We retrospectively reviewed the MRI findings of 100 temporomandibular joints in 78 patients who had complained temporomandibular joint dysfunction. MRI findings were classified according to Wilke's staging criteria. And these findings were compared with arthrographic findings in 22 joints and surgical findings in 44 joints. According to Wilkes's staging. They were classified into 6 stages of abnormality: stage 0 (33 cases), stage I (19 cases), stage II (10 cases), stage III (18 cases), stage IV (6cases), stage V (14 cases). Among the 22 cases in which arthrography and MRI were done, both studies were well correlated in 10 joints. In 7 joints, MRI was superior to arthrography, which correctly demonstrated the meniscal displacement in 2 joints and . Meniscal deformity in 5 joints. In 5 joints, arthrography was superior to MR, which demonstrated the perforation (1 joint), adhesion (2 joint) and recapture of meniscus (2 joints). Compared with surgical findings, MRI correctly demonstrated the displacement of meniscus in all 44 joints. However, in case of the 10 meniscal perforation, MRI demonstrated the meniscal discontinuity in only 4 joints. Retrospective MR findings in 10 proven cases were the defect in posterior attachment in 4, far anterior meniscal displacement without recapture in 8m condylar spur in 4, and close bone to bone contact in 1. In conclusion, MRI as a primary Fiagnostic modality of temporomandibular joint derangment, is superior for the grading of displacement and deformity of meniscus but inferior for the evaluation of perforation, adhesion and recapture of meniscus to conventional arthrography. In case of the suspected meniscal perforation, arthrographic correlation is recommanded preoperatively.
Arthrography ; Congenital Abnormalities ; Humans ; Joints ; Magnetic Resonance Imaging* ; Retrospective Studies ; Temporomandibular Joint*

OBJECTIVE: To describe the neuroradiologic findings of primary antiphospholipid antibody syndrome (PAPS). MATERIALS AND METHODS: During a recent two-year period, abnormally elevated antiphospholipid antibodies were detected in a total of 751 patients. In any cases in which risk factors for stroke were detected-hypertension, diabetes mellitus, hyperlipidemia, smoking, and the presence of SLE or other connective tissue diseases-PAPS was not diagnosed. Neuroradiologic studies were performed in 11 of 32 patients with PAPS. We retrospectively reviewed brain CT (n = 7), MR (n = 8), and cerebral angiography (n = 8) in 11 patients with special attention to the presence of brain parenchymal lesions and cerebral arterial or venous abnormalities. RESULTS: CT or MR findings of PAPS included nonspecific multiple hyper-inten-sity foci in deep white matter on T2-weighted images (5/11), a large infarct in the territory of the middle cerebral artery (4/11), diffuse cortical atrophy (2/11), focal hemorrhage (2/11), and dural sinus thrombosis (1/11). Angiographic findings were normal (5/8) or reflected either occlusion of a large cerebral artery (2/8) or dural sinus thrombosis (1/8). CONCLUSION: Neuroradiologic findings of PAPS are nonspecific but in young or middle-aged adults who show the above mentioned CT or MR findings, and in whom risk factors for stroke are not present, the condition should be suspected.
Adult ; Antiphospholipid Syndrome/*radiography ; Brain/pathology/*radiography ; Cerebral Angiography ; Female ; Human ; Magnetic Resonance Imaging ; Male ; Middle Age ; Risk Factors ; Tomography, X-Ray Computed

