproducibility, has been used to evaluate pulmonary function in childhood asthma. We investigated whether FEF25-75% is the most sensitive parameter among other spirometric parameters in the diagnosis of pulmonary function and airway obstruction. METHODS: This study included 32 children with asthma. We recorded values of spirometry(FVC, FEV1, PEFR, and FEF25-75%) before and after symptomatic improvement and compared them. The values were recorded as a percent of the predicted normal value. RESULTS: The FEV1 value before and after symptomatic improvement was 71.7+/-15.6% and 83.8+/-12.8%, respectively; PEFR was 75.4+/-18.3% and 85.0+/-16.0%; and FEF25-75% was 60.8+/-17.9% and 81.5+/-16.3%. According to symptomatic improvement, FEF25-75% improved more than the other spirometric parameters. Of the 40 cases of spitometric measurement before symptomatic improvement, abnormal FEV1, PEFR, FEF25-75% values were observed in 25, 17 and 28 cases, respectively. There was statistically significant difference between FEF25-75% and PEFR(P=0.005), but not between FEF25-75% and FEV1(P=0.091). After symptomatic improvement, abnormal FEV1, PEFR, and FEF25-75% values were observed in 14, 12 and 9 cases, respectively. There was statistically significant difference between FEF25-75% and FEV1(P=0.044) but not between FEF25-75% and PEFR (P=0.097). The cases of normalized values with symptomatic improvement, 11 in FEV1, 7 in PEFR and 19 in FEF25-75%. CONCLUSION: FEF25-75% showed the most improvement rate before and after symptomatic improvement. FEF25-75% was helpful in the assessment of treatment effectiveness and reversible bronchial responsiveness. However, this study did not suggest that FEF25-75% is the most sensitive measurement of airway obstruction.
Airway Obstruction ; Asthma* ; Child ; Diagnosis ; Humans ; Peak Expiratory Flow Rate ; Reference Values ; Spirometry ; Treatment Outcome

BACKGROUND: Non-functioning pituitary adenomas (NFPAs) are characterized by the absence of clinical and biochemical evidence of pituitary hormone hypersecretion, and these tumors constitute approximately one third of all the tumors of the anterior pituitary. Recently, hormonal deficiencies have gradually evolved to become the leading presenting signs and symptoms in patients with NFPAs. We investigated pituitary hormonal insufficiencies according to the magnetic resonance imaging (MRI) findings in patients with NFPA. METHODS: We evaluated the patients who were newly diagnosed with NFPA from 1997 through 2009. Among them, we analyzed 387 patients who were tested for their combined pituitary function and who underwent MRI. The severity of the hypopituitarism was determined by the number of deficient axes of the pituitary hormones. On the MRI study, the maximal diameter of the tumor, Hardy's classification, the thickness of the pituitary gland and the presence of stalk compression were evaluated. RESULTS: The mean age was 46.85 +/- 12.93 years (range: 15-86) and 186 patients (48.1%) were male. As assessed on MRI, the tumor diameter was 27.87 +/- 9.93 mm, the thickness of the normal pituitary gland was 1.42 +/- 2.07 mm and stalk compression was observed in 201 patients (51.9%). Hypopituitarism was observed in 333 patients (86.0%). Deficiency for each pituitary hormone was most severe in the patients with Hardy type IIIA. Hypopituitarism was severe in the older age patients (P = 0.001) and the patients with a bigger tumor size (P < 0.001) and the presence of stalk compression (P < 0.001). However, the patients who had a thicker pituitary gland showed less severe hypopituitarism (P < 0.001). Multivariate analysis showed that age, tumor diameter and the thickness of pituitary gland were important determinants for pituitary deficiency (P = 0.004, P < 0.001, P = 0.022, respectively). CONCLUSION: The results suggest that the hormonal deficiencies in patient with NFPA were correlated with the MRI findings, and especially the tumor diameter and preservation of the pituitary gland.
Humans ; Hypopituitarism ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Male ; Multivariate Analysis ; Pituitary Gland ; Pituitary Hormones ; Pituitary Neoplasms