PURPOSE: To evaluate whether there are any differences in MR findings between the childhood and the adult moyamoya disease. MATERIALS AND METHODS: We compared the brain MR findings in 22 children (13 boys and 9 girls, 2-18 years of age) who had moyamoya disease with 15 adult patients (7 men and 8 women, 19-55 years of age). The MR findings were classified as parenchymal-(infarctions and intracranial hemorrhages) and vascular abnormalities (intracranial vascular patency and moyamoya vessels). The difference in each of these MR findings was analyzed using Chi-squaretest and Fisher's exact test (two-tailed). Out of 22 children, two children with normal MR finding were excluded from the statistical analysis. Moyamoya diseases were diagnosed angiographically in all adult patients. In children, they were diagnosed by MR imaging, MR angiography(6), and/or conventional cerebral angiography(18). RESULTS: In children, cerebral infarctions were observed in 20 of 22 patients (91%) (cortex 86%, periventricular white matter/centrum semiovale 32%, basal ganglia 10%). In two patients, there was no parenchymal abnormality. Intra-cranial hemorrhages were not demonstrated in any patients. In adults, intra-cranial hemorrhages(intracerebral hematoma, intraventricular hemorrhage, alone or combined) were demonstrated in 10 of 15 patients(67%). Cerebral infarctions with or without intracranial hemorrhage were detected in 10 of 15 patients(67%)(cortex 40%, periventricular white matter/centrum semiovale 53%, basal ganglia 20%). The difference in parenchymal abnormalities between the childhood and the adult moyamoya disease was statistically significant (p=0. 000164). There was no significant difference between the two groups with regard to the occlusive changes of the internal carotid and middle cerebral arteries or to moyamoya vessels(p> 0.01 ). CONCLUSION: This study could prove the fact that the principal clinical symptoms in the childhood moyamoya disease were due to cerebral infarction and those in the adult cases were due to infarction and intracranial hemorrhage. In addition, cortical infarction was more prevalent in children and infarction in periventricular white matter/centrum semivoale and basal ganglia was more frequentin adults. There was no significant difference in vascular abnormalities between the two groups.
Adult* ; Basal Ganglia ; Brain ; Cerebral Infarction ; Child* ; Female ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Male ; Middle Cerebral Artery ; Moyamoya Disease* ; Vascular Patency

In this study, radiographic evaluation was made using panoramic radiography and cross-sectional tomography of SCANORA in male and female adults in their 20 s on the relationship between the maxillary sinus floor and the apex of the maxillary molar, to test the accuracy and effectiveness of the cross-sectional tomography, and to use this information in the assessment of preop, and postop, root canal treatment, apical surgery, extraction and implantology. Forty-one adults with an average age of 24.4 years were studied panoramic radiography and cross-sectional tomography. In panoramic view and cross-sectional view, the position of the apices of maxillary molars were classified as separated, contacted, or protruded type; the general shape of the maxillary sinus floor was evaluated horizontally and vertically from cross-sectional tomography. The accuracy of each radiography was tested using maxilla from 5 fresh cadavers from the Anatomy Lab at Yonsei University Dental College, and panoramic view and cross-sectional tomography were taken in the same condition as with the patients. The results were as follows ; 1. Panoramic view and cross-sectional view were taken in the maxilla specimen, and the actual distance between the maxillary sinus floor and the tooth apices were measured in the specimen; the median values of the distance from the tooth apices to the maxillary sinus floor in the panoramic view, cross-sectional view and in the acrual maxilla specimen were 2.83mm, 4.51mm, and 4.15mm, respectively. In the cross-sectional view, the measured distance was close to the actual distance but in the panoramic view, the measured distance was far from the actual distance. 2. When the results of the panoramic view and cross-sectional view were compared, 40.5% of the results agreed with each other in the two radiographic methods and buccal roots of the 2nd molar were the closest to the maxillary sinus floor in the cross-sectional tomography. 3. In cross-sectional view, when the vertical relatioship of the maxillary sinus floor and maxillary roots was assessed, in 1st molars, type II (the sinus floor that extends down to the buccolingual furcation area) was predominant, while in 2nd molars, type I (the sinus floor located above the level connecting the buccal and lingual apices) was predominant. In the horizontal relationship, in 1st olars, type II (ths lowest floor of the maxillary sinus located in between the buccal and lingual roots) was predominant; in 2nd molars, type I (the lowest floor of the maxillary sinus located on the buccal side of the buccal roots) and type II appeared in similar frequency. In conclusion, the SCANORA cross-sectional tomography was more effective than the frequently used panoramic view, in that the relationship of the maxillary molars and maxillary sinus floor can be evaluated more accurately and the buccolingual cross-sectional view can also be observed. And maxillary sinus floor that was close to maxillary 2nd molar had tendency to be located on buccal side than that close to 1st molar. Therefore, cross-sectional tomography is an effective and accurate method to evaluate the position of the teeth in relation to the sinus floor preoperative and can be easily used to diagnose localized periapical lesions. Also the image quality obtained was quite satisfactory.
Adult ; Cadaver ; Dental Pulp Cavity ; Female ; Humans ; Male ; Maxilla ; Maxillary Sinus* ; Molar* ; Radiography ; Radiography, Dental, Digital ; Radiography, Panoramic ; Tooth ; Tooth Apex

