It is thought to be reliable roentgenologic sign of pulmonary plethora that the diameter of anterior segmental artery(d-ASA) is larger than that of anterior segmental bronchus(d-ASB). To evaluate the reliability of this sign, we compared d-ASA with d-ASB on chest rentgenograms of 100 normal adults. Of the total 105 cases. d-ASA was larger than d-ASB in 40 cases (38.1%), smaller than d-ASB in 34 cases(32.4%) and equal to (d-ASA and) d-ASB in 31 cases(29.5%). The ratio(ABR) and difference between d-ASA and d-ASB ranged from 0.70 to 1.58(mean, 1.05±0.30) and from -1.85mm to +2.45mm(mean of absolute value, 0.75mm±0.57). These results showed that the relationships between d-ASA and d-ASB were variable. Conclusively, d-ASA may be larger than d-ASB in even normal adults and mild degree of pulmonary plethora cannot exectly evaluated with this findings only.
Adult ; Arteries* ; Bronchi* ; Humans ; Thorax

Our aim was to identify histologic changes in cervical carcinoma tumor cells due to chemotherapy,by electron microscopic examination. Cisplatin and 5-fluorouracil were used between March 1, 1994 and February 28, 1995 on a total of 16 patients. The treatment schedule consisted of 75 mg/m2 cisplatin via iv with hyperhydration on Day 1, in combination with 1000 mg/m2 5-fluorouracil via continuous iv on Day 1 to 5. The treatment was repeated every 4 weeks with a maxinum of 3 courses. Ultrastructurally, chemotherapy induced apoptosis,indicated by condensation of nucleus and cytoplasm,fragmentation of nuclei, and apoptotic bodies. Due to repeat chemotherapy, increased levels of desmosomes were noted and parts of tumor nests were replaced by mature squamous cells. Tumor nests were reduced in size, mitochondria exhibited swelling, the endoplasmic reticulum was dilated, and infiltration of inflammatory cells increased after chemotherapy. These results suggest that chemotherapy induces apoptosis and injury to the cytoplasm and nuclei of tumor cells. However, the exact selection mechanism of the biochemical pathway of cell death is not fuUy understood. Further study of the molecular biologic actions of cell death after chemotherapy is warranted.
Apoptosis ; Appointments and Schedules ; Cell Death ; Cisplatin ; Cytoplasm ; Desmosomes ; Drug Therapy* ; Endoplasmic Reticulum ; Fluorouracil ; Humans ; Mitochondrial Size

PURPOSE: MR findings of the spinal metastasis and the tuberculosis are well known, but sometimes it might be difficult to differentiate these lesions. Therefore we reviewed and analyzed the MR findings which would be useful for the differentiation. MATERIALS AND METHODS: T1- and T2-weighted spin echo images and gadolinium-enhanced Tl-weighted images were obtained with 1. 5T and 1. 0T superconductive MR imager. We reviewed MR findings in 16 cases of spinal metastases and 24 cases of spinal tuberculosis in terms of signal intensity, contrast enhancement pattern, disc space involvement, spinal canal compressing feature and paraspinal soft tissue mass. RESULTS: The signal intensities of both lesions were hypointense on T1WI and hyperintense on T2WI except those of the metastatic lesions from the prostatic carcinoma. Heterogeneous enhancement was noted in 63% of metastasis, whereas peripheral rim enhancement was noted in 83% of spinal tuberculosis(p (.001). Spinal canal compression by collapsed vertebra was only noted in spinal metastasis, and that by paraspinal soft tissue was noted in both spinal metastasis and tuberculosis(p (.001). Disc space invasion was noted in 19% of spinal metastasis and 88% of spinal tuberculosis. Spinal tuberculosis was common at lower thoracic spine(T10) and typically involved two or more adjacent vertebral bodies(96%). CONCLUSION: The important differential point between spinal metastasis and tuberculosis was the enhancement pattern, involvement of two or more contiguous vertebral bodies and the feature of spinal canal compressing. The secondary importance was the disc space involvement pattern.
Neoplasm Metastasis* ; Spinal Canal ; Spine ; Tuberculosis ; Tuberculosis, Spinal*

