No abstract available.
Child* ; Humans

Canavan disease(CD) is a rare autosomal recessive leukodystrophy caused by the deficiency of aspartoacylase and the accumulation in brain of N-acetylaspartate(NAA). CD has been reported mainly Ashkenazi Jews but also occurs in other ethnic groups. Usually it presents as early as the third month of life with megalencephaly, hypotonia later progressing to hypertonia, psychomotor and mental retardation, blindness, occasionally deafness and seizure. Diagnosis is based on the clinical feature, N-acetylaspartic aciduria, radiologic and pathologic findings. Histologically, the affected white matter shows extensive vacuolation and demyelination. There is no treatment for CD and the only prevention is through genetic counselling and prenatal diagnosis. We experienced a case of Canavan disease that was presented with hypotonia and developmental delay. Diagnosis was confirmed histologically. Radiologic findings are extensive high signal throughout the white matter on T2-weighted MRI and increased NAA peak and decreased choline peak of the white matter on MR spectroscopy.
Blindness ; Brain ; Canavan Disease* ; Choline ; Deafness ; Demyelinating Diseases ; Diagnosis ; Ethnic Groups ; Humans ; Intellectual Disability ; Jews ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Muscle Hypotonia ; Prenatal Diagnosis ; Seizures

PURPOSE: To investigate the prognosis, survival rate and curve on the eyes for corneal dystrophy and corneal degeneration, we performed statistical analysis. METHODS: Forty-one recipients (62 eyes) have received penetrating keratoplasty for corneal dystrophy and corneal degeneration for about 14 years from April 1984 to October 1997. We analyzed survival rate and curve on sex, age and type of corneal dystrophy and corneal degeneration. RESULTS: Mean age was 35 years and sex distribution of recipient was predominant in female patients (M: 16 recipients, 19 eyes, F: 25 recipients, 43 eyes). In the causative disease of first keratoplasty, corneal dystrophy and corneal degeneration were 46 eyes and 16 eyes. Granular type was the most common type of keratoplasty. In 62 grafts, graft rejection was developed in 19 eyes (30.6%). Graft rejection periods ranged from 53 days to 10 years and 3 months. Mean graft rejection time was 2 years and 8 months. In this study, 5 years survival rate developed in 75% of corneal dystrophy and developed in 31% of corneal degeneration. The statistical analysis showed significant relationship between survival rate and disease type (p=0.0032, p<0.05). But age and sex were not maintained with association with survival rate (p>0.05). CONCLUSIONS: This result suggests that corneal dystrophy was higher than corneal degeneration in survival rate with statistically significant difference. But sex and age did not have influence on survival rate.
Corneal Transplantation ; Female ; Graft Rejection ; Humans ; Keratoplasty, Penetrating* ; Prognosis* ; Sex Distribution ; Survival Rate* ; Transplants

Vesicovaginal fistula is a uncommon status in the developed countries. In the past it was mostly by obstetric causes. But now a days, posthysterectomy fistulas are seen. Fistula is a discomfort to the patient because of urine leakage, odor, and its inconvenience. We have experienced one case of fistula after abdominal hysterectomy and have repaired it by Latzko partial colpocleisis. So we report a case with some references.
Developed Countries ; Fistula ; Humans ; Hysterectomy ; Odors ; Vesicovaginal Fistula*

No abstract available.
Head* ; Necrosis*

Objective: The present study aimed to analyze the correlation between platelet-to-lymphocyte ratio (PLR) and platelet-to-neutrophil ratio (PNR) with prognosis of patients who underwent mechanical thrombectomy (MT). Methods: A total of 432 patients was included, PLR and PNR were calculated from laboratory data on admission. Prognosis was evaluated with a modified Rankin Scale at 3 months after MT. Using receiver operating characteristic (ROC) analysis, optimal cutoff values of PLR and PNR were identified to predict the prognosis after MT. Multivariate analyses were performed to identify the relationship of PLR and PLR with prognosis of MT. Results: Patients with favorable outcomes had a lower mean PLR (135.0, standard deviation [SD] 120.3) with a higher mean PNR (47.1 [SD] 24.6) compared with patients with unfavorable outcomes (167.6 [SD] 139.3 and 35.4 [SD] 22.4) (p<0.001 and <0.001, respectively). In ROC analyses, the optimal cutoff value of PLR and PNR to predict the 3 months prognosis were 145 and 41, respectively (p=<0.001 and p=0.006). In multivariate analysis, PLR less than 145 (odds ratio [OR] 1.29, 95% confidence interval [CI] 1.06–2.06; p=0.016) and PNR greater than 41 (OR 1.22, 95% CI 1.10–1.62; p=0.022) were predictors of favorable outcome at 3 months. Conclusions In patients with MT, PLR and PNR on admission could be predictive factors of prognosis and mortality at 3 months. Decreased PLR and increased PNR were associated with favorable clinical outcome 3 months after MT.

