PURPOSE: We performed this study to evaluate the incidence of thoracic inlet pathologies. We also evaluated the extension of the thoracic inlet lesions to neck and/or mediastinum to determine anatomic connections between neck and mediastinum. MATERIALS AND METHODS: we evaluated chest radiographs and CT scans of the 41 patients with various pathologies involving this region. RESULTS: Thyroid lesions and malignant lymphomas were the most common pathologic lesions in this region (54%). Thoracic inlet lesions extending from mediastinum included various pathologies including thymic lesion (n=8) in the anterior mediastinum, neurogenic tumor(n=2) in the posterior mediastinum and malignant lymphoma(n=5) in the multiple compartment. Thoracic inlet lesions extending from the neck(n=9) were mostly thyroid lesions(n=8) arising in the visceral space of the neck. Thoracic inlet lesions(n=11) involving both neck and mediastinum were thyroid lesions, abscesses, thymic lesion, malignant lymphomas and cavernous hemangiomas. Thyroid lesions and cavernous hemangiomas showed remarkable enhancement on post contrast enhanced CT. Teratoma contained fat density and Two cases of abscesses contained air density. CONCLUSION: Thyroid lesions and malignant lymphomas were the most common pathologies in the thoracic inlet. There was anatomic connection between neck and mediastinum through the thoracic inlet. CT was valuale in evaluation of the location, extension, and density of the mass for the differential diaguonis of the thoracic inlet lesions.
Abscess ; Bays* ; Hemangioma, Cavernous ; Humans ; Incidence ; Lymphoma ; Mediastinum ; Neck ; Pathology ; Radiography, Thoracic ; Teratoma ; Thyroid Gland ; Tomography, X-Ray Computed

We present a case of multiple cutaneous leiomyoma in a 45 year old woman. About 20 years ago, multiple skin colored papules developed on right cheek and man4ibular area. About 10 years after the onset of the disease a uterine myoma developed which wae tree,ted by total hysterectomy. The skin lesions were gradually increasing in number and size, Some larger nodular lesions changed to brown in color and became painful after cold exposure. The histopathologic finding showed typical leiomyoma arieing from arrector pilorum muscle.
Cheek ; Female ; Humans ; Hysterectomy ; Leiomyoma* ; Middle Aged ; Skin

No abstract available.
Aneurysm* ; Cerebral Infarction* ; Foramen Ovale, Patent*

Malignant histiocytosis is a rare, usually fatal malignant neoplasm. We present a case of a 62 year-old female with malignant histiocytosis involving the skin, lymph nodes and bone marrow. The patient achieved a complete remission for 1 year after the completion of COPP chemotherapy (cyclophosphamide, vincristine, procarbazine and prednisone). We propose that COPP chemotherapy is a valuable therapeutic regimen for malignant histiocytosis.
Bone Marrow ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Histiocytic Sarcoma* ; Humans ; Lymph Nodes ; Middle Aged ; Procarbazine ; Skin ; Vincristine

No abstract available.
Humans ; Hyperbilirubinemia* ; Infant, Newborn*

PURPOSE: To analyse the causes and radiologic findings in patients with mediastinitis and to evaluate theefficacy of chest CT scanning in patients with delayed diagnosis. MATERIALS AND METHODS: Seventeen patients withhistopathologically(n=15) or cliniclly diagnosed(n=2) mediastinitis were involved in this study. Eleven of theformer group underwent surgery, and in four, tube drainage was performed. All underwent chest radiography and CTscanning, and in seven patients, the causes of delayed diagnosis were analysed. RESULTS: The most common cause ofmediastinitis was esophageal rupture (n=11). Others were extension from neck abscess to the mediastinum(n=3),complications after a Benthall procedure(n=1), tuberculous lymphadenitis (n=1) and mycotic aneurysm(n=1). Patientswith esophageal rupture suffered from underlying diseases such as esophageal cancer(n=2), iatrogenic esophagealrupture(n=2), Boerhaave's syndrome(n=2), and esophagitis(n=1). In patients with neck abscess(n=3), each wassecondary to infected cystic hygroma, Ludwig angina, or deep neck infection, respectively. On chest CT, patientswith esophageal rupture(n=11) had an abscess in the posterior mediastinum; nine abscesses extended to the cervicalarea along the retropharyngeal space, and the patient with Ludwig angina had an abscess involving all compartmentsof the mediastinum. Among the total of 17 patients, diagnostic delays were found in seven, while five hadspontaneous esophageal ruptures and two suffered complications after a Benthall procedure and Tbc lymphadenitis,respectively. The causes of diagnostic delay varied. Among seven patients, pnevmonia was initially diagnosed intwo, who were treated ; one had multiorgan failure, and one was suffering from pericardial effusion and lungabscess. In three other patients, chest radiographs initially showed non-specific findings, leading to delayed CTexamination. CONCLUSION: The most common cause of mediastinitis was esophageal rupture, and in these patients,chest radiographs and clinical symptoms were sometimes not specific. CT was valuable for the detection ofmediastinitis, and for early diagnosis can be the modality of choice.
Abscess ; Delayed Diagnosis* ; Drainage ; Early Diagnosis ; Humans ; Ludwig's Angina ; Lymphangioma, Cystic ; Mediastinitis* ; Mediastinum ; Neck ; Pericardial Effusion ; Radiography ; Radiography, Thoracic* ; Rupture ; Thorax* ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