PURPOSE: The aim of our study was to identify the CT features helpful in the differential diagnosis of Iobar consolidation. MATERIALS AND METHODS: We evaluated the CT findings in 52 consecutive patients with Iobar consolidation which were proved to be pulmonary tuberculosis(n=24), malignant obstructive pneumonitis due to bronchogenic carcinoma(n=21), and lung abscess(n=7). We retrospectively reviewed CT scans with respect to 1) number of cavities or low attenuation area suggesting necrosis(we described these as cavity), 2) the contour of cavity, 3) enhancement of the cavity wall, 4) enhancement of pleura, 5) small nodules adjacent to the consolidation, 6) similar lesion in other location in lung, 7) air-bronchogram 8) mediastinal lymph node enlargement, and 9) extrapleural change. RESULTS: The helpful CT fingings in the patients with pulmonary tuberculosis were multiple cavities(more than three;79.2%), small nodules adjacent to the Iobar consolidation(75.0%), similar lesion in another lobe or lung(91.7%), air-bronchogram(91.7%), and mediastinal lymph node enlargement(58.3%). Although extrapleural change had low sensitivity it was highly specific for pulmonary tuberculosis(sensitivity, 43.5%;specificity, 91. 7%). Multiple cavities(61.9%) and mediastinal lymph node enlargement(52.4%) were common findings of malignant obstructive pneumonitis. In the patients with lung abscess, the common findings were small number of cavities(one or two, 85.7%) and air-bronchogram(85.7%). However, other findings of pulmonary tuberculosis were rarely seen in the patients with malignant obstructive pneumonitis or lung abscess. CONCLUSION: The CT findings of Iobar consolidation may be used as useful adjuncts in the differential diagnosis of Iobar consolidation.
Diagnosis, Differential ; Humans ; Lung Abscess* ; Lung* ; Lymph Nodes ; Pleura ; Pneumonia* ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary

No abstract available.
Urokinase-Type Plasminogen Activator*

Rare cases of IgG associated mesangial glomerulonephritis(IgG GN) defined by exclusive or predominant mesangial IgG deposits were reported first by Sato et al.(1993). and subsequently 10 pediatric cases were reported by Yoshikawa et al. (1994). Previous reports suggested that the prognosis of IgG GN is relatively benign course but recent report suggested that prognosis of IgG GN is highly variable. Also the recurrence of IgG GN in a renal transplant was reported by Fakhouri et al. (2002). Such a recurrence highlights the specificity of this type of glomerulonephritis. We experienced two pediatric cases of IgG GN proven by renal biopsy. Case 1. 4-year-old girl with nephrotic syndrome admitted because of general edema. The patient's urinalysis showed proteinuria and microscopic hematuria. Renal biopsy was performed because of relapsed nephritic syndrome. Light microscopic finding was nonspecific with almost normal histology. Immunofluorescent findings showed diffuse segmental IgG(+) and IgM(+) deposits in the capillary walls, and focal segmental spotty C4(trace), C1q(trace) deposits. Electron microscopic findings showed focal portion of mesangial electron dense deposits without mesangial widening. Case 2. 11-year-old girl admitted for evaluation of microsopic hematuria detected through mass school urinary screening program. Renal biopsy was performed for exact diagnosis. Immunofluorescent findings showed focal segmental IgG(+), IgM(+/-) and C3(+/-) deposits. Electron microscopic findings showed focal portion of esangial electron dense deposits without mesangial widening.
Biopsy ; Capillaries ; Child ; Edema ; Electrons ; Glomerulonephritis ; Hematuria ; Humans ; Immunoglobulin G ; Light ; Mass Screening ; Nephrotic Syndrome ; Preschool Child ; Prognosis ; Proteinuria ; Recurrence ; Sensitivity and Specificity ; Transplants ; Urinalysis

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*

Malignant obstruction develops frequently in advanced gastric cancer. Although it is primarily the gastric outlet that is obstructed, there are occasional reports of colonic obstruction. Treating intestinal obstruction usually requires emergency surgery or stent insertion. There are several kinds of complications with stent insertion, such as bowel perforation, stent migration, bleeding, abdominal pain and reobstruction. Nevertheless, endoscopic stent insertion could be a better treatment than emergency surgery in cases of malignant bowel obstruction in cancer patients with poor performance status. We report a case of advanced gastric cancer with carcinomatosis in which a recurrent colonic stent was inserted at the same site because of cancer growth into the stent. The patient maintained a good condition for chemotherapy, thus improving their chances for survival.
Aged ; Female ; Humans ; Intestinal Obstruction/etiology/radiography/*surgery ; Neoplasm Recurrence, Local ; Prosthesis Implantation/*methods ; *Stents ; Stomach Neoplasms

