No abstract available.
Child* ; Humans ; Pneumonia*

PURPOSE: To evaluate CT features of metastatic ureteral tumors. MATERIALS AND METHODS: CT findings in 16 patients with ureteral metastases were evaluated retrospectively ;there were eight cases of bilateral ureteral involvement. Primary tumors metastatic to the ureter were advanced gastric cancer (n=13), breast cancer (n=l), colon cancer (n=l), or adenocarcinoma of unknown primary (n=l). We analysed CT findings with regard to the site of ureteral obstruction, configuration of obstructed sites of ureter, presence or absence of periureteral soft tissue density, and status in other organs. RESULTS: Among 24 ureters involved, ureteral wail thickening was noted in 15, periureteral soft tissue density in 13. Small nodular enhancing lesions less than lcm, within the retroperitoneal space around the involved ureters were noted in seven patients, and four of them were multiple lesions. CONCLUSION: Among various primary tumors, gastric cancer was the most common cause of ureteral metastasis. The common CT findings of ureteral metastases were thickening of ureteral wall, periureteral soft tissue density, and small periureteral enhancing nodular lesions. The constellation of these CT findings may be helpful in making the diagnosis of ureteral metastases.
Adenocarcinoma ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Retroperitoneal Space ; Retrospective Studies ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction

Background : Recurrent wheezing in infants is manifested in a number of disease spectrums and gastroesophageal reflux ( GER ) has been known to be associated with apnea, recurrent pneumonia, asthma, chronic cough, and wheezing. The prevalence of GER in infants with recurrent wheezing and the relationship between atopy and GER in infantile asthmatics have not yet been established, but it was hypothesized that microaspiration of food allergen could induce food-induced wheezing. Objective : To evaluate the prevalence of GER in infants with recurrent wheezing episodes, and to determine whether the presence of atopy affects the prevalence of GER in infantile asthmatics. Method : Seventy infants with recurrent wheezing episodes were evaluated for GER using 24 hour continuous esophageal pH monitoring. Patients were classified into five groups, : 12 atopic asthmatics : 20 nonatopic asthmatics : 15 infants with recurrent bronchiolitis : 8 infants with recurrent pneumonia : and 15 infants with chronic lung disease ( CLD ) of prematurity. GER was considered to be prevalent when reflux index was higher than 95 percentile of normal values by Vandenplas, 1991. Result : The prevalence of GER in infants with recurrent wheezing was 21.4%. The prevalence of GER in each group was 25% in atopic asthmatics, 20% in nonatopic asthmatics, 6.7% in infants with recurrent bronchiolitis, 12.5% in infants with recurrent pneumonia, and 40% in infants with CLD of prematurity. There were no significant differences in prevalence of GER between atopic asthmatics and nonatopic asthmatics, between asthmatics with atopic dermatitis and those without, and between asthmatics with family history of allergy and those without. CONCLUSION: The prevalence of GER in infants with recurrent wheezing was high, especially in infantile asthmatics and infants with chronic lung disease of prematurity. The presence of atopy may not affect the prevalence of GER in infantile asthmatics.
Apnea ; Asthma ; Bronchiolitis ; Cough ; Dermatitis, Atopic ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hypersensitivity ; Infant* ; Lung Diseases ; Pneumonia ; Prevalence* ; Reference Values ; Respiratory Sounds*

