The purpose of this study is to describe the magnetic resonance imaging (MR) findings of metastatic brain tumors with emphasis on the signal intensities of the lesion on MR. Thirty four patients with intracranial metastases were studies with MR imaging. The diagnosis was established on the basis of either brain biopsy or combination of brain MR findings and the presence of primary tumors. The primary tumors include lung cancer (n=18), breast cancer (n=3), stomach cancer (n=3), rectal cancer (n=1), renal cell carcinoma (n=1), hepatocellular carcinoma(n=1), ovarian cancer (n=1), thyroid cancer (n=1), melanoma (n=1) and unknown primary sites (n=4). The parenchymal lesions were solitary in 35% (12/34) and multiple in 65% (22/34). The size of the lesions was variable, ranging from several millimeters to 5cm in diameter. The corticomedullar junction of the cerebral heispheres was the most common location of the lesions (68%). The signal intensity of solid portion of the lesions was usually either isointense (44%) or hypointense (29%) on T1-weighted images, whereas it appeared in isointense (47%), hypointense (8%) or hyperintense (11%) on proton density-weighted or T2-weighted images. The remaining cases showed mixed signal intensities. The enhancement patterns were variable including nodular (<1cm) (6%), homogenous (19%), heterogeneous (10%), ring-like enhancement (22%) or mixed pattern(43%). The size of surrounding edema was larger than the tumor diameter in 76%. In conclusion, although there are no specific MR findings of intracranial metastasis except multiplicity, intracranial metastasis should be included in differential diagnosis with high priority, when a solitary mass showing isointensity on boty T1-and T2-weighted images with massive surrounding edema, especially in the corticomedullary junction of the cerebral hemispheres is encountered.
Biopsy ; Brain Neoplasms* ; Brain* ; Breast Neoplasms ; Carcinoma, Renal Cell ; Cerebrum ; Diagnosis ; Diagnosis, Differential ; Edema ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging ; Melanoma ; Neoplasm Metastasis ; Ovarian Neoplasms ; Protons ; Rectal Neoplasms ; Stomach Neoplasms ; Thyroid Neoplasms

The purpose of this study is to describe the magnetic resonance imaging (MR) findings of metastatic brain tumors with emphasis on the signal intensities of the lesion on MR. Thirty four patients with intracranial metastases were studies with MR imaging. The diagnosis was established on the basis of either brain biopsy or combination of brain MR findings and the presence of primary tumors. The primary tumors include lung cancer (n=18), breast cancer (n=3), stomach cancer (n=3), rectal cancer (n=1), renal cell carcinoma (n=1), hepatocellular carcinoma(n=1), ovarian cancer (n=1), thyroid cancer (n=1), melanoma (n=1) and unknown primary sites (n=4). The parenchymal lesions were solitary in 35% (12/34) and multiple in 65% (22/34). The size of the lesions was variable, ranging from several millimeters to 5cm in diameter. The corticomedullar junction of the cerebral heispheres was the most common location of the lesions (68%). The signal intensity of solid portion of the lesions was usually either isointense (44%) or hypointense (29%) on T1-weighted images, whereas it appeared in isointense (47%), hypointense (8%) or hyperintense (11%) on proton density-weighted or T2-weighted images. The remaining cases showed mixed signal intensities. The enhancement patterns were variable including nodular (<1cm) (6%), homogenous (19%), heterogeneous (10%), ring-like enhancement (22%) or mixed pattern(43%). The size of surrounding edema was larger than the tumor diameter in 76%. In conclusion, although there are no specific MR findings of intracranial metastasis except multiplicity, intracranial metastasis should be included in differential diagnosis with high priority, when a solitary mass showing isointensity on boty T1-and T2-weighted images with massive surrounding edema, especially in the corticomedullary junction of the cerebral hemispheres is encountered.
Biopsy ; Brain Neoplasms* ; Brain* ; Breast Neoplasms ; Carcinoma, Renal Cell ; Cerebrum ; Diagnosis ; Diagnosis, Differential ; Edema ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging ; Melanoma ; Neoplasm Metastasis ; Ovarian Neoplasms ; Protons ; Rectal Neoplasms ; Stomach Neoplasms ; Thyroid Neoplasms

