PURPOSE: In order to classify the involving patterns of maxillary sinus aspergillosis on CT that will be an important guidance for functional endoscopic sinus surgery(FESS) and to evaluate CT findings of each pattern. MATERIALS AND METHODS: We reviewed CT findings of 37 cases of maxillary sinus aspergillosis which were confirmed pathologically. These were classified into three patterns according to the location:the maxillary pattern(I), the infundibular pattern(11), and combined pattern(Ill). All cases were correlated with FESS findings. We also evaluated CT density, presence of contrast enahncement and calcifications, and surrounding bony changes of each pattern. RESULT: The combined pattern was most commonly seen in 24 of 37 cases(64.9%). The maxillary pattern was identified in 8(21.6%), with 5(13.5%)cases demonstrating the infundibular patttern. These patterns were consistent with FESS findings. Calcifications were seen in 28 cases(75.7%). 31 cases(83.8%) revealed hypodensity and 16cases among them showed peripheral enhancement. Central high density with peripheral low density rim was shown in 25%(2/8) of the maxillary pattern and 12.5%(3/24) of combined patttern. Surrounding bony changes were noted mainly in infundibular pattern and combined pattern. Erosion of uncinate process showed all cases of both patterns. Erosion or elevation of ethmomaxillary plate was seen in 3 of 5 cases of infundibular pattern and all cases of the combined pattern. CONCLUSION: CT fidnings of maxillary sinus aspergillosis can be classified into 3 patterns according to their distribution. These classification could be helpful for planning FESS approach. Calcifications are the most characteristic findings of maxillary sinus aspergllosis whereas CT density or enhancement pattern do not contribute to diagnosis.
Aspergillosis* ; Classification ; Diagnosis ; Maxillary Sinus*

Bladder cancer is a relatively common cancer type, with a high recurrence rate, that can be often encountered in the imaging study. Accurate diagnosis and staging have a significant impact on determining treatment and evaluating prognosis. Bladder cancer has been evaluated by transurethral resection of bladder tumor for clinical staging and treatment, but it is often understaged when compared with final pathologic result by radical cystectomy. If the location, size, presence of muscle invasion, lymph node metastasis, distant metastasis, and presence of upper urinary tract cancer can be accurately diagnosed and evaluated in an imaging study, it can be treated and managed more appropriately. For an accurate diagnosis, radiologists who evaluate the images must be aware of the characteristics of bladder cancer as well as its types, imaging techniques, and limitations of imaging studies. Recent developments in MRI with functional imaging have improved the quality of bladder imaging and the evaluation of cancer. In addition, the Vesical Imaging Reporting and Data System was published to objectively assess the possibility for muscle invasion of cancer. Radiologists need to know the types of bladder cancer treatment and how to evaluate the changes after treatment. In this article, the characteristics of bladder urothelial carcinoma, various imaging studies, and findings are reviewed.

Bladder cancer is a relatively common cancer type, with a high recurrence rate, that can be often encountered in the imaging study. Accurate diagnosis and staging have a significant impact on determining treatment and evaluating prognosis. Bladder cancer has been evaluated by transurethral resection of bladder tumor for clinical staging and treatment, but it is often understaged when compared with final pathologic result by radical cystectomy. If the location, size, presence of muscle invasion, lymph node metastasis, distant metastasis, and presence of upper urinary tract cancer can be accurately diagnosed and evaluated in an imaging study, it can be treated and managed more appropriately. For an accurate diagnosis, radiologists who evaluate the images must be aware of the characteristics of bladder cancer as well as its types, imaging techniques, and limitations of imaging studies. Recent developments in MRI with functional imaging have improved the quality of bladder imaging and the evaluation of cancer. In addition, the Vesical Imaging Reporting and Data System was published to objectively assess the possibility for muscle invasion of cancer. Radiologists need to know the types of bladder cancer treatment and how to evaluate the changes after treatment. In this article, the characteristics of bladder urothelial carcinoma, various imaging studies, and findings are reviewed.

Facial nerve palsy is one of major accompanying features in Guillain-Barré syndrome (GBS). In most of the cases, facial weakness develops simultaneously with other symptoms such as motor weakness, sensory change and other cranial neuropathies. However, facial palsy also occurs after the nadir of neurological deficits or even after the beginning of limb weakness improvement, called delayed facial palsy (DFP). DFP has been reported in Miller Fisher syndrome, but it rarely found from the acute motor axonal neuropathy subtype of GBS. Recently, we experienced a patient who diagnosed acute motor axonal neuropathy accompanying with delayed facial diplegia.

