No abstract available.

Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

Breast thermography produces a picture of the heat emitted from the surface of the breast. And abnormal temperature over the breast has been suggested as an indicator of malignancy. The mechanisms for the heat production at the area of the skin over the breast are suggested hypermetabolism, hypervascularization, and hyperfusion of the affected regions of the breast. The purpose of this study was to evaluate the diagnostic accuracy of breast thermography in breast cancer. One hundred thirty breast cancers and one hundred ten benign breast masses were examined by a digital infrared thermographic system (NEC San-ei, Therm Tracer 6T67) between January 1991 and December 1995. In this study, thermograms were classified as normal (Th-1), equivocal (Th-2), or abnormal (Th-3). Normal thermograms were those with normal symmetric vascularity, equivocal thermograms were those with only heat in the area of mass, and abnormal thermograms were those with heat and increased vascularity in the area of mass. Among the 110 benign breast masses, there were 98 Th-1 cases (89.1%), 2 Th-2 cases (1.8%) and 10 Th-3 cases (9.1%). Among the 130 breast cancers, there were 98 Th-3 cases (75.4%), 20 Th-2 cases (16.2%), and 12 Th-1 cases (9.2%). The sensitivity of the breast thermograms was 90%, the specificity 89.1%, and the diagnostic accuracy 89.6%. A thermal difference(deltaT) of less than 1oC was seen in 10 cases (7.7%) of breast cancer, and a deltaT of more than 1oC was seen in 120 cases (92.3%). Among the latter of a deltaT of more than 3oC was seen in 67 cases(51.4%). The correlation of the breast-cancer tumor size with deltaT was highly significant(p<0.0001). The classification of the thermographic diagnosis was found to be statistically correlated with tumor size (p<0.0001), axillary node status (p<0.001) and nuclear grade (p<0.05), but not with the presence or abscence of estrogen receptor. These results suggest that thermography is useful as a diagnostic tool for breast cancer. And that a deltaT of more than 2oC of on a breast thermogram strongly suqqests a malignancy.
Breast Neoplasms* ; Breast* ; Classification ; Diagnosis* ; Estrogens ; Hot Temperature ; Sensitivity and Specificity ; Skin ; Thermogenesis ; Thermography*

No abstract available.

No abstract available.

Ectopic paragonimiasis has been diagnosed in many organs such as the mesentery, ovary, pleura, central nervous system, subcutis and very rarely in the liver. However, simultaneous involvement of the colon and liver, which mimics colonic cancer with liver metastasis, is quite unusual, and to our knowledge has never been reported. Our case is a 63 year old woman who visited our hospital because of upper abdominal pain. Radiologically, space occupying lesions were detected in the transverse colon, mesocolon and left hepatic lobe. After the radical presection, they were proved to be an ectopic paragonimiasis forming multiple cavitary parasitic granulomas with Charcot-Leyden crystals and degenerating eggs.
Abdominal Pain ; Central Nervous System ; Colon* ; Colon, Transverse ; Colonic Neoplasms ; Eggs ; Female ; Granuloma ; Humans ; Liver* ; Mesentery ; Mesocolon ; Middle Aged ; Neoplasm Metastasis ; Ovary ; Ovum ; Paragonimiasis* ; Pleura

We report here on a rare case of a ruptured basilar tip aneurysm that was successfully treated with coil embolization in the bilateral cervical internal carotid artery (ICA) occlusions with abnormal vascular networks from the posterior circulation. A 43-year old man with a familial history of moyamoya disease presented with subarachnoid hemorrhage. Digital subtraction angiography demonstrated complete occlusion of the bilateral ICAs at the proximal portion and a ruptured aneurysm at the basilar artery bifurcation. Each meningeal artery supplied the anterior cranial base, but most of both hemispheres were supplied with blood from the basilar artery and the posterior cerebral arteries through a large number of collateral vessels to the ICA bifurcation as well as the anterior cerebral and middle cerebral arteries. The perfusion computed tomography (CT) scans with acetazolamide (ACZ) injection revealed no reduction of cerebral blood flow and normal cerebrovascular reactivity to ACZ. An abdominal CT aortogram showed no other extracranial vessel abnormalities. A ruptured basilar tip aneurysm was successfully treated with coil embolization without complications. Endovascular embolization may be a good treatment option with excellent safety for a ruptured basilar tip aneurysm that accompanies proximal ICA occlusion with vulnerable collateral flow.
Acetazolamide ; Aneurysm ; Aneurysm, Ruptured ; Angiography, Digital Subtraction ; Basilar Artery ; Carotid Artery, Internal ; Collateral Circulation ; Glycosaminoglycans ; Meningeal Arteries ; Middle Cerebral Artery ; Moyamoya Disease ; Perfusion ; Posterior Cerebral Artery ; Skull Base ; Subarachnoid Hemorrhage

