Five cases of histologically proven polymorphic reticulosis were examined with computed tomography(CT). CT findings were mucosal thickening along the septal and lateral walls of the nasal cavities(n=4), obliteration of the contour of the nasopharynx(n=4), involvement of the paranasal sinuses (n=2), destruction of the nasal septum and/or sinus walls(n=3) and mass in the palate, tonsil or neck (n=1). CT examination was helpful in determining the extent of the disease in the nasal cavity and paranasal sinuses. However, lesions in the palate and tonsils could not be easily evaluated with CT. CT findings of polymorphic reticulosis are nonspecific and granulomatous diseases may show similar CT findings.
Granuloma, Lethal Midline* ; Nasal Cavity ; Nasal Septum ; Neck ; Palate ; Palatine Tonsil ; Paranasal Sinuses

The word "Delayed" in the legend of Figure 2 should have been written as "Controls."

Dissecting aneurysm involves development of a hematoma in the media of aorta, which is usually contagious with the lumen of the aorta via a tear in the media. The high percentage of co-existing diseases such as other cardiovascular diseases in these patients accounts for much of the surgical morbidity and mortality. Complications in Dacron patch graft surgery for repair of descending thoracic aortic aneurysm include massive hemorrhage, myocardial ischemia, myocardial infarction, heart failure, paraplegia and renal failure. A 60 year-old, 59kg woman underwent Dacron patch graft surgery for descending thoracic aortic aneurysm, under the high thoracic epidural block supplemented with light general anesthesia(N2O-O2). During operation, systolic blood pressure of upper extremities ranging from 120 mmHg to 100 mmHg was maintained, while diastolic pressure was maintained from 60 mmHg to 4) mmHg. Mean arterial pressure of 15-20 mmHg was maintained in lower extremities. When aorta was declamped, hypotension and bradycardia continued for 10 minutes. After administration of epinephrine and CaCl2, vital signs were stable. Total aorta cross-clamping time was 47 minutes, and total urine output was 200 ml. Although mannitol and steroid were administered for prevention, paraplegia occured postoperatively because of prolonged aorta cross clamping time.
Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm, Thoracic* ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Cardiovascular Diseases ; Constriction ; Epinephrine ; Female ; Heart Failure ; Hematoma ; Hemorrhage ; Humans ; Hypotension ; Lower Extremity ; Mannitol ; Middle Aged ; Mortality ; Myocardial Infarction ; Myocardial Ischemia ; Paraplegia* ; Polyethylene Terephthalates ; Renal Insufficiency ; Transplants ; Upper Extremity ; Vital Signs

Purpose: This study aimed to comprehensively examine middle-aged male taxi drivers' perceptions of the risk of cardiovascular disease. Methods: A qualitative method was used, with focus group interviews. The participants were middle-aged male taxi drivers who had been driving for more than ten years and for more than six hours daily. Results: The data were analyzed using qualitative thematic analysis. Middle-aged male taxi drivers' perceptions of the risk of cardiovascular disease were categorized into three main themes:　 “individual perceptions of cardiovascular disease”, “possibility of behaviors for cardiovascular disease” and “motivations of behaviors for cardiovascular disease”. Six sub-themes were extracted as follows: “perception of vulnerability”, “perception of seriousness”, “perception of profitability”, “perception of disability”, “self-awareness” and “advancing toward health care”. Conclusion It is necessary to invigorate support systems through measures including education, counseling, and web-based programs to prevent cardiovascular disease in middle-aged male taxi drivers.

Hyperglycemic state frequently presents with neurologic manifestations including choreoathetosis, ballismus, dysphagia, seizures, and coma. Also, hyperglycemic hemianopia has been rarely reported to cause temporary damage to the visual cortex, resulting in homonymous hemianopia. A 65-year-old man was admitted because of right homonymous hemianopia accompanied by hyperglycemia. Brain single-photon emission computed tomography showed focal hyperperfusion in the left occipital lobe. Herein we report a case of reversible homonymous hemianopia with cerebral hyperperfusion associated hyperglycemia without seizure.

