PURPOSE: To determine the MR findings of cervical lymphadenopathy which distinguish tuberculouslymphadenitis(TL) from metastatic lymphadenopathy(ML). MATERIALS AND METHODS: We retrospectively analyzed the MRfindings of 14 patients with TL and 19 with ML. Thirty-nine lesions in 14 patients with TL and 80 lesions in 19with ML were classified into three categories: conglomerate lesion (TL, 7; ML, 8); discrete lesion withoutnecrosis (TL, 3; ML, 15); and discrete lesion with necrosis (TL, 29; ML, 57). Between TL and ML, we compared age,sex, bilaterality, multiplicity, associated pulmonary tuberculosis, infiltration of adjacent fat, muscle, skin andsubcutaneous tissue, margin, and signal intensities on T1- and T2-weighted images. In discrete lesion, we alsocompared the minimal to maximal dimension ratio, and in discrete necrotic lesion, the thickness and evenness ofrim enhancement, and the location and extent of necrosis. RESULTS: There were statistically significantdifferences between TL and ML in age(34.7+/-13.1 years; 56.1+/-14.3 years), male to female ratio(3:11; 13:6),bilaterality(1/14; 10/19), multiplicity(5/14; 14/19), and associated active pulmonary tuberculosis(7/14; 1/19). OnT2-weighted images, TL showed predominantly homogeneous (30/39) or high (20/39) signal intensity, similar to thatof cerebrospinal fluid, but the signal inteusity of ML was predominantly heterogeneous(58/80), or lower than orsimilar to that of fat(41/80). Between TL and ML, however, there were no statistically significant differences ininfiltration of adjacent tissue, margin, signal intensity and its heterogeneity on T1-weighted image, minimal tomaximal dimension ratio, thickness and evenness of rim enhancement, or the location and extent of necrosis. CONCLUSION: In cervical lymphadenopathy, the existence of TL rather than ML is suggested by single or unilaterallesion in a young woman, by associated active pulmonary tuberculosis, or by homogeneous high signal intensity onT2-weighted MR images.
Cerebrospinal Fluid ; Female ; Humans ; Lymphatic Diseases* ; Male ; Necrosis ; Neoplasm Metastasis* ; Population Characteristics ; Retrospective Studies ; Skin ; Tuberculosis* ; Tuberculosis, Pulmonary

No abstract available.
Gene Ontology* ; Uterine Cervical Neoplasms*

OBJECTIVES: Our study was to determine the usefulness of CA 125 screening for asymptomatic female subjects. Though CA 125 has been used as a useful marker for the detection of ovarian cancer, its efficacy to detect early ovarian cancer in asymptomatic women has not been established. STUDY DESIGN: From April 1995 to December 1997, a total of 13,038 subjects who visited our Center for Health Promotion were screened. Serum CA 125 level was measured by a radioimmunoassay kit (Centocor, USA). In most cases transvaginal ultrasound was done at the same time. The specificity, sensitivity and positive predictive value were obtained on the basis of normal CA 125 range between 2.4~36.3 U/ml. RESULT: 1) Two cases of ovarian cancer were detected out of 13,038 subjects screened. One ovarian cancer patient showed 1,625 U/ml of CA 125 level, on the other hand, the other level patient showed 27 U/ml. 2) Therefore, the sensitivity, specificity, and positive predictive value were 50%, 97.3%, and 0.3%, respectively. Since 346 cases out of 13,038 screened subjects showed false positive results on the basis of the upper limit of normal CA 125 level set at 36.3 U/ml,the false positivity was 2.6%. 3) The CA 125 levels in false positive cases ranged from 36.3 U/ml to 352.8 U/ml with the mean value of 66.19+/-51.47 (S.D.). 4) The clinical features of the false positive cases included uterine myoma including adenomoysis (150), benign ovarian cyst (19), cervicitis (6), tuberculosis (3), pregnancy (2), and each one case of breast cancer, mammary cyst, endometritis, lung cancer, liver cirrhosis, pancreatic cancer, cervical cancer, renal cyst, uterine anomaly, and post TAH state. In the remainder of false positive 156 cases, no abnormal findings were observed. Among 258 pateints who underwent combined tests of CA 125 and transvaginal ultrasound, the sensitivity of ovarian cancer was 100%. 5) The false positive rate was lower in the older age group (>50) than in the younger group (<50). CONCLUSION: The prevalance of ovarian cancer in our study was 0.0153% (15.3 per 100,000 population) which is comparable to the rate of 15.8 per 100,000 population reported by the Korean Medical Insurance Corporation. Although the CA 125 test by itself shows a low positive predictive value, its clinical usefulness as a screening test can be enhanced dramatically by the combined use of transvaginal ultrasound examination, especially in postmenopausal women.
Breast Neoplasms ; Endometritis ; Female ; Hand ; Health Promotion ; Humans ; Insurance ; Leiomyoma ; Liver Cirrhosis ; Lung Neoplasms ; Mass Screening ; Ovarian Cysts ; Ovarian Neoplasms ; Pancreatic Neoplasms ; Pregnancy ; Radioimmunoassay ; Sensitivity and Specificity ; Tuberculosis ; Ultrasonography ; Uterine Cervical Neoplasms ; Uterine Cervicitis

