OBJECTIVE: To evaluate the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using macromolecular contrast agent (P792) for assessment of vascular disrupting drug effect in rabbit VX2 liver tumor models. MATERIALS AND METHODS: This study was approved by our Institutional Animal Care and Use Committee. DCE-MRI was performed with 3-T scanner in 13 VX2 liver tumor-bearing rabbits, before, 4 hours after, and 24 hours after administration of vascular disrupting agent (VDA), using gadomelitol (P792, n = 7) or low molecular weight contrast agent (gadoterate meglumine [Gd-DOTA], n = 6). P792 was injected at a of dose 0.05 mmol/kg, while that of Gd-DOTA was 0.2 mmol/kg. DCE-MRI parameters including volume transfer coefficient (K(trans)) and initial area under the gadolinium concentration-time curve until 60 seconds (iAUC) of tumors were compared between the 2 groups at each time point. DCE-MRI parameters were correlated with tumor histopathology. Reproducibility in measurement of DCE-MRI parameters and image quality of source MR were compared between groups. RESULTS: P792 group showed a more prominent decrease in K(trans) and iAUC at 4 hours and 24 hours, as compared to the Gd-DOTA group. Changes in DCE-MRI parameters showed a weak correlation with histologic parameters (necrotic fraction and microvessel density) in both groups. Reproducibility of DCE-MRI parameters and overall image quality was not significantly better in the P792 group, as compared to the Gd-DOTA group. CONCLUSION: Dynamic contrast-enhanced magnetic resonance imaging using a macromolecular contrast agent shows changes of hepatic perfusion more clearly after administration of the VDA. Gadolinium was required at smaller doses than a low molecular contrast agent.
Animals ; Antineoplastic Agents/therapeutic use ; Benzophenones/therapeutic use ; Disease Models, Animal ; Heterocyclic Compounds/administration & dosage/*chemistry ; Liver Neoplasms/drug therapy/pathology/*radiography ; *Magnetic Resonance Imaging ; Male ; Organometallic Compounds/administration & dosage/*chemistry ; Rabbits ; Reproducibility of Results ; Valine/analogs & derivatives/therapeutic use

PURPOSE: Kikuchi-Fujimoto disease (KFD) is a benign disease, which is characterized by a cervical lymphadenopathy with fever, and it often mimics malignant lymphoma (ML). 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) is a powerful imaging modality for the diagnosis, staging and monitoring of ML, with the limitations including the nonspecific FDG uptake in infectious or inflammatory processes. This study compared clinical manifestations and PET/CT findings between KFD and ML patients. METHODS: We retrospectively reviewed the medical records of 23 patients with KFD and 33 patients with ML, diagnosed histopathologically, between January 2000 and May 2013 at the Department of Pediatrics, Yeungnam University Medical Center. Among them, we analyzed the clinical manifestations, laboratory findings and characteristics, and the amount of 18F-FDG uptake between 8 KFD and 9 ML patients who had 18F-FDG PET/CT. RESULTS: The 18F-FDG PET/CT maximum standardized uptake values (SUVmax) ranged from 8.3 to 22.5 (mean, 12.0) in KFDs, and from 5.8 to 34.3 (mean, 15.9) in MLs. There were no significant differences in SUVmax between KFDs and MLs. 18F-FDG PET/CT with ML patients showed hot uptakes in the extranodal organs, such as bone marrow, small bowel, thymus, kidney, orbit and pleura. However, none of the KFD cases showed extranodal uptake (P<0.001). 18F-FDG PET/CT findings of KFD with nodal involvement only were indistinguishable from those of ML. CONCLUSION: Patients who had extranodal involvement on PET/CT were more likely to have malignancy than KFD.
Academic Medical Centers ; Bone Marrow ; Child* ; Diagnosis ; Electrons ; Fever ; Fluorodeoxyglucose F18 ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Kidney ; Lymphatic Diseases ; Lymphoma* ; Medical Records ; Orbit ; Pediatrics ; Pleura ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography* ; Retrospective Studies ; Thymus Gland

OBJECTIVE: To prospectively evaluate the safety and short-term therapeutic efficacy of switching monopolar radiofrequency ablation (RFA) with multiple electrodes to treat medium-sized (3.1-5.0 cm), hepatocellular carcinomas (HCC). MATERIALS AND METHODS: In this prospective study, 30 patients with single medium-sized HCCs (mean, 3.5 cm; range, 3.1-4.4 cm) were enrolled. The patients were treated under ultrasonographic guidance by percutaneous switching monopolar RFA with a multichannel RF generator and two or three internally cooled electrodes. Contrast-enhanced CT scans were obtained immediately after RFA, and the diameters and volume of the ablation zones were then measured. Follow-up CT scans were performed at the first month after ablation and every three months thereafter. Technical effectiveness, local progression and remote recurrence of HCCs were determined. RESULTS: There were no major immediate or periprocedural complications. However, there was one bile duct stricture during the follow-up period. Technical effectiveness was achieved in 29 of 30 patients (97%). The total ablation time of the procedures was 25.4 +/- 8.9 minutes. The mean ablation volume was 73.8 +/- 56.4 cm3 and the minimum diameter was 4.1 +/- 7.3 cm. During the follow-up period (mean, 12.5 months), local tumor progression occurred in three of 29 patients (10%) with technical effectiveness, while new HCCs were detected in six of 29 patients (21%). CONCLUSION: Switching monopolar RFA with multiple electrodes in order to achieve a sufficient ablation volume is safe and efficient. This method also showed relatively successful therapeutic effectiveness on short-term follow up for the treatment of medium-sized HCCs.
Adult ; Aged ; Carcinoma, Hepatocellular/radiography/*surgery ; Catheter Ablation/instrumentation/*methods ; Contrast Media/diagnostic use ; Disease Progression ; Electrodes ; Female ; Humans ; Iohexol/analogs & derivatives/diagnostic use ; Kaplan-Meier Estimate ; Liver Neoplasms/radiography/*surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prospective Studies ; Tomography, X-Ray Computed/*methods ; Ultrasonography, Interventional

