Emphysematous cystitis is a rare condition characterized by gas collection in the wall and lumen of the bladder. We experienced three cases of emphysematous cystiris. All patients were female; one was associated with a long term history of diabetes mellitus and another with urinary indwelling catheter. All of the cases were easily diagnosed on plain radiograph and CT scan, and were successfully treated with antibiotic therapy. In one of the cases, however, associated abscess due to perivesical extension of inflammation was treated by combined external drainage.
Abscess ; Catheters, Indwelling ; Cystitis* ; Diabetes Mellitus ; Drainage ; Female ; Humans ; Inflammation ; Tomography, X-Ray Computed ; Urinary Bladder

From March 1987 to July 1989, six patients (five dadults and one child) with lung abscess (size, 5-13cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr catheter was inserted for drainage. Five of 6 had a dramatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days (average, 15.5days) in successful cases. One case of the failure in drainage was due to persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provided anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating patients with lung abscess.
Abscess ; Catheters* ; Drainage* ; Empyema, Pleural ; Humans ; Lung Abscess* ; Lung* ; Methods ; Punctures

The recovery time of the blood glucose level after anesthetic and surgical stress in 30 surgical pediatric patients with A.S,A. physical status class 1 or 2 was evaluated Although they had fasted from 4 to ll hours, none of the patients exhibited hypoglycemia, dehydration or hypotension; This showed that the duration of fasting, age, body weight, and sex did not influence hypoglycemia, dehydration. and hypotension. All patients were anesthetized with Halothane(0.5~1.5 Vol. %)-N2O(1.5L/min) under endotracheal intubation. Just after surgical stimulus, the blood glucose concentration increased about 27mg%, and then returned to pre-operative values within 30 minutes. The author concluded that the hormonal effects arising from the strong stimuli disappeared within 30 minutes. Also, the increase in blood glucoee concentration during intraabdominal surgery was more notable than in surgery to the skin, head or neck. Changes in blood glucose concentration in the recovery room are poasibly related to postoperative pain control.
Anesthesia* ; Blood Glucose* ; Body Weight ; Dehydration ; Fasting ; Head ; Humans ; Hypoglycemia ; Hypotension ; Intubation, Intratracheal ; Neck ; Pain, Postoperative ; Recovery Room ; Skin

PURPOSE: Complete resection of the tumor nodule(mural nodule or solid portion of the tumor) is the essential goal of surgical treatment for heman-gioblastoma. The purpose of this study was to classify the morphologic types of intracranial hemangioblastoma on MRI and to compare the location and contour of tumor nodule on MRI with those on angiography. MATERIALS AND METHODS: The MRI findings of 34 lesions(38 lesions if 4 spinal cord lesions were included) in 26 patients(17 males and 9 females, range of age, 18-67 years, mean, 39 years) with surgically and histopathologically proved intracranial hemangioblastomas were reviewed. Seventeen patients underwent CT scanning in a short interval. Contrast-enahnced T1 -weighted imaging pa- tterns of hemangioblastoma were classified according to Ho's morphologic types. The location and contour of tumor nodule were compared between MRI and angiography in 15 patients(24 lesions). RESULTS: By location, cerebellar hemisphere was predominated(55%), followed by cerebellar vermis(26%), supratentorial region(5%), and medulla oblongata (3%). Spinal cord lesions(11%) were seen in 3 patients of 5 von HippeI-Lindau diseases. The frequency of morphologic types was as follows; Type 1 (purely cystic), 3%, Type 2(mural nodule), 50%, Type 3(cyst with wall enhancement), 3%, Type 4 (cystic nodule), 15%, Type 5(solid with internal cyst), 9%, and Type 6(solid), 20%. All tumor nodules(33 lesions) enhanced intensely with intravenous contrast material on MRI, of which 24 lesions(in 15 patients) revealed hypervascular masses fed by pial arteries on angiography. They were superficial and abutted pia mater partially or in large portion on both MR I and angiography. CONCLUSION: Over 70% of intracranial hemangioblastomas had a surrounding cyst, and superficial, pial-based location and number of the tumor nodules on MRI was correlated well with those on angiography. MRI is the examination of choice for preoperative evaluation of intracranial hemangioblastoma.
Angiography ; Arteries ; Female ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Male ; Medulla Oblongata ; Pia Mater ; Spinal Cord ; Tomography, X-Ray Computed

No abstract available.
Perfusion*

Percutaneous aspiration needle biopsy of the intrathoracic disease is a safe, easy, and accurate diagnostic method. It usually causes mild pain or discomfort during the procedure. We had a patient who complained of severe sharp pain, well localized at the biopsy site of the target mass during CT-guided transthoracic aspiration biopsy. It was pathologically confirmed as an intrathoracic schwannoma after special staining. To our knowledge, there has been no published report of such a painful percutaneous needle biopsy in a patient with schwannoma in Korea. Two cases were reported in other radiologic journals. The severe sharp pain developed during the transthoracic aspiration needle biopsy is a reliable sign of neurogenic tumor, therefore the participating radiologist should recommend specific immumochemical stain for neurogenic tumor to pathologist.
Biopsy ; Biopsy, Needle* ; Humans ; Korea ; Needles* ; Neurilemmoma*

