A Case of Parry-Romberg Syndrome in Neonate

Parry-Romberg syndrome(Progressive hemifacial atrophy), described in the last century by Parry(1825) and Romberg(1846), is a very rare disorder characterized by a slowly progressive and self-limited unilateral(rarely bilateral) atrophy of the faces affecting variably the skin, subcutaneous fat tissues, musculature, connective tissue, cartilage and bones. And this disorder is usually accompanied by contralateral Jacksonian epilepsy, trigerminal neuralgia, and changes in the eyes and hair. The onset is slow and progressive, starting at 5-15 years of age and lasting from 2-10 years, ending with the face being "burned out". There are a few cases of this disease which presented during the neonatal period. This disorder seems to affect females more than males, and its etiology and incidence has yet to be determined. Trauma, infection with a slow virus, sympathetic dysfunction, immunological abnormality and cranial vascular malformation are proposed causes. No typical or consistent neuropathologic findings occur. No specific treatment for the syndrome exists; however, various reconstructive surgical procedures can have in reasonably good cosmetic effects, as well as antiinflammatory or immunosuppressive treatment. We report a case of Parry-Romberg syndrome, which was presented at 1 month of age, and has progressd to contralateral hemiparesis.

A Case of Gastric Carcinoma Spread to the Duodenum / 대한소화기내시경학회지

In 1861 Rokitanski laid down the law that the pyloric ring served as a barrier to the duodenal spread of gastric cancer. Although this theory was generally accepted, direct spread of gastric carcinoma into the duodenum has been reported. We report a case of gastric cancer spreading into the duodenum that was diagnosed by endoscopic duodenal biopsy and review the literature.

Nodular Hepatocellular Carcinoma: Contrast Enhancement Patterns on Three-Phase Spiral CT

PURPOSE: To evaluate contrast enhancement patterns of nodular hepatocellular carcinomas (HCCs) on three-phasespiral CT. MATERIALS AND METHOD: A retrospective analysis of contrast enhancement patterns was performed in 48 patients with HCC. Three-phase dynamic CT images of hepatic arterial dominant phase, portal dominant phase, and delayed phase were obtained at 30, 65, and 360 seconds after the initiation of injection of contrast material, respectively. Iodized-oil CT was performed two weeks after angiography and infusion of iodized-oil. Masses were divided into three groups, according to size ; 1-20 mm (n=34), 21-40 mm (n=26), and over 40 mm (n=19). Contrast enhancement patterns of tumors compared with attenuation of surrounding liver parenchyma, were cheracterized asone of four types, as follows : high, iso, low, and mixed attenuation. RESULTS: Seventy-three of 79 HCC nodules detected on iodized-oil CT (92%) were detected on three-phase spiral CT. In the 1-20 mm group, masses showed high-attenuation in the arterial dominant phase(19/34, 55.9%), and iso-attenuation in the portal dominant phase(16/34, 47.1%) and delayed phase(18/34, 52.9%). In the 21-40mm group, masses showed high-attenuation in the arterial dominant phase(21/26, 80.8%), low-attenuation in the portal dominant phase(13/26, 50%) and delayed phase(21/26, 80.8%). In the over 40 mm group, the masses showed mixed-attenuation in the arterial dominantphase(9/19, 47.4 %), low-attenuation in the portal dominant phase(12/19, 63.2%), and delayed phase(16/19, 84.2%).The most common enhancement pattern was high(arterial dominant)-iso(portal dominant)-iso(delayed) in the 1-20 mmgroup (8/34, 23.5 %), high-low-low in the group 21-40mm (8/26, 30.8%), and mixed-low-low in the over 40mm group(5/19, 26.3%). CONCLUSION: Hepatocellular carcinomas showed variable enhancing patterns according to the size ofthe tumor on three-phase spiral CT. Understanding these enhancing characteristics of HCCs on three-phase spiral CT may be helpful in their diagnosis.