PURPOSE: Results of 181 percutaneous needle aspiration biopsies performed with an 18-gauge needle during a period of 3 years were analyzed to determine efficacy and safety of the procedure. MATERIALS AND METHODS: Biposies were performed in patients that could not be diagnosed by bronchoscopy or sputum cytology. The biopsy procedure with 18-gauge Crown needle was guided by fiuoroscopy. The biopsy specimen placed in 10% formalin solution were histologically confirmed. RESULTS: In 160 patients(89%), the positive diagnosis was made by percutaneous needle aspiration biopsy. There were 153 lung lesions(120 malignant and 33 benign lesions) and 7 mediastinal lesions. the diagnostic accuracy of malignant and benign disease was 91% and 80% respectively. Complications included pneumothorax(n=11) and hemothorax(n=l):six of them required treatment with chest tube and the remainder showed spontaneous resporption. CONCLUSION: PCNB with an 18-gauge needle provided a reliable, relatively safe diagnostic tool to establish the diagnosis of both malignant and benign chest lesions.
Biopsy ; Biopsy, Needle* ; Bronchoscopy ; Chest Tubes ; Crowns ; Diagnosis ; Formaldehyde ; Humans ; Lung ; Needles* ; Sputum ; Thorax*

PURPOSE: Results of 181 percutaneous needle aspiration biopsies performed with an 18-gauge needle during a period of 3 years were analyzed to determine efficacy and safety of the procedure. MATERIALS AND METHODS: Biposies were performed in patients that could not be diagnosed by bronchoscopy or sputum cytology. The biopsy procedure with 18-gauge Crown needle was guided by fiuoroscopy. The biopsy specimen placed in 10% formalin solution were histologically confirmed. RESULTS: In 160 patients(89%), the positive diagnosis was made by percutaneous needle aspiration biopsy. There were 153 lung lesions(120 malignant and 33 benign lesions) and 7 mediastinal lesions. the diagnostic accuracy of malignant and benign disease was 91% and 80% respectively. Complications included pneumothorax(n=11) and hemothorax(n=l):six of them required treatment with chest tube and the remainder showed spontaneous resporption. CONCLUSION: PCNB with an 18-gauge needle provided a reliable, relatively safe diagnostic tool to establish the diagnosis of both malignant and benign chest lesions.
Biopsy ; Biopsy, Needle* ; Bronchoscopy ; Chest Tubes ; Crowns ; Diagnosis ; Formaldehyde ; Humans ; Lung ; Needles* ; Sputum ; Thorax*

Levodopa treatment in Parkinson's disease (PD) can cause a wide range of non-motor manifestations including poor impulse control and stereotyped behaviors. Punding is a term used to describe complex prolonged, purposeless and repetitive behavior in patients under dopamine replacement therapy. We report a 64-year-old PD patient who, concomitantly with self-increment of levodopa, developed punding behaviors in association with dopamine dysregulation syndrome. Gradual reduction of dopaminergic medication partially alleviated repetitive behavior over time.
Dopamine ; Humans ; Levodopa ; Middle Aged ; Parkinson Disease ; Stereotyped Behavior

The components of bore marrow change dramatically during lifetime. To evaluate the bone marrow of cranium and upper cervical spine, the authors retrospectively evaluated 300 examinations of cranium and the second cervical bone in patients without known bone marrow abnormality. T1-weighted images were used to analyze the changes of lone marrow signal intensity according to the age and sex. The signal intensity of bone marrow of cranium increased most rapidly from birth to age of 10 years. Between 11 and 20 years of age, gradual increase of signal intensity was noted. There was minimal augment of signal intensity after age of 20 years. The examination of signal intensity of bone marrow of the cranium revealed slightly higher score in male than in female. The synchondrosis of the second cervical vertebra was visible in 97%. These results may be useful in the detection of abnormal bone marrow signal of cranium and upper cervical spine.
Bone Marrow* ; Female ; Humans ; Male ; Parturition ; Retrospective Studies ; Skull* ; Spine*

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system that leads to neurological disability. The diagnosis of MS relies on the MRI criteria, which can demonstrate dissemination in space and time. Exclusion of other demyelinating mimics is essential because there are no specific biomarker for MS and MRI criteria are still have imperfect. There is incremental improvements in MS treatment option that have contributed to the delay of disease progression. The early initiation of DMT may ameliorate the neurological disability. In this review, we discusses the new diagnostic MS criteria and summarize the evidences supporting the early treatment in the course of MS.
Central Nervous System ; Demyelinating Diseases ; Diagnosis ; Disease Progression ; Early Diagnosis* ; Magnetic Resonance Imaging ; Multiple Sclerosis*

PURPOSE: Congenital Iobar agenesis of the liver is a rare anomaly. We report five cases (three cases of right Iobar agenesis and two cases of left Iobar agenesis) and discuss the radiologic findings of this congenital anomaly. MATERIALS AND METHODS: Between July, 1992 and February, 1993, three cases of right Iobar agenesis and two cases of left Iobar agenesis of the liver were diagnosed by means of computed tomography(CT) and/or sonography. MR imging was performed in two patients, cholangiography in two, and digital subtraction angiography in one. RESULTS: The main findings of right Iobar agenesis of the liver were nonvisualization of the right portal vein and absence of liver tissue to the right of gallbladder. The findings of left Iobar agenesis were nonvisualization of left portal vein, absence of liver tissue to the left of the gallbladder, and absence of ligamentum teres. The ancillary finding of the Iobar agenesis was visualization of less than three hepatic veins. CONCLUSION: It is important to consider Iobar agenesis of the liver in differential diagnosis when imaging studies reveal abnormal portal vein branches, unusual position of gallblader, absence of ligamentum teres, and visualization of less than three hepatic veins.
Angiography, Digital Subtraction ; Cholangiography ; Diagnosis, Differential ; Gallbladder ; Hepatic Veins ; Humans ; Liver ; Portal Vein

