Ultrasonographic Findings of Aspergillus Bursitis in a Patient with a Renal Transplantation: A Case Report

Aspergillus bursitis is an uncommon condition demonstrated as a nonspecific soft tissue mass. To our knowledge, the ultrasonographic findings of aspergillus bursitis in immunocompromised patients have not been previously reported. Here, we report a case of aspergillus bursitis in a renal transplant recipient, accompanied by the associated ultrasonographic findings.

A Primary Leiomyoma in the Neural Foramen of the Lumbar Spine: A Case Report

A primary leiomyoma in the neural foramen of the lumbar spine is a very rare condition. We examined a 23-year-old female presented with back and right flank pain. A plain radiography showed a well-defined, osteolytic lesion in the L3 body. In addition, MR images showed a mass lesion with intense enhancement, after intravenous injection with contrast material, in the right neural foramen at the L2/3 level. A histopathologic examination of the resected specimen revealed a benign leiomyoma.

Localized Polyarteritis Nodosa of the Breast with Mammary Duct Ectasia: A Case Report / 한국유방암학회지

We describe here a case of localized polyarteritis nodosa that involved the unilateral breast in a 69-yr-old woman. She presented with a tender breast mass and had suffered for two months. On physical examination, an ill-defined 2 cm sized, firm mass was palpated. Ultrasonographic examination revealed a mass like lesion that contained microcalcifications. The mass was excised because of the suspicion of carcinoma. The histologic findings were vasculitis involving medium and small sized-arteries that showed marked neutrophilic and lymphocytic infiltrations with intimal fibroplasias and fragmentation of the internal elastic lamina. The patient progressed well after surgical excision. The discussion includes the importance of differential diagnosis between localized polyarteritis nodosa and other vasculitis, and review of previously reported cases of vasculitis of the breast. Only 13 cases of polyarteritis nodosa of the breast have been reported and this is the first case of polyarteritis nodosa with mammary duct ectasia.

Usefulness of a Pharmacokinetic Model Based on Dynamic Contrast-enhanced MRI for the Detection and Localization of Prostate Cancer

PURPOSE: To investigate the usefulness of a pharmacokinetic model based on dynamic contrast-enhanced (DCE) MR imaging for the detection and localization of prostate cancer. MATERIALS AND METHODS: Forty-four patients that had undergone radical prostatectomy for prostate cancer and dynamic contrast enhanced (DCE) MR imaging (slice thickness, 4 mm; time resolution of each set, 5 seconds), were enrolled in the study. From the pharmacokinetic model, the time of arrival, and the parameters Ah, Kep, and Kel were extracted and were compared for cancerous tissue and non-cancerous tissue in the central gland and peripheral zone. The diagnostic performance of each parameter for differentiating cancerous tissue from non-cancerous tissue was evaluated using receiver-operating-characteristics analysis. RESULTS: The Kep and Kel values were significantly greater in cancerous tissue (0.13 sec(-1) +/- 0.14 and 1.59 x 10(-3) sec(-1) +/- 1.35 x 10(-3)) than in non-cancerous tissue from the central gland (0.03 sec(-1) +/- 0.02 and 0.26 x 10(-3) sec(-1) +/- 1.24 x 10(-3)) and peripheral zone (0.04 sec(-1) +/- 0.07 and 0.58 x 10(-3) sec(-1) +/- 1.98 x10(-3)) (p < 0.05). The area under the ROC curve for differentiating cancerous from non-cancerous tissue was 0.850 (95% CI, 0.778-0.876) for Kep and 0.814 (95% CI, 0.737-0.876) for Kel. CONCLUSION: Kep and Kel are useful perfusion parameters for the differentiation of prostate cancerous tissue from non-cancerous tissue.

US Guided Fine-needle Non-suction Technique: A Useful and Comfortable Method for Thyroid Nodule

as useful as the conventional suction technique for the cytopathological evaluation of thyroid nodules.

MR Imaging of Solitary Fibrous Tumors in the Head and Neck

OBJECTIVE: Solitary fibrous tumor (SFT) is a very rare tumor. The purpose of this study is to determine the MR imaging features of SFT in the intracranial and extracranial head and neck regions. MATERIALS AND METHODS: We retrospectively reviewed six MR images and two CT images of six histologically proven cases of SFT that occurred in four men and two women, and their ages ranged from 46 to 59 years. These imaging findings were correlated with the microscopic findings of their surgical specimens. RESULTS: Six SFTs arose in the meninges (the petrous ridge and the pituitary fossa), the parotid gland, the parapharyngeal space, the buccal space and the maxillary sinus. On the MR images, SFTs in the intracranial and extracranial head and neck regions were mostly isointense to the muscle on the T1-weighted images, they were hyperintense on the T2-weighted images and they all had intense enhancement. On the T1- and T2-weighted images, hypointense lines were observed within in five SFTs. On the CT images, the SFTs were hypodense to the muscle on the unenhanced images and they were heterogeneously enhanced on the contrast-enhanced images. An exceptional case of pituitary SFT was hypointense on the T2-weighted images and it was hyperdense on the unenhanced CT images, which correlated with the increased collagenous component and the cellular compactness. CONCLUSION: The imaging features of SFT are nonspecific; however, SFT should be included in the differential diagnosis of masses involving the intracranial and extracranial head and neck regions.

