Injury to vertebral vessel is not usually associated with neurologic deficit and a lot of such injuries have not been recognized. Also, vertebral artery injuries are the least common arterial injuries because of their deep location in a bony canal. The incidence of vertebral artery injury occurring in penetration wound of the neck varies from 1.0% in gunshot wounds to 7.4% in stab wounds. But even vertebral artery injuries in penetration wound of the neck rarely results in cerebellar infarction. Authors experienced a case of cerebellar infarction induced by post-vertebral artery injury in penetration wound of the neck with hypoplastic contralateral verterbral artery. We thus report with a review of the related literature.
Arteries ; Cerebellum ; Incidence ; Infarction* ; Neck ; Neurologic Manifestations ; Vertebral Artery* ; Wounds and Injuries ; Wounds, Gunshot ; Wounds, Stab

PURPOSE: Tc-99m labeled diethylenetriaminepentaacetic acid (DTPA) -coupled galactosylated human serum albumin (GSA) is a currently used imaging agent for asialoglycoprotein receptor (ASGPR) of the liver, but, it has several shortcomings. Recently a new ASGPR imaging agent, (99m) Tc-lactosylated human serum albumin (LSA), with simple labeling procedure, high labeling efficiency, high stability was developed. In order to assess the feasibility of the (99m) Tc-LSA as a ASGPR imaging radiopharmaceuticals, we performed biodistribution study of the tracer in liver injured mice model and the results were compared with histolgic data. MATERIALS AND METHODS: To induce hepatic damage in ICR mice, diethylnitrosamine (DEN) (60 mg/kg/week X 5 time, low dose or 180 mg/kg/week X 2 times, high dose) and thioacetamide (TAA) (50 mg/kg X 1 time) were administrated intraperitoneally. Degree of liver damage was evaluated by tissue hematoxilin-eosin stain, and expression of asialoglycoprotein receptor (ASGPR) was assessed by immunohistochemistry using ASGPR antibody. (99m) Tc-LSA was intravenously administrated via tail vein in DEN or TAA treated mice, and biodistribution study of the tracer was also performed. RESULTS: DEN treated mice showed ballooning of hepatocyte and inflammatory cell infiltration in low dose group and severe hapatocyte necrosis in high dose group, and low dose group showed higher ASGPR staining than control mice in immunohistochemical staining. TAA treated mice showed severe hepatic necrosis. (99m) Tc-LSA Biodistribution study showed that mice with hepatic necrosis induced by high dose DEN or TAA revealed higher blood activity and lower liver activity than control mice, due to slow clearance of the tracer by the liver. The degree of liver uptake was inversely correlated with the degree of histologic liver damage. But low dose DEN treated mice with mild hepatic injury showed normal blood clearance and hepatic activity, partly due to overexpression of ASGPR in mice with mild degree hepatic injury. CONCLUSION: Liver uptake of (99m) Tc-LSA was inversely correlated with degree of histologic hepatic injury in DEN and TAA treated mice. These results support that (99m) Tc-LSA can be used to evaluate the liver status in liver disease patients.
Animals ; Asialoglycoprotein Receptor ; Diethylnitrosamine* ; Hepatocytes ; Humans ; Immunohistochemistry ; Liver Diseases ; Liver* ; Mice* ; Mice, Inbred ICR ; Necrosis ; Radiopharmaceuticals ; Serum Albumin* ; Thioacetamide* ; Veins

An inflammatory myofibroblastic tumor (IMT) is relatively rare quasineoplastic lesion. An IMT usually presents as a single mass within a single organ or sometimes as multifocal lesions within a single anatomic region. An IMT involving noncontiguous multi-organs within different anatomic regions is extremely rare. We present a case of an aggressive IMT that involved the musculoskeletal system and multiple abdominal visceral organs.
Musculoskeletal System ; Myofibroblasts*

