To evaluate the correlation between the internal echo patterns and henodynamics in hepatic cavernous hemangioma, we compared the interanal echo pattern with the hemodynamic pattern examined by intravenous bolus CT(multi-phase incremental bolus dynamic CT) in 34 diagnosed hemangiomas (25 patients). We classified cavernous hemangiomas as two different hemodynamic patterns according to the findings of the early phase of intravenous bolus CT scans. Early enhancing type means that most portion of a mass is enhanced during the early hpase and late enhancing type means that only minimal peripheral portion of a mass is enhanced during the early phase. We classified ultrasonogrphic patterns as hypoechoic and hyperechoic according to main echogenicity of the mass. The late enhancing type tends toward the high echo type (20/21) and the early enhancing type tends to ward the low echo type (11/13) (p<0.01) Therefore, we believe that the early enhancing type which represents rapid contrast inflow toward mass, contains large portions of cavernous space and showes hypoechoic, but late enhancing type which represents late contrast inflow toward a mass, contains large portions of fibrous space and showes hyperechoic. In conclusion, there was significant correlation between internal hemodynamics and echo patterns in hepatic cavernous hemangioma.
Hemangioma ; Hemangioma, Cavernous* ; Hemodynamics* ; Tomography, X-Ray Computed

To evaluate the correlation between the internal echo patterns and henodynamics in hepatic cavernous hemangioma, we compared the interanal echo pattern with the hemodynamic pattern examined by intravenous bolus CT(multi-phase incremental bolus dynamic CT) in 34 diagnosed hemangiomas (25 patients). We classified cavernous hemangiomas as two different hemodynamic patterns according to the findings of the early phase of intravenous bolus CT scans. Early enhancing type means that most portion of a mass is enhanced during the early hpase and late enhancing type means that only minimal peripheral portion of a mass is enhanced during the early phase. We classified ultrasonogrphic patterns as hypoechoic and hyperechoic according to main echogenicity of the mass. The late enhancing type tends toward the high echo type (20/21) and the early enhancing type tends to ward the low echo type (11/13) (p<0.01) Therefore, we believe that the early enhancing type which represents rapid contrast inflow toward mass, contains large portions of cavernous space and showes hypoechoic, but late enhancing type which represents late contrast inflow toward a mass, contains large portions of fibrous space and showes hyperechoic. In conclusion, there was significant correlation between internal hemodynamics and echo patterns in hepatic cavernous hemangioma.
Hemangioma ; Hemangioma, Cavernous* ; Hemodynamics* ; Tomography, X-Ray Computed

PURPOSE: We evaluated the capability of MR in the diagnosis of anomalous pulmonary venous connection (APVC). MATERIALS AND METHODS: The patient group consisted of 11 total APVC and 8 partial APVC diagnosed with MR. Echocardiography was performed in all cases, cardiac angiography in 12 cases and operation in 12 cases. We compared MR findings with those of operation, echocard iography and cardiac angiography. RESULTS: In surgically proven 12 cases, diagnostic accuracy of preoperative MR, echocardiography and cardiac angiography was 100%, 67% and 63%, respectively. In the remaining cases, MR findings well correlated with those of echocardiography or cardiac angiography. Stenosis of common pulmonary vein or superior vena cava was identified in 4 cases. In one patient, MR depicted associated cor triatriatum clearly. CONCLUSION: MR is an effective modallty in depicting anomalous pulmonary venous con nections.
Angiography ; Constriction, Pathologic ; Cor Triatriatum ; Diagnosis ; Echocardiography ; Humans ; Pulmonary Veins ; Vena Cava, Superior

The provocation test of variant angina are known as ergonovine test, hyperventilation, acetylcholine, exercise and cold pressor test, but beta-blocker provocation test has not been reported as a case. So, this paper reports on the diagnosis of variant angina by beta-blocker provocation test and the case of subendocardial infarcion induced by this test. This study reports with literature and investigation about the following case : A 45-year-old man with a history of recurrent episode of typical angina on the early morning for the past 20 days. He was administrated beta-blocker given by oral route, and on the next morning there was chest pain as same degree as before, Holter EKG displayed ST segment elevation and ventricular tachycardia. It was confirmed focal spasm on coronary angiography, ST segment elevation on EKG, and newly developed hypokinesia on left ventriculogram and followed-up echocardiagraphy. When the chest pain is absent, EGK was normal. And we confirmed that elevation of cardiac enzyme was absent as a result of serial follow up study.
Acetylcholine ; Chest Pain ; Coronary Angiography ; Diagnosis ; Electrocardiography ; Ergonovine ; Follow-Up Studies ; Humans ; Hyperventilation ; Hypokinesia ; Infarction* ; Middle Aged ; Spasm ; Tachycardia, Ventricular

