When a soft tissue mass in the bony wall of the paranasal sinus is present, it is difficult to make a distinction between tumor and inflammatory mass on CT. Fungal sinusitis may have soft tissue attenuation on the bony wall of the sinus, bony sclerosis, focal bony destruction, and calcific area on CT. This is a report of four proven cases of fungal sinusitis, asperogillosis in 3 cases and mucormycosis in 1 case, All 4 patients had CT and one patient had MRI, On CT, bony sclerosis and destruction were well visualized in all cases. On MRI, mycetoma in the maxillary sinus was hypointense on T1 weighted images and more hypointense on T2 weighted images. Although CT appears to be the best modality for initial examination of the patient with sinusitis, the differentiation of fungal sinusitis from tumor mass or other entity may be better accomplished with MRI.
Humans ; Magnetic Resonance Imaging ; Maxillary Sinus ; Mucormycosis ; Mycetoma ; Sclerosis ; Sinusitis

The paroxysmal kinesigenic choreoathetosis is characterized by choreathetoic, dystonic and/or tonic movements induced by sudden voluntary movements, without loss of consciousness, urinary incontinence and clonic movement. These attacks begin in childhood, and are occasionally familial. The response to anticonvulsants is usually excellent. We present 4 cases of paroxysmal kinesigenic choreoathetosis with a brief review of literature, which is believed to be the first report in Korea.
Anticonvulsants ; Korea ; Unconsciousness ; Urinary Incontinence

A case of metastatic alveolar soft part sarcoma is presented with clincal, pathological and radiological features. Alveolar soft part sarcoma is a rare soft-tissue neoplasm that is malignant and invariably fatal. It was first described and named by Christopherson, et al. in 1952. Since 1952 numerous examples of this tumor have been reported and have been studied with the electron microscope, but there is still considerable uncertainty as to the exact histogenesis of the tumor. Most cases occur in young females involving the lower extrimities especially in the right side. The most initial presenting symptom is a slowgrowing painless mass and the principal metastatic sites are the lungs, followed by the brain and skeleton. Cerebral metastasis, in fact, may be the first manifestation of the disease. Treatment is radical surgical excision but radiotherapy and chemotherapy are less effective. We present the reported case of metastatic alveolar soft pat sarcoma with electron microscopic findings.
Brain ; Drug Therapy ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Radiotherapy ; Sarcoma ; Sarcoma, Alveolar Soft Part* ; Skeleton ; Uncertainty

No abstract available.
Fistula*

One case of multicentric glioblastoma multiforme is presented. On the brain CT scan, multiple lesions were found and cerebral metastases or brain abscesses were considered preoperatively. Multicentric glioblastoma multiforme is quite rare, but it should be considered when there is no evidence of extracranial primary malignant lesion.
Brain ; Brain Abscess ; Glioblastoma* ; Neoplasm Metastasis ; Tomography, X-Ray Computed

In early thrombolytic therapy for acute focal ischemic stroke, the start of treatment within therapeutic time window is one of the most important thing. Recently, new imaging modalities such as SPECT, transcranial doppler, diffusion/ perfusion-weighted MRI, and MR anglography have been implicated to avoid time consumption and delayed therapy. Of these, MR angiography is nomnvasi and rapid technique to visualize large and medium-sized arteries. We explored the usefulness of MR angiography in early thrombolytic therapy. Arterial occlusion of three patients with severe ischemic stroke were demonstrated on MR anglography and wluch were treated with Urokmase (10, 000-20, 000 units/kg) by intravenous infusion within 2-4 hours after symptom onset. Recanalization and brain lesion was assessed by repeated MR angiography and MRI or CT 24 hours later. Clinical improvement was observed in two patients 5-24 hours after initiation of treatment. In one patient hemorrhagic infarction without clinical deterioration was detected by follow-up computed tomography. Recanalization was documented on repeated MR angiography of three patients. MR angiography can document occlusion of stroke-related vasculature without delay of thrombolytic therapy and repeated MR anglography can reveal whether recanalization has occurred.
Angiography ; Arteries ; Brain ; Follow-Up Studies ; Humans ; Infarction ; Infusions, Intravenous ; Magnetic Resonance Angiography* ; Magnetic Resonance Imaging ; Stroke ; Thrombolytic Therapy ; Tomography, Emission-Computed, Single-Photon