OBJECTIVES: To evaluate the clinical significance of abnormal bronchi originating from the trachea or main bronchi. METHODS: 21 patients (male:female ratio, 13:8; mean age, 58.2 years, range 34-77), who were diagnosed with major tracheobronchial anomalies by bronchoscopy from January 2001 to March 2005, were enrolled in this study. The anomalous bronchi consisted of 13 tracheal bronchi and 8 cardiac accessory bronchus. The clinical features, bronchoscopic findings, and outcomes were analyzed retrospectively. RESULTS: Common symptoms, including hemoptysis, cough and dyspnea, resulted from the underlying lung disease regardless of the bronchial anomalies. In this series of 13 tracheal bronchi, 7 cases originated from the trachea within 1cm of the carina (carinal type) and 6 cases originated at a higher level(tracheal type). Most patients had favorable outcome with conservative treatment for the underlying lung disease. CONCLUSION: Most tracheobronchial anomalies are found incidentally in the process of diagnosing lung disease. The clinical outcome of patients with a bronchial anomaly depends on the underlying lung disease.
Bronchi* ; Bronchoscopy ; Cough ; Dyspnea ; Hemoptysis ; Humans ; Lung Diseases ; Retrospective Studies ; Trachea*

MELAS is the condition associated with mutant mtDNA that most closely mimics thrombotic cerebrovascular disease. It is characterized by mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes. These children develop short stature and either a focal or generalized seizure disorder. Ultimately, the patient presents with an acute hemiparesis that can alternate from side to side. In this article, we report the MELAS in siblings having point mutation in the mitochondrial DNA with an A to G transition at the 3,243rd position. MELAS is recognized as one of the several distinct syndromes containing cerebral infarct. And, mitochondrial DNA analyses, serum lactate level, and muscle biopsy are diagnostic clue of this syndrome.
Acidosis, Lactic ; Biopsy ; Child ; DNA, Mitochondrial ; Epilepsy, Generalized ; Humans ; Lactic Acid ; MELAS Syndrome* ; Mitochondrial Encephalomyopathies ; Paresis ; Point Mutation ; Siblings*

We examined the possible anti-inflammatory mechanisms of gabapentin in the attenuation of neuropathic pain and the interaction between the anti-allodynic effects of gabapentin and interleukin-10 (IL-10) expression in a rat model of neuropathic pain. The anti-allodynic effect of intrathecal gabapentin was examined over a 7-day period. The anti-allodynic effects of IL-10 was measured, and the effects of anti-IL-10 antibody on the gabapentin were assessed. On day 7, the concentrations of pro-inflammatory cytokines and IL-10 were measured. Gabapentin produced an anti-allodynic effect over the 7-day period, reducing the expression of pro-inflammatory cytokines but increasing the expression of IL-10 (TNF-alpha, 316.0 +/- 69.7 pg/mL vs 88.8 +/- 24.4 pg/mL; IL-1beta, 1,212.9 +/- 104.5 vs 577.4 +/- 97.1 pg/mL; IL-6, 254.0 +/- 64.8 pg/mL vs 125.5 +/- 44.1 pg/mL; IL-10, 532.1 +/- 78.7 pg/mL vs 918.9 +/- 63.1 pg/mL). The suppressive effect of gabapentin on pro-inflammatory cytokine expression was partially blocked by the anti-IL-10 antibody. Expression of pro-inflammatory cytokines was significantly attenuated by daily injections of IL-10. The anti-allodynic effects of gabapentin may be caused by upregulation of IL-10 expression in the spinal cord, which leads to inhibition of the expression of pro-inflammatory cytokines in the spinal cords.
Amines/pharmacology/*therapeutic use ; Analgesics/pharmacology/*therapeutic use ; Animals ; Antibodies/immunology/pharmacology ; Behavior, Animal/drug effects ; Cyclohexanecarboxylic Acids/pharmacology/*therapeutic use ; Cytokines/*metabolism ; Disease Models, Animal ; Injections, Spinal ; Interleukin-10/genetics/immunology/*metabolism ; Male ; Neuralgia/*drug therapy/metabolism/pathology ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins/biosynthesis/genetics/pharmacology ; Spinal Cord/metabolism ; Up-Regulation ; gamma-Aminobutyric Acid/pharmacology/*therapeutic use

