The leukemias are the most common form of childhood cancer. The same kinds of leukemia are found in childrenand in adults. Because the radiologist is involved in the initial diagnosis, the evaluation of response to therapyand demonstration of complications, it is important that he understands the clinical and radiological features ofleukemia. This report is a clinical and radiological review of 80 cases who visited to Chonnam National UniversityHospital from Jan. 1977 to June 1981. The results are summarized as follows. 1. Most prevalent group of age wasbetween 10 to 14 years old(25%) and male was affected more frequently than female with the ratio of 1.4:1. Acuteform of leukemia was 95% and acute myelocytic leukemia was more frequent than acute lymphocytic leukemia. 2.Pallor with anemic conjuctiva was the most prominent clinical manifestation of the leukemia. Fever was the mostcommon symptom in childhood leukemia and general weakness was the most common in adult leukemia. 3. Hematologicexamination revealed marked anemia(Hemoglobin level was less than 8.0gm/100ml in 65%). In 17.5% the leukocytecount was less than 5,000/cu.mm and more than 10,000/cu.mm in 65%. Platelet count was less than 50,000/cu/mm in 23.8% and between 50,000 and 150,000/cu.mm in 43.7%. 4. The abnormal findings in chest X-ray films were observedin 35%. Pneumonia(18.8%) was the most common and lymphadenopathy(17.5%), pleural effusion(12.5%), leukemicinfiltration (3.75%), pulmonary congestion and pulmonary edema(3.75%) were descending order of frequency. 5. Theabnormal findings in long bone X-ray films were observed in 75% and the bone changes were more frequent in acutelymphocytic leukemia (57.1%) than in acute myelocytic leukemia(17.9%). Metaphseal transverse radiolucent band(75.0%) was the most common and osteolytic lesion(60.7%), periosteal reaction (35.7%), osteosclerosis(7.1%) were descending order of frequency. 6. The common sites of bony changes were femur(75%), tibia(57.1%), fibular(57.1%)humerus, radius and ulna in order of frequency. 7. In 35.7% of the cases who complained of bone or joint pain withabnormal findings in long bone x-ray films, leukocyte count was less than 5,000/cu.mm.
Adult ; Arthralgia ; Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Fever ; Humans ; Jeollanam-do ; Leukemia ; Leukemia, Myeloid, Acute ; Leukocyte Count ; Male ; Platelet Count ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Radius ; Thorax ; Ulna ; X-Ray Film

PURPOSE: The formation of a liposarcoma is Known to be associated with a mutation of the p53 and MDM2 genes, and the histopathological subtypes of a liposarcoma are related to the prognosis of the patient. This study was performd to examine the relationship between the histopathological subtypes, the type of p53 mutation, and the proliferative rate. METHODS: Immunohistochemistry was used to measure the p53 protein and Ki-67 (Mib-1 labeling index) expression levels in 24 liposarcomas cases in which the liposarcoma developed primarily in the abdominal cavity. RESULTS: p53 expression was observed in 11.1% of the well- differentiated liposarcoma cases, 27.3% of the myxoid and round cell liposarcoma cases, and 50% of the pleomorphic liposarcoma cases. There were significant differences between the Ki-67 expression level according to the histopathological subtypes. There were significant differences between p53 positive or negative group and the Ki-67 expression level, and there was a quantitative correlation between them. CONCLUSION: The p53 protein was expressed in 25% of all liposarcomas, particularly in pleomorphic liposarcomas because it was expressed more frequently than in the other liposarcoma subtypes (in 2 cases out of 4 cases). The survival rate was much higher in the mucinous round cell liposarcomas which had high p53 and Ki-67 expression levels. The p53 expression level might be a prognostic predictor of a liposarcoma.
Abdominal Cavity ; Humans ; Immunohistochemistry ; Liposarcoma* ; Mucins ; Prognosis ; Survival Rate

