No abstract available.
Humans ; Moral Development* ; Students, Medical*

No abstract available.
Acanthoma*

Eight cases of combine hepatocellular-cholangiocarcinoma(HCC-CC) of the liver were analysed along with their growth patterns and histologic subtypes to draw a possible implication in understanding of their histogenesis. The relative incidence of combined HCC-CC among the surgically resected primary carcinomas of the liver(485 cases) was 1.6%. The combination patterns varied and were classified as follows; the multinodular tumor, each consisting of HCC or CC element(type 1) was found in 1 case, the single tumor mass with two distinct compartments of HCC and CC(type 2) in 3, and the single tumor with random mixture of two elements(type 3) comprised the remaining 4 cases. Of the 7 cases of single tumor mass(type 2 and 3) HCC and CC comprised the major component in 5 and 2 cases, respectively. The histologic features of both HCC and CC elements were not different from those of isolated HCC and CC, except for two of CC element in type 3 which disclosed the intermediated differentiation or socalled cholangiolocellular carcinoma in part. We conclude that there is no significant difference in the relative incidence of combined HCC-CC among primary carcinomas of the liver and their subtypes compared to that in other countries, regardless of high incidence of both HCC and CC in Korea. Also, we discussed a possible histogenisis along a hypothesis that some of the combined HCC-CC be the consequence of interposition of different cell type from a new subclone into the growth of an initial single cell type of primary carcinoma of the liver.
Incidence ; Carcinoma, Hepatocellular

No abstract available.
Aging* ; Glucose* ; Metabolism*

PURPOSE: To analyse the causes and radiologic findings in patients with mediastinitis and to evaluate theefficacy of chest CT scanning in patients with delayed diagnosis. MATERIALS AND METHODS: Seventeen patients withhistopathologically(n=15) or cliniclly diagnosed(n=2) mediastinitis were involved in this study. Eleven of theformer group underwent surgery, and in four, tube drainage was performed. All underwent chest radiography and CTscanning, and in seven patients, the causes of delayed diagnosis were analysed. RESULTS: The most common cause ofmediastinitis was esophageal rupture (n=11). Others were extension from neck abscess to the mediastinum(n=3),complications after a Benthall procedure(n=1), tuberculous lymphadenitis (n=1) and mycotic aneurysm(n=1). Patientswith esophageal rupture suffered from underlying diseases such as esophageal cancer(n=2), iatrogenic esophagealrupture(n=2), Boerhaave's syndrome(n=2), and esophagitis(n=1). In patients with neck abscess(n=3), each wassecondary to infected cystic hygroma, Ludwig angina, or deep neck infection, respectively. On chest CT, patientswith esophageal rupture(n=11) had an abscess in the posterior mediastinum; nine abscesses extended to the cervicalarea along the retropharyngeal space, and the patient with Ludwig angina had an abscess involving all compartmentsof the mediastinum. Among the total of 17 patients, diagnostic delays were found in seven, while five hadspontaneous esophageal ruptures and two suffered complications after a Benthall procedure and Tbc lymphadenitis,respectively. The causes of diagnostic delay varied. Among seven patients, pnevmonia was initially diagnosed intwo, who were treated ; one had multiorgan failure, and one was suffering from pericardial effusion and lungabscess. In three other patients, chest radiographs initially showed non-specific findings, leading to delayed CTexamination. CONCLUSION: The most common cause of mediastinitis was esophageal rupture, and in these patients,chest radiographs and clinical symptoms were sometimes not specific. CT was valuable for the detection ofmediastinitis, and for early diagnosis can be the modality of choice.
Abscess ; Delayed Diagnosis* ; Drainage ; Early Diagnosis ; Humans ; Ludwig's Angina ; Lymphangioma, Cystic ; Mediastinitis* ; Mediastinum ; Neck ; Pericardial Effusion ; Radiography ; Radiography, Thoracic* ; Rupture ; Thorax* ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

