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

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

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

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

Sarcoidosis is a systemic granulomatous disease of unknown etiology that involves many organs, occasionally mimicking malignancy. We herein report a 50-yr-old woman of muscular sarcoidosis of chronic myopathic type, manifested by hypercalcemia and muscle wasting. Besides insignificant hilar lymphadenopathy, her sarcoidosis was confined to generalized atrophic muscles and therefore, F-18 FDG PET/CT alone among conventional imaging studies provided diagnostic clues for the non-parathyroid-related hypercalcemia. On follow-up PET/CT during low-dose steroid treatment, FDG uptake in the muscles disappeared whereas that in the hilar lymph nodes remained. PET/CT may be useful in the evaluation of unexpected disease extent and monitoring treatment response in suspected or known sarcoidosis patients.
Female ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Hypercalcemia/complications/*diagnosis ; Kidney Calculi/complications/diagnosis ; Lymph Nodes/radionuclide imaging ; Middle Aged ; Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Sarcoidosis/complications/drug therapy/*radionuclide imaging ; Steroids/therapeutic use ; Tomography, X-Ray Computed

Cystic masses of the adrenal gland are unusual in the fetus and most are secondary to hemorrhage. Cysticneuroblastoma is extremely rare, and in contrast to solid neuroblastoma, follows a benign course, is diagnosedearlier, and rarely presents with metastatic lesions(1-4). We report one case of cystic neuroblastoma diagnosedprenatally by ultrasound(US) and magnetic resonance(MR) imaging, and include a review of the literature.
Adrenal Glands ; Fetus ; Hemorrhage ; Neuroblastoma*

BACKGROUND: Hypertrophic scar following a burn is caused by the excessive deposit of collagen resulting in an exaggerated wound healing response. The burn patient complains of pain and itching over the scar, which can give rise to cosmetic and functional problems. OBJECTIVE: The aim of this study was to investigate the clinical and histological correlation of a hypertrophic burn scar for itching and pain sensations. METHODS: Thirty-eight patients underwent a scar release and skin graft. the modified Vancouver scar scale and the verbal numerical rating scale were recorded. All biopsies were taken from scar tissue (scar) and normal tissue (normal). Histologically, tissues were observed in the epidermis, the monocytes around the vessels, the collagen fiber, elastic fiber, and the mast cells. RESULTS: The mean total score of MVSS was 8.4+/-2.7 (pliability 2.0+/-0.9; thickness 1.8+/-0.9; vascularity 2.0+/- 0.9; and pigmentation 2.1+/-0.9). Pain and itching were 2.4+/-2.0 and 2.9+/-3.0. Epidermis were 7.9+/-2.8 layers (scar) and 4.0+/-0.8 layers (normal). The collagen fibers were thin and dense (scar) and thicker and loose (normal). The elastic fibers were thin and nonexistent (scar) and thin and loose (normal). Mast cells were 11.2+/-5.8/high power field (scar) and 7.4+/-4.1 (normal). CONCLUSION: As the scar tissue thickens, the itching becomes more severe. The stiffness of the scar with the pain appeared to be associated with the condition of the tissue. The correlation between clinical and histological post-burn hypertrophic scars will help further studies on the scar. This helped with the development of the base material for therapeutic strategies.
Biopsy ; Burns ; Cicatrix ; Cicatrix, Hypertrophic* ; Collagen ; Elastic Tissue ; Epidermis ; Humans ; Mast Cells ; Monocytes ; Pigmentation ; Pruritus* ; Sensation* ; Skin ; Transplants ; Wound Healing

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