No abstract available.
Angelica*

PURPOSE: We evaluated the MR and CT findings of the masticator space lesions in order to identify the differences among the malignant and benign tumors and infectious conditions. MATERIALS AND METHODS: MR and CT findings in 46 cases with proven masticator space lesions were reviewed retrospectively. We analysed the involvement of masticator muscles, adjacent spaces, orbit and intracrahium, homogeneity, necrosis, cystic changes, growth patterns, calcifications, enhancement patterns, MR signal intensity, and CT attenuation. RESULTS: Among the 29 cases of malignant tumors, seven cases were mandibular tumors including four chondrosarcomas, and 22 cases were extramandibular tumors. Malignant tumors of mandibular origin showed large masses with severe bone destruction and epicenter of mandible. Extramandiblular malignant tumors showed the epicenter out of the mandible and less severe bone destruction than mandibular tumors: Among the nine benign tumors, four cases were ameloblastomas which showed the well-defined masses and the expansion of the mandible, and four cases were extramandibular tumors which showed well-marginated extramandibular masses with no bone destruction. Among the eight infectious conditions, five cases were mandibular osteomyelitis with or without abscess formations, and the other three cases were infections from adjacent soft tissue or limited to the soft tissue. CONCLUSION: By careful observations of growth patterns, involvement of the masticator and adjacent spaces, bone changes, and epicenter of the lesions, one can discriminate a mandibular lesion from an extramandibular lesion. With this approach, it is thought to be easier to suggest a dignosis among a wide spectrum of masticator lesions.
Abscess ; Ameloblastoma ; Chondrosarcoma ; Magnetic Resonance Imaging* ; Mandible ; Muscles ; Necrosis ; Orbit ; Osteomyelitis ; Retrospective Studies

Unilateral absence of pulmonary artery is a rare congenital anomaly that is frequently associated with other cardiovascular abnormalities. Most patients who have no associated cardiac anomalies have only minor or absent symptoms in childhood and survive into adulthood. We experienced a case of unilateral absence of pulmonary artery in a 5 year-old female patient with the chief complaint of abnormal chest X-ray finding. Unilateral absence of pulmonary artery was diagnosed by lung perfusion scan, cardiac catheterization with pulmonary and aortic angiography. So we report this case with brief review of related literatures.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Cardiovascular Abnormalities ; Child, Preschool ; Female ; Humans ; Lung ; Perfusion ; Pulmonary Artery* ; Thorax

Reversible cerebral vasoconstriction syndrome (RCVS) is a group of syndromes characterized by reversible segmental constriction of cerebral arteries. Posterior reversible encephalopathy syndrome (PRES) is another clinical-radiologic syndrome characterized by reversible, posterior-predominant brain edema. Although the exact causes of these reversible syndromes are poorly understood, these entities may share some common pathophysiologic elements leading to hemorrhagic strokes and rarely, deep intracerebral hemorrhage (ICH). Recent studies have suggested that endothelial dysfunction is a common pathophysiologic factor associated with these syndromes. We report on two young female patients who presented with deep ICH and were later diagnosed as RCVS and PRES. Both patients suffered from vasoconstriction and delayed ischemic stroke. Early detection of distinguishing clinical-radiologic features associated with these reversible syndromes and removing triggers would facilitate successful treatment with no complications.
Brain Edema ; Cerebral Arteries ; Cerebral Hemorrhage* ; Constriction ; Female ; Humans ; Posterior Leukoencephalopathy Syndrome* ; Stroke ; Vasoconstriction* ; Vasospasm, Intracranial

PURPOSE: Transabdominal sonography has been widely used in the diagnosis of suspected urinary calculi, assisted by secondary findings from urinary tract obstruction, but this method shows low specificity and relatively high incidence of false-positives. Recently, detection of stone itself with new Doppler finding and bladder distension on sonography has demonstrated high sensitivity. METHODS: We performed prospective transabdominal ultrasonography for emergency department patients with acute urinary colic pain over a 3 month period. With adequate bladder distension by intravenous hydration and initial spontaneous voiding drive, stones itself could be tracked along the entire length of urinary tract by emergency physician who received short-term education course. RESULTS: One hundred and thirty one patients enrolled; 86 received a sonographic exam and 57 showed urinary calculi. The detection rate of urinary calculi was 71.3%. The most common sonographic feature used in the diagnosis of urinary calculi was a distinct echogenic stone appearance within the dilated urinary tract with posterior acoustic shadowing. CONCLUSION: We concluded that detection of urinary calculi by transabdominal ultrasonography could be very useful in mbination with secondary sonographic finding from urinary tract obstruction in the evaluation of suspected urinary colic.
Acoustics ; Colic ; Diagnosis ; Education ; Emergencies ; Emergency Service, Hospital ; Humans ; Incidence ; Prospective Studies ; Sensitivity and Specificity ; Shadowing (Histology) ; Ultrasonography* ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract

The purpose of this study was to determine the prevalence and characteristics of symptomatic coronary heart disease (CHD) in patients with moyamoya disease (MMD). This retrospective study evaluated 456 patients who received examination for MMD between 1995 and 2012. We reviewed the patients' medical history and coronary imaging, including conventional coronary angiography and coronary computed tomography angiogram (CTA). Among 456 patients with MMD, 21 (4.6%) patients were found to have symptomatic CHD. Ten patients were treated with coronary artery bypass graft or percutaneous coronary intervention for unstable angina or myocardial infarction. Eleven were treated with medication for stable angina (n = 6) and variant angina with mild degree of stenosis (n = 5).The median age of these patients was 44 yr (range, 27-59). The median Framingham score at diagnosing MMD was < 1% (range, < 1%-16%). The old age was associated with CHD in uni- and multivariate analyses (P = 0.021, OR, 1.053; 95% CI, 1.008-1.110). Considering low age of onset and low stroke risk factor, CHD might be a systemic manifestation that is clinically relevant to MMD.
Adult ; Age Factors ; Aged ; Coronary Angiography ; Coronary Artery Disease/*etiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Moyamoya Disease/*complications ; Retrospective Studies

OBJECTIVE: Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical course. Furthermore, poorer clinical outcomes occur in cases of recurrent bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has not been investigated yet. This study evaluated the prognostic implications of the perfusion status during the clinical course of adult hMMD. METHODS: This retrospective study enrolled 52 adult hMMD patients between April 1995 and October 2010 from a single institute. Demographic data, clinical and radiologic characteristics, including hemodynamic status using single photon emission computed tomography (SPECT), and follow up data were obtained via a retrospective review of medical charts and imaging. Statistical analyses were performed to explore potential prognostic factors. RESULTS: Hemodynamic abnormality was identified in 44 (84.6%) patients. Subsequent revascularization surgery was performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, ischemic n=5, Actuarial stroke rate 5.8+/-1.4%/year). Recurrent hemorrhage was associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and omission of revascularization (10.218; 95%; CI=1.532-68.136). CONCLUSION: Decreased basal perfusion seems to be associated with recurrent bleeding. Revascularization might prevent recurrent stroke in hMMD by rectifying the perfusion abnormality. A larger-sized, controlled study is required to address this issue.
Adult ; Cerebral Hemorrhage ; Cerebral Revascularization ; Follow-Up Studies ; Hemodynamics ; Hemorrhage* ; Humans ; Moyamoya Disease* ; Perfusion* ; Retrospective Studies ; Stroke ; Tomography, Emission-Computed, Single-Photon

We present two patients with a dural arteriovenous fistula (dAVF) of the ophthalmic sheath who developed progressive exophthalmos, conjunctival chemosis, and visual loss. These symptoms mimic those of cavernous sinus dAVFs. Dural AVFs of the ophthalmic sheath are extremely rare and their clinical management is controversial. We successfully treated these two patients by transvenous coil embolization. Transvenous embolization appears to be a safe and effective method to treat dAVFs of the ophthalmic sheath.
Cavernous Sinus ; Central Nervous System Vascular Malformations* ; Embolization, Therapeutic* ; Exophthalmos ; Humans ; Methods

OBJECTIVE: Chronic subdural hematoma (CSDH) is a rare complication of unruptured aneurysm clipping surgery. The purpose of this study was to identify the incidence and risk factors of postoperative CSDH after surgical clipping for unruptured anterior circulation aneurysms. METHODS: This retrospective study included 518 patients from a single tertiary institute from January 2008 to December 2013. CSDH was defined as subdural hemorrhage which needed surgical treatment. The degree of brain atrophy was estimated using the bicaudate ratio (BCR) index. We used uni- and multivariate analyses to identify risk factors correlated with CSDH. RESULTS: Sixteen (3.1%) patients experienced postoperative CSDH that required burr hole drainage surgery. In univariate analyses, male gender (p<0.001), size of aneurysm (p=0.030), higher BCR index (p=0.004), and the use of antithrombotic medication (p=0.006) were associated with postoperative CSDH. In multivariate analyses using logistic regression test, male gender [odds ratio (OR) 4.037, range 1.287-12.688], high BCR index (OR 5.376, range 1.170-25.000), and the use of antithrombotic medication (OR 4.854, range 1.658-14.085) were associated with postoperative CSDH (p<0.05). Postoperative subdural fluid collection and arachnoid plasty were not showed statistically significant difference in this study. CONCLUSION: The incidence of CSDH was 3.1% in unruptured anterior circulation aneurysm surgery. This study shows that male gender, degree of brain atrophy, and the use of antithrombotic medication were associated with postoperative CSDH.
Aneurysm* ; Arachnoid ; Atrophy ; Brain ; Drainage ; Hematoma, Subdural ; Hematoma, Subdural, Chronic* ; Humans ; Incidence* ; Logistic Models ; Male ; Multivariate Analysis ; Retrospective Studies ; Risk Factors* ; Surgical Instruments*

BACKGROUND: The internet is an important and rapidly-evolving source of health-related information, and many patients with atopic dermatitis attempt to find information from the internet. OBJECTIVE: This study was performed to investigate the current information available on atopic dermatitis on the internet in Korea. METHODS: We chose two search engines and three community portal sites to analyze the information in which the topic of 'atopy' could be found. RESULTS: Among the 595 web sites and 1,485 communities, 97% of the web sites and 73.7% of the communities were related products or service advertisements, and some of them provided incorrect or exaggerated information. There were only 10 web sites and 20 available communities with genuine information, and most of these also presented unattested treatment methods, including alternative therapies. CONCLUSION: It is quite understandable that patients with atopic dermatitis want to seek information related to their disease, and the internet has the potential to be a useful source of information. However, there are no regulations to control the accuracy and quality of information on the internet. We should take an active role in identifying the accuracy and evaluating the quality.
Complementary Therapies ; Dermatitis, Atopic* ; Humans ; Internet* ; Korea* ; Search Engine ; Social Control, Formal