PURPOSE: To evaluate the usefulness, patterns and appearances of false positive lesions, and technical problems of CTAP(CT Arterioportography). MATERIALS AND METHODS: CTAP was done in 45 patients in whom hepatic lesions were suggested on other radiologic studies. CTAP findings were compared with the informations obtained by operations, biopsies, and follow-up imagings. Additional findings, which were not detected in other radiologic studies, false positive manifestations, and technical errors were analyzed. RESULTS: CTAP detected 51 additional hepatic lesions which are not detected in other imaging studies. Of the 51 lesions, ten were true positive hepatic tumors, 2 were inflammatory lesions and 39 were false positive .lesions. False positive lesions included perfusion defects of periportal and perifissural areas, subcapsular perfusion defects and nonlobar, nonsegmental geographic perfusion defects. In 2 cases, CTAP aided in deciding the surgical strategy. On the other hand, there were 4 cases causing interpretational confusion and 6 cases of improper imaging due to technical errors. CONCLUSION: CTAP was valuable in detection of additional hepatic cancer lesion as well as in making the treatment plan. However, since many false positive lesions and improper imaging due to technical error occur during the examination, the understanding of such problems is essential for correct interpretation of CTAP.
Biopsy ; Follow-Up Studies ; Hand ; Humans ; Liver Neoplasms ; Perfusion

This study was conducted to investigate whether memory accuracy can be assessed by analyzing electrophysiological responses (i.e., electroencephalography [EEG]) for retrieval cues related to the witnessed scene. Specifically, we examined the different patterns of EEG signals recorded during witnessed (target) and unwitnessed (lure) stimuli using event-related potential (ERP) analysis. Moreover, using multivariate pattern analysis, we also assessed how accurately single-trial EEG signals can classify target and lure stimuli. Participants watched a staged-crime video (theft crime), and the EEG signals evoked by the objects shown in the video were analyzed (n=56). Compared to the target stimulus, the lure stimulus elicited larger negative ERPs in frontal brain regions 300 to 500 milliseconds after the retrieval cue was presented. Furthermore, the EEG signals observed 450 to 500 milliseconds after the retrieval cue was presented showed the best classification performance related to eyewitness memory, with the mean classification accuracy being 56%. These results suggest that the knowledge and techniques of cognitive neuroscience can be used to estimate eyewitness memory accuracy.

This study was conducted to investigate whether memory accuracy can be assessed by analyzing electrophysiological responses (i.e., electroencephalography [EEG]) for retrieval cues related to the witnessed scene. Specifically, we examined the different patterns of EEG signals recorded during witnessed (target) and unwitnessed (lure) stimuli using event-related potential (ERP) analysis. Moreover, using multivariate pattern analysis, we also assessed how accurately single-trial EEG signals can classify target and lure stimuli. Participants watched a staged-crime video (theft crime), and the EEG signals evoked by the objects shown in the video were analyzed (n=56). Compared to the target stimulus, the lure stimulus elicited larger negative ERPs in frontal brain regions 300 to 500 milliseconds after the retrieval cue was presented. Furthermore, the EEG signals observed 450 to 500 milliseconds after the retrieval cue was presented showed the best classification performance related to eyewitness memory, with the mean classification accuracy being 56%. These results suggest that the knowledge and techniques of cognitive neuroscience can be used to estimate eyewitness memory accuracy.
Brain ; Classification ; Cognitive Neuroscience ; Cues ; Electroencephalography ; Evoked Potentials ; Machine Learning ; Memory

BACKGROUND AND OBJECTIVES: It has been suggested that the combination of a leukotriene receptor antagonist with an antihistamine may have beneficial effects in the treatment of allergic rhinitis. The aim of this study were to evaluate the effects of combining a leukotriene receptor antagonist, pranlukast, and an antihistamine, cetirizine, to treat nasal symptoms of allergic rhinitis and the quality of life of the patients. SUBJECTS AND METHOD: Thirty-three patients with allergic rhinitis were enrolled in this study. The control group (n=12) received 5 mg cetirizine plus 120 mg pseudoephedrine twice a day while the study group (n=21) received 5 mg cetirizine plus 225 mg pranlukast twice a day. Patients completed a daily symptom-score list for nasal obstruction, rhinorrhea, sneezing, nasal itching during the 7-day treatment period. They also answered the quality of life questionnaire before and after the completion of 7-day treatment. RESULTS: There were significant improvements in the nasal symptoms after the treatment in the control and the study group. However, there was no significant difference between the control and the study group on the improvement of nasal symptom-scores except for the rhinorrhea symptom-score. There were significant improvements in the quality of life domain after the treatment in the control group and the study group. However, there was no significant difference between the control and the study group on the improvement in quality of life domain except for activity limitations. CONCLUSION: A combination of pranlukast and cetirizine is as effective as a combination of pseudoephedrine and cetirizine in treating allergic rhinitis. Therefore, a combination of pranlukast and cetirizine may be another therapeutic alternative for allergic rhinitis patients who are not tolerable of pseudoephedrine.
Cetirizine* ; Histamine Antagonists ; Humans ; Hypersensitivity ; Leukotrienes ; Nasal Obstruction ; Pruritus ; Pseudoephedrine ; Quality of Life ; Surveys and Questionnaires ; Receptors, Leukotriene ; Rhinitis* ; Sneezing

