PURPOSE: To correlate histologic subtypes with MR signal intensity in meniagioma and to find etiologic factors responsible for the signal characteristics of T2WI. MATERIALS AND METHODS: We. reviewed MRIs and histopathologic studies in 35 cases of meningioma. MR signal intenisty was measured with respect to cerebral cortex(gray matter) as hypointense, isointense, or hyperintense. Pathologically, meningioma was classified into subtypes, acording to the new WHO classification of brain tumors. The degree of cellularity, collagen, and vascularity was graded from 1 to 3, and presence or absence of psammoma bodies, microcysts, micronecrosis and microhemorrhage was obeserved. Multiple linear regression analysis was done to find relationship between the pathologic findings and MR signal intensity of T2WI. RESULTS: Even in the same subtype, cellularity, collagen and vascularty of the tumor were different. T1WI was not useful in discriminating pathologic subtype because most tumors were isointense or hypointense to the cortex regardless of histologic type. Most tumors showed various signal intensity on T2WI, but T2WI were not useful, either. Exceptionally, all five cases of microcystic meningiomas were hyperintense on T2W1. In analysing the relationship between MR signal intensity and pathologic factor, increased collagen content produced decreased signal intensity(P<0.01) and the existence of microcyst resulted in high signal intensity(P<0.01). Cellularity, vascularity, microcalcification, micronecrosis and microhemorrhage had no relationship with signal intensity on T2WI. CONCLUSION: Except for the five microcystic meningiomas with hyperintenty on T2WI there was no relationship between MR signal intensity and subtype of meningiomas. Pathologic factors influencing T2 signal intensity were microcyst and collagen. Even in the same subtypes of meningiomas, the T2 signal intensity was different. This may be due to different ratio of microcyst and collagen.
Brain Neoplasms ; Classification ; Collagen ; Linear Models ; Magnetic Resonance Imaging* ; Meningioma*

Humans ; Mandible ; Mandibular Condyle ; Mouth ; Prognosis ; Temporomandibular Joint

No abstract available.
Dilatation* ; Esophageal Perforation*

Unilateral absence of a pulmonary artery is an uncommon anomaly, which presents as an isolated lesion or in combination with other congenital heart disease such as TOF or PD^. We encountered three cases of isolated unilateral absence of a pulmonary artery;one was left pulmonary artery agenesis with right sided aortic arch and the others were right pulmonary artery agenesis with left sided aortic arch. Plain chest radiograph showed considerable loss of unilateal lung volume and lack of ipsilateral hilar shadow. Pulmonary angiogram which was done in two cases, revealed proximal interruption of a pulmonary artery. Chest CT was done in only one case, on which right pulmonary artery was absent and was replaced by adipose tissue. CT with its clean demonstration pulmonary artery without any evidence of aquired obstruction of a pulmonary artery by pulmonary embolism or tumor invasion, maybe a valuable method for evaluaton of the unilateral absence of a pulmonary artery.
Adipose Tissue ; Aorta, Thoracic ; Heart Defects, Congenital ; Lung ; Pulmonary Artery* ; Pulmonary Embolism ; Radiography, Thoracic ; Tomography, X-Ray Computed

Female ; Fractures, Bone ; Head ; Humans ; Male ; Mandible ; Orthopedics ; Retrospective Studies ; Zygomatic Fractures

Follow-Up Studies ; Fracture Fixation ; Humans ; Malocclusion ; Mandible ; Recurrence

Although various procedures for reconstructing the lower eyelid have been reported, their basic principle is always to build a new eyelid that is composed of three elements: an outer cutaneous layer, an inner mucosal layer, and a semirigid supporting tissue between the two layers. Mustarde cheek rotation flap over a chondromucosal graft has been used often to reconstruct the full thickness defect of the lower eyelid. However, Mustarde cheek flap leaves a large unacceptable scar on the face. Therefore we have repaired three cases of lower eyelid defect after resection of the basal cell carcinoma using monopedicled or bipedicled upper eyelid musculocutaneous flap over a septal chondromucosal composite graft. In addition, in case of wide defect including overall tarsal plate, the authors increased indication of mucochondral composite graft by halving method of mucochondral composite tissue. As a result, we made a minimal donor site scar and get the effect of upper blepharoplasty as well by using upper eyelid musculocutaneous flap. Based on follow-ups of 10 to 19 months, the functional and aesthetic results were found to be good in all cases. This procedure may be applicable for total or subtotal reconstruction of the lower eyelid.
Blepharoplasty ; Carcinoma, Basal Cell ; Cheek ; Cicatrix ; Eyelids* ; Follow-Up Studies ; Humans ; Mustard Plant ; Myocutaneous Flap* ; Tissue Donors ; Transplants*