No abstract available.
Groin* ; Vulvar Neoplasms*

Angioedma is a group of disorders with multifactorial etiology but a similar clinical expression, is characterized by swelling of subcutaneous or submucosal tissue. Systemic lupus erythematosus(SLE) is a chronic multi-systemtic disease characterized by inflammation and tissue damage resulting from deposition of auto-antibodies and immune complex. We experienced a case of angioedema which was the first manifestation of SLE in 24-year-old female patient. She had suffered from severe facial edema and multiple lymphadenopathy for six months and she also had pleural effusion, positive anti-nuclear and anti-DNA antibody test. Marked decrease of C3 and C4 levels was noted with normal antigenic level, and activity of Cl esterase inhibitor. The angioedema was not improved with anti-hitamine agents and instead disappeared with use of corticosteroid and non-steroidal anti-inflammatory drugs. Complement levels normalized after corticosteroid treament. We report a case of SLE which initial manifestation was angioedema.
Angioedema ; Antigen-Antibody Complex ; Complement System Proteins ; Edema ; Female ; Humans ; Inflammation ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Pleural Effusion ; Young Adult

No abstract available.
Humans ; Infant*

PURPOSE: This study was performed to investigate the epidemiology of enterovirus (EV) infections in children at a secondary hospital during recent 5 years. METHODS: We collected the cerebrospinal fluid, stool and throat swab samples from the pediatric patients with suspected EV infections in KEPCO Medical Center, Seoul, Korea from July 2006 to September 2010. EV detection and genotype identification were performed by RT-PCR at Korea Centers for Disease Control and Prevention. RESULTS: A total of 386 samples were collected from 277 patients during study period. Ninety-eight patients (35.4%) were diagnosed with EV infections. The RT-PCR positive rate was the highest in throat swab samples (48.3%). The median age of patient was 4.7 years (range, 0.1-12.5 years). Aseptic meningitis (50, 51.0%) was the most common clinical manifestation; herpangina (22, 22.4%) and hand-foot-mouth disease (18, 18.4%). One hundred EVs were isolated from 98 patients and 20 genotypes of EV were identified; Echovirus 30 (28 cases, 28%), Enterovirus 71 (12 cases, 12%), Echovirus 25 (10 cases, 10%), Echovirus 9 (9 cases, 9%) and Coxsackievirus A6 (8 cases, 8%). Aseptic meningitis caused by Echovirus 30 was the most common manifestation in 2008. There was no complicated case caused by Enterovirus 71. CONCLUSION: This study showed the epidemiology of confirmed EV infection in children from 2006 to 2010. There is a need for continuous surveillance of EV infections and its clinical manifestations.
Centers for Disease Control and Prevention (U.S.) ; Child ; Echovirus 9 ; Enterovirus ; Enterovirus B, Human ; Enterovirus Infections ; Genotype ; Herpangina ; Humans ; Korea ; Meningitis, Aseptic ; Pharynx

