PURPOSE: Recent studies suggest that nimodipine, a potent calcium-channel blocker, may improve neurological outcome after experimental hypoxia-ischemic brain injury. This study was conducted to evaluate the therapeutic effect of nimodipine on hypoxia-ischemia in immature rat brain. METHODS: Seven-day postnatal rats were subjected to hypoxia-ischemia by unilateral common carotid artery occlusion combined with 2 hours of hypoxia(in 8% oxygen at an ambient temperature of 36degrees C). Then 20 rats received an intraventricular injection of nimodipine while the remaining 23 rats were injected with saline. Histologic examinations and morphometric analyses of brain tissue specimens were carried out 2 weeks after the hypoxia-ischemia. RESULTS: Histopathological analysis of each rat showed that the brains of the nimodipine-treated animals were less damaged when compared with control rats treated with saline. Fifty percent of nimodipine treated rats but only 13% of saline-treated rats revealed normal histologic findings(P< 0.05). Gliosis &/or nerve cell necrosis were observed, over three brain lobes in 15% of nimodipine-treated rats and 57% of saline-treated rats respectively(P<0.05). At the level of dorsal hippocampus, saline-treated rats revealed 0.18+/-0.17mm smaller ipsilateral cerebral hemispheres than contralateral hemispheres to artery dissections but nimodipine-treated rats showed only 0.07+/-0.14mm smaller hemispheres(P<0.05). The difference between contralateral and ipsilateral cerebral cortex was 0.4+/-0.36mm in saline-treated rats and 0.11+/-0.14mm in nimodipine-treated rats(P<0.05). The contraction of cerebral hemisphere and cortex were significantly reduced in nimodipine-treated rats. CONCLUSION: The finding indicates that post-insult nimodipine treatment in the immature rat decreases the extent of hypoxic-ischemic brain damage.
Animals ; Arteries ; Brain ; Brain Injuries ; Carotid Artery, Common ; Cerebral Cortex ; Cerebrum ; Gliosis ; Hippocampus ; Hypoxia-Ischemia, Brain* ; Injections, Intraventricular ; Models, Animal* ; Necrosis ; Neurons ; Nimodipine* ; Oxygen ; Rats*

A statistical analysis of the diagnostic value for 244 aspiration biopsy cytology(ABC) among a total 1,043 cases from various sites was performed. ABC, using diagnostic terminology similar to that of a surgical pathology reports, was compared to the final tissue diagnosis. For the entire series, a sensitivity of 91.8%, a specificity of 99.3%, a positive predictive value of 98.9%, a negative predictive value of 94.8%, and an efficacy of the test of 96.3% were shown. There were 8 false negative and 1 false positive diagnosis. The diagnostic accuracy was 89.8%. Those results indicate that the ABC is a considerably highly accurate procedure that should be routinely employed.
Biopsy, Needle ; Child* ; Diagnosis ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Intranuclear Inclusion Bodies ; Meningioma ; Pathology, Surgical ; Sensitivity and Specificity

A 30-year-old woman who was diagnosed as peripheral neuroblastoma by fine needle aspiration of a soft mass of the right upper arm is described. She presented a slowly growing, soft mass of the right upper arm for 1 month. The right humerus revealed no abnormal finding on X-ray. Ultrasonogram of the right upper arm revealed a well demarcated, smooth marginated solid mass without invasion of adjacent structures. Fine needle aspiration was done under the impression of soft tissue tumor with undetermined biologic behavior. The aspirates were highly cellular and the tumor cells were dispersed both singly and in clusters of varying size. The clusters occasionally showed a central capillary core and rosette-like structures. The tumor cells were small in size and had a small to medium amount of cytoplasm. Some of them revealed slender cytoplasmic processes. The nuclei showed distinct nuclear membranes, finely clumped chromatin and small conspicuous nucleoli. Cellular pleomorphism or mitotic figure was not definite. These cytologic findings were interpreted as a malignant, non-lymphomatous, small round cell tumor, most likely representing peripheral neuroblastoma or Ewing's sarcoma. Final diagnosis was confirmed by simple excision as peripheral neuroblastoma.
Adult ; Arm ; Biopsy, Fine-Needle ; Capillaries ; Child* ; Chromatin ; Cyclosporine* ; Cytoplasm ; Diagnosis ; Female ; Humans ; Humerus ; Nephrotic Syndrome* ; Neuroblastoma ; Nuclear Envelope ; Pilomatrixoma ; Sarcoma, Ewing ; Ultrasonography

