Transitional cell carcinoma is the most common malignant tumor of the urteter, usually presenting as focal ureteral wall thickening or a mass filling the ureter lumen and combined with periureteral infiltration or adjacent lymph node enlargement. Retroperitoneal mass due to exophytic growth of ureteral transitional cell carcinoma has not been described in the literature, and we now report the CT findings in such a case.
Carcinoma, Transitional Cell* ; Lymph Nodes ; Ureter*

PURPOSE: To evaluate the extrahepatic spread of peripheral cholangiocarcinoma with CT. MATERIALS AND METHODS: We retrospectively reviewed CT findings of extrahepatic spread in thirty-six patients with peripheral cholangiocarcinoma confirmed adenocarcinoma at surgery(n=5) or percutaneous biopsy(n--31) without primary leion in other organs, and analysed the frequency and distribution of enlarged lymph nodes, direct invasion of adjacent solid organs, and thrombosis of major vessels. RESULTS: Among the 36 cases, enlarged metastatic lymph node was noted in twenty-four(66.7%), direct invasion into adjacent organs in six(16.7%), portal and inferior vena caval thrombosis in five(13.9%). Enlarged lymph nodes were seen in hepatic nodes(n=16, 44.4%), portocaval nodes(n=15, 41.7%), interaortocaval nodes (n=10, 27.8) and celiac nodes in two(5.6%). Direct invasion was detected in the greater omentum(n=6), gallbladder(n:3) and stomach(n=2). Portal vein thrombosis(n:5) and thrombosis of inferior vena cava(n=2) were noted. CONCLUSION: Lymph node metastasis was seen in 67% in patients with peripheral cholangiocarcinoma. Direct invasion to adjacent organs and thrombosis in portal vein or inferior vena cava were occasionally associated.
Adenocarcinoma ; Cholangiocarcinoma* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Portal Vein ; Retrospective Studies ; Thrombosis ; Vena Cava, Inferior

No abstract available.
Muscles ; Orbit ; Orbital Myositis

Reptiles are used for various purposes these days, including public exhibits, medicinal applications, and as laboratory animals. As the international exchange of reptiles has gradually increased, more people have had the opportunity to come in contact with these animals. Snakes typically live in the rhizosphere where various bacterial strains exist and as such they can lead to opportunistic human diseases. When snakes are encountered in veterinary medicine, it is necessary to monitor their microflora. Native microflora of reptiles imported from other countries has not yet been reported in Korea. In this study, oral and cloacae samples were collected from 18 Burmese pythons transported from Vietnam. The specimens were incubated at 37degrees C for 18 h to produce colony growth under aerobic condition and isolated colonies were then identified using a VITEK automated identification system. There were fourteen types of aerobic bacteria isolated from both oral and cloacae samples, nine from only oral specimens, and fifteen from only cloacae specimens. Most bacteria isolated were opportunistic pathogens of humans which therefore have the potential to induce disease in people. Based on the microflora and the prevalence of bacterial strains in snakes, quarantine procedures for reptiles transported internationally should be strengthened. Characterization of the microflora of reptiles with the potential to induce zoonosis should be performed in those used as laboratory animals and to prevent zoonotic outbreaks in the general population as well as among veterinarians.
Animals ; Animals, Laboratory ; Asian Continental Ancestry Group ; Bacteria ; Bacteria, Aerobic ; Boidae ; Cloaca ; Disease Outbreaks ; Humans ; Korea ; Mouth ; Opportunistic Infections ; Organothiophosphorus Compounds ; Prevalence ; Quarantine ; Reptiles ; Rhizosphere ; Snakes ; Veterinarians ; Veterinary Medicine ; Vietnam

BACKGROUND: Endothelial dysfunction is suggested to be one of the pathogenesis of cerebral white matter lesion (cWML). Vascular endothelial growth factor (VEGF) plays a crucial role in angiogenesis and integrity of vascular endothelial cell, and altered expression of VEGF gene induces vascular diseases including cerebrovascular diseases. The objective of this study is to investigate whether single nucleotide polymorphism (SNP) of VEGF gene confers an increased risk of cWML. METHODS: Total 337 study subjects without history of stroke were included. The presence and severity of cWML were measured on fluid-attenuated inversion recovery image. Genotypes of VEGF -2578G>A, -1154G>A, -634G>C and +936C>T were analyzed. RESULTS: Among 337 study subjects, cWML was found in 208 patients (62%), and fifty-eight cases (17%) of them had overt cWML. In univariate analysis, age, female sex and plasma total homocysteine level (tHcyt) were higher in the mild and overt cWML group than no cWML group (p<0.05). The percentage of previous history of hypertension and the value of systolic blood pressure were higher in overt cWML group than no cWML group. In univariate and logistic regression analysis, none of four tested VEGF SNPs was significantly different between control group, mild and overt cWML groups. There was no difference between plasma tHcyt levels and each VEGF SNPs in control group and cWML groups. CONCLUSIONS: In this study, old age, female sex, hypertension and plasma tHcyt were associated with cWML. However, we failed to find an association between cWML and VEGF gene polymorphism, which may indicate that genetic polymorphism of VEGF does not play a direct role in the pathogenesis of cWML.
Blood Pressure ; Endothelial Cells ; Female ; Genotype ; Homocysteine ; Humans ; Hypertension ; Logistic Models ; Plasma ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Stroke ; Vascular Diseases ; Vascular Endothelial Growth Factor A

