PURPOSE: The purpose of this study was to determine the characteristics of hypoxic-ischemic encephalopathy (HIE) on diffusion-weighted imaging (DWI) and the role of DWI for the diagnosis of HIE. MATERIALS AND METHODS: Six patients with HIE underwent MRI including DWI. MR examinations were performed within 4 - 32 days (mean, 11.8 days) after hypoxic brain insult. We assessed the distribution of the lesions and compared the DWI and T2, FLAIR images for the subjective conspicuity of the lesions. RESULTS: In all patients, symmetrical hyperintense lesions were demonstrated in the bilateral basal ganglia on T2, FLAIR, and DWI. On ADC map image, the lesions were hypointense in four of six patients and isointense in other two patients. Lesion conspicuity on DWI was higher than on T2 and FLAIR images in four of six patients and similar in other two patients. For the involvement of the cortex and subcortical white matter, in five of six patients, bilateral symmetric hyperintense lesions were seen on T2, FLAIR, and DWI. Lesion conspicuity on DWI was higher than on T2 and FLAIR images in three of them and similar in other two patients. On ADC map image, the lesions showed hypointensity in three of five patients and isointensity in other two patients. For the involvement of the deep cerebral white matter, T2, FLAIR, and DWI showed bilateral symmetric hyperintense lesions in four of six patients. Among them, Lesion conspicuity on DWI was higher than on T2 and FLAIR images in only one patient. CONCLUSION: HIE is characterized by symmetrical hyperintense lesions in the bilateral basal ganglia, cerebral cortex, and white matter on DWI and the lesions are more conspicuously demonstrated on DWI than on T2 and FLAIR images.
Anoxia ; Basal Ganglia ; Brain ; Cerebral Cortex ; Humans ; Hypoxia-Ischemia, Brain

PURPOSE: To determine the frequency and distribution of parenchymal changes on mammography before and after hormone replacement therapy. MATERIALS AND METHODS: Mammograms of 100 postmenopausal women who underwent hormone replacement therapy without breast disease were evaluated. Mammograms obtained annually after hormone replacement were analysed and compared with that of pretreatment. In addition, mammograms of control group and treatment group were compared. RESULTS: An increase in density of breast parenchyma was seen on the mammogram of 20 women(20%) receiving therapy. The mammograms from the control group showed no change. Mammographic changes were detected at first year in 13 women, 2nd year in 4 women, 3rd year in 2 women, and 4th year in 1 woman (average,19 months). CONCLUSION: We conclude that increase in mammographic density following postmenopausal hormone replacement therapy is not uncommon(20%).
Breast Diseases ; Breast* ; Estrogen Replacement Therapy* ; Female ; Hormone Replacement Therapy ; Humans ; Mammography*

PURPOSE: The aim of this study was to evaluate the frequency, radiologic findings and clinical significance of the simple pulmonary eosinophilia (SPE) that was diagnosed among the asymptomatic patients who underwent low-dose CT scans for the early detection of lung cancer. MATERIALS AND METHODS: From June 2003 to May 2005, 1,239 asymptomatic patients (1,275 examinations) who visited the health promotion center in our hospital and who underwent low-dose CT were enrolled in this study. SPE was defined as the presence of > 500 eosinophils per microliter of peripheral blood and the presence of abnormal parenchymal lesions such as nodules, airspace consolidation or areas of ground-glass attenuation (GGA) on CT, and there was spontaneous resolution or migration of the lesions on the follow-up examination. We analyzed the CT findings of SPE and we investigated the relationship between the occurrence of SPE and the season, smoking and the presence of parasite infestation. RESULTS: 36 patients were finally diagnosed as having SPE; this was 24% of the 153 patients who were diagnosed with parasite infestation and 2.8% of the total low-dose CT scans. These 36 patients consisted of 31 men and 5 women with a mean age 45.7 years. There was no significant relationship between SPE and the presence of parasite infestation, smoking or gender. Among the patients with peripheral blood eosinophilia, the eosinophil count was significantly higher in the patients with SPE than that in the patients without pulmonary infiltration (p < 0.05). SPE more frequently occurred in winter and spring than in summer and autumn (p < 0.05). The CT findings were single or multiple nodules in 18 patients, nodules and focal GGA in 9 patients and GGA only in 9 patients. Most of the nodules were less than 10 mm (88%, 49/56) in diameter and they showed an ill-defined margin (82%, n = 46); 30% of the nodules (n = 17) showed a halo around them. CONCLUSION: Simple pulmonary eosinophilia can be suggested as the cause if single or multiple ill-defined nodules or focal GGA are found on the low-dose CT performed in asymptomatic patients with peripheral blood eosinophilia. Short interval follow-up should be recommended to avoid invasive procedures or unnecessary aggressive treatment due to mistaking these lesions as lung cancer or metastatic malignancy.
Early Detection of Cancer ; Eosinophilia ; Eosinophils ; Female ; Follow-Up Studies ; Health Promotion ; Humans ; Lung Neoplasms* ; Lung* ; Male ; Mass Screening* ; Parasites ; Pulmonary Eosinophilia* ; Seasons ; Smoke ; Smoking ; Tomography, X-Ray Computed*

