PURPOSE: To describe the sonographic findings of nasal bone fracture and evaluate the diagnostic value of sonography (US). MATERIALS AND METHODS: Thirty-six patients with sustained nasal trauma underwent plain radiography, US and CT, and the CT findings were used as the gold standard. The sonographic findings were retrospectively reviewed and compared with those of radiography and CT. Twelve patients underwent follow-up US within 3 months of reduction. RESULTS: Sonographic findings of nasal bone fractures were irregularity (n=7), discontinuity (n=25) and dis-placement with discontinuity (n=28) of the thin smooth echogenic line formed by the ventral cortex of the nasal bone. Sixty-five nasal bone fractures (36 patients) were identified by CT; 60 of these were revealed on US but only 41 by plain radiographs. CT demonstrated unilateral involvement of nasal bone fractures in seven bones and bilateral involvement in 58, while US revealed unilateral involvement in 12 and bilateral involvement in 48. Plain radiographs, unilat-eral involvement in 21 bones and bilateral fractures in 20. Plain radiographs were more limited in detecting the location of nasal bone fractures than was US. On follow-up US in 12 patients, normal alignment without residual abnormality was observed in seven patients, residual cortical irregularities in four, and minimal cortical depression in one. CONCLUSION: The sonographic findings of nasal bone fractures were similar to those of CT in detecting the location and degree of depression or displacement of nasal bone fractures. We believe that US is very useful for the evaluation of such fractures, especially in cases in which plain radiographs reveal equivocal abnormality, or postreduction status is uncertain.
Depression ; Follow-Up Studies ; Humans ; Nasal Bone* ; Radiography ; Retrospective Studies ; Ultrasonography*

Congenital lipoid adrenal hyperplasia, the most severe form of congenital adrenal hyperplasia, is caused by mutations in the steroidogenic acute regulatory protien (StAR). It is characterized by failure of synthesis of all three classes of adrenal steroids and massive accumulation of lipids and cholesterol in the adrenal cortex. The computed tomography (CT) unequivocally delineated massively enlarged adrenal glands of fat-tissue attenuation, enabling early diagnosis and replacement therapy. We report a case of congenital lipoid adrenal hyperplasia, in which CT established that lipoid deposition at the adrenal cortex disappeared after the adrenal hormone replacement therapy.
Adrenal Cortex ; Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Cholesterol ; Early Diagnosis* ; Hormone Replacement Therapy ; Hyperplasia* ; Steroids

Proptosis of the left eye had developed in a 3-year old girl for 6 months duration. Computed tomogram studies showed a large mass in the retrobulbar space. A frozen section confirmed the presence of meningioma. To the author's knowledge, the patient was the youngest reported patient who has the primary orbital meningioma. We performed en bloc excision of the optic nerve and the tumor mass without enucleation. The patient showed no evidence of the anterior segment necrosis or increased intraocular pressure postoperatively. She had satisfactory cosmetic appearance without recurrence of the tmnor after 8 month.
Child, Preschool ; Exophthalmos ; Female ; Frozen Sections ; Humans ; Intraocular Pressure ; Meningioma* ; Necrosis ; Optic Nerve* ; Orbit ; Recurrence

The authors performed reconstructive surgery for three cases of extensive upper and lower lid defects using modified Hughes procedure during the past one year. Two cases were upper lid reconstruction for the recurrent sebaceous carcinoma and the upper lid coloboma due to thermal bum. The other one was the adenoid cystic carcinoma of the lower lid. The first stage of this procedure was performed by tarsoconjunctival flap. The second procedure was performed after 6 weeks. This lid sharing technique was excellent for both cosmesis and lid function. All of the three patients have been very happy without any complications such as malposition of the lid margin, lid retraction or blepharoptosis.
Blepharoptosis ; Carcinoma, Adenoid Cystic ; Coloboma ; Humans

The authors reviewed 104 cases(51 men and 53 women) of the orbital tumors diagnosed hitopathologically at the Department of Ophthalmology, Yeungnam University Hospital from March 1984 to April 1996. Age istribution of the orbital tumors was reviewed. Eighty-four cases of benign tumors were found evenly distributed in all decades, but twenty cases of malignant tumors were mainly distributed in 1st, 6th, and 7th decades. The frequency of benign orbital tumors was in the following order; dermolipoma(19%, 20 cases), dermoid cyst(13.5%, 14 cases), mucocele(7.7%, 8 cases), lipoma(6.7%, 7 cases) and pleomorphic adenoma (5.8%, 6 cases). Of malignant orbital tumors, the frequency was in the following order; retinoblastoma (3 cases), malignant melanoma (2 cases), sebaceous carcinoma(2 cases), and maxillary sinus carcinoma (2 cases). Malignant orbital tumors of eight expired cases were revealed as secondary or metastatic orbital tumors.
Adenoma, Pleomorphic ; Classification* ; Dermoid Cyst ; Humans ; Male ; Maxillary Sinus ; Melanoma ; Ophthalmology ; Orbit* ; Retinoblastoma

Teratocarcinoma is a form of mixed germ cell tumor composed of a mixture of teratoma and embryonal carcinoma. It is rarely found in the brain, but when present it is most commonly found in the pineal region. We investigated a case of primary teratocarcinoma in the pineal region. The patient was a 10 year old boy who had suffered from a bitemporal headache for one month. Brain CT and MRI revealed a rather well defined ovoid heterogenous mass in the pineal gland region, measuring 4.3 x 3.8 x 3.0 cm in size. Microscopically the tumor contained areas of immature teratoma and embryonal carcinoma. Immunohistochemical staining revealed positive reactions for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, and alpha-fetoprotein in the embryonal carcinoma component.