OBJECTIVE: The aim of this study was to determine the role of intra-arterial (IA) nimodipine injections for cerebral vasospasm secondary to ruptured subarachnoid hemorrhage (SAH) and to investigate the factors that influence vasodilation and clinical outcomes. METHODS: We enrolled 29 patients who underwent aneurysm clipping for ruptured cerebral aneurysms between 2009 and 2011, and who received IA nimodipine after subsequently presenting with symptomatic vasospasm. The degree of vasodilation shown in angiography was measured, and the correlation between the degree of vasodilation and both the interval from SAH to cerebral vasospasm and the interval from clipping to cerebral vasospasm was determined. The change in blood flow rate after IA injection was assessed by transcranial Doppler ultrasound. Multiple clinical parameters were completed before and after IA nimodipine injection to evaluate any improvements in clinical symptoms. RESULTS: For eight patients, Glasgow Coma Scale (GCS) scores increased by two or more points. The regression analysis demonstrated a positive correlation between the change in GCS scores after IA nimodipine injection and the change in blood vessel diameter (p=0.025). A positive correlation was also observed between the interval from SAH to vasospasm and the change in diameter (p=0.040); and the interval from clipping to vasospasm and the change in diameter (p=0.022). CONCLUSION: IA nimodipine injection for SAH-induced vasospasm led to significant vasodilation in angiography and improvement in clinical symptoms without significant complications. Our findings suggest that IA nimodipine injection should be utilized when intractable vasospasm develops despite rigorous conservative management.
Aneurysm ; Aneurysm, Ruptured ; Angiography ; Blood Vessels ; Glasgow Coma Scale ; Glycosaminoglycans ; Humans ; Injections, Intra-Arterial ; Intracranial Aneurysm ; Nimodipine ; Subarachnoid Hemorrhage ; Vasodilation ; Vasospasm, Intracranial

Middle cerebral artery (MCA) fusiform aneurysms often have an unfavorable geometry that may limit surgical or endovascular treatment. Herein, we present a case of a fusiform aneurysm of the proximal MCA, which was successfully treated using stent-assisted coil embolization. A 42-year-old man presented with repeated headache and syncope. Five years earlier, a right MCA aneurysm had been treated by aneurismal wrapping. Magnetic resonance images (MRI) revealed a partially-thrombosed proximal MCA aneurysm at the right perisylvian region. Digital subtraction angiography (DSA) revealed a multilobulated fusiform-shaped aneurysm. The patient underwent stent-assisted coil embolization under general anesthesia and symptoms resolved postoperatively. A three-month follow-up angiography revealed no recanalization of the aneurysm and indicated tolerable blood flow through the right MCA, as compared to the preoperative angiography. We suggest that in selected patients, stent-assisted coil embolization of proximal MCA fusiform aneurysms can be an effective treatment modality.
Adult ; Anesthesia, General ; Aneurysm ; Angiography ; Angiography, Digital Subtraction ; Embolization, Therapeutic ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Spectroscopy ; Middle Cerebral Artery ; Stents ; Syncope

PURPOSE: Development of drug resistance has been the major obstacle in cis-Diamminedichloroplatinum (II) (cisplatin)-based combination chemotherapy in the treatment of advanced bladder cancer for which a variety of mechanisms has been suggested. We investigated to determine the changes of expression of apoptotic regulator proteins Bcl-2 and Bax in cisplatin-resistant bladder cancer cell lines and the reversibility of chemoresistance with antisense oligonucleotide against Bcl-2. MATERIALS AND METHODS: In T24, J82, 253J, 253J-BV and HT-1376 bladder cancer cell lines, we established cisplatin-resistance using stepwise exposure to cisplatin. The changes of Bcl-2 and Bax proteins in the resistant cell lines were determined by Western blot. Then, after administration of antisense oligonucleotide targeting the Bcl-2 coding sequence to the T24, T24-R1, and T24-R2 cell lines with lipofectamine, changes of Bcl-2 expression were determined along with cisplatin cytotoxicity before and after transfection. RESULTS: We confirmed the acquisition of cisplatin resistance in all 5 cell lines as the percent increase of IC50 in each cell lines were 210%, 175%, 181%, 280% and 153%, respectively. The expression of Bcl-2 protein increased in all 5 cisplatin-resistant cell lines, while the expressions of Bax decreased in 4 of 5 cisplatin-resistant cell lines. Treatment with antisense oligonucleotide significantly enhanced the cytotoxicity of cisplatin in T24, T24-R1 and T24-R2 cell lines. CONCLUSIONS: These results suggest that the up-regulation of Bcl-2 expression as well as down-regulation of Bax expression may be one of the mechanisms of cisplatin resistance in bladder cancer cells, and antisense Bcl-2 oligonucleotide may be helpful in chemotherapy of bladder cancer by reversing cisplatin resistance.
bcl-2-Associated X Protein ; Blotting, Western ; Cell Line* ; Cisplatin* ; Clinical Coding ; Down-Regulation ; Drug Resistance ; Drug Therapy ; Drug Therapy, Combination ; Genes, bcl-2 ; Inhibitory Concentration 50 ; Oligonucleotides, Antisense ; Transfection ; Up-Regulation ; Urinary Bladder Neoplasms* ; Urinary Bladder*