Improvement of Fat Suppression and Artifact Reduction Using IDEAL Technique in Head and Neck MRI at 3T

PURPOSE: To quantitatively and qualitatively compare fat-suppressed MRI quality using iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) with that using frequency selective fat-suppression (FSFS) T2- and postcontrast T1-weighted fast spin-echo images of the head and neck at 3T. MATERIALS AND METHODS: The study was approved by our Institutional Review Board. Prospective MR image analysis was performed in 36 individuals at a single-center. Axial fat suppressed T2- and postcontrast T1-weighted images with IDEAL and FSFS were compared. Visual assessment was performed by two independent readers with respect to; 1) metallic artifacts around oral cavity, 2) susceptibility artifacts around upper airway, paranasal sinus, and head-neck junction, 3) homogeneity of fat suppression, 4) image sharpness, 5) tissue contrast of pathologies and lymph nodes. The signal-to-noise ratios (SNR) for each image sequence were assessed. RESULTS: Both IDEAL fat suppressed T2- and T1-weighted images significantly reduced artifacts around airway, paranasal sinus, and head-neck junction, and significantly improved homogeneous fat suppression in compared to those using FSFS (P < 0.05 for all). IDEAL significantly decreased artifacts around oral cavity on T2-weighted images (P < 0.05, respectively) and improved sharpness, lesion-to-tissue, and lymph node-to-tissue contrast on T1-weighted images (P < 0.05 for all). The mean SNRs were significantly improved on both T1- and T2-weighted IDEAL images (P < 0.05 for all). CONCLUSIONS: IDEAL technique improves image quality in the head and neck by reducing artifacts with homogeneous fat suppression, while maintaining a high SNR.

Meningovascular and Spinal form of Neurosyphilis Presenting as Multiple Cranial Nerve Palsy, Cerebral Infarction and Meningomyelitis in a Human Immunodeficiency Virus Negative-Patient: MR Imaging Features

Neurosyphilis is a rare infection of the brain and spinal cord caused by a spirochete named Treponema pallidum. We describe the magnetic resonance imaging of a 53-year-old man with syphilis who manifested as both meningovascular, and spinal meningomyelitic types, which involved the optic, trigeminal, facial and vestibulocochlear nerves, both middle and left posterior cerebral arteries, thoracic spinal cord and meninges of the lumbar spine. This case report suggests that neurosyphilis should be considered as a possible diagnosis in patients showing complex brain and spinal imaging features. These features include enhancing meningeal lesions with multiple cranial nerve involvement, stenoses in large to medium size cerebral arteries, and intramedullary and meningeal lesions of spine.

Brain Stem Hypoplasia Associated with Cri-du-Chat Syndrome

Cri-du-Chat syndrome, also called the 5p-syndrome, is a rare genetic abnormality, and only few cases have been reported on its brain MRI findings. We describe the magnetic resonance imaging findings of a 1-year-old girl with Cri-du-Chat syndrome who showed brain stem hypoplasia, particularly in the pons, with normal cerebellum and diffuse hypoplasia of the cerebral hemispheres. We suggest that Cri-du-Chat syndrome chould be suspected in children with brain stem hypoplasia, particularly for those with high-pitched cries.

Quantification of Cutaneous Mast Cell Using Image Analysis / 대한피부과학회지

BACKGROUND: The presence of mast cells often in increased numbers, has been noted in various cutaneous disorders. Recent studies suggest that mast cells are of primary importance in these conditions and their presence does not merely represent a second event. Previous reports of mast cell enumeration in normal and pathologic tissues have revealed inconsistent results, reflecting technical difficulties in quantitation. OBJECTIVE: The purpose of our study is to develop a new approach for quantifying mast cell in tissue section that is accurate, reproducible and avoids problems caused by the variation in distribution of these cells in the tissue. METHODS: Mast. cells were quantitated in eight cases of mastocytosis and in the flank and back skin of three normal human controls in toluidine blue stain using a computerized image analysis system. RESULTS: Macular and nodular mastocytosis patients had from twenty-fold to nearly a 100-fold greater mast cell content than was observed in normal skin. CONCLUSION: Image analysis in conjunction with toluidine blue stain offers a single and accurate method for mast cell quantification. This technique also provides a practical and important new diagnostic tool for establishing the presence of increased lesional skin mast cells in patients with mastocytosis.

