No abstract available.
Down Syndrome*

No abstract available.

BACKGROUND: The aim of this study was to determine the prognostic value and optimal sampling time of serum S-100B protein for the prediction of poor neurological outcomes in post-cardiac arrest (CA) patients treated with therapeutic hypothermia (TH). METHODS: We prospectively measured serum S100 calcium binding protein beta subunit (S-100B protein) levels 12 times (0-96 hours) after the return of spontaneous circulation (ROSC). The patients were classified into two groups based on cerebral performance category (CPC): the good neurological outcome group (CPC 1-2 at 6 months) and the poor neurological outcome group (CPC 3-5). We compared serial changes and serum S-100B protein levels at each time point between the two groups and performed receiver operating characteristic curve analysis for the prediction of poor neurological outcomes. RESULTS: A total of 40 patients were enrolled in the study. S-100B protein levels peaked at ROSC (0 hour), decreased rapidly to 6 hours and maintained a similar level thereafter. Serum S-100B protein levels in the poor CPC group (n = 22) were significantly higher than in the good CPC group (n = 18) at all time points after ROSC except at 4 hours. The time points with highest area under curve were 24 (0.829) and 36 (0.837) hours. The cut-off value, the sensitivity (24/36 hours) and specificity (24/36 hours) for the prediction of poor CPC at 24 and 48 hours were 0.221/0.249 ug/L, 75/65% and 82.4/94.1%, respectively. CONCLUSIONS: Serum S-100B protein was an early and useful marker for the prediction of poor neurological outcomes in post-CA patients treated with TH and the optimal sampling times were 24 and 36 hours after ROSC.
Area Under Curve ; Heart Arrest* ; Humans ; Hypothermia* ; Prospective Studies ; ROC Curve ; S100 Calcium Binding Protein beta Subunit* ; Sensitivity and Specificity

PURPOSE: To give a help in the interpretation of cardiac cine-MR examination, the extent, shape, and timing of appearance of signal void regions near atrioventricular(A-V) valve prospectively evaluated in the healthy population. MATERIALS AND METHODS: Using an axial gradient-echo technique with small flip angle, repetition time(TR) of 36 msec and echo time(TE) of 22 msec, 20 volunteers without known valvular abnormalities undertook cardiac cine-MR imaging including atrioventricualr valve areas. RESULTS: Transient signal void was observed within the atrium near the tricuspid(13/20 = 65%) and mitral valves(9/20 = 45%), respectively, which is so called "physiologic atrioventricular valvular insufficiency". Eight subjects revealed the signal void areas near both tricuspid and mitral valves but, 5 subjects didnot show any evidences of physiologic insufficiency. This physiologic condition does not extend more than lcm proximal to A-V valve plane and is generally observed only during early systole. Its morphology is semilunar or triangular configuration with the base to the valve plane in most cases of normal tricuspid insufficiency and small globular appearance in most cases of normal mitral insufficiency. CONCLUSION: Awareness of normal signal void areas near the A-V valve and their characteristics is critical in the interpretation of cardiac cine MR examinations and maybe helpfal in the study of the normal cardiac physiology.
Magnetic Resonance Imaging* ; Mitral Valve ; Mitral Valve Insufficiency ; Physiology ; Prospective Studies ; Systole ; Volunteers

PURPOSE: MR is the most useful imaging method in evaluating the anatomic changes of the optic chiasm (OC). The purpose of this study is to investigate the relationship between the OC displacement and visual manifestations. MATERIALS AND METHODS: We retrospectively reviewed 44 patients who showed displacement of OC on brain MR. The pattern of OC displacement was classified into 3 groups according to following criteria: group A included the patients with OC displacement only due to empty sella;group B represented the patients with OC displacement by a lesion and the border between the lesion and OC was distinct;and group C was the patients with OC displacement by a lesion and had a indistinct border or thinning of the OC. RESULTS: Visual symptoms and signs were noted in 12 patients and the most common sign was bitemporal hemianopsia. In group A(7 patients), the visual symptoms and signs were seen in only one patient(14%), in whom contracted visual fields persisted since previous pituitary apoplexy had developed. In group B(30 patients), the visual symptoms and signs were seen in 4 patients(13%) who had tumorous conditions except one case of cysticercosis. In group C(7 patients), the visual symptoms and signs were seen in all patients (100%). CONCLUSION: The more OC is compressed, the more the prevalence of visual symptoms and signs increases. However, there was no correlation between the occurrence of visual symptoms and the presence of OC displacement only without compression.
Brain ; Cysticercosis ; Hemianopsia ; Humans ; Optic Chiasm* ; Pituitary Apoplexy ; Prevalence ; Retrospective Studies ; Visual Fields

