PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

It is now generally accepted that most, if not all, colon cancers originate within previously benign adenomas. Endoscopic polyp resection and regular follow up endoscopic examination are essential for prevention of carcinoma fro benign adenoma. However, small colorectal polyps are difficult to recognize during follow up endoscopic examinations because of the lack of reliable endoscopic landmarkers. Endoscopic Indiaink marking of the colon was first described by Ponsky and King in l975. The method has subsequently been advocated by expert as the best available means to mark the site of a colonic lesion. We prospectively studied the effectiveness of India ink as a long term colonic mucosal marker. Twelve patients who were diagnosed as colorectal polyp had a India ink marking with standard sclerotherapy needle. All patients who were followed at 6 months interval (mean duration 13 months) continue to display intensely stained mucosa at the original sites. No side effects or complications were encountered. India ink appears to be a safe and effective long term marker for colonic mucosal lesions.
Adenoma ; Colon* ; Colonic Neoplasms ; Follow-Up Studies ; Humans ; India* ; Ink* ; Mucous Membrane* ; Needles ; Polyps ; Prospective Studies ; Sclerotherapy

No abstract available.
Wernicke Encephalopathy*

BACKGROUND/AIMS: The aims of this study are to clarify the morphology of fundic gland polyp (FGP) and to compare the features of FGP between familial adenomatous polyposis-associated group and sporadic development group. METHODS: A total of 15 endo- scopic biopsy specimens of FGP from 13 patients were divided into three groups; Group A(3 cases; familial adenomatous polyposis family, multiple FGPs), Group B(3 cases; sporadic development, multiple FGPs) and Group C(7 cases; sporadic development, single FGP), and their endoseopic /microscopic features including mucin histochemistry and immunohistoc- hemistty(for PCNA) were compared. RESULTS: FGPs were confined to the gastric body and fundus in all 3 groups, and measured 2-8 mm. Their numbers varied even in Group A and Group B, The difference was observed in their median age: 26 years in Group A and 55 years in Group B, respectively, but there were no differences in endoscopic, histologic, mucin histochemical and immunohistochemical(for PCNA) features. Micro-scopically, all FGPs were composed of fundic glands and scattered microcysts with a spectrum of disordered glandular architecture which ranged from convoluted gland to Y-shaped gland, to stellateshaped gland, and to irregular tortuous glancl with dilated lumen. CONCLUSIONS: We assume that diversity af morphologic features of FGP may develop from progression of hyperplastic/hamartomatous fundic glandular proliferation which may end up with microcyst formation as an evolutional change. Familial adenomatous polyosis-associated FGPs were not endoscopically and histologically distingishable from sporadic deveoped FGPs.
Adenomatous Polyposis Coli* ; Biopsy ; Esophagus* ; Humans ; Intestines* ; Mucins ; Polyps* ; Stomach*

No abstract available.
Angiography, Digital Subtraction ; Venous Thrombosis

A 73-year-old woman with chronic hepatitis C was hospitalized with proximal muscle weakness and generalized muscle pain. The patient was diagnosed as rhabdomyolysis with myoglobinuric acute renal failure. But there was no history of muscle compression, ingestion of drugs which can cause rhabdomyolysis, or alcohol abuse. The initial clinical features and laboratory findings showed no evidence of infectious myopathy or electrolyte abnormality. The electromyography and muscle biopsy was performed and polymyositis was diagnosed. Polymyositis, an idiopathic inflammatory myopathy, can cause rhabdomyolysis, but myoglobinuric acute renal failure due to polymyositis is very rare. We report a case of myoglobinuric acute renal failure caused by polymyositis with review of the literatures.
Acute Kidney Injury* ; Aged ; Alcoholism ; Biopsy ; Eating ; Electromyography ; Female ; Hepatitis C ; Hepatitis C, Chronic* ; Hepatitis, Chronic* ; Humans ; Muscle Weakness ; Muscular Diseases ; Myalgia ; Myoglobinuria ; Myositis ; Polymyositis* ; Rhabdomyolysis

