No abstract available.
Diagnosis* ; Tomography, Emission-Computed, Single-Photon*

Intraperitoneal bleeding caused by ruptured ectopic pregnancy is a serious obstetrical emergency requiring accurate and prompt diagnosis and treatment to save the life. The plain X-ray of the abdomen is simple andnoninvasive method but a review of literature failed to disclose any previous systematic investigations andanalysis of plain x-ray findings of ruptured ectopic pregnancies except well known sign of free fluid ofperitoneal cavity which is obviously nonspecific, the present study has been undertaken to make a criticalanalysis of the plain abdonimal findings of ruptured ectopic pregnancies. In addition, plain chest film wereevaluated to aid the diagnosis of hemorrhagic nature of peritoneal fluid. The materials consisted of 64 cases ofsurgically proven ruptured ectopic pregnancies seen at St. Mary's Hospital and Holy Family Hospital, Catholic Medical college, during the period of Jan. 1979 through Dec. 1980. The results of the study are as follows; 1.Intraperitoeal fluid smaller in amount than 1 liter appeared as comb-like, new-moon, half-moon and full-moondensities in the minor pelvis. As the amount exceeds 1 liter, widening of paracolic gutter and obliteration of thehepatic angle occurred. 2. Indentation and displacement of the bladder and rectum were present in 29 cases (45%).3. Local ileus of considerable intensity occurred in LLQ and RUQ in 35%. Remakable gaseous distension of sigmoidcolon were noted in 30%. 4. Blurring of psoas muscle shadow took place in 33% and scoliosis in 11%. The curvature of lumbar scoliosis was directed away from the ruptured site of pregnance in the majority. 5. In the chest x-ray,the diameter of basal pulmonary artery appeared significantly reduced in acute group. On the other hand, thecardiothoracic ratio became slightly increased in non-acute group. These pulmonary arterial change and cardiomegaly seem to reflect acute and subacute blood loss, respectively.
Abdomen ; Ascitic Fluid ; Cardiomegaly ; Diagnosis ; Emergencies ; Female ; Hand ; Hemorrhage ; Humans ; Ileus ; Methods ; Pelvis ; Pregnancy ; Pregnancy, Ectopic ; Psoas Muscles ; Pulmonary Artery ; Rectum ; Scoliosis ; Thorax ; Urinary Bladder

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

In 1951, Leborgen pointed out the special diagnostic importance of punctate calcifications in the diagnosis of breast cancer by mammography. Calcifications within the breast may occure in both malignant and benign diseases, the characteristic findings have been reported subsequently by many other investigators. This study was done toreevalute the significance and diagnostic value of calcifications of female breast cancers. The clinical materals were 980 cases of those underwent mammography, and 76 cases of those histopathologically diagnosis was confirmed. Fine calcifications were radiologically found in 24 cases of these 76. A morphological analysis was made inregards to the relationship between the calcific particles and various mammary diseases. The results were asfollows; 1. The irregularly fine spiculate and punctate calcifications were found in 11 cases (45.8%) of cancergroup, and rather uniformly fine smooth calcifications were found in 14 out of 52 cases (26.9%) of benign conditions. 2. In cancer group, the calcifications were finely punctate or spiculate in shape and in numerable innumber with a tendency toward formation of densely packed clusters within and adjacent to the lesional areas. Nospiculate calcifications were observed in benign conditions. There were, however, no difference in either size ordensity of particles in both benign and malignant conditions. 3. These fine calcifications of the breast detectedby mammography seem to be a useful marker in localizing so small a lesion as not to be palpable and in obtaining proper biopsy specimen.
Biopsy ; Breast Neoplasms ; Breast ; Diagnosis ; Female ; Humans ; Mammography ; Research Personnel

Although the usefulness of mammography as a screening test for breast cancer is still indispute, its use topatients over 50 years of age is valid. Since Wolfe first classified the breast parenchymal patterns of mammography into 4 patterns, many authors have adopted the criteria in studying the changes of the parenchymalpatterns for certain ages and the risks for breast cancer of certain parenchymal patterns. Authors reviewed 49cases of breast masses which diagnosed by mammography and by operation during the period from January 1978 to July 1983 at St. Mary's Hospital, Catholic Medical College. The parenchymal tissue patterns were classifed according toWolfe into NI, P1, P2 and DY. Risk groups were classified into low risk group (N1, P1) and high group(P2, DY). Onthe basis of these criteria, benign and malignant disease were analyzed against the breast parenchymal patterns.The results and conclusions were as follows: 1. Age ranged from 16 years to 67 years with the most prevalent agebeing 4th and 5th decades. 2. Diagnoses were; fibroadenoma 17 cases, fibrous dysplasia 16 cases, ductal papilloma3 cases, and cancer 13 cases. 3. Categorization of those 26 bening disease according to the Wolfe's criteria was:N1 6 cases, P1 10 cases, P2 9 cases and DY 11 cases. On the other hand, categorization of 13 cases of cancerwas:N1 5 cases, P1 3 cases, P2 3 cases, and DY 2 cases. 4. Of 13 cases of cancer, 8 fell in the low risk group andremainder in the high risk group. There were no significant correlation between the parenchymal patterns and theincidence of breast cancer.
Breast Neoplasms ; Breast ; Diagnosis ; Fibroadenoma ; Hand ; Mammography ; Mass Screening ; Wolves

