PURPOSE: To date, the high spatial frequency algorithm (HSFA) which reduces image smoothing and increases spatial resolution has been used for the evaluation of parenchymal lung diseases in thin-section high-resolution CT. In this study, we compared the ultrahigh spatial frequency algorithm (UHSFA) with the high spatial frequency algorithm in the assessment of thin section images of the lung parenchyma. METHODS AND MATERIALS: Three radiologists compared the UHSFA and HSFA on identical CT images in a line-pair resolution phantom, one lung specimen, 2 patients with normal lung and 18 patients with abnormal lung parenchyma. RESULTS: Scanning of a line-pair resolution phantom demonstrated no difference in resolution between two techniques but it showed that outer lines of the line pairs with maximal resolution looked thicker on UHSFA than those on HSFA. Lung parenchymal detail with UHSFA was judged equal or superior to HSFA in 95% of images. Lung parenchymal sharpness was improved with UHSFA in all images. Although UHSFA resulted in an increase in visible noise, observers did not found that image noise interfered with image interpretation. The visual CT attenuation of normal lung parenchyma is minimally increased in images with HSFA. The overall visual preference of the images reconstructed on UHSFA was considered equal to or greater than that of those reconstructed on HSFA in 78% of images. CONCLUSION: The ultrahigh spatial frequency algorithm improved the overall visual quality of the images in pulmonary parenchymal high-resolution CT.
Humans ; Lung Diseases ; Lung* ; Noise

PURPOSE: To describe HRCT findings in five patients with pathologically proved acute interstitial pneumonia MATERIALS AND METHODS: This study included 5 patients with pathological and clinical diagnosis of acute interstitial pneumonia. Mean age of the patients was 40(range, 31-53 years). CT scans were reviewed by two chest radiologists retrospectively. CT scans were assessed for the presence and distribution of ground-glass attenuation, air-space consolidation, interlobular septal thickening, honeycombing, and pleural effusion. RESULTS: The area of ground-glass attenuation and air-space consolidation were seen at HRCT in all 5 patients. These lesions were distributed diffusely in both lungs, but involved predominantly subpleural lungs in 2 patients and posterior lungs in 3 patients. Three patients had mild interlobular septal thickening. None of them showed honeycombing. Three of the 5 patients died within 52 days of initial manifestation. CONCLUSION: Acute interstitial pneumonia differs from the more chronic form of idiopathic interstitial pneumonia in their HRCT findings.
Diagnosis ; Humans ; Idiopathic Interstitial Pneumonias ; Lung ; Lung Diseases, Interstitial* ; Pleural Effusion ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

PURPOSE: Transaxillary and periareolar incision in augmentation mammaplasty has risks of injury to branches of intercostal nerves that lead to sensory loss of upper inner arm and nipple. The aim of study was to compare the incidence of sensory loss between two groups according to incision method. METHODS: One hundred seventy one cases that received transaxillary or periareolar subpectoral breast augmentation at the M.D. Clinic from Jan. 2006 to Jul. 2007 were evaluated for sensory loss of upper inner arm and nipple. The cases were divided into transaxillary (118 cases, 69%) and periareolar group (53 cases, 31%). The type of sensory loss was divided into temporary and permanent. The postoperative follow-up periods were from 7 to 22 months (mean: 8.5 months). RESULTS: In cases of upper inner arm, results were as follows; temporary sensory loss in 9 cases (7.6%) and permanent in 2 cases (1.7%) in the transaxillary incision group and, temporary sensory loss in 1 case (1.9%) and no permanent sensory loss in the periareolar incision group. There is no statistical difference between the two groups for permanent sensory loss (P=0.340). In cases of nipples, results were as follows; temporary sensory loss in 26 cases (22%) and permanent sensory loss in 12 cases (10.2%) in the transaxillary incision group, and temporary sensory loss in 12 cases (10.2%) and permanent sensory loss in 3 cases (5.7%) in the periareolar incision group. There was no statistical difference between two groups (P=0.335). CONCLUSION: There was no statistical difference in sensory loss of upper arm and nipple between transaxillary and periareolar approach after subpectoral augmentation mammaplasty.
Arm ; Breast ; Female ; Follow-Up Studies ; Incidence ; Intercostal Nerves ; Mammaplasty ; Nipples

