Intramural dissection of the esophagus is rare esophageal disorder which has been seen predominantly in women in their seventh or eighth decade and presents as acute chest pain, accompanied by dysphagia. The etiology of this disorder remain uncertain and the diagnosis is made by esophageal endoscopy, contrast esophagography, or both. Patient with this disorder is best managed conservatively with nothing by mouth and intravenous hydration.
Chest Pain ; Deglutition Disorders ; Diagnosis ; Endoscopy ; Esophageal Diseases ; Esophagus ; Female ; Humans ; Middle Aged* ; Mouth

BACKGROUND: Color Doppler echocardiography is sensitive in detecting mitral regurgitation and useful in quantitating its severity. The presence of an eccentric regurgitant jet suggests that regurgitation is caused by prolapsing or flail leaflet of mitral valve. Until recently the direction of regurgitant jet in mitral valve prolapse has been examined in a single(parasternal short axis view) or orthogonal plane using color Doppler echocardiography, and few in the apical rotation method of a transducer. The purpose of this study was to clarify the usefullness of the apical rotation method of a transducer in detection of the direction of mitral regurgitant jet and diagnosis of the sites of mitral valve prolapse. METHODS: Twenty four patients(8 men and 16 women, mean age:47.3+/-18.8 years) with mitral valve prolapse with eccentric regurgitant jet were examined by two-dimensional and color Doppler echocardiograply using conventional parasternal long and short axis views, and four apical longitudinal planes(four chamber, vertical, two chamber and transverse views) obtained by the apical retation method of a transducer. RESULTS: Thirty one regurgitant jets were detected in twenty four patients, eighteen patients had anterior, nine patints posterior, and three patients bi-leaflet(anterior and posterior) prolapse. In eighteen patients with anterior leaflet prolapse, ten had medial, eight had middle, three had lateral, and three had two portions(two, medial and middle; one, middle and lateral) prolapse. In nine patients with posterior leaflet prolapse, five had medial, three had middle, two had lateral, and one had two(medial and middle) scallop prolapse. CONCLUSION: Color Doppler echocardiography by the apical rotation method of transducer is useful in assessment of the site of prolapse in patients with mitral valve prolapse with eccentric regurgitation.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler, Color ; Female ; Humans ; Male ; Mitral Valve Insufficiency ; Mitral Valve Prolapse* ; Mitral Valve* ; Pectinidae ; Prolapse* ; Transducers*

Axin is a negative regulator of the Wnt/beta-catenin pathway and is involved in the regulation of axis formation and proliferation. Involvement of Axin in the regulation of other signaling pathways is poorly understood. In this study, we investigated the involvement of Akt in growth regulation by Axin in L929 fibroblasts stimulated by EGF. Akt activity was increased by EGF treatment and Ras activation, respectively. Both the EGF- and Ras-induced Akt activations were abolished by Axin induction, as revealed by both Western blot and immunocytochemical analyses. The proliferation and Akt activation induced by EGF were decreased by Axin induction, and the effects of EGF were abolished by treatment of an Akt-specific inhibitor. Therefore, Axin inhibits EGF-induced proliferation of L929 fibroblasts by blocking Akt activation.
Animals ; Cell Line ; Cell Nucleus/metabolism ; Cell Proliferation ; Epidermal Growth Factor/*pharmacology ; Fibroblasts/drug effects/physiology ; Mice ; Proto-Oncogene Proteins c-akt/antagonists & inhibitors/*metabolism ; Repressor Proteins/genetics/*physiology ; Signal Transduction ; ras Proteins/biosynthesis/genetics

Myxomas are benign mesenchymal neoplasms composed of undifferentiated stellate cells in the myxoid stroma and can affect the heart, subcutaneous tissues, bone and skin. Myxomas arising from muscle tissue are called intramuscular myxomas, and account for 17% of all myxomas. Intramuscular myxomas are most commonly located in the large muscles of the thigh, shoulder, and buttocks.However, intramuscular myxomas of the head and neck region are rarely reported. In this study, we report a case of intramuscular myxoma arising from the paraspinal space of the head and neck region.
Head ; Head and Neck Neoplasms ; Heart ; Muscle Neoplasms ; Muscles ; Myxoma ; Neck ; Shoulder ; Skin ; Subcutaneous Tissue ; Thigh

No abstract available.
Lymphoma*

BACKGROUND/AIMS: Endoscopic ultrasound elastography (EUS-EG) has been widely used for the evaluation of pancreatic cancer in the Western world. To date, there is very little experience with EUS-EG in Korea. We described the results of comparison between normal pancreas and pancreatic cancer in Korea. METHODS: The present study was performed at a tertiary hospital on 35 subjects comprising 20 with normal pancreas (control group) and 15 with pancreatic cancer (disease group). We compared the EUS-EG performance of the two groups. RESULTS: The pancreas in the control group showed a mean elasticity value of 0.53% (95% confidence interval [CI], 0.45 to 0.61). The elasticity value was higher than that previously reported from Western country (0.47%; 95% CI, 0.38 to 0.57). In the disease group, the mean elasticity value of pancreatic lesions was 0.02% (95% CI, 0.01 to 0.02). The mean elasticity value of the disease group was significantly lower than that of the control group (p<0.0001). CONCLUSIONS: EUS-EG could be a highly sensitive diagnostic modality for pancreatic cancer in Korea with little EUS-EG experience. We also provided the reference range of elasticity value of normal pancreas, which might be valuable in the interpretation of pancreatic elasticity data for Korean adults.
Adult ; Elasticity ; Elasticity Imaging Techniques ; Endosonography ; Humans ; Korea ; Pancreas ; Pancreatic Neoplasms ; Reference Values ; Tertiary Care Centers ; Western World