No abstract available.
Child* ; Hematuria* ; Humans

PURPOSE: The thickening of the gallbladder wall is a valuable finding for the diagnosis of cholecystitis, butmay be seen in non-cholecystic disease as well as in acute or chronic cholecystitis. The purpose of this study isto determine the value of color Doppler sonography in differentiating the causes of thickened gallbladder wall. MATERIALS AND METHODS: Ninety eight patients with thickened gallbladder wall(more than 3mm) which was not due to gallbladder cancer were prospectively evaluated with color Doppler sonography. Sixty-six cases, confirmed bypathologic reports and clinical records, were analyzed for correlation between thickened gallbladder wall andcolor flow signal according to the underlying causes. RESULTS: Of the 66 patients, 28 cases were cholecystitisand 38 cases had non-cholecystic causes such as liver cirrhosis, ascites, hepatitis, pancreatitis, renal failure,and hypoalbuminemia. Of the 28 patients with cholecystitis(12 acute, 16 chronic), 23(82%) had color Doppler flowsignals in the thickened gallbladder wall. Of the 38 patients with non-cholecystic causes, eight(21%) had color Doppler flow signals. There was a statistically significant difference of color Doppler flow signals between the cholecystitis and non-cholecystic groups(p=0.0001). No significant difference of color Doppler flow signals was found between cases of acute and chronic cholecystitis. Of the 23 patients with color Doppler flow signals in 28cases of cholecystitis, 18(78.3%) showed a linear pattern and five(21.7%) showed a spotty pattern. Of the eight patients with color Doppler flow signals in the 38 non-cholecystic cases, four(50%) showed a linear pattern andfour(50%) showed a spotty pattern. In cholecystitis, a linear color Doppler flow signal pattern is a much more frequent finding than a spotty pattern. CONCLUSION: Color Doppler sonography is a useful and adequate method for determining whether a thickened gallbladder wall is the result of cholecystitis or has non-cholecystic causes.
Ascites ; Cholecystitis ; Diagnosis ; Gallbladder* ; Hepatitis ; Humans ; Hypoalbuminemia ; Liver Cirrhosis ; Pancreatitis ; Prospective Studies

Allergic angitis and granulomatosis is a kind of rare systemic vasculitis, with various manifestations of disease of lung, heart, skin, musculoskeletal system, nervous system and hepatobiliary tract. There was no report of a case with manifestation of pleuritis and pericarditis, while several cases had been reported in Korea. So we here report a case of allergic angitis and granulomatosis with manifestations of pleuritis and pericarditis. The case also showed clinical manifestations of hypereosinophilia, asthma, rhinitis, pulmonary infilterates with eosinophilia and nephritis. Open lung biopsy showed arteritis with heavy infilteration of activated eosinophil in lung, pleura and pericardium. The involvement of heart might cause critical complication leading death. The patients who are supposed as allergic angitis and granulomatosis should be examined for the involvement of heart.
Arteritis ; Asthma ; Biopsy ; Eosinophilia ; Eosinophils ; Heart ; Humans ; Korea ; Lung ; Musculoskeletal System ; Nephritis ; Nervous System ; Pericarditis* ; Pericardium ; Pleura ; Pleurisy* ; Rhinitis ; Skin ; Systemic Vasculitis

Acute thrombosis of the portal and superior mesenteric vein (SMV) due to inflammation of abdominal organs is a rare condition, but delayed diagnosis causes severe problems and serious long term complications. Therefore the early diagnosis and adequate management of the underlying disease and thrombus is very important. Here a case of an 84-year-old man with portal vein and SMV thrombosis on Doppler ultrasonography and computed tomography (CT) after cholecystectomy and choledochostomy by the 10th day is reported. The patient's condition improved without complication after the treatments with an anticoagulant regimen and antimicrobials. In the follow up, there was no thrombus on the CT or sign of a recurrent disease.
Aged, 80 and over ; Cholangitis ; Cholecystectomy* ; Choledochostomy* ; Delayed Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Mesenteric Veins* ; Portal Vein* ; Thrombosis* ; Ultrasonography, Doppler ; Venous Thrombosis