Clear cell sarcoma is rare and difficult to diagnose. Herein, we present a case of clear cell sarcoma in the dorsum of the wrist with MRI findings, including diffusion-weighted imaging, and histopathologic correlation, which was initially diagnosed as giant cell tumor of tendon sheath.
Diffusion Magnetic Resonance Imaging ; Giant Cell Tumors ; Magnetic Resonance Imaging* ; Sarcoma, Clear Cell* ; Tendons ; Wrist*

PURPOSE: To evaluate Metal Artifact Reduction for Orthopedic Implants (O-MAR, Philips Healthcare) technique compared with standard filtered back projection (SFBP) technique on post-operative hip CT regarding image noise reduction and detection of post-operative complications. MATERIALS AND METHODS: Fifty-six hip CT scans after hip replacement with SFBP technique and O-MAR application were retrospectively reviewed. Region of interests (ROIs) were drawn at levels wherein acetabular cup and femoral head were largest at anterior and posterior acetabula, gluteus maximus muscle, subcutaneous fat adjacent to gluteus maximus muscle, and in area adjacent to prosthesis stem wherein lesser trochanter is largest. Hounsfield units (HU) were measured to evaluate artifact quantitatively; mean and standard deviations (SDs) calculated and compared. Periprosthetic complications were evaluated, and visibility rated between two reconstruction techniques; 1-SFBP better, 2–SFBP same as O-MAR, 3–O-MAR better. RESULTS: Average HU was significantly lower in O-MAR at posterior acetabulum, gluteus maximus muscle, and subcutaneous fat (p < 0.05). SD for HU was significantly lower in O-MAR at all ROIs (p < 0.05). Mean visibility of periprosthetic complications was 2.0, so equivalent. CONCLUSION Reconstruction with O-MAR technique in post-operative hip CT scans after hip replacement yielded statistically significant decrease in image noise. However, visibility of periprosthetic complications was not impacted by reconstruction technique.

Metronidazole is an antimicrobial agent widely used for the treatment of anaerobic infection or antibiotics-associated diarrhea. It is generally thought to be safe, but can induce reversible toxic encephalopathy in the case of excessive or cumulative over-dose. Metronidazole-induced encephalopathy generally demonstrates the characteristic features of typical lesion location and bilaterality on magnetic resonance imaging (MRI). We report a case of metronidazole-induced encephalopathy with the involvement of asymmetric white matter. To our knowledge, only a few cases have been reported with respect to white matter lesion characteristics on MRI with diffusion-weighted images.
Brain Diseases ; Brain ; Diarrhea ; Magnetic Resonance Imaging ; Metronidazole ; Neurotoxicity Syndromes ; White Matter

BACKGROUND: Overactive bladder syndrome (OAB) is a common disorder in primary care that affects negatively on the quality of life of outpatients. However, little information is available on related factors and the quality of life in adults with overactive bladder. The purpose of this study was to find related factors of overactive bladder and to measure the quality of life in adults with overactive bladder. METHODS: Among the people who visited a hospital in Seoul and Chung-ju for a health examination or primary care between October 1 and December 31, 2008, we selected 327 participants over 20 years old. We measured their Overactive Bladder Questionnaire (OAB-q), took medical history and reviewed their demographic data. The relationship between OAB, other independent variables and health related quality of life (HRQL) were analyzed. RESULTS: Of 327 respondents, the prevalence of OAB in adults was 38 (11.6%). The factors related to OAB were age (P = 0.007), history of prescription for congestive heart failure (P = 0.023), benign prostatic hyperplasia (BPH) (P = 0.002), and depression (P = 0.008). OAB was significantly associated with BPH medication (P = 0.042; OR = 8.757) and depression medication (P = 0.005; OR = 9.977) in multivariable logistic regression analysis. In each T-test analysis, OAB decreased in HRQL. CONCLUSION: OAB is a common disorder in adults, history of BPH medication and depression medication is more common in OAB. The symptoms that were suggestive of OAB were affected negatively on the quality of life in adults. Effective health care polices and prompt management of OAB should be implemented.
Adult ; Surveys and Questionnaires ; Delivery of Health Care ; Depression ; Heart Failure ; Humans ; Logistic Models ; Outpatients ; Prescriptions ; Prevalence ; Primary Health Care ; Prostatic Hyperplasia ; Quality of Life ; Urinary Bladder, Overactive

Cowden's disease, also known as various hamartomatous malformations of multiple organs, is a rare autosomal dominant disorder. The most important feature of Cowden's disease is its frequent association with malignant neoplasm, particularly in the breast and thyroid gland. Cowden's disease with malignant neoplasms, is quite rare in Korea so far. We report a case of Cowden's disease associated with breast cancer in a 41-year-old female who underwent routine health cheek-up.
Adult ; Breast Neoplasms/*complications/pathology ; Colonoscopy ; Female ; Gastrointestinal Tract/pathology ; Gastroscopy ; Hamartoma Syndrome, Multiple/complications/*diagnosis ; Humans ; Polyps/diagnosis