Small bowel tumors are very rare and generally malignant. As a result of the anatomical location and nonspecific manifestations of small bowel tumors, they are very difficult to diagnose. Balloon-assisted enteroscopy is a relatively noninvasive method compared to surgical resection, and allows for real-time observation, tissue confirmation with biopsy, and interventional procedures. Here, we report the case of a 69-year-old woman with a small bowel metastatic carcinoma observed with double balloon enteroscopy (DBE). She had a history of multiple cancers including ovarian cancer, bladder cancer, and breast cancer. The antegrade DBE procedure was performed before surgery for biopsy tissue confirmation. The patient underwent small bowel resection, and the final diagnosis was the same as that determined by preoperative biopsy. The final diagnosis was metastatic small bowel cancer originating from a cancer of the breast. This is the first detailed report of the preoperative diagnosis of small intestinal metastatic breast cancer by DBE.
Aged ; Biopsy ; Breast Neoplasms ; Diagnosis ; Double-Balloon Enteroscopy* ; Female ; Humans ; Ovarian Neoplasms ; Urinary Bladder Neoplasms

Helicobacter pylori colonizes the gastric mucosa of about half of the world's population, causing chronic gastritis and gastric cancer. An increasing emergence of antibiotic-resistant H. pylori arouses demand on alternative non-antibiotic-based therapies. In this study, we freshly prepared crude N-acetylneuraminic acid obtained from glycomacropeptide (G-NANA) of whey through a neuraminidase-mediated reaction and evaluated its antibacterial ability against H. pylori and H. felis. Overnight cultures of the H. pylori were diluted with fresh media and different concentrations (1-150 mg/mL) of crude G-NANA were added directly to the culture tube. Bacterial growth was evaluated by measuring the optical density of the culture medium and the number of viable bacteria was determined by a direct count of the colony forming units (CFU) on agar plates. For the in vivo study, mice were orally infected with 100 µL (5×108 cfu/mL) of H. felis four times at a day's interval, accompanied by a daily administration of crude G-NANA or vehicle. A day after the last infection, the mice were daily administered the crude G-NANA (0, 75, and 300 mg/mL) for 10 days and euthanized. Their stomachs were collected and bacterial colonization was determined by quantitative real-time PCR. Crude G-NANA inhibited H. pylori's growth and reduced the number of viable bacteria in a dose-dependent manner. Furthermore, crude G-NANA inhibited bacterial colonization in the mice. These results showed that crude G-NANA has antibacterial activity against Helicobacter and demonstrated its therapeutic potential for the prevention of chronic gastritis and gastric carcinogenesis induced by Helicobacter infection in humans.
Agar ; Animals ; Bacteria ; Carcinogenesis ; Cats ; Colon ; Felis ; Gastric Mucosa ; Gastritis ; Helicobacter ; Helicobacter Infections ; Helicobacter pylori ; Humans ; Mice ; N-Acetylneuraminic Acid* ; Real-Time Polymerase Chain Reaction ; Stem Cells ; Stomach ; Stomach Neoplasms ; Whey*

PURPOSE: The purpose of this study was to assess the value of the parallel wire balloon angioplasty technique for treating dysfunctional hemdialysis fistula with rigid stenosis, and this type of lesion was resistant to conventional angioplasty. MATERIALS AND METHODS: Between March 2002 and August 2003, we included 6 patients (mean age: 59, males: 2, females: 4) who were treated via parallel the wire balloon angioplasty technique and their hemodialysis fistula has stenoses that were resistant to conventional angioplasty. We performed conventional angioplasty in all patients, but we failed to achieve sufficient dilatation. In the cases of highly resistant stenosis, an additional 0.016 inch wire was inserted into the 7 F vascular sheath. During angioplasty, a 0.016 inch guide wire was inserted between the balloon and the stenosis and then it was pushed to and fro until the balloon indentation disappeared. After the procedure, we performed angiography to identify the residual stenosis and the procedure-related complications. RESULTS: The undilatable stenoses in 5 patients were successfully resolved without complications via the parallel wire angioplasty technique. In one patient, indentation of balloon was not resolved, but the residual stenosis was both minimal and hemodynamically insignificant. CONCLUSION: The parallel wire angioplasty technique seems to be a feasible and cost-effective method for treating a dysfunctional hemodialysis fistula with undilatable and rigid stenosis.
Angiography ; Angioplasty ; Angioplasty, Balloon ; Constriction, Pathologic* ; Dialysis ; Dilatation ; Female ; Fistula* ; Humans ; Male ; Renal Dialysis*

