PURPOSE: The aim of this study was to evaluate the utility of contrast-enhanced MRI with first-pass and delayed images in prediction of myocardial viability after acute myocardial infarction. MATERIALS AND METHODS: Ten patients (M:F=:4, mean age =6 5 years) with acute myocardial infarction underwent first-pass image after bolus injection of gadolinium (one image/sec for 120sec)and delayed image (7 2 minutes later). According to 60 segments on midventricular level, the assessment of MRI were concerned about location of lesion, depth of lesion, enhancement on first-pass image and enhancement pattern on delayed image. MRI findings were compared with wall motion on resting echocardiography and stress or follow-up echocardiography. RESULTS: 1) MRI findings were classified into 4 types: normal enhancement on first-pass and delayed images (type 1), normal enhancement on first-pass image and nontransmural hyperenhancement on delayed image (type 2), non-transmural enhancing defect on first-pass image and transmural enhancement with endocardial non-enhancing defect on delayed image (type 3), and transmural enhancing defect on first-pass image and transmural hyperenhancement on delayed image (type 4).2) Type 2 suggested viable myocardium and type 3 had high porbability of viability. Type was compatible with non-viable myocardium. CONCLUSION: Enhancing defect on first-pass image and involving thickness on both the first-pass image and delayed image in contrast enhanced MRI may predict myocardial viability.
Echocardiography ; Follow-Up Studies ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Myocardial Infarction* ; Myocardium

Present study aimed to investigate the immunological activities of cell wall associated protein antigen solubilized with Triton X-100 (TSP) from Mycobacterium tuberculosis H37Rv and conducted on 43 patients with pulmonary tuberculosis (newly diagnosed, medicated within 12 months and chronic refractory patients) and 17 normal healthy controls. These immunological responses were compared with those induced by the PPD or 30 kDa antigen from M, tuberculosis H37Rv culture filtrates, identified as biologically important secreted proteins. Proliferative responses to mycobacterial antigens were compared in peripheral blood mononuclear cells (PBMC) of healthy subjects and pulmonary tuberculosis patients. Signiticant blastogenic responses to the TSP were observed in healthy tuberculin reactors, newly diagnosed and some of antituberculosis drug-medicated patients by H-thymidine incorporation assay. IL-12 p40 and IFN-r mRNA expressions to the TSP were markedly increased, whereas IL-10 and TNF-a mRNA expressions were decreased at a 5 day-stimulation by PBMC in healthy tuberculin reactors, newly diagnosed and medicated patients. However, patients with chronic refractory tuberculosis exhibited more depressed IL-12 p40 and IFN-r mRNA expressions to all of the antigens than another groups. Interestingly, very low IL-10 and TNF-a mRNA expressions cultured with the TSP were also shown. These data suggest that the TSP may be involved in the macrophage activation by induction of Th1 stimulatory signals, such as IL-12, and suppression of Th1 inhibitory cytokine, IL-10.
Tumor Necrosis Factor-alpha

No abstract available.
Mucins* ; Nevus*

Cervical pregnancy is a rare and dangerous form of ectopic pregnancy in which the blastocyst implants within the cervical canal below the internal os of the uterine cervix. The characteristic clinical sign is a severe asymptomatic uterine bleeding in early pregnancy or during curettage. Most cervical pregnancies result in early spontaneous abortion, complicated by severe hemorrhage from the eroded blood vessels within the cervical tissue. Because of uncontrolled profuse vaginal bleeding, total hysterectomy has been the mostly necessitated to control life-threatening bleeding. Transvaginal sonography allows early diagnosis, and conservative treatment (two-time treatment : first treatement with systemic or intraamnionic methotrexate, secondly with curettage or ligature of the uterine arteries) improves the patient's fertility. Successful treatment is defined as elimination of the cervical pregnancy with preservation of the uterus. We report two cases of cervical pregnancy managed, successfully with methotrexate, leucovorin and curettage.
Abortion, Spontaneous ; Blastocyst ; Blood Vessels ; Cervix Uteri ; Curettage ; Cytochrome P-450 CYP1A1 ; Early Diagnosis ; Female ; Fertility ; Hemorrhage ; Humans ; Hysterectomy ; Leucovorin ; Ligation ; Methotrexate ; Pregnancy* ; Pregnancy, Ectopic ; Uterine Hemorrhage ; Uterus

Background: An evident relationship has been shown between psoriasis and metabolic comorbidities. However, the results in pediatric psoriasis vary from study to study, and no meta-analysis exists on the association of metabolic comorbidities with pediatric psoriasis. Objective: To evaluate the association between psoriasis and metabolic comorbidities in pediatric patients. Methods: We searched articles published in PubMed, EMBASE, and Cochrane Library databases from inception to April 30, 2019. All observational studies reporting the prevalence of obesity or metabolic comorbidities in pediatric patients with psoriasis were included. Results: The meta-analysis included 16 unique studies meeting the inclusion criteria. The pooled odds ratios in pediatric patients with psoriasis was 2.40 (95% confidence interval [CI], 1.60∼3.59) for obesity (13 studies), 2.73 (95% CI, 1.79∼ 4.17) for hypertension (8 studies), 2.01 (95% CI, 1.09∼3.73) for diabetes mellitus (8 studies), 1.67 (95% CI, 1.42∼1.97) for dyslipidemia (7 studies), and 7.49 (95% CI, 1.86∼30.07) for metabolic syndrome (4 studies). Conclusion Pediatric patients with psoriasis showed a significantly higher prevalence of obesity, hypertension, diabetes, dyslipidemia, and metabolic syndrome. Adequate monitoring and timely management of metabolic comorbidities should be considered in these patients.