OBJECTIVE:To determine whether elevated or low levels of maternal serum alpha- fetoprotein(AFP) measured at 15-20 weeks of gestation predict increased risk of adverse pregnancy outcome, including preterm birth(before 36 weeks of gestation), fetal growth retardation(FGR), preeclampsia, placental abruption, FDIU, placenta previa and fetal anomaly. METHOD: Data of pregnancy outcomes in singleton pregnancies with elevated or low maternal serum AFP levels measured at 15-20 weeks of gestation were gathered retrospectively. As a part I study, case-control study including 106 women with maternal serum AFP) 2.0 MOM(Multiples of median) and matched control group of 212 women with 0.5 MOM Abruptio Placentae ; alpha-Fetoproteins* ; Case-Control Studies ; Female ; Fetal Development ; Follow-Up Studies ; Humans ; Mothers ; Placenta Previa ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Pregnant Women ; Retrospective Studies

Immunosuppressive medications after renal allograft transplantation have impacted the course of acute and chronic rejection: however, they have no defined effects on the prevention of recurrent and Glomerulonephritis (GN) in an allograft kidney. Authors experienced a case of rapidly progressive glomerulonephritis (RPGN). The 35-year-old female patient developed a rapid deterioration of renal function 4 years after renal transplantation. The allograft biopsy showed crescentic glomerulonephritis evolving from membranoproliferative glomerulonephritis (MPGN) type I. She was given pulse steroid and oral cyclophosphamide therapy immediately after the renal biopsy. Graft function stabilized and proteinuria decreased even though graft function did not recover to pre-treatment level and low grade proteinuria persisted.
Adult ; Allografts ; Biopsy ; Cyclophosphamide ; Female ; Glomerulonephritis* ; Glomerulonephritis, Membranoproliferative ; Humans ; Kidney Transplantation* ; Kidney* ; Proteinuria ; Transplants

Cutaneous angiosarcoma is a rare, aggressive vascular malignancy with a grave prognosis. It usually arises in the scalp or face as a locally-advanced patch, plaque or tumor at presentation and most often affects males and the elderly. Histopathologically, well-differentiated angiosarcomas are composed of well- or ill-formed vascular channels, often lined by flattened atypical endothelial cells and are distinguished from benign counterparts by their so-called "collagen dissection pattern" and anastomosing architecture. Varied differentiation may be observed even in the same tumor. Epithelioid angiosarcoma is a rare variant of poorly-differentiated angiosarcoma. The patients were seven cases of angiosarcomas including an epithelioid variant. They were six males and one female with an age range between 65~84 years (avg. 74 years). Lesions resembled seborrheic dermatitis, erysipelas or "spreading bruise" that varied from blue to red in color and from papule to mass in size. They revealed satellite lesions far from the main lesion in some cases. Skin biopsies were performed for all patients and histopathologic features were compatible with angiosarcoma and epithelioid angiosarcoma. We herein report seven angiosarcomas of diverse clinical features because their early detection and precise differential diagnosis should be mandatory for effective management.
Aged ; Biopsy ; Dermatitis, Seborrheic ; Diagnosis, Differential ; Endothelial Cells ; Erysipelas ; Female ; Hemangiosarcoma* ; Humans ; Male ; Prognosis ; Scalp* ; Skin

Vasculitis is one of the rare complications of antithyroid drugs. In most cases, it is associated with ANCA and usually involves more than one organ. Renal involvement is the most common manifestation, and mainly presents as pauci-immune glomerulonephritis. We experienced MPO-ANCA-positive vasculitis and renal involvement presenting as membranous nephropathy following propylthiouracil (PTU) treatment. Cases of MPO-ANCA-positive vasculitis with membranous nephropathy are very uncommon, and the relationship between PTU and glomerulonephritis with immune complex deposition is unclear at present. A 58-year-old woman who had been treated with PTU for Graves' disease was admitted because of dyspnea and general edema. Chest computed tomography showed multiple nodules in both lung fields. The serum level of MPO-ANCA was positive. Initial laboratory findings included proteinuria, hematuria and increased serum creatinine. We thought that MPO-ANCA-associated vasculitis was induced by PTU and renal involvement. Renal biopsy revealed membranous nephropathy.
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies, Antineutrophil Cytoplasmic ; Antigen-Antibody Complex ; Antithyroid Agents ; Biopsy ; Creatinine ; Dyspnea ; Edema ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Graves Disease ; Hematuria ; Humans ; Lung ; Middle Aged ; Propylthiouracil ; Proteinuria ; Thorax ; Vasculitis

