Objective: We investigated whether circle of Willis (COW) morphology on 3D time-of-flight (TOF) MR angiography differs between young normal subjects, older normal subjects, and patients with carotid atherosclerotic plaques. Methods: One hundred seventy-seven subjects were grouped according to age into a young group (20 – 40 years; n = 91) and an older group (> 60 years; n = 86). Subjects underwent brain MR examination as part of a health check-up. Fifty-three patients with carotid atherosclerotic plaque were also included for evaluation in this study. COW morphology on 3D TOF MR angiography was analyzed in terms of completeness or incompleteness of the anterior and posterior components of the circle and completeness of the circle. Results: An incomplete pattern of anterior circulation was significantly more common in carotid atherosclerotic plaque patients (20.7%) than normal older subjects (5.5%) (p < 0.01). A complete posterior circulation pattern was more frequent in normal young subjects (46.5%) than in normal older subjects (16.5%) or the patient group (18.9%) (p < 0.01). Of patients with carotid artery stenosis, 18.9% had a bilateral incomplete connection and were significantly more likely to have an incomplete pattern than normal young (2.3%) or normal older subjects (2.2%) (p < 0.001). Conclusion: Young, healthy subjects were significantly more likely to have a complete pattern of posterior circulation than older subjects. Patients with carotid atherosclerotic plaques were significantly more likely to have incomplete anterior circulation and an incomplete circle than young, normal subjects.
Circle of Willis

BACKGROUND: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. METHODS: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. RESULTS: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at 90o abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). CONCLUSIONS: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.
Adrenal Cortex Hormones* ; Compliance ; Elbow ; Follow-Up Studies ; Humans ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation ; Shoulder Joint* ; Shoulder* ; Triamcinolone ; Ultrasonography*

Recently, according to the increase of adult patient, it is neccessory to understand the growth changes of adult after cessation of active pubertal growth in clinical orthodontics. The purpose of this study was to investigate the growth changes of craniofacial structure after active growth period(afult) in order to use reference in clinical orthodontics. Authors followed the 40 sample(male 25, female 15) from 24 to 31 years of age. By analyzing the serial cephalograms, authors could get the following findings. ? The mandible rotated clockwise in female, but not in male, and no incremental growth change in both genders. ? The anterior facial height and lower anterior facial height were increased in both genders, the increase of lower anterior facial height exceed the posterior facial height increase in famale. ? The cranial base was stable throughout observation period. ? The upper incisors uprighted slightly in female. ? There were quite great the individual variation in the growth change of ceaniofacial structure in adult.
Adult* ; Female ; Humans ; Incisor ; Male ; Mandible ; Orthodontics ; Skull Base

Bone resorptiion was predominate in compression site, bone formation in tension site of periodontal ligament during tooth movement. The biologic response at compressiion site was different from tension site. Thus the CGRP immuno-positive nerve fiber will respond differently to mechanical force according to the area(compression or tension site). The purpose of this study was to investigate this response of CGRP immuno-positive nerve fiber in the periodontal ligament according to the duration of applied force and the area (compression or tension site) during experimental tooth movement. The experimental animals were 7 week old male rat (approximately 200 gm), The orthodontic force was applied mesially to the right maxillary molar using the Ni-Ti coil spring during 12 hours, 1, 3, 7, and 12 days. Immunohistochemical staining using antibody against CGRP was performed after sacrifice. The results were as follows. The CGRP immuno-positive nerve bundle showed reduced immunoreactivity and nerve fibers reduced in density after application of orthodontic force for 12 hours and 1 day. The CGRP immuno-positive nerve fibers showed many thin branches at the apical periodontal ligament after application of force for 3 days as compared with normal. The tension site in the apical periodontal ligament showed more branches than the compression site. In 7 day group, the CGRP irnrnuno-positive nerve fibers increased in terms of the number and had many thin branches in the apical periodontal ligament. The tension site had more branches than the compression site, In 12 day group, the CGRP immuno-positive nerve fibers showed similar distribution to normal control at compression site of apical periodontal ligament, but the fibers at the tension site increased in number. The CGRP immuno-positive nerve fibers showed more increased at tension site than compression site after application of orthodontic force. Therefore it seems to have some relation to the bone remodeling besides the local inflammatory process.
Animals ; Bone Remodeling ; Humans ; Male ; Molar* ; Nerve Fibers ; Osteogenesis ; Periodontal Ligament* ; Rats* ; Tooth Movement* ; Tooth*

