For the purpose to define the clinical usefulness of fasting serum total bile acid, the authors carried out to measure the serum total bile acid in 18 cases of acute hepatitis, 10 cases of chronic active hepatitis, 21 cases of liver cirrhosis, 7 cases of hepatocellular carcinoma and 35 cases of adult healthy control. Diagnosis were confirmed histopathologically in all the patients. Blood samples were obtained usually in the morning before meals from th anterior cubital vein of all the patients and adult healthy control in Pusan National University Hospital during the periods from January to August, 1984. Total bile acid was measured fluorome cally by means of an enzymatic technique. The results obtained were as follows: 1) The mean value of serum total bile acid in adult healthy subject in fasting was 2.6+/-2.3 umol/L. 2) The mean values of serum total bile acid were significantly higher in the patients with various liver diseases, as compared with those in adult healthy subjects. 3) In acute hepatitis and chronic active hepatitis, the percentages of abnormal values were significantly higher or tended to be higher in total bile acid, as compared with those in total bilirubin, ALP, LDH and GGT activity and tended to be lower in total bile acid, as compared with those in AST and ALT activity. 4) In liver cirrhosis and hepatocellular carcinoma, the percentages of abnormal values of total bile acid were significantly higher in the patients with above 100IU/L of AST activity, compared with those in the patients with 50~100IU/L of AST activity. 5) Total bile acid showed a significant correlation with total bilirubin and ALP in acute hepatitis, with total bilirubin in chronic active hepatitis and hepatocellular carcinoma, and with ALP in liver cirrhosis. On the basis of the results obtained, it was suggested the measurement of serum total bile acid is clinically a highly sensitive, useful test in diagnosis of various liver diseases.
Adult ; Male ; Female ; Humans ; Carcinoma, Hepatocellular

Incisional metastases following surgery for cervical cancer are extremely rare. We report a case of a recurrence which occurred at a incisional site following radical hysterectomy and pelvic lymphadenectomy for squamous cell carcinoma of the cervix. The recurrence was found at the incisional site just below umbilicus that was not included for post-operative adjuvant radiotherapy. We performed wide local excision and postoperative adjuvant radiotherapy for 5 weeks. She has been under follow up until now, and there is no evidence of recurrence.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Follow-Up Studies ; Hysterectomy ; Lymph Node Excision ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence* ; Umbilicus ; Uterine Cervical Neoplasms

Tearing of the acetabular labrum is a common cause of chronic hip pain. MR arthrography (MRA) of the hip is the imaging procedure of choice for the evaluation of acetabular labrum. Familiarity with the various imaging findings of MRA of the hip allows recognition of normal variants and differentiation from true pathologic conditions. This article comprehensively reviews the technical aspects and interpretation of MRA of the hip. The appearances of normal and abnormal labra in MRA are discussed. Potential pitfalls in labral tear interpretation, such as sulci around the hip, normal variants of the labrum and plicae, and osseocartilaginous and soft tissue lesions identified on MRA of the hip are also described.

Tearing of the acetabular labrum is a common cause of chronic hip pain. MR arthrography (MRA) of the hip is the imaging procedure of choice for the evaluation of acetabular labrum. Familiarity with the various imaging findings of MRA of the hip allows recognition of normal variants and differentiation from true pathologic conditions. This article comprehensively reviews the technical aspects and interpretation of MRA of the hip. The appearances of normal and abnormal labra in MRA are discussed. Potential pitfalls in labral tear interpretation, such as sulci around the hip, normal variants of the labrum and plicae, and osseocartilaginous and soft tissue lesions identified on MRA of the hip are also described.

