PURPOSE: This study was conducted to compare the PET and CT findings for patients with a pulmonary lymphangitic metastasis. MATERIALS AND METHODS: We retrospectively reviewed the PET and CT findings of seven patients diagnosed with a pulmonary lymphangitic metastasis between May 2005 and May 2007. RESULTS: All patients had interstitial thickening, as seen on a CT scan, while the PET scans showed abnormal findings in only three patients. In these three patients, one patient had interlobular septal thickening of more than 10, another patient had interlobular septal thickening of more than 5 but less than 10, and another patient had interlobular septal thickening of less than 5. All of the patients had bronchovascular bundle thickening. However, among the four patients that had normal FDG uptake, no patient had interlobular septal thickening of more than 10, two of the patients had interlobular septal thickening of more than 5 but less than 10, and the remaining patients had interlobular septal thickening of less than 5. Only two of the patients had bronchovascular bundle thickening. CONCLUSION: All patients with pulmonary lymphangitic metastasis have typical CT findings, but some of the patients had FDG uptake, as seen in the PET scans. Thus, CT is a more useful modality for diagnosis for pulmonary lymphangitic metastases.
Diagnosis ; Humans ; Lung Neoplasms ; Lymphatic Metastasis ; Neoplasm Metastasis* ; Positron-Emission Tomography ; Retrospective Studies ; Tomography, X-Ray Computed

Symmetrical bilateral thalamic infarction is a rare cerebrovascular disease, caused by occlusion of the paramedian thalamic arteries. The clinical manifestations of this disease are much different from classical thalamic syndrome, with disturbance of consciousness, memory, eye movement and behavior. Observing two cases of bilateral symmetrical thalamic infarction on CT scan with characteristic clinical findings in Medical Center, pertinent literature were reviewed.
Arteries ; Consciousness ; Eye Movements ; Infarction* ; Memory ; Thalamic Diseases ; Tomography, X-Ray Computed

Repetitive nerve stimulation (RNS) test was systematically performed in proximal and distal muscles of 142 cases with myasthenia gravis (MG) and 45 norrnal controls and then analyzed qualitatively. Diagnostic sensitivity was 75% based on abnorrnal decremental response in at least one muscle. The sensitivity increased from 56% in ocular MG to 96% in type Iib MG according to severity of disease. Higher diagnostic yield was noted in the orbiculans oculi in ocular MG and in the trapezius in gereralized MG. RNS test on proximal muscle showed a higher positive rate than that on distal muscles. When distal muscle testing was negative, there was an additional increase of 24% in proximal muscle testing. The posttetanic exhaustion (PTE) enhanced diagnostic sensitivitY as much as 8% in generalized MG. The posttetanic facilitation(PTF) and PTE were observed in 50% and 38% of generalized MG and were most prominent in MG with moderate severity. Five patterns on RNS findings were classified according to test paramcters. The most common response was the pattern which showed normal arnplitude of compound muscle action potential, decremental response at low rate stimulation, and PTF without PTE.
Action Potentials ; Muscles ; Myasthenia Gravis* ; Superficial Back Muscles

Repetitive nerve stimulation test (RNS) is an easy and non-invasive test which provides objective for the presence of a myasthenic neuromuscular defect and for monitoring possible improvement through various therapeutic measures, and makes the differentiation of neuromuscular junction disorders. Analysing the RNS test of 45 normal controls and 146 patients with myasthenia gravis quantitatively, the following results obtained. 1. At low rate stimulation, the decremental response upto 2 standard deviation in normal control are 7.1% in orbicularis oculi(~), 7.6% in flexor carpi ulnaris (FCU) and 5.4% in abductor digiti guinti muscle(ADQ). There are two kinds of facilitation noticed: incremental responses at repetitive low stimulation (13.3-14.9%) immediately after tetanic stimulationy and increased mean amplitudes of compound muscle action potentials after exercise(l3-17%). Four minutes after the tetanic stimulation, the decremental responses at low rate stimulation become accentuated slightly even in normal control group. 2. At low rate stimulation. There are singificant decremental decremental responses in patients with myasthenia gravis, but statistically no significant differences are seen in the quantity of decremental responses among 2, 3 and 5/sec rate of stimulation. 3. The pattern and severity of decremental responses at low rate stimulation are depending on the clinical type of generalized myasthenia gravis. There are no decremental responses in FCU or ADQ in ocular type. The decremental responses of oo are greater than that of FCU in mild generalize myasthenia, but the reverse is true in moderate generalized type. 4. Statistically significant post-tetanic facilitation and exhaustion are noticed in patients with generalized myasthenia gravis.
Action Potentials ; Humans ; Myasthenia Gravis* ; Neuromuscular Junction Diseases

Repetitive nerve stimulation test (RNS) is an easy and non-invasive test which provides objective for the presence of a myasthenic neuromuscular defect and for monitoring possible improvement through various therapeutic measures, and makes the differentiation of neuromuscular junction disorders. Analysing the RNS test of 45 normal controls and 146 patients with myasthenia gravis quantitatively, the following results obtained. 1. At low rate stimulation, the decremental response upto 2 standard deviation in normal control are 7.1% in orbicularis oculi(~), 7.6% in flexor carpi ulnaris (FCU) and 5.4% in abductor digiti guinti muscle(ADQ). There are two kinds of facilitation noticed: incremental responses at repetitive low stimulation (13.3-14.9%) immediately after tetanic stimulationy and increased mean amplitudes of compound muscle action potentials after exercise(l3-17%). Four minutes after the tetanic stimulation, the decremental responses at low rate stimulation become accentuated slightly even in normal control group. 2. At low rate stimulation. There are singificant decremental decremental responses in patients with myasthenia gravis, but statistically no significant differences are seen in the quantity of decremental responses among 2, 3 and 5/sec rate of stimulation. 3. The pattern and severity of decremental responses at low rate stimulation are depending on the clinical type of generalized myasthenia gravis. There are no decremental responses in FCU or ADQ in ocular type. The decremental responses of oo are greater than that of FCU in mild generalize myasthenia, but the reverse is true in moderate generalized type. 4. Statistically significant post-tetanic facilitation and exhaustion are noticed in patients with generalized myasthenia gravis.
Action Potentials ; Humans ; Myasthenia Gravis* ; Neuromuscular Junction Diseases

