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: 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: 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: 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

OBJECTIVE: The purpose of the study was to review the current status of intra-arterial (IA) thrombolysis in Korea by conducting a retrospective analysis of the data from multiple domestic centers. MATERIALS AND METHODS: The radiologists at each participating institution were asked to fill out case report forms on all patients who had undergone IA recanalization due to acute anterior circulation ischemia. These forms included clinical, imaging and procedure-related information. A central reader analyzed the CT/MR and angiographic results. The rates of successful recanalization, hemorrhagic transformation and functional outcome were obtained. The univariate analyses were performed together with the multivariate analysis. RESULTS: We analyzed the data from 163 patients, and they had been treated at seven institutes. The initial imaging modalities were CT for 46 patients (28%), MR for 63 (39%), and both for 54 (33%). Various mechanical treatment methods were applied together in 50% of the patients. Radiologically significant hemorrhage was noted in 20/155 patients (13%). We found various factors that influenced the recanalization rate and the occurrence of significant hemorrhagic transformations. The favorable outcome rate, reported as modified Rankin Scale < or = 2, was 40%, and the mortality rate was 11%. The factors that predicted a poor functional outcome were old age (p = 0.01), initially severe neurological symptoms (p < 0.0001), MR findings of a wide distribution of lesions (p = 0.001), involvement of the basal ganglia (p = 0.01), performance of procedures after working hours (p = 0.01), failure of recanalization (p = 0.003), contrast extravasation after the procedure (p = 0.007) and significant hemorrhagic transformation (p = 0.002). The subsequent multivariate analysis failed to show any statistically significant variable. CONCLUSION: There was a trend toward increased dependency on MR imaging during the initial evaluation and increased usage of combined pharmacologic/mechanical thrombolysis. The imaging and clinical outcome results of this study were comparable to those of the previous major thrombolytic trials.
Acute Disease ; Cerebral Angiography ; Cerebral Infarction/diagnosis/*drug therapy ; Female ; Fibrinolytic Agents/*administration & dosage ; Humans ; Injections, Intra-Arterial ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Thrombolytic Therapy/*methods/standards ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUND: Measurement of bronchodilator response is necessary to establish reversibility of airflow obstruction that was helpful to estimate the diagnosis, treatment, and prognosis in obstructive airway disease. An useful index should be able to detect the bronchodilator response more sensitively not related with degree of airflow obstruction and also be independent of initial FEV1. METHOD: Sensitivities of bronchodilator response in each group classified by degree of airflow obstruction in FEV1, FVC, FEF25~75%, Isovolume FEF25~75%, sGaw were studied and correlation coefficients were calculated between initial FEV1 and reversibilities expressed as absolute, %initial, %predicted, %possible in FEV1. RESULT: Sensitivities of bronchodilator response were 61.5% in FVC, Isovolume FEF25~75% and sGaw, in severe group, and 56.3% in Isovolume FEF25~75% and sGaw, in moderate group, and 62.5% in FEV1 and sGaw and 50.0% in FVC and Isovolume FEF25~75%, in mild group, and 60.0% in sGaw and 58.0% in Isovolume FEF25~75% in total patients. Correlation coefficients between initial FEV1(L) and absolute, % initial, % predicted, % possible were 0.15, -0.22(p<0.05), 0.02, 0.24(p<0.05) and correlation coefficients between initial FEV1(% predicted) and absolute, % initial, % predicted, %possible were 0.06, -0.28(p<0.05), 0.08, 0.39(p <0.05). CONCLUSION: Volume related parameters were more sensitive index not related with degree of airway obstruction and the change in FEV1 expressed as % predicted was the least dependent on initial FEV1 and reversibilities, expressed as % initial or as % possible(predicted minus initial FEV1)were correlated with initial FEV1.
Airway Obstruction ; Diagnosis ; Humans ; Inpatients* ; Prognosis

The patient was a 44-yr-old man with end-stage renal disease who had developed chorea as a result of hypoglycemic injury to the basal ganglia and thalamus and who was subsequently diagnosed with depression and restless legs syndrome (RLS). For proper management, the presence of a complex medical condition including two contrasting diseases, chorea and RLS, had to be considered. Tramadol improved the pain and dysesthetic restlessness in his feet and legs, and this was gradually followed by improvements in his depressed mood, insomnia, lethargy, and feelings of hopelessness. This case suggests that the dopaminergic system participates intricately with the opioid, serotoninergic, and noradrenergic systems in the pathophysiology of RLS and pain and indirectly of depression and insomnia.
Adult ; Analgesics, Opioid/therapeutic use ; Anti-Dyskinesia Agents/therapeutic use ; Chorea/*complications/pathology ; Citalopram/therapeutic use ; Drug Therapy, Combination ; Haloperidol/therapeutic use ; Humans ; Kidney Failure, Chronic/*complications ; Magnetic Resonance Imaging ; Male ; Restless Legs Syndrome/*complications/drug therapy/pathology ; Serotonin Uptake Inhibitors/therapeutic use ; Tramadol/therapeutic use