Multiple Arteriovenous Hemangiomas in a Patient with Chronic Liver Disease

No abstract available.

Erythema Annulare Centrifugum: Analysis of Associated Diseases and Clinical Outcomes according to Histopathologic Classification

No abstract available.

Erythema Annulare Centrifugum: Analysis of Associated Diseases and Clinical Outcomes according to Histopathologic Classification

No abstract available.

A Rare Case of Multiple Spindle Cell Lipomas

No abstract available.

Development of Renal Disorder in a Patient Receiving Infliximab (Remicade(R)) for Psoriasis / 대한피부과학회지

Infliximab (Remicade(R)) has been used for treating many chronic inflammatory diseases, including rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, and psoriasis. Complications such as infusion reaction and infection in infliximab therapy have been reported, but renal complications are rare. We present data on a patient with psoriasis for 15 years who developed new onset renal disorders (IgA nephropathy, acute tubulointerstitial nephritis, acute tubular necrosis) after treatment with infliximab (duration of therapy: 12 months, 8 times). Because the patient with psoriasis receiving infliximab may develop new onset renal disorders, we recommend the evaluation of renal function.

A Giant Pendulous Fibroma with Subepidermal Blister on the Areola / 대한피부과학회지

No abstract available.

Investigation of Water Safety in Non-treated Drinking Water with Trace Toxic Metals

The trace toxic metal copper was assayed using mercury immobilized on a carbon nanotube electrode (MCW), with a graphite counter and a reference electrode. In this study, a macro-scale convection motor was interfaced with a MCW three-electrode system, in which a handmade MCW was optimized using cyclic-and square-wave stripping voltammetry. An analytical electrolyte for tap water was used instead of an expensive acid or base ionic solution. Under these conditions, optimum parameters were 0.09 V amplitude, 40 Hz frequency, 0.01 V incremental potential, and a 60-s accumulation time. A diagnostic working curve was obtained from 50.0 to 350 microg/L. At a constant Cu(II) concentration of 10.0 microg/L, the statistical relative standard deviation was 1.78% (RSD, n = 15), the analytical accumulation time was only 60 s, and the analytical detection limit approached 4.6 microg/L (signal/noise = 3). The results were applied to non-treated drinking water. The content of the analyzed copper using 9.0 and 4.0 microg/L standards were 8.68 microg/L and 3.96 microg/L; statistical values R2 = 0.9987 and R2 = 0.9534, respectively. This method is applicable to biological diagnostics or food surveys.

Development of Novalis Quality Assurance Protocol for Radiosurgery / 의학물리

In Republic of Korea, there are many Quality Assurance protocol for general radiation treatment machine such as linac. However, Quality Assurance protocol for radiosurgery treatment system is not ready perfectly. One of the radiation treatment machine for radiosurgery, novalis system needs to suitable Quality Assurance protocol for using it right way during radiation treatment and maintaining suitable accuracy for daily, weekly, monthly and annually periods. Therefore, in this article, we develop Quality Assurance protocol for novalis system. We collected and analysed domestic and foreign novalis Quality Assurance protocol. After that, we selected essential QA items and each tolerance range for developing proper QA protocol, and we made anatomical phantom for execution of selected QA items and evaluation of overall state of QA, and then, we use this measured value as a reference. Quality Assurance items are consisted of Mechanical accuracy QA part and Radiation delivery QA part. Mechanical accuracy QA part is comprised of radiation generation machine part, assistive devices part and multi-leaf collimator part. Radiation delivery QA part is divided into radiation isocenter accuracy and dosimetric evaluation. After that, developed novalis QA tables are made by using these QA items. These novalis QA tables would be used to good standard in order to maintain apt accuracy for radiosurgery in daily, weekly, monthly and annually periods.

