Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of probable autoimmune etiology. The MR images of patients with clinically suspected ADEM were retrospectively reviewed. The clinical symptoms occurred 5 days to 1 month after viral upper respiratory infection (4) and Coxsakie viral infection(1). The symptoms had begun with fever(3), headache(3), sore throat(1), and drowsy mental state (1), which progressed with monophasic course to altered mental change(2), extremity weakness(2), seizure(1) and/or cerebellary symptom(I) MRI findings of ADEM showed patchy(4), nonhemorrhagic(5), asymmetric(5) high signal intensity lesions on T2-weighted images. The number of the lesions was mostly multiple(4). The lesions mainly involved the brain stem(3) and subcortical white matter(3). Follow-up MR images of 13 days to 20 days after high dose steroid therapy showed marked improvement in two of three, which well correlated with clinical manifestations. MR findin of multiple, patchy, nonhemorrhagic and asymmetric lesions in subcortical white matter and brain stem on T2-weighted images seem to be characteristic features of ADEM, but nonspecific. Therefore, clinical correlation is required in evaluating ADEM.
Brain ; Brain Stem ; Demyelinating Diseases ; Encephalomyelitis, Acute Disseminated ; Extremities ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; White Matter

PURPOSE: The purposes of this study were to analyze the MR findings of medulloblastoma, and to evaluate the subarachnoid dissemination and the significance of contrast enhanced MR of brain and spine for tumor.. MATERIALS AND METHODS: The preoperative brain MR studies of 18 patients (9 males, 9 females;mean age, 9.4 years) with surgically proved medulloblastomas were retrospectively reviewed to characterize these neoplasms with regard to their location, size, MR signal intensity, appearance after contrast enhancement, presence of cyst and necrosis, subarachnoid dissemination, and other associated findings. In 14 patients postoperative spine MR studies were evaluated for staging and therapeutic planning. RESULTS: The most frequent location of medulloblastoma was the inferior vermis and the mean tumor size was 4.1 x 3.6 x 3.9 cm. On Tl-weighted image, medulloblastomas generally had low to intermediate signal, predominantly hypointense relative to white matter. On T2-weighted image, medulloblastomas showed modetately high signal, hyperintense relative to white matter. Inhomogeneous contrast enhancement was demonstrated in 13 patients(72.2%) after injection of gadopentetate dimeglumine(Gadolinium). Cyst and necrosis within the tumor were visualized in 15 patients(83.3%). Subarachnoid disseminations of medulloblastomas were noted in 11 patients(61.1%), of which 6 demonstrated intracranial and 2 intraspinal dissemination. Three had both intracranial and intraspinal dissemination. In nine cases with intracranial lesions, there were intraparenchymal mass formation(7), subarachnoid nodules(5), infundibular lesions(2) and diffuse gyral enhancement(I). In five cases with intraspinal lesions, there were extramedullary intradural small nodules(3), central canal nodules(2), intradural masses(I)and fine nodular and sheet-like leptomeningeal enhancement(1). Other associated findings included intratumoral hemorrhage(11.1%), per/tumoral edema(44.4%), tonsillar herniation(44.4%), hydrocephalus(88.9%) and calcification(44.4%). CONCLUSION: Medulloblastomas revealed low to intermediate signal intensity on Tl-weighted image and intermediate to moderately high signal intensity on T2-weighted image, relative to cerebellar white matter. Medulloblastomas were solid tumors with cystic necrosis, which showed inhomogeneous enhancement and subarachnoid disseminations to the intracranial and intraspinal spaces after Gd-DTPA enhancement. Gd-enhanced MR of brain and spine was an useful diagnostic modality in preoperative diagnosis and in staging of postoperative cases of medulloblastomas, which was superior to postcontrast CT or precontrast MR.
Brain* ; Diagnosis ; Gadolinium DTPA ; Humans ; Male ; Medulloblastoma ; Necrosis ; Retrospective Studies ; Spine*

We report a case of cerebriform intradermal nevus. a cause of cutis verticis gyrata that clinically they resembled neurofibroma and revealed histopathologic finding consistent with intradermal nevus. The patient was a 6 year-old boy, who had a 17x18cm, soft, convoluted. pigmented mass over the parietal and occipital regions. The lesion had been present since birth and had been slowly increasing in size with convolution.
Child ; Humans ; Male ; Neurofibroma ; Nevus, Intradermal* ; Parturition ; Rabeprazole

Cerebral aspergillosis is a rare condition that affects primarily the immunocompromised host. Most of cerebral aspergillosis is developed by hematogenous dissemination from extracranial foci, but aspergillosis of sino-nasal origin rarely affects the CNS. In case 1, wel symptom of tumor recurrence was unilateral numbness of the chin. A 65-year-old male was admitted because of paresthesia around the left chin and left lower lip. Neurologic examination revealed hypesthesia on the left side of chin, lower lip and buccal mucous mem-brane. Bone scan (Tc-99m MDP) showed focal hot uptakes on the left mandible and left first rib. Brain CT with bone window setting showed a focal osteolytic lesion in the bone marrow of the left mandibular canal without destruction of bone cortex. Both coronal T1 weighted image and axial T2 weighted image showed focal low signal intensities on the left ramus. The pathophysiologic mechanism could be understood by identification of the pathologic focus.
Aged ; Aspergillosis* ; Bone Marrow ; Brain ; Chin ; Humans ; Hypesthesia ; Immunocompromised Host ; Lip ; Male ; Mandible ; Neurologic Examination ; Paresthesia ; Recurrence ; Ribs