Background: An evident relationship has been shown between psoriasis and metabolic comorbidities. However, the results in pediatric psoriasis vary from study to study, and no meta-analysis exists on the association of metabolic comorbidities with pediatric psoriasis. Objective: To evaluate the association between psoriasis and metabolic comorbidities in pediatric patients. Methods: We searched articles published in PubMed, EMBASE, and Cochrane Library databases from inception to April 30, 2019. All observational studies reporting the prevalence of obesity or metabolic comorbidities in pediatric patients with psoriasis were included. Results: The meta-analysis included 16 unique studies meeting the inclusion criteria. The pooled odds ratios in pediatric patients with psoriasis was 2.40 (95% confidence interval [CI], 1.60∼3.59) for obesity (13 studies), 2.73 (95% CI, 1.79∼ 4.17) for hypertension (8 studies), 2.01 (95% CI, 1.09∼3.73) for diabetes mellitus (8 studies), 1.67 (95% CI, 1.42∼1.97) for dyslipidemia (7 studies), and 7.49 (95% CI, 1.86∼30.07) for metabolic syndrome (4 studies). Conclusion Pediatric patients with psoriasis showed a significantly higher prevalence of obesity, hypertension, diabetes, dyslipidemia, and metabolic syndrome. Adequate monitoring and timely management of metabolic comorbidities should be considered in these patients.

Marchiafava-Bignami disease (MBD) is characterized by cerebral white matter lesions associated with chronic alcoholism. Premortem diagnosis of MBD is usually based on history and clinical manifestations. We report a case of acute MBD in which diffusion-weighted MRI (DWI) showed high signal intensities along the white matter including the corpus callosum. DWI may be useful in premortem diagnosis of acute MBD.
Alcoholism ; Corpus Callosum ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Humans ; Leukoencephalopathies ; Marchiafava-Bignami Disease

Various treatment modalities are available for mycosis fungoides including topical steroids, topical chemotherapy, phototherapy, and spot radiation therapy. However, these modalities do not always result in optimal effects, with efficacy depending on lesion size, number, and location. Photodynamic therapy (PDT) is a recently introduced therapeutic modality that proved effective in patients with unilesional mycosis fungoides. A 58-year-old woman presented with a seven-year history of a pruritic erythematous scaly patch on her right thigh. Through skin biopsy, we verified the lesion as mycosis fungoides. The lesion did not respond well to a topical steroid. We opted for topical PDT with methyl-aminolevulinate (MAL). MAL cream was applied for 4 hours following irradiation with a red light. Four sessions were administered, separated by five weeks. The lesion clinically improved after treatment without severe side effects. PDT using MAL could be considered an effective and tolerable treatment for mycosis fungoides.
Biopsy ; Drug Therapy ; Female ; Humans ; Middle Aged ; Mycosis Fungoides* ; Photochemotherapy* ; Phototherapy ; Skin ; Steroids ; Thigh

PURPOSE: The clinical features of esotropia after bare scleral pterygium surgery and dipolpia treatment results were evaluated in the present study. METHODS: Twenty eyes of 12 patients who had esotropia after bare sclera pterygium surgery from 2008 to 2011 were retrospectively investigated. RESULTS: Diplopia occurred at 2.8 +/- 1.6 months (1-6 months) after pterygium surgery. The mean pre-operative angle of esotropia was 19.4 +/- 8.9 PD (8-40 PD) at distance and 16 +/- 7.3 PD (0-30 PD) at near. All patients showed limitation of abduction in the pterygium operated eye. Two patients were prescribed prism glasses, 2 patients underwent conjunctiva surgery, and medial rectus recession with simultaneous intraoperative adjustment surgery was performed in 8 patients. An additional strabismus operation was required for 2 patients who received conjunctival surgery due to diplopia recurrence. Seven patients (70%) showed orthotropia at 3 months. CONCLUSIONS: In this study, diplopia following postoperative adhesion caused by bare sclera pterygium surgery technique was observed. Conjunctiva-perimuscular scar tissue removal and medial rectus recession were effective methods in eliminating diplopia.
Cicatrix ; Conjunctiva ; Diplopia ; Esotropia ; Eye ; Eyeglasses ; Glass ; Humans ; Pterygium ; Recurrence ; Retrospective Studies ; Sclera ; Strabismus

We present a rare case of optochiasmatic cavernous angioma (CA) that progressed despite radiation therapy. A 31-year-old female patient presented with sudden loss of left visual acuity and right homonymous hemianopsia. Magnetic resonance imaging (MRI) revealed a suprasellar mass and findings compatible with a craniopharyngioma or an optic glioma with bleeding. An open biopsy was conducted using the transcranial approach, and histological examination revealed gliosis. During the one-year follow-up period, imaging suggested intratumoral bleeding and the mass continued to grow. We recommended re-operation, but the patient refused due to fear of surgery. Consequently, the patient received fractionated radiation therapy (3,000 cGy) to the parasellar area. Despite the radiotherapy, the mass continued to grow for the following 6 years. The final MRI before definitive treatment revealed a multilobulated, multistage hematoma with calcification in the parasellar area, extending into the third ventricle and midbrain. The patient ultimately underwent reoperation due to the growth of the tumor. The mass was completely removed with transcranial surgery, and the pathologic findings indicated a cavernous angioma (CA) without evidence of glioma. As shown in our case, patients may suffer intratumoral hemorrhage after biopsy and radiotherapy. This case places the value of biopsy and radiotherapy for a remnant lesion into question. It also shows that reaching the correct diagnosis is critical, and complete surgical removal is the treatment of choice.
Adult ; Biopsy ; Caves ; Craniopharyngioma ; Female ; Follow-Up Studies ; Glioma ; Gliosis ; Hemangioma, Cavernous ; Hematoma ; Hemianopsia ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Optic Nerve Glioma ; Reoperation ; Third Ventricle ; Visual Acuity