Malignant gastric lymphoma is an uncommon but important lesion with a more favorable prognosis than that ofgastric carcinoma. A total of 16 cases of gastric malignant lymphoma examined during a period from Jan. 1980 toSept. 1983 at Seoul National University Hospital were subjected to the radiological and pathologic correlations.In all cases, the diagnosis was established by histopathology of the resected specimens (9 cases) or endoscopicbiopsy specimesn ( 7 cases). Based on the comparative study of upper G-I series and macroscopic findings of thesurgically resected specimen, the authors investigated the reliable radiographic findings which can be valuable indifferentiation of gastric lymphoma from other gastric lesions, especailly carcinoma, and suggested the followingdiagnostic criteria for the malignant lymphoma of the stomach. 1. Discrete multiple polypoid lesions with orwithout central umbilication. 2. Geographic ulcer, deviated from center of the mass. 3. Irregular thickness ofelevated rim of the mass. 4. Diffuse giant gastric rugae. 5. Giant gastric rugae, mixed with other lesion.
Diagnosis ; Lymphoma ; Prognosis ; Seoul ; Stomach ; Ulcer

PURPOSE: To correlate signal intensities of hepatocellular carcinomas on MR images with applied field strength, tumor vascularity, history of transarterial chemoembolization, and their histopathologic findings. MATERIALS & METHODS: Twenty-two tumors in 18 patients with histologically proved hepatocellular carciomas were examined by MRI at 0.5T(14), 1.5T(5), or 2.0T(3). Tumor size ranged from 1 cm to 10 cm. We analyzed the signal intensities, presence of pseudocapsule and mosaic pattern of hepatocellular carcinomas on TI-, T2- and heavily T2-weighted images, and correlated them with histologic type and grade, as well as tumor vascularity on hepatic arteriography. RESULTS: Signal intensities of the tumors were hyperintense(6), isointense(11), or hypointense(5) on Tl-weighted images, hyperintense(21) or isointense(1) on T2-weighted images, and hyperintense(15) or isointense(3) on heavily T2-weighted images. There were hypointense tumors(3/13) on Tl-weighted MR images at 0.5 T, whereas they were absent at 2.0 T(0/4). Only one tumor was avascular which was hyperintense on Tl-weighted images. Capsules were present in 13 cases and Tl-weighted images depicted them in 10 cases, while T2-weighted images depicted them in 8 cases. Mosaic patterns with inhomogeneous signal intensity were present in 15 cases, and were seen in 7 cases on Tl-weighted images whereas 11 cases on T2-weighted images. Mixed trabecular and pseudoglandular patterns of histologic growth were seen in 5 tumors. On MR images, trabecular portion was seen as hypointense area on Tl-weighted images and hyperintense on T2-weighted images. Pseudoglandular portion was seen as isointense or hyperintense area on Tl-weighted images and as marked hyperintense and on T2-weighted images. Mixed cytologic feature of classic and clear cell was found in 4 tumors and three of these 4 cases were hyperintense on Tl-weighted images. Four of the six tumors with grades I-II were hyperintense on Tl-weighted images. Tumors with grades II-Ill, Ill-IV were 14 cases, and only two of these cases showed hyperintensity on Tl-weighted images. Peliotic change was present in one case, and was seen as hyperintense foci on T2, & heavily T2-weighted images. CONCLUSION: Pathologic correlation suggest that hyperintensity on Tl-weighted images might be due to pseudoglandular pattern, low grade of malignancy or clear cell portion of hepatocellular carcinoma. Marked hyperintensity on T2-weighted images may be due to pseudoglandular pattern or peliotic change.
Angiography ; Capsules ; Carcinoma, Hepatocellular* ; Humans ; Magnetic Resonance Imaging*