Candida lipolytica is also called Yarrowia lipolytica, and this is now microbiologically classified as a member of the Yarrowia genus. Y. lipolytica is a rare opportunistic pathogen that was first isolated in 1976 from a patient with traumatic ocular candidiasis. Five cases of infant patients were reported in 2000 in Korea for the first time, and then in 2001 a case was reported from an AML patient. No more cases have been reported since then. The authors experienced the case of a patient with blood culture positivity for Y. lipolytica and this patient had a previous history of raw beef ingestion and long term antibiotics therapy. Thus, we report on this case along with a review of the literature.
Anti-Bacterial Agents ; Candidiasis ; Eating ; Fungemia ; Humans ; Infant ; Korea ; Yarrowia

Pilomatricoma is a rare benign neoplasm arising from the outer sheath of hair follicles. A firm, freely movable, and well-circumscribed subcutaneous nodule is a characteristic clinical feature of pilomatricoma. Diagnosis is usually based on clinical features, and surgical excision is performed without the use of imaging. Radiological evaluation has been used primarily as a means for differentiating pilomatricoma from other tumors or inflammatory conditions and also for examining unusually large or aggressive tumors. As a result it is important to be familiar with radiological characteristics of pilomatricoma. In this report, three cases of pilomatricoma from a pool of 28 pathologically confirmed cases are examined. Characteristic radiological findings of pilomatricoma are well-defined, oval shaped subcutaneous nodules adherent to the overlying skin with various amounts of calcification on plain radiography, CT scan, and ultrasound.
Diagnosis ; Hair Follicle ; Pilomatrixoma* ; Radiography ; Skin ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: This is study of whether 3-D conformal radiotherapy for carcinomas of the ethmoid sinus were better than those treated with conventional 2-D plan. MATERIALS AND METHODS: The 3-D conformal treatment plans were compared with conventional 2-D plans in 4 patients with malignancy of the ethmoid sinus. Isodose distribution, dose statistics, and dose volume histogram of the planning target volume were used to evaluate differences between 2-D and 3-D plans. In addition, the risk of radiation exposure of surrounding normal critical organs are evaluated by means of point dose calculation and dose volume histogram. RESULTS : 3-D conformal treatment plans for each patient that the better tumor coverages by the planning target volume with improved dose homogeneity, compared to 2-D conventional treatment plans in the same patient. On the other hand, the radiation dose distributions to the surrounding normal tissue organs, such as the orbit and optic nerves are not significantly reduced with our technique, but a substantial sparing in the brain stem and optic chiasm for each patient. CONCLUSION : Our findings represented the potential advantage of 3-D treatment planning for dose homogeniety as well as sparing of the normal tissue surrounding the tumor. However, further investigational studies are required to define the clinical benefit.
Brain Stem ; Ethmoid Sinus* ; Hand ; Humans ; Optic Chiasm ; Optic Nerve ; Orbit ; Radiotherapy, Conformal*

PURPOSE: Diffusion-weighted MRI (DWI) is well known to be sensitive in the detection of hyperacute infarct, but has not been systematically investigated in patients with acute or subacute infarct. We evaluated the usefulness of diffusion-weighted MRI in assessing the various stages of brain infarct. MATERIALS AND METHODS: Fifty-five consecutive patients with symptoms of brain infarct underwent fast spinecho T2-weighted MRI (T2W1) and DWI. Using only a brief clinical history, two radiologists first attemptelto detect the lesion using T2W1, which was then compared with DWI. The usefulness of the latter was then evaluated in terms of the following criteria: 1) Its abilility to detect a lesion not seen at T2WI (detection); 2) localization of the responsible ischemic focus among multiple high-signal intensities seen at T2WI (localization); 3) conspicuity of a lesion which was subtle at T2WI (conspicuity); 4) detection of multiple lesions (multiplicity). RESULTS: DWI was useful in 44 of 55 patients (80%), including 9 of 9 (100%) with hyperacute infarct (<6 hours), 20 of 27 (74%) with acute infarct (<48 hours), and 15 of 19 (79%) with subacute infarct (<2 weeks). Among the nine patients at the hyperacute stage, DWI was useful for detection of the lesion in six (67%), for localization, 4 (44%) in one (11%), for conspicuity in four (44%), and for multiplicity in five (56%); at the acute stage (20 patients), for detection in three (15%), for localization in ten (50%), for conspicuity in eight (40%), and for moltiplicity in five (25%); and at the subacute stage (15 patients), for detection in three (20%), for localization in nine (60%), for conspicuity in two (13%), and for multiplicity in three (20%). CONCLUSION: DWI is very sensitive for the diagnosis of hyperacute infarct. In the assessment of this, it is useful during the acute or subacute period for the detection of small lesions, the localization of ongoing lesions among multiple high signal intensities seen at T2WI, and the determination of lesion conspicuity.
Brain ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Stroke*