PURPOSE: This study was performed in order to compare unenhanced CT with diffusion-weighted, T2-weight-ed,and fast FLAIR MR imaging in the detection of hyperacute cerebral ischema induced in a dog and to deter-mine whichmodality first detected cerebral ischemia. MATERIALS AND METHODS: Experimental cerebral infarction was induced bythe occlusion of intracerebral arter-ies using embolic materials (polyvinyl-alcohol, 300 -6 00 micro) introducedthrough a microcatheter into the internal carotid artery of five dogs weighing 12 -20 kg. Serial CT and MR imageswere obtained at one hour intervals from one to five hours after occlusion, and were analyzed independently by tworadiologists. We assessed changes in attenuation, as seen on unenhanced CT and the signal intensity of the lesionon each MR image, and measured the contrast-to-noise ratio (CNR) of the lesions. RESULTS: Ischemic lesions weredetected on unenhanced CT 1 -3 hours after occlusion of cerebral arteries. In all dogs, the lesions were detectedearliest on diffusion-weighted images obtained at 1 hour. They were detect-ed on T2-weighted images at 3 -5 hoursand on fast FLAIR images of 2 -5 hours. The CNR of ischemic lesions increased gradually during the 5-hour period.It was highest on diffusion-weighted images, while on unen-hanced CT, T2-weighted, and fast FLAIR images it wassimilar. CONCLUSION: Hyperacute ischemic lesions were detected earliest on diffusion-weighted images, and earlieron unenhanced CT than on fast FLAIR or T2-weighted MR image.
Animals ; Brain Ischemia ; Carotid Artery, Internal ; Cerebral Arteries ; Cerebral Infarction* ; Dogs* ; Magnetic Resonance Imaging*

The present study was attempted to investigate whether polyphenolic compounds isolated from wine, which is brewed from Rubus coreanum Miquel (PCRC), may affect the release of catecholamines (CA) from the isolated perfused adrenal medulla of the spontaneously hypertensive rats (SHRs), and to establish its mechanism of action. PCRC (20~180 microgram/ml) perfused into an adrenal vein for 90 min relatively dose-dependently inhibited the CA secretory responses to ACh (5.32 mM), high K+ (56 mM), DMPP (100 micrometer) and McN-A-343 (100 micrometer). PCRC itself did not affect basal CA secretion (data not shown). Also, in the presence of PCRC (60 microgram/ml), the CA secretory responses to veratridine (a selective Na+ channel activator (10 micrometer), Bay-K-8644 (a L-type dihydropyridine Ca2+ channel activator, 10 micrometer), and cyclopiazonic acid (a cytoplasmic Ca2+ -ATPase inhibitor, 10 micrometer) were significantly reduced, respectively. In the simultaneous presence of PCRC (60 microgram/ml) and L-NAME (an inhibitor of NO synthase, 30 micrometer), the inhibitory responses of PCRC on the CA secretion evoked by ACh, high K+, DMPP, and Bay-K-8644 were considerably recovered to the extent of the corresponding control secretion compared with that of PCRC-treatment alone. The level of NO released from adrenal medulla after the treatment of PCRC (60 microgram/ml) was greatly elevated compared with the corresponding basal level. Taken together, these results demonstrate that PCRC inhibits the CA secretion from the isolated perfused adrenal medulla of the SHRs evoked by stimulation of cholinergic receptors as well as by direct membrane-depolarization. It seems that this inhibitory effect of PCRC is mediated by blocking the influx of calcium and sodium into the adrenal medullary chromaffin cells of the SHRs as well as by inhibition of Ca2+ release from the cytoplasmic calcium store at least partly through the increased NO production due to the activation of NO synthase.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Medulla ; Calcium ; Catecholamines ; Chromaffin Cells ; Cytoplasm ; Dihydropyridines ; Dimethylphenylpiperazinium Iodide ; Indoles ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Polyphenols ; Rats, Inbred SHR ; Receptors, Cholinergic ; Sodium ; Veins ; Veratridine ; Wine

