Search PubMed⌕ Search

Biomedical subjects

J F Lirng

Publications and source records attributed to J F Lirng.

At least 37 records · Page 2Linked to original sources
PubMed1999

Persecutory delusions in dementia.

BACKGROUND: Persecutory delusions are common in dementia. This study was undertaken to investigate the prevalence, associated factors, and characteristics of persecutory delusions in demented patients. METHOD: The sample population included 167 demented patients (DSM-III-R criteria) admitted to a geropsychiatric ward. Patients were assessed for the occurrence of any persecutory delusions since the onset of dementia. The content of persecutory delusions, the patients' response to the delusions, and any concomitant psychiatric symptoms were also explored. RESULTS: Of the 167 demented patients, 45 (26.9%) showed symptoms of persecutory delusions. Patients with persecutory delusions had a higher prevalence of other delusions, hallucinations, and physically aggressive behaviors. The deluded patients often thought that their caregivers were their persecutors and had a wide range of responses to their delusions. After they were hospitalized, many of these patients attacked medical staff and were uncooperative with treatment. CONCLUSION: Persecutory delusions are common in dementia of various types. Deluded patients often have vigorous responses to their delusions including physically aggressive behaviors and suicide attempts. Careful evaluation is needed to assess the potential for violent and suicidal behaviors in these patients. Medical staff should be alert to clinical strategies for handling the treatment of such patients when they become violent or uncooperative.

Age of Onset↗
PubMed1999

Arachnoid granulations--computerized tomography and magnetic resonance imaging features: a case report.

A 71-year-old woman had arachnoid granulations found in the straight and transverse sinuses on computerized tomography (CT) and magnetic resonance imaging (MRI). The arachnoid granulations appeared as low-density masses on CT. They gave low signals on T1-weighted MR images and high signals on T2-weighted images. Arachnoid granulations are usually of no clinical significance. They have characteristic CT and MRI manifestations and should not be mistaken for sinus thrombosis or intrasinus tumors.

Aged↗
PubMed1999

Intracranial pathology: comparison of intraoperative ultrasonography with computerized tomography and magnetic resonance imaging.

BACKGROUND: High-resolution, real time, intraoperative ultrasonography (IOUS) has been used in a number of cases in our neurosurgical department to identify, localize and characterize intracranial abnormalities. We compare the images of IOUS with those of computerized tomography (CT) and magnetic resonance imaging (MRI) in order to enhance our experience and confidence. METHODS: IOUS images were compared with preoperative CT scans and/or MRIs in 30 intracranial masses. Tumor size and margin, echogenicity and edema were the features compared. RESULTS: The images of IOUS, CT and MRI correlated closely except for images of primary gliomas. IOUS was more effective than CT and MRI in delineating the extent of a glioma, determining whether a lesion was cystic, with or without septation, or solid and in guiding surgical procedures. The contrast enhancement available with CT and MRI could not be demonstrated with IOUS. CONCLUSIONS: IOUS provides exquisite detail of intracranial pathology as well as, or even better than, CT and MRI. Its application should be emphasized to minimize damage of normal brain tissue and increase the completeness of tumor resection.

Adult↗
PubMed1999

Magnetic resonance imaging of unilateral olivary hypertrophy due to pontine tegmental hemorrhage: a case report.

Olivary hypertrophy (OH) is not a primary lesion but, rather, develops as a lesion of the Guillain-Morraret triangle, which is composed of the contralateral dentate nucleus, the ipsilateral red nucleus and the ipsilateral inferior olivary nucleus. OH is usually accompanied by palatal myoclonus or other involuntary movements such as extremity myorhythmia. One case of unilateral OH following ipsilateral pontine tegmental hemorrhage is presented. Magnetic resonance imaging (MRI) showed high signal intensity in the inferior olivary nuclei on T2- and proton-density-weighted images. Enlargement of the inferior olivary nuclei was also noted. MRI may currently be the only procedure capable of confirming the diagnosis.

Cerebral Hemorrhage↗
PubMed1999

Giant cell reparative granuloma: a case report.

Giant cell reparative granuloma (GCRG) is an infrequent benign lesion with undetermined etiopathogenesis affecting the maxillary and mandibular bone and, rarely, the skull. It is also extremely rare in the sphenoid bone. GCRG is usually diagnosed by histologic examination of bone lesions. We report a case of GCRG originating from the sphenoid bone. Computerized tomography revealed an expansile lesion with thinning or destruction of the cortical bone. The lesion itself was slightly hyperdense with good but inhomogeneous contrast enhancement. Reported magnetic resonance image findings showed hyperintensity on both T1-weighted and T2-weighted images and variable contrast enhancement. Plain skull radiographs usually reveal a lytic lesion within the bone.