Background: Transsphenoidal surgery is one of the important treatment options in the manage-ment of prolactinomas; however, complete resection of the tumor does not always lead to endocrinological remission. While many studies have investigated preoperative factors associated with surgical outcome, little has been known about the relationship between postoperative factors and long-term surgical outcomes; moreover, there is no consistency in results. The aim of this study was to demonstrate the reliability of immediate postoperative prolactin levels as predictors of long-term outcomes. Methods: A total of 105 female patients who underwent complete removal of their histologically confirmed prolactinomas were included, and their medical records were retrospectively reviewed. To evaluate the predictability of immediate postoperative prolactin levels for long-term remission, prolactin levels were measured at 2, 6, 12, 18, 24, 48, and 72 h after surgery. Results: From the 105 included patients, 95 (90.5%) and 10 (9.5%) belonged to the remissionand non-remission groups, respectively. A significant difference was observed in the prolactin level measured 6 h after surgery between the remission and non-remission groups, and this difference stayed apparent until 72 h after surgery. We derived a cut-off value for every postoperative time point that showed a significant relationship with disease remission. Conclusion Our study suggests that immediate postoperative measurement of prolactin levels is a reliable predictor of long-term remission and can contribute to early identification of patients who require adjuvant treatment after surgery.

Sialoblastoma and hepatoblastoma of neonate were very rare cancer. We present a case of concurrent sialoblastoma with hepatoblastoma associated with chromosomal anomaly.
Hepatoblastoma* ; Humans ; Infant, Newborn*

PURPOSE: Fluid-attenuated inversion recovery (FLAIR) imaging can be obtained faster with shorter repletion time (TR), but it gets noisier. We hypothesized that shorter-TR FLAIR obtained at 3 tesla (3T) with a 32-channel coil may be comparable to conventional FLAIR. The aim of this study was to compare the diagnostic value between conventional FLAIR (TR = 9000 ms, FLAIR9000) and shorter-TR FLAIR (TR = 6000 ms, FLAIR6000) at 3T in terms of diffusion-weighted imaging-FLAIR mismatch. MATERIALS AND METHODS: We recruited 184 patients with acute ischemic stroke (28 patients < 4.5 hours) who had undergone 5-mm diffusion-weighted imaging (DWI) and two successive 5-mm FLAIR images (no gap; in-plane resolution, 0.9 × 0.9 mm) at 3T with a 32-channel coil. The acquisition times for FLAIR9000 and FLAIR6000 were 108 seconds (generalized autocalibrating partially parallel acquisitions [GRAPPA] = 2) and 60 seconds (GRAPPA = 3), respectively. Two radiologists independently assessed the paired imaging sets (DWI-FLAIR9000 and DWI-FLAIR6000) for the presence of matched hyperintense lesions on each FLAIR imaging. The signal intensity ratios (area of DWI lesion to contralateral normal-appearing region) on both FLAIR imaging sets were compared. RESULTS: DWI-FLAIR9000 mismatch was present in 39 of 184 (21.2%) patients, which was perfectly the same on FLAIR6000. Three of 145 patients (2%) with DWI-matched lesions on FLAIR9000 had discrepancy on FLAIR6000, showing no significant difference (P > 0.05). Interobserver agreement was excellent for both DWI-FLAIR9000 and DWI-FLAIR6000 (k = 0.904 and 0.883, respectively). Between the two FLAIR imaging sets, there was no significant difference of signal intensity ratio (mean, standard deviation; 1.25 ± 0.20; 1.24 ± 0.20, respectively) (P > 0.05). CONCLUSION: For the determination of mismatch or match between DWI and FLAIR imaging, there is no significant difference between FLAIR9000 and FLAIR6000 at 3T with a 32-channel coil.
Humans ; Magnetic Resonance Imaging ; Stroke

PURPOSE: To compare T2 relaxation times (T2) in the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex between 1.5T and 3.0T MR imagers. MATERIALS AND METHODS: Twelve healthy volunteers underwent FLAIR and CPMG imaging perpendicular to the hippocampal body at both 3.0T and 1.5T. T2 was measured in the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex. The T2 relaxation time ratios of the cingulate cortex, insular cortex, and amygdaloid body to the hippocampal body were compared between 1.5T and 3.0T. RESULTS: The mean T2 of the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex at 1.5T were 109.5+/-3.1, 117.0+/-7.1, 114.7+/-2.4, and 111.3+/-2.4, respectively; 99.7+/-3.8, 100.7+/-4.3, 97.9+/-3.4, and 96.2+/-2.0, respectively, at 3.0T. Percentage changes of T2 in the cingulate cortex, insular cortex, amygdaloid body, and hippocampal body at 3.0T with respect to those at 1.5T were -8.9%, -13.5%, -14.6%, and -13.5%, respectively. The mean T2 ratios of the cingulate gyrus, insular cortex, and amygdaloid body to the hippocampal body at 1.5T and 3.0T were 0.96 and 1.02 (p=0.003); 1.02 and 1.03 (p>0.05); 0.97 and 0.98 (p>0.05), respectively. CONCLUSION: T2 decrease in the cingulate cortex was less than the amygdaloid body, insular cortex, and hippocampal body at 3.0T. The mean T2 ratio of the cingulate gyrus to the hippocampal body was significantly different between 1.5T and 3.0T.
Amygdala ; Brain ; Gyrus Cinguli ; Hippocampus ; Relaxation