BACKGROUND: Differential diagnosis between a generalized tonic-clonic seizure and syncope may be difficult due to similar clinical features. The need for a biological marker to distinguish a seizure from syncope has been emphasized from past studies. Transient hyperammonemia could be an indicator of recent convulsive seizure. The purpose of this study is to review the use of plasma ammonia level in the differential diagnosis of seizure and syncope. METHODS: Adult patients who were admitted to the Department of Neurology at Gangnam Severance Hospital with final diagnosis of a generalized tonic-clonic seizure or syncope were eligible for this study. Plasma ammonia levels were checked within 8 hr after an insult. RESULTS: Among the patients with a loss of consciousness who underwent analysis of plasma ammonia level, diagnoses were made with a seizure (n=65) and syncope (n=38). The seizure group had 70.29+/-70.86 micromol/L and the syncope group had 28.37+/-10.27 micromol/L of ammonia level, respectively. The seizure group presented with a significantly increased plasma ammonia (p<0.05) compared to the syncope group. The cut-off value with the reliable diagnostic level was defined as 36 micromol/L (=61.308 microg/dL) with a sensitivity of 0.65 and specificity of 0.80 by receiver operating characteristic (ROC) curve analysis. CONCLUSIONS: Plasma ammonia measurement during acute post-ictal period may be a useful test for the identification and the differential diagnosis of seizures and syncope.
Adult ; Ammonia ; Biomarkers ; Diagnosis, Differential ; Humans ; Hyperammonemia ; Neurology ; Plasma ; ROC Curve ; Seizures ; Sensitivity and Specificity ; Syncope ; Unconsciousness

No abstract available.
Central Nervous System ; Epilepsy ; Sarcoidosis

The association of anisakiasis of the colon with colon cancer is rare and difficult to diagnose. Only one case of this type has been reported to date. In this study, we report a case of synchronous colon cancer and colonic anisakiasis. A 50-year-old woman was admitted for abdominal pain, and a volume-rendered surface-shaded image of CT colonography (CTC) revealed a concentric narrowing in the sigmoid colon and a segmental fold thickening in the ascending colon. A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed. This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.
Adenocarcinoma/*complications/*radiography/surgery ; Anisakiasis/*complications/*radiography/surgery ; Colectomy ; Colonic Diseases/*complications/*radiography/surgery ; *Colonography, Computed Tomographic ; Female ; Humans ; Middle Aged ; Sigmoid Neoplasms/*complications/*radiography/surgery

This essay illustrates the various CT findings of the hepatic venous invasion of the hepatocellular carcinoma with an anglographic correlation. The thrombosed hepatic vein is directly visualized as a dilated tubular structure or multiple nodules of the similar attenuation to that of the parenchymal tumor, connecting the parenchymal tumor and the inferior vena cava on contrast enhanced CT scans. Enhancement of the thrombosed vein on spiral CT scans obtained in early arterial phase can suggest thrombosis caused by tumor invasion rather than a simple thrombosis. When the thrombosed hepatic vein is not directly visualized and replaced by a large tumor, the tumor thrombi within the inferior vena cava or right atrium can suggest the presence of the hepatic venous invasion.
Carcinoma, Hepatocellular* ; Heart Atria ; Hepatic Veins* ; Thrombosis ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Veins ; Vena Cava, Inferior

Sleep-related painful erection (SRPE) is characterized by deep penile pain accompanied with erection occurring rapid eye movement (REM) movement period. Two (47-year-old and 40-year-old, respectively) male visited with the complaint of painful penile erection occurring during sleep. They had no problems with erection during daytime sexual activities except for mild premature ejaculation in one patient. Urologic inspections revealed no focal abnormalities. Polysomnography with simultaneous penile erection monitoring showed several episodes of awakening with painful erection which are time-locked to onset of REM sleep periods. According to the diagnostic criteria in international classification of sleep disorders, each patient was diagnosed to have chronic, severe SRPE. Despite of a low prevalence of SRPE, this condition should be considered in a patient who presents with nocturnal penile. A polysomnography accompanied with penile erection recording may help confirm diagnosis.
Adult ; Classification ; Diagnosis ; Humans ; Male ; Penile Erection ; Polysomnography ; Premature Ejaculation ; Prevalence ; REM Sleep Parasomnias* ; Sexual Behavior ; Sleep Wake Disorders ; Sleep, REM

