OBJECTIVE: In order to confirm the local production of total and specific IgE antibodies in the nasal polyp tissues. MATERIAL AND METHOD: We measured total IgE and house dust mite(Dermatophagoides pteronpssinus .' DP)-specific IgE antibody using enzyme-linked immunosorbent assay(ELISA) in the supernatant of nasal polyp homogenates from 72 subjects undergoing nasal polypectomy. The subjects were divided into three groups according to skin reactivity to DP: 20 strongly atopic subjects to group I(mean wheal diameter) 3mm), 19 weakly atopic subjects to group II (mean wheal diameter 1-3mm) and 33 negative skin responders to group III. RESULT: Group I showed significantly higher levels of total and DP-specific IgE levels in the nasa
Antibodies ; Dust* ; Immunoglobulin E* ; Nasal Polyps* ; Pyroglyphidae* ; Skin ; United States National Aeronautics and Space Administration

Only a few tests can evaluate the function of the saccule and inferior vestibular nerve. Vestibular-evoked myogenic potentials (VEMP) are inhibitory potentials recorded in the contracting muscles, usually in the sternocleidomastoids (SCM), when sound stimuli are applied. A disynaptic pathway originating in the saccule is known to mediate VEMP. The main pathway of saccule-induced inhibitory postsynaptic potentials to ipsilateral SCM motoneurons seems to be the medial vestibulospinal tract which descends within the medial longitudinal fasciculus. VEMP have been applied to determine saccular function in many disorders involving the peripheral vestibular apparatus. However, the characteristics and the diagnostic values of VEMP require further exploration in central vestibulopathies. In this review, the basic principles and recording methods of VEMP are overviewed. We will also review VEMP responses found in central as well as peripheral vestibular disorders. Despite several issues that need further elucidation, such as the exact neural pathway mediating VEMP, aging effects on VEMP, and normalization of the muscle contraction during the recording, VEMP allows us exclusive information on the function of saccule and its neural pathway, which cannot be provided by other vestibular function tests.
Aging ; Brain Stem ; Cerebellum ; Contracts ; Inhibitory Postsynaptic Potentials ; Muscle Contraction ; Muscles ; Negotiating ; Neural Pathways ; Saccule and Utricle ; Vertigo ; Vestibular Function Tests ; Vestibular Nerve ; Vestibule, Labyrinth

PURPOSE: To analyze the characteristics of CT and MRI findings of facial nerve schwannoma in ten patients. MATERIALS AND METHODS: Ten patients with pathologically confirmed facial nerve schwannoma, underwent physical and radiologic examination. The latter involved MRI in all ten and CT scanning in six. We analyzed the location (epicenter), extent and number of involved segments of tumors, tumor morphology, and changes in adjacent bony structures. RESULTS: The major symptoms of facial nerve schwannoma were facial nerve paralysis in seven cases and hearing loss in six. Epicenters were detected at the intraparotid portion in five cases, the intracanalicular portion in two, the cisternal portion in one, and the intratemporal portion in two. The segment most frequently involved was the mastoid (n=6), followed by the parotid (n=5), intracanalicular (n=4), cisternal (n=2), the labyrinthine/geniculate ganglion (n=2) and the tympanic segment (n=1). Tumors affected two segments of the facial nerve in eight cases, only one segment in one, and four continuous segments in one. Morphologically, tumors were ice-cream cone shaped in the cisternal segment tumor (1/1), cone shaped in intracanalicular tumors (2/2), oval shaped in geniculate ganglion tumors (1/1), club shaped in intraparotid tumors (5/5) and bead shaped in the diffuse-type tumor (1/1). Changes in adjacent bony structures involved widening of the stylomastoid foramen in intraparotid tumors (5/5), widening of the internal auditary canal in intracanalicular and cisternal tumors (3/3), bony erosion of the geniculate fossa in geniculate ganglion tumors (2/2), and widening of the facial nerve canal in intratemporal and intraparotid tumors (6/6). CONCLUSION: The characteristic location, shape and change in adjacent bony structures revealed by facial schwannomas on CT and MR examination lead to correct diagnosis.
Diagnosis ; Facial Nerve* ; Ganglion Cysts ; Geniculate Ganglion ; Hearing Loss ; Humans ; Magnetic Resonance Imaging* ; Mastoid ; Neurilemmoma ; Paralysis ; Tomography, X-Ray Computed