BACKGROUND/OBJECTIVES: Atopic dermatitis (AD) is a chronic disease with an increasing incidence globally; therefore, there is a growing demand for natural compounds effective in treating dermatitis. In this study, the protective effects of Lycium barbarum leaves with and without chlorophyll (LLE and LLE[Ch-]) on AD were investigated in animal models of AD and HaCaT cells. Further, we investigated whether LLE and LLE(Ch-) show any differences in physiological activity.MATERIALS/METHODS: AD was induced by 2,4-dinitrochlorobenzene (DNCB) for three weeks, while NC/Nga mice were fed LLE or LLE(Ch-) extracts for 7 weeks. Serum immunoglobulin E (IgE) and cytokine (tumor necrosis factor [TNF]-α, interleukin [IL]-6, and IL-4) concentrations and the degree of DNA fragmentation in lymphocytes were examined. A histopathological examination (haematoxylin & eosin staining and blue spots of toluidine) of the dorsal skin of mice was performed. To elucidate the mechanism of action, the expression of the thymus and activation-regulated chemokine (TARC) and macrophage-derived chemokine (MDC) were measured in HaCaT cells. RESULTS: Serum IgE and cytokines (TNF-α and IL-6) levels as well as DNA fragmentation of lymphocytes were significantly decreased in AD-induced mice treated with LLE or LLE(Ch-) compared to those of the control group. The epidermal thickness of the dorsal skin and mast cell infiltration in the LLE group significantly reduced compared to that in the control group. The LLE extracts showed no cytotoxicity up to 1,000 µg/mL in HaCaT cells. LLE or LLE(Ch-)-treated group showed a reduction of TARC and MDC in TNF-α-and IFN-γ-stimulated HaCaT cells. CONCLUSIONS These results suggest that LLE potentially improves inflammation by reducing the expression of chemokines that inhibit T helper 2 cell migration. LLE(Ch-) showed similar effects to LLE on blood levels of IgE, TNF-α and IL-6 and protein expression in HaCat cells, but the ultimate effect of skin improvement was not statistically significant.Therefore, both LLE and LLE(Ch-) can be used as functional materials to alleviate AD, but LLE(Ch-) appears to require more research to improve inflammation.

Pheochromocytomas are neoplasms of the adrenal gland that are derived from chromaffin cells. One of the most important features of this tumor is that it can synthesize and release catecholamines such as norepinephrine and epinephrine. Due to this, arterial hypertension is one of the most common manifestations of the tumor. Although arterial hypertension is a substantial risk factor for aortic dissection, aortic dissection is actually a rare manifestation of pheochromocytoma. Here, we report a patient with pheochromocytoma who presented with acute type B aortic dissection.
Adrenal Glands ; Catecholamines ; Chromaffin Cells ; Epinephrine ; Humans ; Hypertension ; Norepinephrine ; Pheochromocytoma* ; Risk Factors

Purpose: To compare the per-patient diagnostic performance of simulated abbreviated MRI (AMRI) to that of conventional MRI (CMRI) with full-sequence dynamic gadoxetic acid (GA) enhancement for early-stage hepatocellular carcinoma (HCC) screening in high-risk patients. Materials and Methods: A total of 201 consecutive patients at high-risk for HCC, who underwent 3T liver MRI, were included in this retrospective study. The AMRI protocol comprised T2-weighted imaging, hepatobiliary phase imaging after GA injection, and diffusion-weighted imaging. For each patient, two AMRI and CMRI image sets were independently reviewed by two radiologists.Inter-reader agreement was assessed using Cohen’s kappa value. A composite reference standard was used to determine the diagnostic performance of each image set for each reader. Results: A total of 93 HCCs were detected in 79 patients. The inter-reader agreement was almost perfect for both image sets (κ = 0.839, 0.948). In AMRI, the per-patient sensitivity and negative predictive values (NPV) were 94.9% and 96.4%, respectively. In CMRI, the per-patient sensitivity and NPV were 96.2% and 97.5%, respectively. Conclusion AMRI, using only three sequences, had a comparable diagnostic performance to CMRI in screening early-stage HCC. AMRI could be an alternative HCC screening tool for highrisk HCC patients.

