No abstract available.
Animals ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary* ; Leptin* ; Rats* ; Receptors, Leptin*

PURPOSE: To evaluate the degree of contrast enhancement of intracranial tumors on delayed (6-8min.) MR imaging after administration of Gd-DTPA. MATERIALS AND METHODS: Both immediate and delayed post-contrast MR imagings were studied prospectively in 35 patients. with brain tumors (11 gliomas, 6 meningiomas, 4 neurinomas, 5 parencymal metastases, 5 hemangioblastoma, 4 others) at either 0.5 T or 2.0 T unit. After precontrast TI-, proton-density, and T2-weighted spin echo images were obtained, each patient underwent Tl-weighted imaging immediately following infusion of 0.1 mmol/Kg of Gd-DTPA. Subsequently, the second postcontrast Tl-weighted images were obtained with no additional injection of the contrast media. Time-interval between the postcontrast immediate and the delayed images was approximately 6-8 minutes. Degree of contrast enhancement of the lesions was assessed both visually and quantitatively. For quantitative study, contrast enhancement ratio(CER) of tumors was calculated in both immediate and delayed post-contrast images. RESULTS: There was stronger visual enhancement in 7 of 11 cases with gliomas and 3 of 5 cases with parenchymal metastasis on delayed images when compared with immediate images, whereas all 10 cases of extraaxial tumors(meningiomas and neurinomas) showed decreased enhancement on delayed images. Quantitatively, mean CERs of gliomas and metastases were higher on delayed study than on immediate study by 20. 5% and 49.2%, respectively. Extraaxial tumors showed decrease of CER on delayed study by 19.7% as compared with that of immediate study. Hemangioblastomas showed visually poor enhancement on delayed image in 4 cases and equal enhancement on both immediate and delayed images in remaining one case, and quantitatively demonstrated decrease of CER on delayed study by 15.4%. CONCLUSION: Since there was more conspicuous contrast enhancement in many intraaxial tumors such as gliomas and metastases on 6-8 minutes delayed post-contrast MR study, the delayed post-contrast study may be needed in some intraaxial tumors for their characterization, and may also be helpful for the differential diagnosis between intraaxial and extraaxial tumors.
Brain Neoplasms* ; Brain* ; Contrast Media ; Diagnosis, Differential ; Gadolinium DTPA ; Glioma ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging* ; Meningioma ; Neoplasm Metastasis ; Neurilemmoma ; Prospective Studies

We studied the ultrastructural alteration of glomerular anionic sites in 6 patients with minimal change nephrotic syndrome, 5 patients with membranous glomerulonephritis, 4 patients with focal segmental glomerulosclerosis, and 4 patients with IgA nephropathy by staining with polyethyleneimine (PEI) as a cationic probe. The control study was examined by using a nephrectomy specimen of non-glomerular disease which had no proteinuria. This method seems to selectively stain heparan sulphate in the basement membranes and has been widely used to evaluate changes in basement membrane charge in various human diseases as well as in experimental studies. The anionic sites in the lamina rara interna and lamina densa of normal glomerular basement membrane were always less numerous and less regularly distributed than those in the lamina rara externa. Characteristic common findings in these glomeruli showed a marked decrease of glomerular anionic sites in the regions with immune-complex deposits and normal distribution in the regions with focally those being absorbed and newly forming glomerular basement membrane. They were not detected in the gap of the basement membrane and on the area of the detached overlying epithelium using the PEI method. But the foot process fusion of epithelial cells seems not to influence the loss of anionic sites on the glomerular basement membrane.
Basement Membrane ; Epithelial Cells ; Epithelium ; Foot ; Glomerular Basement Membrane* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Nephrectomy ; Nephrosis, Lipoid ; Polyethyleneimine ; Proteinuria

Polyarteritis nodosa (PAN) is a chronic inflammatory disorder characterized by a necrotizing vasculitis of small and medium-sized artery, which can involve several organs, such as, the kidney, skin, peripheral nerves, muscle, heart, and gastrointestinal tract. In addition to systemic involvement of the classical PAN, a localized disease of the gallbladder, uterus, testis, and skin has been reported. In particular, a limited involvement of the breast is an unusual manifestation of PAN and usually runs a favorable prognosis when compared with the classical PAN. We describe a 64-year-old female patient who had a limited disease of PAN on both the breasts. She presented with mass-like lesions on both the breasts. After surgical excision of the breast lesions, she has been doing well with only a low dosage of prednisolone.
Arteries ; Breast* ; Female ; Gallbladder ; Gastrointestinal Tract ; Humans ; Kidney ; Middle Aged ; Myocardium ; Peripheral Nerves ; Polyarteritis Nodosa* ; Prednisolone ; Prognosis ; Skin ; Testis ; Uterus ; Vasculitis

Nail-patella syndrome is a relatively rare autosomal dominant disorder characterized by dysplastic nail, hypoplastic or absent patella, and dislocation of radial head and iliac horns. In addition, renal abnormalities have been reported. The usual clinical signs of the renal involvement are asymptomatic proteinuria, microscopic hematuria, and in some cases progression to end stage renal disease. We present the case of adult with nail-patella syndrome, who developed proteinuria. Electron microscopy revealed irregular thickening of the glomerular basement membrane with areas of rarefaction, giving rise to a pathognomonic "moth-eaten" appearance.
Adult ; Animals ; Dislocations ; Glomerular Basement Membrane ; Head ; Hematuria ; Horns ; Humans ; Kidney Failure, Chronic ; Microscopy, Electron ; Nail-Patella Syndrome* ; Patella ; Proteinuria