Acute abdomen caused by abdominal tuberculosis is a rare manifestation, and includes bleeding of a gastric or ileal ulcer, obstruction of the small bowel by an adhesive band, perforation of the ileum, ileocolic intussusception and fistula, and mesenteric abscesses caused by necrotic lymph nodes. The clinical and radiologic features of these complicated tuberculosis may mimic other acute abdominal diseases. Although not definitive, careful evaluation of the radiologic findings of the bowel wall, mesenteric fat infiltration, and lymph node enlargement may provide useful diagnostic clues to the presence of acute abdomen due to tuberculosis.
Abdomen, Acute* ; Abscess ; Adhesives ; Fistula ; Hemorrhage ; Ileum ; Intussusception ; Lymph Nodes ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Ulcer

BACKGROUND: Alcohol dependence and Alzheimer's disease induce cognitive dysfunction in common. However, the cognitive dysfunction from alcohol dementia can be improved with appropriate treatment while that from Alzhimer's disease is usually irreversible and progressive. Nevertheless, the discrete diagnosis for the cause is delicate or sometimes impossible in those patients showing both characteristics of alcohol dementia and Alzhimer's disease. Thus, we investigated the feasibility of the computerized comprehensive neuropsychological test, Cognitive Assessment and Reference Diagnoses System(CARDS), to differentiate the diagnoses between alcohol dementia and Alzhiemr's disease in their early stages. METHODS:32 elderly subjects with cognitive dysfunction were recruited. They are divided by two groups; 16 subjects with alcohol dependence and 16 subjects without alcohol dependence(as early Alzhiemr's disease) We assessed the cognitive dysfunctions of each group using CARDS. The subscales of the CARDS include; (1) Amnesia, (2) Aphasia, (3) Apraxia, (4) Dysexecution, (5) Attention/Calculation. RESULTS: Alcohol dependence group showed lower mean score in amnesia subscale, but showed higher mean scores in apraxia and dysexcution subscales than early Alzheimer group. And both groups didn't show significant differences of mean scores in agonisa, aphagia, and attention/calculation subscale. CONCLUSION: In summary, this study shows that the elderly patients with alcohol dependence have cognitive deficits mainly in the amnesia domain of CARDS assessment, whereas early Alzhiemr's disease patients show equal or worse cognitive function in other domains except amnesia. Thus, we suggest that CARDS will be helpful to differentiate alcoholic dementia and Alzhiemr's disease in their early stages.
Aged* ; Alcoholics ; Alcoholism* ; Alzheimer Disease* ; Amnesia ; Aphasia ; Apraxias ; Dementia ; Diagnosis* ; Humans ; Neuropsychological Tests

