Hydroxyurea is an effective treatment for a variety of myeloproliferative disodrers. A distinct cutaneous reaction to long-term administration of hydroxyurea has been characterized and designated hydroxyurea dermopathy. Epidermal dysmaturation refers to histologic changes that may be observed in the epidermis after any significant cytoreductive therapy. We report a patient with hydroxyurea-induced dermatomyositis-like eruption showing epidermal dysmaturation who developed an erythematous scaly patches on the dorsal aspects of the hands while on long-term administration of hydroxyurea for chronic myelogenous leukemia.
Dermatomyositis ; Epidermis ; Hand ; Humans ; Hydroxyurea ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive

No abstract available.
Collodion*

PURPOSE: To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. MATERIALS AND METHODS: We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years). RESULTS: The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CONCLUSION: CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.
Actinomyces ; Diagnosis ; Enterobacter ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Klebsiella ; Male ; Medical Records ; Necrosis ; Nocardia ; Pneumonia* ; Pseudomonas ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. MATERIALS AND METHODS: We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years). RESULTS: The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CONCLUSION: CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.
Actinomyces ; Diagnosis ; Enterobacter ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Klebsiella ; Male ; Medical Records ; Necrosis ; Nocardia ; Pneumonia* ; Pseudomonas ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Phototherapy*

PURPOSE: The purpose of this study was to determine the diagnostic value of a sign of early enhancing superior ophthalmic vein (SOV), as seen on helical CT images in patients with carotid-cavernous fistula (CCF). MATERIALS AND METHODS: This study involved 16 patients with CCF and 28 control patients. Axial CT images with scanning delays of 30 seconds following bolus injection of contrast material (90 mL, 3 mL/sec) were obtained, and this procedure was followed by coronal CT imaging. To determine the presence or absence of early enhancement or, dilatation of the SOV, bulging of the cavernous sinus, and enlargement of extraocular muscle, CT images were analysed by three observers in a blinded, random manner. Early enhancement of SOV was determined to be present where enhancement of the SOV was similar to or stronger than that of the ipsi-lateral posterior cerebral artery. RESULTS: A sign of early enhancing SOV was seen in 14 of the 16 patients with CCF but in no control patients (88% sensitivity and 100% specificity). The respective sensitivity and specificity of other CT features were 71% and 100% (dilatation of the SOV, as seen on axial images), 60% and 83% (dilatation of the SOV, as seen on coronal images), 71% and 89% (dilatation of the cavernous sinus), and 65% and 98% (enlargement of extraocular muscle). CONCLUSION: A sign of early enhancing SOV is a characteristic and specific CT finding of CCF, and is useful for the diagnosis of CCF.
Cavernous Sinus ; Diagnosis ; Dilatation ; Fistula* ; Humans ; Posterior Cerebral Artery ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Veins*

Protein-losing enteropathy (PLE) is a syndrome characterized by excessive gastrointestinal protein loss, resulting in hypoproteinemia and edema. A variety of benign and malignant conditions can be associated with PLE and acute leukemia is a very rare cause of PLE. We report a case of PLE associated with acute lymphoblastic leukemia. A 27-year-old man was admitted due to watery diarrhea, epigastric pain and bilateral leg edema. Laboratory findings showed hypoproteinemia and polycythemia. The diagnosis of PLE and acute lymphoblastic leukemia were confirmed on the measurement of fecal alpha1-antitrypsin clearance and bone marrow examination. After systemic chemotherapy and autologous stem cell transplantation, his clinical symptoms and abnormal laboratory findings were gradually improved.
Adult ; Bone Marrow Cells/pathology ; Endoscopy, Gastrointestinal ; Humans ; Magnetic Resonance Imaging ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/*diagnosis/genetics ; Protein-Losing Enteropathies/complications/*diagnosis ; Thoracic Vertebrae/radiography ; Tomography, X-Ray Computed ; Translocation, Genetic ; alpha 1-Antitrypsin/analysis

