PURPOSE: After the RS (respiratory syncytial) virus, the influenza virus is the most common cause of childhood lower respiratory tract infection. We assessed the radiologic findings of childhood lower respiratory tract infection by the influenza virus. MATERIALS AND METHODS: A total of 105 pediatric patients (76 males and 29 females; mean age, 2.4 years) with symptoms of respiratory tract infection were examined between March 1997 and April 2000. Nasopharyngeal aspirates were obtained and influenza virus infection was confirmed by direct or indirect immunofluorescent assays. Peribronchial infiltration, hyperinflation, atelectasis, pulmonary consolidation, and hilar lymphadenopathy were evaluated retrospectively at simple chest radiography. RESULTS: Bilateral perihilar peribronchial infiltration was noted in 78.1% of patients (n=82), hyperinflation in 63.8% (n=67), atelectasis in 3.8% (n=4; segmental 50%, lobar 50%), and pulmonary consolidation in 16.2% [n=17; segmental 70.6% (n=12), lobar 29.4% (n=5)]. Hilar lymphadenopathy was noted in one patient in whom there was no pleural effusion, and subglottic airway narrowing in 12 of 14 in whom the croup symptom complex was present. CONCLUSION: The major radiologic findings of influenza virus infection were bilateral perihilar peribronchial infiltration and hyperinflation. In some patients, upper respiratory tract infection was combined with subgolttic airway narrowing. Atelectasis or pleural effusion was rare.
Croup ; Female ; Humans ; Influenza, Human* ; Lymphatic Diseases ; Male ; Orthomyxoviridae* ; Pleural Effusion ; Pulmonary Atelectasis ; Radiography ; Respiratory System* ; Respiratory Tract Infections* ; Retrospective Studies ; Thorax

The enamel matrix derivative (EMD) has been recently used in the periodontal regenerative techniques. The present study was established to investigate the influence of EMD on human periodontal ligament cells using expression of mRNA of periodontal ligament specific gene (PDLs)17, PDLs22, type I collagen when EMD applied to periodontal ligament cells. Periodontal ligament cells were obtained from a healthy periodontium and cultured in Dulbecco's modified Eagle's medium (DMEM) plus 10% fetal bovine serum and beta-glycerophosphate with ascorbic acid. Test groups were two; One adds EMD in culture media and another added EMD and Dexamethasone (DEX) in culture media. Positive control group added DEX in culture media, and negative control group adds niether of EMD nor DEX. Emdogain(R) (Biora, Sweden, 30 mg/ml) was diluted by 75 microgram/ml concentration to culture media. For reverse transcription-polymerase chain reaction (RT-PCR), total RNA isolated on days 0, 7, 14 and 21. mRNA of PDLs17 was expressed on days 14 and 21 in EMD or DEX group, and expressed on days 7, 14 and 21 in EMD plus DEX group, the other side, expressed on days 21 in negative control group. mRNA of PDLs22 expressed on days 7, 14 and 21 in EMD group, and expressed on days 14 and 21 in DEX group, and expressed on days 7, 14 and 21 in EMD plus DEX group. Negative control group expressed on days 14 and 21. Type I collagen was expressed on all days and all groups. These results indicate that EMD promotes differentiation of periodontal ligament cells, and this is considered to offer basis that can apply EMD to periodontal tissue regeneration technique.
Ascorbic Acid ; Collagen Type I ; Culture Media ; Dental Enamel* ; Dexamethasone ; Humans* ; Periodontal Ligament* ; Periodontium ; Regeneration ; RNA ; RNA, Messenger ; Sweden

Panniculitis is an inflammatory reaction of the subcutaneous fat. Erythema nodosum is its most common form and mesenteric panniculitis is well known. We describe a case of posterior mediastinal panniculitis confirmed by gun biopsy and describe the CT and pathologic findings. CT showed a paraspinal mass containing a small amount of fat in the posterior mediastinum.
Biopsy ; Erythema Nodosum ; Mediastinum ; Panniculitis* ; Panniculitis, Peritoneal ; Subcutaneous Fat

