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A Case of Intradural-Extramedullary Form of Primary Spinal Cysticercosis Misdiagnosed as an Arachnoid Cyst

  • Yoo, Minwook;Lee, Chang-Hyun;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.226-229
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    • 2014
  • We describe a rare case of intradural-extramedullary primary spinal cysticercosis. A 42-year-old man visited our institute for lower back pain. He denied having consumed raw meet. Magnetic resonance (MR) images revealed an intradural pure cystic mass at the L3-L4 level. A radiologic diagnosis of spinal arachnoid cyst was established. Three years later, he complained of aggravated back pain, and follow-up MR examination showed a markedly expanded cyst, occupying the subarachnoid space from the T11 to the S1 level. L2 hemilaminectomy was performed, and a yellowish infected cyst bulged out through the dural opening. The cyst was removed en bloc. The histopathological findings of the cyst were consistent with parasitic infection. Serum enzyme-linked immunosorbent assay (ELISA) confirmed the presence of spinal cysticercosis. As there was no intracranial lesion, the final diagnosis was primary spinal cysticercosis, which is very rare. MR imaging is a sensitive diagnostic tool for detecting cystic lesions in the spine; however, it is difficult to distinguish cysticercosis from non-infectious cysts such as an arachnoid cyst without using gadolinium enhancement. Clinicians treating spinal cysts with an unusual clinical course should include cysticercosis as a differential diagnosis. We recommend contrast-enhanced MR imaging and serum ELISA in the diagnostic work-up of such cases.

A Case of Pancreatic Cancer Recurred in Liver after Surgical Resection, in Complete Response after Chemotherapy and Tumorectomy (수술적 절제술 후 간에 재발한 췌장암에서 항암화학요법과 종양절제술로 완전 관해를 보인 증례)

  • Jun Hyuk Son;Jae Woo Lee;Dong Kee Jang;Sang Hyub Lee;Ji Kon Ryu;Yong-Tae Kim
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.105-107
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    • 2015
  • Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

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Stroke-like Manifestation in a Patient with Leptomeningeal Metastasis of Pancreatic Cancer (급성뇌졸중 양상으로 발현된 췌장암의 연수막 전이)

  • Boo Suk Na;Soo Jin Song;Jong Min Song;Ho Geol Woo;Young Nam Kwon;Dokyung Lee;Tae-Beom Ahn
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.113-115
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    • 2015
  • Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

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Pearls and Potential Pitfalls for Correct Diagnosis of Ovarian Cystadenofibroma in MRI: A Pictorial Essay

  • Giacomo Avesani;Gianluca Caliolo;Benedetta Gui;Federica Petta;Camilla Panico;Viviana La Manna;Francesca Moro;Antonia Carla Testa;Giovanni Scambia;Riccardo Manfredi
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1809-1821
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    • 2021
  • Ovarian cystadenofibroma is a benign ovarian tumor that is characterized by a consistent percentage of masses, which remain indeterminate in ultrasonography and require magnetic resonance (MR) investigation; they may mimic borderline or malignant lesions. Three main morphologic patterns, resembling different ovarian neoplasms, can be identified in cystadenofibromas: multilocular solid lesions, unilocular cystic lesions with parietal thickening, and purely cystic masses. However, a cystoadenofibroma has typical features, such as T2-weighted hypointensity associated with no restrictions in diffusion-weighted imaging (the so-called "dark-dark appearance") and progressive post-contrast enhancement (type I perfusion curve). The purpose of this study was to review the features of ovarian cystadenofibromas in MR imaging and to suggest pearls and pitfalls regarding their correct diagnosis.

