![]() Together with Cassia the three remaining Blackguards will be the main characters of Blackguards 2. In the Blackguards she sees the fighters and the power she needs for her plans, even if they are a shadow of their former glory: Naurim became fat and lazy, but also more cunning Zurbaran lost his self-confidence and Takate seems to have lost his killer instinct. Cassia, main protagonist of Blackguards 2, is looking for them: Cassia’s only goal is to rule from the Shark Throne at all costs, even if it’s only for one day. Nevertheless, their fame for defeating the Nine Hordes seems to be everlasting – at least for the three survivors, as all others have found their end. He believes there are no challenges left after the defeat of the Nine Hordes. Takate, on the other hand, is back among the forest people and arranges his own gladiatorial games, letting humans fight for their destiny, just as he was forced to. She shackled, mortified, and sold him for one symbolic copper piece at the slave market. ![]() Wizard Zurbaran was even less lucky: his mistress tracked down the former slave, who was unable to escape servitude. ![]() He used his popularity for shady businesses and excessive parties and got quite potbellied – not a very good condition for battles, and so he hung up his axe and ditched his old gang. ![]() Dwarf Naurim has retired with his fame as a successful gladiator and defeater of the Nine Hordes. ![]()
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![]() All 6 of these patients had small (<1 cm) to medium-sized (1.1–2.9 cm) tumors. Three patients exhibited only intrameatal tumors, and 6 patients had intrameatal tumors with medial extension out of the porous. The ages of these 9 patients (5 men and 4 women) ranged from 40 to 65 years, and the right and left side were involved in 4 and 5 patients, respectively. The most common finding was vestibular schwannoma involving the IAC and/or CPA (n = 9, Table Table2, 2, Figure Figure1). ![]() The Institutional Review Board of Konkuk University Medical Center approved the study (KUH1110056). All patients were administered systemic high-dose steroids (prednisolone 1 mg/kg/day for 4 days, tapered off over the next 10 days). The scanning encompassed the region from the mastoid to the upper edge of the petrous bone. All injections were followed by a saline flush of up to 20 mL. Postcontrast 3D volumetric T1-weighted images (TR/TE, 8.85/3.95 ms FOV, 180 mm flip angle, 12° matrix, 256 × 256 acquiring slice thickness, 1.2 mm reconstructed slice thickness, 0.6 mm) were obtained at 1 minute after an intravenous bolus injection of a standard dose of gadobutrol (Gadovist Schering, Berlin, Germany 0.1 mmol/kg of body weight) through the antecubital vein using a power injector with a rate of 1 mL per second. The parameters for acquiring FIESTA data for cranial nerves on 1.5/3.0 T MRI were the following: TR, 6.1/7.28 ms TE, 1.7/2.30 ms FOV, 180 mm flip angle, 65°/60° matrix, 512 × 256 acquiring slice thickness, 1 mm reconstructed slice thickness, 0.5 mm. ![]() Our IAC MRI protocol included 2-mm thick T1 (TR/TE on 1.5 T and 3.0 T MRI 600/14 ms and 800/2 ms) and T2 (TR/TE 4000/92 ms and 4000/107 ms) weighted axial images, 3D balanced steady-state gradient echo sequence (FIESTA) for cranial nerves, and postcontrast 3D volumetric T1-weighted images (SPGR). MRI was conducted using a 1.5 or 3.0 T MRI (Signa HDx: GE healthcare, Milwaukee, WI) with a phased-array head coil. 4 MRI was performed within 10 days after the onset of sudden hearing loss in all patients, excluding 1 patient who underwent MRI 18 days after the onset of sudden hearing loss (See Results). The mean PTA thresholds in the conversational frequencies (0.5, 1, 2, and 4 kHz) were calculated and used to define each patient's hearing level. No patient had a history of familial deafness or metabolic diseases. 3 All patients had a complete history and underwent a neuro-otological examination. The patients met the clinical diagnostic criteria for SSNHL, which is defined as sensorineural hearing loss of 30 dB or more over at least 3 contiguous frequencies in pure tone audiometry (PTA) that develops within 3 days. The most commonly observed MRI abnormality in patients with SSNHL was vestibular schwannoma, and all of the lesions were small or medium-sized tumors involving the IAC.Ī retrospective analysis of the charts and MRI findings of 291 patients with SSNHL who were admitted to the Department of Otorhinolaryngology-Head and Neck Surgery at tertiary referral hospital from January 2007 to December 2012 was performed. Intralabyrinthine schwannoma, labyrinthine hemorrhage, IAC metastasis, and a ruptured dermoid cyst were each observed in 1 patient. The tumor was small (<1 cm) or medium-sized (1.1–2.9 cm) in these 6 patients. All 9 patients had intrameatal tumors, and 6 of the 9 patients displayed extrameatal extension of their tumors. Vestibular schwannoma involving the internal auditory canal (IAC) and/or cerebellopontine angle was observed in 9 patients. In 291 patients, MRI abnormality, which was considered a cause of SSNHL, was detected in 13 patients. This study aimed to assess abnormal magnetic resonance imaging (MRI) findings in patients with SSNHL and evaluate the value of MRI in identifying the cause of SSNHL.Ī retrospective analysis of the charts and MRI findings of 291 patients with SSNHL was performed. The etiology of sudden sensorineural hearing loss (SSNHL) remains unclear in most cases. ![]() |
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