PURPOSE: To assess the signal enhancement by gadolinium-DTPA-polylysine (Gd-polylysine) as compared to gadopentetate (Gd-DTPA) in MR imaging of heart that have undergone ischemia-reperfusion, and to estimate the extent of myocardial damage covered bythe MR signal enhancement. MATERIALS AND METHODS: A series of contrast enhanced cardiac MR images were obtained from 17 cats subjected to a 90 minutes of occlusion of the left anterior descending coronary artery (LAD) followed by a 90 minutes of raperfusion. Time courses of changes in the signal intensity (Sl) of the ischemic area were measu red in Gd-polylysine group (8 cats) and Gd- DTPA group (9 cats). The size of U R signal enhanced area was then compared to the sizes of infarction and the area at risk revealed byTTC histochemical staining. RESULTS: Maximum Sis were obtained at 60 minutes and 30 minutes after injection of the contrast material, respectively for Gd-polylysine group and Gd-DTPA group. Signal enhancement was stronger and persistent for a longer period in Gd-polylysine group than in GD-DTPA group. Sizes of the enhanced area, the infarction, and the area at risk were about 30%, 15%, and 50% of the total left ventricle (LV) area; the difference between the groups was statistically insignificant. CONCLUSION: Gd-polylysine can be used better for a blood pool marker than Gd-DTPA in MR imaging of myocardial ischemia, due to its strong and persistent signal enhancement. The MR signal enhanced area includes both the infarcted area and a portion of the area at risk.
Animals ; Cats* ; Coronary Vessels ; Gadolinium DTPA ; Gadolinium* ; Heart ; Heart Ventricles ; Infarction ; Magnetic Resonance Imaging* ; Myocardial Ischemia ; Pentetic Acid ; Polylysine*

This study was performed to assess the accuracy of 31P magnetic resonance spectroscopy(MRS) in the evaluation of myocardial ischemia in cats. Twelve cats underwent myocardial ischemia and reperfusion induced by 90 minutes ligation followed by 90 minutes recirculation of the left anterior descending coronary artery (LAD). MRS was performed using a 4.7T Biospec MRS/MRI system (Bruker, Switzerland). An inner diameter 1.5cm-sized doubly tuned surface coli was used for the collection of the MR signal. The coli was implanted to the epicardial surface at the expected area of infarction. 31P MRS was acquired before and during the periods of ischemia and reperfusion with 5-minute to 30-minute of intervals. After completion of the 31P MRS study, animals were sacrificed and the hearts were excised for 2,3,5-triphenyl tetrazolium chloride (TTG0 histochemical staining. The area of infarct was measured on the photographs of TTG stained heart slices using a computer programmed planimetry and the results were compared with those of the 31P MRS study. The level of phosphocreatine (PCr) was decreased to 28.2±6.9% of the baseline level 90 minutes after occlusion and recovered to 43.8±4.8% of the baseline level at the end of the reperfusion. A 50% depletion of PCr was reached 5 minutes after the LAD occlusion. The ATP was decreased to a 26.6±3.6% of the baseline level 90 minutes after occlusion and recovered to a 35.9±6.0 of the baseline level 90 minutes after reperfusion. The decreasing rate of ATP was slower than that of PCr showing a 50% of depletion 15 minutes after occlusion. The PCr/ATP ratio was 1.16±0.09 at the baseline, decreased to 0.88±0.07 at 30 minutes of occlusion, and then progressively increased during the late ischemic and reperfused periods. The ratio of the infarcted area to the effective signal area of the surface coli was inversely correlated to the ATP (r=0.68) and PCr (r=0.40) levels obtained at the end of reperfusion. In conclusion, 31P MRS reflects the changes in myocardial high energy phosphorous metabolism during the actue ischemia and reperfusion. If on adequate localization technique is feasible, 31P MRS can be used clinically in the diagnosis and monitoring of the patients with acute myocardial infarction.
Adenosine Triphosphate ; Animals ; Cats* ; Coronary Vessels ; Diagnosis ; Heart ; Humans ; Infarction ; Ischemia ; Ligation ; Metabolism ; Myocardial Infarction* ; Myocardial Ischemia ; Phosphocreatine ; Polymerase Chain Reaction ; Reperfusion ; Spectrum Analysis*

