Conegenital anomalies of the ribs are common but rarely result in shadow which might be mistaken forpathological lesions. Careful inspection of the bony parts, which should be a routine, will usually be sufficientto avoid mistakes. Authors reviewed 6,921(5,865 male, 1,056 female) chest P-A films in adult (older than 16years), and radiolographic findings of congenital anomalies of the ribs were analized. The result were as follows;1. Congenital anomalies of the ribs were present in 193 patients. The incidence of congenital anomalies of theribs were 2.7% in male, 3.3% in female. 2. Among the 193 cases of congenital rib anomalies, 7 cases(0.1%) ofcervical ribs, 31 cases (0.4%) of underdeveloped ribs, 81 cases (1.2%) of anterior bifurcation, 34 cases (0.5%) ofbroadned ribs, 19 cases (0.3) of complete fusion and 21 cases (0.3%) of pseudathrosis were included. 3. 11.4% ofthe cases were bilateral, and right to left was 4:3 in unilateral involvement. 4. The location of the ribanomalies were as follows; (1) Underdeveloped ribs; 1st rib 31 case (79.5%), 2nd rib 3 cases(7.7%), 4th rib 3cases(7.7%), 5th rib 2 cases(5.1%). (2) Anterior bifurcation; 3rd rib 37 cases. 4th rib 29 cases, 5th rib 12cases, 6th rib 6cases, 2nd rib 2 cases. (3) Broadened ribs; 3rd 17 cases, 4th rib 15 cases, 5th rib 4 cases, 2ndrib 1 case. (4) Complete fusion; 1st-2nd rib 13 cases (68.4%), 5-6th ribs 4 cases (21.0%), 4-5th ribs 1case(5.3%), 6-7 ribs 1case(5.3%). The fusion occur in the posterior portion of 1st-2nd and 4-5th ribs,and in theposterior portion of 5-6th and 6-7ribs. (5) Pseudarthrosis; 1st-2nd and 2nd-3rd ribs, and in the posterior portionof 3-4th, 4-5 and 5-6th ribs. 5. In the cases of anterior bifurcation, the rib bifurcates almost in its anterior2.1-5.0 cm and most common in 3.1-4.0cm. 6. The characteristic radiographic findings in anterior bifurcation wereas follow;
Adult ; Female ; Humans ; Incidence ; Male ; Pseudarthrosis ; Ribs ; Thorax

Peripartum cardiomyopathy is defined as a syndrome of cardiac failure occurring in tbe latter part of pregnancy or in the puerperium, without obvious cause and without prior evidence of heart disease. Despite its infrequency, this clinical problem may have devastating consequences upon maternal and fetal outcome. It is important to recognize the association of cardiac failure and pregnancy as a separate syndrome so that, once identified, peripartum cardiomyopathy can be treated promptly and aggressively. We experienced two cases of peripartum cardiomyopathy, and report these cases with a brief review of the literatures.
Cardiomyopathies* ; Heart Diseases ; Heart Failure ; Peripartum Period* ; Postpartum Period ; Pregnancy

PURPOSE: Recently, paranasal sinus(PNS) CT has increasingly been used because of the wide applications of a functional endoscopic sinonasal surgery(FESS) as one of the therapeutic modalities of the chronic sinonasal inflammatory disease. MATERIALS AND METHODS: We retrospectively analyzed PNS CT findings in 76 patients with chronic sinonasal inflammatory disease who had undergone the PNS CT from April 1991 to July 1992. RESULTS: There were 5 sinonasal patterns of inflammation ;4 cases of infundibular type(5.3%), 14 cases of ostiomeatal unit(OMU) type(18%), one case of sphenoethmoidal(SER) type(1%), 56 cases of sinonasal polyposis type(74%), and one case of sporadic type(1%). The mucosal abnormality was seen in 74 OMU cases, 71 maxillary sinus cases, 69 ethmoidal sinus cases, 55 frontal sinus cases, 49 SER, and 46 sphenoidal sinus cases. The normal bony variant included ethmoid bulla(25 cases, 335), concha bullosa (20 cases 25%), Hailer cells(10 cases, 13%), paradoxical curvature of middle turbinate (4 cases, 5%), lateral deviation of uncinate process(3 cases, 4%), and deviation of nasal septurn(31 cases, 41%). CONCLUSION: The PNS CT is an excelleht imaging method providing detailed informations about the mucosal abnormality, pathological pattern, the anatomical structure and landmark, and bony variants prior to an operation.
Frontal Sinus ; Humans ; Inflammation ; Maxillary Sinus ; Retrospective Studies ; Turbinates

Non-specific periventricular white matter lucencies on computed tomography(leukoaraiosis) were found in 130(40%) of 324 patients with ischemic or hemorrhagic strokes. Patients with leukoaraiosis were significantly older than those without it and correlated with hypertension and lacunar infarction but not with cortical infarction. In patients with hemorrhage, leukoaraiosis occurred sinigificantly more often when aneurysm or arteriovenous malformation were not demonstrated. Our fiindings suggest that leukoaraiosis in cerebrovascular disease is associated with small vessel disease.
Aneurysm ; Arteriovenous Malformations ; Hemorrhage ; Humans ; Hypertension ; Infarction ; Leukoaraiosis* ; Stroke ; Stroke, Lacunar

