PURPOSE: To determine the usefulness of three-dimensional CT angiography using multidetector-row CT (MDCT) for delineating the arterial anatomy of the liver. MATERIALS AND METHODS: Hepatic arterial three-dimensional CT angiography was performed using MDCT (Lightspeed Qx/I; GE Medical Systems, Milwaukee, Wis., U.S.A.) in 45 patients with HCC undergoing conventional angiography for transcatheter hepatic arterial chemoembolization. The scanning parameters during the early arterial phase were 2.5 mm slice thickness, 7.5 mm rotation of table speed, and a pitch of 3. Images were obtained by one radiologist using maximum intensity projection from axial CT images obtained during the early arterial phase. Two radiologists blinded to the findings of conventional angiography independently evaluated the hepatic arterial anatomy and the quality of the images obtained. RESULTS: Compared with conventional angiography, reader A correctly evaluated the hepatic arterial anatomy depicted at three-dimensional CT angiography. Reader B's evaluation was correct in 40 of 45 patients. Interobserver agreement was good (kappa value, 0.73), and both readers assessed the quality of three-dimensional CT angiography as excellent. CONCLUSION: Three-dimensional CT angiography using MDCT was accurate for delineating the arterial anatomy of the liver, and interobserver agreement was good. The modality may provide, prior to conventional angiography, valuable information regarding a patient's hepatic arterial anatomy.
Angiography* ; Hepatic Artery* ; Humans ; Liver

PURPOSE: The purpose of this study was to evaluate the utility of the CT cholangiography by using helical CT with multiplanar reformation in patients with extrahepatic biliary obstruction. MATERIALS AND METHODS: Helical CT was performed in 36 patients of extrahepatic biliary obstruction confirmed by operation or invasive cholangiography(percutaneous transhepatic cholangiography or endoscopic retrograde cholagiopancreatography). The cause of obstructions were 18 benign diseases(11 common bile duct stones, four choledochal cysts, three pancreatitis) and 18 malignant diseases(seven common bile duct carcinomas, seven pancreatic head carcinomas, three ampullary carcinomas, one periampullary duodenal carcinoma). After helical scanning through the extrahepatic bile duct, retrospective reconstruction of the helical data was performed. And then, CT cholagiogram was obtained with multiplanar reformation. We evaluated the technical success rate and the accuracy in determinating the level and the cause of the obstruction. We compared findings of the CT cholangiogram with that of operation or invasive cholangiography. RESULTS: In 100%(36/36) of cases, CT cholangiography could be obtained successfully. The accuracy of the CT cholangiography in determinating the level of the obstruction was 100%(11 cases of suprapancreatic duct, 13 cases of intrapancreatic duct, 13 cases of infrapancreatic duct and ampulla), and the accuracy in determinating the cause of the obstruction was 91.7%(all cases of 18 benign diseases, and 15 cases of 18 malignant diseases). CONCLUSION: In evaluating the obstruction of extrahepatic bile ducts, the CT cholangiography by using helical CT with multiplanar reformation is an useful noninvasive method in determinating the level.and the cause of biliary obstruction and therefore could replace t~e invasive cholangiography.
Bile Ducts, Extrahepatic ; Cholangiography* ; Choledochal Cyst ; Common Bile Duct ; Head ; Humans ; Retrospective Studies ; Tomography, Spiral Computed*

Background: A decrease in computed tomography (CT)-derived skeletal muscle radiodensity (SMD) reflects age-related ectopic fat infiltration of muscle, compromising muscle function and metabolism. We investigated the age-related trajectory of SMD and its association with vertebral trabecular bone density in healthy adults. Methods: In a cohort of healthy adult kidney donors aged 19 to 69 years (n=583), skeletal muscle index (SMI, skeletal muscle area/height2), SMD, and visceral-to-subcutaneous fat (V/S) ratio were analyzed at the level of L3 from preoperative CT scans. Low bone mass was defined as an L1 trabecular Hounsfield unit (HU) <160 HU. Results: L3SMD showed constant decline from the second decade (annual change –0.38% and –0.43% in men and women), whereas the decline of L3SMI became evident only after the fourth decade of life (–0.37% and –0.18% in men and women). One HU decline in L3SMD was associated with elevated odds of low bone mass (adjusted odds ratio, 1.07; 95% confidence interval, 1.02 to 1.13; P=0.003), independent of L3SMI, age, sex, and V/S ratio, with better discriminatory ability compared to L3SMI (area under the receiver-operating characteristics curve 0.68 vs. 0.53, P<0.001). L3SMD improved the identification of low bone mass when added to age, sex, V/S ratio, and L3SMI (category-free net reclassification improvement 0.349, P<0.001; integrated discrimination improvement 0.015, P=0.0165). Conclusion L3SMD can be an early marker for age-related musculoskeletal changes showing linear decline throughout life from the second decade in healthy adults, with potential diagnostic value for individuals with low bone mass.

