PURPOSE: To describe the MR features of intraspinal cysticercosis. MATERIALS AND METHODS: Medical records and MR images of four cases of intraspinal cysticercosis were retrospectively reviewed. The MR findings were described with regard to the location and signal intensity of the lesions, contrast enhancement, presence or absence of associated intracranial cysticerci, and other findings. RESULTS: There were three cases of subarachnoidal form and one case of intramedullary form. Cysticerci of subarachnoidal form in three cases were located in retromedullary space at C2 level, anterior to cord at C1 -C6 levels, and lumbosacral area, respectively. The signal intensities of the lesions were same as those of CSF. Localized arachnoidal enhancement was found in all three cases. In one case there was a large area of high signal intensity within the spinal cord on T2 weighted image suggesting either ischemia secondary to vascular compromise or inflammatory edema. All of these three cases accompanied intracranial cysticercosis. Intramedullary cysticercosis in one case was shown as a single I cm cystic lesion at C2 level, which showed hypointense signal on T1 weighted image, hyperintense signal on T2-weighted image, and signet-ring-like enhancement. This lesion did not accompany intracranial cysticerci. CONCLUSION: lntraspinal cysticercosis manifested as single or multiple cysts within either spinal cord or subarachnoid space, and were frequently associated with arachnoiditis.
Arachnoid ; Arachnoiditis ; Cysticercosis* ; Edema ; Ischemia ; Magnetic Resonance Imaging* ; Medical Records ; Retrospective Studies ; Spinal Cord ; Subarachnoid Space

No abstract available.
Aortic Coarctation*

PURPOSE: To identify the characteristic quadriphasic (unenhanced, corticomedullary, nephrographic, and excretory phase) helical multidetector computed tomography (MDCT) features of renal masses less than 4 cm to distinguish benign from malignant renal masses. MATERIALS AND METHODS: In total, 84 patients were retrospectively analyzed to determine the characteristic features for the prediction of subtypes of small renal masses. The patients' age, gender, and tumor size and CT features, including the presence of intra-tumor degenerative changes, septation, calcification, and wall irregularity, were evaluated. In addition, the degree and pattern of enhancement obtained during four phases were analyzed. The relationship between the subtype of the small renal masses and the gender, morphological features, and pattern of contrast enhancement on the CT was analyzed by using the chi-square test. Tumor size and degree of contrast enhancement were compared by the Mann-Whitney U test. The predictive value of each of the CT features was determined by multivariate logistic regression analysis. RESULTS: Of the 84 small renal masses, 17 (20%) were benign and 67 (80%) were malignant. Univariate analysis revealed that renal cell carcinoma lesions showed heterogeneous enhancement (p=0.002) and higher mean attenuation value on the corticomedullary and nephrographic phases (135.1+/-53.9, p=0.000, and 132.4+/-43.6, p=0.006). The multivariate analysis with logistic regression model showed that only the mean attenuation value on the corticomedullary phase had a statistically significant correlation (p=0.021). CONCLUSIONS: For the characterization of small renal masses, the degree of enhancement on the corticomedullary phase is a valuable parameter. Furthermore, the heterogeneous enhancement pattern and degree of enhancement on the nephrographic phase can provide information for differentiating small renal masses.
Carcinoma, Renal Cell ; Humans ; Logistic Models ; Multidetector Computed Tomography ; Multivariate Analysis ; Retrospective Studies

Clothing dermatitis frequently goes unrecognized either becaue he clinical picture is mistaken for other disorders, such as seborrheic dermatitis, and prurius, or beacuse it is difficult to trace the causal agent. Contact dermatitis to disperse dyes, especially to azo dyes, has been well known and the most frequent sources of sensitization to dyes are dresses, stockings, and trousers made of synthetic fabrics We described a case of hat band contact dermatitis due to disperse dyes, proven by a patch test. Although chrome was not proven by the diphenylcirbizide method, many dyes known to be contact allergens were proved in different kinds of hat bands.
Allergens ; Clothing* ; Coloring Agents* ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Patch Tests

BACKGROUND: The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis. METHODS: Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed. RESULTS: Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality. CONCLUSIONS: Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.
Comorbidity ; Health Expenditures ; Hospital Mortality ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Insurance* ; Insurance, Health ; Intensive Care Units ; Korea* ; Length of Stay ; Male ; Mortality ; Multivariate Analysis ; Risk Factors ; Sepsis* ; Steroids

No abstract available.
Humans

BACKGROUND: Tourniquet pain is probably mediated by C-fiber. The ability of fentanyl to interrupt this nociceptive conduction was studied by administering either fentanyl or saline intrathecally along with hyperbaric bupivacaine for spinal anesthesia. METHOD: The incidence of tourniquet pain was evaluated in 60 patients having orthopedic surgery of the lower extremities during spinal anesthesia by administering either 30 mcg fentanyl (group 2) or saline (group 1) along with 0.5% hyperbaric bupivacaine 10 mg. We measured the maximal sensory spread of analgesia to pinprick, the incidence of tourniquet pain, and the sensory anesthesia to pinprick at the onset of tourniquet pain. RESULTS: The average maximal sensory spread of analgesia was the same in both groups (T9). The incidence of tourniquet pain was significantly greater in group 1 (33%) than in group 2 (10%). The sensory levels of anesthesia at the onset of tourniquet pain were not different in two groups. CONCLUSIONS: Intrathecal fentanyl was effective against tourniquet pain for 2 hours of the orthopedic surgery of the lower extremities.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Bupivacaine* ; Fentanyl* ; Humans ; Incidence ; Lower Extremity ; Orthopedics ; Tourniquets*

OBJECTIVE: Moyamoya disease (MMD) is an uncommon cerebrovascular disorder, characterized by progressive occlusion at the terminal portion of the internal carotid artery. Incidence of the disease is high in East Asia and familial MMD accounts for about 15% of the disease. Although the pathogenesis is unknown, association of HLA class I or II alleles with MMD has been reported with conflicting results. We investigated whether there is a difference in HLA class II association between familial and non-familial forms of the disease. METHODS: A total of 70 Korean children with MMD, including 16 familial cases (10 probands), and 207 healthy controls were studied. Among familial cases, only 10 probands were used for the HLA frequency analysis. High resolution HLA-DRB1 and DQB1 genotyping was performed using polymerase chain reaction (PCR)-sequence specific oligonucleotide hybridization and PCR-single strand conformation polymorphism methods. RESULTS: The phenotype frequencies of HLA-DRB1*1302 (70.0%) and DQB1*0609 (40.0%) were significantly increased in familial MMD compared to both controls [vs. 15.5%, corrected p (pc) = 0.008, odds ratio (OR) = 12.76; vs. 4.3%, pc = 0.02, OR = 14.67] and non-familial MMD patients (vs. 14.8%, pc = 0.02, OR = 13.42; vs. 1.9%, pc = 0.02, OR = 35.33). The frequencies of DRB1 and DQB1 alleles in non-familial MMD patients were not significantly different from those in controls. CONCLUSION: Our findings suggest that the genetic polymorphism of HLA class II genes or other closely linked disease relevant gene(s) could be a genetic predisposing factor for familial MMD.
Alleles ; Carotid Artery, Internal ; Cerebrovascular Disorders ; Child ; Chimera ; Far East ; Genes, MHC Class II ; HLA-DQ Antigens ; HLA-DR Antigens ; HLA-DRB1 Chains ; Humans ; Incidence ; Moyamoya Disease ; Odds Ratio ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Genetic

No abstract available.
Borrelia burgdorferi* ; Borrelia* ; Humans ; Korea*

No abstract available.