Diabetes is a chronic disease that affects a patient’s quality of life. This cross-sectional study aimed to determine the socio-demographic and disease profile factors associated with poor quality of life among patients with diabetes. The study was conducted at a primary health care clinic in Kuching between August to November 2010. Short Form - 36 (SF - 36) questionnaire was used to assess the quality of life of diabetic patients aged ≥ 18. A total of 142 respondents participated in the survey. After adjusting for age, those with no education scored lower at vitality (p=0.043) and emotional health (p=0.033) compared with those who have tertiary education. Those working in the private sector scored better for physical functioning (p=0.042) compared with pensioners and the unemployed. Patients with uncontrolled diabetes scored lower in the role-emotional domain (p=0.003). Participants who were on <3 (p=0.014) and ≥3 (p=0.024) oral medications had better score for role-physical than those on insulin. Those on insulin had worse score for bodily pain than those on oral medication only (vs <3 oral drugs, p=0.026; vs ≥3 oral drugs, p=0.001). Various socio-demographic factors, uncontrolled diabetes and insulin usage were found to have negative impact on a diabetic patient’s quality of life. Programmes addressing the physical and emotional needs of diabetic patients at the primary health care setting are essential to help improve their quality of life.

PURPOSE: To assess the difference between auditory and visual stimuli when determining hemispheric language dominance by using functional MRI. MATERIALS AND METHODS: In ten healthy adult volunteers (8 right-handed, 1 left-handed, 1 ambidextrous), motor language activation in axial slices of frontal lobe was mapped on a Simens 1.5T Vision Plus system using single-shot EPI. Series of 120 consecutive images per section were acquired during three cycles of task activation and rest. During each activation, a series of four syllables was delivered by means of both a visual and auditory method, and the volunteers were asked to mentally generate words starting with each syllable. In both inferior frontal gyri and whole frontal lobes, lateralization indices were calculated from the activated pixels. We determined the language dominant hemisphere, and compared the results of the visual method and the auditory method. RESULTS: Seven right-handed persons were left-hemisphere dominant, and one left-handed and one ambidextrous person were right-hemisphere dominant. Five of nine persons demonstrated larger lateralization indices with the auditory method than the visual method, while the remaining four showed larger lateralization indices with the visual method. No statistically significant difference was noted when comparing the results of the two methods(p>0.05). CONCLUSION: When determining hemispheric language dominance using functional MRI, the two methods are equally appropriate.
Adult ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Volunteers

Lymphoplasmacyte-rich meningioma is a rare WHO Grade I subtype of meningioma. The lymphoplasmacyte-rich meningioma does not have typical imaging features of a meningioma so it can mimic intracranial inflammatory condition or brain neoplasm. We report the clinicopathologic features of lymphoplasmacyte-rich meningioma in a 35-year-old woman. She suffered from progressive headache, dizziness and tinnitus over two years. The tumor exhibited atypical neuroimaging features, including obvious peritumoral edema and irregular enhancing components. She underwent total resection and histologic examination revealed a meningioma with numerous plasma cells. Her symptoms have since resolved and there has been no evidence of tumor recurrence after one year of follow-up.
Adult ; Brain Neoplasms ; Dizziness ; Edema ; Female ; Follow-Up Studies ; Headache ; Humans ; Meningioma* ; Neuroimaging* ; Plasma Cells ; Recurrence ; Tinnitus

Few reports exists citing a case of a retropharyngeal bronchogenic cysts. In this study, we report a bronchogenic cyst with a cystic appearance observed in the retropharyngeal space.
Bronchogenic Cyst ; Pharyngeal Diseases ; Tomography, X-Ray Computed