The incidence of thymolipoma or thynuc cyst is very rare among the tumors of thymic origin, which are usually benign or invasive thymoma. Thymic tumor has been found among 10 to 15% of the patients with myasthenia gravis(MG). However the patients with thymolipoma or thynuc cyst rarely manifestated as MG. Moreover the case of MG with thymolipoma and thymic cyst is extremely rare ; Only one case has been reported hitherto. We hereby report a 41-year-old woman presenting as ocular MG with thymolipoma and thymic cyst. She complained diplopia, ptosis and headache, which had begun 3 months prior to admission and have been fluctuating thereafter. Ocular MG was confirmed by positive Tensilon and Jolly test. Her chest CT showed an enlarged thymus which turned out to be thymolipoma with thymic cyst on the pathologic examination. Although rare, thymolipoma and/or thymic cyst should be considered in the differential diagnosis of thymic tumor in MG.
Adult ; Diagnosis, Differential ; Diplopia ; Edrophonium ; Female ; Headache ; Humans ; Incidence ; Mediastinal Cyst* ; Myasthenia Gravis* ; Thymoma ; Thymus Gland ; Thymus Neoplasms ; Tomography, X-Ray Computed

No abstract available.
Asian Continental Ancestry Group ; Bacteremia/complications/*diagnosis/microbiology ; Base Sequence ; Diabetes Mellitus, Type 2/*complications ; Diabetic Foot/microbiology ; Gram-Positive Cocci/genetics/*isolation & purification ; Humans ; Male ; Middle Aged ; RNA, Ribosomal, 16S/chemistry/genetics ; Republic of Korea

PURPOSE: We evaluated outcomes of treatment in medial condyle fracture of the distal humerus in children. MATERIALS AND METHODS: Seven patients (4 females, 3 males) who were treated at the Pusan National University Hospital and followed-up until skeletal maturity after treatment were included. The average age at the time of fracture was 4.6 years (range, 2 to 10 years). Treatment was performed from 1 day to 6 months after the fracture: 4 patients underwent a surgical treatment for 17 days, 2 months, 2 months and 6 months after fracture, respectively. All fractures were Milch type 1. Five patients had Kilfoyle type 3, and two patients had type 2 fractures. Final outcomes were evaluated by the Mayo elbow performance score and carrying angle. RESULTS: There were 3 excellent, 3 good and 1 fair result at the final follow-up. There was no elbow pain in any of the patients. One of the four patients who underwent a late surgical treatment received corrective osteotomy due to cubitus varus. All four patients had a limitation of elbow motion. The other three patients who had accurate diagnosis and treatment had a full range of motion. CONCLUSION: Diagnosis of medial condyle fracture of the distal humerus based on plain radiograph is difficult in children due to its cartilaginous structures. When a patient shows pain, tenderness and swelling on the medial side of the elbow, an additional examination with magnetic resonance imaging may be required even if no fracture line is found in the radiograph. Accurate diagnosis and early treatment is important for good results.
Child* ; Elbow ; Female ; Follow-Up Studies ; Humans ; Humerus* ; Lifting ; Magnetic Resonance Imaging ; Osteotomy

Synovial sarcoma is a rare tumor that usually occur in the extremities of young adults. The head and neck is relatively a rare location as fewer than 100 cases of synovial sarcoma have been reported in the head and neck area. In the head and neck region, however, the most common site is the hypopharynx. There are 12 cases with laryngeal localization in the literature. We experienced a 30-year-old female patient with an endolaryngeal mass. Initial suspension laryngoscopic biopsy specimen of the primary lesion was consistent with laryngeal synovial sarcoma. The tumor arose from the right false vocal cord. It was treated by extended vertical hemilaryngectomy and postoperative radiotherapy. Microscopically, the tumor was characterized by a monophasic fibrous appearance. We report this rare case with a literature review.
Adult ; Biopsy ; Extremities ; Female ; Head ; Humans ; Hypopharynx ; Larynx ; Neck ; Radiotherapy ; Sarcoma, Synovial* ; Vocal Cords ; Young Adult

OBJECTIVES: Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. METHODS: A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. RESULTS: Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of ‘usual activity’, ‘anxiety’ and ‘visual analogue scale(VAS)’, whereas those with urinary incontinence, no depression showed lower QOL in ‘motility’, ‘usual activities’ and ‘pain’ domain. Statistically significant interaction effects of two diseases were observed in the domain of ‘VAS’, ‘self care’ and ‘anxiety’. CONCLUSIONS: Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.
Aged ; Comorbidity ; Depression ; Diagnosis ; Humans ; Quality of Life ; Urinary Incontinence

Diagnosis of Kawasaki disease (KD) is occasionally delayed because it is solely based on clinical symptoms. Previous studies have attempted to identify diagnostic biomarkers for KD. Recently, patients with KD were reported to have elevated serum ferritin levels. We investigated the usefulness of the serum ferritin level as a diagnostic biomarker for distinguishing KD from other acute febrile illnesses. Blood samples were obtained from pediatric patients with KD (N = 77) and those with other acute febrile illnesses (N = 32) between December 2007 and June 2011 for measuring various laboratory parameters, including serum ferritin levels. In patients with KD, laboratory tests were performed at diagnosis and repeated at 2, 14, and 56 days after intravenous immunoglobulin treatment. At the time of diagnosis, serum ferritin levels in patients with KD (188.8 µg/L) were significantly higher than those in patients with other acute febrile illnesses (106.8 µg/L, P = 0.003). The serum ferritin cut-off value of 120.8 µg/L effectively distinguished patients with KD from those with other acute febrile illnesses, with a sensitivity and specificity of 74.5% and 83.3%, respectively. Serum ferritin may be a useful biomarker to distinguish KD from other acute febrile illnesses.