The Differences in Results of Short Wavelength Automated Perimetry According to Lens Opacities

PURPOSE: Perimetric examination plays an important role in the diagnosis of glaucoma, which is among the leading causes of blindness worldwide. Several examination methods have been developed for early detection of glaucoma. Among those, short-wavelength automated perimetry (SWAP) is the most widely investigated. In this study, the effects of nuclear opacities on SWAP were examined. METHODS: Lens opacities were divided into cortical and nuclear opacity groups ; each group consisted of fifteen eyes. The eyes studied underwent standard white-on-white perimetry and SWAP exams before and after cataract operation. The differences in the results of the examinations were compared between the two opacity groups. The t test was used for comparing the data. RESULTS: In the cortical opacity group, the average difference between the mean deviation before and after the operation was 5.46dB in white-on-white perimetry and 5.02dB in SWAP. In the nuclear opacity group, the average difference between the mean deviation before and after the operation was 4.01dB in white-on-white perimetry and 10.82dB in SWAP. There was no statistically significant difference in the cortical opacity group (p=0.6575). However, there was a statistically significant difference in the nuclear opacity group (p<0.0001). CONCLUSIONS: In clinical situations, more caution should be taken when interpreting the SWAP results of nuclear cataract patients in order to make an accurate decision.

The Correlations Between Landmark of Inferior Oblique Muscle Recession and Adjacent Globe Structures

PURPOSE: This study aimed to find out whether there are relationships among anatomic characteristics of inferior oblique muscle insertion, corneal diameter, axial length and inferior oblique recession landmark. METHODS: Thirty-one Korean cadaver orbits were dissected to expose the full length of extraocular muscles and sclera, and then we measured the length from the recession landmark of inferior oblique to the lateral edge of insertion of inferior rectus and to the inferior edge of insertion of lateral rectus. RESULTS: The mean of angles between the inferior oblique muscle insertion and lateral rectus direction is 27.9+/-9.0degrees and the range is from 15 degrees to 50 degrees . There is a statistically significant correlation between cord length of 8 mm recession landmark of inferior oblique and angles of inferior oblique insertion with lateral rectus direction. We divided the shapes of inferior oblique insertion into straight and convexed curves. Twelve insertions are straight and thirteen insertions are curved. There is no statistically significant correlation between shape of inferior oblique insertion and cord length from recession landmark. In corneal diameter and axial length, we found correlations with cord length of 8 mm and 10 mm recession landmark of inferior oblique. CONCLUSIONS: We conclud that there are some correlations among anatomic characteristics, axial length and corneal diameter with recession landmark of inferior oblique.

Postoperative Refractive Error in Combined Operation of Vitrectomy and Intraocular Lens Implantation

PURPOSE: To compare the actual and expected refractive errors of intraocular lens (IOL) implantation with vitrectomy in various conditions. METHODS: One hundred sixty-five eyes were divided into five groups: Group 1 had cataract extarction and IOL implantation only, Group 2 had cataract extraction and IOL implantion after vitrectomy, Group 3 had cataract extraction and implantation of an IOL with vitrectomy, Group 4 had cataract extraction and IOL implantaion with vitectomy and scleral encircling, and Group 5 had cataract extraction and IOL implantaion with vitrectomy and intraocular gas injection. The actual and expected refractive errors of IOL implantation were compared. RESULTS: Mean myopic shift was 0.15 diopter for group 1, 0.22 diopter for group 2, 0.20 diopter for group 3, 1.40 diopter for group 4, 0.91 diopter for group 5. CONCLUSIONS: Vitrectomy alone has no influence on refractive error but when scleral encircling or intraocular gas injection were performed with vitectomy, there were statistically significant myopic shifts.

The Measurement of Size of Human Extraocular Muscles and their Changes in Thyroid Associated Ophthalmopathy in Korea

Enlargement of the extraocular muscles may cause diplopia and exophthalmos. The most common cause of the exophthalmos is thyroid associated ophthalmopathy(TAO), followed by inflammatory diseases and orbital tumors. TAO has the classical features of proptosis and lid retraction. However, the diagnosis is frequently confused with other eye diseases due to various symptoms and signs. Therefore, measurement of the size of extraocular muscles in both normal and TAO patients will make diagnosis and treatment plan easier in TAO and other muscular diseases of the orbit. For the clinical application, we measured the size of muscle with and without magnification and the results were compared. Normal mean values of cross sectional length and thickness of the extraocular muscles measured by CT scan showed 8.83x 3.60 in the inferior rectus, 9.20x3.20 in the superior muscle group, 9.45x 3.48 in the medial rectus and 9.65x3.23 mm in the lateral rectus muscle with no sex differences. All four muscles showed statistically significant enlargement in TAO and the thickness showed greater increase than the length. Superior muscle group(superior rectus and levator muscle)was the most frequently involved in TAO in both sexes. There was no significant statistical difference in the methods of measurement.