PURPOSE: To retrospectively evaluate the usefulness of diffusion-weighted images, ADC maps and conventional MR images for determination of brain tumor consistency. MATERIALS AND METHODS: Twenty-three patients with brain tumor underwent MR examinations with T1, T2 and diffusion-weighted images. Regions of interest (ROIs) were drawn in the tumors, and the measured signal intensities (SI) were normalized with the contralateral side. We evaluated the correlation between SI ratios from various images and tumor consistency assessed at surgery. In three patients with both cystic and solid components, each component was evaluated independently. Qualitatively observed SIs were also correlated with tumor consistency. RESULTS: Statistical analysis revealed significant correlation between tumor consistency and ADC ratio (r = -0.586, p = 0.002), SI ratios on T2-weighted images (r = -0.497, p = 0.010), and observed SIs on T2-weighted images (r = -0.461, p = 0.018). The relative ratio of ADC value correlated with tumor consistency most strongly. CONCLUSION: The measured ratio of ADC, SI ratio and observed SI grade on T2-weighted images can provide valuable information about the consistency of brain tumor.
Brain ; Brain Neoplasms ; Humans ; Retrospective Studies

PURPOSE: To understand clinical significance of irregular interface between meningioma and adjacent brain parenchyma in predicting histological grading of tumor, focusing on brain parenchymal invasion. MATERIALS AND METHODS: Pathologically confirmed 79 cases with meningiomas with pathological reports about the presence of parenchymal invasion were included. We defined the presence of interface irregularity as either spiculations or fuzzy margins between the tumor and brain parenchyma. We counted number of spiculations and measured ratio of fuzzy margin length to whole length of mass with consensus of two neuroradiologists. We classified the patients into Present group and Absent group, and the two groups were compared by using the Mann-Whitney U test. Statistical correlations between the presence of an interface irregularity and brain parenchymal invasion by the tumor as well as meningioma histological grade were tested with chi-square test. The optimal cutoff values of spiculation numbers and the ratio of fuzzy margins were determined. The sensitivity and specificity of number of spiculations, ratio of fuzzy margin and the presence of irregular interface as combined parameters for predicting the parenchymal invasion were calculated using ROC curve analysis. RESULTS: Statistically significant differences were noted between the Present and Absent groups for number of spiculations and ratio of fuzzy margin (P = 0.038 and P = 0.028, respectively). The optimal cutoff value for number of spiculations (> 4.5 with 61.1% sensitivity and 68.9% specificity) and the ratio of fuzzy margin (> 0.24 with 66.7% sensitivity and 65.6% specificity) were determined. The sensitivity and specificity of interface irregularity as the combined parameters were 72% and 59%, respectively. The interface irregularity between tumor and brain parenchyma significantly correlated with not only brain parenchymal invasion (P = 0.001) and but also histological grade (P < 0.001). CONCLUSION: The interface irregularity between tumor and brain parenchyma in MRI can be a strong predictive factor for brain parenchymal invasion and high grade meningioma.
Brain* ; Consensus ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Pathology* ; ROC Curve ; Sensitivity and Specificity

PURPOSE: To examine whether the ACR phantom could be used in quality standards for magnetic resonance imaging (MRI) instruments in Korea. MATERIALS AND METHODS: We conducted the phantom test using the ACR MRI phantom in 20 MRI instruments currently used in Korea. According to ACR criteria, we acquired the phantom images which were then assessed by the following seven tests: geometric accuracy, high spatial resolution, slice thickness accuracy, slice position accuracy, image intensity uniformity, percent signal ghosting, and low contrast object detectability. The phantom images were interpreted by three experienced radiologists according to ACR criteria. Then, we examined the failure rate of each test and evaluated the inter-observer variation in the measurements and test failure. RESULTS: The failure rate of each test could be broken into the following components: geometric accuracy (11-21%), high contrast spatial resolution (10-15%), slice thickness accuracy (6-22%), slice position accuracy (5-17%), image intensity uniformity (6%), percent signal ghosting (16%), and low contrast object detectability (8-10%). In this series, all the failure rates were less than 30%. In addition, no inter-observer variation was seen in the measurements and test failure. CONCLUSION: ACR MRI phantom promises to be established as the standard phantom for MRI instruments in Korea because of its objectivity in assessing the phantom images.
Korea ; Magnetic Resonance Imaging* ; Observer Variation

