The characteristics of radionuclide brain scan imaging of intracranial lesion are determined, in part, by the rate and quantity of radioactive material in the region of involvement, which is associated with alterations in the blood brain barrier. Findings, noted on the blood flow studies, often serve to direct attention to forthcoming imaging of specific pathological change on the status studies, e.g, carotid artery occlusion and cerebral infarction. We have seen that the 62 year old woman with left side hemiparesis shows typical "Flip-Flap" pattern in brain scan imaging, thought to be due to carotid artery occlusion.
Blood-Brain Barrier ; Brain ; Carotid Arteries ; Cerebral Infarction ; Female ; Humans ; Middle Aged ; Paresis

PURPOSE: To determine the rates at which normal ovaries in women of reproductive age were observed at MRI, as well as differences in the size of a normal ovary and follicles, and the number of follicles, according to age. MATERIALS AND METHODS: The MRI findings in 46 patients with normal ovaries were retrospectively analysed and proven grossly at surgery and/or pathologically. The detection rate and size of the ovaries, and the number of follicles and size of the largest were determined, and differences were analyzed according to age: under 30, 30-39, and 40 years or over. RESULTS: Among 46 patients, bilateral ovaries were detected in 39 and unilateral ovary in seven. The overall detection rate was 92.4% (85/92), varying according to age. It was 100% (18/18) in those aged under 30, 95% (38/40) in the 30-40 age group, and 85.3% (29/34) among those aged 40 or over. Ovary size ranged between 15 and 50 (average, 24.3) mm and was most commonly 20-30 mm, regardless of age (60%). The average size was 28.8 mm under 30 years of age, 25.3 mm between 30 and 39, and 20.3 mm at age 40 or over (p<0.01). The number of follicles was recorded as 2, 3, 4, or 5 or more, with 10.6%, 23.5%, 18.8% and 47.1% of patients, respectively, assigned to these categories. Among those aged 30-39, ovaries containing five or more follicles were most common, with 83.3% of those under 30 and 47.4% of those aged 30-39 falling into this category. Among patients aged 40 or over, only 24.1% of ovaries contained five or more follicles; most (37.9%) contained three (p<0.05). The size of the largest follicle ranged from 2 to 30 mm and, regardless of age, 5-10-mm follicles were most common (43.5%). There were no significant differences according to age. CONCLUSION: MRI is a useful tool for detecting normal ovaries in women of reproductive age. We found that most normal ovaries were 20-30 mm in size and contained five follicles or more, the largest follicle being 5-10 mm. The size of an ovary and the number of follicles decreased significantly with age.
Female ; Humans ; Magnetic Resonance Imaging* ; Ovary* ; Retrospective Studies

PURPOSE: The aim of this study is to correlate the non-characteristic dual-phase CT imaging findings of hepato-cellular carcinoma with the observed characteristics of surgical specimens. MATERIALS AND METHODS: We studied four cases in which homogeneous low attenuation was observed during the arterial and delayed phases of dynamic CT scanning and in which hepatocellular carcinoma with coagulation necrosis above 95% was pathologically confirmed. We compared the findings of dual phase CT scanning, ultrasonography, angiography and Lipiodol CT scanning with the observed features of surgical specimens. RESULTS: Nodules were 30-50 (mean, 41) mm in size, and were round in three cases and oval in one. In all four cases, a low density lesion was observed during the arterial and delayed phases of dual-phase CT scanning. Ultrasonography demonstrated internal echo and the presence of a hypoechoic halo, implying that in all cases a capsule was present. At angiography and LiCT, minimal peripheral and central tumor staining or lipiodol up-take was observed. In all surgical specimens a complete capsule was visible, and histologic structures were mainly of the trabecular type, Edmondson grade II or III was recorded, and the mass had undergone extensive coagulation necrosis (above 95%). CONCLUSION: In cirrhotic liver which is hepatitis B-antigen positive, clear sonographic findings of internal echo and a capsule, rather than a simple cyst, indicate the possibility of hepatocellular carcinoma with extensive coagulation necrosis. This is so even if the arterial and delayed phases of dual-phase CT scanning indicate the presence of a low-density lesion, and in such cases additional work-up is therefore required.
Angiography ; Carcinoma, Hepatocellular* ; Diagnosis* ; Ethiodized Oil ; Hepatitis ; Liver ; Liver Neoplasms ; Necrosis* ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Humans ; Lung ; Renal Insufficiency, Chronic ; Rhabdomyolysis