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

No abstract available.
Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Interferons ; Polyneuropathies ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating

PURPOSE: The pulsatility index (PI), measured by transcranial Doppler (TCD), is a surrogate marker for distal vascular resistance in cerebral arteries, and elevated plasma total homocysteine (tHcyt) is regarded as a cause of ischemic stroke, including lacunar infarction. We investigated the relationship between the PI of cerebral arteries and plasma tHcyt in patients with lacunar infarction. MATERIALS AND METHODS: Plasma tHcyt level and TCD examination were performed in 94 patients with lacunar infarction. Mean flow velocity (MFV) and PI were assessed at the ipsilateral middle cerebral artery (MCA) and contralateral MCA, relative to the infarction, and the basilar artery (BA). Multivariate regression analysis was conducted between log-transformed tHcyt levels (logHcyt) and the PI of individual arteries. RESULTS: There was a significant correlation between logHcyt and the PI in all tested arteries (ipsilateral MCA: r=0.21, p=0.03; contralateral MCA: r=0.21, p=0.04; BA: r=0.35, p=0.01). In multivariate regression analysis, this significance remained unchanged after adjusting for vascular risk factors, creatinine, hematocrit and platelet count (ipsilateral MCA: beta=0.26, p=0.01; contralateral MCA: beta=0.21, p=0.04; BA: beta=0.39, p=0.001). There was no significant association between logHcyt and MFV of individual arteries. CONCLUSION: A significant association between plasma tHcyt and the PI of cerebral arteries indicates that homocysteine plays a role in the increase of distal arterial resistance in lacunar infarction.
Aged ; Basilar Artery/ultrasonography ; Cerebral Arteries/physiopathology/*ultrasonography ; Female ; Hematocrit ; Homocysteine/*blood ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery/ultrasonography ; Regression Analysis ; Risk Factors ; Stroke, Lacunar/*blood/physiopathology/ultrasonography ; Ultrasonography, Doppler, Transcranial ; Vascular Resistance

PURPOSE: Lacunar stroke, in the context of small vessel disease, is a type of cerebral infarction caused by occlusion of a penetrating artery. Pulsatility index (PI) is an easily measurable parameter in Transcranial Doppler ultrasound (TCD) study. PI reflects distal cerebral vascular resistance and has been interpreted as a surrogate marker of small vessel disease. We hypothesized that an increased PI, a marker of small vessel disease, might be associated with a larger infarct volume in acute lacunar stroke. MATERIALS AND METHODS: This study included 64 patients with acute lacunar stroke who underwent TCD and brain MRI. We evaluated the association between the mean PI value of bilateral middle cerebral arteries and infarct volume on diffusion-weighted MRI using univariate and multivariate linear regression. RESULTS: The mean infarct volume and PI were 482.18±406.40 mm3 and 0.86±0.18, respectively. On univariate linear regression, there was a significant positive association between PI and infarct volume (p=0.001). In the multivariate model, a single standard deviation increase of PI (per 0.18) was associated with an increase of 139.05 mm3 in infarct volume (95% confidence interval, 21.25 to 256.85; p=0.022). CONCLUSION: We demonstrated that PI was an independent determinant of infarct volume in acute lacunar stroke. The PI value measured in acute stroke may be a surrogate marker of the extent of ischemic injury.
Aged ; Cerebral Infarction/*diagnostic imaging/*physiopathology ; *Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Linear Models ; Male ; Middle Aged ; Middle Cerebral Artery ; Pulsatile Flow/physiology ; Retrospective Studies ; Stroke, Lacunar/*diagnostic imaging/*physiopathology ; *Ultrasonography, Doppler, Transcranial ; Vascular Resistance/physiology

OBJECTIVE: Polymyositis (PM) has known to be the most common type of idiopathic inflammatory myopathy (IIM). However, recent immunopathological studies demonstrated that PM was overdiagnosed previously due to suboptimal classification system. Using newly proposed classification system, we investigated the frequency, clinical and pathological characteristics of PM. METHODS: Among the patients diagnosed as IIM during past 6 years, we classified a 'definite' or 'probable PM' using the European Neuromuscular Center (ENMC) diagnostic criteria. The findings of clinical, laboratory and pathological findings were analyzed. Response to treatment was assessed at 6 months after treatment. RESULTS: Of total 97 cases with IIM, twenty-three cases (24%) were satisfactory to the diagnostic criteria for PM (definite=5 and probable=18). Most cases were young adults, and female predominance was found. All cases showed proximal muscle weakness, and about two-thirds of patients showed extramuscular manifestation. One (4%) had breast cancer, and accompanying connective tissue disorders (CTDs) were found in 3 cases (13%), two of which had systemic sclerosis. Interstitial pneumonia was found in one case (4%). All cases showed marked elevation of serum creatine kinase level. On muscle biopsy, there were endomysial mononuclear cell infiltrations in all cases. Three-fourths of patients responded to immunosuppressant therapy (74%). CONCLUSION: Using ENMC criteria, the frequency of PM was lower than that had been reported previously. The results of clinical characteristics, response to therapy and clinical outcome were similar to the previous reports. However, association of malignancy or CTDs was low in PM.
Adult ; Male ; Female ; Humans ; Biopsy ; Breast Neoplasms