Subcapsular hematoma of the liver in the neonate is an uncommon clinical presentation, although these tumors are frequently found upon perinatal autopsy. We describe the sonographic and MR findings of a subcapsular hematoma of the liver in a neonate having a clinical history of an inserted umbilical venous catheter, necrotizing enterocolitis and sepsis, and we also include a review of the relevant literature.
Autopsy ; Catheters ; Enterocolitis, Necrotizing ; Hematoma* ; Humans ; Infant, Newborn* ; Liver* ; Sepsis ; Ultrasonography

We report the dynamic magnetic resonance imaging findings (MRI) of a metaplastic carcinoma of the breast. A 44-year-old woman presented with a 2-month history of a mass in the right breast. The tumor showed a central irregular necrosis that was depicted upon low signal intensity on a T1-weighted image and high signal intensity on a T2-weighted image. The periphery of the tumor showed strong enhancement on a contrast enhanced T1-weighted image. The time-signal intensity curve revealed an early strong contrast enhancement and a delayed washout pattern.
Adult ; Breast* ; Female ; Humans ; Magnetic Resonance Imaging ; Necrosis

PURPOSE: Vascular endothelial growth factor (VEGF) is a major positive effector of angiogenesis. We investigated the mechanism of tumor growth inhibition by adenoviral transfer of antisense- VEGF in glioma and the role of VEGF for in vivo growth of human glioma cells according to the stage of the tumor growth. MATERIALS AND METHODS: Replication-deficient adenoviral vector containing the VEGF cDNA in an antisense orientation (Ad5CMV-alphaVEGF) were constructed to increase the in vivo applicability of antisense sequence. The effect of Ad5CMV-alphaVEGF was studied in vitro and in vivo with human glioma cell line U-87 MG. Immunohistochemical staining of the subcutaneous tumor with anti-VEGF antibody and CD34 antibody were performed to compare VEGF protein expression and the microvessel count respectively. RESULTS: The growth curve of U-87 MG cells treated with Ad5CMV-alphaVEGF remained as same as that of mock-infected and Ad5(dl312)-infected U-87 MG cells in vitro, suggesting that Ad5CMV-alphaVEGF does not have direct cytotoxic effect. The growth of subcutaneous human glioma xenografts was inhibited by early intratumoral injection of Ad5CMV-alphaVEGF. Immuno histochemical staining of tumors showed that VEGF protein expression and mean microvessel counts were decreased in early Ad5CMV-alphaVEGF treatment group. CONCLUSION: The efficient down-regulation of VEGF produced by tumor cells using Ad5CMV- alphaVEGF in early stage of glioma growth has an antitumor effect in vivo through antiangiogenic mechanism.
Adenoviridae ; Cell Line ; DNA, Complementary ; Down-Regulation ; Genetic Therapy* ; Glioblastoma* ; Glioma ; Heterografts ; Humans ; Microvessels ; Vascular Endothelial Growth Factor A

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

OBJECTIVE: Gastric carcinoma is one of the most common cause of death in Korea with limited effectiveness of chemotherapy. Thymidylate synthase(TS) is a critical therapeutic target for the fluoropyrimidine cytotoxic drugs, that are the mainstay of the treatment for the advanced gastrointestinal malignancies. We assessed the relationship between the levels of TS expression and survival and effect of 5-fluorouracil based chemotherapy in gastric adenocarcinoma. METHODS: Thirty six patients with gastric adenocarcinoma who underwent curative resection of stomach at Ewha Womans University Hospital were evaluated. TS protein expression in tumor tissues was assessed by standard immunohistochemical staining techniques with TS 106 monoclonal antibody. RESULTS: TS expression was high(3+) in 19 patients (52.8%) and low(< or =2+) in 17 patients(47.2%). Between these two groups, there was no significant difference in the histopathologic type or stage. Seventy-two point five percent of patients with low TS expression were disease free at 5 years compared with 58.2% of patients with high TS expression(p=0.31) and 73.7% of patients with low TS expression were alive at 5 years compared with 61.4% of patients with high TS expression(p=0.34). In patients with high TS expression, disease-free survival (DFS) and overall survival(OS) of patients who received adjuvant chemotherapy were longer than those of patients with surgery alone without significance(p=0.28, p=0.16). CONCLUSIONS: We could not confirm the association between the level of TS expression in tumor tissues and DFS and OS of patients with gastric adenocarcinoma who underwent curative resection. Further study with more cases as well as prospective study will be necessary for establishment of relationship between TS expression of tumor and prognosis of gastric adenocarcinoma
Adenocarcinoma* ; Cause of Death ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Female ; Fluorouracil ; Humans ; Korea ; Prognosis* ; Stomach ; Thymidylate Synthase*