PURPOSE: Achieving good eyelid position and symmetric palpebral fissure for asymmetric bialteral congenital ptosis would require skillful technique and a lot of experiences of surgeon. Patients were divided into two groups, A and B, in terms of preoperative MRD and the possible relationship between preoperative MRD difference. The outcome of the surgery was studied. METHODS: External levator resection with apponeurotic approach was performed for 19 patients with asymmetric bilateral congenital ptosis from October 1994 to June 2000. According to differences of MRD between the both eyes, patients were divided into two groups. Group A included 8 patients with 1.0~2.0 mm of MRD differences, and group B included 11 patients with more than 2.0 mm of MRD differences. RESULTS: Age of patients ranged from 3 to 20 years (mean 6.1 years) and follow-up period was 9 to 60 months (mean 20 months). Six patients of group A and seven patients of group B showed almost excellent symmetric palpebral fissure. Only one patient of group B had postoperative MRD difference more than 2.0 mm, and none in group A. CONCLUSIONS: Success rate was 100% in group A and 91% in group B, but no statistical difference was found between group A and group B (p>0.05).
Eyelids ; Follow-Up Studies ; Humans

PURPOSE: The purpose of this study was to evaluate the CT findings of acute pyelonephritis (APN) in children and to assess the correlation between these findings, clinical parameters and renal scar development, as seen on follow-up CT scans. MATERIALS AND METHODS: Contrast-enhanced CT scans of thirty children in whom APN had been diagnosed were assigned to one of three groups according to whether an abscess had formed, and then to subgroups on the basis of the number of lesions in the renal parenchyme. Initial CT findings were retrospectively correlated with five clinical parameters (maximal body temperature, fever duration, leukocytosis, pyuria and admission period) and renal scar development, as seen on follow-up CT (n=12). RESULTS: CT scans demonstrated linear, wedge-shaped, low-density renal parenchymal lesions in 35 kidneys of 25 patients and abscesses in seven kidneys of seven patients, but no abnormal lesions in five patients. In the three groups there was correlation between these findings and some clinical parameters (maximal body temperature, fever duration and admission period), but no subgroup showed significant correlation with any clini-cal parameter. Renal cortical scars detected by follow-up CT were more prevalent in patients in whom initial CT demonstrated the presence of an abscess. CONCLUSION: Clinical parameters correlated with the presence of renal parenchymal hypoenhancing lesions and abscess formation, as seen on CT scans, rather than the number of renal parenchymal lesions. Renal cortical scars were more prevalent in patients in whom initial CT revealed the presence of an abscess. Enhanced CT is thought to be useful both for diagnosing APN and for predicting its clinical course in children.
Abscess ; Body Temperature ; Child ; Cicatrix ; Fever ; Follow-Up Studies ; Humans ; Kidney ; Leukocytosis ; Pyelonephritis* ; Pyuria ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Body Weight* ; Diet* ; Exercise Therapy* ; Humans

Based on the genetic homology between mouse chromosome 16 and human chromosome 21, experimentally induced trisomy 16 mouse has been considered to serve as a suitable model for human Down syndrome. Mice with trisomy 16 express several phenotypic characteristics of human trisomy 21 syndrome; i.e., intrauterine growth retardation, anarsarca, congenital heart disease, brain abnormality, etc. To elucidate morphogenesis of characteristic craniofacial malformation in human Down syndrome, we studied trisomy 16 mouse fetuses that were produced by crossing karyotypically normal C57BL/6 female ice with males carrying the two Robertsonian translocation chromosome Rb(16.17)/Rb(11.16). We examined a series of trisomy 16 conecptuses and their normal littermate controls from day 14 to day 18 of gestation by gross observation and serial microscopic sections. In addition to smaller size and generalized edema, we observed variable, but definite delay in brain and craniofacial development in trisomy 16 mice. The brain revealed less stratified telencephalon, underdeveloped thalamus and hypothalmus with relatively wide third ventricle, and small rhombencephalon. Craniofacial underdevelopment was characterized by persistent open eye, cochlea with fewer turns, delayed closure of the palate, more simple nasal cavity, etc. The tongue was shorter and convex upward, that were especially prominent at 14 days of gestation. The convex tongue and underdeveloped brain made the cranial base convex upward, and the angle between the cranial base an vertebral axis more obtuse. Small head with increase cephalic index and midfacial hypoplasia appeared to account for brain underdevelopment.
Female ; Male ; Humans ; Mice ; Animals