No abstract available.
Polycystic Kidney Diseases*

BACKGROUND: To evaluate the metabolic and pathological changes associated with myocardial ischemia-reperfusion, magnetic resonance spectroscopy with 31P was applied as well as pathological examination. METHODS: Effect of adenosine on the recovery of high energy phosphorous metabolites during the reperfusion period following 90 minutes of left anterior descending coronary artery(LAD) ligation was assessed by 31P spectroscopy in 13 cats(8 : control group, 5 : adenosine group). In adenosine group 0.2 mg/kg/min of adenosine was infused intravenously for 90 minutes from 30 minutes before reperfusion. The experiments were peformed on a 4.7 T/30cm Biospec MRS/MRI system(Bruker, Switzerland) and the MR signals were obtained by using innerdiameter 1.5 cm sized doubly tuned surface coil. The size of the spectral peaks was measured by area integration method. RESULTS: In control group, high energy phosphorous metabolites decreased continueously during the ischemic period revealing the lowest values at the end of the periods : 17.0% for PCr and 24.0% for ATP, PCr depleted below 50% of the baseline level immediately after the LAD ligation and ATP, after 15 minutes of ischemia. Therfore the depletion rate was faster in PCr change than in ATP. The recovery of the PCr and ATP occurred after reestablishment of blood flow showing, for example, 43.3% and 36.3% of the baseline levels after 10 minutes of reperfusion. After infusion of adenosine, there was a tendency of higher recovery rates of high energy phosphates than in control group. Recovery rates of PCr and ATP after 90 minutes of reperfusion, were 28.2%, 11.2% in control group and 38.3%, 18.6% in adnosine group, respectively. In adenosine grop, relative sizes of infarction were not statistically different from those of control group. CONCLUSIONS: 31P MRS can be used for in-vivo assessment of the changes of high energy phosphorous metablites concerning acute myocardial ischemia and reperfusion. Adenosine infusion improves the recovery of ATP and PCr during the reperfusion period following acute ischemia.
Adenosine Triphosphate ; Adenosine* ; Animals ; Cats* ; Infarction ; Ischemia ; Ligation ; Magnetic Resonance Spectroscopy ; Myocardial Ischemia ; Phosphates ; Polymerase Chain Reaction ; Reperfusion ; Spectrum Analysis

PURPOSE: To see the stability and error in the diffusion-weighted magnetic resonance (MR) imaging technique in the experimental models and to observe the signal intensities in the early cerebral lesions of the animal models. MATERIALS AND METHODS: Diffusion coefficients of acetone and distilled water were measured by diffusion-weighted MR image and were compared with actual values. Differentiation of diffusion from perfusion were done at the resin flow phantom. The signal intensities caused by early parenchymal changes were measured in normal, hypovolemic, and embolic, and dead animal models by using diffusion-weighted image and compared with pathoIogic finding and vital staining. RESULTS: Diffusion coefficients of acetone and distilled water were 4.48 x 10-3 and 2.72 x 10-3 which were very close to the actual values. Diffusion-weighted MR image obtained at flow phantom was not affected by flow (perfusion) at the 100-400 of b-factor range. Animal study done at that b-factor range revealed a significant signal difference between the left and right sides only at the embolic model induced by polyvinyl alchol particles (p<0.05). These changes were not detected in microscopic finding but could be identified in vital staining. CONCLUSION: Diffusion-weighted MR image can be used to detect early parenchymal change when the appropriate b-factor range was applied.
Acetone ; Animals ; Diffusion* ; Hypovolemia ; Models, Animal ; Models, Theoretical* ; Perfusion ; Polyvinyls ; Water

