It is well known that anatomic variations affecting the ostiomeatal unit (OMU) become one of the causes of mucosal abnormalities of paranasal sinuses (PNS). Findings of coronal plane CT scans of PNS were analyzed in 95 patients with sinusitis or sinusitis-like complaints. Anatomical variations were seen in 88 cases of 60 patients. Mucosal abnormalities were seen in 27 of 47 cases with concha bullosa, 23 of 37 cases with enlarged ethmoid bulla, 8 of 33 cases with Agger nasi, 20 of 26 cases with nasoseptal deviation, 7 of 8 cases with Haller cell, 3 of 6 cases with duoble middle turbinate, 4 of 6 cases with medially bent uncinate process, 1 cases with laterally bent uncinate process, and 33 of 40 cases with mixed variations. Mucosal abnormalities in cases with antomical variations were detected in 61 cases, including maxillary sinus(51 cases), anterior ethmoid sinus (26 cases), frontal sinus (4 cases), and mixed (32 cases). Mucosal abnormalities without anatomical variations were detected in 13 cases involving maxillary sinuses (7 cases), anterior ethmoid sinuses (5 cases), and frontal sinus(1 cases). In conclusion, as coronal plane CT scan has the capability of dolineating anatomical variations and mucosal abnormalities of PNS, it is considered useful in evaluating the treatment and prognosis of chronic or recurrent sinusitis.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Meperidine ; Paranasal Sinuses ; Prognosis ; Sinusitis ; Tomography, X-Ray Computed ; Turbinates

It is well known that anatomic variations affecting the ostiomeatal unit (OMU) become one of the causes of mucosal abnormalities of paranasal sinuses (PNS). Findings of coronal plane CT scans of PNS were analyzed in 95 patients with sinusitis or sinusitis-like complaints. Anatomical variations were seen in 88 cases of 60 patients. Mucosal abnormalities were seen in 27 of 47 cases with concha bullosa, 23 of 37 cases with enlarged ethmoid bulla, 8 of 33 cases with Agger nasi, 20 of 26 cases with nasoseptal deviation, 7 of 8 cases with Haller cell, 3 of 6 cases with duoble middle turbinate, 4 of 6 cases with medially bent uncinate process, 1 cases with laterally bent uncinate process, and 33 of 40 cases with mixed variations. Mucosal abnormalities in cases with antomical variations were detected in 61 cases, including maxillary sinus(51 cases), anterior ethmoid sinus (26 cases), frontal sinus (4 cases), and mixed (32 cases). Mucosal abnormalities without anatomical variations were detected in 13 cases involving maxillary sinuses (7 cases), anterior ethmoid sinuses (5 cases), and frontal sinus(1 cases). In conclusion, as coronal plane CT scan has the capability of dolineating anatomical variations and mucosal abnormalities of PNS, it is considered useful in evaluating the treatment and prognosis of chronic or recurrent sinusitis.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Meperidine ; Paranasal Sinuses ; Prognosis ; Sinusitis ; Tomography, X-Ray Computed ; Turbinates

No abstract available.
Pancreas*

No abstract available.
Infarction* ; Liver*

The clincopathologic features of microcystic adnexal carcinoma are presented. Microcystic adnexal carcinoma is a recently described, very rare neoplasm characterized by a locally aggressive growth pattern, and as far as we know, only two reports on the microcystic adnexal carcinoma have been published in the Korean literature. Recently we experienced two cases of microcystic adnexal carcimoma occurred in a 32-year-old male and 27-year-old female patient. They had 2.5 x 2.0 x 2.0 cm and 1.2 x 0.9 x 0.9 cm sized, slowly growing mass in the glabella and below the lower lip, respectively. The immunohistochemical staining for CEA antigen stains the glandular structures but not pilar structures. So we thinked that this tumor would be originated from primitive adnexal cells differentiating into both pilar and eccrine structures.
Female ; Male ; Humans

