PURPOSE: To evaluate the MR image in the differentiation of benign and malignant lesion in compression of the vertebral body. MATERIALS AND METHODS: MR images of 47 benign(acute traumatic within one month:19, chronic traumatic longer than one month or nontraumatic:28) and 21 metastatic compression fractures were respectively reviewed in terms of margin of lesions, signal intensity, paraspinal mass formation, soft tissue change, and involvement of posterior element of vertebra. MR images of TI-(T1WI) and T2*-weighted gradient echo (GE T2WI) sequences were obtained on 0.5T unit in sagittal and axial orientation with 5mm section thickness. RESULTS: The margin of benign compression fracture was usually indistinct (acute fracture:90% (17/19), chronic fracture:68% (19/28)), whereas it was sharply delineated in metastatic compression fracture (92%, (12/13) (p<0.001). Paraspinal mass was seen in both acute traumatic and metastatic compression fractures (acute fracture :26% (5/19), metastatic fracture: 52% (11/21). Soft tissue change was seen only in acute cornpression fractures (58%, 11/19). Involvement of posterior element of vertebra was noted in metastatic fracture (71%, 15/21), acute fracture (32%, 6/19) and chronic fracture (7%, 2/28) CONCLUSION: On MR imaging, involvement of entire portion of a given vertebral body, sharp margin between normal and abnormal areas in partially involved cases, paraspinal mass formation, and posterior element involvement are more frequently seen in metastatic compression fractures, which are considered to be useful in differentiation between benign and malignant causes of compression fracture.
Fractures, Compression* ; Magnetic Resonance Imaging* ; Spine

MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex (LCLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalls in image interpretation related to evaluation of the LCLC. MR arthrogram of 56 shoulders in 41 asymptomatic young, active, male volunteers were prospectively reviewed to evaluate the labral shapes, capsular insertions and images which may mimic the lesions of glenohumeral instability. The anterior and posterior parts of the labra, respectively, varied in shape: triangular (72%,36%), round (13%,35%), cleaved (8%,1%), notched (2%,0%), flat (5%,24%), and absent (0%,4%). The anterior and posterior capsular insertions, respectively, varied in site: Mosely and Oevergaard type I (82%,62%), type II (13%,36%), and type III (5%2%). A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum (29%) and middle glenohumoral ligament in proximity to anterior labrum (5%) simulated a labral tear. Joint fluid interposed in the central, superior portion of the sublabral sulci (25%) simulated a SLAP lesion. Synovial fold (38%) in the axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral-capsular-ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.
Arthrography* ; Cartilage, Articular ; Humans ; Joints ; Ligaments ; Male ; Prospective Studies ; Shoulder ; Volunteers

The face is the most important for individual identification, which showed racial and regional differences. The aim of the present study was to investigate that how much highly locate the facial structures in the face. In total, 551 Korean young adult volunteers with no deformity or surgical history of the face (218 males and 333 females) were selected. Subjects were photographed while sitting and assuming a standard head position, such that the porion and inferior orbital margin were in the same horizontal plane (Frankfurt plane), and they were gazing forward. The total face height was measured vertically from trichion to gnathion. And total face height was divided three heights such as upper, mid, and lower face height. Total face height of male was larger about 6% than female. The ratio of lower face height about upper face height was calculated, it showed 55.7% in male and 50.3 in female. The face was classified into three sets including high-set, mid-set, and low-set according the ratio. The male face showed relatively high-set face, while female face showed relatively low-set face. The present study is the first study to investigate about high- or low-set face, and the result is useful data to identify characteristics of the east Asian population including Korean.
Asian Continental Ancestry Group ; Congenital Abnormalities ; Female ; Head ; Humans ; Male ; Orbit ; Volunteers ; Young Adult

