No abstract available.
Brain* ; Child* ; Humans

No abstract available.
Tuberculosis, Miliary*

No abstract available.
Fetal Blood* ; Humans* ; Oxygen* ; Phagocytes*

No abstract available.
Paraganglioma*

No abstract available.
Hernia*

PURPOSE: To evaluate the findings of normal facial nerve, as seen on oblique sagittal MRI using a TMJ (tem-poromandibular joint) surface coil, and then to evaluate abnormal findings of peripheral facial nerve palsy. MATERIALS AND METHODS: We retrospectively reviewed the MR findings of 20 patients with peripheral facial palsy and 50 normal facial nerves of 36 patients without facial palsy. All underwent oblique sagittal MRI using a TMJ surface coil. We analyzed the course, signal intensity, thickness, location, and degree of enhancement of the facial nerve. According to the angle made by the proximal parotid segment on the axis of the mastoid seg-ment, course was classified as anterior angulation (obtuse and acute, or buckling), straight and posterior angu-lation. RESULTS: Among 50 normal facial nerves, 24 (48%) were straight, and 23 (46%) demonstrated anterior angula-tion; 34 (68%) showed iso signal intensity on T1WI. In the group of patients, course on the affected side was either straight (40%) or showed anterior angulation (55%), and signal intensity in 80% of cases was isointense. These findings were similar to those in the normal group, but in patients with post-traumatic or post-operative facial palsy, buckling, of course, appeared. In 12 of 18 facial palsy cases (66.6%) in which contrast materials were administered, a normal facial nerve of the opposite facial canal showed mild enhancement on more than one segment, but on the affected side the facial nerve showed diffuse enhancement in all 14 patients with acute facial palsy. Eleven of these (79%) showed fair or marked enhancement on more than one segment, and in 12 (86%), mild enhancement of the proximal parotid segment was noted. Four of six chronic facial palsy cases (66.6%) showed atrophy of the facial nerve. CONCLUSION: When oblique sagittal MR images are obtained using a TMJ surface coil, enhancement of the proximal parotid segment of the facial nerve and fair or marked enhancement of at least one segment within the facial canal always suggests pathology of the facial nerve. The use of this modality, together with the coil, is, therefore, an effective complementary technique for the evaluation of a facial nerve.
Atrophy ; Axis, Cervical Vertebra ; Contrast Media ; Facial Nerve* ; Facial Paralysis ; Humans ; Magnetic Resonance Imaging* ; Mastoid ; Paralysis* ; Pathology ; Retrospective Studies ; Temporomandibular Joint*

Background: Onychomycosis, a common fungal nail infection, particularly affects the elderly. The diagnostic accuracy of a potassium hydroxide (KOH) smear, a primary diagnostic method, can vary based on the examiner’s proficiency. Objective: To evaluate the diagnostic utility of KOH smears in a real-world setting and the influence of clinical and practical factors on onychomycosis. Methods: This study included 381 patients who underwent KOH smear and histopathological staining for nail diseases at Seoul National University Hospital between March 2020 and February 2023. The study evaluated the diagnostic utility of the KOH smear, including its sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic odds ratio. We investigated the influence of factors such as training duration of examiners, prior history of antifungal treatment, and lesion location on diagnostic utility. Results: Of the 381 patients, 139 were male (36.5%) and 242 were female (63.5%). Onychomycosis was the most common diagnosis (59.3%), with 34.1% of patients reporting prior antifungal therapy within the past 6 months. The sensitivity of the monthly KOH smear varied from 16.7% to 70.0% with an annual sensitivity of 48.1%. The specificity ranged from 83.3% to 100.0%, with an annual specificity of 90.3%. While prior antifungal therapy decreased the sensitivity and specificity, no statistical significance was observed. Examiner's experience, measured by training duration, was not associated with sensitivity or specificity. Among patients with a history of antifungal treatment, an increasing number of KOH smear tests showed reduced sensitivity. Conclusion Variations in the diagnostic utility of the KOH smear test, influenced by various factors, highlight the necessity for cautious interpretation in clinical settings.

Mechanical obstruction of the common hepatic duct includes the following causes; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the “syndrome del conducto hepatico” in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mrizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a variant of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of 38℃, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/cm3; albumin 2.6 g/dl (normal 0-1) with the direct bilirubin, 4.4 mg/dl (normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction (Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.
Abdominal Pain ; Aged ; Biliary Tract ; Bilirubin ; Calculi ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Choledocholithiasis ; Common Bile Duct ; Constriction, Pathologic ; Cystic Duct ; Cytochrome P-450 CYP1A1 ; Gallbladder ; Gallstones ; Hepatic Duct, Common ; Humans ; Inflammation ; Jaundice, Obstructive ; Lymph Nodes ; Mirizzi Syndrome* ; Neck ; Physical Examination ; Sclera ; Sclerosis ; Ultrasonography

No abstract available.
Carcinoma, Hepatocellular* ; Catheter Ablation* ; Neoplasm Metastasis*

No abstract available.
Diagnosis* ; Female ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography*