No abstract available.
Mesenteric Artery, Superior

No abstract available.

OBJECTIVE: To determine the level of conus medullaris in normal subjects by the magnetic resonance imaging (MRI). METHODS: The corresponding vertebral level of tip of conus medullaris was evaluated in MRIs (sagittal T1 and T2-weighted imaging) of 226 subjects composed of Koreans (138 males, 88 females) with no spine fracture or significant spinal deformity. The termination of the spinal cord was determined by locating the corresponding vertebral point of the lowest end of the conus medullaris to the three-points (upper, middle, and lower) of the nearest vertebral body and intervertebral discs between the T11 and S3 vertebral bodies. RESULTS: If the male and female groups were combined, the most frequent level of cord termination was the mid-portion of L1 (24.5%) which was followed by the lower portion of L1 (22.1%) and the L1-L2 intervertebral disc level (20.8%). In a female group, the tip of conus was one third of vertebra lower than in a male group with a statistical significance (Mann- Whitney test, p=0.025). CONCLUSION: The spinal cord terminates at the mid-portion of L1 most frequently and the termination level distributes from the mid-portion of T12 to the intervertebral disc level of L1-L2. In a clinical setting, variable levels of the spinal cord termination should be considered in a diagnosis for the determination of the neurological level of the spinal cord associated with a vertebral injury and an unexpected neurological complication after a spinal anesthesia or injection.
Anesthesia, Spinal ; Congenital Abnormalities ; Conus Snail ; Diagnosis ; Female ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Male ; Spinal Cord* ; Spine

BACKGROUND: We intended to investigate the relationship between red cell size observed through a light microscope and mean corpuscular volume (MCV) measured by an automatic hematology analyzer. METHODS: 164 samples which were referred for complete blood count analysis and peripheral blood cell morphology were selected. MCV was measured by Gen-S (Coulter Co., USA). Smear slides of the same samples were examined on a microscope with a CCD camera connected to it. The image observed through the microscope emerged on an IBM-compatible computer system through the CCD camera. Mean red cell size-mean corpuscular area (MCA) of the captured image was calculated by Image-Pro Plus, the image capture and analyzing software. RESULTS: The coefficient of variation (CV) of MCA measurement, which was done 5 times on 10 slides, was 1.5-3.6%. Compared to the measurements performed in the ideal zone, MCA was measured lower in the thickly smeared zone (medial zone) and higher in the thinly smeared zone (lateral zone) on smear slide observation. The correlation between MCA and MCV values was poor (R=0.641, P<0.01). The normal reference range of MCA measurement was 37.40-50.22 m2. CONCLUSIONS: As the red cell size observed on the light microscope does not correlate well with the MCV measured by automatic analyzer, the determination of red cell size by microscopic peripheral blood smear requires profound caution.
Blood Cell Count ; Blood Cells ; Cell Size* ; Computer Systems ; Erythrocyte Indices* ; Hematology ; Reference Values

Liver has a dual blood supply from portal vein and hepatic artery. Hepatocellular carcinoma receive their blood supply almost exclusively from hepatic artery. Thus, the concept of treating hepatocellular carcinoma by chemoembolization through these arteries is very effective. However, there may be several collateral or parasitic vessels feeding them in case of huge tumor or previous chemoembolization. We experierced a case of huge tumor involving right upper posterior portion of liver fed by 9th, 10th, 11th right posterior intercostal arteries and an anomalous hepatic artery. We tried chemoembolization with Adriamycin-Lipiodol suspension and Gelfoam material through the right posterior intercostal arteries to treat the lesion. After the procedure, the patient(55 years old female) became paraplegic with voiding and defecation difficulty which could be due to spinal cord infarction .by anterior spinal arteri. al occlusion caused by embolic material through the artery of Adamkiewicz from a posterior intercostal artery. She recovered completely after 20 days of treatment.
Arteries* ; Carcinoma, Hepatocellular ; Defecation ; Gelatin Sponge, Absorbable ; Hepatic Artery ; Infarction ; Liver ; Portal Vein ; Spinal Cord Injuries* ; Spinal Cord*