The incidence of contralateral reflux after unilateral reimplantation in children with primary unilateral vesicoureteral reflux(VUR) is reported to be 0.8-32%. We evaluated the characteristics of contralateral reflux after endoscopic or open surgical correction of primary unilateral VUR in children. 30 children who underwent unilateral reimplantation by Paquin (25pts) and submucosal Macroplastique injection(5pts) were evaluated. The association between postoperative contralateral reflux and age, sex, ipsilateral implant side, postoperative urinary tract infection, and surgical method were evaluated. There were 18 male and 12 female patients. Initial reflux was observed in the right in 18 and 12 in left. The initial reflux grades were II, III, IV, and V in 2, 11, 14, and 3 patients, respectively. Postoperative urinary tract infection was observed in 4 patients of whom 1 had contralateral reflux. In conclusion, there was no single factor that could predict the development of contralateral reflux after unilateral correction of unilateral primary VUR. Furthermore, the fact that contralateral reflux occurred even after submucosal Macroplastique injection suggests that the method of surgery is not related to the subsequent development of contralateral reflux.
Child* ; Female ; Humans ; Incidence* ; Male ; Replantation ; Ureter ; Urinary Bladder ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

BACKGROUND: During coronary angiography, some electrocardiographic changes occured due to contrast media, which do life threatening influences. METHODS: We compared the electrocardiographic changes which were induced by injection of three radiopaque contrast media during selective coronary angiography in 49 patients with chest pain. One of the contrast media was high osmolar ionic(Urografin_76) and the another was low osmolar ionic(Hexabrix) and the last was non-ionic(Ioversol). Electrocardiograms were obtained before, during and after selective coronary angiography. RESULTS: The changes of S-T segment or T were decreased in non-ionic group rather than high osmolar or ionic group. And there was significant Q-Tc interval prolongation among all three groups except comparision of low osmolar ionic contrast dye and non-ionic contrast dye in left coronary angiography. CONCLUSION: Non-ionic low osmolar contrast media was safer than high osmolar or ionic contrast medial because of lesser change of Q-Tc interval during selective coronary angiography.
Chest Pain ; Contrast Media* ; Coronary Angiography* ; Diatrizoate Meglumine ; Electrocardiography* ; Humans ; Ioxaglic Acid ; Osmolar Concentration

BACKGROUND: Eosinophilic pustular folliculitis (EPF) is characterized by erythematous patches of follicular papules and pustules that mainly involve the face. Although various treatments have been attempted for EPF, including systemic and topical steroids, dapsone and indomethacin, there is no consensus on the first choice for treatment. OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy and safety of naproxen treatment for EPF patients. METHODS: We retrospectively reviewed the clinical records of 16 biopsy-proven EPF patients who were treated with naproxen. Initial dose of oral naproxen was 500 mg to 1,000 mg. Therapeutic effects were evaluated by 3 grades: NR (no response), PR (partial remission, >50% improvement), CR (complete remission). RESULTS: Of the 16 EPF patients, 11 patients (69%) showed either complete remission (50%) or partial remission (19%). The median time to response for good responders (CR+PR) was 1.5 weeks. Two patients (13%) had mild gastrointestinal side effects, such as indigestion, but the symptoms disappeared soon after use of a gastrointestinal protectant. CONCLUSION: Oral naproxen may be an effective and safe treatment modality for EPF.
Consensus ; Dapsone ; Dyspepsia ; Eosinophilia ; Eosinophils ; Folliculitis ; Humans ; Indomethacin ; Naproxen ; Retrospective Studies ; Skin Diseases, Vesiculobullous ; Steroids

BACKGROUND: General anesthesia often produces some degree of hypothermia and hypothermia causes much more blood loss during surgery than normothermia. Electrically heated humidifiers (EHHs) have been used for patients under general anesthesia and in the intensive care unit. However, the benefits of the EHH have not been widely reported in the literature. METHODS: Patients scheduled for posterior lumbar spine fusion, were randomly assigned to a mechanically ventilated with EHH circuit group or to a conventional respiratory circuit group. Their tympanic membrane temperature was monitored every 30 min after induction up to 180 min, and perioperative blood losses, transfusion requirements during surgery, and other complications were noted. RESULTS: Patients in the control group (n = 40) showed a lower mean body temperature at all times than immediately after induction, while the EHH group (n = 40) showed a lower body temperature from 60 minute after induction comparing to the initial temperature. Furthermore, patients in the EHH group had a higher mean body temperature than patients in the control group during surgery (35.9 +/- 0.4 vs 35.4 +/- 0.5, P < 0.001). Mean intraoperative blood loss (9.75 +/- 5.4 vs 7.48 +/- 3.9, P = 0.035) and transfusion requirements (57.5% vs 25%, P = 0.006) were significantly less in the EHH group, but postoperative blood loss, duration of hospitalization, and other complications were not significantly different in the two study groups. CONCLUSIONS: The use of an electrically heated humidifier did not prevent a body temperature drop under general anesthesia. However, it helped maintain body temperature and was associated less blood loss and transfusion requirement during surgery.
Anesthesia, General ; Body Temperature ; Hospitalization ; Hot Temperature ; Humans ; Hypothermia ; Intensive Care Units ; Postoperative Hemorrhage ; Spine ; Tympanic Membrane

