Magnetic resonance (MR) imaging has been widely used in the clinic because of the benefit of high spatial and temporal resolution, and the excellent anatomical tissue contrast. Cancer-targeted MR molecular imaging comprises 3 major components: a relevant molecular target which is specifically highly expressed on the membrane of the cancer cell; a target specific imaging probe which is composed of superparamagnetic iron oxide nanoparticle coreconjugated target specific ligand such as antibody, peptide, and molecules; MR imaging hardware and software which are sensitive to the imaging probe. Among the various molecular targets, HER2/neu receptor antibody, folic acid, and arginine-glycine-aspartic acid (RGD) are well known targeting ligands. The sensitivity of the cancer-targeted MR imaging is affected by the magnetic susceptibility of the T2 contrast agent, resolution of the image, targeting efficiency of the imaging probe, and image acquisition pulse sequence. Recently, successful cancer-targeted MR imaging with T1 contrast agent and cancer-specific molecular MR imaging using innate contrast of the cancer cell by chemical exchange phenomenon without using the imaging probe has been introduced. Cancer-targeted MR molecuar imaging is a robust diagnostic method to detect cancer at the cellular stage of the cancer development and it would help improve early detection rate of the cancer.
Ferric Compounds ; Folic Acid ; Iron ; Ligands ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Membranes ; Molecular Imaging ; Nanoparticles

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

No abstract available.
Adult* ; Child* ; Humans ; Palatine Tonsil*

No abstract available.
Pregnancy*

Morsicatio labiorum is a form of tissue alteration caused by self-induced injury, mostly occurring on the lips, and is considered to be a rarely encountered mucocutaneous disorder. Clinically, it is a macerated grey-white patch and plaque of the mucosa caused by external stimuli (self-induced injury) such as habitual biting, chewing, or sucking of the lip. It is often confused with other dermatological disorders involving the oral mucosa, which can lead to a misdiagnosis. We herein report three cases of morsicatio labiorum; two cases were misdiagnosed as exfoliative cheilitis at the time of the first visit.
Bites and Stings ; Cheilitis ; Diagnostic Errors ; Lip ; Mastication ; Mouth Mucosa ; Mucous Membrane ; Sucking Behavior

OBJECTIVE: We wanted to assess the role of the popliteal lymph nodes for differentiating rheumatoid arthritis (RA) from osteoarthritis (OA), and we also wanted to investigate the relationship between the popliteal lymph nodes and the inflamed synovial volume (ISV) by using contrast enhanced (CE), fat suppressed, three dimensional-fast spoiled gradient echo (3D-FSPGR) MR imaging. MATERIALS AND METHODS: Contrast enhanced 3D-FSGPR MR imaging of 94 knees (21 with RA and 73 with OA) was analyzed. A lymph node was defined as being 'observed' if it could be seen in at least two planes of the three orthogonal reformatted planes. The number of observed lymph nodes, the mean of the smallest dimension of each lymph node and the existence of central fatty change were recorded. The OA group was graded according to the ISV calculated by a segmentation method: grade I was < 20 cm3; grade II ranged from 20 cm3 to 40 cm3; and grade III was > 40 cm3. Statistical analysis of the number and the mean size of the popliteal lymph nodes among the four groups (the RA group and the grade I-III OA groups) was performed. RESULTS: The prevalence of the observed popliteal lymph nodes was significantly different between all the OA groups or between the grade III OA group and the RA group (p < 0.0001, 0.0001, respectively). The popliteal lymph node was observed in 32 out of 73 OA cases, whereas it was visible in all of the 21 RA cases. The number (mean+/-standard deviation) of lymph nodes in the grade I OA group, the grade II OA group, the grade III OA group and the RA group was 1.2+/-0.4, 1.2+/-0.4, 1.3+/-0.5, and 2.7+/-1.1, respectively. The mean size (mean+/-standard deviation) of the lymph nodes was 3.8+/-1.0 mm, 3.6+/-1.1 mm, 4.1+/-0.8 mm, and 5.4+/-1.3 mm, respectively. The incidence of central fatty changes was significantly lower in the RA group than in all the OA groups and the grade III OA group. When differentiating RA from OA, and when the differentiation was confined to the RA group and grade III OA group, respectively, the criteria of the number of lymph nodes, their size, their central fatty change and a combination of all these three criteria showed statistical significance (Az values for the former were 0.869, 0.847, 0.776, and 0.942; Az values for the latter were 0.855, 0.799, 0.712, and 0.916). The number and mean size of the lymph nodes correlated with the ISVs (r = 0.49, p < 0.001; 0.50, 0.001, respectively). CONCLUSION: The number, size and central fatty changes in the popliteal lymph nodes observed on the MR images might serve as simple and useful markers in differentiating RA disease from OA disease. These markers would be particular helpful in cases of severe synovial enhancement where the ISVs of both RA and OA overlap. The number and mean size of the lymph nodes also correlated well with the ISV.
Adult ; Aged ; Arthritis, Rheumatoid/*diagnosis ; Diagnosis, Differential ; Female ; Humans ; Inflammation ; Knee ; *Lymph Nodes ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Osteoarthritis/*diagnosis ; Research Support, Non-U.S. Gov't ; Retrospective Studies ; Synovial Membrane/*pathology