PURPOSE: To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. MATERIALS AND METHODS: Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. RESULTS: The complications manifesting mainly as pulmonary nodules were lung cancer(4/4), tuberculosis (1/2), and Kaposi's sarcoma(1/1). Pulmonary consolidation was a main feature in bacterial infection(4/4), fungal infection(3/4), tuberculosis(1/2), chlamydial infection(1/1), and varicellar pneumonia(1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia(4/6), and increased interstitial marking was a predominant radiographic feature in CMV pneumonia(2/6). CONCLUSION: The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation.
Bacteria ; Chickenpox ; Chlamydia ; Diagnosis, Differential ; Fungi ; Humans ; Kidney Transplantation* ; Lung ; Lung Neoplasms ; Pulmonary Edema ; Sarcoma, Kaposi ; Thorax ; Tuberculosis

Pulmonary blastoma is a rare primary lung malignancy consisting of mesenchymal and epithelial components resembling the fetal lung. We report a case of pulmonary blastoma with solitary hemorrhagic brain metastasis in a 32-year-old man. This metastatic lesion was composed mainly of hemorrhagic high density and central necrotic low density areas; on CT it showed partial contrast enhancement and was thus impossible to distinguish from other hemorrhagic lesions.
Adult ; Brain* ; Humans ; Lung ; Neoplasm Metastasis* ; Pulmonary Blastoma*

PURPOSE: In order to determine specific differences, we compared the temporal bone CT findings of chronic otitis media(COM) with and without cholesteatoma, focusing on bone change. MATERIALS AND METHODS: Between 1997 and 1998, 82 patients(84 cases) underwent temporal bone CT and were shown to have COM, with or without cholesteatoma after mastoidectomy and tympanoplasty. There were 36cases of COM with cholesteatoma(26 patients, M:F=11:15; age range, 16 -61 [mean, 36.2] years), and 58 cases without cholesteatoma(56 patients, M:F=25:31, age range, 15 -61 [mean, 36.2]years). The findings of temporal bone CT were analyzed at the point of bony changes including erosion and medial displacement of ossicles(malleus, incus, and stapes), erosion or destruction of the scutum, tegmen, facial canal, and lateral semicircular canal, and ballooning of the tympanic cavity and mastoid antrum. In addition, the soft tissue changes seen on temporal bone CT were analyzed at the site of lateral bulging of soft tissue in Prussak's space, perforation of the pars flaccida, tympanic membrane retraction, and tympanosclerosis. We retrospectively compared the findings of temporal bone CT with the surgical findings, and to assess statistical significance, the Chi-square test was used. RESULTS: Bone erosion or destruction was seen in 36.2 % of COM cases without cholesteatoma, and in 96.2% of cases with cholesteatoma. Comparing COM with and without cholesteatoma, the erosion of ossicles includ-ing the malleus(81%, 24%), incus(88%, 14%), stapes(58%, 10%), scutum(88%, 10%), facial canal(8%, 0%), and lateral semicircular canal(8%, 0%), was more common in COM with cholesteatoma(p-value<0.05), with the exception of erosion of the tegmen(8%, 3%). Other bony changes including medial displacement of ossi-cles (27%, 3%), ballooning of tympanic cavity and mastoid antrum(96%, 16%), and the soft tissue changes including lateral bulging of soft tissue in Prussak's space(58%, 14%) and perforation of the pars flaccida(35% ,9%) were more common in COM with cholesteatoma (p-alue<0.05). Soft tissue in Prussak's space(58%, 72%), retraction of the tympanic membrane(1%, 9%), and tympanosclerosis(8%, 10%) were not however,important findings(p-value>0.05). CONCLUSION: Bone erosion or destruction was seen in COM without cholesteatoma, but expansile bone erosion or destruction with mass effect suggested COM with cholesteatoma. These findings of temporal bone CT in COM demonstrate the existence and extent of combined cholesteatoma, and are therefore valuable.
Cholesteatoma ; Diagnosis, Differential* ; Ear, Middle ; Humans ; Incus ; Mastoid ; Myringosclerosis ; Otitis Media* ; Otitis* ; Retrospective Studies ; Semicircular Canals ; Temporal Bone ; Tympanic Membrane ; Tympanoplasty