PURPOSE:Prolonged cold ischemia has been shown to be an important factor in the development of post-transplant renal dysfunction. The exact mechanisms have not been completely defined. The expression of ICAM-1 (CD-54) in rat kidneys stored at 0, 4, 12, 24 and 48 hours in University of Wisconsin (UW) solution was studied in an attempt to correlate ischemia time with increased immunogenicity of the graft. METHODS: Kidneys from male Lewis rats were perfused with UW solution, removed and bathed in UW solution at 4 degrees C for 4, 12, 24, and 48 hours respectively. For the evaluation of expression of ICAM-1, immunohistochemical staining, Western blotting and RT-PCR were performed. RESULTS: Immunohistochemical staining in normal non-ischemic kidneys revealed that glomerular capillaries expressed ICAM-1 but that tubular cells did not. The preserved kidneys were analyzed with immunohistochemistry, Western blotting and semi-quantitative RT-PCR and showed increased transcription and expression of ICAM-1 in the cortex of the kidney. This expression reached a maximum at 24 hours and declined at 48 hours. The ICAM-1 protein expression in the preserved kidney cortex was increased at 4 hours (1.68+/-0.60 fold of control kidneys, (p=0.06)), 12 hours (2.38+/-0.90 fold, (p=0.02)), 24 hours (3.70+/-1.29 fold, (p=0.01)), and 48 hours (2.00+/-0.54 fold, (p=0.01)). The mRNA expression (the ratio of ICAM-1/GAPDH) in preserved kidneys cortex relative to control kidneys was increased at 4 hours (1.19+/-0.14 fold of control kidneys), 12 hours (1.38+/-0.16 fold),24 hours (1.77+/-0.29 fold), and 48 hours (1.19+/-0.12 fold) (p<0.05 for all time points). CONCLUSION: We conclude that cold preservation of rat kidneys in UW solution induces increasing levels of ICAM-1 cell surface expression and gene transcription. This increase in adhesion molecule expression can be a contributing factor in the development of post-transplant renal dysfunction by increasing the immunogenicity of the graft.
Animals ; Baths ; Blotting, Western ; Capillaries ; Cold Ischemia ; Humans ; Immunohistochemistry ; Intercellular Adhesion Molecule-1* ; Ischemia ; Kidney Cortex ; Kidney Transplantation ; Kidney* ; Male ; Rats* ; RNA, Messenger ; Transplants ; Wisconsin

We describe a 48-year-old man with family history of rheumatoid arthritis (RA) affected by chronic eosinophilic pneumonia (CEP) with severe peripheral eosinophilia. CEP might develop as a complication of longstanding active RA. The patient with 5 months history of seropositive RA and chronic respiratory symptoms, alveolar and blood eosinophilia, peripheral pulmonary infiltrates and pleural effusion on chest imaging. The lung may be involved as an extraarticular manifestation of RA. However, CEP is not recognized as a typical lung manifestation of RA, and the two diseases rarely coexist. The effusion was an eosinophil predominant exudates and was characterized by low pH, and glucose level and high lactic dehydrogenase. The patient responded rapidly to combination of steroids and disease modifying anti-rheumatic drugs.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Eosinophilia ; Eosinophils* ; Exudates and Transudates ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Lung ; Middle Aged ; Oxidoreductases ; Pleural Effusion* ; Pulmonary Eosinophilia* ; Steroids ; Thorax

The purpose of this study was to evaluate the reliability of 6-axis model surgery simulator (6AMSS) for orthognathic surgery. A rectangular parallelepiped plastic block was assembled to model-mounting plate of 6AMSS. Left-right (X), anterior-posterior (Y), up-down (Z) translation and pitching (empty set X), rolling (empty set Y) and yawing (empty set Z) rotation was planned and performed using 6AMSS. The actual translation and rotation were measured with dial gauge and precisional protractor, respectively. Comparison between the planned and actual movements of plastic block for each variable were made using paired t- test. Statistical analysis for X, Y, Z, empty set X, empty set Y and empty set Z movement have shown no significant differences between planned and actual movement (P > 0.05). This indicate that model surgery performed with the aid of the 6AMSS is accurate in 3D translation and rotation. The 6AMSS is practically useful for accurate fabrication of surgical splint for orthognathic surgery.
Orthognathic Surgery ; Plastics ; Splints