A Case of Cutis Marmorata Telangiectatica Congenita

Cutis marmorata telangiectatica congenita(CMTC) is a rare congenital cutaneous vascular anomaly. The major skin findings are persistent, fixed cutis marmorata, telangiectasia, and phlebectasia. In approximately 50 % of patients, the disorder tends to be associated with various con-genital anomalies. We describe in this report a 4-month-old male infant with CMTC. The patient had red or violet marbled patches, telangiectases, and atrophy on the right arm present at birth. During the follow up period of 12 months, there was no change in the cutis marmorata pattern and telangiectases, whereas the atrophy has been less prominent than at the initial visit.

The Suppressive Effect of Evening Primrose Oil on Murine Contact Sensitivity

BACKGROUND: Evening primrose oil(EPO) is a rich source of cis-linoleic acid and gammalinolenic acid(GLA) and has been used as a therapeutic agent in various skin diseases such as atopic dermatitis. OBJECTIVE: The purpose of this study was to evaluate the suppressive effect of EPO on murine contact sensitivity. METHODS: BALB/c mice were divided into 3 groups, positive control, experimental and negative control groups: the positive control group represents a group of mice which were sensitized and challenged with DNFB, the experimental group represents EPO-pretreated positive control group and the negative control group represents a group of mice which were challenged only. The changes of ear thickness were measured, and H & E staining and immunohistochemical staining for ICAM-1 expression of ear skin were performed to evaluate the histological changes of each group. RESULTS: The Pretreatment of mice with EPO resulted in suppression of contact sensitivity by more than 82%. On H & E staining, only a mild inflammatory reaction was observed in the dermis. Also ICAM-1 expression of keratinocytes, the intensity of the staining was significantly decreased in the experimental group compared with positive group. CONCLUSIONS: Our study indicates that EPO was able to suppress the induction of contact sensitivity.

Five Cases of Agminated Lentigines / 대한피부과학회지

Agminated lentigines may be defind as a circumscribed grouping of small pigmented macules arranged in a small or large group, often in a segmental pattern, each macule consisting of a lentiginous epidermal proliferation of melanocytes. We report five cases of agminated lentigines in otherwise healthy persons. Histologic exarnination of the pigmented lesion revealed findings consistent with lentigo simplex.

The Clinical Features of Skin Tags and the Association Between Skin Tags and Colonic Polyps / 대한피부과학회지

BACKGROUND: Skin tags are benign fleshy or darker colored papillomatous dermal tumors locatei mostly in the neck, axill or groin. Recent reports on a possible association between skin tags and colonic polyps, however, caused interest in these henign tumors of the dermis, especially wite regarding to their frequercy. OBJECTIVE: The purpose rate this study was to explore the clinical profiles of skin tags, the effect of obesity on the frequeny of skin tags and the association between skin tags and obesity in the normal population. We also tried to evaluate the usefulness of skin tags as a general marker for the presence of colonic piyps. METHODS: The first, 524 unselected patients were examined. The patient material comprised of 240 males and 284 females. Each patient was inspected with regard to skin tags by a clermatolgist. 334 patients were classified into obese groups and nonobese groups and then we evaluated the relationship between skin tags and the degree of obesity. The second, ninety consecutive patients referred for coloniscopic evaluation were examined to determine the association between skin tags and colonic polps. RESULTS: We found 22.9% of the males and 22.5% of the females to be skin tag carriers in the general population. We also noticed a steady increase of the frequency according to age eccept for the third decads. Of the skin tags found 51% were in the axillar region, 40% around the neck and 8% in the inguinal region. In the study for the relationship between skin tags and obesity, 44.9% of the obise patients and 23% of the nonobese patients were skin tag carriers(relative risk=1.95, p<0.05). In the study for the association between skin tags and colonic polyps in patients undergoing colonoscopic examination, 18 of patients with skin tags(45%) hnd colonic polyps and 11 of patients without skin tags(22%) had colonic polyps(relative risk=2.05, p<0.05). CONCLUSION: This study identified an obese group that are at risk of the developing skin tags. Consideration of skin tags as a marker for colonic polyps is likely to prove helpful.