Subdural hemorrhage (SDH) can manifest various neurologic symptoms. However, SDH presenting with only hand weakness has rarely been reported. We report two SDH cases with only hand weakness mimicking peripheral neuropathy. Since SDH can present with hand weakness only, we suggest the clinicians to do a careful history taking and recommend a CT scan in the elderly patients.
Aged ; Hand ; Hematoma, Subdural* ; Humans ; Neurologic Manifestations ; Paresis ; Peripheral Nervous System Diseases* ; Tomography, X-Ray Computed

Background: The coronavirus disease 2019 pandemic has been challenging the healthcare service, i.e., the vitalization of the point of care accompanying self-testing in vitro diagnostic medical devices (IVDs). This study aims to suggest priority criteria to classify self-testing IVDs using the analytic hierarchy process technique. Methods: Two dimensions of the characteristics embedded in the IVDs and the diseases to be diagnosed with self-testing IVDs were parallelly considered and independently investigated. In addition, three expert panels consisting of laboratory medical doctors (n=11), clinicians (n=10), and citizens (n=11) who have an interest in the selection of self-testing IVDs were asked to answer to questionnaires. Priorities were derived and compared among each expert panel. Results: First of all, ease of specimen collection (0.241), urgency of the situation (0.224), and simplicity of device operation (0.214) were found to be the most important criteria in light of the functional characteristics of self-testing IVDs. Medical doctors valued the ease of specimen collection, but the citizen’s panel valued self-management of the disease more. Second, considering the characteristics of the diseases, the priority criteria were shown in the order of prevalence of diseases (0.421), fatality of disease (0.378), and disease with stigma (0.201). Third, medical doctors responded that self-testing IVDs were more than twice as suitable for non-communicable diseases as compared to communicable diseases (0.688 vs. 0.312), but the citizen’s group responded that self-testing IVDs were slightly more suitable for infectious diseases (0.511 vs. 0.489). Conclusion Our findings suggested that self-testing IVDs could be primarily classified as the items for diagnosis of non-communicable diseases for the purpose of self-management with easy specimen collection and simple operation of devices, taking into account the urgency of the situation as well as prevalence and fatality of the disease.

BACKGROUND: Wear debris-induced osteolysis leads to periprosthetic loosening and subsequent prosthetic failure. Since excessive osteoclast formation is closely implicated in periprosthetic osteolysis, identification of agents to suppress osteoclast formation and/or function is crucial for the treatment and prevention of wear particle-induced bone destruction. In this study, we examined the potential effect of pentamidine treatment on titanium (Ti) particle-induced osteolysis, and receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclastogenesis. METHODS: The effect of pentamidine treatment on bone destruction was examined in Ti particle-induced osteolysis mouse model. Ti particles were implanted onto mouse calvaria, and vehicle or pentamidine was administered for 10 days. Then, calvarial bone tissue was analyzed using micro-computed tomography and histology. We performed in vitro osteoclastogenesis assay using bone marrow-derived macrophages (BMMs) to determine the effect of pentamidine on osteoclast formation. BMMs were treated with 20 ng/mL RANKL and 10 ng/mL macrophage colony-stimulating factor in the presence or absence of pentamidine. Osteoclast differentiation was determined by tartrate-resistant acid phosphatase staining, real-time polymerase chain reaction, and immunofluorescence staining. RESULTS: Pentamidine administration decreased Ti particle-induced osteoclast formation significantly and prevented bone destruction compared to the Ti particle group in vivo. Pentamidine also suppressed RANKL-induced osteoclast differentiation and actin ring formation markedly, and inhibited the expression of nuclear factor of activated T cell c1 and osteoclast-specific genes in vitro. Additionally, pentamidine also attenuated RANKL-mediated phosphorylation of IκBα in BMMs. CONCLUSION: These results indicate that pentamidine is effective in inhibiting osteoclast formation and significantly attenuates wear debris-induced bone loss in mice.
Acid Phosphatase ; Actins ; Animals ; Bone and Bones ; Fluorescent Antibody Technique ; In Vitro Techniques ; Macrophage Colony-Stimulating Factor ; Macrophages ; Mice ; Osteoclasts ; Osteolysis ; Pentamidine ; Phosphorylation ; Real-Time Polymerase Chain Reaction ; Skull ; Titanium