A Less Intensive Combination of Paclitaxel and Carboplatin in Advanced Non-small Cell Lung Cancer Patients who Have Aged 60 Years or More and Has a Poor Performance Status

BACKGROUND: The aim of this study was to evaluate the response, survival, and toxicities of a less intensive combination of paclitaxel and carboplatin, which is used in advanced non-small cell lung cancer (NSCLC) patients older than 60 years of age including those with a poor performance status. METHODS: Thirty patients received 135 mg/m2 of paclitaxel on day 1, and carboplatin was administered to the patients on day 1 every 4 weeks over an area under the concentration-time curve of 6. RESULTS: The response rate was 40%, the median overall survival was 9.1 months (95% CI, 4.2 to 14 months), and the 1 year survival rate was 31%. The median progression-free survival was 7.7 months (95% CI, 3.1 to 12.2 months). In addition, the toxicities were generally mild and reversible. CONCLUSION: This study demonstrates that a less intensive combination of paclitaxel/carboplatin is active and well tolerated in advanced NSCLC patients who are older than 60 years including those with a poor PS 3~4.

MRI Findings of Intracranial Neurenteric Cyst: Cast Report

Neurenteric cyst is very rare congenital disease and usually presents symptoms in adulthood. It can cause major neurological deficits if detection and treatment are delayed. It is also known to be a source of serious infection of the central nervous system. Neurenteric cyst is usually located in the ventral aspect of the lower cervical or upper thoracic spinal cord. Intracranial neurenteric cyst is very uncommon and less than 35 cases have been reported in the literature. We report MRI findings of two cases of intracranial neurenteric cyst and review the literature.

Evaluation by Contrast-Enhanced MR Imaging of the Lateral Border Zone in Reperfused Myocardial Infarction in a Cat Model

OBJECTIVE: To identify and evaluate the lateral border zone by comparing the size and distribution of the abnormal signal area demonstrated by MR imaging with the infarct area revealed by pathological examination in a reperfused myocardial infarction cat model. MATERIALS AND METHODS: In eight cats, the left anterior descending coronary artery was occluded for 90 minutes, and this was followed by 90 minutes of reper-fusion. ECG-triggered breath-hold turbo spin-echo T2-weighted MR images were initially obtained along the short axis of the heart before the administration of contrast media. After the injection of Gadomer-17 and Gadophrin-2, contrast-enhanced T1-weighted MR images were obtained for three hours. The size of the abnormal signal area seen on each image was compared with that of the infarct area after TTC staining. To assess ultrastructural changes in the myocardium at the infarct area, lateral border zone and normal myocardium, electron microscopic examination was performed. RESULTS: The high signal area seen on T2-weighted images and the enhanced area seen on Gadomer-17-enhanced T1WI were larger than the enhanced area on Gadophrin-2-enhanced T1WI and the infarct area revealed by TTC staining; the difference was expressed as a percentage of the size of the total left ventricle mass (T2= 39.2 %; Gadomer-17 =37.25 % vs Gadophrin-2 = 29.6 %; TTC staining = 28.2 %; p < 0.05). The ultrastructural changes seen at the lateral border zone were compatible with reversible myocardial damage. CONCLUSION: In a reperfused myocardial infarction cat model, the presence and size of the lateral border zone can be determined by means of Gadomer-17- and Gadophrin-2-enhanced MR imaging.

Gangliocytoma Mimicking Extra-axial Tumor: A Report of Two Cases

We report two cases of supratentorial gangliocytomas mimicking an extra-axial tumor. MR imaging indicated that the tumors were extra-axial, and meningiomas were thus initially diagnosed. Relative to gray matter, the tumors were hypointense on T1-weighted images and hyperintense on T2-weighted images. On contrast-enhanced T1-weighted images, homogeneous enhancement was observed, while CT scanning revealed calcification in one of the two cases.

Outcome Evaluation of Intra-arterial Infusion of Urokinase for Acute Ischemic Stroke

Pupose:To evaluate the results of intra-arterial urokinase thrombolysis in cases of acute ischemic stroke and to define the factors affecting prognosis. MATERIALS AND METHODS:Forty-eight patients with angiographically proven occlusion of the intracranial arteries were treated with local intra-arterial infusion of urokinase within six hours of the onset of symptoms. Neurologic status was evaluated on admis-sion and on discharge using the NIH(National Institute of Health) stroke scale score (SSS). When the SSS decreased by at least four points, this was considered indicative of an improved clinical outcome. RESULTS: Complete recanalization was achieved in 17/48 patients (35%), including 8 of 13 (62%) with occlusion of the vertebrobasilar artery (VBA), 9 of 20 (45%) with occlu-sion of the middle cerebral artery (MCA), and none of 15 with occlusion of the internal carotid artery (ICA). Neurologic status improved in 12 (60%) of patients with MCA oc-clusion, in five (38%) of those with VBA occlusion and in three (20%) of those with ICA occlusion (P<0.05). Patients in whom occluded MCA was completely recanalized showed greater clinical improvement than those with partial or no recanalization (P<0.05). The overall mortality rate was 21%, 43% (9/21) in patients in whom CT revealed signs of early infarct, but only 4% (1/27) in those without this sign (P<0.05). The mortality rate of patients with parenchymal hematoma (4/5) was higher than that of those with hemorrhagic infarct (3/9) or without hemorrhage (3/34) (P<0.05). CONCLUSION: In patients in whom occluded MCA was completely recanalized, the clinical outcome was better, while patients with VBA occlusion did not benefit from re-canalization. The presence on CT scans of signs of early infarct and of parenchymal hematoma after thrombolysis correlated with a high mortality rate.