A Case of Basal Cell Epithelioma Arising in a Nevus Sebaceus during Childhood

The potential for sebaceous nevi to evolve into secondary benign or malignant EuIror is well recognized. In general, malignant transformation does not occur until postpubertal life. We experienced a case of basal cell epithelioma arising in a nevus sebaceous on a 12-year-old boy´s parietal scalp. We recommended that surgical excision should be undertaken as early as possible to detect the malignant transformation of nevus sebaceous.

A Case of Bowen' s Disease of the Nail Bed Presenting as Longitudinal Melanonychia / 대한피부과학회지

Bowens disease is an intraepithelial squamous cell carcinoma. It occur s anywhere on the surface of the body. Bowens disease involving the nail bed epithelium is very rate. Recently, some literatures showed that human papillomavirus is sssociated with squamous cell carcinoma of the finger by in situ hybridization or polymerase chain reaction. A 30-year-old housewife deve]oped longitudinal melanonychia with as imptomatic fissured nail plate on her right third finger. The hiat,ologic specimen showed diffuse anaplastic change confined to the nail bed epithelium. The subungual eyithelium was found to contain human papillomavirus DNA type 31/33/35 with the use of in situ hybridization.

A Clinical on Herpes Zoster in Inpatients During a 3 - Year - Period ( 1991 - 1993 ) / 대한피부과학회지

BACKGROUND: Data on the frequency of Herpes Zoster are sparse, especially in inpatients OBJECTIVE: The purpose of this study was to elucidate the epidemilogy and the clinical characteristics of herpes zoster in inpatients. METHODS: During a 3-year-Period from Jan. 1991 to Dec. 1991, 157patients with herpes zoster were evaluated in regard to annual, monthly and seasonal incidence age incidenee and sex ratio. Patients with herpes zoster were further assessed concerning associratel conditions, dermatomic distributions and complications. RESULTS: 1. The annual rate ranged from 2.6% to 3.3% (mean 2.8%) and the ratio of male to female was 0.85: 1. 2. There were no marked manthly of spasonal differences in herpsoster, ranging from 4.5% to 10.8% and 21.7% to 31.2%, respectively. 3. Herpes Zoster was seen most frequently in the 50-59 year age group(27.4%) 4. The dermatomic involvernent of herpes zoster was most freqer t of thoracic dermatome(51.6%) and others were trigeminal(19.1%), cervical(13.4%), lumbar(6.4%), sacral(5.7%), facial(1.9%) and generalized(1.9%). 5. The frequency of associated conditions in herpes zoster was in d scending order, hypertension, tuberculosis, diabetes mellitus, malignancy, SLE, gastric ulcer, chronic renal failiure, rheumatoid arthritis, idiopathic pulmonary fibrosis. 6. The most common complication of herpes zoster was postheret c neuralgia and others were ophathalmologic complications, secondary bacterial infection, keloicl, formation, generalized varicelliform eruption, recurrent herpes zoster. CONCLUSION: Herpes Zoster is a major problem in the Department of Dermatology, especially in inpatients.