Child↗
PubMed1998

Proton magnetic resonance spectroscopy in deep cerebral venous thrombosis.

A 63-year-old man developed a severe left frontal headache followed by an acute change of mentality 6 days later. Magnetic resonance imaging revealed bilateral thalamic ischemia. Angiography confirmed the occlusion of deep cerebral veins. Proton magnetic resonance spectroscopy (1H-MRS) of the thalami showed normal N-acetylaspartate (NAA) peak and the presence of lactate peak, indicating a relatively preserved neuronal viability. The patient improved during the follow-up period, and returned to work 45 days after the onset of the disease. With 1H-MRS, prognosis following venous infarctions may be feasible.

Humans↗
PubMed1998

Verifying complete obliteration of carotid artery-cavernous sinus fistula: role of color Doppler ultrasonography.

The purpose of this study was to evaluate the role of color Doppler ultrasonography in verifying obliteration of carotid artery-cavernous sinus fistula before and after therapeutic embolization or gamma knife radiosurgery. Before treatment, carotid artery-cavernous sinus fistula showed the following data on color Doppler ultrasonography: (1) increased blood flow in the common carotid artery (220 to 1264 ml/min with mean+/-SD of 728+/-378 ml/min); internal carotid artery (435 to 1097 ml/min with mean+/-SD of 834+/-216 ml/min) in fistulas of the direct type; and external carotid artery (85 to 257 ml/min with mean+/-SD of 170+/-75 ml/min) in fistulas of the indirect type in comparison to the contralateral side; (2) reverse pulsatile flow or spiculated wave form with turbulent flow in the engorged superior ophthalmic vein on the lesion side in all patients. All of the above abnormal hemodynamic changes became normal in six patients immediately after first embolization, in two patients with balloon embolization combined with subsequent direct embolization by direct puncture through the superior orbital fissure or internal carotid artery embolization, and in five patients after gamma knife radiosurgery at 4, 4, 8, 9, and 9 months, respectively. Color Doppler ultrasonography might be a good modality in long-term follow-up of carotid artery-cavernous sinus fistula after gamma knife radiosurgery and embolization.

Adolescent↗
PubMed1998

Endovascular embolization of arteriovenous fistulas of the external carotid artery.

BACKGROUND: External carotid arteriovenous fistulas (AVFs) are rare and most hospitals have limited experience with their management. This study was designed to evaluate the effectiveness and safety of endovascular embolization of AVFs of the external carotid artery under angiographic control. METHODS: A series of 13 patients with AVFs involving the branches of the external carotid artery, all treated with endovascular embolization, were reviewed. There were 10 males and three females ranging in age from nine to 46 years, with a mean of 27 years. The most frequent presenting symptoms were pulsatile tinnitus, followed by bruit and/or thrill, ocular problems, headache and a pulsatile mass in the neck. The middle meningeal artery was most often involved, followed by the internal maxillary artery and the occipital artery. The AVFs were caused by trauma in 10 patients and occurred spontaneously in three. N-butyl-2-cyanoacrylate was used to embolize the fistula in 11 patients and a detachable balloon was used in two. RESULTS: All the patients were cured and no significant complications were observed. No recurrence was noted after a clinical follow-up of three months to seven years (mean, 37 months). CONCLUSIONS: Endovascular embolization proved to be a safe and effective procedure. It should be the treatment of choice for repair of external carotid AVFs.

Adolescent↗
PubMed1998

Orbital invasion in nasopharyngeal carcinoma: evaluation with computed tomography and magnetic resonance imaging.

