PURPOSE: To evaluate MR characteristics of acute disseminated encephalomyelitis (ADEM) in children, which was confirmed by clinical findings. MATERIALS AND METHODS: The subjects were six patients, who were diagnosed by clinical findings. One subject had recurrence one year after clinical improvement leading to one additional care with the total of seven. The modes of viral infections were as follows;four cases of non-specific upper respiratory tract infection, one of E-B virus, one of Japanese-B-encephalitis vaccination, and one of upper respiratory infection in Bruton's disease. The Gd-DTPA enhanced scan was performed in all cases. MR findings were evaluated in anatomic location of the lesions, presence or absence of contrast enhancement, and the temporal changes were also evaluated on follow-up MRI. RESULT: There were multifocal high signal intensity lesions on T2WI in all cases. The location of lesions were basal ganglia in five, thalamus and brain stem in four, and cerebral gray and white matter and cerebellar white matter in three. Bilaterality was 77%. There were contrast enhancement in two of three cerebral cortical lesions and one of three white matter lesions. The size of lesions decreased on the first follow-up MRI which were done after 1 month in 4 cases, but new lesions were developed in two cases. On the second follow-up MRI which were done 2 months after, all lesions were decreased in size and there was no newly developed lesion. However, in one case who had recurrent similar symptom after 1 year, several new lesions developed on follow-up MRI, and it was comidened as a recurrence. CONCLUSION: The characteristic MR findings of ADEM were multifocal bilateral white and gray matter lesions which were high signal intensities on T2WI. The majority of lesions improved on follow-up MRI, but occasionally showed multiphasic pattern.
Basal Ganglia ; Brain Stem ; Child* ; Encephalomyelitis, Acute Disseminated ; Follow-Up Studies ; Gadolinium DTPA ; Herpesvirus 4, Human ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Respiratory Tract Infections ; Thalamus ; Vaccination

PURPOSE: The purpose of this study is to measure the magnification of the capsulorhexis by the cornea using open ring guided capsulorhexis (ORGC) during cataract surgery. The study also investigated the magnification changes according to anterior chamber depth and corneal power. METHODS: The subjects comprised 40 eyes from 37 patients whose astigmatism was lower than 0.25 D and who had cataract surgery using ORGC from December 2011 to April 2012. ORGC was set on the anterior capsule and photographs were obtained using a camera connected to a surgical microscope after attaching a ruler around the limbus. The pixel number of 5 mm gradations on a ruler and the inner diameter of ORGC were measured using ImageJ. The inner diameter of ORGC was known to be 5.30 mm and the size of ORGC in the snapshot was therefore calculated by proportional expression. After corneal power and anterior chamber depth were identified, the magnification effect was evaluated. RESULTS: The 37 subjects were composed of 19 males and 21 females, and their average age was 64.8 years. The average depth of the anterior chamber was 3.28 mm, and the average corneal power was 43.534 D. The measured inner diameter of ORGC was 6.14 mm (SD: +/-0.16 mm) and the average magnification of the capsulorhexis was 115.9% (SD: +/-3.1%). The results showed that in the case of shallow anterior depth and low corneal power, the magnification was low equivalent to 110%. However, when the anterior chamber was deep and the corneal power was high, the magnification was greatly increased to 120%. CONCLUSIONS: The capsulorhexis was magnified to an average of 115.9% by the cornea during cataract surgery. In particular, it is necessary to consider capsulorhexis size in cases with deep anterior chamber and high corneal power, because the magnification will be greater in those cases.
Anterior Chamber ; Astigmatism ; Capsulorhexis* ; Cataract ; Cornea* ; Female ; Humans ; Male