PURPOSE: The purpose of this study is to describe Magnetic Resonance(MR) findings of two epidural cavernous malformations of the spine. MATERIALS AND METHODS: MR imaging was performed in 2 patients(29-year-old man and 54-year-old woman). Sagittal T1 -, T2-weighted images and Gadolinium (Gd)-enhanced axial and sagittal images were acquired. Two patients had surgery and MR findings were compared with surgical and histopathological findings. RESULTS: MR imaging showed high- and low-signal intensity components of these lesions that were characteristic of an epidural cavernous malformation in one case. The other case showed a high signal intensity on T2- and strong enhancement on Gd-enhanced T1 -weighted images. We think that the former may be due to mixed subacute and chronic hemorrhage and the latter may be due to blood within the endotheliumlined sinusolds without hemorrhage. CONCLUSION: These findings were well correlated with the surgical and histo-pathological findings of cavernous malformation.
Gadolinium ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Spine*

Intraspinal neurenteric cysts are rare congenital lesions that results from abnormal separation of germ layers in the third week of embryonic development, which may cause spinal compression. Although, the diagnosis of neurenteric cyst was very difficult prior to operation, MRI has proven to be a useful imaging modality in detection, localization and characterization of intraspinal neurenteric cysts. We recently experienced intraspinal neurenteric cyst in two patients who presented with progerssive quadriparesis. Myelography, CT myelography and MRI were taken and complete excision was performed. The MRI findings are presented and the literature is reviewed.
Diagnosis ; Embryonic Development ; Female ; Germ Layers ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neural Tube Defects* ; Pregnancy ; Quadriplegia

Surgical results of intermittent exotropia have been reported variabiy according to the criteria of surgical success and the length of follow-up.There have been also controversies about the factors affect the surgical outcoine of intermittent exotropia The surgical outcome and the factors which may affect the surgical results were retrospectively investigated in 165 patients who had undergone surgery for intermittent exotropia with at least 6 months (average 16.6 months, range 6-60 months) of post-operative follow-up.A `satisfactory result` , defined as a final alignment of orthophoria,esotropia less than 5PD or exotropia less than 10PD at far primary position,was achieved in 123 patients (74.5%). The diplopia at. postoperative one day tended to ensure 8 more satisfactory result (P<0.05). The patients with initial postoperative undercorrection of more than 6PD presented 3 significantly negative influence on the surgical result (p=0.05). As the follow-up period increased, the satisfactory results were obtained less frequently due to the progressive exotropic drift (p<0.05). The other factors including age at. onset, age at, operation, types of interinittent exotropia, preoperative deviation angle, presence of vertical deviaiton, dissociated vertical deviation, inferior oblique overaction, and lateral incornitance did not contribute significantly to the surgical results(P>0.05).
Diplopia ; Exotropia* ; Follow-Up Studies ; Humans ; Retrospective Studies

No abstract available.

We evaluated the macular circulatory change with fluores- cein angiography in 41patients (44eyes) who were diagnosed to have branch retinal vein occlusion and followed for 6 months or longer. Final visual acuity improved to 0.5 or better in more than half of cases in their last follow up. The initial corrected visual acuity and size of macular ischemic area were the potent prognostic factors. All cases that showed initial visual acuity of above 0.5 had smaller macular ischemic area and obtained final visual acuity of above 0.5. Visual prognosis of patients with ischemic area less than 1quadrant was much better than those with larger ischemic area. The state of perifoveal capillary network was also potent prognostic factor. Final visual prognosis was slightly better in patients with intact perifoveal capil-lary network than those with broken network. Systemic hypertension and venous occlusive site were not associated with visual prognosis. The relationship between visual improvement and state of perifoveal capillary network was not certain.
Angiography ; Capillaries ; Follow-Up Studies ; Humans ; Hypertension ; Prognosis ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Visual Acuity

Squamous cell carcinoma (SCC) of the lower lip is the most common malignant tumor, comprising 90% of all lip SCC. The typical picture of SCC of the lower lip is an ulcerated lesion with raised margins. Surgery is the treatment of choice for SCC of lower lip. After resection, reconstruction is important both aesthetically and functionally, because the lower lip is a prominent location in the face and it is where essential functions of the sphincter are carried out as in assisting mastication, swallowing, phonation, and expressing emotion. Depending on the location and size of the tumor, different types of flaps are used. We describe here a successful technique to reconstruct a large lower lip defect using a submental island flap and a mucosal flap for patients.
Carcinoma, Squamous Cell ; Deglutition ; Humans ; Lip ; Lip Neoplasms ; Mastication ; Phonation ; Surgical Flaps ; Ulcer

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*

The lips are essential in maintaining oral competence and assist in mastication, deglutition, and articulation. The lips are also important aesthetically, contributing to appearance and facial expression. Defects of up to one third of the lower lip can be closed primarily, but larger defects require more complex techniques. Successful lip reconstruction require careful meticulous planning to achieve the optimum functional and cosmetic result. When planning a reconstruction of a large defect of the lower lip, the following points should be taken into consideration: 1) maintain the sphincter function, 2) retain the sensation, 3) acquire a large enough opening for the mouth, 4) strive for an acceptable cosmetic appearance. It is not possible to satisfy all these criteria in every instance, and careful preoperative evaluation is essential. We describe here a successful technique to reconstruct a large lower lip defect using a depressor anguli oris musculocutaneous flap and a mucosal flap for elderly patients.

Hirayama disease is characterized by focal amyotrophy of the upper limb associated with unilateral or asymmetric bilateral muscle weakness. It occurs in young men in their late teens or early twenties. Repeated or sustained neck flexion is thought to be a cause of the disease. It is important to prevent the progression of the disease through early recognition and management. We reported a patient with Hirayama disease in order to review the typical clinical, electrodiagnostic and radiological findings of Hirayama disease.
Adolescent ; Humans ; Male ; Muscle Weakness ; Neck ; Spinal Muscular Atrophies of Childhood* ; Upper Extremity*