BACKGROUND & PURPOSE: The aim of our study is to evaluate the stroke pattern, the correlation of collateralization with cerebral perfusion and stroke severity, and the utility of transcranial Doppler(TCD) to detect collateral pathways in patients with internal carotid artery(ICA) occlusion in the neck. METHODS: Thirty-six patients(28 men and 8 women, mean age of 59.6 ? 12.9 years) with ICA occlusion confirmed by transfemoral cerebral angiography(25 patients) or magnetic resonance angiography(MRA, 11 patients) were studied retrospectively. They had no potential cardiac source of stroke. We evaluated the pattern of cerebral infarcts by magnetic resonance imaging, and the number and the patency of collateral vessels, and the degree of perfusion through collaterals by cerebral angiography. The collateral vessels detected by TCD and MRA were compared with those by cerebral angiography. RESULTS: We found territorial infarcts in 23 patients(64%) and borderzone infarcts in 15(42%). Territorial infarcts(p<0.0001) and borderzone infarcts(p=0.02) occurred more in the ipsilateral hemisphere to the occluded ICA. The prevalence of small subcortical infarcts did not differ between hemispheres. Collateralizations through leptomeningeal anastomosis(p<0.01) and ophthalmic artery(OA, p<0.05) were associated with angiographically reduced cerebral perfusion. Collateralization through OA was also associated with severe symptomatic group(p<0.05); and collateralization through anterior or posterior communicating artery was associated with mild symptomatic group with marginal statistical significance(p=0.097). The number of collateral vessels was associated with neither the degree of perfusion nor the stroke severity. The sensitivity and specificity of TCD to detect collateralization through anterior communicating artery were 100% and 78%, through posterior communicating artery, 67% and 75%, and through OA, 67% and 63%, respectively. CONCLUSION: Cerebral infarcts related to a proximal ICA occlusion are more likely to be ipsilateral territorial or borderzone. The type of collateralization is more important factor for cerebral perfusion and stroke severity than the number of collateral vessels. TCD is a reliable tool for the evaluation of the collateral vessels in the patients with ICA occlusion.
Arteries ; Carotid Artery, Internal* ; Cerebral Angiography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neck* ; Perfusion ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Stroke*

BACKGROUND & PURPOSE: Thymic tumors are frequently found in patients with myasthenia gravis(MG); the patients with thymoma seem to be more associated with severe MG. This study was performed to analyse the clinical characteristics of thymic tumor-associated MGs and to compare the patients with invasive and noninvasive thymomas. METHODS: We retrospectively reviewed the medical records of 305 MG subjects(M:F = 112:193, age = 30.4 ? 8.1 years) who had been diagnosed to have MG from January 1986 to June 1996, and analysed the clinical characteristics of MG subjects with thymic tumors. Forty seven patients were confirmed to have thymic tumor by the postoperative histopathologic findings(thymic tumor(TT) group) and 191 were known to have nonneoplastic thymus by chest CT or postoperative histopathologic findings(nonneoplastic thymus(NN) group). RESULTS: The incidence of thymic tumor-associated MG was 25.2%. The male to female ratio for the TT and the NN groups were 1:1 and 1:2, and the mean age of onset were 42.9 ? 11.2 years and 28.3 ? 17.5 years, respectively. When we evaluated the disease severity by Osserman's classification, 85% of the TT group and 51% of NN group were severely affected(Iib, III, IV). The generalization of symptoms occurred in 98% of the TT group and 66% of the NN group. The disease severity and the clinical outcome were not significantly different between the MGs with invasive thymoma, noninvasive thymoma and thymic carcinoma. CONCLUSION: Compared with those of MGs with nonneoplastic thymus, the thymic tumor-associated MGs showed several different clinical phenotypes, as in the followings; they showed no sex predominance, the onset age was older, more common generalization of myasthenic symptoms, and more patients were severely affected. The severity and outcome were not different between the MGs with thymic tumor.
Age of Onset ; Classification ; Female ; Generalization (Psychology) ; Humans ; Incidence ; Male ; Medical Records ; Myasthenia Gravis* ; Phenotype ; Retrospective Studies ; Thymectomy ; Thymoma ; Thymus Gland ; Thymus Neoplasms ; Tomography, X-Ray Computed

