We retrospectively reviewed magnetic resonance image findings of primary CNS lymphomas in six patients. All patients showed parenchymal masses (n=8), a solitary mass in 4 and multiple in the other two. One patients showed leptomeningeal lesion. Parenchymal masses were located in forntal lobe (n=4), cerebellum (n=2), basal ganglia (n=1), and parietal lobe (n=1), These masses showed hypointensity on T1-weighted images (WI). On T2 WI, the signal intensity of mass was isointense to the brain parenchyma in 5 and hyperintese in 3. After Gadlinium-DTPA injection, seven lesions were enhanced homogeneously, and the margin of the mass was smooth in 5 and irregular in 3. Peritumoral edema was moderate in 4, absent in 3, and severi in 1. These characteristics may be useful in the diagnosis of primary CNS lymphoma.
Basal Ganglia ; Brain ; Cerebellum ; Diagnosis ; Edema ; Humans ; Lymphoma* ; Magnetic Resonance Imaging* ; Parietal Lobe ; Retrospective Studies

BACKGROUND: Coronary blood flow shows phasic and diastolic dominant flow pattern in normal coronary artery, which can be changed in coronary artery stenosis. We measured and analysed coronary blood flow velocity by Doppler-tipped guidewire to clarify the change of flow pattern in the proximal and distal segments of coronary narrowings. METHODS: Coronary flow velocity were measured by 0.018 or 0.014 inch Doppler-tipped guidewire in 14 paients, 17 sites(LCS 11, RCA 6) in the proximal and distal segment of coronary narrowings, during coronary angiography or coronary angioplasty after bolus intracoronary infusion of 20microg nitroglycerine. Coronary flow reserve also measured after adenosine intracoronary infusion(LCA 12gmicrog, RCA 6microg). Perent stenosis of coronary artery was measured by digital cailper in 2 different projections and averaged. RESULTS: 1) The was no significant correlation between percent stenosis and proximal distal velocity ratio(P/D) ration(r=0.56. P>0.05). 2) Average peak velocity(APV, cm/sec) and diastolic artery, respectively(p<0.01) Distal APV was significantly lower than proximal APV(p<0.01) but DSVR showed no significant difference(P>0.01). 3) Coronary flow reserve(CFR) was significantly lower in significant coronary stenotic patients compared to insignificant stenotic patients(1.8 vs 3.6, P<0.01). CONCLUSION: Coronary flow velocity measurement by Doppler dipped guidewire gave us physiologic information. We think it could be used as an important tool to assess the significance of the intermediate coronary narrowings and the effect of conorary angioplasty.
Adenosine ; Angioplasty ; Arteries ; Blood Flow Velocity ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels* ; Humans ; Nitroglycerin

PURPOSE: To evaluate the plain radiographic and CT findings of the necrotizing fasciitis. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings of 4 cases with necrotizing fasciitis. Three cases were proven pathologically. We evaluated pattern and extent of the gas shadows in plain films. CT findings were analysed, with emphasis on : (a) gas pattern, (b) extent, (c) location and involved site, (d) associated focal abscess, and (e) swelling of the adjacent muscles. RESULTS: On plain radiographs, four cases showed streaky or mottled gas densities in the pelvis, three cases in the perineum, one case in the abdomen, and two cases in the thigh. On CT images, gas pattern was mottled and streaky appearance with swelling of the adjacent muscles. Gasshadows located in the extraperitoneal space in four cases, fascial layer in four cases, and subcutaneous layer infour cases. There were gas shadows in pelvic wall, perineum, abdominal wall, buttock, thigh, and scrotum. Focallow density lesion suggestive of focal abscess was not visualized. CONCLUSION: Plain radiography is useful forearly diagnosis of the necrotizing fasciitis and CT is very useful for detection of precise location and extent of the disease. CT is also useful for differentiation of necrotizing fasciitis from focal abscess and cellulitis.
Abdomen ; Abdominal Wall ; Abscess ; Buttocks ; Cellulitis ; Diagnosis ; Fasciitis, Necrotizing* ; Muscles ; Pelvis ; Perineum ; Radiography ; Retrospective Studies ; Scrotum ; Thigh