A case of carotico-cavernous fistula was managed by intravascular occlusion using a Fogarty catheter and ligation of the carotid artery. The fistula was obliterated by the procedure and neurologic deficits improved progressively without further recurrence. The radiological feature, symptomatology and surgical management were discussed.
Carotid Arteries ; Catheters ; Fistula* ; Ligation ; Neurologic Manifestations ; Recurrence

BACKGROUND AND OBJECTIVES: Incidences of postoperative mucoceles of the frontal, ethmoid, or sphenoid sinuses are currently on the rise. The clinical rogression of the postoperative mucoceles in the frontal, ethmoid, or sphenoid sinuses are different from that of the maxillary mucoceles. In this study, we investigated the clinical patterns and treatments of postoperative mucoceles, which have developed in the frontal, ethmoid, or sphenoid sinuses. MATERIALS AND METHODS: Between June,1994 and August, 2005, twenty-six patients with thirty postoperative mucoceles were treated surgically. They had a previous history of operation and incidences of maxillary mucoceles were excluded from the study. A review of the clinical subjects were performed using their clinical records and radiological findings. RESULTS: The locations of the postoperative mucoceles were, in the order of frequency, the ethmoid, frontal, fronto-ethmoid, spheno- ethmoid, sphenoid, and fronto-ethmoidsphenoid sinus. Postoperative mucoceles occurs mostly in the form of ophthalmic symptoms and headache. The ophthalmic manifestations were different between the anterior, posterior and the antero-posterior mucocele group. The mean duration until diagnosed as postoperative mucocele since the previous sinus surgery was 9.9 years, and endoscopic sinus surgeries and intranasal ethmoidectomies with Caldwell-Luc operations were the majority among previous surgeries. Most postoperative mucoceles could be successfully treated with an endoscopic marsupialization. CONCLUSION: Frontal, ethmoid, or sphenoid postoperative mucoceles developed mostly on the ethmoid sinus and occurs mainly in the form of ophthalmic symptoms. Most postoperative mucoceles were successfully treated with an endoscopic marsupialization.
Ethmoid Sinus ; Headache ; Humans ; Incidence ; Mucocele* ; Paranasal Sinuses ; Sphenoid Sinus*

Intestinal intussusception is rare in adults. Intestinal intussusception is distinct from pediatric intussusception in that an identifiable leading lesion alters normal bowel peristalsis and forms the leading edge of the intussusceptum. The occurrence of lipomas is most common in the colon, followed by the small intestine, and then the stomach. Large lipomas may be associated with complications, such as intussusception or intestinal hemorrhage. In this case, a 77-year-old man was admitted to the hospital with a 10-day history of intermittent abdominal cramping. Computed tomography showed an intussusception of the transverse colon due to a primary mass with a dominant fatty density. The patient's obstructive symptoms resolved after colonoscopic reduction. Colonoscopy plays a useful role in the diagnosis and management of intussusception. The clinical, radiographic, and endoscopic findings are described herein with a brief review of the pertinent literature.
Adult ; Aged ; Colic ; Colon ; Colon, Transverse ; Colonoscopy ; Hemorrhage ; Humans ; Ileum ; Intestine, Small ; Intussusception ; Lipoma ; Peristalsis ; Stomach

Intestinal intussusception is rare in adults. Intestinal intussusception is distinct from pediatric intussusception in that an identifiable leading lesion alters normal bowel peristalsis and forms the leading edge of the intussusceptum. The occurrence of lipomas is most common in the colon, followed by the small intestine, and then the stomach. Large lipomas may be associated with complications, such as intussusception or intestinal hemorrhage. In this case, a 77-year-old man was admitted to the hospital with a 10-day history of intermittent abdominal cramping. Computed tomography showed an intussusception of the transverse colon due to a primary mass with a dominant fatty density. The patient's obstructive symptoms resolved after colonoscopic reduction. Colonoscopy plays a useful role in the diagnosis and management of intussusception. The clinical, radiographic, and endoscopic findings are described herein with a brief review of the pertinent literature.
Adult ; Aged ; Colic ; Colon ; Colon, Transverse ; Colonoscopy ; Hemorrhage ; Humans ; Ileum ; Intestine, Small ; Intussusception ; Lipoma ; Peristalsis ; Stomach

No abstract available.
Cartilage* ; Fascia* ; Transplants* ; Tympanoplasty*