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is an uncommon congenital abnormality of the female urogenital tract characterized by the triad of uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. A 13-year-old female presented with acute lower abdominal pain. Magnetic resonance imaging (MRI) revealed uterine didelphys, hematometrocolpos, obstructed hemivagina, and right ipsilateral agenesis, consistent with OHVIRA syndrome. Also, a well-defined mass with fluid signal intensity, mimicking adnexal neoplasm was seen in the right lower pelvic cavity adjacent to the posterior wall of the bladder. Vaginal septotomy and drainage of hematometrocolpos were done initially, but unilateral hysterectomy was later performed to relieve the patient's symptoms. The cystic mass in the right lower pelvic cavity was also excised and confirmed as a blind megaureter.
Abdominal Pain ; Adolescent ; Congenital Abnormalities ; Drainage ; Female ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Urinary Bladder

Antiphospholipid syndrome (APS) is an autoimmune disease that involves vascular thrombosis and pregnancy morbidity associated with elevated titers of antiphospholipid antibodies. APS can affect any organ and has a variety of clinical manifestations. Infections can be associated with thrombotic events in APS, including the potentially fatal subset catastrophic APS. We report a case of extensive symmetrical peripheral gangrene complicating Escherichia coli sepsis associated with antiphospholipid antibodies in a patient with lupus nephritis.
Antibodies ; Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome ; Autoimmune Diseases ; Escherichia coli* ; Gangrene* ; Humans ; Lupus Nephritis* ; Pregnancy ; Sepsis* ; Thrombosis

PURPOSE : To evaluate MR image qualities we developed a new MRI phantom with the fixation structures necessary to position it into coil firmly. MATERIALS AND METHODS : We designed MRI phantom for eight evaluation items such as slice thickness accuracy, high contrast spatial resolution, low contrast object detectability, geometry accuracy, slice position accuracy, image intensity uniformity, percent signal ghosting and signal to noise ratio. For the positioning of phantom at coils, the fixation structures were set up on the surface of phantom. Six different MRI units were used for test the possibility for the clinical application and their image qualities were evaluated. RESULTS : We acquired appropriate MR image qualities enough for the evaluation on all used MR units and confirmed that their evaluations were within reliable values compared to real ones for some items. The positioning of our phantom into head coils with fixation structures worked well for proper imaging. CONCLUSION : We found that our prototype of MRI phantom had the possibility of clinical application for MR image quality assessment.
Head ; Magnetic Resonance Imaging* ; Quality Control ; Signal-To-Noise Ratio

PURPOSE: Spin-echo (SE) technique is most commonly used pulse sequence for T1-weighted MR imaging. T1-weighted fluid-attenuated inversion recovery (T1FLAIR) is a relatively new pulse sequence and it provides higher tissue contrast between the gray matter (GM) and white matter (WM) of the brain than T1-weighted SE (T1SE) sequence. However, there has been controversy for the evaluation of enhancing brain tumors with T1FLAIR compared to T1SE. The purpose of this study was to compare T1FLAIR and T1SE sequences for the evaluation of enhancing intracranial tumors. MATERIALS AND METHODS: Fifty-two patients with enhancing brain tumors were evaluated with contrast-enhanced (CE) T1SE and T1FLAIR imaging. Eight quantitative criteria were calculated: lesion-to-WM contrast ratio (CR) and contrast-to-noise ratio (CNR), lesion-to-GM CR and CNR, lesion-to-CSF CR and CNR, and WM-to-GM CR and CNR. For qualitative evaluation, two radiologists assessed lesion conspicuity on CE T1SE and T1FLAIR sequences with three-scale: 1, T1SE superior; 2, sequence equal; T1FLAIR superior. RESULTS: Seventy-nine tumors (31 primaries, 48 metastases) were assessed. For quantitative measurement, the T1FLAIR lesion-to-GM, lesion-to-CSF, WM-to-GM CR and CNR values were comparable and statistically superior to those of the T1SE images (p < 0.001 in all). However, lesion-to-WM CR and CNR were similar on both two sequences without statistically significant difference (p = 0.661, 0.662, respectively). For qualitative evaluation, both radiologists assessed that T1FLAIR images were superior to T1SE images for the evaluation of lesion conspicuity. CONCLUSION: For the evaluation of enhancing intracranial tumors, T1FLAIR sequence was superior or comparable to T1SE sequence.
Brain ; Brain Neoplasms* ; Evaluation Studies as Topic ; Humans ; Magnetic Resonance Imaging*