63 cases of meningitis in children were reviewed to study correlation between brain CT findings and clinical course. We divided 63 cases into 3 groups according to clinical course, that is , Group I :Healed without significant sequelae. Group II: Discharged with sequelae such as neurologic deficit or complicated clinical course. Group III : Expired or considered to be expired after hopeless discharge. The CT finding were retrospectively analyzed and compared with each clinical group. We drawed several conclusions as follows; 1. The wrost prognostic CT finding is dirty basal cisternal enhancement. (Group I only 5%, Group II 50%, Group III 45%).2. Focal brain parenchymal lesion, especially multiple, such as granuloma and infarct shows unfavorable clinical outcome, that is, high rate of Group III and evident neurologic deficit, in contrast to only 7% of Group I. 3. In 7 cases of which CT finding is only hydrocephalus, the prognosis is rather favorable, that is, 57% were Group I, 43% were improved after V-P shunt (Group II) and no Group III. But hydrocephalus with dirty disternal enhancement results in grave prognosis, that is, Group I only 8%, Grouop II 54%, Group III 38%, With regard to overall hydrocephalus, predilectron for good or bad prognosis can't be mentioned. 4. No prognostic difference were noted between presence and absence of periventricular low desnity in hydrocephalus. 5. CSF pressure of hydrocephalus ismostly high (over 20cm H20). but normal pressure hydrocephalus were noted in 24%. CSF pressure of normal ventriclesize is mostly under 18cm H2O) but high pressure were noted in 18% of the nomral sized venticle (most of them shows intracranial space occupying lesion such as granuloma, acute infarct, subdural effusion, etc). 6. Most of diffuse braine swelling, diffuse brain atrophy and subdural effusion result in Group I, that is, favorable clinical outcome. 7. Normal CT findings ar found in 29%, of which 61% belong to Group I and 31% to Group II.
Atrophy ; Brain ; Child ; Granuloma ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure ; Meningitis ; Neurologic Manifestations ; Prognosis ; Retrospective Studies ; Subdural Effusion

PURPOSE: To evaluate the effectiveness of a combined procedure of peeling the internal limiting membrane with vitrectomy in diabetic macular edema. METHODS: This study comprised 16 eyes of 16 patients hospitalized during a 1-year period. They were randomized to either a vitrectomy group (10 eyes in 10 patients) or to a combined procedure group (6 eyes in 6 patients). Preoperative and postoperative macular center thickness, best corrected visual acuity and postoperative complications 4 months postoperative were investigated. RESULTS: There were no statistically significant differences in the mean values of preoperative and postoperative best corrected visual acuity (logMAR) between the two groups. The mean values of preoperative and postoperative macular center thickness in the vitrectomy group were respectively 509.50+/-36.77 and 332.60+/-91.73; while in the combined procedure group, they were 516.17+/-55.43 and 333.83+/-51.64. Again, there were no statistically significant differences between the two groups. At the 4-month follow-up, decreased visual acuity was found in 3 eyes of the vitrectomy group and in 2 eyes of the combined procedure group. Vitreous hemorrhage (3 eyes) and tractional retinal detachment (1 eye) were found in the vitrectomy group and vitreous hemorrhage (2 eyes) was diagnosed in the combined group. CONCLUSIONS: In our study, vitrectomy with peeling of the internal limiting membrane was not more effective than vitrectomy alone in decreasing macular edema or in improving best corrected visual acuity. Additional studies of the combined procedure are needed to verify this result.
Follow-Up Studies ; Humans ; Macular Edema* ; Membranes ; Postoperative Complications ; Retinal Detachment ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

PURPOSE: To report one case of Parinaud syndrome after intracranial hemorrhage. CASE SUMMARY: A 45-year-old man visited our emergency department complaining of right-sided weakness and right-sided hypoesthesia. Intracranial hemorrhage in the left thalamus and intraventricular hemorrhage were noted upon brain computed tomography, and the patient was admitted to the department of neurosurgery. He complained of diplopia and upgaze palsy, and he was referred to the department of ophthalmology. The patient exhibited convergence-retraction nystagmus, light-near dissociation and vertical gaze limitation within 15 degrees. The best-corrected visual acuity of both eyes was 20/20, but convergence-retraction nystagmus and light-near dissociation still remained. Upgaze palsy was also not improved. CONCLUSIONS: Once symptoms manifest, Parinaud syndrome does not resolve except in patients with hydrocephalus. If the findings persist for more than 6 months, the likelihood of complete resolution is very small. We reported a case of typical Parinaud syndrome with upgaze palsy, convergence-retraction nystagmus and light-near dissociation after thalamic and intraventricular hemorrhage.
Brain ; Diplopia ; Dissociative Disorders ; Emergencies ; Eye ; Hemorrhage ; Humans ; Hydrocephalus ; Hypesthesia ; Intracranial Hemorrhages ; Middle Aged ; Neurosurgery ; Ocular Motility Disorders ; Ophthalmology ; Paralysis ; Thalamus ; Visual Acuity