BACKGROUND: To evaluate airway responses and inflammation to antigen in Sprague-Dawley rat asthma model, we examined airway responses, serial histologic changes of the lung, and the relationship between airway responses and airway inflammation after antigen airway challenge. METHODS: Sprague-Dawley rats were sensitized with subcutaneous injection of 10 microgram ovalbumin(OA). Antigen airway challenges were done 14 ~16 days after sensitization and the sensitized rats were sacrificed 1h(AE), 6 ~8h(AL) and 1day(AD) after airway challenge, to examine the histologic changes of the lung. Airway responses were measured by body plethysmograph and recorded by enhanced pause(Penh) as an index of airway obstruction 6 ~8h after antigen challenges. Nonsensitized controls(10 rats) were also challenged with antigen and sacrificed 1 day later. Histopathologic examination of two trachea, large bronchi, small bronchi, and vessels was performed to evaluate the severity of inflammation and eosinophilic infiltration with H&E stain. RESULTS: In 17 of 20 rats(85%) in both groups, we observed airway responses. Among them, an early response(ER) in 15 rats(75%), an dual response in 5(25%), and an late response(LR) only in 2 rats(10%) displayed. There were no significant differences in the severity of inflammation among the trachea, large bronchi, small bronchi and vessels in all groups after antigen challenge(p>0.05) and between early and late responders. The significant eosinophil infiltration was observed in 5 rats(50%) of AL(p<0.05) compared with in AE and controls. Also, eosinophil infiltration was observed in higher trend in LR(57.1%) compared to ER(40%)(p>0.05). CONCLUSION: Sprague-Dawley rats sensitized with subcutaneous injection of OA showed a significant airway responses to antigen challenge. But antigen challenges caused a little eosinophil infiltration and no significant airway inflammation. Asthma model of Sprague-Dawley rats could be useful for antigen-induced airway responses, but this model has a limitation for the study of human asthma because of no significant pathologic change.
Airway Obstruction ; Animals ; Asthma* ; Bronchi ; Eosinophils ; Humans ; Inflammation* ; Injections, Subcutaneous ; Lung ; Ovalbumin* ; Rats ; Rats, Sprague-Dawley* ; Trachea

Group occupational health service programme started in 1990 is one of the measures to cope with limited human and financial resources in occupational health. The programme has expanded rapidly to include 52 institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. This study has aims to develop the criteria to assess the quality of newly developed group occupational health service programme, and to investigate the quality of institutions, and finally to develop policies for the quality improvement. 1) Criteria development : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, followings are included as core elements of qualitative occupational health programme ; accessibility, continuity, comprehensiveness, technical quality, intersectoral collaboration, emphasis on preventive services, community participation, and adequacy. Again each element is divided into five major components of national health system infrastructure developed by the World Health Organization ; development of health resources, organized arrangement of resources, delivery of health care, economic support, and management. In turn, each component is categorized into three aspects of quality assessment, structure, process and outcome. Expert panel selected several criteria for each category to evaluate the programme. Criteria were modified according to each group of interviewees, to produce two sets of questionnaire, one for chief operating officer and another for nurses in the institutions, and the chief operating officer and workers in the workplace. 2) Subject : Of all 52 institutions, 25 voluntarily participated in the survey. At individual institution, chief operating officer and practicing nurses were interviewed in depth. After intensive education for interviewees, every interview was performed with standardized guideline and questionnaire. The quality of the 'Group occupational health service programme' was found to be lower than expected. Especially In continuity, comprehensiveness, technical quality, community participation and adequacy, lower quality in structural aspect was commonly identified throughout all the institutions. Quality in terms of accessibility and continuity highly varied among institutions. To improve quality of the programme, more comprehensive and systematic programme such as accreditation has to be introduced. In addition, human resources, governmental fund and information systems for individual workers are to be developed. As a long range plan, integration of occupational health services into the national health systems and pooling of financial resources and planned allocation should be considered.
Accreditation ; Consumer Participation ; Cooperative Behavior ; Delivery of Health Care ; Education ; Financial Management ; Health Resources ; Humans ; Information Systems ; Korea* ; Occupational Health Services* ; Occupational Health* ; Primary Health Care ; Quality Improvement ; Questionnaires ; Social Welfare ; World Health Organization

PURPOSE: No tumor-specific markers for gastric cancer are currently known, although various tumor markers have been utilized. CEA, CA19-9 and AFP are the most commonly used tumor markers for gastric cancer. The aim of this study is to evaluate the prognostic significance of the preoperative CEA, CA19-9 and AFP levels in patients with gastric cancer. METHODS: A total of 366 patients who underwent curative surgery for gastric cancer were analyzed. The clinicopathologic characteristics and disease-free survival rate of the patients were compared between the positive and negative CEA, CA19-9 and AFP groups of patients, respectively. Also, the prognostic significance of each tumor marker was assessed by multivariate analysis. RESULTS: The CEA, CA19-9 and AFP levels were elevated in 14.2%, 7.9% and 19.1% of the patients, respectively. Serosal invasion and advanced cancer were more frequently found in the groups of patients who were positive for CEA and CA19-9 (P<0.05). More lymph node metastasis and an advanced tumor stage were found in the group of patients who were positive for CA19-9 (P<0.05). On univariate analysis, the disease-free survival rate was significantly lower in the CA19-9 positive group (P<0.05). Serosal invasion and lymph node metastasis were the only significant prognostic factors on multivariate analysis. CONCLUSION: CEA, CA19-9 and AFP have proved unhelpful for the early detection of gastric cancer due to the low positive rate. CEA and AFP have no prognostic significance and only CA19-9 can be useful for estimating the severity of gastric cancer and as a limited prognostic factor for gastric cancer patients.
Biomarkers, Tumor ; Disease-Free Survival ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Stomach Neoplasms