PURPOSE: To determine the features of hepatic adenomatous hyperplasia using different imaging modalities. MATERIALS AND METHODS: Twenty-two patients with 29 adenomatous hyperplastic nodules of the liver (0.9-3.1 cm) underwent sonography (29 lesions), CT (24 lesions), angiography (11 lesions), MR (12 lesions), and Lipiodol CT(seven lesions). Each lesion was analyzed for echogenicity, attenuation, vascularity, signal intensity, and Lipiodol uptake. RESULTS: On sonograms, echogenicity was high in 16, low in 11, and iso- in 2 of 29 lesions. On contrast enhanced CT scans, attenuation was high in 4, low in 14, and iso- in 6 of 24 lesions. On hepatic angiograms, vascularity of lesions was avascular in 9 and slightly vascular in 2 of 11 lesions. On MR images, signal intensity was high in 11 and iso- in 1 of 12 lesions on T1-weighted MRI, and iso- in 7, and low in 5 of 12 lesions on T2-weighted MRI. On iodized-oil CT scans, retention of Lipiodol was present in 3 and absent in 4 of seven lesions. CONCLUSION: Common imaging findings of adenomatous hyperplasia of the liver are high echogenicity on sonography, low attenuation on CT, hypovascularity on angiography, high signal intensity on T1-weighted MRI, and iso- or low signal intensity on T2-weighted MRI.
Angiography ; Ethiodized Oil ; Humans ; Hyperplasia* ; Liver* ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed

PURPOSE: We investigated whether Tc-99m MIBI imaging is useful to predict the response of drug treatment in patients with rheumatoid arthritis. MATERIALS AND METHODS: 24 patients (15 women and 9 men, age 49 +/- 12 year) rheumatoid arthritis and treated with disease modifying antirheumatic drugs (DMARDs) were included in this study. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured, and Tc-99m MIBI scan was obtained before drug treatment. Quantitative analysis of uptake in diseased joints was performed and expressed as joint-to background ratio (J/B) and percent retention (%R) of Tc-99m MIBI. Clinical symptoms were evaluated and graded from 0 (no) to 3 (severe) regarding to presence of tenderness and swelling. RESULTS: J/B of the diseased joints were significantly correlated with ESR and CRP (p< 0.05). A highly significant correlation was found between the improvement of clinical symptoms and %R of Tc-99m MIBI (p< 0.05). CONCLUSION: The results demonstrate that Tc-99m MIBI scan may be used to predict the therapeutic response in patients with rheumatoid arthritis.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Blood Sedimentation ; C-Reactive Protein ; Female ; Humans ; Joints ; Male

PURPOSE: This study was aimed to identify the difference in satisfaction and importance of nursing care between patients in comprehensive nursing care unit (CNCU) and general nursing care unit (GNCU). It also confirms the difference between practice environment of nursing work and nurse's intention to work. METHODS: Nursing care satisfaction and importance levels were measured from 202 patients. Practice environment of nursing work and nurse's intention to work were measured from 54 nurses. RESULTS: The satisfaction level was higher in the CNCU in comparison to the GNCU (p < .001). There was no significant difference between the importance and satisfaction level of nursing care for patients at the CNCU (p=.973), whereas in the GNCU, patients' satisfaction level was lower than the importance level (p < .001). The score for practice environment for nursing work was higher in the CNCU than in the GNCU (t=3.34, p=.002). The nurse's intention to work in the CNCU was higher than that of the GNCU, but there was no statistically significant difference. CONCLUSION: Through the survey, the paper suggests that comprehensive nursing care is a service type that satisfies the nursing demand (importance) that patients consider important. Results from nurses showed no significant differences.
Humans ; Intention ; Nursing Care ; Nursing ; Patient Satisfaction