OBJECTIVE: We tried to evaluate the driving ability of stroke patients using Cognitive Behavioral Driver's Inventory (CBDI), Psychological Software Service, U.S.A. to find out whether it is helpful in predicting the outcome of driving rehabilitation. METHOD: Subjects were 18 stroke patients who had driven a car before the stroke. Each patient was evaluated with CBDI and got a driving test. We compared driving test results with CBDI scores. RESULTS: Average CBDI score was 63.0 +/- 19.3. There was no significant difference according to lesion sides or types of stroke. Average score of driving test was 85.3 +/- 10.9. Twelve of 18 subjects passed the driving test and six subjects failed. Average score among right hemiplegics was significantly higher than that of left hemiplegics (p<0.05). Average CBDI score of the subjects who passed the driving test was 52.3 +/- 4.7, while that of the failed subjects was 84.7 +/- 19.6. There was significant difference in CBDI score between 2 groups (p<0.05). Among the 28 items of CBDI, 11 items including brake reaction time, Wechsler Adult Intelligence Scale-Revised Picture Completion showed significant correlation with the total score of the driving test (p<0.05). CONCLUSION: CBDI can be used as a useful tool for predicting driving ability of stroke patients.
Adult ; Humans ; Intelligence ; Reaction Time ; Rehabilitation ; Stroke*

OBJECTIVE: To evaluate the standards of handicapped driver's ability test in Korea and available driving aids in cervical cord injured persons. METHOD: Forty-two cervical cord injured persons (C5~C8) were evaluated with BTE (Baltimore Therapeutic Equipment) work simulator. The isotonic turning torque was measured during clockwise and counter-clockwise turning. And isometric turning torque was measured at 12 directions. RESULTS: By the isotonic measurement, the turning torque increased in the lower level of injury. In the C6 tetraplegics, the counter-clockwise turning torque was significantly higher than clockwise. Among 25 persons with C5 or C6 tetraplegia, only 2 with C6 tetraplegia could operate the power steering with the lowest wheel turning torque (3.0 Nm). Only three persons (1 person with C7 tetraplegia, 2 persons with C8 tetraplegia) could pass the handicapped driver's ability test of Korea (9.4 Nm). By the isometric measurement, turning torque was lowest at left upper quadrant (10 to 12 o'clock direction) in clockwise rotation. CONCLUSION: Among the 42 cervical cord injured persons, only 3 persons with C7 and C8 tetraplegia could pass the handicapped driver's ability test of Korea. And among 25 C5 and C6 tetraplegia, only 2 persons with C6 tetraplegia could operate the power steering. It seems to be essential to modify the standards of handicapped drivers ability test and to evolve the driving aids for the C5 and C6 tetraplegics in Korea.
Disabled Persons ; Humans ; Korea ; Quadriplegia ; Torque*

Gastroesophageal reflux disease (GERD) is thought to be caused by an incompetent lower esophageal sphincter, either because of a chronic hypotonia or an increased frequency of transient lower esophageal sphincter relaxation. Thus, it seems paradoxical under nutcracker esophagus to consider gastroesophageal reflux as a possible diagnosis, particularly in the patient presenting with chest pain. Current therapy in nutcracker esophagus is aimed at reducing the high amplitude peristaltic contractions characteristic of this disorder. Treatment directed at reducing contraction can decrease lower esophageal sphincter pressure and may exacerbate gastroesophageal reflux. It is not easy to treat a case of nutcracker esophagus associated with GERD. We report a 38-year-old male with nutcracker esophagus associated with GERD who lost the diagnostic features of nutcracker esophagus after 6 week of antireflux therapy.
Adult ; Chest Pain ; Diagnosis ; Esophageal Motility Disorders* ; Esophageal Sphincter, Lower ; Gastroesophageal Reflux* ; Humans ; Male ; Manometry* ; Muscle Hypotonia ; Omeprazole* ; Relaxation