BACKGROUND: Ocular symptoms and tumor cranial nerve involvement are commonly observed in patients with nasopharyngeal carcinoma (NPC). These are primarily due to tumor invasion of the cavernous sinus and/or skull base, as direct tumor invasion of the orbit is very rare. This study was designed to assess computed tomography (CT) and magnetic resonance imaging (MRI) in documenting orbital invasion caused by NPC, with a special emphasis on the route of orbital extension. METHODS: A total of 562 patients with histopathologically prove NPC were examined using CT and/or MRI for tumor staging or post-treatment follow-up. We retrospectively reviewed CT and MRI findings to identify tumor invasion to orbital cavities and to evaluate the pathway of tumor spread. RESULTS: Eighteen patients had tumor extension into the orbital cavities. Seventeen patients had ocular complaints. Fourteen of 18 showed unilateral orbital involvement and four patients showed bilateral orbital involvement. The route from the pterygopalatine fossa and inferior orbital fissure into the orbital cavities was the most common pathway of NPC invasion (n = 13), followed by ethmoid sinus and/or sphenoid sinus into the orbits (n = 4). In one patient, the route of orbital invasion was difficult to determine due to massive tumor extension. CONCLUSION: Direct orbital invasion is rare in NPC. The pterygopalatine fossa and inferior orbital fissure are the most common routes of invasion, followed by invasion via the ethmoid and/or sphenoid sinuses. Coronal sections best show these findings on CT or MRI. Our study also shows that either CT or MRI provide essential information in documenting orbital invasion and determining the pathway of tumor spread.

Adult↗
PubMed1998

Hoarding behavior in dementia. A preliminary report.

Hoarding behavior has been reported in several mental disorders and is occasionally reported by the caregivers of dementia patients. Such behavior may have adverse effects on the patients and increase the burden of the caregivers. This study was conducted to investigate the prevalence of hoarding behavior in patients with dementia and identify the characteristics and psychiatric symptoms associated with it. The sample was 133 dementia patients admitted to a geropsychiatric ward. Of the 133 dementia patients, 30 (22.6%) showed hoarding. Hoarding was found in various types of dementia. Patients with hoarding had a higher prevalence of repetitive behaviors, hyperphagia, and pilfering. Results suggested that hoarding behavior is a common symptom in dementia patients and a complex phenomenon. Better understanding of the underlying pathogenesis may highlight specific pharmacological or behavioral methods for treatment of the behavior.

Aged↗
PubMed1997

Intracranial ganglioglioma: CT and MRI findings.

Thirteen cases of pathologically proved intracranial gangliogliomas were reviewed in order to define the characteristic computed tomography (CT) and magnetic resonance image (MRI)-features. All patients were evaluated with CT and four of them were studied by MRI. Six tumors were cystic dominant mixed masses with remarkable focal contrast enhancement (6/13, 46%); and seven were solid in nature with variable contrast enhancement (7/13, 54%). Nine of them contained calcification (9/13, 69%). The temporal lobe was affected in six patients (6/13, 46%); the posterior fossa in four patients; the frontal lobe in two; the remaining huge one in the frontal, temporal and basal ganglion. On MRI, the findings were similar to those of the CT. Gangliogliomas do not have a characteristic CT and MRI features. They may appear as pure cystlike tumors, cystic dominant mixed tumors with remarkable focal contrast enhancement, solid tumors with variable contrast enhancement or diffuse involving the brain parenchyma and/or subarachnoid spaces. However, radiologists should include ganglioglioma in the differential diagnosis when we find patient has a long-standing process as well as a calcified tumor in the temporal lobe with following characteristic; cystic dominant mixed tumor with remarkable focal contrast enhancement, or a solid mass without hemorrhage or significant surrounding edema.

Adolescent↗
PubMed1995

Embolization of carotid cavernous fistula by means of direct puncture through the superior orbital fissure.

PURPOSE: To embolize carotid cavernous fistulas (CCFs) by means of transorbital puncture of the cavernous sinus (CS) and the cavernous segment of the internal carotid artery (ICA) through the superior orbital fissure. MATERIALS AND METHODS: Five patients with CCF were treated with embolization of the CS, and six were treated with embolization of both the CS and the cavernous portion of the ICA after transorbital puncture. All except one had previously undergone occlusion of the ipsilateral proximal ICA before direct transorbital puncture. RESULTS: The fistulas in these cases were all obliterated completely. Only two patients had temporary ptosis. No other remarkable complications were noted. The patent ICA on the side of the fistula in one patient remained patent after embolization. CONCLUSION: Direct transorbital puncture through the superior orbital fissure is an alternate treatment for CCF, especially when the ipsilateral ICA has been occluded.

Adult↗
PubMed1995

Cerebral phaeohyphomycosis complicated with brain abscess: a case report.