Adhesive Capsulitis of the Shoulder: MR Arthrography

PURPOSE: Adhesive capsulitis is a clinical syndrome involving pain and decreased joint motion caused by thickening and contraction of the joint capsule. The purpose of this study is to describe the MR arthrographic findings of this syndrome. MATERIALS AND METHODS: Twenty-nine sets of MR arthrographic images were included in the study. Fourteen patients had adhesive capsulitis diagnosed by physical examination and arthrography, and their MR arthrographic findings were compared with those of 15 subjects in the control group. The images were retrospectively reviewed with specific attention to the thickness of the joint capsule, volume of the axillary pouch (length, width, height(depth)), thickness of the coracohumeral ligament, presence of extra-articular contrast extravasation, and contrast filling of the subcoracoid bursa. RESULTS: Mean capsular thickness measured at the inferior portion of the axillary pouch was 4.1 mm in patients with adhesive capsulitis and 1.5 mm in the control group. The mean width of the axillary pouch was 2.5 mm in patients and 9.5 mm in controls. In patients, the capsule was significantly thicker and the axillary pouch significantly narrower than in controls (p<0.05). Capsule thickness greater than 2.5 mm at the inferior portion of the axillary pouch (sensitivity 93%, specificity 80%) and a pouch narrower than 3.5 mm (sensitivity 93%, specificity 100%) were useful criteria for the diagnosis of adhesive capsulitis. In patients with this condition, extra-articular contrast extravasation was noted in six patients (43%) and contrast filling of the subcoracoid bursa in three (21%). CONCLUSION: The MR arthrographic findings of adhesive capsulitis are capsular thickening, a low-volume axillary pouch, extra-articular contrast extravasation, and contrast filling of the subcoracoid bursa. Capsule thickness greater than 2.5 mm at the inferior portion of the axillary pouch and a pouch width of less than 3.5 mm are useful diagnostic imaging characteristics.

CT Findings of Diffuse Pneumocephalus due to Bacterial Meningitis: A Case Report

We report a case of diffuse pneumocephalus due to infection. Brain CT revealed diffuse brain swelling and diffuse pneumocephalus in the ventricular system, subarachnoid space, subdural/epidural space and superior sagittal sinus. CSF disclosed the presence of a yellowish-green pus-like liquid. Polymerase chain reaction was positive for Haemophilus influenza Ag.

Sono-Guided Ethanol Sclerotherapy for Benign Thyroid Csts: Results in 22 Cases

PURPOSE: To evaluate the efficacy and safety of sono-guided ethanol sclerotherapy for benign thyroid cysts. MATERIALS AND METHODS: We studied 22 patients with benign thyroid cysts (9 pure and 13 complex) confirmed by fineneedle aspiration biopsy. The procedure was performed every one or three months for a total of one or twosessions(mean 1.2 times). Sono-guided needle aspiration of the cysts was followed by instillation of absoluteethanol(99.9%) into the cystic cavity ; the injected volume of ethanol was 40-100% that of aspirated fluid.Follow-up ultrasonography was performed one to ten months( mean: 3.5 months) after the final session, andcomplications occurring after ethanol sclerotherapy were observed. RESULTS: Initial cystic volume was3.5-42(mean: 13)ml. In 21 patients( 95%), cystic volume had decreased: In 13 patients(59%), the decrcase was 50%or more, and in six (27%) was 1-49%. In two patients(9%), the cysts had been obliterated, but in one there was nochange. The volume of instilled ethanol correlated significantly with the volume reduction rate of the cyst (p<0.01, t test). After ethanol sclerotherapy, the volume of thyroid cysts larger than 10ml had significantlydecreased compared to that of thyroid cysts with a volume less than 10 ml(p< 0.005, t test). Importantlongstanding and severe complications were not observed ; in two patients, a small amount of leakage insubcutaneous tissue caused local pain and redness. CONCLUSION: Sono-guided ethanol sclerotherapy is a safe andeffective tool for the treatment of benign thyroid cysts.