BACKGROUND: Exercise has almost always been intuitively considered beneficial, but although rewards greatly outweigh risks, exercise occasionally produces bad or even fatal outcomes such as acute renal failure or sudden death. Exertional rhabdomyolysis has been occasionally reported in adult patients following such strenuous activities as military basic training, weight lifting, and marathon running. The purpose of the present study was to investigate whether exertional rhabdomyolysis developed, and how exercise could influence biochemical markers of rhabdomyolysis during resting, exercise, and recovery period in long-distance runners. METHODS: Twenty-four young long-distance runners who volunteered to participate in the study, trained with running over 200km every week for 2 to 3 years were studied. Levels of serum creatine kinase(CK), lactate dehydrogenase(LDH), asparatate amino-transferase (AST), and myoglobin, and urine myoglobin were measured at 24hr(pre-exercise period) before, immediately (post-exercise period), and at 24hr(recovery period) after 10km running. Ten long-distance runners who were randomly selected at 24hr after 10km running, including one complaining of calf pain, and age-matched nine young control students were subjected to bone scan with technetiun-99m methylene diphosphonate(99mTc-MDP) RESULTS: Serum CK activities in pre-exercise period were higher than that of the upper normal range. Serum CK and LDH activities were significantly increased in post-exercise period compared with pre-exercise period(p<0.05), were not decreased to the level of post- exercise in recovery period. The level of serum myoglobin was increased and decreased significantly,(p<0.05, p<0.01, respectively) and urine myoglobin and serum AST activities were remained within nomal range in each period. The mean uptake count of 99mTc-MDP in both lower extremities of runners was significantly greater than that of the control group(p<0.001), and had good correlation with the serum CK activities of post-exercise, and recovery period(r=0.87 p<0.001, r=0.8 p<0.01, respectively). CONCLUSION: This study suggests that rhabdomyolysis in the well trained long-distance runners may be developed in low grade, but ongoing injuries during each running. For the diagnosis of rhabdomyolysis in the well trained long-distance runners, serum CK levels are thought to be the most useful marker, and the cut- off value of serum CK levels should be lowered less than usual five times of normal value. A quantitative measurements of 99mTc-MDP uptake with serum CK levels can be more helpful in making the diagnosis of rhabdomyolysis in the well trained long-distance runners.
Acute Kidney Injury ; Adult ; Biomarkers* ; Creatine ; Creatine Kinase ; Death, Sudden ; Diagnosis ; Fatal Outcome ; Humans ; L-Lactate Dehydrogenase ; Lactic Acid ; Lower Extremity ; Military Personnel ; Myoglobin ; Reference Values ; Reward ; Rhabdomyolysis* ; Running ; Technetium Tc 99m Medronate ; Weight Lifting

No abstract available.
Pulmonary Embolism*