BACKGROUND AND OBJECTIVE: Percutaneous transluminal coronary angioplasty of chronic total occlusion has been limited by a relatively low success rate and a high restenosis rate. This study investigated procedural outcome, factors predictive of procedural success and safety of coronary angioplasty for chronic total coronary occlusion. MATERIALS AND METHODS: The study population was composed of 45 lesions attempting PTCA with or without stent implantation for recanalization of chronic total coronary occlusion between January 1997 and July 1999. The clinical and angiographic data of the 45 lesions were reviewed. The results of successful PTCA in 28 lesions were compared with those in 17 lesions whose PTCA was failed. RESULTS: The overall success of balloon angioplasty and stenting was achieved in 28 lesions (62.2%) and did not differ significantly by clinical variables. The most common cause of failure of balloon angioplasty was inability to pass the guide wire across the occlusion( 14 of 23 lesions, 61%). Procedural success was more common in patients with occlusions with a tapered entry configuration(77.2% vs. 47.8%, p=.042), with lesions without side branches(82.3% vs. 50%, p=.03). Multiple logistic regression analysis identified the absence of side branch(p<0.01) and the presence of a tapered entry configuration(p<0.05) as independent predictors of procedural success. One case(2.2%) needed emergency coronary bypass surgery after failure to recanalize the occluded vessel. There was no Q wave acute myocardial infarction, death. CONCLUSIONS: The favorable cases(>60%) of chronic total coronary occlusions can be successfully dilated by balloon angioplasty with or without stent implantation, with a major complication rate of 2.2%. Therefore, with careful patient selection, we need to try the aggressive recanalization for chronic total coronary occlusion.
Angioplasty ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary* ; Coronary Occlusion ; Emergencies ; Humans ; Logistic Models ; Myocardial Infarction ; Patient Selection ; Stents

OBJECTIVE: To determine if a combination of ferucarbotran-enhanced T2*weighted-gradient echo (T2*W-GRE) and T2-weighted turbo spin echo (T2W-TSE) images in gadolinium- and ferucarbotran-enhanced MRI has additive efficacy compared to each image alone for detecting small (< or = 2.0 cm) hepatocellular carcinoma (HCC) lesions in a group of cirrhotic patients and metastases in a group of non-cirrhotic patients. MATERIALS AND METHODS: Two readers retrospectively analyzed gadolinium- and ferucarbotran-enhanced T2*W-GRE, T2W-TSE, and combined T2*W-GRE/T2W-TSE images of 119 patients with 157 HCCs and 32 patients with 98 metastases. The diagnostic accuracy and sensitivity for each image set and the combined set were evaluated using the alternative-free response receiver operating characteristic method. RESULTS: The mean area under the curve value of the combined set (0.966) tended to be better than that for each individual image set (T2W-TSE [0.910], T2*W-GRE [0.892]). Sensitivities in the combined set were higher than those in each individual image set for detecting HCC (mean, 93.0% versus 81.6% and 86.7%, respectively, p < 0.01). Sensitivities in the combined set and the T2W-TSE set were the same for detecting metastases, and both were higher than the sensitivity seen in the T2*W-GRE set (mean, 97.5% versus 85.2 %, p < 0.01). CONCLUSION: Combining ferucarbotran-enhanced T2*W-GRE and T2W-TSE has additive efficacy for detecting HCC in cirrhotic patients, but T2W-TSE is preferred for detecting metastases in non-cirrhotic patients.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis ; Contrast Media/*administration & dosage ; Female ; Gadolinium DTPA/*diagnostic use ; Humans ; Iron/*diagnostic use ; Liver Neoplasms/*diagnosis/secondary ; *Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Observer Variation ; Oxides/*diagnostic use ; Predictive Value of Tests ; Sensitivity and Specificity

OBJECTIVES: The objectives of this study are to identify the relationship between the Korean occupational stress scale (KOSS) and emotional labor, and to study the association between emotional labor and musculoskeletal symptoms, absence or early leave due to physical problems among civil affairs officials. METHODS: 391 public workers who provide social insurance service were analyzed. A structured self-reported questionnaire was used to assess sociodemographics, job stress, emotional labor, musculoskeletal symptoms and the experience of absence or early leave due to physical problems. For a comprehensive understanding of the relationship among these factors, multiple logistic regression analysis was used. RESULTS: The Pearson coefficient was 0.409 between the job demand of KOSS and the emotional labor score. The odds ratio of musculoskeletal symptoms is 2.32(95% CI: 1.17~4.61), 2.48(95% CI: 1.15~5.33) in the groups of moderate and, high emotional labor score, respectively, compared to the low score group. On the other hand, the odds ratio of the experience of absence or early leave due to physical problems is 2.43(95% CI: 1.24~4.76) and, 3.08(95% CI: 1.44~6.57) in the same groups. CONCLUSIONS: Emotional labor acts as a factor of job demand of KOSS, and has an effect on musculoskeletal symptoms and absence or early leave among civil affairs officials.
Absenteeism ; Hand ; Logistic Models ; Musculoskeletal Diseases ; Odds Ratio ; Questionnaires ; Social Security ; Stress, Psychological