Intracranial Inflammatory Pseudotumors: MRI and CT Findings

PURPOSE: The purpose of this study was to describe the MR imaging and CT findings of intracranial inflammatory pseudotumors. MATERIALS AND METHODS: We reviewed the MR imaging (n=8) and CT (n=4) studies of eight patients (M:F = 4:4, mean age: 41 years) with pathologically proven intracranial inflammatory pseudotumor. The findings were then evaluated with regard to location, shape, MR signal intensity, CT density and degree of contrast enhancement of the lesion, surrounding parenchymal edema, adjacent bone change and the location of accompanying extracranial lesion. RESULTS: In two patients, the parietal convexity was involved unilaterally, with no extracranial mass, and in the other six, the middle cranial fossa was involved unilaterally and extracranial mass was present. The lesion also involved the tentorium in four cases, the cavernous sinus in four, the anterior cranial fossa in one, and the posterior cranial fossa in one. The location of extracranial mass was the mastoid and middle ear cavity in two cases, the infratemporal fossa in two, both the infratemporal fossa and paranasal sinuses in one, and the orbit in one. MR images showed diffuse dural thickening in all eight cases, leptomeningeal thickening in four, and focal meningeal-based mass in two. As seen on T1-weighted images, the lesions were isointense to gray matter in eight cases, and on T2-weighted images were hypointense in seven cases and isointense in one. Marked homogeneous contrast enhancement was seen in all eight cases. The lesions seen on brain CT, performed in two cases, were isodense. Adjacent brain parenchymal edema and the destruction of adjacent bones were each seen in five cases. CONCLUSION: The characteristic MR findings of intracranial inflammatory pseudotumors are(1) diffuse dural thickening;(2) a focal meningeal-based mass which on T2-weighted images is seen as hypointense; and marked (3) contrast enhancement : these findings are, however, nonspecific. In order to differentiate these tumors, an awareness of these findings is, however, useful.

CT, MR and Angiographic Findings of Hemangiopericytomas

PURPOSE: Hemangiopericytoma(HP) exhibits its pathologic findings different from those of meningioma or oth-erangiomatous tumor; and its clinical behavior is unique and prognosis worse than other cases. We reviewed the CT,MR and angiographic findings of HPs and evaluated differential radiologic points of comparison be-tween typicalmeningiomas and meningeal HPs. MATERIALS AND METHODS: MR(n=16), CT(n=5) and angiographic imaging(n=10) wereperformed in 18 pa-tients(M:F=12:6, mean age:45 years) with histologically proven primary HPs. We evaluated theimaging find-ings of HPs with respect to site, shape, size, signal intensity, enhancement characteristics,vascular signal voids, calcification, bony and adjacent sinus involvement, and angiographic findings. RESULTS:HPs were meningeal in 14 cases and nonmeningeal in four. Meningeal HPs were located in the parasagittalregion(n=8), convexity(n=3), intradural extramedullary space(n=1), choroid plexus(n=1), and ol-factorygroove(n=1). Nonmeningeal HPs were located in the masticator space(n=2), paraspinal area(n=1) and supraclaviculararea(n=1). The mean maximal dimension of tumors was about 5.4cm and their shape was papillary(n=8) orlobulated(n=7). MR images showed high(n=13) or iso(n=3) signal intensities on T2WI, and heterogeneity onT2WI(n=9). Vascular signal voids in the mass were seen in all cases, while in two cases, CT scanning showednodular dense calcification. Bone destruction was present in six cases, but no hyperostosis was found. In fivecases, the superior sagittal sinus was involved. Angiographic images revealed highly vascu-lar masses supplied bythe internal carotid artery(n=5), external carotid artery(n=8), descending scapular artery(n=1) andradiculomedullary artery(n=1), with delayed tumor blush during the capillary and venous phase in which there wasno arteriovenous shunt. CONCLUSION: HP is one of the extra-axial tumors in which there is hypervascularity,aggressive bony destruc-tion arising in the meningeal and extrameningeal area, and heterogeneous high signalintensity, as seen on T2WI. Calcification is rare.

