Manganese is an essential element in the body. It is mainly diposited in the liver and to a lesser degree in the basal ganglia of the brain and eliminated through the bile duct. Rapid turnover of manganese in the body makes it difficult to evaluate the manganese exposure in worker, especially in those with irregular or intermittent exposure, like welder. Therefore, conventional biomarkers, including blood and urine manganese can provide only a limited information about the long-term or cumulative exposure to manganese. Introduction of magnetic resonance imaging (MRI) made a progress in the assessment of manganese exposure in the medical conditions related to manganese aculmulation, e. g., relaxation time on MRI due to its paramagnetic property, resulting in high signal intensity(HSI) on T1-weighted image(T1WI) of MRI. Manganese deposition int he brain, therefore, can be visualized as an HSI in the globus pallidus, the substantia nigra, the putamen and the pituitary. Clinical and epidemiologic studies regarding the MRI findings in the cases of occupational and non-occupational manganese exposure were reviewed. Relationships between HSI on T1WI of MRI and age, gender, occupational manganese exposure, and neurological dysfunction were analysed. Relationship between biological exposure indices and HSI on MRI were also reviewed. Literatures were reviewed to establish the relationships between HSI, manganese deposition in the brain, pathologic findings, and neurological dysfunction. HSI on T1WI of MRI reflects regional manganese deposition in the brain. This relationship enables an estimation of regional manganese deposition in the brain by analysing MR signal intensity. Manganese deposition in the brain can induce a neuronal loss in the basal ganglia but functional abnormality is supposed to be related to the cumulative exposure of manganese is relatively too short to reflect the long-term cumulative exposure of manganese in the brain, use of brain MRI for the assessment of exposure in a group of workers seems to be hardly rationalized, while it can be a useful adjunct for the evaluation of manganese exposure in the cases with suspected manganese-related health problems.
Basal Ganglia ; Bile Ducts ; Biomarkers ; Brain* ; Epidemiologic Studies ; Globus Pallidus ; Liver ; Magnetic Resonance Imaging* ; Manganese* ; Neurons ; Putamen ; Relaxation ; Substantia Nigra

Adenoid cystic carcinoma of the major salivary gland is a relatively rare tumor which is well known for its high local recurrence rate and frequent distant metastasis. Metastasis of this tumor to kidney has not been reported previously to our knowledge. We report two cases of renal metastasis from adenoid cystic carcinoma of the salivary gland.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Kidney ; Neoplasm Metastasis* ; Recurrence ; Salivary Glands*

No abstract available.
Pulmonary Edema*

No abstract available.
Arteriovenous Fistula*

PURPOSE: The purpose of this study is to evaluate that sequential CT scans after oral contrast ingestion can show morphological and functional status of the biliary tree, especially for the gallbladder and assess whether the CT scans demonstrate other radiological informations than conventional oral cholecystography. MATERIALS AND METHODS: Thirty volunteers in third decades and eight patients with hepatobiliary disease were included for the study. CT scans were obtained 3, 6, 9, 12 hours after oral contrast ingestion and thirty minutes after fat meal in thiry volunteers. Conventional oral cholecystography was also obtained in all volunteers at 12 hours after oral contrast ingestion and after fat meal. We evaluate opacification of gallbladder, biliary tree, and duodenum by contrast media on CT scans and attenuation values of gallbladder, common hepatic duct and common bile duct in each artatomic area on CT and its sequential change. CT scans were performed 6 hours after oral contrast ingestion in eight patients with hepatobiliary disease. And gallbladder function was evaluated by opacification of gallbladder by contrast media in all patients. RESULTS: In thirty volunteers, opacified gallbladder by contrast media was seen in all cases in all sequential periods of time on CT scans, but in 22 cases on conventional oral cholecystography. Contrast-filled intrahepatic ducts were demonstrated in 3 cases at 3 hours after oral contrast ingestion and 11 cases at 6 hours and were not seen thereafter. Contrast-filled common hepatic duct was noted in 28, 18 and 4 cases respectively at 3, 6 and 9 hours after oral contrast ingestion and the CT attenuation values of common hepatic ducts had become progressively decreased. Contrast-filled common bile duct was noted in 28, 18 and 4 cases respectively at 3, 6 and 9 hours and the CT attenuation values of common bile ducts were not changed untill 9 hours but slightly increased at 12 hours. Contrast media was noted in 7, 5, 6 and 5 cases at 3, 6, 9, and 12 hours in cystic duct and 8, 3, 2, 5 cases in duodenum. Contrast-filled cystic duct and duodenum were noted in 24 cases and 19 cases respectively on CT scans after fat meal. The CT attenuation values of gallbladder were increased in sequential periods of time and the difference of density of gallbladder between 3 hours and 6 hours was statistically significant(p=0.0001). The CT attenuation values of gallbladder at 6 hours were heighter than that in 3 hours, statistically. Opacified gallbladder were noted in 2 cases of fatty liver(n=2), 1 case of alcoholic liver disease(n=1), in 1 case of liver cirrhosis(n=1). Patients of gallbladder stone(n=2) or hepatocellular carcinoma (n=2) had non-opacified gallbladder on CT scans. CONCLUSION: The CT scans after oral contrast ingestion can show the morphological and functional aspects of gallbladder better than conventional oral cholecystography and can also show biliary trees and other surrounding structures, so it is helpful method for assessment of not only gallbladder diseases but also other hepatobiliary diseases.
Alcoholics ; Bile Ducts* ; Bile* ; Biliary Tract ; Carcinoma, Hepatocellular ; Cholecystography ; Common Bile Duct ; Contrast Media ; Cystic Duct ; Duodenum ; Eating* ; Gallbladder Diseases ; Gallbladder* ; Hepatic Duct, Common ; Humans ; Liver ; Meals ; Tomography, X-Ray Computed ; Volunteers