A 49-year-old man with liver cirrhosis and hypertension was found to have hyperkalemia out of a degree of renal insufficiency and metabolic acidosis with low to normal anion gap, aggravated by volume contraction with diarrhea and medications (captopril, spironolactone and atenolol) interfering with potassium homeostasis. Plasma renin activity and serum aldosterone levels of this patient on a regular diet after discontinuation of medications were very low compared to those of five other cirrhotic patients with normokalemia as controls. Also, the renin-aldosterone stimulation testing on this patient performed by sodium restricted diet and furosemide, upright position and by angiotensin converting enzyme inhibition (captopril, 50 mg) showed the blunted renin and aldosterone responses to each of these stimuli, almost no changes from baseline renin and aldosterone levels, it was concluded that the underlying defect responsible for hyperkalemia in this case was hyporeninemic hypoaldosteronism and this was aggravated by other factors or drugs affecting potassium homeostasis.
Aldosterone/blood ; Captopril/pharmacology ; Furosemide/pharmacology ; Humans ; Hyperkalemia/*etiology ; Hypertension/*complications ; Hypoaldosteronism/*complications ; Liver Cirrhosis/*complications ; Male ; Middle Aged ; Renin/blood

Acute coronary closure occurs 2-10% during the procedure of PTCA, 50-80% of those events are in the catheterization room. The causes of acute coronary closure are mainly due to dissection, thrombosis or spasm. We recently experienced a case of acute left main coronary artery closure due to guiding catheter induced embolization in the 56 year-old female, unstable angina patient complicated by diabetes mellitus and chronic renal failure. The patient received cardiopulmonary resuscitation shortly after acute closure because of cardiac arrest. During the resuscitation, we performed PTCA at the site of acute closure. The blood pressure maintained normaly after successful recanalization. And then we inserted IABP(intraaortic balloon pump) balloon and did PTCA of original stenosis sites. The patient removed IABP 24 hours later and discharged a month later without complication.
Angina, Unstable ; Blood Pressure ; Cardiopulmonary Resuscitation* ; Catheterization ; Catheters* ; Constriction, Pathologic ; Coronary Vessels ; Diabetes Mellitus ; Female ; Heart Arrest ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Resuscitation ; Spasm ; Thrombosis

No abstract available.
Humans ; Sarcoma, Kaposi*

BACKGROUND AND OBJECTIVES: The mucosal epithelium of middle ear and eustachian tube needs hydration to maintain proper amount of moisture. Recent discoveries of various types of water channel proteins (aquaporins ; AQPs) in mucous epithelium suggest that they play critical roles in the regional regulation of water balance. The purpose of this study is to assess the distribution and expression of different subtypes of AQPs in the rat eustachian tube. SUBJECTS AND METHOD: We analyzed the distribution and expression of AQP1, 2, 4, 5, and 7 using RT-PCR, Western blot, and immunohistochemistry study in the rat middle ear and eustachian tube samples. RESULTS: The expression of the mRNA of AQP1, 4, and 5 were observed in the rat eustachian tube and middle ear. The bands of AQP1, 4, and 5 were detected at 28 kDa, 31 kDa, and 26 kDa proteins in the Western blot analysis, respectively. The immunohistochemical analysis demonstrated that AQP1 was expressed in fibroblasts at subepithelial portions of the rat eustachian tube and that AQP4 was observed at the basolateral membrane of the ciliated epithelial cells. The distribution of AQP5 in rat eustachian tube was limited to the apical surface of serous gland cells, but all of the epithelial goblet cells were labeled negative. CONCLUSION: We demonstrated that there are various subtypes of AQP in rat eustachian tube and that they existed at specific cells and sites. This study may be a preliminary study to determine the possibility of relationship between AQP expression and AQP-related disease in the middle ear and eustachian tube.
Animals ; Aquaporins ; Blotting, Western ; Ear, Middle ; Epithelial Cells ; Epithelium ; Eustachian Tube* ; Fibroblasts ; Goblet Cells ; Immunohistochemistry ; Membranes ; Rats* ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger

BACKGROUND AND OBJECTIVES: The dominant mode of cell death in cardiomyocytes under acute ischemic insult, either necrosis or apoptosis, remains to be clearly shown. MATERIALS AND METHODS: Cultured neonatal rat ventricular myocytes (NRVM) were incubated under hypoxic (mixture gas of 95%N2/5%CO2 in glucose containing media), ischemic (hypoxia plus glucose depletion in the media), ischemic and acidic conditions (ischemia with media pH 7.1). The level of cell death was assessed by trypan blue staining. To differentiate the mode of cell death, genomic DNA extraction and electrophoresis, Annexin V/propodium iodide staining, western blot for caspase activation and transmission electron microscopy were employed. RESULTS: The number of cell deaths in the NRVM cultured under hypoxic conditions was similar to that of the controls. The rate of cell death was significantly increased in the NRVM cultured under ischemic conditions, and was accelerated further in an acidic milieu, which simulated the accumulation of metabolic byproducts in ischemia. No signs of apoptotic cell death were observed in the NRVM cultured under ischemic conditions. The morphological examination of the cells in ischemia mostly revealed necrotic death. CONCLUSION: The presence of glucose protected the cardiomyocytes from cell death under hypoxic conditions. Incubation of the NRVM in ischemia resulted in increased cell deaths, which was accelerated in an acidic milieu. In our model of acute ischemia, without reoxygenation, the cardiomyocyte cell deaths appeared to be primarily induced via necrosis rather than apoptosis.
Animals ; Apoptosis ; Blotting, Western ; Cell Death* ; DNA ; Electrophoresis ; Glucose ; Hydrogen-Ion Concentration ; Ischemia ; Microscopy, Electron, Transmission ; Muscle Cells ; Myocytes, Cardiac* ; Necrosis ; Rats ; Trypan Blue