Dental restorative materials must have the physical properties to withstand wear and corrosion. Base metal alloys possess better mechanical properties and lower price than the gold alloys. For these reason such alloys have largely replaced the precious metal alloys. One aspect to consider is the release of metal substances to oral environment. The release of elements from dental alloys is a continuing concern because the elements may have the potentially harmful biological effects on local tissue. The purpose of this study was to minimize metal release on the nonprecious metal surfaces by ion bea assisted deposition(IBAD) of titanium nitride (TiN). Ni-Cr-Be alloys with and without TiN coatings were secured in an wear test machine opposing ruby ball to determine their relative resistance to wear with 100m, 200m, 300m and 400m sliding distance. And the corrosion behavior of the Ni-Cr-Be alloys with and without TiN coating and 3 dental noble alloys have been studied. Potentiodynamic curves were used to analyse the corrosion characteristics of the alloys. The measurement of the released Ni and Ci ions was conducted by analysis of the electrolyte solution with atomic absorption spectroscopy. The results were as follows : 1. The critical sliding distance that wore down TiN coating of 2.5micrometer thickness in this study condition was 300m. 2. Ion beam assisted deposition of TiN showed a good surface modification with respect to the properties of wear and corrosion resistance. 3. X-ray diffraction showed that the strongest peak of TiN(111) in the coatings. 4. The release of Ni and Cr ions from alloys measured by means of atomic absorption spectroscopy was reduced by ion beam assisted deposition of TiN.
Absorption ; Alloys* ; Corrosion ; Dental Alloys ; Gold Alloys ; Ions ; Spectrum Analysis ; Tin* ; Titanium ; X-Ray Diffraction

PURPOSE: Pilocytic astrocytoma is a benign tumor predominantly arising from cerebellum in pediatric age. But it occasionally arises in supratentorium. We describe radiologic findings of supratentorial pilocytic astrocytoma. MATERIALS AND METHODS: Eleven CT and 7 MR examinations in 11 patients were retrospectively reviewed with attention to location, CT density, MR signal intensity, and degree and pattern of contrast enhancement on CT and MR. RESULTS: The tumors were located around the third ventricle (hypothalamus in three cases, optic chiasm in three cases) and in cerebral hemisphere (temporal lobe in three cases, frontal lobe in one case, thalamus in one case). On CT, the tumors were all sharply demarcated and rarely associated with edema. The tumors showed moderate to strong contrast enhancement. Necrosis appeared frequently in tumors around the third ventricle in contrast to frequent cyst formation in hemispheric masses. On MR, the tumors appeared hypo- or isointense on T1- weighted images and hyperintense on T2- weighted images. After administration of contrast agent, the tumors showed intense enhancement more than that of CT. CONCLUSION: The typical location and radiologic findings described above are helpful in the diagnosis of the supratentorial pilocytic astrocytoma.
Astrocytoma* ; Cerebellum ; Cerebrum ; Diagnosis ; Edema ; Frontal Lobe ; Humans ; Necrosis ; Optic Chiasm ; Retrospective Studies ; Thalamus ; Third Ventricle

Plummer-Vinson syndrome is a clinical entity characterized by dysphagia, iron deficiency anemia, cheilosis, glossitis, and cervical esophageal web, especially in middle aged women. Recently, the authors experienced a case of Plummer-Vinson syndrome. A 53-year-old female was admitted due to intermittent solid food dysphagia for 18 months. She had a 2 years history of iron deficiency anemia. On admission glossitis, fissures at the angle of the mouth, spoon nails, and iron deficiency anemia were noted. Esophagogram and esophagoscopic examination revealed thin walled concentric web at upper esophagus. Esophageal web was succefully teared by endoscopic balloon dilatation with subseguant improvement of dysphagia. Skin manifestations as well as anemia were markedly improved after oral iron replacement therapy.
Anemia ; Anemia, Iron-Deficiency ; Deglutition Disorders ; Dilatation ; Esophagus ; Female ; Glossitis ; Humans ; Iron ; Middle Aged ; Mouth ; Plummer-Vinson Syndrome* ; Skin Manifestations ; Tears

No abstract available.
Nasal Cavity* ; Papilloma, Inverted* ; Paranasal Sinuses*

PURPOSE: The purpose of this study is to describe Magnetic Resonance(MR) findings of two epidural cavernous malformations of the spine. MATERIALS AND METHODS: MR imaging was performed in 2 patients(29-year-old man and 54-year-old woman). Sagittal T1 -, T2-weighted images and Gadolinium (Gd)-enhanced axial and sagittal images were acquired. Two patients had surgery and MR findings were compared with surgical and histopathological findings. RESULTS: MR imaging showed high- and low-signal intensity components of these lesions that were characteristic of an epidural cavernous malformation in one case. The other case showed a high signal intensity on T2- and strong enhancement on Gd-enhanced T1 -weighted images. We think that the former may be due to mixed subacute and chronic hemorrhage and the latter may be due to blood within the endotheliumlined sinusolds without hemorrhage. CONCLUSION: These findings were well correlated with the surgical and histo-pathological findings of cavernous malformation.
Gadolinium ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Spine*

Intraspinal neurenteric cysts are rare congenital lesions that results from abnormal separation of germ layers in the third week of embryonic development, which may cause spinal compression. Although, the diagnosis of neurenteric cyst was very difficult prior to operation, MRI has proven to be a useful imaging modality in detection, localization and characterization of intraspinal neurenteric cysts. We recently experienced intraspinal neurenteric cyst in two patients who presented with progerssive quadriparesis. Myelography, CT myelography and MRI were taken and complete excision was performed. The MRI findings are presented and the literature is reviewed.
Diagnosis ; Embryonic Development ; Female ; Germ Layers ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neural Tube Defects* ; Pregnancy ; Quadriplegia