PURPOSE: The purpose of this study was to analyze the characteristic MR findings of childhood metachromatic leukodystrophy. MATERIALS AND METHODS: Five female patients (10--29 months old;mean age, 21.8 months) of biochemically confirmed metachromatic leukodystrophy were included in this study. We evaluated the extent of white matter degeneration, which was shown as high signal intensity on T2-weighted image, and the presence or absence of the enhancement. Result.' All 5 cases showed high signal intensity in periventricular deep white matter and centrum semiovale which were bilateral, symmetric and confluent. Posterior predominace, sparing of subcortical U fibers and immediate periventricular white matter, and the involvement of splenium of corpus callosum were also noted in all cases. There were other manifestations, such as 'tigroid pattern' in centrum semiovale (n=4), the involvement of genu of corpus callosum(n=4), posterior limb of internal capsule(n=4), descending pyramidal tracts (n=3), deep cerebellar white matter(n=1), claustrum(n=2), and diffuse brain atrophy(n=1). In three cases with Gd-infusion, contrast enhancement of the lesion was not seen. CONCLUSION: In childhood metachromatic leukodystrophy, MRI can clearly demonstrate the chracteristic extent of the white matter lesion and other associated findings, facilitating the differential diagnosis from other similar leukodystrophies.
Brain ; Corpus Callosum ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Leukodystrophy, Metachromatic* ; Magnetic Resonance Imaging* ; Pyramidal Tracts

Magnetic resonance (MR) imaging of thirteen patients with tuberous sclerosis were reviewed. Seven patients underwent computed tomography (CT). The characteristic MR finding of tuberous sclerosis was those of subependymal nodules which were best seen on short repetition time (TR) spin-echo images. Hypointensities within the nodules consistent with calcification were most evident on long TR images. Contrast enhancing lesions, indicative subependymal giant cell astrocytoma, occurred in four cases. Cortical tubers (n=11) and white matter lesions(n=8) exhibited long T1 and T2 relaxation characteristics although reversed pattern was noted in one newborn patients. Cortical tubers and white matter lesions had more irregular shapes in early childhood patients. MR imaging is the sensitive method in detection of gyral tubers and white matter lesions and also valuable in detecting giant all astrocytoma.
Astrocytoma ; Humans ; Infant, Newborn ; Magnetic Resonance Imaging ; Methods ; Relaxation ; Tuberous Sclerosis* ; White Matter

No abstract available.
Child* ; Humans ; Measles*

Authors reviewed 264 cases of meconium aspiration pneumonia of the newborn at Sohwa Children's Hospital from July 1981 to June 1984. The radiologic findings were retrospectively analysed with particular attention to the degree of pulmonic infiltrations. The results were as follow: 1. The male to female ratio was 1.8:1 and clinical conditions which commonly associated were postterm infants (41.3%), placental dysfunction syndrome (33%) and perinatal asphyxia (11.4%). 2. There were improved (76.9%) and expired cases (12.1 %) as clinical course. 3. Radiologic findings were noticed .as pulmonic infiltration (68.2%), hyperinflation (35.2%), pneumomodiastinum (18.6%), pleural effusion (14.4%), pneumothorax (13.3%) and suggestive interstitial emphysema (6.8%). The more the degree of pulmonic infi ltration was been severe, the more the incidence of other pulmonic lesions was increased. 4. Pulmonic infiltrations were commonly occured in both lungs but pneumothorax, pleural effusion and hyperinflation in right. 5. Radiologic findings of 32 expired cases were noticed as pulmonic infiltrations (93.8%), hyperinflation (53.1 %), pneumomediastinum (37.5%), pneumothorax (18.8%), suggestive interstitial emphysema (18.8%) and pleural effusion (18.8%).
Asphyxia ; Emphysema ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Newborn ; Lung ; Male ; Meconium Aspiration Syndrome ; Meconium ; Mediastinal Emphysema ; Pleural Effusion ; Pneumonia ; Pneumothorax ; Retrospective Studies