Peritoneal tuberculosis is a disease rarely seen nowadays. Its symptoms are easy fatigue, abdominal distension, intermittent abdominal pain and ascites. Its onset is insidious, which si-mulates symptoms of peritonitis or carcinomatosis. Peritoneal tuberculosis should be considered in the differential diagnosis when a Patient's symptoms and signs are ascites, ovarian tumor, vague abdominal pain and abdominal distension with high serum level of CA 125, an antigenic determinant of epithelial ovarian cancers. We have recently experienced a case of peritoneal tuberculosis with markedly elevated serum level of CA 125 in 54 year-old woman and report our case with a brief review of the literature.
Abdominal Pain ; Ascites ; Carcinoma ; Diagnosis, Differential ; Fatigue ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; Peritonitis ; Peritonitis, Tuberculous*

PURPOSE: To compare breath-hold gadolinium enhanced MR angiography(MRA) with digital subtraction angiography. MATERIALS AND METHODS: Ten patients underwent angiography and breath-hold gadolinium enhanced MRA;the latterperformed at 1.5T with 3D FSPGR after a bolus injection of gadopentetate dimeglumine(0.4mmol/kg) RESULTS: Sevenof ten pathologic conditions(70%) evaluated by both techniques had a similar appearance. The conditions examinedwere as follows : the artery feeding renal cell carcinoma(n=2): renal artery stenosis(n=2); pulmonaryAVM(n=2);abdominal aortic aneurysm(n=1); atheromatous plaque in the lower abdominal aorta(n=1);an enlargedbronchial artery(n=1); and an aberrant renal artery(n=1). For evaluating an anatomic relationship, a reconstructed3D image obtained by MRA is more advantageous. CONCLUSION: Breath hold contrast enhanced MRA is a potentiallyuseful noninvasive screening method for detecting vascular abnormality of the aorta and its branches.
Angiography ; Angiography, Digital Subtraction ; Aorta ; Arteries ; Gadolinium ; Humans ; Mass Screening ; Renal Artery

PURPOSE: To investigate the nature of edematous lesions seen on MR images during acute episodes of hypertensive encephalopathy(HTE) with particular attention to the findings of diffusion-weighted imaging (DWI). MATERIALS AND METHODS: A total of 17 MR examinations in fourteen patients with hypertensive encephalopathy were performed. The diagnoses were idiopathic HTE in eight cases, eclampsia in three, and cyclosporin-induced HTE in three. The apparent diffusion coefficients(ADCs) of edematous lesions and normal white matter revealed by DWI were assessed and compared, and the changes observed at follow-up MR imaging were analysed. RESULTS: DWI obtained within one week of the appearance of acute neurological symptoms revealed the edema as iso-intense in all patients with eclampsia and cyclosporin-induced HTE, and in five of eight patients with idiopathic HTE. In the other three patients with idiopathic HTE, DWI demonstrated slightly hyperintense edema. The ADCs of edematous lesion in patients with idiopathic HTE, eclampsia and cyclosporin-induced HTE were 1.21 +/-0.34, 1.08 +/-0.28, and 1.28 +/-0.22 mm 2 /ms, respectively, while for normal white matter the corresponding figures were 0.77 +/-0.25, 0.71 +/-0.22, and 0.68 +/-0.27mm 2 /ms The differences in ADCs between edema and normal white matter were thus significantly different between the three patient groups (p<0.05), while the ADCs of edematous lesions showed no sisgnificant variation between these groups (p<0.05). Follow-up MRI revealed that in three cases, edematous lesions were reversible and there were no residual signal changes. CONCLUSION: Vasogenic rather than cytotoxic edema is present during the acute stage of HTE.
Diagnosis ; Diffusion ; Eclampsia ; Edema ; Female ; Follow-Up Studies ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Pregnancy