The recent therapeutic advances for treating hematologic neoplasm have improved patients' survival, but these treatments have increased the frequency of neurologic complications and toxic effects. Most of the neurological features of leukemia are divided into three main categories: the primary effects of the disease, the treatment-related side effects and the infectious complications. The purpose of this pictorial assay is to document the radiologic abnormalities seen in the intracranial structures during and after the treatment of leukemia, and to aid in the clinical management of patients.
Hematologic Neoplasms ; Humans ; Leukemia

PURPOSE: We wanted to determine the differential points between craniopharyngioma and pituitary macroadenoma on MRI. MATERIALS AND METHODS: The MRI findings in twenty seven patients (age range: 14-67 years, mean age: 46 years, 17 males and 10 females) with pathologically proven craniopharyngioma and twenty four patients (age range: 23-64 years, mean age: 54 years, 8 males and 16 females) with pathologically proven pituitary macroadenoma were analyzed retrospectively by two radiologists. We analyzed the location, the contour of the mass, the presence of high signal intensity on the T1 weighted images, the thickness of the enhancing wall, separation between the mass and the pituitary gland, and the presence of attachment or compression to the midbrain. RESULTS: On MRI, craniopharyngiomas showed a suprasellar location, high signal intensity on the T1 weighted images and a larger suprasellar portion. After contrast enhancement, the separation of the mass from the pituitary gland is more distinct than that of the pituitary macroadenomas. The craniopharyngiomas showed the presence of attachment or compression to the midbrain. The pituitary macroadenomas had a larger intra- or infrasellar portion than that of the craniopharyngiomas, and they also showed a thicker enhancing wall after contrast enhancement. CONCLUSION: The location, contour of the mass, presence of high signal intensity on T1 weighted images, thickness of the enhancing wall, separation of the mass from the pituitary gland and the presence of attachment or compression to midbrain are useful differential points between craniophayngioma and pituitary macroadenoma on MRI.
Craniopharyngioma* ; Humans ; Magnetic Resonance Imaging ; Male ; Mesencephalon ; Pituitary Gland ; Retrospective Studies

PURPOSE: A relative increase in deoxyhemoglobin levels in hypoperfused tissue can cause prominent hypointense signals in the draining veins (PHSV) within areas of impaired perfusion in susceptibility-weighted imaging (SWI). The purpose of this study is to evaluate the usefulness of SWI in patients with acute cerebral infarction by evaluating PHSV within areas of impaired perfusion and to investigate the usefulness of PHSV in predicting prognosis of cerebral infarction. MATERIALS AND METHODS: In 18 patients with acute cerebral infarction who underwent brain MRI with diffusion-weighted imaging and SWI and follow-up brain MRI or CT, we reviewed the presence and location of the PHSV within and adjacent to areas of cerebral infarction qualitatively and measured the signal intensity difference ratio of PHSVs to contralateral normal appearing cortical veins quantitatively on SWI. The relationship between the presence of the PHSV and the change in the extent of infarction in follow-up images was analyzed. RESULTS: Of the 18 patients, 10 patients showed progression of the infarction, and 8 patients showed little change on follow-up imaging. On SWI, of the 10 patients with progression 9 patients showed peripheral PHSV and the newly developed infarctions corresponded well to area with peripheral PHSV on initial SWI. Only one patient without peripheral PHSV showed progression of the infarct. The patients with infarction progression revealed significantly higher presence of peripheral PHSV (p=0.0001) and higher mean signal intensity difference ratio (p=0.006) comparing to the patients with little change. CONCLUSION: SWI can demonstrate a peripheral PHSV as a marker of penumbra and with this finding we can predict the prognosis of acute infarction. The signal intensity difference of PHSV to brain tissue on SWI can be used in predicting prognosis of acute cerebral infarction.
Brain ; Cerebral Infarction ; Follow-Up Studies ; Humans ; Infarction ; Magnetic Resonance Imaging ; Perfusion ; Prognosis* ; Veins*