Based on the assumption that apparent diffusion coefficients (ADCs) define high-risk clinical target volume (aCTVHR) in high-grade glioma in a cellularity-dependent manner, the dosimetric effects of aCTVHR-targeted dose optimization were evaluated in two intensity-modulated radiation therapy (IMRT) plans. Diffusion-weighted magnetic resonance (MR) images and ADC maps were analyzed qualitatively and quantitatively to determine aCTVHR in a high-grade glioma with high cellularity. After confirming tumor malignancy using the average and minimum ADCs and ADC ratios, the aCTVHR with double- or triple-restricted water diffusion was defined on computed tomography images through image registration. Doses to the aCTVHR and CTV defined on T1-weighted MR images were optimized using a simultaneous integrated boost technique. The dosimetric benefits for CTVs and organs at risk (OARs) were compared using dose volume histograms and various biophysical indices in an ADC map-based IMRT (IMRTADC) plan and a conventional IMRT (IMRTconv) plan. The IMRTADC plan improved dose conformity up to 15 times, compared to the IMRTconv plan. It reduced the equivalent uniform doses in the visual system and brain stem by more than 10% and 16%, respectively. The ADC-based target differentiation and dose optimization may facilitate conformal dose distribution to the aCTVHR and OAR sparing in an IMRT plan.
Contrast Media ; Gadolinium ; Glioma/*radiotherapy ; Humans ; Magnetic Resonance Imaging/*methods ; *Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/*methods ; Radiotherapy, Intensity-Modulated/*methods ; Tumor Burden

PURPOSE: To determine the usefulness of CT for diagnosing metastases to primary and secondary echelon lymph nodes (LNs) and to investigate various CT findings of metastatic LNs in thyroid carcinomas. MATERIALS AND METHODS: We retrospectively reviewed the CT and histologic findings in 59 patients with thyroid carcinomas who had undergone thyroidectomy and neck dissection. Primary echelon LNs (Level VI) were removed by central neck dissection in all patients, and in 21, a total of 136 levels of secondary echelon LNs (Level II-V) were excised away by lateral neck dissection. CT criteria of metastatic LNs included large size, significant homogeneous enhancement, calcification, and cystic change. We evaluated the ability of CT to detect primary and secondary echelon LN metastasis and tried to determine which CT features were useful for the diagnosis of LN metastasis. RESULTS: Histologically, LN metastasis was found in 31 (53%) of 59 patients, including 30 with metastasis to primary echelon LNs. Of the 136 levels of secondary echelon LNs resected in 21 patients, 44 were found at histology to harbor metastatic foci. The sensitivities, specificities, positive and negative predictive values, and accuracies of CT in the diagnosis of metastasis to primary and secondary echelon LNs, respectively, were 27% and 93%, 100% and 93%, 100% and 87%, 57% and 97%, and 63% and 93%. While all secondary echelon LNs with at least one of the following CT criteria-large size (n=19), cystic or necrotic change (n=14), or calcifications (n=8)-were histologically proven to be metastatic, six (24%) of 25 such LNs with a sole sign of significant enhancement at CT were found to be due to reactive lymphadenopathy. CONCLUSION: Although CT was unable to detect metastasis to primary echelon LNs, it was useful in the detection of secondary echelon LN involvement. Large size, cystic change, and calcification are considered highly reliable signs of metastatic LNs.
Diagnosis* ; Humans ; Lymph Nodes* ; Lymphatic Diseases ; Neck Dissection ; Neoplasm Metastasis* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: To compare breath-hold gadolinium enhanced MR angiography(MRA) with digital subtraction angiography. MATERIALS AND METHODS: Ten patients underwent angiography and breath-hold gadolinium enhanced MRA;the latterperformed at 1.5T with 3D FSPGR after a bolus injection of gadopentetate dimeglumine(0.4mmol/kg) RESULTS: Sevenof ten pathologic conditions(70%) evaluated by both techniques had a similar appearance. The conditions examinedwere as follows : the artery feeding renal cell carcinoma(n=2): renal artery stenosis(n=2); pulmonaryAVM(n=2);abdominal aortic aneurysm(n=1); atheromatous plaque in the lower abdominal aorta(n=1);an enlargedbronchial artery(n=1); and an aberrant renal artery(n=1). For evaluating an anatomic relationship, a reconstructed3D image obtained by MRA is more advantageous. CONCLUSION: Breath hold contrast enhanced MRA is a potentiallyuseful noninvasive screening method for detecting vascular abnormality of the aorta and its branches.
Angiography ; Angiography, Digital Subtraction ; Aorta ; Arteries ; Gadolinium ; Humans ; Mass Screening ; Renal Artery