BACKGROUND: Complement activation with transpulmonary leukocyte sequestration is considered a main mediator leading to ischemia-reperfusion lung(I-R) injury. We studied the role of leukocytes in the formation of I-R injury in ovine cardiopulmonary bypass(CPB) model with a membrane oxygenator. MATERIAL AND METHOD: Five sheep were used. CPB circuitry consisted of a roller pump(American Optical Corp., Greenwich, CT, USA) and a membrane oxygenator(UNIVOX-IC, Bentley, Baxter Health Corp, Irvine, CA, USA). The CPB time was fixed at 120 min. Ten minutes after the start of CPB, total CPB was established. Thereafter a total CPB of 100 min was performed, followed by another 10 min of partial CPB. The CPB was discontinued and the animals were fully recovered. For measuring left and right atrial leukocyte counts, blood samples were taken before thoracotomy, 5 min and 109 in after the start of CPB, and 30 min and 120 min after weaning. C3a was measured before thoracotomy, 109 min after the start of CPB, and 30 min and 120 min after weaning. Plasma malondialdehyde(MDA) was checked before thoracotomy, 109 min after the start of CPB, and 30 min after weaning. One to two grams of lung tissue were taken for water content measurement before thoracotomy, 109 min after the start of CPB, and 30 min after weaning. Lung biopsy specimens were examined by light and electron microscopy. RESULT: Of 5 animals, 4 survived the experimental procedures. Of these, 3 animals survived on a long-term basis. No significant differences in transpulmonary gradients of leukocyte were found and no significant complement activation was expressed by C3a levels. MDA level did not show significant changes related to lung reperfusion despite an increase after the start of CPB. On both light and electron microscopic examinations, mild to moderate acute lung change was observed. Interstitial edema, leakage of erythrocytes into the alveolar space and endothelial cell swelling were the main findings. Water content of the lung showed a slight increase after the start of CPB, but there was no statistical significance. CONCLUSION: These findings indicate that ischemia-repersusion lung injury may not be from complement activation-leukocyte sequestration but from another source of oxygen free radicals related to CPB.
Animals ; Biopsy ; Cardiopulmonary Bypass* ; Complement Activation ; Complement System Proteins ; Edema ; Endothelial Cells ; Erythrocytes ; Free Radicals ; Leukocyte Count ; Leukocytes* ; Lung Injury* ; Lung* ; Membranes* ; Microscopy, Electron ; Organ Preservation ; Oxygen ; Oxygenators, Membrane* ; Plasma ; Reperfusion ; Reperfusion Injury ; Sheep ; Thoracotomy ; Weaning

PURPOSE: Ganglioglioma is a rare primary brain tumor usually found in the temporal lobe. The purpose of thisstudy is to describe the characteristic MR findings of temporal lobe ganglioglioma. MATERILA AND METHODS: Over aseven-year period, ten patients with cerebral ganglioglioma were evaluated at our institution. Seven cases oftemporal lobe ganglioma were found ; six of these involved men, and one, a woman ; their mean age was 29.6 years.In three patients, Gd-DTPA-enhanced T1 weighted images were also obtained. We retrospectively analysed the MRIfindings with respect to location, size, cortical involvement, margin, cystic change, degree of enhancement, MRsignal intensity, calcification and peritumoral change. RESULTS: In five cases, tumors were located within thetemporal lobe. In one, a tumor extended from the temporal lobe to the thalamus, and in one from the temporal lobeto the thalamus and cerebral peduncle. All temporal gangliogliomas measured 1.6-3.8cm in their greatestdiameter(mean diameter, 2.7cm). In all cases, the cortices were involved with the maintenance of gyriform. Thetumor margin was ill defined in five cases and well defined in two. Tumors showed multiple small cystic changes infour cases, a large cyst in two, and a solid nodule in one. In three cases in which contrast media wasadministered, no lesions were enhanced. On T1-weighted images, iso-signal intensities were seen in five cases andhigh signal intensities in two. On T2-weighted images, the corresponding figures were five and two. On MRI, tumorcalcification and calvarial erosion were each detected in two cases. CONCLUSION: In patients with temporal lobeepilepsy in whom cortical solid or cystic and poorly enhanced lesions were seen on brain MRI, and in whomaccociated findings such as calcification and or adjacent bony erosion were noted, ganglioglioma must beconsidered.
Brain ; Brain Neoplasms ; Contrast Media ; Female ; Ganglioglioma* ; Humans ; Magnetic Resonance Imaging* ; Male ; Retrospective Studies ; Tegmentum Mesencephali ; Temporal Lobe* ; Thalamus

