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Purpose : In order to determine specific differences, we compared the temporal bone CT findings of chronic otitis media(COM) with and without cholesteatoma, focusing on bone change. Materials and Methods : Between 1997 and 1998, 82 patients(84 cases) underwent temporal bone CT and were shown to have COM, with or without cholesteatoma after mastoidectomy and tympanoplasty. There were 36cases of COM with cholesteatoma(26 patients, M:F=11:15; age range, 16-61 [mean, 36.2] years), and 58 cases without cholesteatoma(56 patients, M:F=25:31, age range, 15-61 [mean, 36.2]years). The findings of temporal bone CT were analyzed at the point of bony changes including erosion and medial displacement of ossicles(malleus, incus, and stapes), erosion or destruction of the scutum, tegmen, facial canal, and lateral semicircular canal, and ballooning of the tympanic cavity and mastoid antrum. In addition, the soft tissue changes seen on temporal bone CT were analyzed at the site of lateral bulging of soft tissue in Prussak’ s space, perforation of the pars flaccida, tympanic membrane retraction, and tympanosclerosis. We retrospectively compared the findings of temporal bone CT with the surgical findings, and to assess statistical significance, the Chi-square test was used. Results : Bone erosion or destruction was seen in 36.2 % of COM cases without cholesteatoma, and in 96.2% of cases with cholesteatoma. Comparing COM with and without cholesteatoma, the erosion of ossicles includ-ing the malleus(81%, 24%), incus(88%, 14%), stapes(58%, 10%), scutum(88%, 10%), facial canal(8%, 0%), and lateral semicircular canal(8%, 0%), was more common in COM with cholesteatoma(p-value 0.05), with the exception of erosion of the tegmen(8%, 3%). Other bony changes including medial displacement of ossi-cles (27%, 3%), ballooning of tympanic cavity and mastoid antrum(96%, 16%), and the soft tissue changes including lateral bulging of soft tissue in Prussak’ s space(58%, 14%) and perforation of the pars flaccida(35%, 9%) were more common in COM with cholesteatoma (p-alue 0.05). Soft tissue in Prussak’ s space(58%, 72%), retraction of the tympanic membrane(19 %, 9%), and tympanosclerosis(8%, 10%) were not however,important findings(p-value 0.05). Conclusion : Bone erosion or destruction was seen in COM without cholesteatoma, but expansile bone erosion or destruction with mass effect suggested COM with cholesteatoma. These findings of temporal bone CT in COM demonstrate the existence and extent of combined cholesteatoma, and are therefore valuable.

Purpose : To demonstrate the MRI findings of olivopontocerebellar atrophy. Materials and Methods : We retrospectively reviewed the MRI findings of eight patients who had been diag-nosed by clinical manifestation and the peculiar pattern of atrophy and signal change on MRI. Results : Seven patients had an atrophy of the olive, pons and cerebellum and increased signal change of the transverse pontine fiber, median raphe and middle cerebellar peduncle on T2WI. Of these, six patients had severe atrophy of the olive, pons and cerebellum and decreased signal change of the basal ganglia, red nucleus, substantia nigra or dentate nucleus on T2WI. Additionally, four of six patients had a cerebral atrophy. Except one patient who had an urinary incontinence, these 5 patients had not been associated with extrapyramidal or autonomic symptom. The other patient with relatively short duration of the disease had only cerebellar atrophy without signal change on T2WI . Conclusion : With progressing of the olivopontocerebellar atrophy, cerebral atrophy and decreased signal change of the basal ganglia, red nucleus, substantia nigra or dentate nucleus on T2WI is combined. Thus, MRI is essential in establishing the diagnosis and evaluating the severity of olivopontocerebellar atrophy.

Purpose : To determine the CT findings of consolidative malignant neoplasms of the lung.Materials and Methods : Seventeen patients in whom pulmonary consolidation was seen on chest radiography were involved in this study. In all cases malignancy was subsequently proven; the neoplasms involved were bronchioloalveolar carcinoma (n = 9), malignant lymphoma (n = 4), mucoepidermoid tumor (n = 1), metastasis from colon cancer (n = 2), and metastasis from pancreatic mucinous adenocarcinoma (n =1). CT images were retrospectively analyzed in terms of enhancement pattern of the consolidation, morphologic appearance of an air-bronchogram, CT angiogram sign, pseudocavitation, and lymphadenopathy.Results :Visually assessed enhancement pattern of the consolidation showed lower attenuation than adjacent muscles in bronchioloalveolar carcinoma (8/9) and metastasis (1/3); isoattenuation in malignant lymphoma (3/4), mucoepidermoid carcinoma (1/1), and metastasis (1/3); and higher attenuation in bronchioloalveolar carcinoma (1/9), malignant lymphoma (1/4), and metastasis (1/3). Among the 15 of 17 patients for whom an airbronchogram was available, a stretching and squeezing pattern was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). CT angiogram sign was identified in bronchioloalveolarcarcinoma (5/9), malignant lymphoma (2/4), and metastasis (3/3). Pseudocavitation was observed in two patients with bronchioloalveolar carcinoma, while lymphadenopathy was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). Conglomerate and extrathoracic lymphadenopathy are commonly associated with malignant lymphoma.Conclusion :Malignant neoplasms which apper as consolidative lung lesions appear not only as bronchioloalveolar carcinoma, which is well known, but also in other forms. Although these lesions cannot be differentiated on the basis of air-bronchography and CT angiography, poor enhancement of consolidative lesion andpseudocavitation are characteristic findings of bronchioloalveolar carcinoma, and conglomerate or extrathoracic lymphadenopathy are also characteristic of malignant lymphoma.

The purpose of this study was to assess surgical results of internal limiting membrane (ILM) maculorrhexis in macular hole surgery. This study is a part of continuing prospective clinical trial of our team of researchers. Thirteen eyes of 13 patients with idiopathic macular hole underwent vitrectomy with the removal of posterior cortical vitreous, peeling of the macular ILM, and intraocular gas tamponade, followed by postoperative face-down positioning. The excised specimens were evaluated with transmission electron microscopy. Complete closure of the hole was observed in all 13 eyes (100% anatomic success rate). Visual improvement of 2 or more lines on ETDRS visual acuity chart was achieved in 11 (85%) of the 13 eyes. Six (54.5%) eyes attained visual acuity of 20/50 or better. Electron microscopy showed ILM in the removed specimens. ILM maculorrhexis is a promising new surgical approach to close idiopathic macular holes but requires further investigation and long-term evaluation.