PURPOSE: To compare functional MR imaging of the motor cortex during active and passive movement. MATERIALS AND METHODS: Seven healthy, right-handed volunteers (M:F=6:1; age:25-30 years) were included in this study. A 1.5-T whole body scanner and the multislice EPI BOLD method were used. The motor paradigm was flexion-extension of a thumb against rest. In the active motion task, the thumb was flexed voluntarily once a second, while in the passive task, it was tied with a thread and pulled to flex and extend passively at the same interval and with the same intensity as in the active task. For image postprocessing, an SPM 96 program was used. The sites, numbers, and signal intensity of the activated pixels were determined, and the threshold for significance was set at p<0.001 to p<0.01. RESULTS: In the active motion task, strong activation at the contralateral side of the primary sensorimotor cortex and supplementary motor cortex occurred in all 14 examples in all seven volunteers. Additionally, the ipsilateral primary sensorimotor cortex and supplementary motor area were activated in 12/14 and 11/14 such tasks, respectively. During passive motion tasks, on the other hand, weak activation occurred at the contralateral side of the primary sensorimotor cortex in all cases, but in the contralateral supplementary motor cortex in only three. In the ipsilateral primary sensorimotor cortex and supplementary motor area, there was no activation. CONCLUSION: Compared with the active motion task, activation occurring in the contralateral primary sensorimotor cortex and supplementary cortex was weaker and less frequent during the passive task, and during this latter, the ipsilateral motor cortex remained inactive. These results may be useful for the clinical application of functional MR imaging in unconscious patients or in animal studies.
Animals ; Hand ; Humans ; Magnetic Resonance Imaging* ; Motor Cortex* ; Thumb ; Volunteers

PURPOSE: To evaluate regional differences in relative metabolite ratios in the normal human brain by 1H MRspectroscopy (MRS), and compare the spectral quality obtained by the automated prescan method (PROBE) and themanual method. MATERIALS AND METHODS: Localized 1H MRS was performed on a GE 1.5T SIGNA MRI/MRS system (version5.5) with active shielded gradients. For 20 normal volunteers aged 8-47 years, spectral parameters were adjustedby the auto-prescan routine provided by a PROBE package(N=34)and manually (N=33). Five regions of the human brainwere examined (N=PROBE,manual): frontal white matter(N=6,10), parietal white matter(N=8,9), basal ganglia(N=6,5),thalamus(N=4,5), and cerebellum(N=4,4). For all spectra, a STEAM localization sequence with three-pulse CHESS H2Osuppression was used, with the following acquisition parameters: TR=3.0 sec, TE=30 msec, TM=13,7 msec, SW=2500Hz,SI=2048 pts, AVG=48, and NEX=2. RESULTS: A total of 61 reliable spectra were obtained by PROBE (28/34=82%success) and by the manual method (33/33=100% success). Regional differences in the spectral patterns of the fiveregions were clearly demonstrated by both PROBE and the manual methods. For prescanning, the manual method tookslightly longer than PROBE (3-5 mins and 2 mins,respectively). There were no significant differences in spectralpatterns and relative metabolic ratios between the two methods. However, auto-prescan by PROBE seemed to be veryvulnerable to slight movement by patients, and in three cases, an acceptable spectrum was thus not obtained. CONCLUSION: PROBE is a highly practical and reliable method for single voxel 1H MRS of the human brain; the twomethods of prescanning do not result in significantly different spectral patterns and the relative metaboliteratios. PROBE, however, is vulnerable to slight movement by patients, and if the success rate for obtainingquality spectra is to be increased, regardless of the patient's condition and the region of the brain, it must beused in conjunction with the manual method.
Brain* ; Healthy Volunteers ; Humans* ; Magnetic Resonance Spectroscopy* ; Rabeprazole ; Steam