The extra-pulmonary sites of a small cell carcinoma are the salivary glands, pharynx and larynx, esophagus, stomach, pancreas, colon, rectum, skin and cervix. Primary small cell carcinoma of the esophagus is extremely rare with an incidence ranging from 0.8~2.4% of all esophageal malignancies. There have been approximately 20 cases reported in the Korean literature thus far. However, there has not been a reported case of multiple small cell carcinoma of the esophagus. We report a case of multiple small cell carcinoma of the esophagus in a 61-year-old man who presented with a 2 month-history of progressive dysphagia with a review of the relevant literature.
Carcinoma, Small Cell* ; Cervix Uteri ; Colon ; Deglutition Disorders ; Esophagus* ; Female ; Humans ; Incidence ; Larynx ; Middle Aged ; Pancreas ; Pharynx ; Rectum ; Salivary Glands ; Skin ; Stomach

The recent development of advanced high-resolution transducers has enabled the fast, easy, and dynamic ultrasonographic evaluation of small, superficial structures such as the finger. In order to best exploit these advances, it is important to understand the normal anatomy and the basic pathologies of the finger, as exemplified by the following conditions involving the dorsal, volar, and lateral sections of the finger: sagittal band injuries, mallet finger, and Boutonnière deformity (dorsal aspect); flexor tendon tears, trigger finger, and volar plate injuries (volar aspect); gamekeeper's thumb (Stener lesions) and other collateral ligament tears (lateral aspect); and other lesions. This review provides a basis for understanding the ultrasonography of the finger and will therefore be useful for radiologists.
Collateral Ligaments ; Congenital Abnormalities ; Fingers* ; Pathology ; Tears ; Tendons ; Thumb ; Transducers ; Ultrasonography* ; Upper Extremity ; Palmar Plate

Objective: To investigate the agreement and reliability of estimating the volumes and normative percentiles (N%) of segmented brain regions among NeuroQuant (NQ), DeepBrain (DB), and FreeSurfer (FS) software programs, focusing on the comparison between NQ and DB. Materials and Methods: Three-dimensional T1-weighted images of 145 participants (48 healthy participants, 50 patients with mild cognitive impairment, and 47 patients with Alzheimer’s disease) from a single medical center (SMC) dataset and 130 participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset were included in this retrospective study. All images were analyzed with DB, NQ, and FS software to obtain volume estimates and N% of various segmented brain regions. We used Bland–Altman analysis, repeated measures ANOVA, reproducibility coefficient, effect size, and intraclass correlation coefficient (ICC) to evaluate inter-method agreement and reliability. Results: Among the three software programs, the Bland–Altman plot showed a substantial bias, the ICC showed a broad range of reliability (0.004–0.97), and repeated-measures ANOVA revealed significant mean volume differences in all brain regions.Similarly, the volume differences of the three software programs had large effect sizes in most regions (0.73–5.51). The effect size was largest in the pallidum in both datasets and smallest in the thalamus and cerebral white matter in the SMC and ADNI datasets, respectively. N% of NQ and DB showed an unacceptably broad Bland–Altman limit of agreement in all brain regions and a very wide range of ICC values (-0.142–0.844) in most brain regions. Conclusion NQ and DB showed significant differences in the measured volume and N%, with limited agreement and reliability for most brain regions. Therefore, users should be aware of the lack of interchangeability between these software programs when they are applied in clinical practice.

OBJECTIVE: Henoch-Schonlein purpura (HSP) is a systemic vasculitis, characterized by small-vessel leukocytoclastic vasculitis with the deposition of immune complexes containing IgA. It is the most common acute vasculitic disorder affecting children but is relatively uncommon in adults. We investigated the clinical features and factors affecting the prognosis of adult HSP in Korea. METHODS: From 1996 to 2011 seventy patients over 15 years of age with HSP were retrospectively analyzed. RESULTS: Thirty eight patients (54.3%) were female and the age at disease onset ranged from 15 to 75 years (35.0+/-15.8 years). Purpuric skin rash was observed in all patients and arthralgia was present in 34 patients (48.6%). GI symptoms and kidney involvements were observed in 28 patients (40.0%) and 34 patients (48.6%), respectively. Complete remission was achieved in 46 patients (65.7%). The remission group showed a lower incidence of hematochezia (p=0.044), hematuria (p=0.008), and proteinuria (p=0.011) at diagnosis than the no remission group. About 10% of adult HSP patient progressed to chronic kidney disease (CKD), which showed higher a incidence of nephrotic range proteinuria. Only nephrotic range proteinuria at diagnosis was a significant risk factor for CKD (OR=16.7, p=0.008, 95% CI=2.1~133.1). CONCLUSION: Hematochezia, hematuria and proteinuria at the diagnosis of HSP are important prognostic factors in predicting remission. In addition, HSP patients with nephrotic range proteinuria at diagnosis have an increased risk of renal failure.
Adult ; Antigen-Antibody Complex ; Arthralgia ; Child ; Exanthema ; Female ; Gastrointestinal Hemorrhage ; Hematuria ; Humans ; Immunoglobulin A ; Incidence ; Kidney ; Korea ; Prognosis ; Proteinuria ; Purpura, Schoenlein-Henoch ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Retrospective Studies ; Risk Factors ; Systemic Vasculitis ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous