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*

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

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*

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

alpha-Viniferin (AVF), a trimer of resveratrol, is known to have an anti-inflammatory effect via inhibition of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS). It has been reported that up-regulated COX-2 and iNOS are expressed in colon cancer tissues of humans and rodents as well as pre-neoplastic aberrant crypt foci (ACF) of rodents. In this study, chemopreventive effects of AVF were assessed in Caco-2 cells as well as azoxymethane (AOM)-induced colorectal tumorigenesis in mice. Anti-tumor effect of AVF with regards to apoptotic induction was assessed by TUNEL and caspase-3 expression in human colon cancer Caco-2 cells. For development of ACF, AOM was administered with to mice intraperitoneally at a dose of 10 mg/kg once a week for 3 weeks. To induce colitis-related colon cancer, mice were administered a single dose of AOM (10 mg/kg) and 2% dextran sodium sulfate in drinking water. Mice treated with 0.05 and/or 0.1 mg of AVF by gavage showed significantly reduced development of ACF and colorectal tumors. Immunofluorescence detection in Caco-2 cells showed reduced COX-2 and iNOS expression, whereas cleavage of caspase-3 and apoptotic cell numbers increased upon AVF treatment. Immunostaining showed reduced expression levels of COX-2 and iNOS expression along with increased cleaved caspase-3 expression increased upon AVF treatment. These results suggest that AVF has chemopreventive effects on colorectal cancer via anti-inflammatory potential and pro-apoptotic activity.
Aberrant Crypt Foci ; Animals ; Azoxymethane ; Caco-2 Cells* ; Carcinogenesis ; Caspase 3 ; Cell Count ; Chemoprevention ; Colonic Neoplasms ; Colorectal Neoplasms* ; Cyclooxygenase 2 ; Dextrans ; Drinking Water ; Fluorescent Antibody Technique ; Humans ; In Situ Nick-End Labeling ; Mice* ; Nitric Oxide Synthase Type II ; Rodentia ; Sodium

In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD) usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL). However, the long-term course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient's clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.
Adult ; Catheters ; Disinfectants ; Extracorporeal Membrane Oxygenation ; Female ; Fibrosis ; Humans ; Humidifiers* ; Inhalation ; Inhalation Exposure ; Intensive Care Units ; Korea ; Lung Injury* ; Lung Transplantation* ; Lung* ; Oxygen Inhalation Therapy ; Respiration, Artificial ; Survivors