Methods for the identification and amplification of signals from quantities of intravascularly administered iodinated contrast agent and their combination with image subtraction have evolved into a clinically useful technique called digital subtraction angiography (DAS). The initial motivation for the development of DSA was the desire to replace standard conventional angiographic procedures with simpler, less invasive techniques. We have evaluated IV-DSA and IA-DSA which are made in 150 patients with clinically suspected intracranial diseases from Dec. 1983 to Mar. 1985. Comparison with IA-DSA and conventional angiography indicated that the quality and information of content of the film were equivalent. IV-DSA image quality was inferior to that of conventional angiography. But IV-DSA can be used for intracranial studies to evaluate results of surgery of aneurysm, AVM or tumor and to revaluate vasospasm after subarachnoid hemorrhage before surgery. Also, IV-DSA can be used for neck vessel appearance due to reveal adequate information.
Aneurysm ; Angiography ; Angiography, Digital Subtraction ; Humans ; Motivation ; Neck ; Subarachnoid Hemorrhage

The spinal schwannomas are the most common spinal cord tumors and they make some regressive changes such as necrosis, mucous or cystic degeneration, caseation or calcification occasionally. We experienced a case of intradural ossifying schwannoma in 17 years old male, which occurred in the 2nd 3rd thoracic region. On operative finding, it was a very hard, pinkish gray and bean sized mass, and it firmly adhered to the spinal cord. We found dark bluish necrotic changes at the adhered sites of the spinal cord. On microscopical finding it revealed multiple foci of myxoid degeneration and osseous metaplasia with fibromatosis structure in schwannoma.
Adolescent ; Fibroma ; Humans ; Male ; Metaplasia ; Necrosis ; Neurilemmoma* ; Spinal Cord ; Spinal Cord Neoplasms

PURPOSE: Recombinant ScFv lym-1 was produced, using pET vector system for large scale production. METHODS: ScFv lym-1 gene inserted pET-22b (+) vector, was expressed in E.coli BL-21 strain. ScFv lym-1 antibody extracted from periplasm, was purified with His-Taq column. To evaluated immunoreactivity with Raji cell, ScFv lym-1 was labeled with I-125 and I-125 ScFv lym-1 was purified with desalting column. Raji cell was injected into the C57BR/cdJ SCID mice. Gamma camera imaging were taken time point at 1, 8, 24, and 48 hr with 8 mm pinhole collimator. RESULTS: An active scFv lym-1 could be produced in E.coli with soluble from using pET vector system. Immunoreactivity and affinity constant of IgG lym-1 were 54% and 1.83 x 10(9) M(-1), respectively, and those of scFv lym-1 were 53.7% and 1.46 x 10(9) M(-1), respectively. Biodistribution of I-125 scFv lym-1 antibody showed faster clearance in blood, spleen, kidney and than I-125 IgG lym-1 antibody. Gamma camera image of I-125 scFv lym-1 antibody showed faster clearance and tumor targeting liver than I-125 IgG lym-1 antibody. CONCLUSIONS: In vitro properties of scFv lym-1 were similar to those of IgG lym-1. ScFv lym-1 showed faster blood clearance than IgG lym-1. These results suggest that scFv lym-1 antibody can be useful for tumor imaging agent.
Animals ; Gamma Cameras ; Immunoglobulin G ; Kidney ; Liver ; Lymphoma* ; Mice ; Mice, SCID ; Periplasm ; Radionuclide Imaging ; Spleen

No abstract available.
Acute Disease ; Biopsy ; Fatal Outcome ; Female ; Fluorescent Antibody Technique ; Glomerulonephritis/*complications/diagnosis/drug therapy/immunology ; Humans ; Immunosuppressive Agents/therapeutic use ; Microscopic Polyangiitis/*complications/diagnosis/drug therapy/immunology ; Middle Aged ; Pancreatitis/diagnosis/drug therapy/*etiology/immunology ; Treatment Outcome

