PURPOSE: To determine whether dynamic or conventional MR imaging is most useful for the detection of pituitary microadenoma. MATERIALS AND METHODS: The study involved 20 patients (M:F=1:19, mean age=37 years) in whom a pituitary microadenoma had been identified. Routine unenhanced coronal T1-weighted MR imaging was followed by dynamic imaging (repetition time/echo time/excitation=200/10/1, 3-mm-thick sections, 256X128 or 256 ma-trix,14X14-cm field of view, scan time=30 or 60 seconds, spin-echo pulse sequence), and contrast-enhanced coronal T1-weighted imaging was then immediately performed. Temporal changes in signal intensity were quantified with manually placed ROIs (regions of interest, circular, 3 mm 2), and tissue contrast between the pituitary gland and microadenoma was calculated. Conspicuity of the tumor margin was graded by three radiologists working independently as either 4 (excellent clear margin), 3 (good clear margin), 2 (relatively clear mar-gin), or 1 (unclear margin). RESULTS: Average peak enhancement of the pituitary gland and microadenoma occurred at 58.5 and 91.5 seconds, respectively. Maximum enhancement of the pituitary gland occurred within 30 to 60 seconds of contrast infusion (signal intensity range: 426-442), but during dynamic MR imaging, the microadenoma showed rela-tively constant enhancement (signal intensity range: 230 -250). Maximal contrast between normal pituitary gland and the microadenoma was seen at 60 seconds or in the first three sequential images. Dynamic MR images were superior to conventional T1-weighted images, with or without contrast infusion, not only in terms of tissue contrast between the pituitary gland and the microadenoma (p=0.0048), but also as regards tumor margin conspicuity (p=0.0035). CONCLUSION: Dynamic MR imaging is a useful technique in the detection of pituitary microadenoma.
Humans ; Magnetic Resonance Imaging* ; Pituitary Gland

No abstract available.
Carcinoma, Renal Cell ; Dialysis ; Humans ; Kidney Failure, Chronic

Crypt glandular infection theory is accepted as an explanation of anal fistula's major cause. However, the pathogenesis of an anal fistula in Crohn's disease is different from that of a conventional anal fistula because a Crohn's anal fistula is caused by ulceration which, in turn, is caused by transmural inflammation of the rectal wall due to Crohn's disease. The difficulty with operating on anal fistulas in Crohn's disease lies in the fact that healing of the wound is inhibited because of continuous inflammation of the anorectal tissue due to Crohn's disease. Hence, there is a high possibility of incontinence due to sphincter muscle injury. Especially, because almost all Crohn's disease patients have frequent defecation and diarrhea, the patients will suffer more if incontinence occurs. Nowadays, even with increased understanding of the etiology of Crohn's disease, new medications, and aggressive surgical approaches, the result of treatment is still not satisfactory. Recently, since Korean eating habits have changed to include more western-style food in the diet, inflammatory bowel disease, such as Crohn's disease, is expected to increase. Consequently, the number of cases of anal fistulas in Crohn's disease is also expected to increase. The authors reviewed 20 confirmed cases of anal fistulas in Crohn's disease, which were treated from January 1993 to December 1995 at Song-Do Colorectal Hospital. The results are as follows: 1) Anal fistulas in Crohn's disease were present in 20(0.6%) of the 3378 cases of anal fistulas treated during the time period considered. 2) The male to female ratio for these 20 cases was 2: 1, and the most Prevalent age group was the 3rd decade, followed by the 2nd decade, the 4th decade, and the 5th decade in that order. 3) Three cases of anal fistulas whose origins could be explained by crypt glandular infection theory and which did not involve the rectum healed, although the healing was delayed. 4) Seventeen cases of anal fistulas whose origins could not be explained by crypt glandular infection theory and which involved the rectum did not heal after the operation. he results of the study show that anal fistulas whose origins can be explanined by crypt glandular infection theory and which do not involve the rectum can be cured by conventional fistula surgery. However, perirectal fistulas whose origins can not be explained by crypt glandular infection theory and which involve the rectum do not heal. Because there is the possibility of incontinence after a conventional operation, it is suggested that, in the cases of perirectal fistulas in Crohn's disease, better results, although not completely satisfactory, can be obtained by long-term seton drainage and diversion colostomy.
Colostomy ; Crohn Disease* ; Defecation ; Diarrhea ; Diet ; Drainage ; Eating ; Female ; Fistula ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Male ; Rectal Fistula* ; Rectum ; Ulcer ; Wounds and Injuries