BACKGROUND/AIMS: Matrix metalloproteinases (MMP)-2 and -9 can degrade essential components of vascular integrity. The aim of this study was to investigate the association between those MMPs and variceal bleeding (VB). METHODS: Fifteen controls, 12 patients with acute ulcer bleeding (UB) group, 37 patients with varix (V group), and 35 patients with acute VB group were enrolled. Serum was obtained to measure MMP-2 and -9 activity by zymogram protease assays. RESULTS: The activity levels of these compounds were compared with the controls' median value. The median MMP-9 activity was 1.0 in controls, 1.05 in the UB group, 0.43 in the V group, and 0.96 in the VB group. The level of MMP-9 activity was higher in the VB group than in the V group (p<0.001). In the VB group, there was a signifi cant decrease in MMP-9 activity over time after bleeding (p<0.001). The median MMP-2 activity level was 1.0 in controls, 1.01 in the UB group, 1.50 in the V group, and 1.55 in the VB group. The level of MMP-2 activity was similar in the VB and V groups. CONCLUSIONS: The level of MMP-9 activity increased in association with VB. The role of MMP-9 in the pathogenesis of VB should be verified.
Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinase 9 ; Matrix Metalloproteinases ; Ulcer ; Varicose Veins

BACKGROUND: We introduce a new, simple portable inhalational induction device (PD) that provides co-operative inhalational induction of anaesthesia using N2O and subsequent sevoflurane in the preanaesthetic induction area in children. METHODS: Forty-five children (30 to 94 months old age, <35 kg) who were scheduled to undergo simple operations were assigned randomly to one of three regimens. Patients were encouraged by their parents to inhale N2O followed by sevoflurane (PD N2O-sevo group) or sevoflurane (PD sevo group) using a portable inhalational induction device in the preanaesthetic induction area until they were unable to respond to their names. They were then transferred to the operating room while maintaining inhalation of sevoflurane via the device. The control group underwent conventional inhalational induction in the operating room with the parents in attendance. RESULTS: Patients in the PD N2O-sevo group had a higher co-operative inhalation frequency than the patients in the PD sevo or the control group. Anaesthesia induction in the PD N2O-sevo and the PD sevo groups were faster than in the control group. Parent satisfaction score (0-100) was higher for the PD N2O-sevo group than for the control group. CONCLUSIONS: A new portable inhalational induction device allows faster induction in co-operation with parents present in the preanaesthetic induction area compared to conventional inhalational induction in the unfamiliar operating room with the parents in attendance.
Child ; Humans ; Inhalation ; Methyl Ethers ; Nitrous Oxide ; Operating Rooms ; Parents

BACKGROUND: To investigate the role of sympathetic nervous system (SNS) in moxibustion-induced immunomodulation, the effects of chemical sympathectomy on moxibustion-induced changes in splenic NK cell cytotoxicity, T and B cell proliferation were studied in Sprague-Dawley male rats. METHODS: Chemical sympathectomy was achieved with intraperitoneal injection of 6-hydroxydopamine 50 mg/kg/day for 3 successive days. Direct moxibustion (6-minute interval, 9 moxa ball, each of which weighing 0.007 g and burning for 40 seconds) was applied on unilateral anterior tibial muscle region where Zusanli (ST36) acupoint is located, once a day for 7 successive days. NK cell cytotoxicity was measured by 4hr-51Cr release assay. Mitogen-induced lymphocyte proliferation was analyzed by [3H]-thymidine incorporation assay. RESULTS: NK cell cytotoxicity was suppressed by moxibustion, more in sympathectomized rats than in vehicle-treated rats. T cell proliferation induced by concanavalin A was not affected by moxibustion. B cell proliferation induced by lipopolysaccharide showed no significant change in vehicle- treated rats, but an increase in sympathectomized rats by moxibustion. Sympathectomy alone induced augmentation of NK cell cytotoxicity and suppression of T cell proliferation. CONCLUSION: These results suggest that SNS has no direct relation with moxibution-induced immunomodulation but has an important role in the mechanism to keep the homeostasis of immune system by tonically inhibiting excessive changes of various immune components.
Acupuncture Points ; Animals ; B-Lymphocytes ; Burns ; Cell Proliferation ; Concanavalin A ; Homeostasis ; Humans ; Immune System ; Immunomodulation* ; Injections, Intraperitoneal ; Killer Cells, Natural ; Lymphocytes ; Male ; Moxibustion ; Muscle, Skeletal ; Oxidopamine ; Rats* ; Rats, Sprague-Dawley ; Spleen* ; Sympathectomy ; Sympathectomy, Chemical* ; Sympathetic Nervous System ; T-Lymphocytes