PURPOSE: N-(3-[18F]Fluoroporpy)-2beta- carbomethoxy-3beta-(4-iodophenyl) nortropane ([18F]FP-CIT) has been shown to be very useful for imaging the dopamine transporter. However, synthesis of this radiotracer is some what troublesome. In this study, we used a new method for the preparation of [18F]FP-CIT to increase radiochemical yield and effective specific activity. MATERIALS AND METHODS: [18F]FP-CIT was prepared by N-alkylation of nor-beta-CIT (2 mg) with 3-bromo-l-[18F]fluoropropane in the presence of Et3N (5-6 drops of DMF/CH3CN, 140 degree C, 20 min). 3-Bromo-l-[18F]fluoropropane was synthesized from 5 microliter of 3-bromo-l-trifluoromethanesulfonyloxypropane (3-bromopropyl -l-triflate) and nBu4N18F at 80 degree C. The final compound was purified by reverse phase HPLC and formulated in 13% ethanol in saline. RESULTS: 3-Bromo-l-[18F]fluoropropane was obtained from 3-bromopropyl-l-triflate and nBu4N18F in 77-80% yield. N-Alkylation of nor-beta-CIT with 3-bromo-l-[18F]fluoropropane was carried out at 140 degree C using acetonitrile containing a small volume of DMF as the solvents. The overall yield of [18F]FP-CIT was 5-10% (decay-corrected) with a radiochemical purity higher than 99% and effective specific activity higher than the one reported in the literature based on their HPLC data. The final [18F]FP-CIT solution had the optimal pH (7.0) and it was pyrogen-free. CONCLUSION:: In this study, 3-bromopropyl-l-triflate was used as the precursor for the [18F]fluorination reaction and new conditions were developed for purification of [18F]FP-CIT by HPLC. We established this new method for the preparation of [18F]FP-CIT, which gave high effective specific activity and relatively good yield.
Chromatography, High Pressure Liquid ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Ethanol ; Hydrogen-Ion Concentration ; Positron-Emission Tomography ; Solvents

We evaluated the in vivo kinetics, distribution, and pharmacology of N-(4-[F] fluorornethylbenzyl)spiperone ([F]FMBS), a newly developed derivative of spiperone, as a potentially more selective #radiotrar.er for the dopamine (DA) Dz receptors. Mice received 1.9-3.7 MBq (1.8-3.6 nmol/kg) of [F]FMBS by tail vein injectivn. The time course and regional distribution of the tracer in brain were assessed. Blocking studies were carried out by intravenously preinjecting DA Dp receptor blockers (spiperone, butaclamol) as well as drugs with high affinity for DA Dr lSCH 23390), DA transporter (GBR 12909), and serotonin Sp (5-HTz) (ketanserin) sites. After injection of the tracer, the radioactivity in striatum increased steadily over time, resulting in a striatal-to-cerebellar ratio of 4.8 at 120 min postinjection. By contrast, the radioactivity in cerebellum, frontal cortex, and remaining cortex washed out rapidly. Preinjection of unlabe1ed FMBS (1 rng/kg) and spiperone (1 mg/kg) reduced [F] FMBS striatal-to-cerebellar ratio by 41Zo and 80Ya, respectively. (+)-Butaclamol(1 mg/kg) blocked 80Yo of the striatal [F]FMBS binding, while (-)-butaclamol (1 rng/kg) did not. Preinjection of SCH 23390 (1 mg/kg) and GBR 12909 (5 mg/kg) had no significant effect. On [""F]FMBS binding. Ketanserin (1 mg/kg), a ligand for the 5-H1g receptors, did not cause significant inhibition either in striatum, in frontal cortex, or the remaining cortex. The results demonstrate that [F]FMEtS labels DA Dz receptors selectively in vivo in the mouse brain. It may hold promise as a selective radiotracer for studying DA Dz receptors in vivo by PET.
Animals ; Brain ; Cerebellum ; Dopamine* ; Ketanserin ; Kinetics ; Mice ; Pharmacology ; Radioactivity ; Receptors, Dopamine D2* ; Serotonin ; Spiperone* ; Veins

No abstract available.
Esophageal Atresia* ; Tracheoesophageal Fistula*

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [18F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained : the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. (TBR51), tumor-to-background ratio of areas under time-activity curves (TBRarea) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T51/Tmax). The pSUV, aSUV, TBR51, and TBRarea, in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR51, TBRarea and T51/Tmax for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR51, 83.3%, 100%, 93.8% by TBRarea and 66.7%, 70.0%, 68.8% by Tsl/Tmax. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, aSUV, TBR51, and TBRarea are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.
Fibrosarcoma ; Humans ; Positron-Emission Tomography ; Sensitivity and Specificity

No abstract available.
Receptors, Nicotinic*