No abstract available.
*Editorial Policies ; Humans ; Journal Impact Factor ; Periodicals as Topic/*statistics & numerical data ; Republic of Korea ; Urology/*statistics & numerical data

No abstract available.
Animals ; Dinoprostone* ; Female ; Humans* ; Menstrual Cycle* ; Oviducts*

Congenital rubella syndrome is a transplacental fetal infection with rubella virus and shows a wide spectrum of clinical expression from severe malformation to asymptomatic in the neonatal period. For the confirmation of congenital rubella, one of the following laboratory criteria should be present: isolation of rubella virus, demonstration of rubella-specific IgM antibody, or a rubella IgG antibody that persists and fails to drop at a rate of twofold dilution per month. Recently a reverse transcription-nested polymerase chain reaction (RT-nPCR) method for the prenatal diagnosis of rubella virus infection has been used. We experienced a case of congenital rubella in a 15- month old male who had suffered from respiratory difficulty. He had low birth weight. Thrombocytopenia was noticed shortly after his birth. He was transferred to our hospital because persistent respiratory difficulty had been developing since the age of one month. His growth and development were delayed. Physical examination revealed micrognathia, hepatosplenomegly, lymphadenopathy, and petechiae. Laboratory examination revealed a rubella specific IgM antibody. Chest X-ray suggested a chronic lung change. Rubella virus RNA was detected in the serum by RT-nPCR. This is the first case of congenital rubella, which was confirmed by the detection of rubella virus RNA, in Korea.
Growth and Development ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Lung ; Lymphatic Diseases ; Male ; Parturition ; Physical Examination ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Purpura ; RNA ; Rubella ; Rubella Syndrome, Congenital* ; Rubella virus ; Thorax ; Thrombocytopenia

Congenital rubella syndrome is a transplacental fetal infection with rubella virus and shows a wide spectrum of clinical expression from severe malformation to asymptomatic in the neonatal period. For the confirmation of congenital rubella, one of the following laboratory criteria should be present: isolation of rubella virus, demonstration of rubella-specific IgM antibody, or a rubella IgG antibody that persists and fails to drop at a rate of twofold dilution per month. Recently a reverse transcription-nested polymerase chain reaction (RT-nPCR) method for the prenatal diagnosis of rubella virus infection has been used. We experienced a case of congenital rubella in a 15- month old male who had suffered from respiratory difficulty. He had low birth weight. Thrombocytopenia was noticed shortly after his birth. He was transferred to our hospital because persistent respiratory difficulty had been developing since the age of one month. His growth and development were delayed. Physical examination revealed micrognathia, hepatosplenomegly, lymphadenopathy, and petechiae. Laboratory examination revealed a rubella specific IgM antibody. Chest X-ray suggested a chronic lung change. Rubella virus RNA was detected in the serum by RT-nPCR. This is the first case of congenital rubella, which was confirmed by the detection of rubella virus RNA, in Korea.
Growth and Development ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Lung ; Lymphatic Diseases ; Male ; Parturition ; Physical Examination ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Purpura ; RNA ; Rubella ; Rubella Syndrome, Congenital* ; Rubella virus ; Thorax ; Thrombocytopenia