A Clinical on Herpes Zoster in Inpatients During a 3 - Year - Period ( 1991 - 1993 ) / 대한피부과학회지

BACKGROUND: Data on the frequency of Herpes Zoster are sparse, especially in inpatients OBJECTIVE: The purpose of this study was to elucidate the epidemilogy and the clinical characteristics of herpes zoster in inpatients. METHODS: During a 3-year-Period from Jan. 1991 to Dec. 1991, 157patients with herpes zoster were evaluated in regard to annual, monthly and seasonal incidence age incidenee and sex ratio. Patients with herpes zoster were further assessed concerning associratel conditions, dermatomic distributions and complications. RESULTS: 1. The annual rate ranged from 2.6% to 3.3% (mean 2.8%) and the ratio of male to female was 0.85: 1. 2. There were no marked manthly of spasonal differences in herpsoster, ranging from 4.5% to 10.8% and 21.7% to 31.2%, respectively. 3. Herpes Zoster was seen most frequently in the 50-59 year age group(27.4%) 4. The dermatomic involvernent of herpes zoster was most freqer t of thoracic dermatome(51.6%) and others were trigeminal(19.1%), cervical(13.4%), lumbar(6.4%), sacral(5.7%), facial(1.9%) and generalized(1.9%). 5. The frequency of associated conditions in herpes zoster was in d scending order, hypertension, tuberculosis, diabetes mellitus, malignancy, SLE, gastric ulcer, chronic renal failiure, rheumatoid arthritis, idiopathic pulmonary fibrosis. 6. The most common complication of herpes zoster was postheret c neuralgia and others were ophathalmologic complications, secondary bacterial infection, keloicl, formation, generalized varicelliform eruption, recurrent herpes zoster. CONCLUSION: Herpes Zoster is a major problem in the Department of Dermatology, especially in inpatients.

A case of baboon synrome due to mercury smoke of an amulet / 대한피부과학회지

Baboon syndrome is used to denote a systemic allergic contact dermititis with a characteristic color and distribution pattern. It is also referred to as mercury exanthem, because inhalation of mercury vapor usually causes the skiri lesion in a sensitized person. Diffuse pi,ikish erythema of the buttock, upper inner thigh, and axilla are characteristic features. We report a case of baboon syndrome developed after exposure to the smoke of a burning amulete a charm written on a piece of paper in a 12 year-old female. Mercury sensitivity was confirrned by a patch test. Atomic absorption by a spectrographic method and Scanning electron microscopy/energy dispersive for analysis X-ray detected mercury in the urine and the ed scraped pigments from the amulet, respectively.

Two case of perforating calcific elastosis / 대한피부과학회지

Perforating calcific elastosis, referred to as periumbilical perforating pseudoxanthoma elasticum that can occur in middle-aged, multiparous, obese women with a possible genetic predisposition to pseudoxanthoma elasticum. We report two cases which showed the clinical and histopathologic fundings of perforating calcific elastosis in a 77 year-old and; 69 year-old woman. Clinically, the losio is were well-demarcated, yellow to brownish hyperpigmentcd and verrucous plaques with discreted ratotic papules just above the umbilicus. Histopathologically, altered basophilic calcified elastic fiber were extruded through the hyperplastic epidermis to the surface of the skin and were present in the eticular dermis.

Three cases of pruritic urticarial papules and plaques of pregnancy / 대한피부과학회지

We roport herein three cases of pruritic urticarial papules and plaques of pregnancy in two primigravidas and one multigravida in erythematous papules and urticarial plaques on both thighs, buttock and upper extremites. In the second case, lesions initially developed on both thighs and then preaded on abdomen, back and exter ities. Abdomen, thighs and extremites were involved in the third case. Histopathologic findings revealed acanthosis orfocal spongiosis in epidermis and lymphocytic perivascular infiltration with or without eosinophilsn dermis. They were treated with systemiror topical steroids and, mtihistamines. Itching was relieved within a few days after therapy and skin lesions resolved spontaneously after delivery.