BACKGROUND: Churg-Strauss syndrome (CSS) is characterized by disseminated vasculitis with multi-organ involve-ment. The purpose of this study was to determine the frequency and the types of neurologic involvement in a series of patients with CSS. METHODS: We reviewed the medical records of 16 patients (seven men and nine women, age = 41.9 (18.6) with CSS who were examined at Seoul National University Hospital. The diagnosis of CSS was based on the presence of asthma, peripheral eosinophilia (more than 10% eosinophiles), and histopathological or clinical findings of vasculitis. RESULTS: Of the 16 patients, 12 (75%) had neurologic involvement. Nine (56%) had neurologic symptoms as initial presentations of CSS. Peripheral neuropathy was detected in nine patients (56%) ; six had multiple mononeu-ropathy, and three had distal symmetric polyneuropathy. Three patients (19%) had cerebral infarctions; in two of them, a delayed diagnosis of CSS caused the recurrence of ischemic stroke. Corticosteroid therapy combined with immuno-suppressive agents usually yielded improvement or stabilization of symptoms. CONCLUSIONS: Neurologic involvement is common in CSS, usually manifesting as peripheral neuropathy. Neurologic symptoms are important initial manifesta-tions at the time of diagnosis of CSS. Furthermore, cerebral involvement is not uncommon; thus any neurologic symp-toms in patients with asthma or eosinophilia prompts an aggressive diagnostic approach to CSS.
Asthma ; Cerebral Infarction ; Churg-Strauss Syndrome* ; Delayed Diagnosis ; Diagnosis ; Eosinophilia ; Female ; Humans ; Male ; Medical Records ; Neurologic Manifestations* ; Peripheral Nervous System Diseases ; Polyneuropathies ; Recurrence ; Seoul ; Stroke ; Vasculitis

BACKGROUND: Churg-Strauss syndrome (CSS) is characterized by disseminated vasculitis with multi-organ involve-ment. The purpose of this study was to determine the frequency and the types of neurologic involvement in a series of patients with CSS. METHODS: We reviewed the medical records of 16 patients (seven men and nine women, age = 41.9 (18.6) with CSS who were examined at Seoul National University Hospital. The diagnosis of CSS was based on the presence of asthma, peripheral eosinophilia (more than 10% eosinophiles), and histopathological or clinical findings of vasculitis. RESULTS: Of the 16 patients, 12 (75%) had neurologic involvement. Nine (56%) had neurologic symptoms as initial presentations of CSS. Peripheral neuropathy was detected in nine patients (56%) ; six had multiple mononeu-ropathy, and three had distal symmetric polyneuropathy. Three patients (19%) had cerebral infarctions; in two of them, a delayed diagnosis of CSS caused the recurrence of ischemic stroke. Corticosteroid therapy combined with immuno-suppressive agents usually yielded improvement or stabilization of symptoms. CONCLUSIONS: Neurologic involvement is common in CSS, usually manifesting as peripheral neuropathy. Neurologic symptoms are important initial manifesta-tions at the time of diagnosis of CSS. Furthermore, cerebral involvement is not uncommon; thus any neurologic symp-toms in patients with asthma or eosinophilia prompts an aggressive diagnostic approach to CSS.
Asthma ; Cerebral Infarction ; Churg-Strauss Syndrome* ; Delayed Diagnosis ; Diagnosis ; Eosinophilia ; Female ; Humans ; Male ; Medical Records ; Neurologic Manifestations* ; Peripheral Nervous System Diseases ; Polyneuropathies ; Recurrence ; Seoul ; Stroke ; Vasculitis

Poststroke hypotension may be related to early neurological deterioration and infarct progression by decrease of cerebral perfusion, particularly in patients with ischemic penumbra. However, optimal management guideline of blood pressure in the setting of acute stroke is absent, and remains a matter of debate. We report here a patient who had early neurological deterioration accompanied by systemic hypotension. Phenylephrine-induced hypertensive therapy by imaging-based decision making successfully restored neurologic dysfunction in this patient.
Blood Pressure ; Decision Making ; Humans ; Hypotension ; Neurologic Manifestations ; Perfusion ; Stroke*