No abstract available.
Caloric Tests*

Metastasis of neuroblastoma into the central nervous system is well known, but, in fact, rare clinically. Recently we had experienced one such case, which was characterized by sudden onset of paraplegia and blindness and delayed appearance of radiologic findings. A 7 years old Korean boy was admitted to the pediatric ward of the Seoul National University Hospital on September 28, 1975 due to sudden onset of paraplegia. All physical, laboratory and simple thoracic spine X-ray findings were normal except for albuminocytologic dissociation in the C.S.F. Guillain-Barre syndrome was suspected and steroid therapy was recommended. On November 10, 1975, he was readmitted due to sudden loss of visual acuity bilaterally. At first all radiologic examinations revealed no clue to the lesion. After 4 months from the onset, there appeared typical pedicular destruction of the thoracic spine and confirmed it as neuroblastoma by surgery.
Blindness ; Central Nervous System ; Child ; Guillain-Barre Syndrome ; Humans ; Male ; Neoplasm Metastasis ; Neuroblastoma* ; Paraplegia ; Seoul ; Spine ; Visual Acuity

No abstract available.
Cytomegalovirus* ; Humans* ; Polymerase Chain Reaction*

OBJECTIVE: To evaluate the effect of neuromuscular electrical stimulation (NMES) therapy on swallowing dysfunction in patients with chronic (more than 6 months) dysphagia caused by stroke. METHOD: A total of 16 patients with stroke-caused swallowing disorders based on a videofluoroscopic swallowing study (VFSS) were treated with NMES for two weeks. NMES was applied to the skin over the anterior neck muscles for one hour a day. Swallowing function was evaluated by the functional dysphagia scale using the VFSS, clinical dysphagia scale and the American Speech-Language Hearing Association National Outcomes Measurements System Swallowing Scale (ASHA NOMS scale) before and after electrical stimulation. Follow up VFSS was performed one month after intervention. RESULTS: After completing ten treatment sessions, aspiration, reflex coughing and the total score in the clinical dysphagia scale were significantly decreased (p<0.05). There was also a significant improvement in the ASHA NOMS scale (p<0.05). Regarding the functional dysphagia scale, the residue in the valleculae and piriformis sinus, and total scores were significantly decreased (p<0.05). Specifically, the scores of the pharyngeal phase were mainly decreased as compared to that of the oral phase. In addition, these effects were maintained one month after the intervention as measured with functional dysphagia scale. CONCLUSION: After ten sessions of NMES, we found improvement in dysphagia parameters in chronic dysphagia patients. Specifically, residue in the valleculae and piriformis sinus, and a parameter of the pharyngeal phase were significantly improved.
Cough ; Deglutition ; Deglutition Disorders* ; Electric Stimulation Therapy* ; Electric Stimulation* ; Follow-Up Studies ; Hearing ; Humans ; Neck Muscles ; Reflex ; Skin ; Stroke*

OBJECTIVE: To evaluate and compare the rate and etiologies of second trimester pregnancy loss in monochorionic (MC) or dichorionic (DC) twins, and natural or assisted reproductive technology (ART) twins. METHODS: Between January 1997 and December 2008, there were 146 cases of second trimester twin pregnancy losses (between 12 and 24 weeks gestation) from 2,467 twin pregnancies. They were divided into four groups according to chorionicity and fertilization. Chorionicity was established by ultrasound at early gestation and confirmed by histologic examination after delivery. From a total of 2,467 twin deliveries, 392 MC, 2058 DC, and 17 unknown chorionicity were observed. Fertilization methods were classified as 736 natural, 1,590 ART, and 141 unknown conceptions. The pregnancy loss rate and possible mechanisms were compared in each group. RESULTS: During the study period, there were 43 MC, 86 DC, and 17 unknown chorionicities and 45 natural, 78 ART, and 23 unknown fertilizations. Total twin pregnancy loss rate was 5.9% (146/2,467), with 11.0% (43/392) and 4.2% (86/2,058) for MC twin group and DC twin group, respectively. Likewise, it was 6.1% (45/736) and 4.9% (78/1,590) for natural twin group and ART twin group. The most common cause was intrauterine fetal death (IUFD) in 22 (51.2%) in MC twin group and preterm premature rupture of membranes (PPROM) in 40 (46.5%) in DC twin group, followed by preterm labor (PTL) in 37 (43%). In natural pregnancy, IUFD was the most common etiology in 20 (44.5%) and for ART twin group, it was PTL in 35 (44.9%). CONCLUSION: Twin pregnancy loss rate was higher in MC twin group compared with DC twin group in the second trimester. MC twin group had a higher incidence of IUFD as a cause of second trimester pregnancy loss. The etiologies in DC twin group were PPROM and PTL. It is suggested that antenatal care in twin pregnancy should be explored for preventing fetal loss and promoting neonatal well-being.
Chorion ; Female ; Fertilization ; Fetal Death ; Humans ; Incidence ; Membranes ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy, Twin ; Reproductive Techniques, Assisted ; Rupture ; Twins