OBJECTIVE: To determine the normal variations of end level of the dural sac in Korean subjects by magnetic resonance imaging (MRI). METHOD: The corresponding vertebral level of termination of the dural sac was evaluated by MRIs in two hundred adult Koreans (118 males, 82 females). We excluded the subjects with spine fracture, significant spinal deformity or spinal stenosis. End level of the dural sac was described in terms of their corresponding vertebral level. The vertebral levels were further divided into upper, middle, lower level, and intervertebral disc levels from the L5 to S3 vertebra. RESULTS: The most frequent end level of the dural sac was at the S1-S2 intervertebral disc level (22.5%) which was followed by the upper portion of S2 (21.5%) and the middle portion of S2 (17.0%). There was no significant difference in end level of the dural sac between male and female subjects. CONCLUSION: The dural sac most frequently ended at the S1-S2 intervertebral level and the end level of dural sac were located from the L5-S1 intervertebral level to the mid-point of S3. In a clinical setting, variable levels of the dural sac termination should be considered in an unexpected dural puncture during a caudal anesthesia or injection.
Adult ; Anesthesia, Caudal ; Congenital Abnormalities ; Female ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Male ; Punctures ; Spinal Stenosis ; Spine

PURPOSE: The incidence of overactive bladder (OAB) and the efficacy of alpha blocker and tolterodine combination therapy were examined in patients with symptomatic benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Between March 2001 and December 2001, 144 BPH patients were subdivided into those with BPH, or BPH with OAB, based on urodynamic studies. All patients were treated with alpha blockers for 3 months. Patients with no symptomatic improvement were treated with alpha blockers and tolterodine for 2 months. An increase in the International prostate symptom scores (IPSS) of more than 3 points after medication was considered an improvement, but if not, as a failure. RESULTS: Of the 144 patients, 76 (53%) had BPH and 68 (47%) had BPH with OAB. The patients with BPH and OAB were older (p<0.05), but no differences were observed in the serum creatinine, IPSS, prostate volume, maximum flow rate or post-void residual urine (PVR) between the 2 groups. After 3 months treatment with alpha blockers, 79% (60/76) of the BPH and 35% (24/68) of the BPH with OAB patients had improved (p<0.05). Of the patients showing no improvement, 38% (6/16) with BPH and 73% (32/44) with BPH and OAB showed improvement after the addition of tolterodine. CONCLUSIONS: The combination therapy was more effective than alpha blockers alone in the treatment of patients with coexisting BPH and OAB. We recommend identifying these patients with an initial urodynamic study, which allows for the appropriate management and identification of those patients that may benefit from a more invasive treatment.
Creatinine ; Humans ; Incidence* ; Prostate ; Prostatic Hyperplasia* ; Urinary Bladder ; Urinary Bladder, Overactive* ; Urodynamics ; Tolterodine Tartrate

PURPOSE: We evaluated the impact of three automatic optimization of parameters (AOP) modes of digital mammography on the dose and image quality. METHODS: Computerized Imaging Reference Systems phantoms were used. A total of 12 phantoms with different thickness and glandularity were imaged. We analyzed the average glandular dose (AGD) and entrance surface exposure (ESE) of 12 phantoms imaged by digital mammography in three modes of AOP; namely standard mode (STD), contrast mode (CNT), and dose mode (DOSE). Moreover, exposure factors including kVp, mAs, and target/filter combination were evaluated. To evaluate the quality of the obtained digital image, two radiologists independently counted the objects of the phantoms. RESULTS: According to the AOP modes, the score of masses and specks was sorted as CNT>STD=DOSE. There was no difference in the score of fiber among the three modes. The score of image preference was sorted as CNT>STD>DOSE. The AGD, ESE, and mAs were sorted as CNT>STD>DOSE. The kVp was sorted as CNT=STD>DOSE. The score of all test objects in the phantom image was on a downtrend with increasing breast thickness. The score of masses was different among the three groups; 20-21%>30%>50% glandularity. The score of specks was sorted as 20-21%=30%>50% glandularity. The score of fibers was sorted as 30%>20-21%=50% glandularity. The score of image preference was not different among the three glandularity groups. The AGD, ESE, kVp, and mAs were correlated with breast thickness, but not correlated with glandularity. CONCLUSION: The DOSE mode offers significant improvement (19.1-50%) in dose over the other two modes over a range of breast thickness and breast glandularity with acceptable image quality. Owning knowledge of the three AOP modes may reduce unnecessary radiation exposure by utilizing the proper mode according to its purpose.
Breast ; Mammography ; Phantoms, Imaging ; Radiation Dosage