Cerebral phaeohyphomycosis is used to describe the rare clinical syndrome of cerebral infection caused by dematiaceous (i.e. pigmented olivaceous-brown) fungi. It usually presents as brain abscess. In view of the rarity of this fungal infection and its clinical importance, we report a case of cerebral phaeohyphomycosis caused by Xylohypha bantiana. The patient presented with a seizure attack. The MRI study revealed a ring-enhancing lesion with marked perifocal edema in right high frontoparietal junction of the brain. He underwent an initial craniotomy for removal of the lesion and a second craniotomy for recurrence of the lesion 3 months later. The diagnosis was based on successful cultivation of X. bantiana from the surgical specimen and on histopathology. The patient received antifungal drug therapy of 5-flucytosine and itraconazole. He has done well without any symptoms. We think complete surgical removal of the brain abscess combined with antifungal drug therapy is the best management for this rare fungal disease.

Brain Abscess↗
PubMed1995

MRI of papillary meningiomas in children.

We report two cases of papillary meningioma in children. The MRI appearance of this special type of meningioma is described for the first time. Both lesions were dura based and associated with cystic components. We review the literature pertaining to this type of meningioma and discuss the differential diagnosis of the MRI appearance. Because this is a malignant type of meningioma, early diagnosis and surgical intervention are important in the management of patients.

Child, Preschool↗
PubMed1994

N-butyl-2-cyanoacrylate for embolisation of carotid aneurysm.

We report the use of an N-butyl-2-cyanoacrylate (NBCA) mixture for embolisation of six cases of carotid aneurysm after detachable balloons, and/or microcoils had been placed in the aneurysm. The mixture was injected into the aneurysm to prevent delayed bleeding or distal migration of the balloons, or microcoils. No subarachnoid haemorrhage or distal migration of the balloons or microcoils occurred up to 4.5 years after embolisation. Reflux of the NBCA mixture into the parent artery occurred in one patient, who had a neurological deficit which recovered in a month. NBCA mixture may be useful in embolisation of intracranial or skull base arterial aneurysms, for reducing the size of remaining lumen in an aneurysm at high risk of rebleeding which accommodate no more balloons or microcoils, or preventing possible delayed migration of balloons or microcoils. However, prevention of leakage of the mixture into the parent artery remains a problem.

Adult↗
PubMed1994

Percutaneous transluminal angioplasty of neck vessels.

BACKGROUND: Although surgical endarterectomy or bypass is regarded as the treatment-of-choice for extracranial cerebral vascular stenosis, percutaneous transluminal angioplasty (PTA) has its role as an alternative procedure for symptomatic patients refractory to medical therapy and/or for whom surgical treatment is contraindicated. METHODS: Occlusive blood vessels were first identified by neurologic, ultrasonic and angiographic studies. Patients were premedicated with heparin and corticosteroid. From a transfemoral approach, double lumen balloon dilatation catheter was guided across the area of stenosis, and inflated two or three times to produce dilatation. Following PTA, patients received anticoagulants and corticosteroid for a period, and were followed by clinical examination, Doppler blood-flow and angiographic studies. RESULTS: Seventeen patients undergoing 26 procedures were included in this study. The lesions involved subclavian artery in nine cases, common carotid artery in seven, internal carotid artery in five and proximal vertebral artery in five. Digital subtraction angiography (DSA) was done immediately after PTA and showed improvement of stenotic segment (residual stenosis < 30%) in 22 vessels. Restenosis occurred in two cases of subclavian artery PTA six months later. There were three complications, including TIA in two cases and hematoma at the puncture site in one case. Clinically, symptomatic improvement was obtained in 13 cases. CONCLUSIONS: In patients with significant atherosclerotic stenosis of neck vessels, PTA is a beneficial procedure for improving blood flow to brain circulation and for alleviating symptoms.

Aged↗
PubMed1994

Computed tomography evaluation of chronic paranasal sinusitis.

BACKGROUND: Although chronic paranasal sinusitis has been recognized and diagnosed more frequently in recent years, it is still one of the most frequently overlooked disease and a significant source of morbidity and economic loss. Therefore, a further detailed analysis of its clinical pictures and computed tomographic (CT) presentations is necessary for better understanding. METHODS: We collected 230 cases in recent two years and studied their CT manifestations. RESULTS: The pathological changes of sinusitis on CT were classified into four groups: mucosal thickening, mucosal thickening combined with fluid level, fluid level only, and total sinus opacification, in increasing frequency. Maxillary sinus was the most commonly involved sinus. Focal high density areas were noted in 17 sinuses. Ten of them were operated and revealed only thick mucous without evidence of calcification or fungal infection. There was no correlation between the disease duration and the number of sinuses involved. CONCLUSIONS: CT is the image modality of choice in evaluating patients with chronic paranasal sinusitis.

Adolescent↗