PURPOSE: To evaluate the US findings of soft tissue hemangiomas in extremities and to correlate the echo-pattern with MR signal characteristics of hemangiomas. MATERIALS AND METHODS: We retrospectively studied forty-two patients either with pathologically proven cases or with characteristic features of hemangiomas on MRI, US and plain film. Hemangiomas were divided into two types according to the locations;subcutaneous and intramuscular. Analytic points on US and MR findings were gross morphology of the mass, internal echo-pattern or signal characteristics. We correlated the echo-pattern with MR signal characteristics in hemangiomas. RESULTS: Subcutaneous hemangiomas revealed homogeneously anechoic mass on US, which were well correlated with MR signal characteristics' homogeneous low singnal intensity(SI) on Tl-weighted image(WI) and high SI on T2-WI. Intramuscular hemangiomas showed heterogeneously mixed echoic masses on US. An anechoic component on US corresponded to dilated vascular channels on MRI. The signal intensity of intramuscular hemangioma was less than that of subcutaneous fat on T1-WI and greater than that of fat on T2-WI. Both types of hemangiomas had tubular or lace-like appearance with interspersed fibrofatty septa. CONCLUSION: The echo-patterns in US were well associated with MR signal characteristics on MRI. Regarding US and MR features, intramuscular hemangiomas were different to subcutaneous hemangiomas.
Extremities* ; Hemangioma* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Subcutaneous Fat

The purpose of the study was to investigate the influence of an endodontic infection on presence of furcation involvement in periodontally-involved mandibular molars. All first and second mandibualr molars in 45 patients were selected if at least one was root-filled or had a possible periapical radiolucency. The sample consisted of patients from a referral population at a periodotnal clinic which represented an adult population with a mean age of 47.5 years (range 31 to 63) For mandibular molars with periapical destruction at both roots, frequency of horizontal furcation depth > or = 3 mm was significantly more compared to teeth without periapical destruction. Mean periodontal probing depth was significantly greater at mandibular molars with periapical destruction. It is suggested that a root canal infection in periodontitis-involved molars may potentiate periodontitis progression by spreading of endodontic pathgens through patent accessory canals and dentinal tubules. In conclusion, an endodontic infection in mandibular molars was found to be associated with additional attachment loss in the furcation area, and may thus be considered to be one of several risk factors influencing the prognosis of molars in periodontitis-prone patients.
Adult ; Dental Pulp Cavity ; Dentin ; Humans ; Molar* ; Periodontal Diseases ; Periodontitis ; Prognosis ; Referral and Consultation ; Risk Factors ; Tooth

BACKGROUND/AIMS: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrast-enhanced magnetic resonance imaging (MRI). METHODS: Fifteen patients with hepatic NET (n=128) underwent enhanced MRI and DWI with multiple-b values. We analyzed three different sets: Precontrast set; DWI set (added DWI); combined set (added enhanced image). Two reviewers rated possibility of NET using a 5-point scale for each image set. Their diagnostic performance was compared using Jackknife alternative free-response ROC (JAFROC). RESULTS: Diagnostic performance was better on the combined set (figure of merit [FOM]=0.852, 0.761) than the precontrast set (FOM=0.427, 0.572, P〈0.05) and the DWI set (FOM=0.682, 0.620, P〈0.05). However, DWI improved performance compared with precontrast set without statistical difference. In small NETs (〈1 cm), all sets showed low sensitivity (10.7-65.9%) with high specificity (95.4-100%). Interobserver agreement was moderate in all image sets (k=0.521 to 0.589). CONCLUSIONS: Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.
Humans ; Magnetic Resonance Imaging* ; Neuroendocrine Tumors* ; Sensitivity and Specificity

Cranial fasciitis is a rare fibroblastic tumor which shows a predilection for the scalp and skull of youngchil-dren. Histologically, cranial fasciitis is identical to nodular fasciitis which is typically found in theextremities of adults, though is unique in that it may present as an osteolytic lesion of the skull. We report acase of cranial fasciitis in a 20-month-old girl, describing the ultrasonography, CT and MRI findings.
Adult ; Child* ; Fasciitis* ; Female ; Fibroblasts ; Humans ; Infant ; Magnetic Resonance Imaging ; Scalp ; Skull ; Ultrasonography

Asthma is characterized by bronchial wall inflammation, airway hyperactivity, and variable degrees of reversible airflow obstruction resulting in wheezing, dyspnea, and coughing. Elderly patients with asthma have a high morbidity and mortality in the perioperative period. In an asthmatic attack, if appropriate therapeutic and preventive measures are not instituted, it can result in severe complications. A 76-year-old male who was scheduled for cataract surgery had a history of bronchial asthma. After the operation, the patient complained of dyspnea at rest and tachycardia and breath sounds bilaterally were decreased with wheezing. To relieve the asthmatic attack, O2 mask ventilation, aminophylline 4 mg/kg, IV and a ventolin nebulizer were applied. However, 30 min after the asthmatic attack, SpO2 dropped to 50 - 60% and stuporous mentality appeared. We report an acute myocardial infarction and pulmonary edema after an asthma attack in a patient undergoing cataract surgery.
Aged ; Albuterol ; Aminophylline ; Anesthesia, Local* ; Asthma ; Cataract* ; Cough ; Dyspnea ; Humans ; Inflammation ; Male ; Masks ; Mortality ; Myocardial Infarction* ; Nebulizers and Vaporizers ; Perioperative Period ; Pulmonary Edema ; Respiratory Sounds ; Stupor ; Tachycardia ; Ventilation