Citalopram and paroxetine are selective serotonin reuptake inhibitors and also have antinociceptive effects. We investigated the antiallodynic and antihyperalgesic effects of intrathecally administered morphine, citalopram, paroxetine, and combinations thereof, in a rat model in which peripheral inflammation was induced by complete Freund's adjuvant (CFA). Drugs were intrathecally administered via direct lumbar puncture. Mechanical allodynia was measured using a Dynamic Plantar Aesthesiometer. Thermal hyperalgesia and cold allodynia were determined by measuring latency of paw withdrawal in response to radiant heat and cold water. Behavioral tests were run before and 15, 30, 45, and 60 min after intrathecal injection. Intraplantar injection of CFA produced mechanical allodynia, thermal hyperalgesia, and cold allodynia. Intrathecally administered morphine (0.3 or 1 microg) had antiallodynic or antihyperalgesic effects (24.0%-71.9% elevation). The effects of morphine were significantly increased when a combination of citalopram (100 microg) and paroxetine (100 microg) was added (35.2%-95.1% elevation). This rise was reversed by naloxone and methysergide. The effects of citalopram and paroxetine were also reversed by naloxone and methysergide. We suggest that the mu opioid receptor and serotonin receptors play major roles in production of the antiallodynic and antihyperalgesic effects of morphine, citalopram, paroxetine, and combinations thereof, in animals experiencing inflammatory pain.
Analgesics, Opioid/administration & dosage/*pharmacology ; Animals ; Behavior, Animal/drug effects ; Citalopram/administration & dosage/pharmacology ; Disease Models, Animal ; Hyperalgesia/etiology ; Inflammation/*chemically induced/pathology ; Injections, Spinal ; Male ; Morphine/administration & dosage/*pharmacology ; Pain/*prevention & control ; Pain Measurement ; Pain Threshold/drug effects ; Paroxetine/administration & dosage/pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Serotonin/*chemistry/metabolism ; Serotonin Uptake Inhibitors/administration & dosage/*pharmacology ; Temperature ; Time Factors

PURPOSE: Authors studied the injection method of contrast medium in routine chest spiral CT scan to obtain the best image in the mediastinum. MATERIALS AND METHODS: Dynamic static scan had been performed in 5 normal volunteers as a pilot study. In consideration of the result of pilot study, Chest spiral CT was performed in 217 patients by three different methods. We used 100cc nonionic contrast medium. Average attenuation of great vessels in the mediastinum were assessed in various injection methods. Image quality was graded with three levels of score by two radiologists. RESULTS: Peak enhancement time of the great vessels on pilot at dynamic static scan were as follows :52 sec at ascending aorta, 45 sec at pulmonary artery, and 40 sec at SVC. In the study of spiral CT, the highest attenMarion in the great vessels was obtained after injection of 100cc of contrast medium(2cc/sec, with 35-40 second scan delay), althrough artifact from highly enhancing SVC was most common in this method. Image quality were highest in the scans obtained with other methods(3-2-1cc/sec for 10-15-40 seconds, with 40 second scan delay). CONCLUSION: For chest spiral CT, authors recommend that scans should be obtained after infusion of 70--80cc of contrast medium during 35--40sec to obtain maximal vascular enhacement of mediastinum.
Aorta ; Artifacts ; Healthy Volunteers ; Humans ; Mediastinum ; Pilot Projects ; Pulmonary Artery ; Thorax* ; Tomography, Spiral Computed*