Retroperitoneal fibrosis (RPF) is a rare disease characterized by the presence of fibroinflammatory tissue around the abdominal aorta and ureteral entrapment in most cases. Idiopathic RPF is frequently reported in association with autoimmune diseases; however, there have been few reports of idiopathic RPF associated with Hashimoto's thyroiditis. Here, we report a case of idiopathic RPF with Hashimoto's thyroiditis in a patient with a single functioning kidney, which was successfully treated by corticosteroid therapy and transient intraureteral stent insertion with a double-J catheter.
Aorta, Abdominal ; Autoimmune Diseases ; Catheters ; Humans ; Kidney* ; Rare Diseases ; Retroperitoneal Fibrosis* ; Stents ; Thyroid Gland* ; Thyroiditis* ; Ureter

Metformin, a dimethylbiguanide, is an oral antihyperglycemic drug used in treatment of type 2 diabetes mellitus. It has been reported that metformin may be associated with lactic acidosis in patients with clinical conditions such as renal failure and heart failure. Metformin-associated lactic acidosis (MALA) is a rare, but serious complication with a mortality rate of approximately 30~50%. Therefore, an aggressive treatment strategy including hemodialysis is recommended for these patients. Although continuous renal replacement therapy (CRRT) has been administered in hemodynamically unstable patients with MALA, there are few case reports describing the use of CRRT as a therapeutic modality in Korea. Here, we describe the case histories of two MALA patients who underwent treatment with CRRT.
Acidosis ; Acidosis, Lactic* ; Diabetes Mellitus, Type 2 ; Heart Failure ; Humans ; Korea ; Metformin ; Mortality ; Renal Dialysis ; Renal Insufficiency ; Renal Replacement Therapy

BACKGROUND/AIMS: Submucosal tumors of the esophagus are rare lesions among all esophageal neoplasms. The purpose of this study was to evaluate the clinicopathologic features of esophageal submucosal tumors treated by surgical approach. METHODS: We analyzed the clinicopathologic and endoscopic ultrasonographic features of 18 esophageal submucosal tumors which were treated by surgical approach at Boramae Medical Center and Seoul National University Bundang Hospital from January 2005 to June 2012. RESULTS: The mean age was 48.9 years old and male to female ratio was 2.6:1. Asymptomatic patients were most common (77.8%). In endoscopic ultrasonographic finding, the majority tumor arouse in the middle (55.6%) and lower (44.4%) esophagus, and appeared as hypoechoic lesion (72.2%) in the 4th layer (83.3%). The most common indication for surgical approach was unclear biological behavior of the tumor. Minimally-invasive technique using thoracoscopy was applied for the enucleation (83.3%). The mean diameter of the tumor was 5.4 cm, and the final diagnosis was leiomyoma (89.9%) and gastrointestinal stromal tumor (11.1%). CONCLUSIONS: Leiomyoma was the most common submucosal tumor in esophagus. However, endoscopic ultrasonography was not able to differentiate between leiomyoma and gastrointesinal stromal tumor. For more accurate diagnosis and treatment, minimally-invasive approaches may be suitable for the surgical enucleation of indicated esophageal submucosal tumor.
Adult ; Aged ; Esophageal Neoplasms/*pathology/*surgery/ultrasonography ; Esophagus/pathology ; Female ; Gastrointestinal Stromal Tumors/diagnosis/surgery ; Humans ; Intestinal Mucosa/*pathology ; Leiomyoma/diagnosis/surgery ; Male ; Middle Aged ; Retrospective Studies ; Thoracoscopy

Blunt chest trauma in intoxicated patients is very difficult to evaluate in the emergency medical center. Emergency physicians have difficulty figuring out the nature of the accident because the patients are frequently uncooperative. That is why we should always be cautious when evaluating intoxicated patients. Coronary artery dissection after blunt chest trauma is very rare, but delayed diagnosis can be lethal to the patient. We report a case of a27-year-old intoxicated male patient transferred to our emergency medical center after a motorcycle accident. After the primary survey, there were no severe external wounds, fractures or hemorrhages. We decided to monitor the patient in the observation unit until his mental status fully recovered. About two hours later, he complained of epigastric discomfort and dyspnea. His electrocardiogram showed ST segment elevation in leads I, aVL, V1- V4. Cardiac enzymes were also elevated. The coronary angiogram revealed a total occlusion of the proximal left anterior descending artery (LAD) and a dissecting flap was seen on intravascular ultrasonography. He recovered after successful stent insertion in the LAD lesion.
Arteries ; Coronary Vessels* ; Delayed Diagnosis ; Dyspnea ; Electrocardiography ; Emergencies ; Hemorrhage ; Humans ; Male ; Motorcycles ; Myocardial Infarction ; Stents ; Thorax* ; Ultrasonography, Interventional ; Wounds and Injuries