PURPOSE: Sentinel lymph node (SLN) biopsy has emerged as a substitute for a conventional axillary lymph node (ALN) dissection in early breast carcinomas. We evaluated SLN biopsy in breast carcinoma using a gamma-detection probe in order to identify its accuracy as a staging procedure for lymph node status. METHODS: Fifty-one patients with breast carcinomas who underwent a SLN biopsy followed by an ALN dissection between June 1999 and January 2001 were evaluated. Tc 99m antimony trisulfide colloid was used as a tracer and SLN biopsy using a gamma-detection probe was done following breast lymphoscintigraphy. Intraoperative imprint cytology (II C) was done for each SLN. If a SLN biopsy was free of metastasis by permanent hematoxylin and eosin (H&E) staining, immun ohistochemical (IHC) staining using pan-cytokeratin was do ne to detect micrometastasis. RESULTS: ALN metastases were identified in 21.6% of pa tients and the resection rate of SLN was 94.1%. The mean number of resected SLN was 1.8, all located at the axilla. IIC had a sensitivity of 72.7% and a spe cificity of 100%. The false-negative rate of SLN biopsy was 12.5% when SLNs were evaluated by H&E staining alone. However, the false-negative rate improved up to 0% when IHC staining was added. CONCLUSION: SLN biopsy using a gamma-detection probe proved to be a very sensitive method to detect SLN in breast carcinoma patients. Frozen biopsy should be added to im prove the outcomes of intraoperative examination of SLN. If permanent biopsy revealed that SLN was free of tumorthe by H&E staining, IHC staining should be done to improve false-negative rate of SLN biopsy.
Antimony ; Axilla ; Biopsy* ; Breast Neoplasms* ; Breast* ; Colloids ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Lymph Nodes ; Lymphoscintigraphy ; Neoplasm Metastasis ; Neoplasm Micrometastasis

PURPOSE: Sentinel lymph node (SLN) biopsy has emerged as a substitute for a conventional axillary lymph node (ALN) dissection in early breast carcinomas. We evaluated SLN biopsy in breast carcinoma using a gamma-detection probe in order to identify its accuracy as a staging procedure for lymph node status. METHODS: Fifty-one patients with breast carcinomas who underwent a SLN biopsy followed by an ALN dissection between June 1999 and January 2001 were evaluated. Tc 99m antimony trisulfide colloid was used as a tracer and SLN biopsy using a gamma-detection probe was done following breast lymphoscintigraphy. Intraoperative imprint cytology (II C) was done for each SLN. If a SLN biopsy was free of metastasis by permanent hematoxylin and eosin (H&E) staining, immun ohistochemical (IHC) staining using pan-cytokeratin was do ne to detect micrometastasis. RESULTS: ALN metastases were identified in 21.6% of pa tients and the resection rate of SLN was 94.1%. The mean number of resected SLN was 1.8, all located at the axilla. IIC had a sensitivity of 72.7% and a spe cificity of 100%. The false-negative rate of SLN biopsy was 12.5% when SLNs were evaluated by H&E staining alone. However, the false-negative rate improved up to 0% when IHC staining was added. CONCLUSION: SLN biopsy using a gamma-detection probe proved to be a very sensitive method to detect SLN in breast carcinoma patients. Frozen biopsy should be added to im prove the outcomes of intraoperative examination of SLN. If permanent biopsy revealed that SLN was free of tumorthe by H&E staining, IHC staining should be done to improve false-negative rate of SLN biopsy.
Antimony ; Axilla ; Biopsy* ; Breast Neoplasms* ; Breast* ; Colloids ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Lymph Nodes ; Lymphoscintigraphy ; Neoplasm Metastasis ; Neoplasm Micrometastasis