PURPOSE: The purpose of this study was to determine the role of CT and MR imagings in the diagnosis aortic dissection and differentiation between the true and false lumen. MATERIALS AND METHODS: We retrospectively studied forty patients with aortic dissection(AD) diagnosed imagings or surgery. Of the forty patients, 19 were examined with only CT, 14 with CT and MR, and 7 with MI~: Our points of view were(1) the classification of AD according to configuration of intimal flap by cross-sectional imaging, (2) differentiation between the true and false lumens, (3) the course of the false lumen, and (4)! detectability of the origin of major branch vessels of the abdominal aorta. RESULTS: The classification by corss-sectional imaging were crescentic(65%), circumferential(15%), flat(12%), and irregular(8%) type, in which false negative diagnosis was made in 1 case of crescentic and circumferential type, respectively. In 2 case of flat type and 1 case of irregular type, the differentiation between the true and false lumen was impossible with CT. The course of the false lumen in descending thoracic aorta revealed countrclock wise rotation(66%), clockwise rotation(5%) or fixed(29%) apperance. MR imaging was superior to CT in the detection of the origin of major branch vessels of the abdominal aorta. The determination of the origin of major branches of abdominal aorta arising from the true and false lumen were impossible in 2 cases in which only CT was done. CONCLUSION: Diagnosis of crescentic and circumferential types of AD with narrow and thrombosed false lumen was problematic in both CT and MR with no difference of diagnostic accuracy between the two modalities. The differentiation between the true and false lumen was difficult in flat and irregular types with only CT. Therefore, when surgical treatment is considered as in type B aortic dissection, MR imaging is recommended in order to determine the origin of major branch vessels.
Aorta, Abdominal ; Aorta, Thoracic ; Classification ; Diagnosis* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

Removal of blunt esophageal foreign bodies using Foley catheter under a fluoroscopic guidance is a well-recognized procedure. However, since this procedure is rather cumbersome and uncomfortable to the patient, the authors tried to find an easier and more convenient modified technique. For 10 patients with esophageal foreign body, we tried the method to the patients who is lying in the right lateral decubitus position and 3 assistants hold head. arms, trunk and legs of the patients without tilting the table and without using immobilizer. Foley catheter is inserted through nostril, nasal cavity and pharynx to esophagus. In order to identify the Foley catheter in esophagus, 0.025 inch short wire was inserted in the Foley catheter. The balloon of a Foley catheter was inflated by 10cc of air, and the syringe was kept attached to the Foley catheter during the procedure. After passage of the foreign body through the upper esophageal sphincter, the balloon was deflated immediately and the foreign body was removed through the mouth. We successfully removed in removing all the blunt esophageal foreign body with ease. This modified method is also fast, safe and efficient.
Arm ; Catheters* ; Deception ; Esophageal Sphincter, Upper ; Esophagus ; Foreign Bodies* ; Head ; Humans ; Leg ; Methods* ; Mouth ; Nasal Cavity ; Pharynx ; Syringes

No abstract available.

No abstract available.
Rhinomanometry*

Squamous cell carcinoma is a rare complication of chronic osteomyelitis. Squamous cell carcinoma of extremity campromises approximately 1 to 2% of all squamous cell carcinoma and of these 2.5 to 4.5% are secondary to chronic osteomyelitis. Biopsy of squamous cell carcinoma, which arises in the proliferating edge of the cutaneous ulcer and invades the bone, should include tissues from all portion of sites of ulcer including bone marrow spaces. But histological diagnosis may be difficult becasue of preexisiting and coexisisting metaplasia and pseudo-epitheliomatous hyperplasia. With prompt and aggressive surgical treatment, the prognosis for patient with squamous cell carcinoma secodary to chronic osteomyelitis is good. Routine regional lymphadenectomy at site of amputation seems unnecessary. This case report represets an unusual bone marrow involvement of squamous cell carcinoma which was complicated by femur fracture.
Amputation ; Biopsy ; Bone Marrow ; Carcinoma, Squamous Cell ; Diagnosis ; Epithelial Cells ; Extremities ; Femur ; Humans ; Hyperplasia ; Lymph Node Excision ; Metaplasia ; Osteomyelitis ; Prognosis ; Ulcer