Petrochemistry of Garnet-bearing Metabasite in Marble at Shinri area in Hongseong and its Tectonic Implication (홍성 신리 지역 대리암 내 함석류석 변성염기성암의 암석지화학 연구 및 그 지구조적 의미)

  • Kim, Sung-Won;Koh, Hee-Jae
    • The Journal of the Petrological Society of Korea
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    • v.19 no.3
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    • pp.209-225
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    • 2010
  • The Shinri area near the Yedang Lake, the eastern part of the Hongseong area in SW Gyeonggi Massif, consists of the Neoproterozoic Duckjeongri granodiorite-tonalite, mylonitized amphibole-bearing orthogneiss and impure marble with lens-shaped garnet-bearing metabasites. In this paper, we report mineralogical and geochemical data of Neoproterozoic lens-shaped garnet-bearing metabasites within marble of the Shinri area. The $SiO_2$ contents of garnet-bearing metabasites in marble vary between ~46.98 and 51.17 wt%, and the $Na_2O$ + $K_2O$ contents fall between ~1.95 and 2.85 wt%, similar to the tholeiitic sub-alkaline basaltic rocks. In the Zr/Y vs. Zr diagram, garnet-bearing metabasites also plot in the subalkaline basaltic rocks. The chondrite-normalized REE patterns for Shinri garnet-bearing metabasites show relatively flat patterns to that of chondrite. They show slight LREE-enriched and depleted patterns. The major and trace element data from lens-shaped garnet-bearing metabasites in marble of the Shinri area suggest that these rocks were formed in within plate. In contrast, previous major and trace element data of high pressure type garnet-bearing metabasites from the mafic-ultramafic complex in the Baekdong and Bibong areas suggest that these rocks were formed in a nascent arc to backarc spreading center within subduction zone setting. Based on mineral assemblage and mineral chemistry, P-T estimates for Shinri garnet-bearing metabasites are 9.6-12.7 kb, $695-840^{\circ}C$ for inclusions in the core, and 9.6-13.6 kb, $630-755^{\circ}C$ for those in the rim. These P-T estimates are distinct from those of the Baekdong and Bibong garnet-bearing metabasites with isothermal decompressional retrograde P-T path. In addition to Triassic tectonic activity previously reported in the Shinri area of Hongseong, the details of metamorphic history such as protolith age and Neo-Proterozoic metamorphic episode need to be solved.

Reconstruction of Stereo MR Angiography Optimized to View Position and Distance using MIP (최대강도투사를 이용한 관찰 위치와 거리에 최적화 된 입체 자기공명 뇌 혈관영상 재구성)

  • Shin, Seok-Hyun;Hwang, Do-Sik
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.1
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    • pp.67-75
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    • 2012
  • Purpose : We studied enhanced method to view the vessels in the brain using Magnetic Resonance Angiography (MRA). Noticing that Maximum Intensity Projection (MIP) image is often used to evaluate the arteries of the neck and brain, we propose a new method for view brain vessels to stereo image in 3D space with more superior and more correct compared with conventional method. Materials and Methods: We use 3T Siemens Tim Trio MRI scanner with 4 channel head coil and get a 3D MRA brain data by fixing volunteers head and radiating Phase Contrast pulse sequence. MRA brain data is 3D rotated according to the view angle of each eyes. Optimal view angle (projection angle) is determined by the distance between eye and center of the data. Newly acquired MRA data are projected along with the projection line and display only the highest values. Each left and right view MIP image is integrated through anaglyph imaging method and optimal stereoscopic MIP image is acquired. Results: Result image shows that proposed method let enable to view MIP image at any direction of MRA data that is impossible to the conventional method. Moreover, considering disparity and distance from viewer to center of MRA data at spherical coordinates, we can get more realistic stereo image. In conclusion, we can get optimal stereoscopic images according to the position that viewers want to see and distance between viewer and MRA data. Conclusion: Proposed method overcome problems of conventional method that shows only specific projected image (z-axis projection) and give optimal depth information by converting mono MIP image to stereoscopic image considering viewers position. And can display any view of MRA data at spherical coordinates. If the optimization algorithm and parallel processing is applied, it may give useful medical information for diagnosis and treatment planning in real-time.