This multicenter collaboratory study was conducted to find out the long-term therapeutic efficacy and side effect of cyclosporine A(Cypol(R), Chong Kun Dang) on children with idiopathic nephrotic syndrome who experienced frequently relapsing(FR), steroid dependent(SD), or steroid resistant(SR) pattern. Forty-six children with SD/FR NS and 5 children with SR NS were enrolled in this study. After induction of remission(SD/FR NS) with steroid or after 4 weeks of steroid therapy(SR NS), cyclosporine A was started in a dose of 4-5mg/kg/day in two divided dose and steroid(prednisolone or equivalent dose of deflazacort) was tapered slowly. During 12 months of study period, monthly check up of physical examination and various laboratory tests including BUN, creatinine, Ccr and cyclosporine blood level were done. Out of 46 children with SD/FR NS, 28(60.9%) maintained sustained remission, 16(34.8%) showed 1 or 2 relapses during therapy and 2(4.3%) cases showed no response. At 4 weeks after therapy, values of serum protein, albumin, cholesterol, and 24 hours urinary protein excretion showed normal values. Four out of 5 children with SR NS showed complete or partial remission with cyclosporine A therapy and one child showed no response. Side reaction to cyclosporine A therapy showed hypertricosis in 14 cases, hyperuricemia in 8 cases and hypomagnesemia in 16 cases. However, other laboratory tests including CBC, liver profile, BUN, creatinine and GFR(creatinine clearance utilizing 24 hour urine) did not show any abnormalities during the 12 months of study period. We performed follow-up renal biopsy in 17 children after 12 months cyclosporine A treatment. Eight cases(47.1%) showed mild cyclosporine A nephrotoxicity like interstitial fibrosis and tubular atropy. In conclusion, present study shows that cyclosporine A(Cypol(R), Chong Kun Dang) can be used quitely effectively in maintaining remission and decreasing relapse rate on children with SD/FR or SR NS. However, because administration of cyclosporine A for 12 months is found to be associated with nephrotoxicity in a significant number of patients, we are planning further study using "smaller dosage" of cyclosporine A to reduce its nephrotoxic effect and for longer period of treatment(over 2 years).
Biopsy ; Child* ; Cholesterol ; Creatinine ; Cyclosporine* ; Fibrosis ; Follow-Up Studies ; Humans ; Hyperuricemia ; Liver ; Nephrotic Syndrome* ; Physical Examination ; Recurrence ; Reference Values

BACKGROUND: Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. MATERIALS AND METHOD: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. RESULT: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. CONCLUSION: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.
Biopsy ; Humans ; Positron-Emission Tomography and Computed Tomography* ; Solitary Pulmonary Nodule*

BACKGROUND: Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. MATERIALS AND METHOD: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. RESULT: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. CONCLUSION: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.
Biopsy ; Humans ; Positron-Emission Tomography and Computed Tomography* ; Solitary Pulmonary Nodule*

PURPOSE: To describe the computed tomographic (CT) and sonographic (US) findings of hepatic lymphoma presenting as focal lesion(s). MATERIALS AND METHODS: From May 1989 to August 1996, CT (n = 9) and US (n = 7) findings of ten patients with hepatic lymphoma were retrospectively analyzed. Three were suffering from primary non-Hodgkin's lymphoma (NHL), six had secondary NHL and one had Hodgkin's disease (HD). Findings were analysed with respect to number and contour of the lesions, associated lymphadenopathy or splenic lesion, and the presence or absence of normal vascular structure in the mass. In addition, echogenicity of the lesion and the presence of a capsule or halo was analyzed on US and enhancement pattern was analyzed on CT. RESULTS: Single nodular type lesions were seen in six patients (three primary NHL, three secondary NHL) and the multinodular type were seen in four (three secondary NHL and one HD). Contour was smooth in two patients with secondary NHL and ill-defined or lobulated in all other patients. Lymphadenopathy was seen in three of six patients with secondary NHL, and splenic lesions were seen in the other three. The echogenicity of the mass was mixed in three, homogeneously low in two and target shaped in two. The enhancement pattern was highly variable. CONCLUSION: Hepatic lymphoma has variable radiologic features, so differentiation from other tumorous conditions of the liver was difficult. A history of lymphoma in other part(s) of the body, associated splenic lesion(s) or abdominal lymphadenopathy or normal vasculature within a tumor may suggest the presence of hepatic lymphoma.
Hodgkin Disease ; Humans ; Liver ; Lymphatic Diseases ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Retrospective Studies ; Ultrasonography*