PURPOSE: IL-10, one of the potent Th2 cytokine, has strong anti-inflammatory reaction and immunosuppression action by stabilization of polarized Th2 cell gene expression and blocking of function of antigen presenting cells. The aims of this study were to investigate the immunosuppressive effect of recombinant adenovirus mediated rat IL-10 (Ad:ratIL-10) in mouse to rat skin graft. METHODS: The transgene expression of the recombinant adenovirus was confirmed by X-gal staining of Ad:LacZ infected skin graft. The skin graft was done between mouse and rat after 1 hour infection of donated skin with Ad:ratIL-10, which was already been produced in our Institute for Medical Science. Checked gene expression in grafted skin by in situ RT-PCR and systemic blood by ELISA on day 1, 3, 5 and 7. Immunosuppressive effect of the Ad:ratIL-10 was evaluated by graft survival and compared with control group which was infected by saline. RESULTS: Transgene expression of recombinant adenovirus was peak on third day of skin graft and became disappeared on day 5 and 7. The same expression was confirmed by in situ RT-PCR of Ad:ratIL-10 infected skin graft. The systemic blood level of infected Ad:ratIL-10 checked by ELISA was undetectable but their expression checked in culture cell line of HeLa cell was 275 ng/mL on day 5. Mean grafted skin survival was 6.0 +/- 0.7 days in Ad:ratIL-10 group but statistically indistinguishable to control group of infection with saline (5.6 +/- 0.6 days, p>0.05). CONCLUSION: In summary, the Ad:ratIL-10 alone, infected in grafted skin, was peak on day 3 after graft but showed no immunosuppressive effect on mouse-to-rat skin graft.
Adenoviridae* ; Animals ; Antigen-Presenting Cells ; Cell Line ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Graft Survival ; HeLa Cells ; Humans ; Immunosuppression ; Interleukin-10* ; Mice ; Rats* ; Skin* ; Th2 Cells ; Transgenes ; Transplants*

According to improved radiation therapy technology such as IMRT and proton therapy, the accuracy of patient alignment system is more emphasized and IGRT is dominated research field in radiation oncology. We proposed to study the feasibility of cone-beam CT system using simple x-ray imaging systems for image guided proton therapy at National Cancer Center. 180 projection views (2,304x3,200, 14 bit with 127 micrometer pixel pitch) for the geometrical calibration phantom and humanoid phantoms (skull, abdomen) were acquired with 2degrees step angle using x-ray imaging system of proton therapy gantry room (360degrees for 1 rotation). The geometrical calibration was performed for misalignments between the x-ray source and the flat-panel detector, such as distances and slanted angle using available algorithm. With the geometrically calibrated projection view, Feldkamp cone-beam algorithm using Ram-Lak filter was implemented for CBCT reconstruction images for skull and abdomen phantom. The distance from x-ray source to the gantry isocenter, the distance from the flat panel to the isocenter were calculated as 1,517.5 mm, 591.12 mm and the rotated angle of flat panel detector around x-ray beam axis was considered as 0.25degrees. It was observed that the blurring artifacts, originated from the rotation of the detector, in the reconstructed toomographs were significantly reduced after the geometrical calibration. The demonstrated CBCT images for the skull and abdomen phantoms are very promising. We performed the geometrical calibration of the large gantry rotation system with simple x-ray imaging devices for CBCT reconstruction. The CBCT system for proton therapy will be used as a main patient alignment system for image guided proton therapy.
Abdomen ; Artifacts ; Axis, Cervical Vertebra ; Calibration ; Cone-Beam Computed Tomography ; Humans ; Isothiocyanates ; Proton Therapy ; Protons ; Radiation Oncology ; Skull

PURPOSE: In order to furnish basic information prior to their use, the physical properties of variousself-expandable metallic stents and their MR characteristics were evaluated. MATERIALS AND METHODS: Fourcommercially available self-expandable metallic stents - Gianturco-the R sch, Hanaro, Memotherm, and Wallstent -were used in this study. For evaluation of the physical properties of each, hoop strengths and changes in radiiaccording to the degrees of longitudinal flexion were compared. Stent characteristics seen on MR images wereevaluated by measuring magnetic torque and by comparing images obtained in the vascular phantom using SE T1WI, FSET2WI, and FMPSPGR sequences. These images were analyzed with special emphasis on artifact size and the apparantshepe of the stent. RESULTS: Hoop strength was greatest in the Gianturco-R sch stent, followed by the Memotherm,Hanaro, and Wallstent. When flexed in the longitudinal axis, the radius of the Hanaro and Memotherm stentdecreased slightly as a larger flexion angle was applied. When this was 90degree, however, the connection of theGianturco-R sch stent collapsed. In contrast, the radius of the Wallstent became larger as a larger flexion anglewas applied. At the portal of the MR imaging unit, neither the Memotherm nor Wallstent showed deflection ; exceptfor a thin hyperintense rim at both ends, their images were excellent, and the lumina of these stents were alsoclearly seen. In contrast, the Gianturco-R sch and Hanaro stent demonstrated large deflexion and showed a severeblack-hole artifact. As a result, visualization of the stents themselves and their lumina was impossible. CONCLUSION: The Gianturco-R sch stent showed greater hoop strength than the others. The Wallstent showed goodlongitudinal flexibility and was thought to be effective in tortuous vessels. For follow-up after placement,especially when the nonferromagnetic Memotherm and Wallstent are used, MR imaging appears to be safe and useful.
Artifacts ; Axis, Cervical Vertebra ; Magnetic Resonance Imaging* ; Pliability ; Radius ; Stents* ; Torque