Three-dimensional solid model has not been widely used in surgical prediction of orthognathic surgery because freque from occlusal restorations or prosthesis limited the usefulness of simulated surgery involving occlusion. We prepared three-dimensional(3D) solid model from CT data and integrated the 3D solid model with dental cast using a face-bow transfer technique combined with skeletal reference measurement and confirmation with cephalometric radiographs. With this simple and easy method, it was possible to predict bony interference between the proximal and distal segment of the mandible so that we can prevent condylar displacement after sagittal split ramus osteotomy of the mandible with prominent asymmetry. The method error was within 2mm and it seemed to be useful in preoperative planning for maxillofacial surgery with maxillo-mandibular occlusal change
Mandible* ; Orthognathic Surgery* ; Osteotomy, Sagittal Split Ramus ; Prostheses and Implants ; Surgery, Oral

OBJECT: There have been some controversies about the nature of peripheral neuropathy in patients with subacute comblned degeneration. Mayer concluded that the neuropathy was essentially demyelinating. And other reports which were based on pathologic or electrophyslological filldings have been saying axonopathy. We tried to find the nature of perlpheral neuropathy by doing conventional nerve conduction studies in 19 patients with subacute combined degeneration. SUBJECT AND METHOD: We included 19 patients with subacute combined degeneration, who were diagnosed by decreased serum vitamin B12(200pg/ml) and abnormal neurologic symptoms and/or signs. The patients were between 26 and 86 years of age. Eleven of them were male. We performed conventional nerve conduction studies Including H-reflex, When nerve conduction parameters deviated by more than 2SD from the normal mean value, they were consider as abnormal. RESULTS: nerve conduction studies were abnormal in 13/19. 11/13 with abnormal nerve conduction studies showed the pattern of peripheral polyneuropathy. Ten of them showed decreased amplitudes of sensory nerve action potentials or compound nerve action potentials with/wlthout mild slowing of nerve condcution. The abnormalities of the three patients with nerve conduction parameters of demyelinating range were confined to the distal segments of the median nerves. CONCLUSION: We thought that the results of the nerve conduction studies of our cases were compatible with axonopathy rather than demyelinopathy as a principal ]esion of the peripheral nervous system.
Action Potentials ; H-Reflex ; Humans ; Male ; Median Nerve ; Neural Conduction* ; Neurologic Manifestations ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Polyneuropathies ; Subacute Combined Degeneration ; Vitamins

Eating the meat of pheasants which was killed by potassium cyanide, a 27 year old man developed several symptoms of minor intoxication. A few days later, the patient became mute, apathy, somnelent and indifferent but without any parkinsonia features or dementia. On CT brain scan, bilateral symmetrical and non-enhancing focal low densities are noticed in basal ganglia, similar to the carbon monoxide intoxication.
Adult ; Apathy ; Basal Ganglia ; Brain* ; Carbon Monoxide ; Dementia ; Eating ; Humans ; Meat ; Potassium Cyanide

The purpose of this study is to evaluate the morphologic findings of the labrum and capsuloligamentous structures in the normal and unstable shoulders and to compare the effectiveness of double contrast arthrographic findings which were taken with supine and prone position. We reviewed the computerized tomographic arthrogram in 9 cases of normal shoulder and l3 cases of shoulder instability. We evaluated the shape of the labrum, the attachment of anterior capsule and the amount of capsular laxity. Capsular laxity was compared each others in normal, the unidirectional instability and the multidirectional instability. Among these materials, we simultaneously performed CT arthrogram with supine and prone position and evaluated which is more reliable and accurate. Scapular inclination was ahout 25 degrees in the supine position and ahout 60 degrees in the prone position. Normal glenoid labrum varied in size and shape, so its lack of a classic appearance might not indicate a labral tear. Variations existed in the anterior capsular attachment onto the glenoid. The anterior capsule was used to attach far away from the glenoid rim. but it might not indicate an anterior instability. With the prone position, the labral lesion took more excellent visualization due to the contrast coating on the glenoid labrum in both anterior and posterior. Anterior capsular expansion was seen well with prone position in anterior instability. In summary, for proper interpretation of the instability, awareness of the morphologic variations of the labrum and capsuloligamentous structure is important. CT double contrast arthrography with prone position has made a significant contribution to improving and easing the documentation of variety of anatomic abnormalities. Now we recommend the prone position in CT arthrogram for imaging glenoid labrum pathology in shoulder instability.
Arthrography ; Pathology ; Prone Position ; Shoulder* ; Supine Position

The results of 17 fractures of tibial shaft treated with Rush nails under the image intensifier and early weight bearing are reported. Thirteen of these fractures were closed. All fractures were united between 12 and 21 weeks clinically, 17 and 26 weeks radiologically after operation. All cases were healed without significant complications, such as fracture disease. The advantages of this method were as follows; 1) normal knee motion and early weight bearingare possible during healing. 2) There is a relatively rapid restoration of bone continuity. This method of treatment for tibial shaft fractures were indicated as follows; 1. Mid-shaft fracture. 2. Segmental fracture of shaft. 3. Expectation of compression force at fracture surface by weight bearing. 4. Open fracture of shaft.
Fractures, Open ; Knee ; Methods ; Tibia ; Weight-Bearing