Arachnoid cyst of the cavernous sinus is very rare. When present, its anatomic location frequently gives rise to cranial nerve palsy. We report a case of arachnoid cyst of the cavernous sinus in a 38-year-old man with impaired eyeball movement and diplopia.
Adult ; Arachnoid Cysts ; Arachnoid* ; Cavernous Sinus* ; Cranial Nerve Diseases ; Diplopia ; Humans

Gastrointestinal system involvement is one of the principal complications seen in the recipients of hematopoietic stem cell transplantation (HSCT), and it is also a major cause of morbidity and death in these patients. The major gastrointestinal complications include typhlitis (neutropenic enterocolitis), pseudomembranous enterocolitis, viral enteritis, graft-versus-host disease, benign pneumatosis intestinalis, intestinal thrombotic microangiopathy, and post-transplantation lymphoproliferative disease. As these patients present with nonspecific abdominal symptoms, evaluation with using such imaging modalities as ultrasonography and CT is essential in order to assess the extent of gastrointestinal involvement and to diagnose these complications. We present here a pictorial review of the imaging features and other factors involved in the diagnosis of these gastrointestinal complications in pediatric HSCT recipients.
Child ; *Diagnostic Imaging ; Gastrointestinal Diseases/*diagnosis/*etiology ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Humans

This study reports a case who presented with swallowing difficulty after orthognathic surgery. A female patient, who had undergone orthognathic surgery for esthetic purpose, presented with dysphagia. Administration of botulinum toxin injection to the cricopharyngeus muscle did not relieve or improve the severe dysphagia. The patient required nasogastric tube feeding for about three months. Swallowing ability was recovered after daily rehabilitation therapy and prescribing pyridostigmine. Injuries to the suprahyoid muscles (involved in laryngeal elevation during the pharyngeal phase of swallowing) during orthognathic surgery, and the inadvertent dissemination of inadequately injected botulinum toxin to adjacent muscles, are possible mechanisms of the severe dysphagia experienced by this patient. The authors also reviewed literature on the prevention and management of dysphagia following the orthognathic surgery.

PURPOSE: To demonstrate the mammographic and sonographic appearances of metaplastic carcinoma of the breast. MATERIALS AND METHODS: The mammographic and sonographic findings in eight female patients (aged: 28-78 years, mean: 50.3 years) with pathologically proven metaplastic cancer were analyzed retrospectively by three radiologists. We analyzed the size, density, shape, margin, associated architectural distortion, calcification in the mass and enlarged lymph node at the axilla, on the mammograms. We also analyzed the shape, margin and echogenicity of the lesions on the sonograms. RESULTS: On mammography, irregular (n=4), lobular (n=2) or oval (n=2) shaped high density masses were found. The margins of the masses were indistinct (n=4) or obscured (n=3). There were architectural distortions in three cases and pleomorphic calcifications in two cases. On sonography, irregular (n=5) or oval (n=3) shaped masses with microlobulated margins were found. The echopatterns of the masses were complex (n=5) or hypoechoic (n=3). CONCLUSION: The mammographic and sonographic findings of metaplastic carcinoma of the breast are nonspecific and similar to those of other forms of breast cancer. However, this type of tumor should be included in the differential diagnosis for breast masses which appear as an irregular or oval shape with a microlobulated margin and a complex or hypoechoic echopattern on sonography.
Axilla ; Breast Neoplasms ; Breast* ; Diagnosis, Differential ; Female ; Humans ; Lymph Nodes ; Mammography ; Retrospective Studies ; Ultrasonography*

Hirschsprung's disease (HD) is one of the most common cause of intestinal obstruction in neonates. Enterocolitis is a well known complication of HD. Since a severe form of enterocolitis occurring in HD is the major cause of death and disability of these patients, early diagnosis is essential. Recently, ischemic hemorrhagic necrotizing enterocolitis have been reported as lethal complications of HD. However little distinction is made between inflammatory enterocolitis which often follows HD and hemorrhagic ischemic necrotizing enterocolitis, which is a rare, and often fatal complication of HD. Most of reported cases of hemorrhagic necrotizing enterocolitis developed very early, generally within 3 days of birth except several cases. Which may be confused with necrotizing enterocolitis (NEC) which was not associated with HD. We report here two cases of hemorrhagic necrotizing enterocolitis associated with Hirschsprung's disease, who were initially diagnosed as having NEC.
Cause of Death ; Early Diagnosis ; Enterocolitis ; Enterocolitis, Necrotizing* ; Hirschsprung Disease* ; Humans ; Infant, Newborn ; Intestinal Obstruction ; Parturition