PURPOSE: To assess the usefulness of rectal filling using ultrasonographic gel in patients with lower rectal cancer. MATERIALS AND METHODS: Twenty five patients with lower rectal cancer were enrolled. High resolution pelvic MR was performed twice before and after gel filling. Independently and retrospectively, two radiologists reviewed each set of MR images using five-grade scales for sphincter involvement, CRM (circumferential resection margin) involvement and depiction of the tumor. Same two radiologists retrospectively performed consensus review of each set of MR images for tumor distance from the anal verge and T&N staging. RESULTS: Tumor depiction scores from MR with gel filling were significantly higher than those of MR without distention (p<0.001). Compared to MR without distension, MR with gel filling had no significant differences in prediction of CRM or sphincter involvement (p>0.05). Distance from the anal verge was significantly different between MR with gel filling and rigid endoscopy (6.8 +/- 1.6 cm vs. 5.8 +/- 1.6 cm, p=0.001). There were no significant differences between pathological staging and MR staging with or without gel filling. CONCLUSION: MR with gel filling improved tumor depiction. And also MR with gel filling revealed same ability for the predictions of CRM or sphincter invasion in patients with lower rectal cancer, comparing with MR without gel filling.
Consensus ; Endoscopy ; Humans ; Rectal Neoplasms* ; Rectum ; Retrospective Studies ; Weights and Measures

PURPOSE: This study aimed to evaluate whether a shorter time from the arrival at a hospital to delivery is related to the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age. METHODS: We studied 142 newborns of less than 34 weeks of gestational age. The time from the arrival at the hospital to delivery was measured. The correlation between the time required for delivery and the occurrence of cerebral palsy was elucidated by diagnosing cerebral palsy in neonates using the Korean Infant Development Screening Test and neurological examination. RESULTS: Preliminary result suggested that a shorter time from hospital arrival to delivery was related to a lower development score for gross motor activity and to a higher frequency of cerebral palsy occurrence. Moreover, it was responsible for a tendency of obtaining lower Apgar scores at 1 and 5 minutes. The shorter delivery time was associated with a higher probability of respiratory distress syndrome (RDS) occurrence when the length of delivery time was less than 6 hours and there was a higher probability of a shorter gestation period. However, the multifactor analysis revealed that there was little impact of delivery time on the occurrence of cerebral palsy. Conclusions: The length of hospital arrival time to delivery did not significantly influence the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age.
Cerebral Palsy ; Child ; Child Development ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Mass Screening ; Motor Activity ; Neurologic Examination ; Pregnancy

PURPOSE: This study aimed to evaluate whether a shorter time from the arrival at a hospital to delivery is related to the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age. METHODS: We studied 142 newborns of less than 34 weeks of gestational age. The time from the arrival at the hospital to delivery was measured. The correlation between the time required for delivery and the occurrence of cerebral palsy was elucidated by diagnosing cerebral palsy in neonates using the Korean Infant Development Screening Test and neurological examination. RESULTS: Preliminary result suggested that a shorter time from hospital arrival to delivery was related to a lower development score for gross motor activity and to a higher frequency of cerebral palsy occurrence. Moreover, it was responsible for a tendency of obtaining lower Apgar scores at 1 and 5 minutes. The shorter delivery time was associated with a higher probability of respiratory distress syndrome (RDS) occurrence when the length of delivery time was less than 6 hours and there was a higher probability of a shorter gestation period. However, the multifactor analysis revealed that there was little impact of delivery time on the occurrence of cerebral palsy. Conclusions: The length of hospital arrival time to delivery did not significantly influence the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age.
Cerebral Palsy ; Child ; Child Development ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Mass Screening ; Motor Activity ; Neurologic Examination ; Pregnancy

Primary malignant melanoma of the esophagus is extremely rare, with less than 200 cases reported in the literature. However, primary malignant melanoma is an aggressive tumor. We report a case of primary esophageal malignant melanoma that presented with a large polypoid mass in the lower esophagus, and subsequently showed multiple metastatic nodules in the subcutaneous layer, skin and retroperitoneum. Primary malignant melanoma should be included in the differential diagnosis of a polypoid esophageal mass, especially in cases where metastases to unexpected areas occur or in cases of unexpected metastatic patterns.
Diagnosis, Differential ; Esophagus* ; Melanoma* ; Neoplasm Metastasis ; Skin