Anterior temporal lobectomy is the most popular surgical method for mesiobasal temporal lobe epilepsy. The key point in anterior temporal lobectomy is to resect lateral neocortex as little as possible, and mesiobasal structures as much as possible without surgical complication. We analyzed surgical anatomy on MRI scans of 20 persons to evaluate the relationships of anatomical structures related with surgical steps in anterior temporal lobectomy. On the oblique axial scan, the distance from temporal pole to anterior margin of hippocampus was 29.8+/-1.5mm. The length of hippocampus to the level of posterior margin of cerebral peduncle was 25.6+/-2.4mm. On the oblique coronal image through hippocampal head, the distance between the surface of superior temporal sulcus and lateral margin of temporal horn roof was 32.5+/-2.2mm. The angle between middle fossa base line and the line connecting superior temporal sulcus and lateral margin of temporal horn roof was 33.6+/-5.2 degree. The distance between lateral temporal surface and brain stem, and that between lateral temporal surface and collateral sulcus was 49.9+/-1.9mm and 40.6+/-3.3mm, respectively. The distance between collateral sulcus and lateral margin of temporal horn roof was 14.2+/-1.8mm, and the angle between middle fossa base line and the line connecting lateral margin of temporal horn roof and collateral sulcus was 60.4+/-7.4 degree. On the sagittal image, the angle between superior temporal sulcus and hippocampal axis was 18.8+/-1.1 degree. In conclusion, surgical complication of anterior temporal lobectomy can be reduced by careful consideration of anatomical relationships between anatomical structures encountered in each surgical steps in anterior temporal lobectomy.
Animals ; Anterior Temporal Lobectomy ; Axis, Cervical Vertebra ; Brain Stem ; Epilepsy, Temporal Lobe* ; Head ; Hippocampus ; Horns ; Humans ; Magnetic Resonance Imaging* ; Neocortex ; Tegmentum Mesencephali ; Temporal Lobe*

PURPOSE: The final goal of regenerative periodontal therapy is to restore the structure and function of the periodontium destroyed or lost due to periodontitis. However, the role of periosteum in periodontal regeneration was relatively neglected while bone repair in the skeleton occurs as a result of a significant contribution from the periosteum. The aim of this study is to understand the histological characteristics of periosteum and compare the native periosteum with the repaired periosteum after elevating flap or after surgical intervention with flap elevation. METHODS: Buccal and lingual mucoperiosteal flaps were reflected to surgically create critical-size, "box-type" (4 mm width, 5 mm depth), one-wall, intrabony defects at the distal aspect of the 2nd and the mesial aspect of the 4th mandibular premolars in the right and left jaw quadrants. Animals were sacrificed after 24 weeks. RESULTS: The results from this study are as follows: 1) thickness of periosteum showed difference as follows (P<0.05): control group (0.45+/-0.22 mm)>flap-elevation group (0.36+/-0.07 mm)>defect formation group (0.26+/-0.03 mm), 2) thickness of gingival tissue showed difference as follows (P<0.05): defect formation group (3.15+/-0.40 mm)>flap-elevation group (2.02+/-0.25 mm)>control group (1.88+/-0.27 mm), 3) higher cellular activity was observed in defect formation group and flap-elevation groups than control group, 4) the number of blood vessles was higher in defect formation group than control group. CONCLUSIONS: In conclusion, prolonged operation with increased surgical trauma seems to decrease the thickness of repaired periosteum and increase the thickness of gingiva. More blood vessles and high cellular activity were observed in defect formation group.
Animals ; Bicuspid ; Gingiva ; Guided Tissue Regeneration, Periodontal ; Jaw ; Models, Animal ; Periodontitis ; Periodontium ; Periosteum ; Regeneration ; Skeleton