PURPOSE: To describe MR findings and differential points of supratentorial cystic intracranial lesions. MATERIALS AND METHODS: We retrospectively reviewed and analyzed the MR findings of 59 patients with supratentorial cystic intracranial lesions, and classified them as follows: tumor-associated cyst, infectious cyst, ex-vacuo type cyst, and congenital/developmental cyst. RESULTS: Among 59 patients, 47 tumor-associated cysts were seen in 17, 42 infectious cysts in 13, 17 ex-vacuo type cysts in 10, and 19 congenital/developmental cysts in 19. In 44 of 47 tumor-associated cysts, increased or inhomogeneous internal signal intensity was seen on T1-weighted image, 37 of 47 showed thick uneven walls ; 35 of 47 had enhancing solid components and there was variable perifocal edema and mass effect. Infectious cysts were multiple (11 of 13). In cases of brain abscess, increased internal signal intensity on T1-weighted image, low signal intensity of abscess wall on T2-weighted image, thick even enhancing wall, and marked perifocal edema(4 of 4) were seen in all four cases. Cysts in cysticercosis were variable in appearance depending on the stage, but were smaller than other cystic lesions. Ex vacuo type cysts were of uniform CSF signal intensity in all pulse sequences and there was no identifiable wall or enhancement associated with enlarged adjacent ventricle and encephalomalacia(17 of 17). Congenital/developmental cysts showed a single lesion(19 of 19), a signal intensity similar to CSF in all pulse sequences(15 of 19), no identifiable wall(16 of 19), no enhancement(17 of 19), and no perifocal edema(19 of 19). CONCLUSION: MR was used to categorize supratentorial cystic intracranial lesions into four groups on the basis of their number, size, internal homogeneity of signal intensity on T1-weighted image, enhancing pattern, perifocal edema and mass effect, thereby improving diagnostic specificity and patient management.
Abscess ; Brain Abscess ; Cysticercosis ; Edema ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: This paper is to evaluate radiological features of hypersensitivity pneumonitis, correlated with clinical and pathologic findings. MATERIALS AND METHODS: Patients consisted of 2 men and 3 women, aged 23-51 years old (average 41). Diagnosis was based on the presence of suggestive clinical and radiological findings (chest radiography, high resolutional CT, gallium scintigraphy), and lung biopsy showing characteristic histological features. RESULTS: All patients complained of exertional dyspnea and three patients experienced coughing. On the pulmonary function test, four patients revealed restrictive pattern and one patient was normal. Results of bronchoalveolar lavage, available in four patients, revealed lymphocytosis in three patients and normal finding in one patient. Chest radiographs showed ground glass opacity or diffuse nodular densities. On the HRCT, diffuse nodular opacity and ground glass opacity were seen in variable features. All 4 patients had diffuse increased uptake on the gallium scan. On lung biopsy, a combination of histologic findings showed cellular bronchiolitis, diffuse interstitial infiltrates and non-necrotizing granulomas, consistent with diagnosis of hypersensitivity pneumonitis. CONCLUSION: Hypersensitivity pneumonitis could be diagnosed with these radiological, clinical and pathological findings.
Alveolitis, Extrinsic Allergic* ; Biopsy ; Bronchiolitis ; Bronchoalveolar Lavage ; Cough ; Diagnosis ; Dyspnea ; Female ; Gallium ; Glass ; Granuloma ; Humans ; Hypersensitivity* ; Lung ; Lymphocytosis ; Male ; Radiography ; Radiography, Thoracic ; Respiratory Function Tests

Hidrocystomas, eccrine or apocrine are rare ductal cystic benign lesions of the sweat gland. These uncommon cystic lesions are extremely rare in the external ear. Here, we discuss the clinical features and management of eccrine hydrocystoma in the external ear by describing the clinical, radiographic, pathologic features and management of an external auditory canal eccrine hidrocystoma in a 73-year-old Korean man. To the best of our knowledge, this tumor has not been reported previously in this site. Five month after surgery, there has been no evidence of local recurrence.
Aged ; Ear Canal* ; Ear, External ; Hidrocystoma* ; Humans ; Recurrence ; Sweat Glands

PURPOSE: The purpose of this study is to examine the frequency of posterior element injury in patients with traumatic thoraco-lumbar burst fractures and to evaluate the correlation between the MR imaging and CT findings. MATERIALS AND METHODS: The MR images of 38 patients with 39 thoraco-lumbar burst fractures and the results of the CT examinations of 28 patients with 29 fractures were retrospectively analyzed. Both procedures were performed within two weeks of injury. Twenty-one males and 17 females were included ; their average age was 51.3 (range, 11-75) years. MR images were evaluated for injury to the posterior ligamentous complex, comprising the supraspinous ligament(SSL), the interspinous ligament(ISL), the flaval ligament(FL), and the capsule of facets. Analysis of the CT findings focused on the posterior bony elements of the lamina, pedicle, spinous process, and facet joint. RESULTS: MR imaging revealed posterior ligamentous injuries in 18(46.2%) of 39 burst fractures ; there was tearing of the ISL in 15 cases(38.5%), of the SSL in 11(28.2%), of the capsule of facets in 11(28.2%), and of the FL in nine(23.1%). Among the 29 burst fracture cases examined by CT, posterior bony injuries were detected in 13(44.8%). Lamina and facet joint fractures were detected in six cases(20.7%), facet separation or dislocation in six(20.7%), and spinous process and pedicle fracture in one(3.4%). In 29 burst fracture cases, both MRI and CT were performed. Among the 18 cases in which MR imaging revealed posterior ligamentous injuries, CT failed to demonstrate posterior element fractures in seven. On the other hand, among the 13 cases in which CT indicated posterior bony fractures, MR failed to reveal posterior ligamentous injuries in two. CONCLUSION: Posterior element injury is frequently found in patients with traumatic thoraco-lumbar burst fractures demonstrated by MR imaging(46.2%) and CT(44.8%). Both MRI and CT are useful tools for the evaluation of posterior element injury, which determines the degree of instability of traumatic burst fracture.
Dislocations ; Female ; Hand ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Zygapophyseal Joint