PURPOSE: We report here on the safety and efficacy of nephron-sparing radiofrequency ablation(RFA) for treating renal tumor. MATERIALS AND METHODS: Starting June 2004, a total of 14 patients underwent RFA for renal tumor during the following 3 years. Of these, 12 cases were followed up for at least 6 months postoperatively. Eight cases of combined computed tomography(CT) and ultrasonogram-guided percutaneous RFA, and four cases of intraoperative ultrasonography-guided laparoscopic RFA were performed with mean follow-up of 18.2 months(range: 4-27 months). The treatment indications were a localized, small(<4cm), solid renal mass in the elderly patients and those patients with co-morbid conditions. Physical examination, CBC, determining the serum creatinine levels and urine analysis were performed for the follow-up laboratory study and kidney CT was performed at day 1, 1 week, 1 month, 3 months, 6 months and 1 year after ablation and thereafter semi-annually. The mean follow-up duration was 18.2 months(range: 4-27 months). RESULTS: All the patients underwent successful RFA without any serious events. Four patients had mild perinephric hematoma on the follow-up CT scan and there was one case of mild gross hematuria postoperatively. With a mean follow-up of 18.2 months, two patients showed residual tumor at 3 months & 22 months, respectively, on the follow-up contrast- enhanced CT after the first tumor ablation. One patient underwent a second RFA and another patient underwent laparoscopic radical nephrectomy, and no residual tumor was seen on the follow-up CT. Distant metastasis was not found in any cases and all the patients are alive on serial follow-up. CONCLUSIONS: Percutaneous or laparoscopic RFA is considered a useful treatment for selected patients who have a small renal mass, and to spare the nephrons. The ultimate role of this modality will continue to evolve and this warrants further studies.
Aged ; Creatinine ; Follow-Up Studies ; Hematoma ; Hematuria ; Humans ; Kidney ; Laparoscopy ; Neoplasm Metastasis ; Neoplasm, Residual ; Nephrectomy ; Nephrons ; Physical Examination

In order to investigate the possibility of using a cervical vertebral maturation indicator as a mandibular growth indicator, the relationship of cervical vertebral maturation and mandibular & body height growth changes was assessed in biennial serial lateral cephalometric raadiographs of eighteen korean male and fourteen korean female while they were 8.5 to 185 years old. The following results were obtained. 1. It was a reliable method to evaluate skeletal maturation by using cervical vertebrae. 2. In general, cervical vertebral maturation stages of females were higher than those of males at the same age and there were significant differences in statistics at the age of 105, 14.5. 3. The age of a female at the same cervical vertebral maturation stage were earlier than that of a male. 4. In the case of males, significant Ar-Gn increases were found between stage 3 and 4,5 Ar-Go increases between stage 4 and 5. 5. In the case of females, significant S-Gn and Ar-Gn increases were found between stage 3 and 4. 6. Significant body height increases were found between stage 3 and 4 in both sexes. 7. The peak velocity of body height and mandibular length was observed between cervical vertebral maturation stage 3 and 4 in botli series. 8. The relationship between- inandibular & body height changes and specific maturation stage of cervical vertebra was found, therfore using a cervical vertebral maturation indicator as mandibular growth indicator is quite within realms of possibility.
Body Height ; Cervical Vertebrae* ; Female ; Humans ; Male ; Spine