PURPOSE: We evaluate the prognostic value of primary tumor location for oncologic outcomes in patients with colon cancer (CC). METHODS: CC patients treated with curative surgery between 2009 and 2012 were classified into 2 groups: right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Recurrence-free survival (RFS) and overall survival (OS) were examined based on tumor stage. Propensity scores were created using eight variables (age, sex, T stage, N stage, histologic grade, presence of lymphovascular invasion/perineural invasion, and microsatellite instability status). RESULTS: Overall, 2,329 patients were identified. The 5-year RFSs for RCC and LCC patients were 89.7% and 88.4% (P = 0.328), respectively, and their 5-year OSs were 90.9% and 93.4% (P = 0.062). Multivariate survival analyses were carried out by using the Cox regression proportional hazard model. In the unadjusted analysis, a marginal increase in overall mortality was seen in RCC patients (hazard ratio [HR], 1.297; 95% confidence interval [CI], 0.987–1.704, P = 0.062); however, after multivariable adjustment, similar OSs were observed in those patients (HR, 1.219; 95% CI, 0.91–1.633; P = 0.183). After propensity-score matching with a total of 1,560 patients, no significant difference was identified (P = 0.183). A slightly worse OS was seen for stage III RCC patients (HR, 1.561; 95% CI, 0.967–2.522; P = 0.068) than for stage III LCC patients. The 5-year OSs for patients with stage III RCC and stage III LCC were 85.5% and 90.5%, respectively (P = 0.133). CONCLUSION: Although the results are inconclusive, tumor location tended to be associated with OS in CC patients with lymph node metastasis, but it was not related to oncologic outcome.
Colon ; Colonic Neoplasms ; Humans ; Lymph Nodes ; Microsatellite Instability ; Mortality ; Neoplasm Metastasis ; Propensity Score ; Proportional Hazards Models ; Treatment Outcome

OBJECTIVES : We investigated the relationship between periventricular and deep white matter hyperintensity and cognitive function in Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS : T2-weighted MRI scans were performed in 41 subjects with AD 38 subjects with mild cognitive impairment and 38 control subjects. Periventricular and deep white matter hyperintensities were rated on a Fazekas 0-3 scale by a medical specialist of the department of radiology blind to clinical diagnosis. Cognitive function was assessed by using Cognitive Assessment and Reference Diagnoses System. RESULTS : No significant differences between demographic characteristics and vascular risk factors were revealed comparing AD, MCI and controls. The frequencies of AD were significantly higher than those of MCI and normal control in Grade 2 and 3 of periventricular hyperintensity and Grade 3 of deep white matter hyperintensity. The scores of amnesia, executive function and attention were significantly lower in Grade 2 and 3 of periventricular hyperintensity than in Grade 0 and 1. The scores of attention were significantly lower in Grade 3 of deep white matter hyperintensity than in Grade 0, 1 and 2. CONCLUSION : Periventricualr hyperintensities are associated with cognitive decline in amnesia, executive function and attention, while deep white matter hyperintensities are associated with cognitive decline in attention.
Alzheimer Disease ; Amnesia ; Executive Function ; Humans ; Magnetic Resonance Imaging ; Mild Cognitive Impairment ; Risk Factors ; Specialization

OBJECTIVES : We investigated the relationship between periventricular and deep white matter hyperintensity and cognitive function in Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS : T2-weighted MRI scans were performed in 41 subjects with AD 38 subjects with mild cognitive impairment and 38 control subjects. Periventricular and deep white matter hyperintensities were rated on a Fazekas 0-3 scale by a medical specialist of the department of radiology blind to clinical diagnosis. Cognitive function was assessed by using Cognitive Assessment and Reference Diagnoses System. RESULTS : No significant differences between demographic characteristics and vascular risk factors were revealed comparing AD, MCI and controls. The frequencies of AD were significantly higher than those of MCI and normal control in Grade 2 and 3 of periventricular hyperintensity and Grade 3 of deep white matter hyperintensity. The scores of amnesia, executive function and attention were significantly lower in Grade 2 and 3 of periventricular hyperintensity than in Grade 0 and 1. The scores of attention were significantly lower in Grade 3 of deep white matter hyperintensity than in Grade 0, 1 and 2. CONCLUSION : Periventricualr hyperintensities are associated with cognitive decline in amnesia, executive function and attention, while deep white matter hyperintensities are associated with cognitive decline in attention.
Alzheimer Disease ; Amnesia ; Executive Function ; Humans ; Magnetic Resonance Imaging ; Mild Cognitive Impairment ; Risk Factors ; Specialization