BACKGROUND AND OBJECTIVES: Orbital complications of sinusitis are uncommon but can result in significant morbidity if not appropriately managed. We have experienced 8 cases of orbital subperiosteal absces- ses (SPA) as a complication of acute sinusitis. The purposes of our study are to assess the clinical features, diagnosis, isolated bacteria, and therapeutic results. MATERIALS AND METHOD: Eight patients with acute rhinosinusitis and orbital SPA who had been treated between April 1989 and September 2002 were retrospectively studied with medical records and CT. RESULTS: The most common symptoms and signs were proptosis and opthalmoplegia, and five patients (62%) complained of ocular pain or periorbital erythema. Seven patients (87%) complained of diplopia. We carried out medical treatment in 4 cases and surgical intervention in 4 cases. All patients were cured without complications. Streptococcus intermedius was isolated from 1 case and peptostreptococcus species from another but there was no growth of bacteria in 2 cases. CONCLUSION: Conservative treatment with intravenous antibiotics, topical nasal decongestants are the appropriate initial management in orbital SPA. In cases of medially located SPA of orbit, we recommend endoscopic surgical drainage because it does not require an external incision and has less postoperative edema.
Abscess* ; Anti-Bacterial Agents ; Bacteria ; Diagnosis ; Diplopia ; Drainage ; Edema ; Erythema ; Exophthalmos ; Humans ; Medical Records ; Nasal Decongestants ; Orbit* ; Peptostreptococcus ; Retrospective Studies ; Sinusitis* ; Streptococcus intermedius

We performed indocyanine green angiography(ICGA) in 21 eyes of 21 patients with acute central serous chorioretinopathy(CSC) to investigate choroidal cirulatory changes in this disease. Heidelberg retina angiograph (HRA) that using confocal scanning laser ophthalmoscope was used for ICGA. In the very early phase of HRA, 19 eyes(90%) demonstrated focal areas of delayed filling usually followed by distinctively fluorescent, dilated choroidal vessels running through or around these areas. After mid-phase, diffuse intrachoroidal hyperfluorescence surrounding these dilated vessels and suggesting increased leakage from them was seen in 19 eyes(90%). The focal delays of choroidal filling seemed to reveal choroidal ischemia involved in this disease process rather than physiological delays as they were topographically associated with choroidal hyperfluorescence in the later phase of HRA and leaking points on fluoresecein angiogram. Based on these findings, we suggest the choroid as the primary pathologic focus of acute CSC. Also we propose a scenario of pathogenesis, beginning with choroidal ischemia that leads to increased leakage from choroidal vessels, secondary changes of retinal pigment epithelium and passage of fluid in the subretinal space.
Choroid* ; Humans ; Indocyanine Green* ; Ischemia ; Ophthalmoscopes ; Retina ; Retinal Pigment Epithelium ; Running

Retinal arterial macroaneurysm may be presented with diverse clinical manifestations, such as various types of hemorrhage, exudate, edema or serous detachment especially in the elderly patients. Correct diagnosis can sometimes be difficult. A high index of suspicion is always required, and the characteristic findings of fluorescein angiography are useful for the correct diagnosis. Especially it is inevitably revealed as extrafoveal round hyperfluorescence on indocyanine green angiography(ICGA) which has recently become a useful tool in hemorrhagic and exudative disease, and can be misinterpreted as hot spot in choroidal neovascularization(CNV). So it may be misdiagnosed and treated as CNV associated with age-related macular degeneration(AMD), and the risk of branch retinal artery occlusion will be increased. We experienced four cases of retinal arterial macroaneurysms that showed various types of hemorrhagic and exudative change, and one case with serous retinal detachment. Two of these cases were misdiagnosed and treated as CNV associated with AMD, and branch retinal artery occlusion was developed in one of them. In the case presented with serous retinal detachment, it revealed as mass like lesion adjacent to the optic disc, and differential diagnosis with vascualr tumors was necessary. Our purpose is calling attention to the possibility of retinal arterial macroaneurysm in the diagnosis of various hemorrhagic and exudative lesions, especially in the elderly patients with hypertension.
Aged ; Choroid ; Diagnosis ; Diagnosis, Differential ; Edema ; Exudates and Transudates ; Fluorescein Angiography ; Hemorrhage ; Humans ; Hypertension ; Indocyanine Green ; Retinal Artery Occlusion ; Retinal Detachment ; Retinaldehyde*

