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.
*Editorial Policies ; Humans ; Journal Impact Factor ; Periodicals as Topic/*statistics & numerical data ; Republic of Korea ; Urology/*statistics & numerical data

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.
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

No abstract available
Adenocarcinoma*

No abstract available.
Allografts* ; Parturition* ; Pregnancy*

OBJECTIVES: It is well established that primary insomnia affects the activity of autonomic nervous system. We tried to know how the activity of autonomic nervous system during night sleep changes by analyzing correlation between heart rate variability (HRV) index and the variables related with sleep structure in primary insomnia. METHODS: Thirty three subjects (mean age:36.2+/-14.2 years, male:female=15:18) who were diagnosed with primary insomnia were selected for the study. Nocturnal polysomnography (NPSG) was carried out on each subject and correlation was analyzed between high frequency/low frequency ratio (LF/HF ratio), one of HRV indices and the variables related with sleep structure which were calculated from NPSG. RESULTS: When age and sex were controlled, LF/HF ratio showed negative correlations with slow wave sleep and stage 2 sleep, respectively (r(p)=-0.43, p=0.01;r(p)=-0.37, p=0.04). On the other hands LF/HF ratio showed a positive correlation with arousal index (r(p)=0.65, p<0.001). The activity of autonomic nervous system responded differentially depending on the change of sleep structure in primary insomnia. Especially the increase of arousal index and the decrease of slow wave sleep and stage 2 sleep which are the components of non-REM sleep provoked hyperactivity of sympathetic nervous system. CONCLUSION: This study suggests that the typical change of sleep structure in primary insomnia can negatively impact on cardiovascular system.
Arousal ; Autonomic Nervous System ; Cardiovascular System ; Hand ; Heart ; Heart Rate ; Polysomnography ; Sleep Initiation and Maintenance Disorders