Purpose: To compare the per-patient diagnostic performance of simulated abbreviated MRI (AMRI) to that of conventional MRI (CMRI) with full-sequence dynamic gadoxetic acid (GA) enhancement for early-stage hepatocellular carcinoma (HCC) screening in high-risk patients. Materials and Methods: A total of 201 consecutive patients at high-risk for HCC, who underwent 3T liver MRI, were included in this retrospective study. The AMRI protocol comprised T2-weighted imaging, hepatobiliary phase imaging after GA injection, and diffusion-weighted imaging. For each patient, two AMRI and CMRI image sets were independently reviewed by two radiologists.Inter-reader agreement was assessed using Cohen’s kappa value. A composite reference standard was used to determine the diagnostic performance of each image set for each reader. Results: A total of 93 HCCs were detected in 79 patients. The inter-reader agreement was almost perfect for both image sets (κ = 0.839, 0.948). In AMRI, the per-patient sensitivity and negative predictive values (NPV) were 94.9% and 96.4%, respectively. In CMRI, the per-patient sensitivity and NPV were 96.2% and 97.5%, respectively. Conclusion AMRI, using only three sequences, had a comparable diagnostic performance to CMRI in screening early-stage HCC. AMRI could be an alternative HCC screening tool for highrisk HCC patients.

BACKGROUND: Non-Hodgkin lymphomas have morphologic and biologic variabilities and are classified by a variety of classification schemes. The authors studied the value of DNA content, S-phase fraction, and nuclear areas as a diagnostic discriminant in classification and predicting the clinical outcome of non-Hodgkin lymphoma. METHODS: Thirty cases of non-Hodgkin lymphoma and 13 cases of reactive lymph node specimens embedded in paraffin were used. DNA analysis was done by flow cytometric method using propidium iodide staining. Nuclear areas of lymphoma cells were measured by image analyzer. The results of DNA content, S-phase fraction, nuclear areas were statistically analyzed between groups of lymphoma classified according to the Rappaport classification and Working formulation. RESULTS: Aneuploidy patterns were identified in two cases (6.7%) of non-Hodgkin lymphoma (diffuse poorly differentiated lymphocytic and well differentiated lymphocytic). S-phase fraction and nuclear areas were high in lymphoblastic, diffuse poorly differentiated, diffuse lymphocytic undifferentiated, and diffuse mixed types (unfavorable prognostic group), and which had statistical significance against the low values of diffuse lymphocytic well differentiated type (favorable prognostic group). The S-phase fraction and nuclear area had significant correlation, so they could represent correlation between high proliferative activity and large nuclear area. High, intermediate, and low grades groups classified by Working formulation revealed statistically significant differences of S-phase fraction and nuclear areas between each group. CONCLUSION: The S-phase fraction and nuclear area measurement could be good diagnostic and prognostic factors in classification and clinical management of non-Hodgkin lymphoma.
Aneuploidy ; Classification* ; DNA ; Lymph Nodes ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Paraffin ; Prognosis* ; Propidium

BACKGROUND: Topoisomerase II (topo II) is a major target of anthracyclines and epipodophyllotoxins for anticancer treatment. The expression of topo II is low in drug resistant cell lines. High levels of glutathione S-transferase (GST)pi have been associated with emergence of cell lines resistant to alkylating agents or adriamycin. METHODS: By immunostaining with paraffin embedded bone marrow tissues, the expression of topo II alpha and GSTpi was investigated in 51 patients with acute myeloid leukemia (AML), and the relation of topo II alpha and GSTpi expression to treatment response in 29 patients with AML following induction chemotherapy was also evaluated. RESULTS: Topo II positive cells varied from less than 1% to 60% of leukemic cells and 20 (39.2%) were negative for topo II (positive cells<10%). Treatment response following chemotherapy was not related to topo II. 26 (51.0%) were positive for GSTpi. GSTpi expression was related to treatment resistance of the patients following chemotherapy. In the patients who showed both topo II alpha negative and GSTpi positive, the frequency of treatment resistance following chemotherapy was high. CONCLUSIONS: This study suggests that immunostaining of topo II alpha and GSTpi with the bone marrow paraffin sections of AML patients can be useful to predict the treatment response following chemotherapy and that further study including more patients with prospective study may substantiate topo II alpha and GSTpi as multidrug resistant markers.
Alkylating Agents ; Anthracyclines ; Bone Marrow ; Cell Line ; DNA Topoisomerases, Type II* ; Doxorubicin ; Drug Resistance, Multiple ; Drug Therapy ; Glutathione S-Transferase pi* ; Glutathione Transferase* ; Glutathione* ; Humans ; Immunohistochemistry ; Induction Chemotherapy ; Leukemia, Myeloid, Acute* ; Paraffin ; Podophyllotoxin