PURPOSE: Primary epiploic appendagitis (PEA) is a rare cause of focal abdominal pain and diagnosis is very infrequent, due in part to low or absent awareness among emergency physicians. The study evaluated clinical findings, laboratory data, and computed tomography (CT) findings of PEA to aid in early diagnosis. METHODS: All patients diagnosed with PEA between December 2005 and July 2010 at an emergency department were retrospectively reviewed. The diagnosis of PEA was made by two radiologists. Clinical findings, laboratory data, and CT findings of each patient were analyzed. A p value <0.014 was considered to indicate statistical significance. RESULTS: Fourteen patients (10 men and four women; average age: 38.2 years; range: 15~65 years) were diagnosed with PEA. Abdominal pain was localized in the left side (64%) and the initial impression was diverticulitis (11 patients, 79%). Except in one patient, all patients were afebrile and had no nausea or vomiting. Mean C-reactive protein level was slightly increased (0.90 mg/dL), and mean white blood cell count was 9,855/microL. CT findings in 12 patients consisted of an oval lesion with attenuation equivalent to that of fat and with surrounding inflammatory changes. The other two patients presented with only an oval lesion without surrounding inflammatory changes. All patients were treated conservatively. CONCLUSION: In patients with localized, acute abdominal pain not associated with other symptoms or signs such as nausea, vomiting, fever, or atypical laboratory values, PEA should be suspected.
Abdomen, Acute ; Abdominal Pain ; C-Reactive Protein ; Diverticulitis ; Emergencies ; Fever ; Humans ; Leukocyte Count ; Male ; Nausea ; Peas ; Retrospective Studies ; Vomiting

To investigate the neuroprotective effects of bovine colostrums (BC), we evaluate the ability of consuming BC after focal brain ischemia/reperfusion injury rat model to reduce serum cytokine levels and infarct volume, and improve neurological outcome. Sprague-Dawley rats were randomly divided into 4 groups; one sham operation and three experimental groups. In the experimental groups, MCA occlusion (2 h) and subsequent reperfusion (O/R) were induced with regional cerebral blood flow monitoring. One hour after MCAO/R and once daily during the experiment, the experimental group received BC while the other groups received 0.9% saline or low fat milk (LFM) orally. Seven days later, serum pro-inflammatory cytokine (IL-1beta, IL-6, and TNF-alpha) and anti-inflammatory cytokine (IL-10) levels were assessed. Also, the infarct volume was assessed by using a computerized image analysis system. Behavioral function was also assessed using a modified neurologic severity score and corner turn test during the experiment. Rats receiving BC after focal brain I/R showed a significant reduction (-26%/-22%) in infarct volume compared to LFM/saline rats, respectively (P < 0.05). Serum IL-1beta, IL-6, and TNF-alpha levels were decreased significantly in rats receiving BC compared to LFM/saline rats (P < 0.05). In behavioral tests, daily BC intake showed consistent and significant improvement of neurological deficits for 7 days after MCAO/R. BC ingestion after focal brain ischemia/reperfusion injury may prevent brain injury by reducing serum pro-inflammatory cytokine levels and brain infarct volume in a rat model.
Animals ; Brain ; Brain Injuries ; Colostrum ; Cytokines ; Eating ; Interleukin-6 ; Milk ; Neuroprotective Agents ; Rats ; Rats, Sprague-Dawley ; Reperfusion ; Salicylamides ; Tumor Necrosis Factor-alpha