PURPOSE: To investigate the clinical outcomes of scleral buckle encircling surgery for the retinal detachment of retinopathy of prematurity (ROP). METHODS: The medical records of the patients who had undergone primary scleral buckle encircling for the retinal detachment of ROP (4A, 4B, 5) between January 1989 and March 2002 were retrospectively reviewed. RESULTS: Of the 59 patients (M:F ratio= 32:27, 83 eyes), the mean gestational age, birth weight, and follow-up period were 29.2 weeks, 1244gm, and 52.8 months respectively. Just before scleral buckle encircling surgery there were 48 eyes of stage 4A, 19 of stage 4B, and 16 of stage 5. Attachment of posterior pole retina was achieved in 66.7%, 63.2%, and 25% of eyes, respectively. Final best corrected visual acuity in eyes with attached posterior pole retina was generally poor, and the rate of vision over 20/1000 was 30.3% (10/33) in the verbal group and the rate of vision with moderate fix and follow was 75% (9/12) in the nonverbal group. The mean induced anisometropia after scleral buckle encircling surgery was -12.1 D. The mean reduced myopia after removal of scleral buckling material was 3.4 D. CONCLUSIONS: An anatomic success after scleral buckle encircling surgery in infant with retinal detachment of ROP was fairly achieved, but the final results depended on the extent of retinal detachment. Although the retina was attached after surgery, a severe degree of myopia developed and resulted in low vision. Therefore once retinal detachment develops in infants with ROP, early surgery is required. Furthermore, to maximize the vision, efforts for correcting refractive errors should be made intensively.
Anisometropia ; Birth Weight ; Follow-Up Studies ; Gestational Age ; Humans ; Infant ; Medical Records ; Myopia ; Refractive Errors ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Retinopathy of Prematurity* ; Retrospective Studies ; Scleral Buckling ; Vision, Low ; Visual Acuity

PURPOSE: To evaluate the findings and the role of CT in plexiform neuro-fibromatosis of the mediastinum. MATERIALS AND METHODS: We retropectively reviewed the CT scans of five patients with plexiform neurofibromatosis of the mediastinum. The CT scans were reviewed with attention to the distribution of the lesions, appearance and attenuation of mediastinal lesions, enhancement pattern after intravenous contrast infusion and associated findingssuch as intercostal neurofibroma. RESULTS: In all five patients CT scans demonstrated fusiform low attenuated masses which were oriented longitudinally and extended over multiple contiguous scans along the distribution of major mediastinal nerves. In four patients, mediastinal lesions appeared infiltrative, obliterating adjacent mediastinal fat plane. One patient had well defined fusiform masses along the major mediastinal nerves. Postcontrast enhanced CT scans revealed slight central enhancement in two patient and no contrast enhancement in three patients. Associated findings such as neurofibromas of intercostal nerves and sympathetic trunk, or subcutaneous neurofibromas were detected on CTscans in all five patients. CONCLUSION: Characteristic CT findings of low attenuation masses along the major mediastinal nerves are helpful to differentiate plexiform neurofibromatosis from mediastinal lymphadenopathy and to prevent from misreading as a malignant disease.
Humans ; Intercostal Nerves ; Lymphatic Diseases ; Mediastinum* ; Neurofibroma ; Neurofibromatoses* ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to evaluate the high-resolution CT features of Swyer-James syndrome with special attention to the airway lesions and to determine the clinical utility of high-resolution CT compared with that of chest radiography. MATERIALS AND METHODS: In seven patients with Swyer-James syndrome, we retrospectively reviewed chest radiographs obtained during inspiration and expiration and high-resolution CT scans obtained in inspiration. The high-resolution CT appearance was evaluated and compared with that of chest radiography. RESULTS: On both chest radiographs and high-resolution CT, the affected lung volume was relatively diminished in four patients and normal in three patients. In all seven patients, chest readiographs showed hyperlucency of the lung which was unilateral in four and bilateral in three patients. Unilateral small hilum was seen in six patients and bronchiectasis was demonstrated in one patient on chest radiographs. The hyperlucent lung volume was not diminished on expiratory radiographs in all seven patients. In all patients, high-resolution CT demonstrated low attenuation regions of the lung either bilaterally(n=5) or unilaterally(n=2). Pulmonary vessels were markedly decreased in size and number in the lung parenchyma with low attenuation. Six patients had bronchiectasis on high-resolution CT, which were cylindrical or varicose in five and cystic in one. Bronchiolectasis was observed in three patients on high-resolution CT. CONCLUSION: The high-resolution CT findings are characteristic of Swyer-James syndrome. High-resolution CT is more sensitive than chest radiography in detecting regions of low attenuation and bronchiectasis and may be useful for the diagnosis of Swyer-James syndrome. Our results suggest that bronchiectasis is a frequently associated airway lesion of Swyer-James syndrome and bronchiolectasis may be associated in some cases.
Bronchiectasis ; Diagnosis ; Humans ; Lung ; Lung, Hyperlucent* ; Radiography ; Radiography, Thoracic ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