Differentiation of True Recurrence from Delayed Radiation Therapy-related Changes in Primary Brain Tumors Using Diffusion-weighted Imaging, Dynamic Susceptibility Contrast Perfusion Imaging, and Susceptibility-weighted Imaging (확산강조영상, 역동적조영관류영상, 자화율강조영상을 이용한 원발성 뇌종양환자에서의 종양재발과 지연성 방사선치료연관변화의 감별)

  • Kim, Dong Hyeon;Choi, Seung Hong;Ryoo, Inseon;Yoon, Tae Jin;Kim, Tae Min;Lee, Se-Hoon;Park, Chul-Kee;Kim, Ji-Hoon;Sohn, Chul-Ho;Park, Sung-Hye;Kim, Il Han
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.120-132
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    • 2014
  • Purpose : To compare dynamic susceptibility contrast imaging, diffusion-weighted imaging, and susceptibility-weighted imaging (SWI) for the differentiation of tumor recurrence and delayed radiation therapy (RT)-related changes in patients treated with RT for primary brain tumors. Materials and Methods: We enrolled 24 patients treated with RT for various primary brain tumors, who showed newly appearing enhancing lesions more than one year after completion of RT on follow-up MRI. The enhancing-lesions were confirmed as recurrences (n=14) or RT-changes (n=10). We calculated the mean values of normalized cerebral blood volume (nCBV), apparent diffusion coefficient (ADC), and proportion of dark signal intensity on SWI (proSWI) for the enhancing-lesions. All the values between the two groups were compared using t-test. A multivariable logistic regression model was used to determine the best predictor of differential diagnosis. The cutoff value of the best predictor obtained from receiver-operating characteristic curve analysis was applied to calculate the sensitivity, specificity, and accuracy for the diagnosis. Results: The mean nCBV value was significantly higher in the recurrence group than in the RT-change group (P=.004), and the mean proSWI was significantly lower in the recurrence group (P<.001). However, no significant difference was observed in the mean ADC values between the two groups. A multivariable logistic regression analysis showed that proSWI was the only independent variable for the differentiation; the sensitivity, specificity, and accuracy were 78.6% (11 of 14), 100% (10 of 10), and 87.5% (21 of 24), respectively. Conclusion: The proSWI was the most promising parameter for the differentiation of newly developed enhancing-lesions more than one year after RT completion in brain tumor patients.

Characteristics of Groundwater Quality for Agricultural Irrigation in Plastic Film House Using Multivariate Analysis (다변량분석법을 이용한 시설재배지 지하수 수질 특성)

  • Kim, Jin-Ho;Choi, Chul-Mann;Lee, Jong-Sik;Yun, Sun-Gang;Lee, Jung-Taek;Cho, Kwang-Rae;Lim, Su-Jung;Choi, Seung-Chul;Lee, Gyeong-Ja;Kwon, Yeu-Seok;Kyung, Ki-Chon;Uhm, Mi-Jeong;Kim, Hee-Kwon;Lee, You-Seok;Kim, Chan-Yong;Lee, Seong-Tae;Ryu, Jong-Su
    • Korean Journal of Environmental Agriculture
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    • v.27 no.1
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    • pp.1-9
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    • 2008
  • The main purpose of this study is to accumulate the fundamental data representing groundwater of plastic film houses by means of water quality and its multivariate statistical analysis. Groundwater samples were collected in every two years since 2000 to 2004 from total 211 sites. According to the result of water quality analysis, ground water quality was suitable for irrigation purpose averagely. Correlation analysis showed that EC was highest positively correlated with $Mg^{2+}$ to 0.810(p<0.01), 0.776(p<0.01) in April and July, respectively. $NO_3-N$ was highest positively correlated with T-N to 0.794(p<0.01) in October. This result shows that it can lead to a different result even in similar case sometimes. Four factors were extracted through factor analysis in April and July, but five factors were extracted in October. The proportions of cumulative variance by the factor were 64.9, 60.2, and 70.7 in April, July, and October, respectively. The first factor was highly related to anions and cations such as $Ca^{2+},\;Mg^{2+},\;Cl^-,\;{SO_4}^{2-}$, and EC in contrast to that of stream water. According to the cluster analysis, 211 sites are classified into four groups. Common type of ground water quality was shown in group A. The pH and $PO_4-P$ were highest in Group B. The anions and cations were highest in Group C. $COD_{Cr}$ was highest in Group D.