PURPOSE: To assess the enhancement patterns of sellar and parasellar tumors at two-phase helical CT. MATERIALS AND METHODS: Thirty-two patients with pathologically proven sellar and parasellar tumors [meningioma (n=17), pituitary mocroadenoma (n=6), neurogenic tumor (n=5), cavernous angioma (n=1), chondrosarcoma (n=1), osteosarcoma (n=1), sphenoid carcinoma (n=1)] were included in this study. Two-phase helical CT was performed after the injection of 90 mL of contrast material at a rate of 3 mL/sec. Transverse helical CT scans were obtained during the early and late phases, with scanning delays of 30 and 120 seconds, respectively. Delayed coronal images were obtained after delayed axial images. Attenuation change and the enhancement patterns of the tumors were visually assessed; the former was also assessed quantitatively as the ratio of the CT number at late-phase axial and coronal scanning to that at early-phase scanning. RESULTS: Visual assessment of two-phase helical CT images revealed decreased attenuation in all 17 meningiomas, no change in all six pituitary macroadenomas and increased attenuation in 5 all five neurogenic tumors on late-phase axial scans as compared with early phase scans. Coronal images showed decreased attenuation in all 17 meningiomas, increased attenuation in all five neurogenic tumors and no change in four pituitary macroadenomas (66.7%). The ratio of CT numbers was significantly different between meningiomas, neurogenic tumors and pituitary macroadenomas(p<0.05). CONCLUSION: According to their histopathology, sellar and parasellar tumors showed characteristic enhancement patterns at two-phase helical CT. An analysis of the observed enhancement patterns can be useful in the differential diagnosis of juxtasellar tumors.
Chondrosarcoma ; Diagnosis, Differential ; Hemangioma, Cavernous ; Humans ; Meningioma ; Osteosarcoma ; Tomography, Spiral Computed*

PURPOSE: The minimum stimulus onset asynchronoy(SOAmin) is one of important experimental parameters for an event-related fMRl experiment designed with the stochastic stimulus. In this study, the most efficient SOAmin is explored for the stronger activation in motor and language tasks with the stimulus designed stochastically. MATERIALS AND METHODS: The event-related fMRl during motor and language tasks were obtained in four normal right-handed subjects. EPI-BOLD sequence is used at 1.5 Tesla MR system for the acquisition of event-related fMRl. For each task the subjects are responded for the stimulus' with 2, 3, 4, and 6 seconds SOAmin. The obtained images are processed with SPM99, and the p value is set as 0.05 for the significant activation detection. The Z value and the number of activated pixels are compared for each task. RESULTS: For the motor task, the primary and supplementary motor areas are activated, and for the language task the consistent activated signals are detected in the Broca's. The activated signal is to be stronger for the shorter SOAmin for both motor and language tasks. At primary motor area, the activated signals is the strongest for 3 seconds SOAmin and for the supplementary motor area the result with 2 seconds SOAmin shows the strongest activation. And the result of language task shows the strongest activation at the 2 seconds SOAmin. CONCLUSION: In the event-related fMRl of motor and language tasks with the stochastically designed stimulus, the 2 or 3 seconds SOAmin is efficient for more activated and clustered activation.

Insulin resistance (IR) plays a significant role in the development and progression of non-alcoholic fatty liver disease (NAFLD). However, the natural course of insulin sensitivity under NAFLD remained unclear. Accordingly, this study was designed to investigate the effect of NAFLD on insulin resistance. A total of 20,628 Korean men without homeostasis model assessment of insulin resistance (HOMA-IR < 2.7) were followed-up for 5 years. They were serially checked for HOMA-IR to monitor the development of IR (HOMA-IR ≥ 2.7). The incidence rate of IR increased according to the degree of NAFLD (normal: 11.6%, mild: 28.8%, moderate to severe: 40.5%, P < 0.001). Cox proportional hazards model showed that HRs (95% CI) for IR increased proportionally to the degree of NAFLD (mild: 1.19 [1.02–1.39], moderate to severe: 1.32 [1.08–1.57]). IR was more potentially associated with the more progressive NAFLD than normal and milder state. In addition, NAFLD was the independent risk factor of the development of IR. These results suggest the potential availability of NAFLD as a predictor of IR.
Homeostasis ; Humans ; Incidence ; Insulin Resistance* ; Insulin* ; Male ; Non-alcoholic Fatty Liver Disease* ; Proportional Hazards Models ; Risk Factors