BACKGROUND/AIMS: Colonoscopy has emerged as the dominant colorectal cancer screening strategy, yet the data on the results of performing screening colonoscopy in asymptomatic average risk Koreans is limited. The aim of this study is to determine the results of screening colonoscopy at a community-based single center in Korea. METHODS: A total of 13,743 individuals (5,935 males and 7,808 females, age: 50.6+/-11.8 years) who underwent screening colonoscopy at a community based hospital from April 2006 to March 2008 were analyzed. RESULTS: Of the 13,743 subjects, neoplasia, advanced neoplasia and early colon cancer were detected in 3,270 subjects (23.8%), 315 subjects (2.3%) and 60 subjects (0.5%), respectively. The prevalence of neoplasia and advanced neoplasia increased with age (p<0.001), and this was higher among males as compared to that of females (p<0.001). Of the 3,666 subjects with neoplasia, 1,440 subjects (38.3%) had multiple neoplasia. Old age and male gender were associated with multiple neoplasia. CONCLUSIONS: The overall prevalence of colorectal neoplasia in asymptomatic average-risk Koreans at a community based hospital is comparable with that in a health care setting or university hospitals. Old age and male gender are associated with a higher risk of colorectal neoplasia and having multiple neoplasia.
Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Delivery of Health Care ; Female ; Hospitals, University ; Humans ; Korea ; Male ; Mass Screening ; Prevalence

PURPOSE: To evaluate the utomated 1H magnetic resonance spectroscopy (1H-MRS) method for a routine clinical use, various regions of the normal human brain were examined for regional variations, the reproducibility, and thequality control of the spectral data. MATERIALS AND METHODS: Localized 1H-MRS was performed in a GE 1.5T SIGNAMRI/MRS system using the automated method(PROton brain Exam : PROBE). Six regions of the human brain from normal volunteers (N=25, age=23-65) were examined : Occipital gray matter, parietal white matter, frontal white matter, pons, cerebellum, and basal ganglia regions. STEAM was used as the localization method with the following parameters : TE=30 msec, TR=3.0 sec, AVG=48 AVG, NEX=2, Spectral Width (SW)=2500 Hz, Size (SI)=2048 points (2K),and the size of voxel=7-9 ml, The reproducibility and the quality control of the spectral date were evaluated. RESULTS: For the 6 regions, the regional variation by the spectral patterns and the metabolites ratios relative to creatine was well demonstrated. Rates of the auto prescan success and the percentages of obtaining the acceptable quality spectra were high in the parietal white matter, occipital gray matter, and basal gangliaregions, and low in the frontal white matter and pons regions. CONCLUSION: PROBE is a highly practical as well asreliable method to produce reproducible quality spectra that represent the regional metabolic variations in the human brain, PROBE can be used as a single spectroscopic exam or as an additional series to a routine brain MRI exam, which takes less than 10 minutes for acquiaition of one spectrum. In order to obtain good quality spectra, agood quality control scheme of the MR instrument is mandatory.
Basal Ganglia ; Brain ; Cerebellum ; Creatine ; Humans ; Magnetic Resonance Spectroscopy* ; Pons ; Quality Control ; Rabeprazole ; Spectrum Analysis ; Steam

PURPOSE: The purpose of this study is to determine predictive MR features for grading of astrocytic gliomas and to evaluate the accuracy of MR grading in these tumors. MATERIALS AND METHODS: We retrospectively reviewed 135 cases of supratentorial astrocytic gliomas in adult (age > 15 years), all of which were proved by open biopsy. Two observers analysed MR images independently with criteria of margin, edema, mass effect, signal heterogeneity, necrcosis, cyst formation, hemorrhage, tumor vascularity, enhancement degree, and enhancement size. The patterns of enhancement were categorized into no, homogeneous, heterogeneous, thin smooth rim, thin irregular rim, and thick irregular rim enhancement patterns. Observers finally diagnosed each case as one of low-grade astrocytoma, anaplastic astrocytoma or glioblastoma multiforme. RESULTS: Statistically significant MR features for grading of these tumors were revealed as necrosis (p < 0. 001), edema (0.008), and signal heterogeneity (p < 0.025). When compared with histopathologic grading, MR graded correctly 76%-77% of cases in two tiered system(low-grade astrocytoma versus high-grade astrocytoma), but only 67%-69% of cases in three tiered system(low-grade astrocytoma, anaplastic astrocytoma, glioblastoma multiforme). No contrast enhancement was seen in 45% and 23% of low-grade astrocytoma and anaplastic astrocytoma respectively. Glioblastoma multiforme frequently showed thick irregular rim enhancement (57%), but no enhancement at all in 8%. CONCLUSION: We have concluded that necrosis and edema are significant predictive MR features for gradomg of supratentorial astrocytic gliomas in adult, and MR was correct in 76%--77% of cases for predicting pathologic grading of astrocytomas in two tiered system.
Adult* ; Astrocytoma* ; Biopsy ; Edema ; Glioblastoma ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Necrosis ; Neoplasm Grading* ; Population Characteristics ; Retrospective Studies

