PURPOSE: To correlate radiologic findings with clinical findings in patients with a mosaic patten of lungattenuation, as seen on thin-section CT. MATERIALS AND METHODS: Thirty-one cases in which a mosaic pattern oflung attenuation was detected on combined expiratory and inspiratory scans of thin-section CT were retrospectivelyanalyzed. Cases involving infiltrative lung disease were excluded. Both thin-section CT and clinical findings wereanalyzed and the relationship between the extent of the area of hyperlucency -as seen on expiratory scan- andphysiologic parameters was evaluated. The subjects were 10 men and 21 women ranged in age from 25 to 76 (mean 50)years. RESULT: Twenty-nine patients with small airway disease, [chronic bronchitis and/or bronchiolitis(n=11),bronchiectasis(n=8), bronchial asthma(n=8), mycoplasmic pneumonitis(n=1) and hypersensitive pneumonitis(n=1),] andtwo patients with pulmonary vascular disease, [chronic pulmonary thromboembolism(n=1) and stenosis of the leftupper pulmonary artery(n=1)] were included in our study. Commonly associated thin-section CT findings in the casesinvolving small airway disease(n=29) were bronchial wall thickening(n=25), nodular opacity(n=25), bronchial andbronchiolar dilatation(n=20) and small branching opacity(n=16). These findings were not observed in two patientswith pulmonary vascular disease, though bronchial wall thickening was seen in the patient with chronic pulmonarythromboembolism. At expiratory scan level, there was statistical correlation between FEV1/FVC and the number ofpulmonary segments(r= 0.982, p<0.05), but no correlation between FEV1/FVC and the percentage area ofhyperlucency(r=0.803, p>0.05). CONCLUSION: The mosaic pattern of lung attenuation seen on thin-section CT isindicative of various diseases, involving small airways such as bronchiolitis, bronchitis, bronchiectasis andbronchial asthma, and vascular lung disease. Bronchial wall thickening and nodular opacity can be associated withsmall airway diseases.
Asthma ; Bronchiectasis ; Bronchiolitis ; Bronchitis ; Constriction, Pathologic ; Female ; Humans ; Lung Diseases ; Lung* ; Male ; Vascular Diseases

Spinal anesthesia is widely used for parturients undergoing scheduled elective caesarean section. Hypotension associated with spinal anesthesia is a major concern in obstetrics. Preventive methods for post-spinal hypotension include intravenous fluid preloading, bolus or continuous injection of vasopressors. Intravenous fluid preloading reduces the incidence and severity of maternal hypotension during spinal anesthesia administered for cesarean section. Although fluid preloading prevents maternal hypotension, it is not advisable to delay spinal anesthesia for preloading a fixed volume of intravenous fluid. Ephedrine, the drug of choice to prevent maternal hypotension during spinal anesthesia for caesarean delivery, acts by maintaining the uteroplacental blood flow. Phenylephrine is also effective in reducing maternal hypotension during this procedure. Both the vasopressors are acceptable for preventing hypotension. However, in the absence of maternal bradycardia, phenylephrine is the preferred drug for the management of hypotension during regional anesthesia for caesarean section, because of its improved fetal acid-base status.
Anesthesia, Conduction ; Anesthesia, Spinal* ; Bradycardia ; Cesarean Section* ; Ephedrine ; Female ; Hypotension* ; Incidence ; Obstetrics ; Phenylephrine ; Pregnancy

No abstract available.
Hydrops Fetalis*

A pancreatic pseudocyst with a mediastinal extension is a rare clinical entity. Intrathoracic symptoms such as dysphagia or dyspnea due to compression or associated pleural effusions are quite common. The pseudocysts transverse the diaphragm via the esophageal hiatus or aortic hiatus or by eroding directly through the diaphragm. Here, we report a case of a pancreatic pseudocyst with a mediastinal extension presenting as dysphagia and dyspnea. The diagnosis was confirmed by computerized axial tomography of the chest and abdomen. Usually, the proper management of a larger pseducocyst includes percutaneous or surgical internal drainage, but in this case the mediastinal components disappeared with conservative medical treatment.
Abdomen ; Cytochrome P-450 CYP1A1 ; Deglutition Disorders ; Diagnosis ; Diaphragm ; Drainage ; Dyspnea ; Mediastinum ; Pancreatic Pseudocyst* ; Pleural Effusion ; Thorax