Both idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease(CVD) are well known cause of diffuse interstitial lung disease which lead to fibrosis and honeycombing. We analyzed HRCT findings of 33 patients with IPF and 14 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change and pulmonary volume loss. Criteria of mediastinal lymph node enlargement and pleural thickening were 15mm in long diameter and 3mm, respectively. Volume loss of the lung was measured by using hilar height ratio (apex to hilum/hilum to diaphragmatic dome). Mean age was 61 years for IPF and 46 years for CVD and male: female ratio was 27:6, 4:10, respectively. Predominant HRCT pattern was honeycombing for IPF (63%), and ground-glass opacity for CVD (66%) (p=0.001). Predominantly, subpleural involvement was seen in 90% for IPF and 74% for CVD. Mediastinal lymph node enlargement was seen in 47% of the patient with IPF and 14% with CVD (p=0.004). pleural thickening was seen in 97% of the patients with IPF and 42% with CVD (P=0.002), Pleural effusion was seen in 10% of the patients with IPF and 36% with CVD (P=0.009). Hilar height ratio of more than 1.5 was seen in 84% of the patients with IPF and 29% with CVD. In conclusion, our study shows that patients with IPF are prone to have more progressed stage of pulmonary fibrosis than the patients with CVD on HRCT.
Collagen* ; Female ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung ; Lung Diseases, Interstitial ; Lymph Nodes ; Male ; Pleural Effusion ; Pulmonary Fibrosis

PURPOSE: To describe MR findings of cerebral venous sinus thrombosis. MATERIALS AND METHODS: We reviewed 11 MR images of six patients with cerebral venous sinus thrombosis. The MR images were retrospectively analyzed in terms of location and signal intensity of the thrombi, parenchymal lesions such as hemorrhage and edema, and changes in follow-up study obtained in 4 patients. RESULTS: The thrombus in venous sinus was visualized on MRI in all six patients. The most frequently involved sites were superior sagittal sinus(n=4) and left transvere sinus(n=4). Signal intensity of the thrombus was isointense or hyperintense on both T1 - and T2-weighted images with loss of normal signal void of the sinus on all sequences in all patients. Parenchymal lesion was present in five of six cases, manifested as local hemorrhage in three and edema in three cases(one case overlapped). Local edema seen in three patients was completely resolved on follow-up study of seven to 29 days intervals. CONCLUSION: It is concluded that iso- or high signal intensity with loss of signal void in venous sinus is virtually diagnostic of venous sinus thromosis. If there are local parenchymal lesions such as hemorrhage and/or edema of unknown causes, cerebral venous sinus thrombosis should be included in differential diagnosis.
Diagnosis, Differential ; Edema ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Sinus Thrombosis, Intracranial* ; Thrombosis

