PURPOSE: The purpose of this paper is to describe the CT findings of a variety of branchial cleft anomalies in the head and neck area. MATERIALS AND METHODS: We reviewed the CT findings of 16 patients with neck lesion pathologically proved as branchial cleft anomalies. There were two first and 12 second branchial cleft cysts, one first and one second branchial cleft sinuses. RESULTS: Two cases of first branchial cleft cysts were manifested as thin walled, cystic masses at auricular area. One first branchial cleft sinus was an external opening type and manifested as an ill defined, enhancing solid lesion at posterior auricular area. All 12 cases of second branchial cleft cysts demonstrated a typical location, displacing the sternocleidomastoid muscle posteriorly, the carotid artery and internal jugular vein complex medially and the submandibular gland anteriorly. Eight cases of second branchial cleft cysts were seen as fluid-filled, round or ovoid shaped cysts, and 3 cases of them were seen as irregular-shaped cysts. In one case. suppurative adenopathy with loss of soft tissue planes around the cyst was observed. One case of second branchial cleft sinus was manifested as a tubular-shaped, enhancing lesion at submental area and containing external opening site draining into the anterior border of the sternocleidomastoid muscle. CONCLUSION: We conclude that CT provides important diagnostic and therapeutic informations in patients with a neck mass believed to be a branchial cleft anomaly, as it can differentiate various forms of the branchial anomalies by their characteristic location and shape.
Branchial Region* ; Branchioma ; Carotid Arteries ; Head ; Humans ; Jugular Veins ; Neck ; Submandibular Gland

PURPOSE: The aim of this study was to evaluate whether T1-201 reinjection distinguishes viable from non-viable myocardium in patients with reverse redistribution after acute myocardial infarction. MATERIALS AND METHODS: We studied 42 patients with acute myocardial infarction (age, 55+/-12 years). Eighteen (43%) out of 42 showed reverse redistribution on dipyridamole stress-4 hour redistribution T1-201 single photon emission computed tomography (SPECT). T1-201 reinjection was performed at 24 hours. Reverse redistribution was defined as worsening of perfusion defect at 4 hour delayed scan. All patients underwent follow-up echocardiography in 4 months to assess regional wall motion improvement. T1-201 uptake on reinjection images were analyzed for the prediction of myocardial wall motion improvement. RESULTS: Of 36 segments with reverse redistribution, 17 segments showed normal wall motion on echocardiography, while 19 segments showed all motion abnormalities. Of 19 the segments with reverse redistribution, 11 (58%) showed enhanced uptake after 24 hour reinjection. Myocardial wall motion was improved in 10 of 11 segments (90%) with enhanced uptake on reinjection. Wall motion improvement was not seen in 5 of 8 segments (63%) without enhanced thallium uptake. When myocardial viability was assessed by the uptake on reinjection image, nine of 10 segments (90%) with normal or mildly decreased uptake showed improved wall motion. Wall motion was not improved in 5 of 9 segments (56%) with severely decreased uptake. CONCLUSION: In patients with acute myocardial ifarction, T1-201 reinjection imaging on myocardial segments with reverse redistribution has a high positive predictive value in the assessment of myocardial viability.
Dipyridamole ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Myocardium* ; Perfusion ; Thallium* ; Tomography, Emission-Computed, Single-Photon

PURPOSE: When combined with transurethral resection, intravesical Bacillus Calmette-Guerin(BCG) is effective in delaying recurrence and progression of superficial bladder cancer including carcinoma in situ. Dose schedules vary and the optimum regimen has not been defined. And criteria for selection of patients who may benefit from an additional course of BCG have not yet been established. In an attempt to identify patients who are likely to respond, we analyzed our experience in patients with superficial bladder cancer treated with a subsequent course of BCG therapy MATERIALS AND METHODS: From June 1989 until June 1996, 74 patients with superficial bladder tumor were treated under protocol at our institution with intravesical BCG. Of 74 patients who received an initial once a week for 6 week and once a month for 3-month of intravesical BCG(course 1) for superficial transitional cell carcinoma of the bladder, 21 were treated another course(course 2). RESULTS: First course of BCG was successful in 43(64.1%) of 67 patients treated for prophylaxis and 3(42.8%) of treated for carcinoma in situ. Of 28 patients who failed the initial treatment course, 21 were given an additional BCG therapy. Subsequent progression of disease(muscle infiltration, metastasis or local progression) occurred in 3 patients(14.2%). Of 18 patients(85.7%) without progression 11(52.3%) had a complete response and 7(33.3%) had new tumors, and they were rendered free of disease after transurethral resection. The median duration of response to course 1 of intravesical BCG was shorter for patients with disease progression or recurrence after course 2 than for those with no progression or recurrence(13.8 and 21.3 months, p<0.05). The median intenal between course 1 and 2 of intravesical BCG was 18 months. The internal from course 2 of intravesical BCG to progression or recurrence correlated with the duration of response to course 1 of treatment(p<0.05). CONCLUSIONS: Our analysis indicate that the usefulness of a subsequent course of intravesical BCG for the treatment of new tumors is related to the duration of response to course 1. Patients with a long-lasting response to the initial course of BCG(18 months or more) are likely to benefit from another course.
Appointments and Schedules ; Bacillus* ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Disease Progression ; Humans ; Mycobacterium bovis ; Neoplasm Metastasis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Chronic prostatitis is characterized by various symptoms. To elucidate the prevalence of such symptoms, we developed a questionnaire composed of six pain-related, seven sex-related, and 11 voiding-related questions and evaluated chronic prostatitis patients under 50 years of age. MATERIALS AND METHODS: From March 1995 to July 1996, a total of 500 patients (prostatitis 303, prostatodynia with history of prostatitis 153, prostatodynia only 44) underwent study. The mean age was 35 years and the average duration of infliction was 3.5 months. RESULTS: Perineal, testicular, and penile pains were the most often complained types of perceived pains. The most frequently complained voiding symptoms were frequency, weak stream, residual urine sensation and dribbling which were seen in over 40% of the patients. More than 50% of the patients responded as having some type of voiding difficulty. For sexual symptoms, premature ejaculation , decreased libido and orgasm, decreased potency, and pain associated with ejaculation were seen in 64%, 55%, 54%, and 47% of the patients. When the prostatitis and prostatodynia patients were compared to one another to find out any characteristic symptoms of prostatitis, there was no difference in pain but statistically significantly higher response was observed in ejaculation associated pain and a decrease in orgasm in the prostatitis group. CONCLUSIONS: Our data have helped to elucidate the characteristics of symptoms in prostatitis patients, and the questionaire can be used as a tool to standardize prostatitis symptoms, and to evaluate treatment responses.
Ejaculation ; Humans ; Libido ; Male ; Orgasm ; Premature Ejaculation ; Prevalence* ; Prostate* ; Prostatitis ; Surveys and Questionnaires ; Rivers ; Sensation