Prediction of Parent Artery of Anterior Communicating Artery Aneurysm on CT Angiography

PURPOSE: To determine whether CT angiography can predict the parent artery of an anterior communicating aneurysm on the basis of characteristics of the aneurysm and precommunicating anterior cerebral artery. MATERIALS AND METHODS: Eighteen patients with anterior communicating aneurysm were studied prospectively using CT angiography and conventional angiography. The parent artery of an aneurysm was predicted by evaluating aneurysm neck location, direction of aneurysm projection, and size of the precommunicating anterior cerebral artery, as seen on CT angiography. A somatom Plus-4 spiral CT scanner was used and shaded-surface display three-dimensional images were constructed. RESULTS: Aneurysm neck was located near the parent artery in 12 cases(66.7%), and aneurysm projection was against the parent artery in 11 cases(61.1 %). The parent artery of the anterior cerebral artery was larger in 15 cases (8 3 .3 %), including ten cases of hypoplasia or agenesis of the contralateral anterior cerebral artery. In 17 of 18 aneurysms(94.4%) the parent artery seen on DSA was correctly predicted by CT angiography. CONCLUSION: Teh parent artery of an anterior communicating aneurysm can be predicted by evaluating a-neurysm neck location, direction of aneurysm projection, and precommunicating anterior cerebral artery, as seen on CT angiography.

MR Findings of Atypical Meningioma: Comparison with Benign Meningioma

PURPOSE: Atypical meningioma is an intermediate type, between benign and malignant meningiomas, and has ahigher recurrence rate and poorer prognosis than the benign type. The purpose of this study was to evaluate thedifferential imaging findings between atypical and benign meningiomas. MATERIALS AND METHODS: Over a five-yearperiod, 11 acses of atypical meningioma (in ten patients) were pathologically proven, and 30 benign meningiomaswere collected consecutively over 6 months. In retrospective analysis, the MR findings of atypical and benignmeningiomas were compared with respect to tumor respect to tumor margin, lobulation, intra-/peritumoralhemorrhage, cystic change, heterogeneity peritumoral edema, enhacement of adjacent meninges, invasion of adjacentvenous sinus and adjacent bony change. RESULTS: Significant differential MR findings between the two groups wereill-defined tumor margin(atypical-27%;benign-0%), lobulation(82%;43%), heterogeneity(73%;30%), and peritumoraledema(100%;47%). With regard to moderate edema, there was no significant difference between the twogroups(36%;23%), and with regard to intra-/peritumoral hemorrhage, cystic change, enhancement of adjacentmeninges, invasion of adjacent venous sinus, and adjacent bony change, MR findings between the two groups were notsignificantly different. CONCLUSION: The MR findings of atypical meningioma are significantly different inseveral ways from those of benign meningioma, and these differences may help differentiate the two types.

Differentiation of Hepatocellular Carcinoma from Intrahepatic Cholangiocarcinoma as the Cause of Biliary Obstruction: Value of Dynamic CT During the Hepatic Arterial Phase

PURPOSE: To evaluate the usefulness of dynamic CT during the hepatic arterial phase with rapid IV injection ofcontrast material in distinguishing hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICAC) asthe cause of biliary obstruction. MATERIALS AND METHODS: We retrospectively reviewed two-phase dynamic incrementalCT or helical CT findings in 22 patients with intrahepatic duct obstruction secondary to pathologically provenHCCs (n=12) or ICACs (n=10). Two-phase CT scans were obtained 20-45 seconds (hepatic arterial phase) or 2 minutes(equilibrium phase) after the initiation of a bolus injection of contrast material (5 mL/sec, 150 mL). Theenhancement patterns of tumors, as seen on two-phase images, were classified as hypo-, iso-, or hyperattenuated,relative to surrounding liver parenchyma. Two-phase images were compared and correlated with pathologic findings. RESULTS: During the hepatic arterial phase, diffuse high-enhancement was seen in nine HCCs (75%) and partialenhancement in three (25%); five (50%) of the ten ICACs were hypodense and five (50%) were hypodense withperipheral enhancement. During the equilibrium phase, however, all HCCs were hypodense and capsular enhancementwas seen in four cases (33.3%). All ICACs were hypodense with mild peripheral or central heterogeneousenhancement. Contrast enhancement patterns of HCCs during the hepatic arterial phase were significantly different(P<.0001) from those of ICACs. CONCLUSION: Our results suggest that dynamic CT during the hepatic arterial phase,with rapid IV injection of contrast material, is useful for the differentiation of HCC from ICAC as the cause ofbiliary obstruction.