PURPOSE: To know the normal CT appearance of the anterior skull base and nasal septum after birth. MATERIALS AND METHODS: Coronal CT scans with a helical mode were performed from the nasal bone to the sphenoid sinus in 99 children whose ages ranged from 27 days to 14 years. We investigated the CT appearance of the developing anterior skull base and nasal septum with particular attention to the anteroposterior length of the anterior skull base and the ossification patterns of the cribriform plate, perpendicular plate, crista galli, and vomer. RESULTS: The anteroposterior length of the anterior skull base statistically significantly increased with age. The cribriform plate showed partial or complete ossification in at least one segment at more than 3 months of age and in all three segments at more than 6 months of age. Ossification of the cribriform plate occurred earlier in the middle segment than in the anterior and posterior segments. It began exclusively in the region of the lateral mass of the ethmoid and proceeded medially toward the crista galli. Partial ossification of the perpendicular plate was noted as early as 9 months of age, and complete ossification as early as 13 months of age. All children at 18 months and older showed at least partial ossification of the perpendicular plate. Partial ossification of the crista galli was noted as early as 27 days of age, and complete ossification as early as 3 months of age. CT showed complete ossification of the crista galli in all but two children at 6 months and older. The superior aspect of the vomer exhibited a V- or Y-shape on all CT scans in 66%(65/99) of children at any age. It appeared as an undivided single lump anteriorly and a V or Y posteriorly in 34%(34/99). CONCLUSION: Knowledge of the normal developing patterns of ossification of the anterior skull base and nasal septum could help prevent errors in interpreting CT scans in this region, especially in infants and young children.
Child ; Ethmoid Bone ; Humans ; Infant ; Nasal Bone ; Nasal Septum* ; Parturition ; Skull Base* ; Skull* ; Sphenoid Sinus ; Tomography, X-Ray Computed ; Vomer

PURPOSE: The clinical significance of preoperative serum levels of CEA and CA19-9, levels of CEA and CA19-9 in peritoneal washing fluid and free cancer cells in peritoneal washing fluid in gastric cancer patients were evaluated in this study. MATERIALS AND METHODS: Serum and peritoneal levels of CEA and CA19-9 and peritoneal washing cytology in 115 patients with gastric cancer were analyzed with respect to the prognostic factors using univariate and multivariate analysis. RESULTS: Positive rate of serum CEA and CA19-9 was 16.5%, 13.0%. And that of peritoneal washing CEA, CA19-9 and cytology was 15.7%, 7.8% and 9.6%. A univariate analysis showed that tumor markets in serum and peritoneal washing fluid and peritoneal washing cytology had significant correlations with the progression of the tumors, and patients with positive serum or peritoneal tumor markers had poorer survival after operation than did the patients with negative tumor markers. But in a multivariate analysis showed that only peritoneal CA19-9 was an independent risk factor. And combination of these five markers provided rnore predictable prognostic informations in a multivariate analysis. CONCLUSION: Combination of serum or peritoneal levels of CEA, CA19-9 and washing cytology appeared to be a useful marker for managing gastric cancer patients.
Humans ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; Biomarkers, Tumor

Carbamylated hemoglobin (CarHb) is formed by the reaction of hemoglobin with cyanate derived from the spontaneous dissociation of in vivo urea. Previous studies have shown that formation of CarHb depends upon both the severity and the duration of renal failure. To study the clinical significances of CarHb in Korean patients with chronic renal failure, we measured CarHb levels by high-performance liquid chromatography in 159 CRF patients and 46 normal controls. Patients with CRF had a higher CarHb concentration than normal controls (107.9+/-58.8 vs 35.1+/-14.2 microgramVH/gHb; P<0.001). In patients with CRF, nondialysis group had a higher value than dialysis group (129.8+/-77.9 vs 98.7+/-46.1 microgramVH/gHb; P<0.05). There were no siginificant difference in CarHb levels between hemodialysis (92.0+/-35.8microgramVH/gHb) and peritoneal dialysis (106.7+/-55.3microgramVH/gHb) groups. CarHb levels were not different between diabetic and nondiabetic patients in predialysis and hemodialysis groups. Although there was a significant difference in peritoneal dialysis group, the BUN levels were also lower in diabetic patients than nondiabetic patients. There were no correlation between CarHb and HbA1c percentage in patients with diabetes. CarHb levels were positively correlated with BUN (r=0.489; P<0.001) and creatinine (r=0.458; P<0.01) concentrations. There were negative correlations between CarHb and both Kt/V (r=-0.358; P<0.05) and URR (r=-0.415; P<0.05) in hemodialysis patients. In conclusion, CarHb may be a useful index of uremic control in patients with chronic renal failure, and are independent of the mode of dialysis and the presence of diabetes.
Chromatography, Liquid ; Creatinine ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Renal Dialysis ; Renal Insufficiency ; Urea