No abstract available.
Adult* ; Humans ; Thorax*

No abstract available.
Neurilemmoma*

In spite of recent introduction of such highly sophisticated diagnostic modalities as computerized tomography,cardioangiography and polytomography the simple PA chest remaines as an essential and important method of chestdiagnosis especially in terms of vascular diseases of the lung and heart. Until recently, however, theinterpretation of chest x ray has been largely dependent on much subjective observation of roentgen anatomy of thechest. Several years ago Simon proposed a quantitative approach to interpretation of the chest in an attempt tomake the judgement more objective. In the present study we have carried out a clinical study on normalities of thestandard PA chest of Korean adults. The materials consisted of 216 normal chest films. Age ranged from 20 to 60years and sex distribution 103 males and 113 females, We counted the number of vessels in both lung fields,measured the diameter of the basal artery and investigated the level of hilum points as well as hilar distance.There were 9 to 11 vessels in the upper zone and 9 to 12 in the lower zone. There were no significant sexdifference. The number of vessels was not affected by aging. The average diameter of the basal artery was11.7±2.4mm in the right lower zone and 10±1.8mm in the left lower zone in female. There was significant sexdifference (p 0.01). Aging seemed not to be affected the size of the basal artery. The majority of hilum point waslocated at the level of 5-6th rib at axillary portion and the left hilar point is 0.3-2.0cm higher in locationthan the right. The hilar distance was 4.1±0.4cm on the right 5.0±1.1cm on the left in male and 4.0±0.7cm onthe right and 4.7±0.5cm on the left in female. There was significant sex difference (p 0.01). There wassignificant difference in size of the basal arteries and hilar distance between the Koreans and Englishmen but thenumbers of vessels were not significantly different.
Adult ; Aging ; Arteries ; Clinical Study ; Female ; Heart ; Humans ; Lung ; Male ; Methods ; Ribs ; Sex Characteristics ; Sex Distribution ; Thorax ; Vascular Diseases

Although rare spontaneous regression of either primary or metastatic malignant tumor in the absence of inadequate therapy has been well documented. Since the earliest day of this century various malignant tumors havebeen reported to spontaneously disappear or to be arrested of their growth, but the cases of hepatocarcinoma has been very rare. From the literature, we were able to find out 5 previously reported cases of hepatocarcinoma which showed spontaneous regression at the primary site. Recently we have seen a case of multiple pulmonary metastaticnodules of hepatocarcinoma which completely regressed spontaneously and this forms the basis of the present casereport. The patient was 55-year-old male admitted to St. Mary's Hospital, Catholic Medical College because of ahard palpable mass in the epigastrium on April 26, 1978. The adimssion PA chest roentgenogram revealed multiplesmall nodular densities scattered throughout both lung field especially in lower zones and toward the peripheralportion . A hepatoscintigram revealed a large cold area involving the left lobe and inermediate zone of the liver. Alfa-fetoprotein and hepatitis B serum antigen test were positive whereas many other standard liver function teststurned out to be negative. A needle biopsy of the tumor revealed well differentiated hepatocellular carcinoma. The patient was put under chemotherapy which consisted of 5 FU 500 mg intravenously for 6 days form April 28 to May 3,1978. The patient was discharged after this single course of 5 FU treatment and was on a herb medicine, the nature and quantity of which obscure. No other specific treatment was given. The second admission took place on Dec. 3, 1980 because of irregularity in bowel habits and dyspepsia. A follow up PA chest roentgenogram obtained on the second admission revealed disappearance of previously noted multiple pulmonary nodular lesions. Follow up liverscan revealed persistence of the cold area in the left lobe with slight decreased in size. The patient was discharged again without any specific prescription after confirming negative resuls of various clinical studies including upper GI series and colon study. At the time of finishing this paper the patient is doing well without apparent medical problems.
Biopsy, Needle ; Carcinoma, Hepatocellular ; Colon ; Drug Therapy ; Dyspepsia ; Follow-Up Studies ; Hepatitis B ; Humans ; Liver ; Lung ; Male ; Middle Aged ; Prescriptions ; Thorax

There are many established roentgen signs of ascites such as hepatic angle sign, generalized graying of the abdomen, frog belly appearance and Hellmer's sign. These signs are easily recognized in the standard flat abdomen film. It is however hardly possible to recognize such signs in small films of double contrasted upper GI series. By a retrospectroscopical observation we were able to find some interesting signs of massive ascites in small size films of double contrasted stomach and duodenum of upper GI series. The clinical materials consisted of 27patients with massive ascites and 30 normal subjects. The signs we observed were ;(1) Constriction deformity of the junction of the fundus and body of the stomach. We named this "waist" sign. This constriction was attended by convergence of mucosal folds. We called this "converging folds" sign. (2) The fundus assumed electric bulbappearance with its long axis directed vertically. We called this "electric bulb" sign. In normal subjects the fundus assumed beret-cap like appearance. These signs were only appreciated in the supine and RAO views and not in other views. Of these new signs of massive ascites where fundic view was obtained in supine or RAO position.
Abdomen ; Ascites ; Congenital Abnormalities ; Constriction ; Duodenum ; Stomach