PURPOSE: To compare T2-weighted MR cholangiography (T2-MRC) and contrast-enhanced T1-weighted MRC (enhanced T1-MRC) in the assessment of biliary anatomy in donor candidates for living related liver transplantation (LRLT). MATERIALS AND METHODS: Thirty-three potential donors underwent MR examination for preoperative evaluation. Using the single-shot half-Fourier RARE sequence, T2-weighted single-section and coronal images were obtained, and enhanced T1-MRC was performed, using 3D GRE sequences after the administration of mangafodifir trisodium. To assess the hilar ductal branching pattern and determine diagnostic confidence, two reviewers first evaluated the unpaired T2-MRC and enhanced T1-MRC images, and then paired T2-MRC and enhanced T1-MRC images together. In particular, in 12 cases in which direct cholangiographys were performed, the feasibility of single duct-to-duct anastomosis was assessed using the unpaired and the paired sets sequentially. RESULTS: The reviewers' confidence tended to be higher for enhanced T1-MRC than T2-MRC, but the difference was not statistically significant. For both reviewers, confidence was significantly higher for the paired set than for T2- or enhanced T1-MRC alone (p < .001). The types of biliary anatomy determined in the paired set matched the consensus reading in 33 (100%) and 30 cases(91%) assessed by reviewer 1 and 2, respectively. The separate interpretation of T2- and enhanced T1-MRC findings matched the consensus interpretation in 30 (91%) and 28 cases (85%), respectively, assessed by reviewer 1, and 26 (79%) and 28 cases (85%), respectively, assessed by reviewer 2. The possibility of single anastomosis was accurately predicted in 91.6% of cases in T2-MRC, and 100% at enhanced T1-MRC and the combined set. CONCLUSION: In the evaluation of the biliary anatomy of potential donors for LRLT, the combined use of T2-MRC and enhanced T1-MRC may improve diagnostic confidence and decrease the occurrence of a non diagnostic or equivocal interpretation at T2-MRC alone.
Adult* ; Cholangiography* ; Consensus ; Humans ; Liver Transplantation ; Liver* ; Tissue Donors*

The purpose of this study was to evaluate the influence of accessibility to dental cervices of maxillary molars upon plaque control level of these areas. Fifthy-seven dental students with healthy gingiae participated in this study. Maxillary dental casts were fabricated for each participants. Using the casts, cervical accessibility was measured at the mid-palatal point of maxillary first and second molars. Cervical accessibility was defined as the perpendicular distance from the entrance of gingival sulcus to the imaginary line between the most protruded points of palatal gingiva and tooth surface, and classified into degree I(< or =0.5mm), II(>0.5mm, < or =1.0mm), III(>1.0mm, < or =1.5mm), and IV(>1.5mm). Plaque score was recorded as the distance from crest of gingival margin to the most coronal extent of plaque. Measurements of plaque score were repeated 3 times at 1-week intervals. After the baseline measurements, the participants began to use unitufted brushes on randomly assigned right or left side. Two weeks later, a session of plaque score records identical to the baseline measurements was started. The maxillary second molars showed higher cervical accessibility than the first molars(p<0.01), but the plaque scores of maxillary second molars were also higher than those of first molars(p<0.01). For the maxillary first molars, correlation between accessibility and plaque score was statistically significant, but such correlation was not found for the second molars. Use of unitufted brushes decreased the plaque score(p<0.01). Correlation between accessibility and the degree of plaque score improvement was not found. These findings suggest that cervical accessibility may influence the amount of plaque, and use of adjunctive oral hygiene devices may be helpful in maintaining optimal oral hygiene level at the areas of low cervical accessibility.
Gingiva ; Humans ; Molar* ; Oral Hygiene ; Students, Dental ; Tooth

Migration of an implantable port catheter tip is one of the well-known complications of this procedure, but the etiology of this problem is not clear. We describe here a case of migration of the tip of a port catheter from the right atrium to the right axillary vein in a patient with severe cough. Coughing was suggested for this case as the cause of the catheter tip migration. We corrected the position of the catheter tip via transfemoral snaring.
Axillary Vein ; Catheters, Indwelling/*adverse effects ; Cough/*complications ; Device Removal/*methods ; Foreign-Body Migration/*etiology/radiography ; Heart Atria ; Humans ; Lung Neoplasms/drug therapy ; Male ; Middle Aged

MRI (magnetic resonance imaging ) had been the most up-to-dated modality in evaluating white matter disease in recent years, whereas US (ultrasonogram) has been used extensively in diagnosis of neonatal PVL(periventricular leukomalacia) conventionally. We evaluated the diagnostic value of MRI by reviewing the MR findings and correlation of MR and US of PVL in II preterm infants. Evaluation criteria were MR signal intensity and discrimination of PVL on each pulse sequences land comparision between MR and US findings performed simultaneously, on the extent of PVL, size of the largest cyst and detectability of hemorrhagic lesion. MR findings of 11 cases of PVL were of low signal patterns on T1WI (T1weighted image) in 7, low signal patterns of PDWI (proton density weighted image) in 9, iso signal patterns on T2WI(T2weighted image) in 8 and low signal patterns on STIR(short time inversion recovery) in 7 cases. The lesions of 11 PVL were well discriminated in all 11 cases of T1WI, 7 cases of STR, 5 case of PDWE and 2 cases of T2WI. The lateral ventricle was diffuse dilated (n=1) and focally dilated (n=3) in atrial area. In the comparative study, MR presented more extensive lesions in 7 cases, larger cysts in 6 cases out of 7 PVL and more definitive hemorrhage in 3 cases out of 4 cases than sonography. In conclusion MR was more valuable than sonography in evaluating the extent of lesions, size of the largest cystic lesion and detetion of hemorrhage. TIWI and STIR images were more useful in detection of PVL than T2WI and PDWI.
Diagnosis ; Discrimination (Psychology) ; Hemorrhage ; Humans ; Infant, Newborn ; Infant, Premature ; Lateral Ventricles ; Leukoencephalopathies ; Magnetic Resonance Imaging

Pericardial cysts have been recognized as infrequent benign intrathoracic lesions, and are mainly found by accident. Recently, we experienced 3 cases of pericardial cysts. We report these case with the brief review of literature.
Mediastinal Cyst*