No abstract available.
Blood Platelets* ; Humans ; Platelet Aggregation* ; Plateletpheresis* ; Tissue Donors*

No abstract available.
Lymph Nodes* ; Uterine Cervical Neoplasms*

The prognostic factors for extrahepatic biliary atresia (EHBA) after Kasai portoenterostomy include the patient's age at portoenterostomy (age), size of bile duct in theporta hepatis (size), clearance of jaundice after operation (clearance) and the surgeon's experience. The aim of this study is to examine the most significant prognostic factor of EHBA after Kasai portoenterostomy. This retrospective study was done in 51 cases of EHBA that received Kasai portoenterostomy by one pediatric surgeon. For the statistical analysis, Kaplan-Meier method, Logrank test and Cox regression test were used. A p value of less than 0.05 was considered to be significant. Fifteen patients were regarded as dead in this study, including nine cases of liver transplantation. There was no significant difference of survival to age. The age is also not a significant risk factor for survival in this study (Cox Regression test; p = 0.63). There was no significant difference in survival in relation to the size of bile duct. However, bile duct size was a significant risk factor for survival (Cox Regression test; p = 0.002). There was a significant difference in relation to survival and clearance (Kaplan-Meier method; p = 0.02). The clearing was also a significant risk factor for survival (Cox Regression test; p = 0.001). The clearance of jaundice is the most significant prognostic factor of EHBA after Kasai portoenterostomy.
Bile Ducts ; Biliary Atresia* ; Humans ; Jaundice ; Kaplan-Meier Estimate ; Liver Transplantation ; Prognosis ; Retrospective Studies ; Risk Factors

We report four cases of spontaneous intracranial hypotension that were investigated by radionuclide cisternography Tc-99m-diethylenetriamine pentaacetic acid radionuclide cisternography of all our patients showed direct sign of cerebrospinal fluid leakage as well as indirect signs of less activity than expected over the cerebral convexities and rapid appearance of bladder activity. The headache of all patients was eventually controlled with bed rest and hydration.
Bed Rest ; Cerebrospinal Fluid ; Headache ; Humans ; Intracranial Hypotension* ; Urinary Bladder

PURPOSE: We performed this study to assess the value of CT in the differential diagnosis of palpable neck masses in children. MATERIALS AND METHODS: We retrospectively reviewed the CT scans of the palpable neck masses in 30 children. The masses were proved histopathologically and classified into cystic, solid, and inflammatory mass and their CT findings were analyzed. RESULTS: Twelve cases were cystic masses, 4 were solid masses, and 14 were inflammatory lesions. Cystic masses included cystic lymphangiomas (n=6), branchial cleft cysts (n=3), thyroglossal duct cysts (n=2), and ranula (n=l). Cystic lymphangiomas showed insinuating appearances into adjacent structures and 4 cases occurred in the posterior cervical space. All branchial cleft cysts were round cystic masses with smooth wall and displaced the submandibular gland anteriorly and the sternocleidomastoid muscle posteriorly. Two thyroglossal duct cysts occurred centrally adjacent to the hyoid bone and 1 ranula in the submental area. Solid masses were juvenile hemangioma, pleomorphic adenoma in submandibular gland, neurilemmoma, and fibromatosis colli. Juvenile hemangioma showed well-enhancing mass with indistinct margin and the other solid masses had well-defined margin with their characteristic location. Inflammatory lesions were abscess (n=4), deep neck infections with lymphadenopathy (n=4), submandibular gland inflammation (n=3), and tuberculous lymphadenitis (n=3) and they showed strand-like enhancement in adjacent subcutaneous tissues. Tuberculous lymphadenitis had multiple lymph node enlargement with internal low attenuation areas and showed less surrounding strand-like enhancement than suppurative lymphadenopathies. CONCLUSION: Most neck masses in infants and children were of congenital or inflammatory origin. CT is useful for the evaluation of the child presenting with a neck mass, because it can differentiate various forms of neck masses and is able to reveal the relationship of the masses to the adjacent structures with their characteristic location.
Abscess ; Adenoma, Pleomorphic ; Branchioma ; Child* ; Diagnosis, Differential ; Fibroma ; Hemangioma ; Humans ; Hyoid Bone ; Infant ; Inflammation ; Lymph Nodes ; Lymphangioma, Cystic ; Lymphatic Diseases ; Neck* ; Neurilemmoma ; Ranula ; Retrospective Studies ; Subcutaneous Tissue ; Submandibular Gland ; Thyroglossal Cyst ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

No abstract available.
Calcium* ; Estrogens* ; Female ; Metabolism* ; Ovulation Induction* ; Ovulation*