Polymyositis is one form of inflammatory myopathy. In some patients, this disease does not entirely respond to conventional initial therapy with glucocorticoid, methotrexate and azathioprine. Multiple options exist for treating these patients, but only intravenous immune globulin has been subjected to a randomized clinical trial. We report here on a case of polymyositis that did not respond to multiple drug therapy, but it did respond to tacrolimus. After treatment with tacrolimus, the patient's disease has been well controlled for many years.
Azathioprine ; Humans ; Immunoglobulins, Intravenous ; Methotrexate ; Myositis ; Polymyositis ; Tacrolimus

Tufted angioma is a benign, slowly progressive angioma with typical histologic findings of small, circumscribed angiomatous tufts and lobules scattered in the dermis. More than 50% of cases occur during the first year of life, but rarely it develops late in life. There was only one reported case of tufted angioma after trauma in the English literature. We report a case of tufted angioma, which developed after electrocautery in a 61-year-old woman showing histologic features of typical tufted angioma.
Dermis ; Electrocoagulation* ; Female ; Hemangioma* ; Humans ; Middle Aged

BACKGROUND: Gastric cancer remains the main cause of cancer-related death in Korea. Accurate preoperative staging of gastric cancer is essential to predict prognosis and to plan optimal treatment. Although there are many reports dealing with the diagnostic values of conventional methods, controversies are still present especially in the field of preoperative staging. In this study, we evaluated the accuracy of gastroscopy and upper gastrointestinal series(UGI) for diagnosis of gastric cancer, and determined the usefulness of ultrasonography and computed tomography for preoperative staging. METHODS: One hundred twenty-three patients, who underwent operation from Aug. 1991 to Mar. 1995 under the diagnosis of gastric cancer were analyzed. We excluded 15 patients because their postoperative definitive stagings were undetemined. RESULTS: 1) Among 123 patients, the proportion of early gastric cancer was 26.0%(32/123) and that of the advanced gastric cancer was 74.0%(91/123). 2) The sensitivity of endoscopic diagnosis of gastric cancer was 96.7%(119/123), and the accuracy to determine the depth of invasion was 82.9% (102/123). 3) The sensitivity of UGI study for gastric cancer was 89.9%(98/109), and the accuracy to determine the depth of invasion was 61.5%(61/109). 4) The sensitivity of abdominal ultrasonography to detect the tumor was 11.3%(8/71), the accuracy to determine the T stage was 29.2%(28/96), and the sensitivity and specificity to detect lymph node metastasis was 13.6%(8/59), 100%(37/37), respectively. 5) The sensitivity of abdominal CT to detect the tumor was 74.3%(26/35), the accuracy to determine the T stage was 32.5%(13/40), and the sensitivity and specificity to detect lymph node metastasis were 34.5%(9/29), 72.7%(8/11), respectively. 6) The accuracy of preoperative staging was 45.5%(56/123). The 49.6%(62/123) of gastric cancer was downstaged, whereas only 4.1%(5/123) was overstaged. CONCLUSION: Our results show that high accuracy for diagnosis of gastrie cancer with the gastroscopy and UGI. However preoperative staging with ultrasonography and computed tomograpy was often underestimated, which could be concluded that the usefulness of the radiologic methods was limited.
Diagnosis* ; Gastroscopy ; Humans ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, X-Ray Computed ; Ultrasonography

We report a non-obese patient suffering from spastic gait and right leg paresis caused by thoracic spinal cord compression secondary to spinal epidural lipomatosis. Although spinal epidural lipomatosis is most often associated with the administration of exogenous steroid or endogenous Cushing syndrome, obesity also has been reported as a possible cause. However, idiopathic(non-glucocorticoid induced) spinal epidural lipomatosis in non-obese healthy man is an extremely rare disease and dose not have any good explanation for the abnormal fat deposition in spinal epidural space. We recently experienced a patient with idiopathic thoracic epidural lipomatosis in whom MRI and histopathology established the specific diagnosis. With a case report, brief review of the disease including clinical feature, diagnostic procedure and therapeutic considerations is described.
Cushing Syndrome ; Diagnosis ; Epidural Space ; Gait Disorders, Neurologic ; Humans ; Leg ; Lipomatosis* ; Magnetic Resonance Imaging ; Obesity ; Paresis ; Rare Diseases ; Spinal Cord Compression

PURPOSE: To analyze the clinical and radiological outcome of subtalar arthrodesis using cannulated screws and morselized bone graft. MATERIALS AND METHODS: Twenty one patients with follow-up of more than 1 year after subtalar arthrodesis were included in this study. Mean age was 40.8 years, and mean follow-up duration was 38 months. Underlying diseases were 19 cases of posttraumatic arthritis (18 calcaneal fractures and 1 talar fracture) and 2 cases of tarsal coalition. Clinically AOFAS ankle-hindfoot score, operation time, complication and satisfaction of patients were analyzed. Radiologically time to union, arthritis of surrounding joints, preoperative and postoperative talar declination angle were analyzed. RESULTS: AOFAS ankle-hindfoot score was improved from preoperative 33 points to postooperative 79 points. Eighteen patients (86%) were satisfied with the results. Mean operation time was 91 minutes. All cases were fixed with 1-2 cannulated screws and morselized bone graft. Mean time to radiologic union was 12.1 weeks. There was 1 case of delayed union. There was no significant perioperative changes in talar declination angles. CONCLUSION: Subtalar arthrodesis using cannulated screws and morselized bone graft seems to be relatively simple and effective treatment method for subtalar arthritis.
Arthritis ; Arthrodesis* ; Follow-Up Studies ; Humans ; Joints ; Transplants*