PURPOSE: Transthoracic fine needle aspiration biopsy is a widely practiced technique in the investigation of the lung and mediastinal masses because of its safety, reliability and accuracy. We report the diagnostic accuracy of the transthoracic fine needle aspiration biopsy and the frequency of its complications which required treatment. MATERIALS AND METHODS: We analyzed 1000 transthoracic needle aspiration biopsies whcih were performed in 986 patients with 993 chest lesions. Aspiration biopsies were obtained with Westcott needles (20G or 22G) under the fluoroscopic guidance. Final diagnosis was made with operation, bronchoscopy, sputum study, biopsy of other sites and the clinical course of the patient. We analyzed diagnostic yields of aspiration biopsy and the frequency of the complication requiring treatment. RESULTS: The sensitivity was 87.6% in benign diseases and 95.8% in malignant diseases. Pneumothorax was the most frequent complication, which required pig-tail catheter insertion in 36 cases or thoracostomy in six cases. In 36 cases, minimal hemoptysis developed which did not require treatments. CONCLUSION: We obtained relatively high sensitivities of malignant and benign lesions using transthoracic fine needle aspiration biopsy and the frequency of the complications requiring treatment was very low. Transthoracic fine needle aspiration biopsy is a valuable diagnostic method in the thoracic lesions.
Biopsy* ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Bronchoscopy ; Catheters ; Diagnosis ; Hemoptysis ; Humans ; Lung ; Needles ; Pneumothorax ; Sputum ; Thoracostomy ; Thorax

Dermatofibrosarcoma protuberans(DFSP) is an uncommon soft-tissue neoplasm that usually presents as a painless, often long-standing mass arising in the dermis of skin. It has a frequent tendency to recur after standard surgical excision. Clinically, the initial appearance of the tumor is similar to that of benign tumor such as keloid and dermatofibroma. Therefore making an accurate clinical diagnosis and ensuring adequate surgical excision of this uncommon skin tumor are important. The authors experienced 5 patients of dermatofibrosarcoma protuberans during the recent 2 years, 3 male and 2 female patients. The age of the patients ranged from 21 to 43. Lesions were various in size and shape, and location varies: lower abdomen, right suprabrow region, right anterior superior iliec spine region, right clavicular region, and upper back. Wide excision of tumor with frozen section biopsy or Mohs' microscopic surgery was performed and reconstruction of surgical defect was made according to the size, shape and location. As reconstructive methods, the authors used median forehead flap, split thickness skin graft, or direct closure. The patients were followed up after operation from 4 to 14 months and all remained free of disease. The authors present the experience of 5 cases of dermatofibrosarcoma protuberans occurred in various sites during the short period of time . They obtained satisfactory results with appropriate diagnosis and treatment, which emphasize the importance of accurate diagnosis in early stage. They also present an operative plan of this locally aggressive and highly recurrent tumor.
Abdomen ; Biopsy ; Dermatofibrosarcoma* ; Dermis ; Diagnosis ; Female ; Forehead ; Frozen Sections ; Histiocytoma, Benign Fibrous ; Humans ; Keloid ; Male ; Skin ; Spine ; Transplants

BACKGROUND: Folic acid has been frequently used for hyperhomocyesteinemia in various diseases and decreases the level of homocysteine. OBJECTIVES: To assess the effect of folic acid in the level of homocysteine in epilepsy patients, and to analyze factors affecting its responsiveness and the difference of its efficacy according to methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism. METHODS: Total 75 epilepsy patients with antiepileptic drugs (AEDs) therapy were included. 41 patients had normal level of homocysteine and 34 patients with hyperhomocysteinemia (> or =12 micro mol/ ) were supplemented with folic acid for 1 year. Thirty-four patients with hyperhomocyteinemia were divided into two groups according to the responsiveness of homocysteine to folic acid; decrease group (DG) and non-decrease group (NDG). RESULTS: The level of homocysteine in patients with hyperhomocysteinemia was significantly decreased after administration of folic acid, comparing with patients with normal level. DG was younger and had more male gender, shorter duration of seizure, and initial higher homocysteine level, compared to NDG (p<0.05). Patients with mutant type of MTHFR (CT+TT) had more decreased homocysteine level after supplement of folic acid, but had more increased homocysteine level without supplement of folic acid. Comparing between MTHFR genotypes, TT type had the most decreased homocysteine level than others, but there was no significance. CONCLUSION: Folic acid is useful treatment of hyperhomocysteinemia in epilepsy patients and the supplement of folic acid might be considered in patients with mutant type of MTHFR regardless of homocysteine level. The effect of folic acid supplement is greater in younger age, male sex, shorter duration of seizure, and initial higher homocysteine level.
Anticonvulsants ; Epilepsy* ; Folic Acid* ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; Seizures