Gastritis cystica profunda is an uncommon benign mass that usually occurs on the gastric side of the site of a gastroenterostomy, but has also been known to develop in which has not been operated on. We report the case of stomach a 51-years-old man with pathologically proven gastritis cystica profunda. This patient had not undergone gastric surgery and CT showed a well-defined, 3 cm sized, cystic mass at the gastric antrum.
Gastritis* ; Gastroenterostomy ; Humans ; Pyloric Antrum ; Stomach

PURPOSE: We performed this study to evaluate the usefulness and the limitation of magnetic resonance angiography in imaging portal vein and hepatic vein. MATERIALS AND METHODS: Magnetic resonance portography was performed in five normal subjects and seven patients with hepatomas, two patients with Budd-Chiari syndromes, one patient with liver cirrhosis and one patient with hepatic metastasis from stomach cancer. Magnetic resonance angiography was done with a 1.5-T Scanner. Breath-hold two-dimensional time-of flight images with spoiled gradient echo technique were acquired. Scan parameters were 34/8/40degrees(TR ms/TE ms/flip angle). The portal vein and the hepatic vein were selectively imaged by applying two presaturation bands. These images were then postprocessed by a maximum intensity projection algorithm. MRA findings were compared with ultrasonography in all cases of the hepatic disease, and conventional angiography (SMA portography) in four cases. RESULTS: In normal subjects, the splenic vein, intrahepatic and extrahepatic portions of the portal vein, and the hepatic veins were well visualized. In the patients with hepatic diseases, the varices (4 cases), the splenorenal shunts (2 cases), and the recanalized umbilical vein (1 case) were demonstrated. There were portal vein thrombosis in the cases of hepatomas and hepatic metastasis. In the cases of Budd-Chiari syndrome, the hepatic veins were not visualized and there were inferior vena cava obstructions with multiple collateral vessels. CONCLUSION: Compared with ultrasonography, MRP may be useful in evaluation of varices, splenorenal shunts, and other collaterals, though less accurate than conventional angiography. MRP can be useful as a noninvasive screening alternative in the evaluation of portal vein and hepatic veins.
Angiography ; Budd-Chiari Syndrome ; Carcinoma, Hepatocellular ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Magnetic Resonance Angiography ; Mass Screening ; Neoplasm Metastasis ; Portal Vein ; Portography* ; Splenic Vein ; Splenorenal Shunt, Surgical ; Stomach Neoplasms ; Ultrasonography ; Umbilical Veins ; Varicose Veins ; Vena Cava, Inferior ; Venous Thrombosis

PURPOSE: To characterize the magnetic resonance (MR) imaging features of cervical tuberculous lymphadenitis. MATERIALS AND METHODS: The cervical MR images of 14 patients with pathologically or clinically proven cervical tuberculous lymphadenitis were retrospectively analyzed. T1- and T2-weighted or proton density images and contrast enhanced MR images were obtained in all patients. RESULTS: Most patient had multiple (n=12), unilateral lesions (n=l0), 8 mm to 45 mm in size, round (n=46) or ovoid (n=46) in shape and all with smooth and well-defined margins mostly at internal jugular chain(N2: 41, N3: 2, N4: 21 ). The signal intensities of the most lymph nodes were isointense or slightly hyperintense on T1 -weighted images, and hyperintense (all) with variable homogeneity on T2-weighted and/or proton density images. After contrast enhancement most showed characteristic thin peripheral rim enhancement (n=71). CONCLUSION: The characteristic MR features of cervical tuberculous lymphadenitis would be multiple, unilateral enlarged lymph nodes which show iso or slightly increased signal intensity on T1 -weighted image, high signal intensity on T2-weighted and/or proton density image and peripheral rim enhancement.
Humans ; Lymph Nodes ; Protons ; Retrospective Studies ; Tuberculosis, Lymph Node*

Aspirin has been used for decades for the primary and secondary prevention of cardiovascular disease (CVD). The effect of aspirin in secondary prevention is well-known but is still debatable for primary prevention. Despite the controversy, aspirin is believed to have a beneficial effect in primary prevention and has been widely used. However, whether the doubts concerning the wide use of aspirin are correct has resulted in the publication of data from several large clinical trials recently. There are several clinical guidelines from various international organizations on the use of aspirin for the primary prevention of CVD, and they offer some conflicting recommendations. A reduction in the overall incidence of CVD with the development of modern prevention therapies has weakened the impact of aspirin in primary prevention. Large randomized clinical trials have found decreased or no difference in CVD events but a significant increase in the risk of bleeding. Taking aspirin for the primary prevention of CVD is no longer recommended, especially for patients who have a low to moderate risk. An assessment of the balance between the benefits and risks of aspirin use should be considered.
Aspirin ; Cardiovascular Diseases ; Hemorrhage ; Humans ; Incidence ; Primary Prevention ; Publications ; Risk Assessment ; Secondary Prevention

