PURPOSE: To present the enhancement pattern of acute cerebral or cerebellar cortical infarctions aged 1-3 days on MR. MATERIALS AND METHODS: Contrast-enhanced MR images of 26 patients with acute cerebral or cerebellar ischemic events were retrospectively reviewed. MR was performed within 3 days after ictus. RESULTS: Contrast enhancement in the area of infarction was observed in 61.5% (16/26) on MR. Of these 50% (13/26) showed non-parenchymal enhancement (NPE) representing either vascular or leptomeningeal enhancement, 7.7% (2/26) showed parenchymal enhancement (PE), and 2.8% (1/26) showed both NPE and PE. The earliest enhancement was seen in images obtained 12 hours after the onset of symptoms and appeared as NPE. One patient showed NPE without apparent high signal intensity at the corresponding area on T2-weighted images. In 38. 5% (10/26), there was no enhancement. CONCLUSION: Contrast-enhanced MR imaging may be needed in acute ischemic infarction, because NPE may be seen as the earliest MR finding of acute cortical infarction aged 1-3 days.
Cerebral Infarction* ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Retrospective Studies

The major forms of amyloidosis affecting the eye are primary systemic and localized amyloidosis. Primary Amyloidosis localized to the conjuctiva is relatively rare, especially involved to bulbar conjunctiva and corn eo scleral limbus and is consiccered to be in the differential diagnosis of other conjunctival diseases. We diagnosed a amyloidosis in which the biopsy from the superior bulbar conjunctiva and superior cornea of the left eye of 68-year-old woman showed histopathologic findings of amyloidosis. There were no evidences of amyloid deposit except conJuntiva and cornea on physical and other systemic examination, including immunelectrophoresis, and cornea on physical and other systemic examination, including immunelectrophoresis, and no evidences of underlying disease that can cause amyloidosis. So we concluded that it was primary localized amyloidosis of bulbar conjunctiva and cotnea.
Aged ; Amyloidosis* ; Biopsy ; Conjunctiva* ; Conjunctival Diseases ; Cornea* ; Diagnosis, Differential ; Female ; Humans ; Plaque, Amyloid ; Zea mays

The major forms of amyloidosis affecting the eye are primary systemic and localized amyloidosis. Primary Amyloidosis localized to the conjuctiva is relatively rare, especially involved to bulbar conjunctiva and corn eo scleral limbus and is consiccered to be in the differential diagnosis of other conjunctival diseases. We diagnosed a amyloidosis in which the biopsy from the superior bulbar conjunctiva and superior cornea of the left eye of 68-year-old woman showed histopathologic findings of amyloidosis. There were no evidences of amyloid deposit except conJuntiva and cornea on physical and other systemic examination, including immunelectrophoresis, and cornea on physical and other systemic examination, including immunelectrophoresis, and no evidences of underlying disease that can cause amyloidosis. So we concluded that it was primary localized amyloidosis of bulbar conjunctiva and cotnea.
Aged ; Amyloidosis* ; Biopsy ; Conjunctiva* ; Conjunctival Diseases ; Cornea* ; Diagnosis, Differential ; Female ; Humans ; Plaque, Amyloid ; Zea mays

We report a case of cutis verticis gyrata-mental deficiency syndrome associated with generalized epidermal nevus. The clinical features of the patient included severe mental retardation, drug resistant epilepsy, short stature, scaphocephaly and dysmorphic face with scanty scalp hair, hypertelorism, long palpebral fissure, low nasal bridge, hyperplasia of ala nasi, low-set ears with convoluted fold, and partial obstruction of the nasolacrimal ducts. Multiple convoluted folds and furrows on the scalp were extended to eyebrows and nose. Both lateral ventricle with periventricular leukomalacia were dilated markedly and the corpus callosum was hypoplastic on brain MRI. The nature of the yellowish brown colored elevated skin nevi on the whole body was consistent with systemic epidermal nevus by pathological study.
Brain ; Corpus Callosum ; Craniosynostoses ; Ear ; Epilepsy ; Eyebrows ; Hair ; Humans ; Hyperplasia ; Hypertelorism ; Infant, Newborn ; Intellectual Disability ; Lateral Ventricles ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging ; Nasolacrimal Duct ; Nevus* ; Nose ; Scalp ; Skin