Pituitary stalk interruption and ectopic neurohypophysis seen on magnetic resonance Imaging (MRI) are often associated with either isolated growth hormone (GH) deficiency or combined anterior pituitary hormone deficiency, but their pathogenesis is not clear and the clinical data regarding these anatomical defect is limited. We experienced a 23-year-old male with the absence of secondary sexual characteristics and this was accompanied with pituitary stalk dysgenesis and ectopic neurohypophysis. He received growth hormone for a year when he was 12 years old due to his short stature. Sella MRI showed no visible pituitary stalk with minimal high signal change, suggesting ectopic neurohypophysis. The combined pituitary stimulation test revealed blunted responses of growth hormone, follicle stimulating hormone and luteinizing hormone. For the hypogonadotropic hypogonadism, the patient was given testosterone intramuscularly and he gradually developed secondary sexual characteristics. We concluded that the hypogonadism and growth hormone deficiency in this patient was caused by hypopituitarism due to pituitary stalk dysgenesis and ecopic nuerohypophysis.
Follicle Stimulating Hormone ; Growth Hormone ; Humans ; Hypogonadism ; Hypopituitarism ; Luteinizing Hormone ; Magnetic Resonance Imaging ; Male ; Pituitary Gland ; Pituitary Gland, Posterior ; Testosterone ; Young Adult

Ethanol and its metabolite acetaldehyde increase transforming growth factor beta1 (TGF-beta1) expression in animal studies. TGF-beta1 is related with the hepatic stellate cell (the key element of hepatic fibrogenesis) and the radial glia (the key element of neuronal migration). Blood samples were collected from 41 patients with alcohol dependence, TGF-beta1 levels measured by ELISA were compared with 41 normal subjects. Plasma TGF-beta1 levels in the patients with alcohol dependence (1,653.11+/-532.45 pg/mL) were significantly higher than those of healthy subjects (669.87+/-366.53 pg/mL) (P=0.000). Patients with or without liver pathology showed no difference in TGF-beta1 (P=0.36). Increased TGF-beta1 may mediate deleterious effect of alcohol such as hepatic fibrosis and suppressed neuronal developments in alcohol dependence patients.
Adult ; Alcoholism/*blood ; Enzyme-Linked Immunosorbent Assay ; Humans ; Liver Diseases/pathology/ultrasonography ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Transforming Growth Factor beta1/*blood

OBJECTIVES: Most of the mechanisms reported for antidepressant drugs are the enhancement of neurite outgrowth and neuronal survival in the rat hippocampus. Neural cell adhesion molecule 140(NCAM140) has been implicated as having a role in cell-cell adhesion, neurite outgrowth, and synaptic plasticity. In this report, we have performed to elucidate a correlation among chronic antidepressant treatments, NCAM140 expression, and activation of phosphorylated cyclicAMP responsive element binding protein(pCREB) which is a downstream molecule of NCAM140-mediated intracellular signaling pathway in the rat hippocampus. METHODS: Fluoxetine(10mg/kg) was injected acutely(daily injection for 5days) or chronically(daily injection for 14days) in adult rats. RNA and protein were extracted from the rat hippocampus, respectively. Real-time RTPCR was performed to analyze the expression pattern of NCAM140 gene and western blot analyses for the activation of the phosphorylation ratio of CREB. RESULTS: Chronic fluoxetine treatments increased NCAM140 expression 1.3 times higher than control in rat hippocampus. pCREB immunoreactivity in the rat hippocampus with chronic fluoxetine treatment was increased 4.0 times higher than that of control. CONCLUSION: Chronic fluoxetine treatment increased NCAM140 expression and pCREB activity in the rat hippo-campus. Our data suggest that NCAM140 and pCREB may play a role in the clinical efficacy of antidepressants promoting the neurite outgrowth and neuronal survival.
Adult ; Animals ; Antidepressive Agents ; Blotting, Western ; Fluoxetine ; Hippocampus ; Humans ; Neural Cell Adhesion Molecules ; Neurites ; Neurons ; Phosphorylation ; Plastics ; Rats ; RNA