OBJECTIVES: This study evaluated the stress of community residents using the General Health Questionnaire, GHQ-60, as an instrument of stress measurement. METHODS: The study included 2100 residents, aged 20 and over, living in three areas, a large city, a medium sized city and a rural area, between June and September 2001. A questionnaire interviewing method was used to collect data. The data were analyzed using a t-test, ANOVA, Pearson's correlation coefficients and multiple regression analysis. RESULTS: In this study, the degree of stress, as measured by the GHQ-60, was shown to be significantly higher in the following categories: females, people over 60 years old, people engaged in the primary industries and labor work, low incomes, the divorced and the bereaved, people who received no more than an elementary education, people who suffer from chronic diseases and non-exercisers. A factor analysis suggested that there were three factors of social dysfunction factors; psychosomatic symptom, and depression and anxiety. The social dysfunction factors was statistically significant for the groups described above. The factor of psychosomatic symptoms was statistically significant in the rural residents, and in the groups described above. The depression and anxiety factor was statistically significant in the large city residents, people aged between 20-29 years, students, unmarried persons, university graduates and those having suffered from chronic diseases. From the multiple linear regression analyses, chronic disease, exercise, gender and income, proved to be significant stress related factors. CONCLUSIONS: This study suggests that special attention should be given to the management of the chronic invalided, non-exercisers, females and small income earners, in order to maintain and promote the psychological health of residents in a community.
Anxiety ; Chronic Disease ; Depression ; Divorce ; Education ; Factor Analysis, Statistical ; Female ; Humans ; Linear Models ; Methods ; Single Person

PURPOSE: The aim of this study was to develop a new middle cerebral artery occlusion (MCAO) model in rabbits using a less invasive, endovascular interventional technique. The new animal model's technical feasibility and its success in producing lesions was evaluated using magnetic resonance imaging (MRI). MATERIALS AND METHODS: Ten rabbits were used to develop the MCAO models using a transfemoral catheter-based technique. After catheterization of the common carotid artery, a microcatheter was introduced coaxially through the catheter to cannulate the internal carotid artery and to embolize the MCA with polyvinyl alcohol particles. We evaluated how successful we were in selecting the vessels, catheterization, embolization, and also evaluated how many of the animals survived until the end of experiment. Diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) were performed in one-hour intervals to monitor the ischemic lesion for a total of six hours following successful occlusion of the target artery. The relative volume of the lesion was calculated as a hemispheric lesion volume (HLV, %). The signals of the lesion and contralateral normal brain (control) were measured in each image at every time point. Lesion-to-control signal-intensity ratio (SIR) of DWI, and T2WI were obtained together with relative apparent diffusion coefficient (rADC). RESULTS: Catheterization and embolization of the internal carotid artery were successful in all 10 rabbits, which showed relevant lesions on MRI. All rabbits survived until the end of the experiment. The HLV (mean+/-standard deviation) was 35.7+/-14.6%. The relative ADC was 0.80+/-0.13. The lesion signals on DWI and T2WI showed a gradual increase as time passed, while the ADC value of the lesion gradually decreased (p<0.0001). CONCLUSION: The rabbit MCAO model using an endovascular interventional technique is technically feasible, and provides a reproducible lesion in the target arterial territory. MRI successfully revealed a typical finding of acute cerebral infarction. This model is also believed to be suitable for the MRI investigation of acute cerebral ischemia.
Animals ; Arteries ; Brain ; Brain Infarction ; Brain Ischemia ; Carotid Artery, Common ; Carotid Artery, Internal ; Catheterization ; Catheters ; Cerebral Infarction ; Diffusion ; Endovascular Procedures ; Infarction, Middle Cerebral Artery* ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Models, Animal ; Polyvinyl Alcohol ; Rabbits*