A reproducible noninvasive technique for measuring right ventricular ejection fraction (RVEF) was developed using first pass quantitative radionuclide angiocardiography. Tests were carried out in the right anterior oblique position with a computerized multicrystal scintillation camera with high count rate capabilities. RVEF was calculated on beat to beat basis from the high frequency components of the background-corrected right ventricular time-activity curve. The following results were obtained; 1) In 10 normal adults, RVEF averaged 50.9+/-8.2. In 20 patients with chronic obstructive lung diseases (COPD), RVEF was 37.9+/-6.1% and significantly lower than that of normal persons(P<0.005). 2) There was meaningful correlation between RVEF and forced expiratory volume (FEVI) in patients with COPD (r=0.51). And there was significant difference of RVEF between 13 patients with FEVI less than IL/min (6 patients with right ventricular failure, 7 patients with patients without that) and 7 patients with FEVI IL/min or more (35.7+/-6.0%, 42.1+/-3.2% respectively. P<0.005). 3) All 6 patients with clinical manifestation of right heart failure had abnormal RVEF and had FEVI less than IL/min, which was significantly lower than that of 14 patients without clinical manifestation of right heart failure (33.6+/-4.8%, 39.8+/-5.6%, respectively. P<0.005). 4) In 14 patients without clinical manifestation of right heart failure, 11 patients among whom 7 patients had FEVI less than IL/min, had abnormal RVEF.
Adult ; Angiocardiography ; Forced Expiratory Volume ; Gamma Cameras ; Heart Failure ; Humans ; Lung Diseases, Obstructive* ; Pulmonary Disease, Chronic Obstructive ; Radionuclide Ventriculography* ; Stroke Volume ; Ventricular Function, Right*

PURPOSE: To evaluate the patterns of pseudo-lesions present on spiral CT hepatic arteriography (CTHA). MATERIALS AND METHODS: One hundred and seventy five patients (161 men and 14 women, aged 15-70 years [mean, 52 years]) who underwent spiral CTHA for the detection of hepatic lesions were retrospectively reviewed.Pseudo-lesion type was determined by comparing hyperattenuating lesions on CTHA with the findings of ultrasonography, conventional or multi-phase CT, Lipiodol CT, angiography, CT arterial portography(CTAP), and follow-up of spiral CTHA. Pseudo-lesions were classified according to site, size and shape. RESULTS: A total of 77 pseudo-lesions were found in 56 of the 175 patients(32.6%), and were classified into the following types :peritumoral(n=18), segment I(n=3), segment IV(n=3), gallbladder fossa (n=13), subsegmental (n=3), subcapsular(n=13), straight line sign (n=10), arterioportal shunt (n=13), and technical error (n=1). Fifteen of 77 pseudo-lesions(19.5%) showed hyperattenuation on CTHA and iso attenuation on CTAP, in contrast to adjacent liverparenchyma. CONCLUSION: In patients with hepatic mass, it is very important to understand the characteristicsite, shape and size of pseudo-lesions for the correct interpretation of CT and subsequent management of thepatient.
Angiography* ; Ethiodized Oil ; Female ; Gallbladder ; Humans ; Male ; Retrospective Studies ; Tomography, Spiral Computed*