PURPOSE: In order to determine specific differences, we compared the temporal bone CT findings of chronic otitis media(COM) with and without cholesteatoma, focusing on bone change. MATERIALS AND METHODS: Between 1997 and 1998, 82 patients(84 cases) underwent temporal bone CT and were shown to have COM, with or without cholesteatoma after mastoidectomy and tympanoplasty. There were 36cases of COM with cholesteatoma(26 patients, M:F=11:15; age range, 16 -61 [mean, 36.2] years), and 58 cases without cholesteatoma(56 patients, M:F=25:31, age range, 15 -61 [mean, 36.2]years). The findings of temporal bone CT were analyzed at the point of bony changes including erosion and medial displacement of ossicles(malleus, incus, and stapes), erosion or destruction of the scutum, tegmen, facial canal, and lateral semicircular canal, and ballooning of the tympanic cavity and mastoid antrum. In addition, the soft tissue changes seen on temporal bone CT were analyzed at the site of lateral bulging of soft tissue in Prussak's space, perforation of the pars flaccida, tympanic membrane retraction, and tympanosclerosis. We retrospectively compared the findings of temporal bone CT with the surgical findings, and to assess statistical significance, the Chi-square test was used. RESULTS: Bone erosion or destruction was seen in 36.2 % of COM cases without cholesteatoma, and in 96.2% of cases with cholesteatoma. Comparing COM with and without cholesteatoma, the erosion of ossicles includ-ing the malleus(81%, 24%), incus(88%, 14%), stapes(58%, 10%), scutum(88%, 10%), facial canal(8%, 0%), and lateral semicircular canal(8%, 0%), was more common in COM with cholesteatoma(p-value<0.05), with the exception of erosion of the tegmen(8%, 3%). Other bony changes including medial displacement of ossi-cles (27%, 3%), ballooning of tympanic cavity and mastoid antrum(96%, 16%), and the soft tissue changes including lateral bulging of soft tissue in Prussak's space(58%, 14%) and perforation of the pars flaccida(35% ,9%) were more common in COM with cholesteatoma (p-alue<0.05). Soft tissue in Prussak's space(58%, 72%), retraction of the tympanic membrane(1%, 9%), and tympanosclerosis(8%, 10%) were not however,important findings(p-value>0.05). CONCLUSION: Bone erosion or destruction was seen in COM without cholesteatoma, but expansile bone erosion or destruction with mass effect suggested COM with cholesteatoma. These findings of temporal bone CT in COM demonstrate the existence and extent of combined cholesteatoma, and are therefore valuable.
Cholesteatoma ; Diagnosis, Differential* ; Ear, Middle ; Humans ; Incus ; Mastoid ; Myringosclerosis ; Otitis Media* ; Otitis* ; Retrospective Studies ; Semicircular Canals ; Temporal Bone ; Tympanic Membrane ; Tympanoplasty