Nonepisodic angioedema with eosinophilia (NEAE) is a rare disease characterized by nonrecurrent angioedema with eosinophilia and normal serum IgM levels occurring predominantly in an East Asian female population. A 49-year-old male patient visited our clinic due to swelling of both the scrotums and the lower extremities, and fever. He had history of nasal polyp, cephalosporin allergy, and asthma. He was diagnosed as having NEAE and was treated with systemic corticosteroid, then he was symptom-free for more than 8 months. He had been administered omalizumab for 3 months due to uncontrolled asthma prior to the onset of angioedema which had helped taper the oral corticosteroid, and this may be associated with presentation of NEAE. Here, we report a case of NEAE in a male patient which presented with constitutional symptoms such as fever and scrotal edema

Hanging is a common method of suicide that is being reported more frequently in many countries. Several complications including injuries to the cervical spine, neck vessels, and brain can occur after attempted suicide by hanging. There are only a few reports of brain computed tomography and magnetic resonance imaging of hanging victims. The most common abnormality was diffuse cerebral edema. A subarachnoid hemorrhage is an atypical complication by suicidal hanging. We report a case of a female patient who presented to an emergency department with altered mental status after attempting suicide by incomplete hanging. The patient was diagnosed with a non-aneurysmal and non-traumatic subarachnoid hemorrhage. This case shows that spontaneous subarachnoid hemorrhage can develop due to a sudden elevation of intracranial pressure, as occurs with hanging.
Brain ; Brain Edema ; Emergency Service, Hospital ; Female ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Methods ; Neck ; Spine ; Subarachnoid Hemorrhage* ; Suicide ; Suicide, Attempted*

Although accumulating evidence suggests that microglia-mediated neuroinflammation may be crucial for the initiation and progression of Parkinson's disease (PD), and that the control of neuroinflammation may be a useful strategy for preventing the degeneration of nigrostriatal dopaminergic (DA) projections in the adult brain, it is still unclear what kinds of endogenous biomolecules initiate microglial activation, consequently resulting in neurodegeneration. Recently, we reported that the increase in the levels of prothrombin kringle-2 (pKr-2), which is a domain of prothrombin that is generated by active thrombin, can lead to disruption of the nigrostriatal DA projection. This disruption is mediated by neurotoxic inflammatory events via the induction of microglial Toll-like receptor 4 (TLR4) in vivo , thereby resulting in less neurotoxicity in TLR4-deficient mice. Moreover, inhibition of microglial activation following minocycline treatment, which has anti-inflammatory activity, protects DA neurons from pKr-2-induced neurotoxicity in the substantia nigra (SN) in vivo. We also found that the levels of pKr-2 and microglial TLR4 were significantly increased in the SN of PD patients compared to those of age-matched controls. These observations suggest that there may be a correlation between pKr-2 and microglial TLR4 in the initiation and progression of PD, and that inhibition of pKr-2-induced microglial activation may be protective against the degeneration of the nigrostriatal DA system in vivo . To describe the significance of pKr-2 overexpression, which may have a role in the pathogenesis of PD, we have reviewed the mechanisms of pKr-2-induced microglial activation, which results in neurodegeneration in the SN of the adult brain.
Adult ; Animals ; Brain ; Humans ; Mice ; Microglia ; Minocycline ; Neurons ; Parkinson Disease ; Prothrombin* ; Substantia Nigra ; Thrombin ; Toll-Like Receptor 4

PURPOSE: To evaluate the inter observer variation in interpretation of the mammographic findings suggesting malignancy. MATERIALS AND METHODS: Sixty-two mammograms of proven breast cancer were retrospectively analyzed by5 radiologists based on the 15 findings that suggest malignancy. Using kappa value, the degree of interobserver agreement was calculated. RESULTS: There were fair to excellent interobserver agreements for 5 findings which were clustered microcalcifications(k=0.7642), ductal calcifications (k=0.5463), lobulated mass(k=0.4539), asymmetric breast parenchyma (k=0.4487) and nipple retraction(k=0.4061). The finding in which kappa value was lessthan 0.2 were intramammary lymph node(k=0.1572), duct ectasia(k=0.1453), phleomorphic calcifications(k=0.1309), architectural distortion(k=0.1247) and stellate mass(k=0.0200). CONCLUSION: The most reliable finding suggesting breast cancer was clustered microcalcifications.
Breast ; Breast Neoplasms ; Nipples ; Observer Variation* ; Retrospective Studies