No abstract available.
Arteriovenous Fistula*

Multifocal fibrosclerosis, a rare disorder, has no known etiology and is considered to be a systemic illness manifested by combinations of fibrosing process of multiple areas such as mediastinal fibrosis, retroperitoneal fibrosis, orbital pseudotumor, sclerosing cholangitis, and Reidel's thyroiditis. We have experienced a 49-year-old man with pseudotumor of the orbit, sclerosing cholangitis, and CNS involvements included unrecognized meningitis and suspicious CNS vasculitis. The patient showed clinical improvement with corticosteroid therapy.
Cholangitis, Sclerosing ; Fibrosis ; Humans ; Meningitis ; Middle Aged ; Orbit ; Orbital Pseudotumor ; Retroperitoneal Fibrosis ; Thyroid Gland ; Thyroiditis ; Vasculitis, Central Nervous System

For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.
Anxiety ; Chronic Disease ; Depression ; Family Relations ; Hospice Care ; Hospices ; Humans ; Mass Screening ; Pain Measurement ; Palliative Care ; Prognosis ; Quality of Life

Intractable hiccups are defined as hiccup persisting for more than 48hours, and these appear in various diseases. A 28-year-old woman admitted due to intractable hiccups without gastroenteral system abnormalities and peripheral nervous systemic involvement. High signal intensity lesion of the medulla oblangata in the tegmental region was detected on T2-weighted MR imaging, which might be a causative etiology. We encountered a rare case developing intractable hic-cups as presenting symptom of 'clinically definte' multiple sclerosis.
Adult ; Female ; Hiccup* ; Humans ; Magnetic Resonance Imaging ; Multiple Sclerosis* ; Peripheral Nervous System

BACKGROUND: The physician's hands are close to the X-ray field in C-arm fluoroscopy-guided pain interventions. We prospectively investigated the radiation attenuation of Proguard RR-2 gloves. METHODS: In 100 cases, the effective doses (EDs) of two dosimeters without a radiation-reducing glove were collected. EDs from the two dosimeters-one dosimeter wrapped with a glove and the other dosimeter without a glove- were also measured at the side of the table (Group 1, 140 cases) and at a location 20 cm away from the side of the table (Group 2, 120 cases). Mean differences such as age, height, weight, radiation absorbed dose (RAD), exposure time, ED, and ratio of EDs were analyzed. RESULTS: In the EDs of two dosimeters without gloves, there were no significant differences (39.0 +/- 36.3 microSv vs. 38.8 +/- 36.4 microSv) (P = 0.578). The RAD (192.0 +/- 182.0 radcm2) in Group 2 was higher than that (132.3 +/- 103.5 radcm2) in Group 1 (P = 0.002). The ED (33.3 +/- 30.9 microSv) of the dosimeter without a glove in Group 1 was higher than that (12.3 +/- 8.8 microSv) in Group 2 (P < 0.001). The ED (24.4 +/- 22.4 microSv) of the dosimeter wrapped with a glove in Group 1 was higher than that (9.2 +/- 6.8 microSv) in Group 2 (P < 0.001). No significant differences were noted in the ratio of EDs (73.5 +/- 6.7% vs. 74.2 +/- 9.3%, P = 0.469) between Group 1 and Group 2. CONCLUSIONS: Proguard RR-2 gloves have a radiation attenuation effect of 25.8-26.5%. The radiation attenuation is not significantly different by intensity of scatter radiation or the different RADs of C-arm fluoroscopy.
Fluoroscopy ; Hand ; Prospective Studies

BACKGROUND AND PURPOSE: It is particularly difficult to differentiate dementia with Lewy bodies (DLB) from the related dementias of Alzheimer's disease (AD) and Parkinson's disease dementia (PDD). Few studies have been designed to comparatively analyze detailed neuropsychological assessments of DLB patients and patients with AD and PDD. METHODS: Three groups of patients participated in this study: 10 with DLB, 76 with AD, and 17 with PDD, who had been diagnosed as probable DLB, AD, and PDD, respectively, according to the clinical criteria of the consortium on DLB, National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorder Association, and the clinical diagnostic criteria for PDD. All patients were evaluated by careful neurological examination with detailed neuropsychological testing. RESULTS: Significant differences among the three groups were found for attention, memory, and executive function, which included tasks of backward digit span, three-word recall, verbal delayed recall, and the Stroop test. Post hoc analysis revealed that the deficiencies of attention on the digit span task were greater in the DLB group than in the AD and PDD groups. The scores for episodic verbal memory tasks were significantly lower in the DLB and AD groups than in the PDD group. The performance in frontal executive function, as indicated by the Stroop test, was significantly worse in the DLB and PDD groups than in the AD group. CONCLUSIONS: The results of the present study show that the pattern of cognitive dysfunction, in terms of attention, episodic memory, and executive functions, differ between patients with DLB and patients with AD and PDD.
Alzheimer Disease ; Cognition ; Dementia ; Executive Function ; Humans ; Lewy Bodies ; Memory ; Memory, Episodic ; Neurologic Examination ; Neuropsychology ; Parkinson Disease ; Stroop Test