No abstract available.
Alzheimer Disease ; Dementia ; Humans ; Venous Thrombosis

Diffuse or focal white matter hyperintensity lesions on MRI have been reported in only a few patients with Hashimoto's encephalopathy (HE), and anti-TPO antibody level is high in most cases. We report a 59-year-old woman who presented with acute onset of disorientation with confusion. Anti-thyroglobulin antibody was detected in high titer, although anti-TPO antibody titer was not high. Thyroid sonography and biopsy revealed Hashimoto's thyroiditis. Initial fluid-attenuated inversion recovery (FLAIR) image and diffusion-weighted imaging (DWI) revealed ill-defined, diffuse, high-signal intensity lesions on the deep white matters and globus pallidus. Brain SPECT showed significant hypoperfusion in both basal ganglia (especially globus pallidus), frontal and temporal lobes. With the impression of HE, the patient was treated on a high-dose steroid. Over the next 15 weeks, her cognition improved to a nearly normal state and the MRI findings on DWI and FLAIR showed resolution paralleling her clinical improvement. Our case illustrates the peculiar changes in the MR findings, especially in DWI, with hypoperfusion on brain SPECT in patients with HE and allows for a greater understanding of the pathophysiology of HE.
Autoantibodies ; Basal Ganglia ; Biopsy ; Brain ; Brain Diseases ; Cognition ; Female ; Globus Pallidus ; Hashimoto Disease ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Temporal Lobe ; Thyroid Gland ; Thyroiditis ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Base Sequence ; Benzamides/therapeutic use ; Bone Marrow/pathology ; Female ; Fusion Proteins, bcr-abl/*genetics ; Humans ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy/*genetics ; Middle Aged ; Philadelphia Chromosome ; Piperazines/therapeutic use ; Protein Kinase Inhibitors/therapeutic use ; Pyrimidines/therapeutic use ; Sequence Analysis, DNA ; Thiazoles/therapeutic use ; Translocation, Genetic

A congenital hepatoportal arteriovenous fistula associated with an intrahepatic portal vein aneurysm is a rare type of arteriovenous malformation. Only 14 pediatric cases have been reported to the best of the authors' knowledge. An intrahepatic shunt between the portal and systemic veins is also relatively rare. We report a case of a congenital hepatoportal arteriovenous fistula associated with an intrahepatic portal vein aneurysm and a portohepatic venous shunt in a neonate who presented with tachypnea and melena.
Aneurysm* ; Angiography ; Arteriovenous Fistula* ; Arteriovenous Malformations ; Humans ; Infant, Newborn ; Melena ; Portal Vein* ; Tachypnea ; Veins

PURPOSE: The purpose of this study was to evaluate the anti-tumoral effect of recombinant vaccinia virus (rVV) (Thymidine kinase (-)/GM-CSF (+)) that was administered as a US guided intratumoral injection in a rabbit model of hepatic VX2 carcinoma. MATERIALS AND METHODS: VX2 carcinoma was implanted in the livers of 12 rabbits. US was performed at every week interval to detect hepatic mass after the implantation of VX2 carcinoma. The accurate tumor size and volume was evaluated with CT when the tumor was detected on US. US guided injection of rVV (109 pfu/ml) was preformed in three rabbits, intravenous injection of the same dose of rVV was done in two rabbits and another seven rabbits that were without any treatment were selected as a control group. We evaluated the change of the hepatic tumor size and extrahepatic metastasis on serial CT. Tumor specimens were harvested from rabbits that were killed at 8 weeks after VX2 implantation. These tissues were histoimmuopathologically compared to each other (the virus injection group and the control group). The differences between these groups were statistically assessed with student t-tests. RESULTS: Tumor growth was significantly suppressed in the US guided injection group compared with the intravenous injection group or the control group (p< 0.01). The intravenous injection group showed statistically significant tumor suppression compared to the control group (p< 0.01) until 2 weeks after virus injection. Quantification of the pulmonary metastatic nodules was performed in view of both the number and volume. The average number or volume of the pulmonary metastatic nodules in the US injection group was much smaller than these in the control group. Histopathologically, the tumors of the US guided injection group showed less extensive necrosis than those of the control group. Immunohistochemically, the tumor of the US guided injection group showed more prominent infiltration of CD4 (+) and CD8 (+) lymphocytes than did the tumors of the other group. CONCLUSION: rVV was markedly effective in suppressing hepatic tumor growth and extrahepatic metastasis in a rabbit model of hepatic VX2 carcinoma. US guided intra-tumoral injection was more effective than systemic intravenous injection.
Humans ; Injections, Intravenous ; Liver ; Lymphocytes ; Necrosis ; Neoplasm Metastasis ; Phosphotransferases ; Rabbits ; Vaccinia virus* ; Vaccinia*

OBJECTIVE: To evaluate the early clinical experience associated with radiofrequency (RF) ablation in patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: The RF ablation treatment was performed on 17 tumors from 16 patients (mean age, 60.5 years; range, 43-73 years) with RCC. The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery. All tumors were treated by a percutaneous CT (n = 10), followed by an US-guided (n = 2), laparoscopy-assisted US (n = 2), and an open (n = 2) RF ablation. Furthermore, patients underwent a follow-up CT at one day, one week, one month, three and six months, and then every six months from the onset of treatment. We evaluated the technical success, technical effectiveness, ablation zone, benign periablation enhancement, irregular peripheral enhancement, and complications. RESULTS: All 17 exophytic tumors (mean size, 2.2 cm; range, 1.1-5.0 cm) were completely ablated. Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17-33 months). A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1). CONCLUSION: The RF ablation is an alternative treatment for exophytic RCCs and represents a promising treatment for some patients with small RCCs.
Adult ; Aged ; Carcinoma, Renal Cell/radiography/*surgery ; *Catheter Ablation/adverse effects ; Female ; Humans ; Kidney Neoplasms/radiography/*surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to compare the diagnostic performance of ultrasound (US) elastography and conventional B-mode US for discrimination between benign and malignant breast lesions. MATERIALS AND METHODS: During a 13-month period, 277 women with 335 sonographically visible breast lesions who were scheduled to undergo biopsy were examined with US elastography. Elastographic findings were classified as benign or malignant based on the area ratio, with 1.00 as the threshold. Findings on conventional B-mode US were classified according to the BI-RADS category, as follows: lesions of BI-RADS categories 2 and 3 were considered benign, while those in categories 4 and 5 were considered malignant. Statistical analysis included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and ROC curve analysis for comparison of the diagnostic performance of US elastography and conventional B-mode US. RESULTS: Of the 335 breast lesions, 85 (25.4%) showed malignancy on pathology. Findings on B-mode US showed malignancy in 264 (78.8%) and elastographic findings showed malignancy in 102 (30.4%). The sensitivity, specificity, PPV, NPV, and accuracy of B-mode US and elastography were 98.8%, 28.0%, 31.8%, 98.6%, and 79.4% and 69.4%, 81.2%, 57.8%, 88.8%, and 79.4%, respectively. Elastography showed significantly higher specificity and PPV and lower sensitivity and NPV, compared with B-mode US (p < 0.001). The area under the ROC curve (AUC value) was 0.761 for elastography, and 0.634 for B-mode US (p < 0.001). CONCLUSIONS: US elastography can improve specificity and PPV of B-mode US, but with significant sacrifice of sensitivity and NPV. Therefore, US elastography may complement B-mode US for differentiation of breast masses.
Biopsy ; Breast ; Complement System Proteins ; Discrimination (Psychology) ; Elasticity Imaging Techniques ; Female ; Humans ; ROC Curve ; Sensitivity and Specificity