PURPOSE: To report the first case of cystoid macular edema in a retinitis pigmentosa patient with pars plana vitrectomy. CASE SUMMARY: A 43-year-old female visited our hospital with visual disturbances of both eyes. Corrected visual acuity was 20/22 in the right eye and 20/25 in the left eye. Peripheral depigmentation and atrophy of the retinal pigment epithelium, pigmentary retinal degeneration, and attenuated arterioles were observed in both eyes. Cystoid macular edema was observed on optical coherence tomography which showed that the central macular thickness was 308 µm in the right eye and 422 µm in left eye. Intravitreal aflibercept was injected into the left eye. One month after injection, the central macular thickness showed no response with a thickness of 449 µm. An intravitreal dexamethasone implant was then injected, 1 month after injection, the central macular thickness was 367 µm. Six months after injection, the patient again complained of visual disturbance of the left eye with a corrected visual acuity of 20/70. Vitreous opacity was observed and the central macular thickness was 501 µm. The patient underwent pars plana vitrectomy. Three days after surgery, the central macular thickness was 320 µm. One year after surgery, the corrected visual acuity was 20/33 and the central macular thickness was 311 µm. CONCLUSIONS: Pars plana vitrectomy due to cystoid macular edema in a retinitis pigmentosa patient has not been previously reported in the Republic of Korea. Pars plana vitrectomy can therefore be an effective treatment for cystoid macular edema in retinitis pigmentosa patients.
Adult ; Arterioles ; Atrophy ; Dexamethasone ; Female ; Humans ; Macular Edema ; Republic of Korea ; Retinal Degeneration ; Retinal Pigment Epithelium ; Retinitis Pigmentosa ; Retinitis ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

The effects of statins on insulin resistance and new-onset diabetes are unclear. The purpose of this study was to evaluate the effects of rosuvastatin on insulin resistance and adiponectin in patients with mild to moderate hypertension. In a randomized, prospective, single-blind study, 53 hypertensive patients were randomly assigned to the control group (n=26) or the rosuvastatin (20 mg once daily) group (n=27) during an 8-week treatment period. Both groups showed significant improvements in systolic blood pressure and flow-mediated dilation (FMD) after 8 weeks of treatment. Rosuvastatin treatment improved total cholesterol, low-density lipoprotein (LDL)-cholesterol, and triglyceride levels. The control and rosuvastatin treatment groups did not differ significantly in the change in HbA1c (3.0+/-10.1% vs. -1.3+/-12.7%; p=0.33), fasting glucose (-1.3+/-18.0% vs. 2.5+/-24.1%; p=0.69), or fasting insulin levels (5.2+/-70.5% vs. 22.6+/-133.2%; p=0.27) from baseline. Furthermore, the control and rosuvastatin treatment groups did not differ significantly in the change in the QUICKI insulin sensitivity index (mean change, 2.2+/-11.6% vs. 3.6+/-11.9%; p=0.64) or the HOMA index (11.6+/-94.9% vs. 32.4+/-176.7%; p=0.44). The plasma adiponectin level increased significantly in the rosuvastatin treatment group (p=0.046), but did not differ significantly from that in the control group (mean change, 23.2+/-28.4% vs. 23.1+/-27.6%; p=0.36). Eight weeks of rosuvastatin (20 mg) therapy resulted in no significant improvement or deterioration in fasting glucose levels, insulin resistance, or adiponectin levels in patients with mild to moderate hypertension.
Adiponectin ; Blood Glucose ; Blood Pressure ; Cholesterol ; Fasting ; Fluorobenzenes ; Glucose ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypertension ; Insulin ; Insulin Resistance ; Lipoproteins ; Plasma ; Prospective Studies ; Pyrimidines ; Single-Blind Method ; Sulfonamides ; Rosuvastatin Calcium