PURPOSE: To evaluate the CT findings of patients with surgically confirmed perforated appendicitis and to compare the characteristics between children and adults. METHOD AND MATERIALS: Patients in whom complicated appendicitis was clinically suspected underwent contrast enhanced CT scanning. The scans of 50 patients (19children and 31 adults) with surgically confirmed perforated appendicitis were analysed. Without knowledge of operative findings, we retrospectively analyzed the CT findings with regard to : 1) the detection of the appendiceal wall thickening; 2) the presence of appendicolith; 3) the size, features, and location of periappendical abscess; 4) mesenteric fat infiltration and lymphadenopathy; 5) wall thickening of the cecum and terminal ileum; and 6) ascites and free air. RESULTS: Appendiceal wall thickening was detected in seven children(37%) and 13 adults (42%) (p>0.05). Appendicolith was detected in 21 patients (42%) and was more frequent in children (13 cases, 68%) than in adults (8 cases, 26%). There were statistically significant differences between the two groups (p<0.05). The mean diameter of periappendiceal abscesses was 3.7+/-1.9 cm (3.2+/-1.9 cm in children and 4.0+/-1.8 cm in adults), with no stastistically significant differences between the two groups (p>0.05). Periappendiceal abscess with well-defined cyst was more frequent in children (17/19, 89%) than in adults (13/31,42%) (p<0.05). The most commonly involved site was the midabdomen and pelvis in children (9/19, 47%), and the right lower quadrant in adults (18/31, 58%), (p <.05). Mesenteric lymph nodes were commonly detected in children, and cecal wall thickening in adults. CONCLUSION: The CT findings of perforated appendicitis included appendiceal wall thickening, appendicolith, periappendiceal abscess, mesenteric fat infiltration and enlargement of mesentericlymph nodes, and thickening of the cecum wall Periappendiceal abscess with well-defined cyst in the midabdomen or pelvis was more frequent in children, as were appendicolith and enlargement of mesenteric lymph nodes.
Abscess ; Adult* ; Appendicitis* ; Ascites ; Cecum ; Child* ; Humans ; Ileum ; Lymph Nodes ; Lymphatic Diseases ; Pelvis ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: The purpose of this study was to compare one-step 2 hour 75 gm oral glucose tolerance test (OGTT) proposed by the World Health Organization (WHO) with two-step 3 hour 100 gm OGTT of National Diabetes Data group (NDDG) criteria for determining gestational diabetes. METHODS: Data for 111 pregnant Korean women who were diagnosed of gestational diabetes either by 75 gm OGTT or 100 gm OGTT and 100 normal controls were reviewed and analyzed retrospectively. The effectiveness of the two tests was determined by comparing the frequency of diabetes-related pregnance outcomes such as macrosomia, cesarean delivery, and preterm birth. Chi-square, Fisher's Exact test, and T-tests were used for statistical analysis. RESULTS: Among 111 gestational diabetic women, 59 (53.2%) were diagnosed by WHO criteria of 75 gm OGTT and 52 (46.8%) were diagnosed by 100 gm OGTT of NDDG criteria. Frequency of macrosomia and cesarean section was higher in 75 gm test group than in 100 gm test group (12.3% vs 5.8% and 35.1% vs 21.2%, respectively), but the difference was statistically not significant. When compared to the control group, 75 gm test group reached statistical significance in having higher incidence of macrosomia (12.3% vs 3%, p<0.05) whereas 100gm test group did not. CONCLUSION: Efficacy of the diagnostic criteria of WHO was comparable to that of NDDG for diagnosing gestational diabetes. This suggests WHO's 75 gm OGTT to be an efficient diagnostic tool for gestational diabetes in Korean women.
Cesarean Section ; Diabetes, Gestational* ; Female ; Glucose Tolerance Test* ; Humans ; Incidence ; Pregnancy ; Premature Birth ; Retrospective Studies ; World Health Organization