PURPOSE: PCNA has been widely used because it is highly accurate, relatively simple and safe to administer. Regardless of its high diagnostic rate, PCNA has the difficulty in excluding malignancy in the cases of, negative for malignancy" results in PCNA cytologic reports. So, we analysed PCNA cases to evaluate the clinical outcome of "negative for malignancy" results in PCNA cytologic reports. MATERIALS AND METHODS: PCNA in 170 cases were done between January, 1991 and December, 1993 and the diagnosis was malignancy in 86 cases, specific benign disease in 30 cases, "negative for malignancy" in 45 cases and inadequate sample in 9 cases. We analysed 36 cases among 45 cases of "negative for malignancy" results in cytologic examinations. The final diagnosis was made on the basis of histopathologic examinations, radiologic findings and clinical courses. we compared the final diagnosis to the radiologic diagnosis. RESULTS: Of the 36 cases with initial "negative for malignancy" results, the final diagnosis was benign in 30 cases and malignant in 6 cases(17%). In radiologic diagnosis of the malignancy, "positive predictive value" was 42%, "negative predictive value" was 96%, and accuracy was 78%. CONCLUSION: In the cases of PCNA results of "negative for malignancy", malignancy can not be excluded because 17% of the cases are proved to be malignant. And if malignancy is highly suggested at radiologic examination, the possibility of malignancy is 42%, and so intensive follow-up examination is needed.
Biopsy, Fine-Needle* ; Diagnosis ; Follow-Up Studies ; Proliferating Cell Nuclear Antigen ; Thorax*

Stereotactic vacuum-assisted breast biopsy (VAB) has been used to evaluate microcalcifications or non-palpable breast lesions on mammography. Although stereotactic VAB is usually performed in a prone or upright position, an expensive prone table is necessary and vasovagal reactions often occur during the procedure. For these reasons, the lateral decubitus position can be applied for stereotactic VAB, and true lateral mammography can be used to detect the lesion. We report on 15 cases of lateral decubitus positioning for stereotactic VAB with true lateral mammography for non-palpable breast lesions or microcalcifications. The mean procedure time was approximately 30.1 minutes, and no complications occurred during the procedures. Fourteen cases had benign breast lesions and one case had a ductal carcinoma in situ. The lateral decubitus stereotactic VAB with true lateral mammography can be applied for microcalcifications or non-palpable breast lesions and helps to minimize anxiety and vasovagal reactions in patients.
Anxiety ; Biopsy ; Breast ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Mammography ; Stereotaxic Techniques

We encountered a case of Sweet's syndrome associated with myelodysplastic syndrome in a 60-year-old woman. The clinical presentation strongly suggested Sweet's syndrome. A skin biopsy specimen taken from her skin lesion on the leg showed an infiltration of numerous neutrophils in the subcutis instead of the dermis which is the main area of neutrophilic infiltration in Sweet's syndrome. Among infiltrating cells, many neutrophils(8%) showed nuclear segmentation anomalies, that is, hyposegmentation(pseudo-Pelger-Huet anomaly) or hypersegmentation. Peripheral blood neutrophils had similar anomalies. This subcutaneous variant of Sweet's syndrome, Sweet's panniculitis, is rare and nuclear segmentation anomalies of neutrophils are probably a good clue to underlying myelodysplastic syndrome.
Biopsy ; Dermis ; Female ; Humans ; Leg ; Middle Aged ; Myelodysplastic Syndromes* ; Neutrophils* ; Panniculitis ; Skin ; Sweet Syndrome*

BACKGROUND: The purpose of this study was to find additional effects of intrathecal nalbuphine 1 mg to morphine 0.1 mg for pain relief during a cesarean section. METHODS: Sixty healthy patients at full term who were scheduled for an elective cesarean delivery with spinal anesthesia were enrolled in the study. They received 0.5% bupivacaine 10 mg with either morphine 0.1 mg (group M), or nalbuphine 1 mg (group N), or morphine 0.1 mg nalbuphine 1 mg (group M + N). Analgesic effects were evaluated by a verbal rating scale on the duration of complete analgesia (time from the intrathecal injection to the first pain report), effective analgesia (time from the intrathecal injection to the first analgesic request), and cumulative doses of additional analgesics. Hemodynamic changes and adverse effects were also observed. RESULTS: The duration of complete analgesia increased significantly in group M, compared with group N and group M + N. Effective analgesia was longer in group M and group M + N, compared with group N. The incidence of pruritus was significantly lower in group N, compared with group M and M + N. The incidence of nausea and vomiting was the same among all groups. CONCLUSIONS: We concluded that intrathecal addition of nalbuphine 1mg to morphine 0.1 mg during spinal anesthesia for a cesarean delivery reinforced intraoperaitive analgesia compared with intrathecal morphine 0.1 mg. However, it reduced the duration of complete analgesia and had no effect on the incidence of pruritus.
Analgesia ; Analgesics ; Anesthesia, Spinal ; Bupivacaine ; Cesarean Section* ; Female ; Hemodynamics ; Humans ; Incidence ; Injections, Spinal ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Vomiting

No abstract available.
Nipples* ; Paget's Disease, Mammary*

No abstract available.
Nevus*