PURPOSE: To determine the usefulness of cerebral perfusion computed tomography (CT) in patients with acute cerebral ischemic infarction. MATERIALS AND METHODS: Twelve patients with acute middle cerebral artery infarction underwent conventional CT and cerebral perfusion CT within 25 hours of the onset of symptoms. For each patient, perfusion CT scans were obtained at the levels of the basal ganglia and 1 cm caudal to them. Using special imaging software, perfusion imaging maps for cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to peak (TTP) were created, and the infarcted lesion was evaluated on each map. MTT and TTP delay times were measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Lesion size on each perfusion map was determined and compared with the value obtained by diffusionweighted MR imaging (DWMRI). RESULTS: In all patients, perfusion CT maps depicted the perfusion defect lesion, for which the MTT and TTP delay was remarkable. A comparison of lesion size between each perfusion map and DWMR images showed that the closest correlation involved CBF maps (8/12, 67%). On MTT maps, the lesion was larger than at DWMRI, suggesting that MTT mapping can be used to evaluate ischemic penumbra. CONCLUSION: Perfusion mapping facilitates the evaluation not only of the ischemic core and ischemic penumbra, but also of hemodynamic status in the area of the perfusion defect. This finding demonstrates that perfusion CT can be useful for the diagnosis and treatment of patients with acute cerebral ischemic infarction.
Basal Ganglia ; Blood Volume ; Cerebrum ; Diagnosis ; Hemodynamics ; Humans ; Infarction* ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Perfusion Imaging ; Perfusion* ; Tomography, X-Ray Computed

PURPOSE: Subclinical prostatitis is a very frequent histologic finding in pathological examinations of prostate surgery specimens. We evaluated the correlation between the symptoms of benign prostatic hyperplasia (BPH) and the grades of inflammation in surgical specimens of patients who had undergone operation for BPH without any evidence of clinical prostatitis. MATERIALS AND METHODS: Seventy five patients with BPH, who had gone through transurethral resection of the prostate (TURP) at our department from March 2004 to May 2007, were retrospectively studied. Of the 75 patients, 57 patients were pathologically diagnosed as having a BPH with prostatitis and 18 patients had the only BPH (group G0). Chronic inflammation was graded as I (group G1: scattered inflammatory cell infiltrate within the stroma without lymphoid nodules), II (group G2: nonconfluent lymphoid nodules) or III (group G3: large inflammatory areas with confluence of infiltrate). The serum prostate-specific antigen (PSA) level, PSA density (PSAD), International Prostate Symptom Score (IPSS) and maximum urinary flow rate were compared among the grades of inflammation. RESULTS: In the patients had undergone TURP, prostatic inflammation was found in 76% (57/75). The storage symptoms of IPSS and PSAD were significantly correlated to the extent of inflammation in each groups (p<0.05). No significant correlations were observed between PSA, size of prostate, voiding symptoms, quality of life (QoL) of IPSS, and maximum urinary flow rate. CONCLUSIONS: The extent of chronic inflammation had considerably more relationship with storage symptoms than voiding symptoms and with the increased PSAD. These findings suggest that the subclinical prostatitis may be one of the factors of storage symptoms of BPH patients and postoperative maintained lower urinary tract symptoms.
Humans ; Inflammation ; Lower Urinary Tract Symptoms ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatitis ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate

88 workers exposed to cadmium were examined at the 12 factories using or producing cadmium in order to know the present state of cadmium exposure and renal dysfunction in 1992. Cadmium in blood and in urine were measured and compared by the 3 exposure level of cadmium in air. Cadmium in blood of low, moderate and high exposure group were 2.5, 3,8 and 7.6 microgram/L, respectively. Cadmium in urine were 1.8(1.3), 3.8(2,6) and 7.9 microgram/L(6.1 microgram/g creatinine) , resrectively. However, there was no relationship between Urinary cadmium and beta(2)-microglobulin. Cumulative exposure estimate (CEE) was calculated by multiplying the mean ambient cadmium level of the factory and working duration. CEE has a high correlation with cadmium in blood and urine, but no relation to beta(2)-microglobulin. Because working durations were relatively shorter than European workers', the highest CEE was just 300 microgram. year/m(3), which was not enough to induce renal tubular dysfunction. This study, however, suggested the possibility that renal tubular dysfunction caused by cadmium could be happened in Korea in the near future.
Cadmium* ; Korea ; Occupations*