The Wada test was performed for lateralization of language and memory function, using intracarotid injection of Sodium Amytal. But, the internal carotid artery(ICA) Wada test has some limitations for testing memory function. The posterior cerebral artery(PCA) Wade test has been designed to modify to modify the ICA Wada test for testing memory function selectively. In our study, 10 patients out of 12 patients with intractable seizure underwent only the ICA Wada test and the other 2 patients underwent both are ICA and the selective PCA Wada test In all 12 patients undergoing the ICA Wada test, we succesfully localized speech and language dominace. Four of 12 patients who underwent the ICA Wada test for evaluation of memory function displayed superior memory functions in one hemisphere, but the other hemisphere also significantly contributed to memory. The selective PCA Wada test, performed in 2 patients, showed successful results of memory function test in both patients. Four of 12 patients underwent temporal lobectomy and there was no major post-operative language or memory deficits. We conclude that the ICA and PCA Wada tests are useful for preoperative evaluation of medically intractable epilepsy, and the PCA Wada test is valuable in memory evaluation in some patients who have hight risk of postoperative global amnesia after temporal lobectomy following equivocal results of memory function by the ICA Wada test.
Amnesia ; Amobarbital ; Drug Resistant Epilepsy* ; Humans ; Memory Disorders ; Memory* ; Passive Cutaneous Anaphylaxis ; Seizures

No abstract available.
Female ; Humans ; Vaginosis, Bacterial*

BACKGROUND: To analyze the morphologic characteristics of low density lymph node in etiologic differentiation of lymphadenopathy, emphasizing the different features between tuberculosis and lung cancer, on contrast enhanced CT scan,. METHOD: A total of 64 patients who showed low density lymph nodes on chest CT scan were analyzed. Primary causes were tuberculosis (n=28), lung cancer (n=27), malignant lymphoma (n=5) and metastasis from extrathoracic malignancies (n = 4). CT scan was performed with 10mm slice thickness and 7 characteristic features were evaluated: location,size, presence or absence of the nonnecrotic lymph node, calcification, perinodal fat obliteration, thickness and evenness of the enhancing rim. RESULTS: In patients with tuberculous lymphadenopathy, lymph nodes with uneven (68.0%) and thick (62.1%) enhancing rim were more common than lung cancer (p<0.05). Low density lymph nodes with less than 1cm in size were found only in tuberculous lymphadenopathy(n=10). In 48.2% of patients with lung cancer, more than 1 nonnecrotic enlarged lymph node were coexisted, whereas 21.4% in patients with tuberculous lymphadenopathy(p=0.06). However, the size, location and calcification were not statistically significant between tuberculous lymphadenopathy and lung cancer. CONCLUSION: Tuberculous lymphadenopathy is strongly suggested when enhancing rim of enlarged lymph nodes is uneven and thick, when the coexisting nonnecrotic lymph nodes are few in number and when central low density is encountered in normal sized lymph nodes.
Humans ; Inflammation ; Lung Neoplasms ; Lymph Nodes* ; Lymphatic Diseases ; Lymphoma ; Neoplasm Metastasis ; Tomography, X-Ray Computed* ; Tuberculosis

The tests for sputum acid fast bacilli and sputum cytology for malignancy were negative. The PC20 of bronchial methacholine challenge test was 20.2 mg/ml. Transbronchial lung biopsy showed bronchial inflammatory change with infiltration of eosinophils and the existence of fungal hypae. Antibody index for serum IgE-Af and IgG-Af was 10.2 and 2.1 respectively, comparing with Af-sensitive asthma patients. Recently we experienced an allergic bron-chopulmonary aspergillosis with atypical respiratory symptoms. Forty-seven years old female was admitted to our hospital because of cough, sputum, right pleuritic pain for 2 weeks. She had experienced pneumonia several times, but had been not confirmed any causative organism. On physical examination, breathing sound was decreased over right upper lung, but wheezing and crackle were not heard over both lungs. The chest X-ray showed segmental consolidation in right upper lobe, and HRCT showed tubular bronchiectasis and obstruction of right upper lobal bronchus due to mucoid impaction. Allergic skin prick test against Aspergillus fumigatus(Af) and serum preeipitin were negative, but intrader mal skin test was positive for Af. Specific IgE for Af was positive with class I. Total eosinophil count was 650/mm3, total IgE level was more than 3000 IU/ml, ESR was 62mm/hr, and eosinophils in induced sputum was 35%. The test for sputum acid fast bacilli and spu-Tum cytology for malignancy were negative. The PC20 of bronchial methacholine challenge-Test was 20.2 mg/ml. Transbronchial lung bi-Opsy showed bronchial inflammatory change With infiltration of eosinophils and the exis-Serum lgE-Af and lgG-Af was 10.2 and 2.1 Respectively, comparing with Af-sensitive Asthma patients.
Aspergillosis ; Aspergillus ; Asthma* ; Biopsy ; Bronchi ; Bronchiectasis ; Cough ; Eosinophils ; Female ; Humans ; Immunoglobulin E ; Lung ; Methacholine Chloride ; Physical Examination ; Pneumonia ; Respiratory Sounds ; Skin ; Skin Tests ; Sputum ; Thorax