No abstract available.
Humans ; Myasthenia Gravis ; Myositis ; Thymus Neoplasms

For quality assurance purposes, the authors correlated aspiration cytology and subsequent tissue findings and examined the reasons for discrepancies. In three months from Jan. to Mar. 1996, 1,383 aspirations were performed, of which 285 (20.6%) had subsequent tissue diagnoses within two months. The aspiration sites were thyroid (483), lymph node (LN) (290), breast (250), soft tissue (154), liver (89), lung (49), salivary gland (26), pancreas (22), gallbladder (3), bone (3), joint (2), adrenal gland (2), scrotum (2), mediastinum (2), omentum (2), oral cavity (1), chest wall (1), and intraabdominal (1) and pelvic cavities (1). A total of 68 discrepancies were identified, and biopsies and smears from these cases were reviewed monthly. In 27 cases (40%), the discrepancy was attributed to sampling error. In five cases (9%), aspiration gave superior results with better sampling and preservation than biopsy. Thirty six cases (53% of discrepant cases) were errors in cytologic diagnosis. We categorized these discrepancies into "A", "B", and "C" ("A": minor disagreement with no affect on patient care, "B": minimal affect on patient care, "C": major affect on patient care), which were 9 (13%), 14 (21%) and 13 (19%) cases, respectively. In thirteen cases of category "C", there were eleven false negative and two false positive diagnoses. Eleven false negative cases included thyroid (3), lymph node (2), breast (2), bone (1), salivary gland (1), lung (1), and liver (1). Three cases of thyroid were papillary carcinomas diagnosed as nodular hyperplasia (1), occasional pleomorphic cells (1), and cystic change (1). Two breast cases of invasive ductal carcinomas were diagnosed as ductal hyperplasia. A malignant lymphoma was diagnosed as reactive hyperplasia and a metastatic carcinoma of LN was diagnosed as tuberculosis. Other cases were malignant tumors of bone, salivary gland, lung, and liver those were misinterpreted as benign lesion or normal. Of two false positive cases, one was nodular hyperplasia of thyroid diagnosed as papillary carcinoma and the other was normal islet cell of pancreas diagnosed as islet cell tumor. A continuous monitoring of laboratory performance is an essential component of the quality control and assurance, and the review of discrepant cases provides useful information for improvement of diagnosis.
Adenoma, Islet Cell ; Adrenal Glands ; Aspirations (Psychology) ; Biopsy ; Breast ; Carcinoma, Ductal ; Carcinoma, Papillary ; Diagnosis ; Gallbladder ; Humans ; Hyperplasia ; Islets of Langerhans ; Joints ; Liver ; Lung ; Lymph Nodes ; Lymphoma ; Mediastinum ; Mouth ; Omentum ; Pancreas ; Patient Care ; Quality Control ; Salivary Glands ; Scrotum ; Selection Bias ; Thoracic Wall ; Thyroid Gland ; Tuberculosis

No abstract available.
Carcinoma, Hepatocellular* ; Diagnosis*

The lateral margin of the psoas muscle, contrasted by retroperitoneal fat, is usually visualized o plainabdominal radiography. Failure to visualize all or segment of lateral margin of the psoas muscle, so called psoassing, has been emphasized as reliable finding of retroperitoneal pathology. But the significance of psoas sign hasbeen controversial. The authors reevaluated ‘psoas sign’ by comparing 160 abdominal radiography with CT. Theresults were as follows: 1. In 160 supine radiographys, good visualization was present in 106 cases(66.3%), faintvisualizatin in 24(15.0%), segmental nonvisualization in 18(11.3%), and completer nonvisualization in 12(7.5%). In113 erect radiographs, good visualization was present in only 36 cases(31.9%). 2. Asymmetric visualization waspresent in 84 out of 160 cases. In patient with scoliosis, lateral margin of convex side was seen more clearlythan concave side, and this finding was statistically significant (p<0.005). 3. Ascites did not directly influenceto psoa visualization contrary to common belief. 4. In 54 cases of faint or nonvisualization, normal was16(29.6%), intraperitoneal pathology was 16(29.6%), and retroperitoneal pathology was 22(40.7%). 1) In normalpatient, psoas contact with kidney or intestine and deformed psoas muscle were responsible for poor visualization. 2) The major cause of poor visualization in intraperitoneal pathology were psoas contact with displaced kidney byhepatomegaly, ascites with scanty retroperitoneal fat and derformed psaos muscle. 3) The major cause of poorvisualization in retroperitoneal pathology were psoas invasion by tumor or inflammation, psoas conntact withenlarged kidney or perirenal lesion. 5. In summary, the mechanism of faint or nonvisualization of psoas marginwere: 1) psoas contact with normal or pathologic organs 2) psoas invasion by tumor or inflammation 3) deformedpsoas muscle 4) scanty retroperitoneal fat
Ascites ; Humans ; Inflammation ; Intestines ; Intra-Abdominal Fat ; Kidney ; Pathology ; Psoas Muscles ; Radiography ; Radiography, Abdominal ; Scoliosis