OBJECTIVE: Elevated cellular retinoic acid binding protein-I (CRABP-I) is thought to be related to the abnormal proliferation and migration of smooth muscle cells (SMCs). Accordingly, a higher CRABP-I level could cause disorganized vessel walls by causing immature SMC phenotypes and altering extracellular matrix proteins which could result in vulnerable arterial walls with inadequate responses to hemodynamic stress. We hypothesized that elevated CRABP-I level in the cerebrospinal fluid (CSF) could be related to subarachnoid hemorrhage (SAH). Moreover, we also extended this hypothesis in patients with vascular malformation according to the presence of hemorrhage. METHODS: We investigated the CSF of 26 patients : SAH, n=7; unruptured intracranial aneurysm (UIA), n=7; arteriovenous malformation (AVM), n=4; cavernous malformation (CM), n=3; control group, n=5. The optical density of CRABP-I was confirmed by Western blotting and presented as mean+/-standard error of the measurement. RESULTS: CRABP-I in SAH (0.33+/-0.09) was significantly higher than that in the UIA (0.12+/-0.01, p=0.033) or control group (0.10+/-0.01, p=0.012). Hemorrhage presenting AVM (mean 0.45, ranged 0.30-0.59) had a higher CRABP-I level than that in AVM without hemorrhage presentation (mean 0.16, ranged 0.14-0.17). The CRABP-I intensity in CM with hemorrhage was 0.21 and 0.31, and for CM without hemorrhage 0.14. Overall, the hemorrhage presenting group (n=11, 0.34+/-0.06) showed a significantly higher CRABP-I intensity than that of the non-hemorrhage presenting group (n=10, 0.13+/-0.01, p=0.001). CONCLUSION: The results suggest that elevated CRABP-I in the CSF could be related with aneurysm rupture. Additionally, a higher CRABP-I level seems to be associated with hemorrhage development in vascular malformation.
Aneurysm ; Arteriovenous Malformations ; Blotting, Western ; Cerebrospinal Fluid* ; Extracellular Matrix Proteins ; Hemodynamics ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Myocytes, Smooth Muscle ; Phenotype ; Rupture ; Subarachnoid Hemorrhage ; Tretinoin* ; Vascular Malformations

Solitary Fibrous tumor is usually arising in the pleura of the thoracic cavity and it has been described in a variety of extrapleural sites including the abdominal cavity, soft tissue, upper respiratory tract and rarely in head and neck region. We experienced a rare case of solitary fibrous tumor in the parotid gland. A 49-year-old woman presented with a painless mass in the left parotid. The mass was well-demarcated and easily dissected, and it showed a patternless arrangement of potential malignant spindle cells in a fibrotic background and prominent vascular structures. In immunochemistry, the mass cells were positive for CD34, vimentin, and negative for actin, S-100 protein, and cytokeratins. Therefore, the parotid mass diagnosed as SFT. During the 24 months of follow-up, there was no recurrence of tumor growth.
Abdominal Cavity ; Actins ; Female ; Follow-Up Studies ; Head ; Humans ; Immunochemistry ; Keratins ; Middle Aged ; Neck ; Parotid Gland* ; Pleura ; Recurrence ; Respiratory System ; S100 Proteins ; Salivary Glands ; Solitary Fibrous Tumors* ; Thoracic Cavity ; Vimentin

Penetrating injuries of the neck are diagnostic and therapeutic challenges to emergency physicians or surgeons. The neck is unique in that it contains a dense concentration of vital structures in a small anatomic space. Two treatment strategies have emerged over time. First, exploration of all penetrating neck injuries, and second, selective approach based in clinical and diagnostic work-up. We present a previously unreported case in the Korean literature, a zone III neck injury caused by a metal stick penetrating through the neck.
Emergencies ; Neck Injuries* ; Neck*