The diagnosis of a Battered Child Syndrome is made by the pediatrician, surgeon and the radiologist because almost parents deny the diagnosis or refuse to answer the doctor's questions. The imaging modalities play a key role in the investigation and documentation of the battered child syndrome, because of the high frequency of the typical skeletal lesion. Although physical abuse is denied by parents, the recognition of this entity is possible by the primary diagnostic imaging study in the suspected child abuse. The imaging studies are either a bone scan and x-ray series or a complete radiolographic skeletal survey by X-ray series. In an expected intracranial injury, a CT scan of the head is mandatory We experienced a case of Battered Child Syndrome in a 6 month-old male infant who had subdural hemorrhage and fractures of skull and ribs in different stages of healing and repair. The brief review of the literature was made.
Battered Child Syndrome* ; Child ; Child Abuse ; Diagnosis ; Diagnostic Imaging ; Head ; Hematoma, Subdural* ; Humans ; Infant ; Male ; Parents ; Ribs ; Skull ; Tomography, X-Ray Computed

To make an accurate diagnosis of esophageal rupture during balloon dilatation without the help of esophagograph, an infusion pump, a pressure transducer and a radiopaque esophageal balloon were connected through a three-way connector. The pressure transducer was connected consecutively to an amplifier, a differentiator and a speaker to detect a pressure drop in the esophageal balloon. Under fluoroscopic monitoring, a radiopaque balloon catheter was inserted in the mid-thoracic esophagus of 30 rabbits and inflated with air until the esophagus was ruptured. A pressure drop in the balloon at the time of esophageal rupture was not only recorded graphically, but also was identified through a speaker. To examine esophageal rupture grossly, the rabbits were sacrificed after esophagography. We could detect the time of esophageal rupture during balloon dilatation in all rabbits accurately by observing the pressure drop on the pressure recorder and by hearing the sound made on a speaker. In 8 patients with esophageal stricture, a deflated radiopaque balloon catheter was inserted to the position inside the narrowing point and inflated by injecting air until the 'hourglass' deformity created by the stricture disappeared from the balloon contour which the pressure change in the balloon was monitored with a pressure recorder. The balloon pressures at the time of disappearance of the "hourglass" deformity from the balloon contour ranged from 200 mmHg to 2000 mmHg in 8 patients with esophageal strictures. Esophageal ruptured did not occur in these patients. In conclusion, our results indicate that this new method is not only safe but promising for patients in the future with esophageal strictures. First, it would reduce the chance of mediastinitis in patients of esophageal rupture. Second, esophageal balloon dilatation can be performed more effectively and safely. Third, it is cost-effective. Forth, radiation esposure to the patient can be reduced.
Catheters ; Congenital Abnormalities ; Constriction, Pathologic ; Diagnosis* ; Dilatation ; Esophageal Stenosis ; Esophagus ; Hearing ; Humans ; Infusion Pumps ; Mediastinitis ; Methods ; Rabbits ; Rupture* ; Transducers, Pressure

To make an accurate diagnosis of esophageal rupture during balloon dilatation without the help of esophagograph, an infusion pump, a pressure transducer and a radiopaque esophageal balloon were connected through a three-way connector. The pressure transducer was connected consecutively to an amplifier, a differentiator and a speaker to detect a pressure drop in the esophageal balloon. Under fluoroscopic monitoring, a radiopaque balloon catheter was inserted in the mid-thoracic esophagus of 30 rabbits and inflated with air until the esophagus was ruptured. A pressure drop in the balloon at the time of esophageal rupture was not only recorded graphically, but also was identified through a speaker. To examine esophageal rupture grossly, the rabbits were sacrificed after esophagography. We could detect the time of esophageal rupture during balloon dilatation in all rabbits accurately by observing the pressure drop on the pressure recorder and by hearing the sound made on a speaker. In 8 patients with esophageal stricture, a deflated radiopaque balloon catheter was inserted to the position inside the narrowing point and inflated by injecting air until the 'hourglass' deformity created by the stricture disappeared from the balloon contour which the pressure change in the balloon was monitored with a pressure recorder. The balloon pressures at the time of disappearance of the "hourglass" deformity from the balloon contour ranged from 200 mmHg to 2000 mmHg in 8 patients with esophageal strictures. Esophageal ruptured did not occur in these patients. In conclusion, our results indicate that this new method is not only safe but promising for patients in the future with esophageal strictures. First, it would reduce the chance of mediastinitis in patients of esophageal rupture. Second, esophageal balloon dilatation can be performed more effectively and safely. Third, it is cost-effective. Forth, radiation esposure to the patient can be reduced.
Catheters ; Congenital Abnormalities ; Constriction, Pathologic ; Diagnosis* ; Dilatation ; Esophageal Stenosis ; Esophagus ; Hearing ; Humans ; Infusion Pumps ; Mediastinitis ; Methods ; Rabbits ; Rupture* ; Transducers, Pressure