OBJECTIVES: To determine if agricultural work is related to radiological flattening of lumbar lordosis, and to identify the relationship between of back pain and flat back in selected Korean farmers. METHODS: Between June 2006 and July 2008, 414 farmers, 155 (37.4%) males and 259 (62.6%) females participated in this study. We collected data on hazardous agricultural work postures and other factors from interviews, surveys, and x-ray views of lateral lumbar. The operational definition of a flat back was below -1 SD of lordotic angle, with a normal distribution between L1 and S1 level. Logistic regression analysis was conducted to evaluate the relationship between flat back and hazardous working posture ratio, sex, the severity of back pain. RESULTS: Mean lordotic angle was 42.9+/-15.7degrees. Flat back had a higher prevalence in the females (24.7%) than the males (5.8%). The odds ratio of flat back risk is 3.30 (95% CI: 1.46~7.46) in the females compared to the males, 1.31 (95% CI: 0.61~2.79), 4.11 (95% CI: 1.77~9.55) in the group of hazardous working posture ratio compared to the low risk group, 2.78 (95% CI: 1.27~6.07), 5.74 (95% CI: 2.27~14.49) in the group of L4-L5 disc space narrowing compared to normal group, 3.06 (95% CI: 1.27~7.31), 5.45 (95% CI: 1.70~17.46) in the group of lumbar spine compression fracture compared to no fracture. Odds ratio of severe back pain is 2.29 (95% CI: 1.12~4.72) in the group of flat back compared to normal group. CONCLUSIONS: Hazardous agricultural working postures, such as 'low- lifting, pulling, pushing work and high- squatting posture work' are associated with flat back. Low back pain is significantly associated with flat back group in female farmers.
Agriculture ; Animals ; Back Pain ; Female ; Fractures, Compression ; Humans ; Korea ; Lifting ; Logistic Models ; Lordosis ; Low Back Pain ; Male ; Odds Ratio ; Posture ; Prevalence ; Sex Ratio ; Spine

BACKGROUND: Heat shock proteins (HSPs), or stress proteins, are immunodominant antigens of many microorganisms. In this study, we have detected the anti-HSP 70 antibody and tried to explain the role of the antibody with respect to the pathogenesis of SLE. Furthermore, we have attempted to find out the possibility to link the presence of the autoantibody with the monitoring and diagnosis of systemic lupus erythematosus (SLE). METHODS: A total of 80 samples from 55 SLE patients were screened for the presence of anti-HSP 70 antibodies. Simultaneously 59 healthy people were tested as a control group. The anti-HSP 70 antibodies were measured by enzyme-linked immunosorbent assay (ELISA) and confirmed by western blot in anti-HSP 70 antibody ELISA positive samples. The activity of disease state was confirmed by the patients' medical record and systemic lupus activity measure (SLAM). RESULTS: The mean optical density (O.D.450) of ELISA in healthy controls and SLE patients were 0.15+/-0.18 (mean+/-S.D.) and 0.13+/-0.14. The correlation of SLAM Score and ELISA O.D. was r2=0.19, P=0.014. And, the mean O.D. value of ELISA was 0.18+/-0.02 and 0.11+/-0.01 before and after treatment (P <0.05). We compared samples with SLAM Score. The O.D. of anti-HSP 70 ELISA in these patients were 0.20+/-0.02 and 0.08+/-0.002 before and after treatment respectively (n=10, mean+/-S.D., P <0.01). CONCLUSIONS: Anti-HSP 70 antibody was not a clinically useful diagnostic marker in SLE patients. However, the titer of anti-HSP 70 antibody can be used for the monitoring of the therapeutic effectiveness in these patients.
Antibodies ; Blotting, Western ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Heat-Shock Proteins ; Humans ; Immunodominant Epitopes ; Lupus Erythematosus, Systemic* ; Medical Records

Sinus of Valsalva aneurysms are rare cardiac anomalies and are usually caused by the separation of the aortic wall media from the valve ring tissue. These aneurysms frequently rupture into the low-pressure areas like the right ventricle and right atrium, rarely do they rupture into the left atrium, left ventricle, pericardial sac, or pulmonary artery. Cerebral infarction has been reported as a rare complication of unruptured sinus of Valsalva aneurysm. We experienced very rare two cases of Valsalva aneurysms of right coronary sinus dissecting into the interventricular septum in patients with cerebral infarction. In two cases these aneurysms ruptured into the left ventricle. These aneurysms were excised and the defect was closed with autopericardium. At the end of the surgical repair, coaptation was found to be insufficient and aortic valve replacement was undertaken.
Aneurysm* ; Aortic Valve ; Cerebral Infarction* ; Coronary Sinus ; Heart Atria ; Heart Ventricles ; Humans ; Pulmonary Artery ; Rupture ; Sinus of Valsalva*