PURPOSE: The purpose of this study was to compare the clinical utility of diffusion-weighted images(DWI) withthat of apparent diffusion coefficient(ADC) maps for detecting early ishemic strokes. MATERIALS AND METHODS: In22 patients with infarct, lesion conspicuity as seen on T2-weighted images(T2WI), low diffusion-weightedimages(DWI ; b value 300 sec/mm2), high DWI(b value 1000 sec/mm2), and ADC maps was retrospectively compared. Theinfarct was hyperacute (< 6 hours) in six, acute (< 48 hours) in six, and subacute (< 2 weeks) in ten. All imageswere obtained using an echo-planar spin echo sequence; lesion conspicuity was graded from 0 to 2 by tworadiologists. Signal intensity was analysed in 17 patients[hyperacute (n=5); acute (n=4); and subacute (n=8)].Lesion-to-controlateral normal side signal intensity ratio(SIR) and contrast-to-noise ratio(CNR) were measured andcompared between four different types of images. RESULT: With regard to lesion conspicuity, high DWI wassuperior to the other images for detecting hyperacute strokes(Grade 2, 6/6). In such cases, an ADC map showedgrade 0 lesion conspicuity in one case, grade 1 in three, and grade 2 in two. There was no significant differencein lesion conspicuity in acute and subacute strokes between DWI(low & high) and T2WI(Grade 2, 16 in each). An ADCmap in acute and subacute stroke showed Grade 1 in four cases and Grade 2 in 12. Signal intensity analysis of SIRand CNR showed that high DWI was also superior to the other images for detecting hyperacute ischemic strokes(p <0.05, n=5), and superior to an ADC map in acute and subacute stroke(p < 0.05, n=12). CONCLUSION: Diffusion-weighted images with a high b value could be more useful than ADC maps and conventional T2-weightedimages, especially for the detection of hyperacute strokes.
Diffusion* ; Humans ; Retrospective Studies ; Stroke*

Quantifying and rating the impairments due to mental and behavior disorders are difficult for their own characteristics. Korean Academy of Medical Sciences (KAMS) is developing guidelines of rating impairment in mental and behavioral disorders based on Korean Neuropsychiatric Association (KNPA)'s new guidelines. We compared the new KNPA's guidelines and the American Medical Association (AMA)'s 6th Guides in assessing impairment due to mental and behavioral disorders to develop new guidelines of KAMS. Two guidelines are different in diagnosing system, applicable disorders, qualification of assessors, application of scales, contents of assessment and rate of impairment of the whole person. Both AMA's and the proposed guidelines have individual merits and characteristics. There is a limitation in using the 6th AMA's Guides in Korean situation. However to improve objectivity in Korean assessment of psychiatric impairment, the new AMA's Guides can serve as a good reference.
Academies and Institutes ; Behavioral Symptoms/classification/*diagnosis/physiopathology ; Brief Psychiatric Rating Scale/standards ; *Disability Evaluation ; Humans ; Korea ; Mental Disorders/classification/*diagnosis/physiopathology ; *Practice Guidelines as Topic ; Program Development

We report a case of ganglioneurocytoma manifesting as a complex partial seizure in a young adult male. MR images depicted a well-marginated cystic mass with a heterogeneous solid portion abutting the dura in the parietal lobe. The solid portion showed minimal heterogeneous enhancement, and pressure erosion of the overlying calvarium had occurred. Following gross total resection, the clinical outcome was satisfactory, with no further seizures, and during the five-year follow-up period, the tumor did not recur.
Adult ; Brain Neoplasms/*pathology ; Case Report ; Follow-Up Studies ; Ganglioneuroma/*pathology ; Human ; Magnetic Resonance Imaging ; Male ; Neurocytoma/*pathology ; Parietal Lobe/*pathology