BACKGROUND: It has been reported that the association between blood pressure and cognitive impairment could be modified by factors such as gender, education, and Apo E genotypes. This study was aimed to investigate whether `age' could also be a modifier of the association. METHODS: The study group consisted of 489 participants aged 65 years or over who lived in Namwon, Korea. The presence of hypertension was ascertained by the measurement of their resting blood pressure. A cognitive impairment was considered to be present when a Korean Mini-Mental State Examination score was less than 19 (30th percentile). RESULTS: A higher systolic blood pressure was significantly associated with cognitive impairment, after an adjustment for age, gender, education, and occupation. However, the significance was lost in subjects aged 71 or over. CONCLUSIONS: High systolic blood pressure is a factor strongly associated with cognitive impairment in an aged population. However, in the subjects with far advanced age, the association is not significant. Further studies are required to elucidate whether blood pressure lowering strategies should be differentiated according to age in order to reduce cognitive impairment.
Adult* ; Aged* ; Apolipoproteins E ; Blood Pressure* ; Education ; Genotype ; Humans ; Hypertension ; Jeollabuk-do ; Korea ; Occupations

Lung toxicity associated with cyclophosphamide use is a rare but serious side effect, that may result in a fatal course. However no such cases have been reported in Korea, so clinicians would not be alert to this adverse effect. We recently experienced a woman with Wegener's granulomatosis and idiopathic pulmonary fibrosis. This patient had been administered 12 grams of cyclophosphamide for 4 months. At that time of admission, She felt aggravating dyspnea on exertion for 2 weeks. Her chest x-ray and high resolution CT revealed aggravated reticular opacities and ground glass appearances. Dyspnea was improved and ground glass appearances on HRCT was disappeared after discontinuation of cyclophosphamide. We diagnosed this case as cyclophosphamide-induced pneumonitis and report it with a brief review of the literature.
Cyclophosphamide* ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Female ; Glass ; Humans ; Idiopathic Pulmonary Fibrosis ; Korea ; Lung* ; Pneumonia ; Thorax ; Wegener Granulomatosis*

Mood stabilizers and atypical antipsychotics are commonly combined for the treatment of bipolar mania. The aim of this study was to compare the effectiveness and tolerability of topiramate and divalproex in combination with risperidone for treating acute mania patients in a naturalistic treatment setting. Seventy-four patients who met the DSM-IV criteria for bipolar mania were enrolled in this study. In order to assess the efficacy and the extrapyramidal symptoms, the Young Mania Rating Scale (YMRS), Clinical Global Impression (CGI) and Simpson-Angus Rating Scale were measured at the baseline and at weeks 1, 3 and 6. From the baseline to the endpoint, the YMRS and CGI scores were reduced by 67.9% and 56.6% in the topiramate group. The YMRS and CGI scores were also reduced by 63.7% and 58.2% in the divalproex group. The weight and BMI increased significantly by 3.6% and 3.3% from the baseline to the endpoint in the divalproex group, while they decreased by 0.4% and 0.5%, respectively, with no significant difference in the topiramate group. There were no serious adverse events in either group. Topiramate is effective and tolerable for treating acute mania, and may also be a promising alternative to a weightgain liable mood stabilizer such as divalproex.
Antipsychotic Agents ; Bipolar Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Risperidone ; Valproic Acid*

The principal objective of this study was to investigate the prevalence of toxoplasmosis in household and stray cats in Seoul, Republic of Korea. We collected blood samples from 72 stray and 80 household cats, and all samples were examined by ELISA and nested PCR. The overall positive rates of Toxoplasma gondii in stray cats were 38.9% (28/72), with 15.3% (11/72) in ELISA and 30.6% (22/72) in PCR. The positive rate in male stray cats was slightly higher than that of female stray cats. The highest positive rate of T. gondii infection was noted in Gangnam and Songpa populations in ELISA and in Gwangjin population in PCR. In household cats, however, we could not detect any specific antibodies or DNA for T. gondii. In conclusion, we recognized that the infection rate of toxoplasmosis in stray cats in Seoul was considerably high but household cats were free from infection.
Animals ; Animals, Domestic/parasitology ; Antibodies, Protozoan/blood ; Cat Diseases/*epidemiology/immunology/parasitology ; Cats ; Female ; Male ; Prevalence ; Republic of Korea/epidemiology ; Toxoplasma/genetics/immunology/*isolation & purification ; Toxoplasmosis, Animal/*epidemiology/immunology/parasitology