The incidence of kidney cancer has been rising over the past two decades, especially in cases in which the disease is localized and small in size (<4 cm). This rise is mainly due to the widespread use of routine abdominal imaging such as ultrasonography, computed tomography, and magnetic resonance imaging. Early detection was initially heralded as an opportunity to cure an otherwise lethal disease. However, despite increasing rates of renal surgery in parallel to this trend, mortality rates from renal cell carcinoma have remained relatively unchanged. Moreover, data suggest that a substantial proportion of small renal masses are benign. As a result, the management of small renal masses has continued to evolve along two basic themes: it has become less radical and less invasive. These shifts are in part a reflection of an improved understanding that the biology of incidentally discovered renal cell carcinoma may be more indolent than previously thought. However, not all small renal masses are indolent, and de novo metastatic disease can develop at the initial presentation. Therefore, it is with this background of clinical uncertainty and biological heterogeneity that clinicians must interpret the benefits and disadvantages of various clinical approaches to small renal masses.
Biology ; Carcinoma, Renal Cell ; Incidence ; Kidney Neoplasms ; Magnetic Resonance Imaging ; Nephrectomy ; Population Characteristics ; Uncertainty ; Watchful Waiting

STATEMENT OF PROBLEM: Among the physical properties of adhesion luting cement, the aspect that requires the most important factor is the degree of solubility and water sorption. Dissolution or an inadequate due to excessive water sorption inside the oral cavity compromises the while concurrently increasing the susceptibility to secondary dental caries. Susceptibility to dissolution and difficulty of removing remnant cement from the gingival sulcus have hindered the use of dental resin cement in the clinical practice, but the improved characteristics of newer generation resin cements have interest in and enabled resin cements to be widely used in adhesion of fixed prosthesis, such as laminate veneers and all-ceramic crowns. PURPOSE: The purpose of this study is to compare and analyze the degrees of solubility and water sorption of a variety of resin cements widely used for clinical purposes with different curing methods. MATERIALS AND METHODS: Self-curing resin cements, Avanto(R), CandB(TM) CEMENT and Superbond CandB cements comprised group 1, 2 and 3. The dual-curing resin cements Panavia(TM) F, Calibra(R) and Variolink(R) II were divided into groups 4, 5, and 6, respectively. The investigation was carried out using disc-shaped specimens as specified by ANSI/ADA Specification No. 27. The degree of water sorption, water solubility and lactic acid solubility of each test group was analyzed statistically leading to the following conclusion. RESULTS: The degree of water sorption was shown to increase in the following order : group 6, 5, 4, 2, 1 and 3. There were significant differences between the water sorption of each group. Results of the degree of water solubility were shown to increase in the following order : group 6, 5, 4, 2, 1 and 3. Statistically significant differences were found between each group, with the exception of groups 1 and 3. Finally, the degree of lactic acid solubility was found to increase in the following order : group 6, 5, 4, 2, 3 and 1. Significant differences were found between each group. In general dual-curing resin cements displayed substantially lower values than self-curing resin cements with regard to water sorption, water solubility, and lactic acid solubility. CONCLUSIONS: From the results of this study, dual-curing resin cements show a significantly lower degree of water sorption and solubility than their self-curing counterparts. Clinically, when selecting resin cements, the product with a lower degree of water sorption and solubility are preferred. The results of this study indicate that the use-of dual-curing resin cements is preferable to self-curing cements.
Crowns ; Dental Caries ; Fibrinogen ; Lactic Acid ; Mouth ; Prostheses and Implants ; Resin Cements* ; Resins, Synthetic ; Solubility* ; Water*

We describe a group of 3 cases of invasive meningococcal disease that occurred in a military training camp in April 2011. All three patients were hospitalized. Ultimately, two patients recovered and one died. One patient had meningitis, one patient had septicemia and meningitis, and the other had no definite septicemia or meningitis. Neisseria meningitidis serogroup W-135 was detected in the serum and cerebrospinal fluid (CSF) of all patients by real-time polymerase chain reaction. In the one case of mortality, two strains were isolated from the patient's blood and CSF. Using multilocus sequence typing analysis, these strains were identified as a novel sequence type, ST-8912. Special attention is required for the meningococcal disease in military camp because the military personnels are in high risk of contact transmission.
DNA, Bacterial/blood/cerebrospinal fluid ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Male ; Meningitis/complications/*diagnosis/microbiology ; Military Personnel ; Multilocus Sequence Typing ; Neisseria meningitidis, Serogroup W-135/genetics/*isolation & purification ; Real-Time Polymerase Chain Reaction ; Sepsis/complications/*diagnosis/microbiology ; Young Adult