The circulatory stimulation accompanying laryngoscopy and tracheal intubation and its attendant potential hazards are well recognized. This study was perfomed to compare cardiovascular effects of rapid sequence induction with slow induction during induction of anesthesia and following tracheal intubation with laryngoscope. Eighty six adult patients ASA class I or II, ages 20-55, with no previous history of hypertension and pulmonary diseases that undergoing elective surgery requiring intubation, were admitted to the study. These patients were randomly divided into four groups. Group 1. Rapid sequence induction (n=20) Group 2. Slow induction for 7min. (n=20) Group 3. Slow induction for 10min. (n=21) Group 4. Slow induction for 15min. (n=25) Anesthesia was induced with lidocaine 1.5mg/kg and thiopental sodium 5mg/kg i.v. in a rapid sequence induction in group 1. Tracheal intubation with laryngoscope was facilitated with succinylcholine chloride 1mg/kg iv. Thereafter 50% nitrous oxide in oxygen, 2.0 vol% enflurane, and vecuronium bromide 0.1mg/kg was administered. Group 2, 3, 4 patients received thiopental sodium 5mg/kg iv, vecuronium bromide 0.1mg/kg iv, 2.0 vol% enflurane and 5096 nitrous oxide in oxygen with mask ventilation for 7 min, 10 min and 15 min before intubation with laryngoscope, respectively. After tracheal intubation inhalation of the anesthetic gases were administered. Blood pressure and heart rate measurements and electrocardiography were obtained throughout the study period. Slow induction (Group 2, 3, 4) significantly blunted the increase in heart rate and blood pressure caused by laryngoscopy and endotracheal intubation than rapid sequence induction (group 1). Less unwanted effects were observed in group 2 and 3. Therefore, the author suggests that 7-10 minute of slow induction with volatile anesthetics following thiopental sodium injection is more effective in attenuating cardiovascular responses to tracheal intubation and laryngoscopy.
Adult ; Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Blood Pressure ; Electrocardiography ; Enflurane ; Heart Rate ; Humans ; Hypertension ; Inhalation ; Intubation ; Intubation, Intratracheal ; Laryngoscopes ; Laryngoscopy ; Lidocaine ; Lung Diseases ; Masks ; Nitrous Oxide ; Oxygen ; Succinylcholine ; Thiopental ; Vecuronium Bromide ; Ventilation

PURPOSE: We performed invasive thermometry to verify the elevation of local temperature in the liver during hyperthermia. MATERIALS AND METHODS: Three 40-kg pigs were used for the experiments. Under general anesthesia with ultrasonography guidance, two glass fiber-optic sensors were placed in the liver, and one was placed in the peritoneal cavity in front of the liver. Another sensor was placed on the skin surface to assess superficial cooling. Six sessions of hyperthermia were delivered using the Celsius TCS electro-hyperthermia system. The energy delivered was increased from 240 kJ to 507 kJ during the 60-minute sessions. The inter-session cooling periods were at least 30 minutes. The temperature was recorded every 5 minutes by the four sensors during hyperthermia, and the increased temperatures recorded during the consecutive sessions were analyzed. RESULTS: As the animals were anesthetized, the baseline temperature at the start of each session decreased by 1.3degrees C to 2.8degrees C (median, 2.1degrees C). The mean increases in temperature measured by the intrahepatic sensors were 2.42degrees C (95% confidence interval [CI], 1.70-3.13) and 2.67degrees C (95% CI, 2.05-3.28) during the fifth and sixth sessions, respectively. The corresponding values for the intraperitoneal sensor were 2.10degrees C (95% CI, 0.71-3.49) and 2.87degrees C (1.13-4.43), respectively. Conversely, the skin temperature was not increased but rather decreased according to application of the cooling system. CONCLUSION: We observed mean 2.67degrees C and 2.87degrees C increases in temperature at the liver and peritoneal cavity, respectively, during hyperthermia. In vivo real-time thermometry is useful for directly measuring internal temperature during hyperthermia.
Anesthesia, General ; Animals ; Fever* ; Glass ; Liver* ; Peritoneal Cavity ; Skin ; Skin Temperature ; Swine ; Thermometry ; Ultrasonography