PURPOSE: We present a case of photodynamic therapy (PDT) with verteporfin for choroidal neovascularization (CNV) complicated by Vogt-Koyanagi-Harada syndrome. METHODS: A 46-year-old male who had bilateral subfoveal CNV complicated by Vogt-Koyanagi-Harada syndrome underwent 3 sessions of PDT with verteporfin in 1 year. RESULTS: After 3 sessions of PDT with verteporfin, maintenance of visual acuity was achieved without any complication as alteration of retinal pigment epithelium and aggravation of intraocular inflammation, but subfoveal fibrosis developed. CONCLUSIONS: PDT with verteporfin is a good treatment method without any complication for the CNV complicated by Vogt-Koyanagi-Harada syndrome, even though multiple sessions were needed.
Choroid* ; Choroidal Neovascularization* ; Fibrosis ; Humans ; Inflammation ; Male ; Middle Aged ; Photochemotherapy* ; Retinal Pigment Epithelium ; Uveomeningoencephalitic Syndrome* ; Visual Acuity

There have been many reports to date regarding the role of GnRH as a local regulatory factor of ovarian function as studies of human and rat ovaries revealed GnRH and its receptor. In recent studies it has been shown that GnRH directly causes apoptosis in the granulosa cells of the rat ovary, and such results leads to the suggestion that the use of GnRH agonist for more stable long term ovarian hyperstimulation in human IVF-ET programs causes granulosa cell apoptosis which may lead to follicular atresia. Therefore this study attempts to determine if granulosa-luteal cell apoptosis occurs in patients during IVF-ET programs in which GnRH agonist is employed for ovarian hyperstimulation. The quality of oocyte-cumulus complexes obtained during ovum pickup procedures were assessed morphologically and then the fertilization rate and developmental rate was determined. Apoptotic cells among the granulosa-luteal cells obtained during the same procedure were observed after staining with Hematoxylin-rosin. The fragmentation degree of DNA extracted from granulosa-luteal cells was determined and comparatively analyzed. There was no difference in the average age of the patients, the number of oocytes retrieved, and fertilization and developmental rates between the FSH/hMG group and GnRH-long group. There was also no difference in the apoptosis rate and pyknosis rate in the granulosa-luteal cells between the two groups. However, when the oocyte-cumulus complexes were morphoogically divided into the healthy group and atretic group without regard for the method of hyperstimulation, the results showed that the number of oocytes obtained averaged 11.09+/-8.75 and 10.33+/-4.53 per cycle, respectively, showing no significant difference, but the fertilization rate (77.05%, 56.99%, respectively, p<0.01) and developmental ,ate (65.96%, 41.51%, respectively, p<0.01) was significantly increased in the healthy group when compared to the atretic group. The degree of apoptosis in the granulosa-luteal cells showed that in the healthy group it was 2.25% which was not significantly different from the atretic group (2.77%), but the pyknosis rate in the atretic group (27.81%) was significantly higher compared to the healthy group (11.35%, p<0.01). The quantity of DNA fragmentation in the FSH/hMG group was 32.22%, while in the GnRH-long group it was 34.27%, showing no significant difference. On the other hand the degree of DNA fragmentation was 39.05% and 11.83% in the healthy group and atretic group, respectively, showing significantly higher increase in the atretic group (p<0.01). The above results suggest that death of granulosa-luteal cells according to the state of the oocyte-cumulus complex is more related to pyknosis rather than apoptosis. Also, the GnRH agonist used in ovarian hyperstimulation does not seem to directly affect the apoptosis of retrieved oocytes and granulosa-luteal cells, and which is thought to be due to the suppression of the apoptogenic effect of GnRH agonist as a result of the high doses of FSH administered.
Animals ; Apoptosis* ; DNA ; DNA Fragmentation ; Female ; Fertilization ; Follicular Atresia ; Gonadotropin-Releasing Hormone* ; Granulosa Cells ; Hand ; Humans* ; Luteal Cells ; Oocytes ; Ovary ; Ovum ; Rats