BACKGROUND: Reestabilshment of blood flow is a standard therapeutic modality to salvage the myocardium at risk in an acute phase of myocardial infarction. However, there are significant evidences that reperfusion per se may injure the potentially viable myocardium, and a number of pharmacological agents were tried to reduce this reperfusion injury. Adenosine, an endogenous vasodilator, is suggested to reduce repergusion inury. To evaluate the myocardial protective effect of adenosine, magnetic resonance spectroscopy with superscript P was applied to feline model of acute myocardial ischemia-reperfusion, as well as pathological examination. METHODS: Effects of adenosine on the recovery of high energy phosphorous metabolites during 90 minutes of reperfusion period following 90 minutes of left anterior descending coronary artery ligation were assessed by31P spectroscopy in 27 cats(10: control group, 8: adenosine I group, 9: adenosine II group). In adenosine groups 0.2 mg/kg/min of adenosine was infused intravenously for 90 minutes from 30 miniutes before reperfusion in group I, and from just before reperfusion in group II. The experiments were performed on a 4.7 T/30 cm Biospec MRS/MRI system and the MR signals were obtained by using inner-diameter 1.5 cm-sized doubly tuned surface coil. The size of the spectral peaks was measured by area integration method. RESULTS: 1) Phosphocreatine(PCr) decreased rapidly with progression of ischemia, and recovered in reperfusion period in each group. PCr values in the reperfusion period were significantly higher in adenosine group than those in control group, although there was no difference between adenosine group I and II. 2) ATP decreased with progression of ischemia, and recovered in reperfusion period in each group. ATP values in the reperfusion period were significantly higher in adenosine groups than those in control group, byt there was no difference between adenosine group I and II. 3) pH decreased uniformly with progression of ischemia and recovered in reperfusion period, showing no difference between control and adenosine groups. 4) PCr/ATP ratio, representing the potential of oxidative phosphorylation, dereased with progression of ischemia and increased in reperfusion period. PCr/ATP ratio showed no difference between control, adenosine I and II groups. 5) Risk area/left ventricle ratio was not different in control and adenosine groups. Infarct size/risk area and infarct size/left ventricle ratios were smaller in adenosine II than those in control group. Howerver no significant diffence was noticed between adenosine I and control, and between adenosine I and II group. CONCLUSION: Intravenous infusion of adenosine showed the tendency of reducing the infarct size in the feline model of acute myocardial ischemia-reperfusion, and adenosine could improve significantly the recovery of high energy phosphate metabolites. This myocardial pretective effect of adenosine is considered to be present mainly in the reperfusion period.
Adenosine Triphosphate ; Adenosine* ; Coronary Vessels ; Hydrogen-Ion Concentration ; Infusions, Intravenous ; Ischemia ; Ligation ; Magnetic Resonance Spectroscopy ; Myocardial Infarction ; Myocardial Ischemia ; Myocardium ; Oxidative Phosphorylation ; Polymerase Chain Reaction ; Reperfusion ; Reperfusion Injury ; Spectrum Analysis

In order to observe the pattern of a flow image on multisection MR imaging technique, a flow phantom experiment was preformed using a superconducting high filed 2.0 Tesla MRI scanner. The pattren of the first section images was homogeneous round at all flow velocities until the turbulence forming level. The patterns of the second section images,however,changed into a homogeneous round shape, a ring shape, a target shape, and a small round shape as the velocity increased. When scanned at velocities higher than the trubulence forming level, the images become distored and irregular, and eventually disappeared after the cut-off velocity. The homogeneous round image senn at the lower velocity levels in throught to be due to the overwhelming effects of fully managetized spins influxed into the imaging section during the prior repetition time(TR). Later in the higer velocity levels the effects of the partially saturated spins and fully magnetized spins influxed during the section transit time(TR/slice number) are added, and result in ring, target, and small round patterns in the second section image.
Magnetic Resonance Imaging*

Aneurysm ; Bone Cysts ; Curettage ; Cytochrome P-450 CYP1A1 ; Female ; Humans ; Joints ; Mandible ; Maxilla ; Middle Aged ; Tooth ; Transplants