Huntington's disease(HD) is an autosomal dominantly inherited neurodegenerative disease, which is characterized by choreic movement and progressive dementia. HD is a disease caused by CAG repeat expansion of huntintin gene and definitely diagnosed or is excluded by molecular genetic analysis. Juvenile HD, of which onset is in children or young adult, is the most severely disabled type and shows several distinct clinical and genetic features in contrast to usual late-onset type. We report a 10 year-old girl who presented with involuntary movement, seizure and moderate dysarthria confirmed by molecular genetic analysis.
Child ; Chorea ; Dementia ; Dysarthria ; Dyskinesias ; Female ; Humans ; Molecular Biology ; Neurodegenerative Diseases ; Seizures ; Young Adult

We performed an immunohistochemical study on the estrogen receptor alpha (ER-alpha) distribution in the cerebellum of a human neonate with multiple congenital anomalies, that had been acquired during autopsy. Although the exact pathology in the brain was not clearly elucidated in this study, an unidentified stressful condition might have induced the astrocytes into reactive states. In this immunohistochemical study on the neonatal cerebellum with multiple congenital anomalies, intense ER-alpha immunoreactivities (IRs) were localized mainly within the white matter even though ER-alpha IRs were known to be mainly localized in neurons. Double immunohistochemical staining showed that ER-alpha IR cells were reactive astrocytes, but not neurons. Interestingly, there were differences in the process length among the reactive astrocytes showing ER-alpha IRs. Our quantitative data confirmed that among the glial fibrillary acidic protein (GFAP)-expressing reactive astrocytes, the cells exhibiting intense ER-alpha IRs have much longer cytoplasmic processes and relatively weaker GFAP IRs. Taken together, the elongated processes of reactive astrocytes might be due to decreased expression of GFAP, which might be induced by elevated expression of ER-alpha even though the elucidation of the exact mechanism needs further studies.
Abnormalities, Multiple/*pathology ; Astrocytes/*metabolism ; Autopsy ; Brain/pathology ; Cerebellum/*metabolism ; Cytoplasm/metabolism ; Estrogen Receptor alpha/*metabolism ; Female ; Gastrointestinal Diseases/congenital/*pathology ; *Gene Expression Regulation ; Glial Fibrillary Acidic Protein/metabolism ; Humans ; Immunohistochemistry/methods ; Infant, Newborn ; Urogenital Abnormalities/*pathology

PURPOSE: Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. MATERIALS AND METHODS: We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site "Korean Pub Med" to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. RESULTS: Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into 3~4 categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors. Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wall invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (8) and unconventional fractionation. CONCLUSION: By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting and close communication, survey items for cervix cancer PCS were developed to measure structure, process and outcome of the radiation treatment of the cervix cancer. Subsequent future research will focus on the use of brachytherapy and its impact on outcome including complications. These finding and future PCS studies will direct the development of educational programs aimed at correcting identified deficits in care.
Barium ; Brachytherapy ; Cervix Uteri* ; Chemoradiotherapy ; Consensus ; Enema ; Female ; Humans ; Internet ; Japan ; Korea* ; Magnetic Resonance Imaging ; Radiotherapy* ; Biomarkers, Tumor ; United States ; Uterine Cervical Neoplasms ; Weights and Measures

BACKGROUND: Seizures in the neonate are relatively common and their clinical features are different from those in children and adults. The study aimed to provide the clinical profiles of neonatal seizure in our hospital. METHODS: A total of 41 newborns with seizures were enrolled in this study over a period of three years. They were evaluated with special reference to risk factors, neurologic examinations, laboratory data, neuroimaging studies, EEG findings, seizure types, response to treatment, and prognosis, etc. RESULTS: The average age at onset of seizures was 6.1+/-4.6 days and the majority of patients(42%) had multifocal clonic seizure and 24% had subtle seizure. Factors that are known to increase risk of neonatal seizures include abnormal delivery history, birth asphyxia, and electrolyte imbalance, etc. However, they remain obscure in about 20% of cases. More than 50 percent showed abnormal lesions on neuroimaging studies such as brain hemorrhage, periventricular leukomalacia, brain infarction, cortical dysplasia, hydrocephalus, etc. and 17 out of 32 patients showed abnormal electroencephalographic patterns. Phenobarbital was tried as a first line antiepileptic drug and phenytoin was added if it failed to control seizures. The treatments were terminated in the majority of patients during the hospital stay. The overall prognosis was relatively good except for those with abnormal EEG background or congenital central nervous system malformations. CONCLUSIONS: Neonatal seizures may permanently disrupt brain development. Better understanding of their clinical profiles and appropriate management may lead to a reduction in neurological disability in later childhood.
Adult ; Asphyxia ; Brain ; Brain Infarction ; Central Nervous System ; Child ; Electroencephalography ; Humans ; Hydrocephalus ; Infant, Newborn ; Intracranial Hemorrhages ; Length of Stay ; Leukomalacia, Periventricular ; Malformations of Cortical Development ; Neuroimaging ; Neurologic Examination ; Phenobarbital ; Phenytoin ; Prognosis* ; Reproductive History ; Risk Factors ; Seizures*