BACKGROUND: Impetigo is a common bacterial infection caused by Staphylococcus aureus, and group A beta-hemolytic Streptococcus or both. Recently, S. aureus has been reported as the most frequently isolated pathogen of impetigo and the incidence of methicillin-resistant S. aureus (MRSA) among patients with impetigo has increased. OBJECTIVE: To investigate the predominant microorganism and the antibiotic susceptibility of the impetigo causative pathogen. METHODS: Bacterial culture and antimicrobial susceptibility testing were performed in patients with impetigo from June 2006 to May 2012. RESULTS: Of 164 patients, bacteria were cultured from 139 patients. Among them, S. aureus was isolated from 114 (82%) patients. The others were Acinetobacter baumannii, Enterobactercloacae, Enterococcus species, Enterococcus faecium, Enterococcus faecalis, Klebsiella oxytoca, and Candida albicans. The resistance rates of S. aureus against antibiotics were as follows: penicillin, 95.6%; erythromycin, 43.9%; fusidicacid, 38.1%; clindamycin, 24.5%; gentamycin, 21%; tetracycline, 12.3%; trimethoprim-sulfamethoxazole, 0.9%; ciprofloxacin, 0%; habekacin, 0%; linezolid, 0%; teicoplanin, 0%; and vancomycin, 0%. Thirty-four (29.8%) S. aureus isolates were MRSA, and the prevalence of MRSA increased during the 6-year period. CONCLUSION: The most predominant pathogen in impetigo was S. aureus, which was sensitive to ciprofloxacin, habekacin, linezolid, trimethoprim-sulfamethoxazole, teicoplanin, and vancomycin. An increase in the prevalence of MRSA was observed during the 6-year period, and the effective antibiotics for MRSA were trimethoprim-sulfamethoxazole, teicoplanin and vancomycin.
Acetamides ; Acinetobacter baumannii ; Anti-Bacterial Agents ; Bacteria ; Bacterial Infections ; Candida albicans ; Ciprofloxacin ; Clindamycin ; Dibekacin ; Enterococcus ; Enterococcus faecalis ; Enterococcus faecium ; Erythromycin ; Gentamicins ; Humans ; Impetigo ; Incidence ; Klebsiella oxytoca ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxazolidinones ; Penicillins ; Prevalence ; Staphylococcus aureus ; Streptococcus ; Teicoplanin ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin ; Linezolid

Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is an uncommon, benign dermatosis and is characterized by asymptomatic grouped keratotic papules and plaques with a linear pattern on the extremities. Various treatments, including topical steroids, topical calcipotriol, topical 5-fluorouracil, retinoid, cryotherapy, and carbon dioxide laser ablation have been tried for PEODDN, but the results were unsatisfactory. Recently, topical photodynamic therapy (PDT) has been shown to be effective for various cutaneous disorders. We report a case of PEODDN showing partial remission with PDT using topical 5-aminolevulanic acid in a 4-year-old girl.
Calcitriol ; Cryotherapy ; Extremities ; Fluorouracil ; Lasers, Gas ; Nevus ; Photochemotherapy ; Preschool Child ; Skin Diseases ; Steroids ; Triazenes

Turner's syndrome (TS) is a genetic disorder caused by numeric and/or structural abnormalities of the X chromosome. It is characterized by a short stature, gonadal dysgenesis, and frequently by webbed neck, cubitus valgus, lymphedema, broad chest with wide spaced nipples, micrognathia, and brachimetacarpalia. Several cutaneous manifestations are associated with TS, including melanocytic nevi, hypertrophic scarring, and vitiligo. Rarely reported findings include hemangiomas, angiokeratomas, and halo nevi. We present a case of halo nevi and vitiligo in a 13-year-old girl with TS. To the best of our knowledge, halo nevi and vitiligo in TS has not been reported in the Korean literature.
Adolescent ; Angiokeratoma ; Cicatrix, Hypertrophic ; Gonadal Dysgenesis ; Hemangioma ; Humans ; Lymphedema ; Neck ; Nevus, Halo ; Nevus, Pigmented ; Nipples ; Thorax ; Turner Syndrome ; Vitiligo ; X Chromosome