PURPOSE: To determine the MR imaging criteria by which bland and proliferative effusion of the knee may be differentiated. MATERIALS AND METHODS: We retrospectively reviewed the MR images of 64 patients (65cases), in whom T2-weighted sagittal scans revealed anteroposterior distension of the suprapatellar bursa of at least 0.5cm. The patients were divided into two groups: bland effusion (n=36) , and proliferative effusion [(n=29); pigmented villonodular synovitis (n=5), rheumatoid arthritis (n=6), septic arthritis (n=6), chronic synovitis (n=5), gouty arthritis (n=3), tuberculous arthritis (n=2), and lipoma arborescens (n=2)]. All conditions were diagnosed on the basis of operative data or clinical criteria. The knee joint space was divided into four compartments: the suprapatellar pouch, central zone, posterior femoral recess, and subpopliteal recess, and the amount and distribution of effusion was then compared between the two groups. The ratios of the width and the length of the lateral recess of the suprapatellar bursa to those of its medial recess were deter mined, and the findings for the two groups were compared. Abnormality of the intracapular fat pads (prefemoral fat, Hoffa 's fat, and quadriceps fat sign) as seen on sagittal scans, is a predictor proliferative effusion, and any such abnormality was evaluated. The synovium was classified as either thin or thick, and as having either a smooth or an irregular margin, as seen on Gadolinium-enhanced T1W1 images. RESULTS: As compared with bland effusion, proliferative effusion involved more prominent joint effusion in the suprapatellar pouch and posterior femoral recess, and in the suprapatellar bursa, the ratio of the width of the lateral recess to that of the medial recess was greater. When comparing the ratio of the length of the lateral recess to that of the medial recess, however, no significant statistical difference was noted. Sensitivity: specificity for proliferative effusion was 58%: 86% on coronal scan and 64%: 93% on axial scan at a threshold value of 0.7 (the ratio of the width). The prefemoral fat pad sign was 41% sensitive and 100% specific, while Hoffa 's fat pad sign had a sensitivity of 32% and a specificity of 95%. The corresponding figures for the quadriceps fat pad sign were 14% and 100%. The pattern of the synovium in bland effusion was thin and smooth in two, thick and smooth in one, and thin and irregular in one. In proliferative effusion, the pattern was thick and smooth in 11 cases, thin and irregular in four, and thick and irregular in 14. CONCLUSION: In proliferative effusion, the synovium tended to be thick and irregular. Proliferative effusion demonstrated greater predilection for the suprapatellar pouch, especially the lateral recess, and posterior femoral recess, than did bland effusion. Difference in the distribution of joint effusion effectively predict both proliferative effusion as well as intracapsular fat pad signs.
Adipose Tissue ; Arthritis ; Arthritis, Gouty ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Humans ; Joints* ; Knee Joint* ; Knee* ; Lipoma ; Magnetic Resonance Imaging ; Retrospective Studies ; Sensitivity and Specificity ; Synovial Membrane ; Synovitis ; Synovitis, Pigmented Villonodular

PURPOSE: To determine the CT findings of consolidative malignant neoplasms of the lung. MATERIALS AND METHODS: Seventeen patients in whom pulmonary consolidation was seen on chest radiography were involved in this study. In all cases malignancy was subsequently proven; the neoplasms involved were bronchioloalveolar carcinoma (n = 9), malignant lymphoma (n = 4), mucoepidermoid tumor (n = 1), metastasis from colon cancer (n = 2), and metastasis from pancreatic mucinous adenocarcinoma (n =1). CT images were retrospectively analyzed in terms of enhancement pattern of the consolidation, morphologic appearance of an air-bronchogram, CT angiogram sign, pseudocavitation, and lymphadenopathy. RESULTS: Visually assessed enhancement pattern of the consolidation showed lower attenuation than adjacent muscles in bronchioloalveolar carcinoma (8/9) and metastasis (1/3); isoattenuation in malignant lymphoma (3/4), mucoepidermoid carcinoma (1/1), and metastasis (1/3); and higher attenuation in bronchioloalveolar carcinoma (1/9), malignant lymphoma (1/4), and metastasis (1/3). Among the 15 of 17 patients for whom an air-bronchogram was available, a stretching and squeezing pattern was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). CT angiogram sign was identified in bronchioloalveolar carcinoma (5/9), malignant lymphoma (2/4), and metastasis (3/3). Pseudocavitation was observed in two patients with bronchioloalveolar carcinoma, while lymphadenopathy was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). Conglomerate and extrathoracic lymphadenopathy are commonly associated with malignant lymphoma. CONCLUSION: Malignant neoplasms which apper as consolidative lung lesions appear not only as bronchioloalveolar carcinoma, which is well known, but also in other forms. Although these lesions cannot be differentiated on the basis of air-bronchography and CT angiography, poor enhancement of consolidative lesion and pseudocavitation are characteristic findings of bronchioloalveolar carcinoma, and conglomerate or extrathoracic lymphadenopathy are also characteristic of malignant lymphoma.
Adenocarcinoma, Bronchiolo-Alveolar ; Adenocarcinoma, Mucinous ; Angiography ; Carcinoma, Mucoepidermoid ; Colonic Neoplasms ; Humans ; Lung ; Lung Neoplasms* ; Lymphatic Diseases ; Lymphoma ; Mucoepidermoid Tumor ; Muscles ; Neoplasm Metastasis ; Radiography ; Retrospective Studies ; Thorax