Illustrations in almost all textbooks and atlases of anatomy normally show that the zygomatic arch (ZA) and coronoid process (CP) of the mandible overlap vertically. Their topographic relationship is important for plastic surgeons in various situations, such as restorations of ZA fractures. The present study investigated the topographic relationship between the ZA and CP of the mandible in three-dimensional models of Korean human cadavers. The topographic relationship was classified into three types: overlapped, tangential, and separate. The overlapped type was the most common, but the three types showed similar incidences in three-dimensional models. There were no lateral or sex differences according to the three types. The incidence of both sides showing the same type was 70.1%. In conclusion, the predominance of illustrations in almost all textbooks and atlases showing the overlapped type is misleading, since the other two types - where the CP of the mandible does not overlap the ZA - are almost as common.
Cadaver ; Humans ; Incidence ; Mandible ; Sex Characteristics ; Zygoma

PURPOSE: The purpose of this study was to assess the clinical outcomes of hypofractionated radiotherapy (HFRT) with three-dimensional conformal technique for medically inoperable patients with early stage non-small-cell lung cancer (NSCLC) and to evaluate prognostic factors. MATERIALS AND METHODS: We performed a retrospective review of 26 patients who underwent HFRT for early stage NSCLC between September 2005 and August 2011. Only clinical stage T1-3N0 was included. The median RT dose was 70 Gy (range, 60 to 72 Gy) and the median biologically equivalent dose (BED) was 94.5 Gy (range, 78.0 to 100.8 Gy). In 84.6% of patients, 4 Gy per fraction was used. Neoadjuvant chemotherapy with paclitaxel and cisplatin was given to 2 of 26 patients. RESULTS: The median follow-up time for surviving patients was 21 months (range, 13 to 49 months). The overall response rate was 53.9%, and the initial local control rate was 100%. The median survival duration was 27.8 months. Rates of 2-year overall survival, progression-free survival (PFS), local control (LC), and locoregional-free survival (LRFS) were 54.3%, 61.1%, 74.6%, and 61.9%, respectively. Multivariate analysis showed that BED (>90 vs. < or =90 Gy) was an independent prognostic factor influencing PFS, LC, and LRFS. Severe toxicities over grade 3 were not observed. CONCLUSION: Radical HFRT can yield satisfactory disease control with acceptable rates of toxicities in medically inoperable patients with early stage NSCLC. HFRT is a viable alternative for clinics and patients ineligible for stereotactic ablative radiotherapy. BED over 90 Gy and 4 Gy per fraction might be appropriate for HFRT.
Cisplatin ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Multivariate Analysis ; Paclitaxel ; Radiotherapy, Conformal ; Retrospective Studies

The Peutz-Jeghers syndrome has three cardinal features: gastrointestinal polypasis, mucocutaneous piginentation and autosomal dominant heredity. This syndrome is ciinically important because of the complication caused by the gastrointestinal ployp, leading to abdominal pain, gastrointestinal bleeding and intussusception. We experienced a case of Peutz-Jeghers syndrome who complained of dizziness, vague abdominal pain, melanin pigmentations of the lips, oral mucosa and digits and reported with the review of the literature.
Abdominal Pain ; Anemia* ; Dizziness ; Hemorrhage ; Heredity ; Intussusception* ; Lip ; Melanins ; Mouth Mucosa ; Peutz-Jeghers Syndrome ; Pigmentation