Forensic entomology investigates postmortem interval (PMI) estimation using insect evidence. We estimated the minimum PMI of a putrefied male cadaver using pupae in the soil and maggots found in the body. Most of the maggots, collected during the autopsy, were postfeeding third instar larvae with empty crop contents, which developed freezing injuries when the cadaver was placed in the freezer. Pupae in the soil were collected 45 days after the discovery of the body. DNA barcoding revealed that most pupae and maggots were Chrysomya pinguis, with a few exceptions. The minimum PMI was estimated at 10 days before the discovery time based on the scene investigation, maggot developmental stage, distribution of pupae moving away from the body toward pupariation sites, DNA barcoding results, and weather information. To reduce the gap between the minimum and maximum PMI values, complete entomological evidence collection should be conducted at the time of discovery.
Autopsy ; Cadaver ; Diptera* ; DNA ; Entomology* ; Forensic Sciences ; Freezing* ; Humans ; Insects ; Larva* ; Male ; Postmortem Changes ; Pupa* ; Soil ; Weather

Kearns-Sayre syndrome (KSS) is a rare multisystem mitochondrial disorder associated with progressive external ophthalmoplegia, atypical pigmentary degeneration of the retina, and complete heart block. KSS can lead to a risk of sudden death because of the potential progression of conduction abnormalities such as right or left bundle branch block or complete atrioventricular (AV) block. Here we describe the case of a KSS patient with type I diabetes who experienced syncope in the presence of complete AV block, confirmed by muscular biopsy.
Atrioventricular Block* ; Biopsy ; Bundle-Branch Block ; Death, Sudden ; Heart Block ; Humans ; Kearns-Sayre Syndrome* ; Mitochondrial Diseases ; Ophthalmoplegia, Chronic Progressive External ; Retina ; Syncope

No abstract available.
Diabetes Mellitus* ; Humans ; Insulin* ; Puberty, Delayed*

There have been controversies on the effect of albumin in treating edema in nephrotic syndrome patients. We evaluated the additive diuretic effect of coadministration of furosernide with albumin in the six patients with nephrotic syndrome. We administered 160mg of furosemide intravenously for 1 hour with 100rnl of 20% albumin or 5% dextrose by random cross-over design. The urine and plasma furosemide concentrations were measured by HPLC. After the administration of furosemide alone, urine volume, urinary excretions of sodium and chloride were increased significantly compared to those of basal state (P<0.05). But, coadministration of furose-mide with albumin did not increase significantly the urine voume (2285+/-445ml vs. 3023+/-715ml), urinary excretions of sodium (194+/-58rnmol/day vs. 282+/-85 mmol/day) and chloride (213+/- 54mmoVday vs. 286+/- 74mmoVday) comparing to those of furosemide only cases. Addition of albumin to furosemide did not significantly changed pharmacokinetic parameters such as AUC (28.3+/-5.5ug/ml hr vs 36.0+/-6.7ug/ml hr), total plasma clearance (115+/-30mVmin vs 108+/-41ml/min), volume of distribution (0.13+/-0.02L/kg vs 0.10+/- 0.01L/kg), elirnination half life (1.4+/-0.3hr vs 1.5+/-0.3hr), and urine furosemide excretion (44+/-8% vs 43+ 10%). We concluded that albumin infusion did not enhance the diuretic action of furosemide pharmacodynamically and pharmacokinetically in patients with nephrotic syndrome.
Area Under Curve ; Chromatography, High Pressure Liquid ; Cross-Over Studies ; Diuretics ; Edema ; Furosemide* ; Glucose ; Half-Life ; Humans ; Nephrotic Syndrome* ; Pharmacokinetics ; Plasma ; Sodium

PURPOSE: The relationship of gastroesophageal reflux(GER) to respiratory diseases has been recognized. Diagnosis of gastroesophageal reflux disease can be confirmed by 24 hour esophageal pH probe study and barium fluoroscopic esophagography. However, for 24 hour esophageal pH monitoring in children, patients should be admitted, and the fluoroscopic studies may have radiation exposure. The objective of this study was to determine the value of color Doppler(CD) ultrasonography as a screening test of gastroesophageal reflux disease in children. METHODS: Thirty-four CD ultrasonographic examinations were performed and compared to simultaneous 24 hour esophageal pH monitoring. The patients were aged 3 months to 10 years, mean age of 36 months. The CD study was performed over a period of 10 minutes after weight-related feeding. The CD ultrasonographic finding was staged in the following way: 1) normal : 0 reflux, 2) grade I : 1-3 refluxes, 3) grade II : 3-6 refluxes, and 4) grade III: >6 refluxes. RESULTS: Gastroesophageal refluxes were detected in 28 out of 34 patients on CD ultrasonography. Fifteen cases were classified as grade I, 12 cases as grade II, and 1 case as grade III. There was agreement in the diagnosis of reflux or no reflux between pH measurements and CD ultrasonography in 28 out of 34 patients(82%) patients. In the remaining six patients, pH measurements were positive for reflux, and color Doppler ultrasonography showed no reflux in two, while pH-metry were negative and CD showed reflux in four patients. Positive and negative predictive values of CD sonography compared with 24 hour pH monitoring were 85.7% and 66.7% respectively. CONCLUSION: We suggest that CD ultrasonography can be used as a useful and convenient screening method for outpatients suspected of reflux.
Barium ; Child* ; Diagnosis ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Mass Screening* ; Outpatients ; Ultrasonography ; Ultrasonography, Doppler, Color*