BACKGROUND: Midkine (MK) is a member of the heparin-binding growth factor family. Overexpression of MK is observed not only in cancerous tissue but also in precancerous lesions of the colon and the prostate. Using immunohistochemical methods, we investigated MK expression in preinvasive and invasive neoplasia of the uterine cervix. METHODS: We performed immunohistochemical analysis of archived cone biopsy and hysterectomy specimens from 161 squamous cell lesions of the uterine cervix (29 cervical intraepithelial neoplasia 1 (CIN1), 35 CIN2, 49 CIN3, 30 microinvasive squamous cell carcinomas (MIC), and 18 invasive squamous cell carcinoma). In addition, we examined if there is a correlation between MK expression and status of human papilloma virus infection determined by a commercially available DNA chip. RESULTS: None of the normal cervical mucosa showed MK immunostaining. The level of MK expression gradually increased according to the histologic grade. Moderate and strong expressions were most frequently observed in cervical tissue with CIN3 and MIC. MK immunostaining was more accentuated in the invasive border of MIC. CONCLUSION: MK may play a functional role in the disease progression of cervical squamous cell neoplasia.
Biopsy ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Colon ; Disease Progression ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Mucous Membrane ; Oligonucleotide Array Sequence Analysis ; Papilloma ; Prostate

BACKGROUND: Although post operative pain has been reduced significantly since the advent of laparoscopic surgery, many patients still complain of moderate abdominal and shoulder pain after surgery. METHOD: Patients scheduled for elective laparoscopic cholecystectomy were assigned to three groups by simple randomization(12 patients per group). Group I patients(control) had no specific treatment, group II patients had 10 ml of normal saline instillation, and group III patients had 10 ml of 0.5% bupivacaine instillation. Instillation was made directly into the gallbladder bed and right subdiaphragmatic space under direct vision by the surgeon at the end of the procedure and before evacuating the pneumoperitoneum. RESULT: Compared to that of the group I, VAS of group II and III did not show any statistically significant difference. Compared to the group I, group II & III showed no significant difference in numbers of requests of Tiaprofenic acid during the 36hours after the surgery. CONCLUSION: Topical instillation of 0.5% bupivacaine 10 ml to the gallbladder bed and right subdiaphragmatic space after laparoscopic cholecystectomy is not effective for the post operative pain control.
Bupivacaine* ; Cholecystectomy, Laparoscopic* ; Gallbladder ; Humans ; Laparoscopy ; Pain, Postoperative* ; Pneumoperitoneum ; Shoulder Pain

The most common cardiac cause of massive hemoptysis is mitral stenosis. Mitral regurgitation is rarely complicated by massive hemoptysis. A 48-year-old man with no significant medical history was admitted to our hospital with hemoptysis and production of 500 mL of blood within 24 hours. A pan-systolic murmur was found on chest examination. A chest computed tomography showed airspace consolidation in the right upper and middle lobes, with faint bilateral ground glass opacity. Echocardiography revealed mitral valve prolapse and grade IV mitral regurgitation. The patient was diagnosed with sporadic primary mitral valve prolapse. After mitral valve repair surgery, the patient recovered fully.
Echocardiography ; Glass ; Hemoptysis* ; Humans ; Middle Aged ; Mitral Valve Insufficiency* ; Mitral Valve Prolapse* ; Mitral Valve Stenosis ; Mitral Valve* ; Thorax