The familial occurrence of bilateral acoustic neuroma has rarely been reported in the literatures, and its inheritance is known to be an autosomal dominant trait in association with or without von Recklinghausen's disease. Recently, we experienced an unusual case of bilateral acoustic neuroma, which was familially occurred in mother and her son. A 18-year-old Korean boy was referred to us due to bilateral hearing disturbance and staggering gait of one year duration. There were no stigmata of von Recklinghausen's disease. Neurological examination, simple skull films and vertebral angiograms revealed various evidences of bilateral cerebellopontine angle tumors. At operation, a hen egg-sized firm mass was subtotally removed at the left cerebellopontine angle region and a peanut-sized mass was totally removed at the right cerebellopontine angle region via suboccipital craniectomy. The histological diagnosis was neurofibroma. In family history, 13 years ago his mother was operated on C6-7 neurofibroma at her age of 28 years, and again operated on bilateral acoustic tumors 2 years later. The histological diagnosis was also neurofibroma.
Acoustics* ; Adolescent ; Cerebellopontine Angle ; Christianity ; Diagnosis ; Gait ; Hearing ; Humans ; Male ; Mothers ; Neurofibroma ; Neurofibromatosis 1 ; Neurologic Examination ; Neuroma, Acoustic* ; Skull ; Wills

PURPOSE: Whereas sexual function has long been assumed to be an important component of adult men's lives, the impact of sexual dysfunction has not been estimated in parallel to other modern disease entities. We compared the seriousness of erectile dysfunction (ED) with that of other diseases by use of self-administered questionnaires. MATERIALS AND METHODS: Between January 2012 and July 2012, 434 healthy male volunteers (group 1) and 263 ED patients (group 2) were enrolled. The questionnaire consisted of the following: "If you must undergo only one disease in all your life, which disease could you select among these items or ED?" The comparative disease entities included hypertension, diabetes mellitus (oral hypoglycemic agent/insulin injection), hemodialysis, myocardial infarction, herpes zoster, chronic sinusitis, chronic otitis media, gastric cancer (early/late), lung cancer (early/late), liver cancer (early/late), and dementia. RESULTS: Group 1 recognized ED as being a more serious disease than hypertension, diabetes mellitus (oral hypoglycemic agent), herpes zoster, chronic sinusitis, and chronic otitis media. In comparison, group 2 recognized ED as being a more serious condition than diabetes mellitus (insulin injection) and dementia (p<0.001 and p<0.001, respectively). In particular, ED was deemed to be more serious than hemodialysis, gastric cancer (early), lung cancer (early), and liver cancer (early) by men in group 2 in their 30s to 40s, and these results were statistically significant compared with the same age subgroups in group 1 (p<0.001, p<0.007, p<0.02, and p<0.007, respectively). CONCLUSIONS: In contrast with their healthy counterparts, Korean men with ED recognized ED as being as serious as hemodialysis, dementia, and early stage cancer, which reflects the severe bother of ED in Korean patients.
Adult ; Dementia ; Diabetes Mellitus ; Erectile Dysfunction ; Herpes Zoster ; Humans ; Hypertension ; Liver Neoplasms ; Lung Neoplasms ; Male ; Myocardial Infarction ; Otitis Media ; Quality of Life ; Renal Dialysis ; Sinusitis ; Stomach Neoplasms