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

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

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*

PURPOSE: A graft patency is influenced by various factors; the degree of preoperative ischemia, type of procedure, kinds of the conduit and the stati of inflow and outflow vessels. The aim of this study was to evaluate the patency rate according to the distal anastomosis level, kinds of conduit and the impact of runoff score. METHODS: Between August 1998 and August 2003, 141 lower extremity arterial bypass operations were performed. The runoff scores of the outflow arteries were graded according to the system proposed by the Ad Hoc Committee on Reporting Standards, SVS/ISCVS. The graft patency was determined by clinical examination, and ABI measurements, and with a Duplex scan if required, and assessed by a regular follow-up schedule. RESULTS: The primary patency rates according to the level of distal anastomosis at 1, 3 and 5 years were as follows; femoral artery (FA) 94.8, 87.1 and 87.1%, above-knee popliteal artery (AKPA) 83.7, 79.3 and 68.0%, below-knee popliteal artery (BKPA) 85.9, 64.4 and 42.9%, respectively, and the secondary patency rates; FA 95, 87.6 and 87.6%, AKPA 91.6, 68.3 and 38.6%, BKPA 83.8, 69.9 and 46.6%, respectively. The patency rates of below-knee popliteal bypass showed no statistical difference between each conduit, but showed a tendency to increase in the order: PTFE, vein patch and vein graft. No significant difference in the patency rate was shown except between a runoff score of 1 and above 1 at each level. CONCLUSION: The patency rates for the relatively proximal site of the distal anastomosis were superior to those of the distal site. The choice of conduit influenced the patency of infrapopliteal bypass grafts. The patent outflow vessels and the autogenous vein graft at infrapopliteal artery were more favorable for good graft patency. The recommended runoff score system seems to be revision in order to improve the predictability of a graft patency.
Appointments and Schedules ; Arteries ; Femoral Artery ; Follow-Up Studies ; Ischemia ; Lower Extremity* ; Polytetrafluoroethylene ; Popliteal Artery ; Transplants* ; Veins

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*

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*

PURPOSE: CT or MRT is performed in preoperative staging of laryngeal cancer. These methods are used in assessment of the deep tissues and cartilage of the larynx, but cannot compete with laryngoscopy in the evaluation of the laryngeal surface. The purpose of this study is to evaluate feasibilty and clinical value of the 3-D reconstruction of the mucosal surface in laryngeal cancer. METHODS AND MATERIALS: Twenty two patients with laryngeal cancer proved by means of surgical.exploration (pathologic) or clinical examinations including laryngoscope, imaging studies and biopsy underwent preoperative staging with computed tomography(G-P);and three dimensional(3D) CT reconstruction. The TNM classification of the American Joint Committee on Cancer was used to compare the imaging findings with pathologic or clinical staging. RESULTS: When the extension of primary tumor(T staging) was evaluated, the findings at only transaxial CT and those at pathologic or clinical examination were concordant in 8 of 14 cases(57.1%) of supraglottic tumor, and 3 of 6 cases(50%) of glottic tumor. The overall accuracy of CT with additional 3D-reconstruction was 85.7% for assessment of supraglottic tumor, and 66.6% for glottic tumor. CONCLUSION: 3D CT reconstruction after transaxial CT may improve outcome in preoperative staging of laryngeal cancer and has a potential value in guiding management decisions.
Biopsy ; Cartilage ; Classification ; Humans ; Joints ; Laryngeal Neoplasms* ; Laryngoscopes ; Laryngoscopy ; Larynx