Non-Hodgkin's lymphoma frequently involves the kidneys, with previous reports demonstrating approximately a 48 Yo incidence at autopsy. In contrast, lymphoma originating within the kidneys is a rare event, because the renal parenchyma does not have lymphatics. Most common type of primary renal lyrnphoma that calssified by Working formulation and irnmunohistochemistry was diffuse large B-cell, intermediate grade. A 43-year-old woman presented with epigastric discomfort, anorexia, fever, and weight loss. The past rnedical history was unremarkable. On physical examination, she was febrile, and conjunctiva was pale. Lymph node was enlarged and palpated at right inguinal area. But no other lymphadenopathy or hepatosplenomegaly was found. Laboratory study showed WBC 6,900/mm, hemoglobin 6.7g/dL, serum LDH 783IU/L, GFR 31.45 ml/min. The chest X-ray was within normal limit; no mediastinal lympha- denopathy was present. The abdominal X-ray revealed enlargement of right kidney. The abdominal CT scan showed markedly enlarged both kidneys containing inhomogeneous solid masses with poor excretion of intravenous contrast, a few small paraaortic lymphadenopathies, and contour bulging on the pancreas body. A percutaneous renal biopsy was obtained from this patient at the right kidney. Microscopic exarnination showed a diffuse infiltrate of predominantly large lymphoid cells having round to oval vescicular nuclei. Immunohistochemical studies revealed a B-cell-type lymphoma. The tumor was judged to be an intermediate-grade, large-cell, diffused, B-cell-type non-Hodgkin's lymphoma. We report a case of primary bilateral B-cell renal lymphoma in a 43-year-old female patient with review of the literature.
Adult ; Anorexia ; Autopsy ; B-Lymphocytes* ; Biopsy ; Conjunctiva ; Female ; Fever ; Humans ; Incidence ; Kidney ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Pancreas ; Physical Examination ; Thorax ; Tomography, X-Ray Computed ; Weight Loss

Aureobasidium Pullulans (AP) is a fungus known as a "black fungus" characterized by production of melanin pigment. It is infected mainly by subcutaneous pathway, but causes a very rare disease in human. There was a very few report of AP infection in human all around the world and no report in Korea, yet. We reported the first Korean case of AP sepsis patient who received the second kidney transplantation in China. The patient was a 61-year old male who underwent the first kidney transplantation at Severance Hospital in July 1992 and had experienced chronic renal graft dysfunction for the last several years. He went to China and underwent the 2nd kidney transplantation from acute brain-injury donor on December 31, 2002. He discharged and came back to Korea at POD #14 and admitted to our department. At admission, there was no specific symptom or sign of infection and the function of allograft kidney was good with serum creatinine of 1.2 mg/dL. He was on tacrolimus 4 mg bid, deltacortef 10mg bid and MMF 1.0 gm bid. During the hospitalization, the dosage of tacrolimus was controlled by adjusting serum tacrolimus level around 10~15 ng/mL, and reduced the dosage of deltacortef to 5 mg bid and MMF to 500 mg bid. Since Zenapax was already administered during the hospitalization in China, we added additional injection of Zenapax twice with 2 weeks interval. On POD #22, he developed skin rash and edema compatible to cellulites on the intravenous puncture site of left upper arm during his hospital stay in China. MMF was stopped and broad spectrum antibiotic therapy was started immediately. On POD #23, he developed acute myocardiac infarction and he undertook PTCA with arterial stent insertion. He was transported to intensive care unit due to acute respiratory failure on POD #27, and the left arm color was changed to black on POD #30. The empirical intravenous amphotericin therapy was started at POD #35, but the patientdied due to multiple organ failure caused by fungal sepsis. After his death, we received positive culture report of AP from his blood and skin lesion specimens collected on POD #29 and 35.
Allografts ; Amphotericin B ; Arm ; China* ; Creatinine ; Edema ; Exanthema ; Fungi ; Hospitalization ; Humans ; Infarction ; Intensive Care Units ; Kidney Transplantation* ; Kidney* ; Korea ; Length of Stay ; Male ; Melanins ; Middle Aged ; Multiple Organ Failure ; Punctures ; Rare Diseases ; Respiratory Insufficiency ; Sepsis* ; Skin ; Stents ; Tacrolimus ; Tissue Donors ; Transplants