Brainstem lesions may produce a cheiro-oral syndrome infrequently. The cheiro-oral syndrome in pontine lesion is due to involvement of ventral trigeminothalamic tract and the medial part of the medial lemniscus. The cheiro-oral syndrome rarely associates with internuclear ophthalmoplegia. A 58-year-old hypertensive man complained of dizziness, diplopia, and dysesthesia in the right hand and ipsilateral perioral region. On neurologic examination, there was left internuclear ophthalmoplegia. Others were unremarkable. Brain MRI demonstrated a small round lesion in the paramedian tegmentum of the left upper pons and lower midbrain, which involved ventral trigeminothalamic tract, medial part of medial lemniscus and medial longitudinal fasciculus. We report a case of brainstem infarction with a rare combination of cheiro-oral syndrome and internuclear ophthalmoplegia.
Brain ; Brain Stem Infarctions* ; Brain Stem* ; Diplopia ; Dizziness ; Hand ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Middle Aged ; Neurologic Examination ; Ocular Motility Disorders ; Paresthesia ; Pons

BACKGROUND: Hyperhomocysteinemia has been known to be associated with cerebrovascular disease. It is toxic to vascular endothelial cell and promotes arteriosclerotic detachment. There was no study of the homocysteine level in ischemic stroke patients in Korea except case report. Therefore we measured total plasma homocysteine level in ischemic stroke patients and evaluated association with other stroke risk factors. METHODS: We measured total plasma homocysteine level in 44 patients with ischemic stroke and 16 age-matched normal controls, and analyzed its relationship to other stroke risk factors. Total plasma homocysteine level was determined by using a radioenzymatic method. RESULTS: Total plasma homocysteine level was 12.12 5.11 micromol/L in patients and 9.40 1.93 micromol/L in controls. It was 13.03 5.78 micromol/L in lacunar infarction and 9.96 1.57 micromol/L in territory infarction. The total plasma homocysteine level of the patients with hypertension, DM, hyperlipidemia, heart disease, smoking, alcohol, previous stroke, carotid bruit was not different statistically from those without them. CONCLUSIONS: Total plasma homocysteine level was significantly higher in the ischemic stroke patients than that of controls. Lacunar infarction showed significantly higher level of total plasma homocysteine compared to territory infarction.
Cerebral Infarction* ; Endothelial Cells ; Heart Diseases ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hyperlipidemias ; Hypertension ; Infarction ; Korea ; Pilot Projects* ; Plasma* ; Risk Factors ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar

BACKGROUND AND OBJECTS: It is common to find cerebral infarction without a history of stroke on neuroimaging. This study was to determine the frequency, MRI characteristics of these lesions, and the risk factors related with silent brain infarcts in patients with first-ever ischemic stroke. METHOD: Sixty seven patients with acute ischemic stroke, who hospitalized in our hospital from April 1992 to May 1994, were reviewed. Brain MRI was performed in all patients. We evaluated frequency, site, size, and anatomic location of silent infarcts and compared the risk factors of the patients with silent infarcts with that of the ones without silent infarcts. RESULTS AND CONCLUSIONS: The prevalence of silent infarct was 58.2% ( (39/67). The predilection sites were in the right hemisphere and subcortical area (basal ganglia, thalamus), and their sizes were less than 1 cm mostly. The significant risk factor of silent infarcts was hypertension(P<0.01), and the other risk factors, such as age, sex, DM, and EKG abnormality, were not remarkable.
Brain* ; Cerebral Infarction ; Electrocardiography ; Ganglia ; Humans ; Magnetic Resonance Imaging* ; Neuroimaging ; Prevalence ; Risk Factors* ; Stroke*

No abstract available.
Bone Regeneration ; Calcium* ; Heterografts ; Humans* ; Osteoblasts* ; Osteogenesis*