OBJECTIVES: The aim of this prospective study is to investigate predictors estimating relapse in Korean alcohol-dependent patients using variables like alcohol history, drinking craving, treatment motivation and insight. METHODS: Alcohol dependent patients(N=48) who completed questionnaires about sociodemographic variables and drinking history, Timeline Follow-Back(TLFB), Obsessive-Compulsive Drinking Scale(OCSD), Alcohol Urge Questionnaire(AUQ), Pennsylvania Alcohol Craving Scale(PACS), University of Rhode Island Change Assessment(URICA), Hanil Alcohol Insight Scale(HAIS) were followed-up for 24weeks. Subjects who drank heavily(5 standard drinking or more/day) or were not followed up anymore were classified as the relapse group. We used logistic regression analysis with backward elimination of SPSS PC+11.5 to investigate relapse estimate predictors. RESULTS: Average drinking amount per drinking day for last 1 year and HAIS score were predictors of relapse in alcohol-dependent patients. CONCLUSIONS: Our findings suggest that therapist should give more attention to alcohol-dependent patients who had more drinks per drinking day for last 1 year and had lower insight level.
Alcoholism ; Drinking ; Follow-Up Studies* ; Humans ; Logistic Models ; Motivation ; Pennsylvania ; Prospective Studies ; Recurrence* ; Rhode Island

Alcohol influences the neuroadaptation of brain cells where receptors and enzymes like protein kinase C (PKC) exist. Naltrexone acts on opioid receptors. However, other mechanisms of action remain unknown. We prepared SH-SY5Y neuroblastoma cells, and fed them with 150 mM ethanol for 72 h followed by treatment with naltrexone for 24 h. We performed microarray analysis and reverse transcriptase-polymerase chain reaction. Our results showed that PKC epsilon increased 1.90 times and showed an overall decreasing pattern as time increased. Phosphorylated ERK also increased 2.0 times according to the change of PKC epsilon. Integrin alpha7 increased 2.32 times and showed an increasing pattern as time increased. In conclusion, naltrexone influences PKC epsilon neuronal signaling system and endothelial adhesion molecule integrin alpha7 in addition to the well-known opioid system.
Antigens, CD/*metabolism ; Cell Line, Tumor ; Comparative Study ; DNA, Complementary/genetics ; Humans ; Integrin alpha Chains/*metabolism ; Naltrexone/*pharmacology ; *Neuroblastoma/enzymology/metabolism/pathology ; Oligonucleotide Array Sequence Analysis ; Protein Kinase C-epsilon/*metabolism ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors

OBJECTIVES: In order to provide useful data for the further clinical studies with Korean alcohol-dependent patients, enrollment and non-relapse rates were investigated while alcohol-dependent patients were followed up for 24 weeks. METHODS: The subjects of this study were alcohol-dependent male patients who, for the first time, visited a hospital among 3 groups of hospitals, University Hospital, General Hospital or Mental Hospital, or those who needed to be followed up after discharge from those hospitals. After assigning 12 subjects to each hospital, we investigated enrollment and non-relapse rates while cognitive-behavioral therapy and pharmacotherapy were provided. RESULTS: 1) Forty-eight patients were enrolled and the rate of enrollment was 36.4%. The enrollment rate in the University Hospital group was 52.1%, in the General Hospital group 50.0%, and in the Mental Hospital group 10.4%. 2) In 48 patients, non-relapse rate was 27.1% at 12 week and 18.8% at 24 weeks after starting follow-up. It was 24.4% and 20.0% at 12 and 24 weeks, repectively, in the University Hospital group while the General Hospital group showed 33.3% and 16.7%, respectively, and the Mental Hospital Group showed 20.0% at both 12 and 24 weeks. CONCLUSION: These results provide important data for further clinical studies of Korean alcohol-dependent patients.
Alcoholism ; Drug Therapy ; Follow-Up Studies* ; Hospitals, General ; Hospitals, Psychiatric ; Hospitals, University ; Humans ; Male*

PURPOSE: Insufficient teaching of clinical microbiology, often caused by limited resources in medical schools, might be a reason for inaccurate diagnosis and treatment of infectious diseases by doctors. The purpose of this study is to develop and assess a multimedia self learning tool (MSLT) for clinical microbiology course. METHODS: We developed the MSLT based on existing self-directed learning tools. This tool was used by second- and third-year medical students. We randomly assigned 67 participating students to two groups: one (29) with lectures only and the other (38) with the MSLT only. We conducted pre- and post-tests. RESULTS: There are no differences in the pre- and post-test scores between the lecture group and the MSLT group in knowledge of bacterial classification, understanding of infectious diseases, proper use of laboratory tests, and proper selection of antimicrobials. However, post-test scores were significantly higher in both groups. CONCLUSION: The MSLT was found to be as equally effective as lectures, at least, test scorewise. Teachers could use either this tool alone or combined with conventional lectures to improve and enhance teaching in clinical microbiology. The results shed new insights into the possibility of introducing new teaching methods in clinical microbiology for future medical education.
Classification ; Communicable Diseases ; Computer-Assisted Instruction ; Diagnosis ; Education, Medical ; Humans ; Learning* ; Lectures ; Multimedia* ; Schools, Medical ; Students, Medical* ; Teaching