Purpose: This study aimed to evaluate angiographic and contrast enhancement (CE) patterns on three-dimensional (3D) black blood (BB) contrast-enhanced MRI in patients with acute medulla infarction. Materials and Methods: From January 2020 to August 2021, we retrospectively analyzed stroke 3D BB contrast-enhanced magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) findings of patients visiting the emergency room for symptom evaluation of acute medulla infarction. In total, 28 patients with acute medulla infarction were enrolled in this study. Four types of 3D BB contrast-enhanced MRI and MRA were classified as follows: 1=unilateral contrast-enhanced vertebral artery (VA)+no visualization of VA on MRA; 2=unilateral enhanced VA+hypoplastic VA; 3=no enhanced VA+unilateral complete occlusion of VA; 4=no enhanced VA+normal VA (including hypoplasia) on MRA. Results: Of the 28 patients with acute medulla infarction, 7 (25.0%) showed delayed positive findings after 24 hours on diffusion-weighted imaging (DWI). Of these patients, 19 (67.9%) showed CE of the unilateral VA on 3D BB contrast-enhanced MRI (type 1 and 2). Of the 19 patients with CE of VA on 3D BB contrast-enhanced MRI, 18 showed no visualization of enhanced VA on MRA (type 1), and 1 showed hypoplastic VA. Of the 7 patients with delayed positive findings on DWI, 5 showed CE of the unilateral VA and no visualization of the enhanced VA on MRA (type 1). Symptom onset to door time or initial MR check time was significantly shorter in the groups with delayed positive findings on DWI (P<0.05). Conclusion Unilateral CE on 3D BB contrast-enhanced MRI and no visualization of the VA on MRA are related to the recent occlusion of the distal VA. These findings suggest that the recent occlusion of the distal VA is related to acute medulla infarction, including delayed visualization on DWI.

Purpose: Vessel wall imaging (VWI) for carotid plaque is better for detecting unstable carotid plaque such as intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), and thin/ruptured fibrous cap. However, the role of VWI before carotid artery stenting (CAS) is unclear. Thus, this study aimed to determine the findings of symptomatic carotid stenosis before CAS on angiography and carotid VWI and to evaluate the imaging findings associated with post-procedural clinical events after CAS. Materials and Methods: This retrospective study included 173 consecutive patients who underwent carotid VWI, CAS, and post-procedural diffusion-weighted imaging (DWI) after CAS. Findings of unstable plaque on carotid VWI and unstable findings on angiography were analyzed. We also analyzed the incidence of post-procedural clinical events, any stroke, myocardial infarction (MI), and death within 30 days of CAS. Results: Of 173 patients, 101 (58.4%) had initial ischemic symptoms and positive findings on DWI. Symptomatic patients were significantly higher in patients with IPH than in patients without IPH (62.4% vs. 45.8%, P=0.031). Degree of stenosis, thrombus of the stenotic lesion, flow delay of internal carotid artery, and flow arrest by filter thrombus had significantly higher prevalence in the symptomatic group. Twenty patients (11.6%) had post-procedural clinical events such as any stroke, clinical symptoms, and/or MI. Hyperlipidemia and intraluminal thrombus on angiography were identified as significant factors influencing post-procedural events after CAS. Conclusion An intraluminal thrombus on angiography was identified as a significant factor influencing post-procedural clinical events after CAS.

No abstract available.
Leukemia* ; Sweet Syndrome*

BACKGROUND: Many shoulder diseases are related to glenohumeral joint synovitis and effusion. The purpose of the present study is to detect effusion within the biceps long head tendon sheath as the sign of glenohumeral joint synovitis using ultrasonography, and to evaluate the clinical meaning of effusion within the biceps long head tendon sheath. METHODS: A consecutive series of 569 patients who underwent ultrasonography for shoulder pain were reviewed retrospectively and ultimately, 303 patients were included. The authors evaluated the incidence and amount of the effusion within the biceps long head tendon sheath on the ultrasonographic short axis view. Furthermore, the authors evaluated the correlation between the amount of effusion within the biceps long head tendon sheath and the range of motion and the functional score. RESULTS: The effusion within the biceps long head tendon sheath was detected in 58.42% of the patients studied: 69.23% in adhesive capsulitis, 56.69% in rotator cuff tear, 41.03% in calcific tendinitis, and 33.33% in biceps tendinitis. The average amount of the effusion within the biceps long head tendon sheath was 1.7 +/- 1.6 mm, and it was measured to be the largest in adhesive capsulitis. The amount of effusion within biceps long head tendon sheath showed a moderate to high degree of correlation with the range of motion, and a low degree of correlation with the functional score and visual analogue scale for pain in each type of shoulder disease. CONCLUSIONS: The effusion within the biceps long head tendon sheath is closely related to the range of motion and clinical scores in patients with painful shoulders. Ultrasonographic detection of the effusion within the biceps long head tendon sheath might be a simple and easy method to evaluate shoulder function.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Retrospective Studies ; Shoulder Joint/physiopathology/*ultrasonography ; Synovitis/*ultrasonography ; Tendons/*ultrasonography