Characterization of Dissolved Organic Matter in Stream and Industrial Waste Waters of Lake Sihwa Watershed by Fluorescence 3D-EEMs Analysis (형광 3D-EEMs를 이용한 시화호유역 하천 및 공단폐수의 유기물 특성 분석)

  • Lee, Mi-Kyung;Choi, Kwang-Soon;Kim, Sea-Won;Kim, Dong-Sup
    • Journal of Korean Society of Environmental Engineers
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    • v.31 no.9
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    • pp.803-810
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    • 2009
  • This study is conducted to examine spatial variations of Dissolved Organic Matter (DOM) in stream and waste waters of the different watershed areas (agricultural, residential, and industrial complex area) by using fluorescence 3D-EEMs (3 Dimensional Excitation Emission Matrix Spectroscopy). Furthermore, the research investigates the changes of DOM characterization by synchronous and 3D-EEMs during a rainfall event. The characterizations of DOM obtained by 3D-EEMs show two noticeable peaks at humic and protein-like regions. Humic-like substances (HLS) are found in rural and urban areas, and humic and protein-like substances (PLS) are shown in industrial area. According to the fluorescence peak $T_1:C_1$ ratios, it is observed that high amount of HLS was discharged from Banweol Industrial Complex (3TG). Additionally, linear relationships (Regression rate, $r^2$=0.65, $r^2$=0.66) have been shown between PLS (peak $T_1,\;B_1$) and biochemical oxygen demand (BOD), which indicates the impact of sewage. For the rainfall event (30 mm), no remarkable difference of DOM was found at rural area except increment of fluorescence intensity comparing dry period. In contrast, HLS at urban area is highly discharged within 30 minutes from the beginning of rainfall. Also, there are high influences of HLS and PLS within 20 minutes at industrial complex (4TG). Fluorescence 3D-EEMs has not only verifies a watershed of DOM origination but also monitors diffuse and point source impacts.

Quality Evaluation of Red seabream, Pagrus major by Chemoenzymatic Method (효소 화학적 방법에 의한 참돔, Pagrus major의 품질판정)

  • 배진한;김태진;정호진;여해경;심길보;조영제
    • Journal of Aquaculture
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    • v.17 no.3
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    • pp.167-172
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    • 2004
  • Chemoenzymatic method was used in this study to evaluate the quality of cultured red seabrim. Level of ATP related compounds, ATPase and Adenylate energy charge (AEC) well reflected changes in condition of fish. ATP level in the muscle of exercised cultured red seabream was decreased significantly during cultured period. In contrast, the level of ADP in the muscle was increased during the period. Level of ATP related compounds in the muscle of cultured red seabream without exercise didn't show significant difference compared to the exercised group. AEC value in muscle of cultured red seabream without exercise was 0.89$\pm$0.02, while AEC value of the exercised group was 0.88$\pm$0.04. ATP and AEC levels among different size of fish did not show any significant difference. AEC value in all sample was higher than 0.8, indicating that the condition of cultured fish was healthy. Activity of Mg2$^{+}$ (+Ca2$^{+}$), Mg2$^{+}$ (-Ca2$^{+}$) and Ca2$^{+}$-ATPase during culture period did not change significantly, regardless of exercise. Therefore, the AEC appears to have some validity as fish health indicator.