The venous malformation in head and neck is a developmental vascular disease which arises from the arrest in the certain stage of vascular embryogenesis. However, the lesion extends along the fascia and has a tendancy to recur after incomplete therapy. Retrospectively, the authors reviewed radiologic studies of 20 patients diagnosed as venous malformation during the last 5 years. The diagnosis was verified by histopathology (5 patients) and direct puncture angiography (15 patients). The radiologic studies included. CT with intravenous contrast injection (20 patients), RI angiography with 99m Tc-pyrophosphate (6 patients), and direct puncture angiography (15 patients). Multiplicity of venous malformation was noted in 9 patients. On CT scan, the lesions had lobulated irregular shape, with heterogeneous appearance, showed delayed enhancing characteristics, and had the phleboliths(21 lesions). The venous malformations were located at the masticator space (including masseter muscle) (n=12), retrobulbar space(n=6), submandibular space(n=4), paravertebral space(n=3) and so on. In two cases, the lesions were very extensive involving entire neck and parapharynx. On RI angiography using 99mTc-pyrophosphate, all of the lesions showed persistent and delayed uptake. With direct punture angiography the lesions could be classified as acinar pattern (n=17) and mixed pattern (acinar and saccular) (n=2). Venous connections were noted in 10 lesions. In conclusion, if a soft tissue mass on head and neck shows a heterogeneous attenuation density with or without calcified phlebolith on CT scan, RI angiography is recommended as a next diagnostic study. If it shows delayed persistent uptake, venous malformation can be suspected. Finally direct puncture angiography can verify the nature and extent of the lesions.
Angiography ; Diagnosis* ; Embryonic Development ; Fascia ; Female ; Head* ; Humans ; Neck* ; Pregnancy ; Punctures ; Retrospective Studies ; Technetium Tc 99m Pyrophosphate ; Tomography, X-Ray Computed ; Vascular Diseases

PURPOSE: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). MATERIALS AND METHODS: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: 49.1+/-10.8). RESULTS: Eighteen lesions of primary HPT consisted of 13 adenomas and 5 hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). CONCLUSION: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.
Adenoma ; Diagnosis ; Humans ; Hyperparathyroidism, Primary ; Hyperparathyroidism, Secondary* ; Hyperplasia ; Parathyroid Glands ; Radionuclide Imaging* ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.
Hemangioma* ; Liver* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Hemangioma* ; Liver* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: The appearance of multiple-drug-resistant Mycobacterium tuberculosis strains has been seriously compromising successful control of tuberculosis. Rifampin-resistance, caused by mutations in the rpoB gene, can be indicative of multiple-drug-resistance, and its detection is of great importance. The present study aimed to develop an oligonucleotide chip for accurate and convenient screening of drug-resistance. METHODS: In order to detect point mutations in the rpoB gene, an oligonucleotide chip was prepared by immobilizing specific probe DNA to a microscopic slide glass by a chemical reaction. The probe DNA that was selected from the 81 bp core region of the rpoB gene was designed to have mutation sites at the center. A total of 17 mutant probes related to rifampin-resistance including 8 rifabutin-sensitive mutant probes were used in this study. For accurate determination, wild type probes were prepared for each mutation position with an equal length, which enabled a direct comparison of the hybridization intensities between the mutant and wild type. RESULTS: Mycobacterial genomic DNA from clinical samples was tested with the oligonucleotide chip and the results were compared with those of the drug-susceptibility test in addition to sequencing and INNO-LiPA Rif. TB kit test in some cases. Out of 15 samples, the oligonucleotide chip results of 13 samples showed good agreement with the rifabutin-sensitivity results. The two samples with conflicting result also showed a discrepancy between the other tests, suggesting such possibilities as existence of mixed strains and difference in drug-sensitivity. Further verification of these samples in addition to more case studies are required before the final evaluation of the oligonucleotide chip can be made. CONCLUSION: An oligonucleotide chip was developed for the detection of rpoB gene mutations related to drug-susceptibility. The results to date show the potential for using the oligonucleotide chip for accurate and convenient screening of drug-resistance to provide useful information in antituberculosis drug therapy.
DNA ; Drug Therapy ; Glass ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Point Mutation* ; Rifabutin ; Rifampin ; Tuberculosis

PURPOSE: In order to determine the effect of neuronal nitric oxide synthase(nNOS) in seizure-related neuronal vulnerability of the hippocampus, the expression patterns of nNOS were examined in pentylenetetrazole(PTZ)-induced seizure groups and in PTZ seizure groups which were pretreated with nNOS inhibitors. METHODS: Male Sprague-Dawley rats weighing 200-300 g were used in PTZ(40 mg/kg)-induced seizure experiments. A specific inhibitor, 50 mg/kg 7-nitroindazole(7-NI), and a non-specific inhibitor, 50 mg/kg nitro-L-arginine(L-NA) were treated 30 min before the administration of PTZ to block nNOS. nNOS expression was evaluated by using immunohistochemical staining in the hippocampus of each group. RESULTS: The onset time of the first myoclonic jerk was markedly delayed in the 7-NI and the L- NA pretreated groups in comparison to the PTZ group. In addition, 7-NI markedly suppressed the severity of PTZ-induced seizures. The expression of nNOS in the hippocampal CA3 area was higher than that in CA1 area in the PTZ treated groups. In the L-NA pretreated groups, the expression levels in the CA3 and CA1 areas were lower than those of the PTZ treated groups. Interestingly, in the 7-NI pretreated groups, the nNOS expression levels in CA1 and CA3 areas were makedly lower than those of PTZ and L-NA pretreated groups. There was no expression in CA2 area of all groups. CONCLUSION: These results suggest that the hippocampal neurons expressing nNOS may be vulnerable to PTZ-induced seizures and that nNOS may play an important role in seizure-related neuronal vulnerability.
Animals ; Hippocampus* ; Humans ; Immunohistochemistry ; Male ; Myoclonus ; Neurons* ; Nitric Oxide ; Nitric Oxide Synthase Type I* ; Pentylenetetrazole ; Rats* ; Rats, Sprague-Dawley ; Seizures*

BACKGROUND: Lidocaine is a well known antiarrhythmic agent. However, recent reports indicate that indocaine has myocardial protective effects on acute myocardial ischemia and reperfusion. The exact mechanism of myocardial protection of lidocaine is still not clearly understood. In this study we intended to assess the effects of lidocaine on high energy phosphate metabolism in cats subjected to myocardial ischemia-reperfusion by using 31P MR spectroscopy. Effect of lidocaine on size of infarct will also be evaluated by 2, 3, 5-triphenyltetrazolium chloride(TTC) staining. METHODS: Twenty-seven cats were used for this study. The animals were divided into three groups : for group 1(n=10) and group 2(n=7), animals were subjected to a 90 min of LAD occlusion followed by a 90 min of reperfusion ; for group 3(n=10), a 20 min of occlusion followed by a 90 min of reperfusion. In group 2 and group 3, lidocaine(5mg/kg/hr) was infused continuously during the occlusion and reperfusion periods with an initial bolus injection(1mg/kg) before ligation of LAD. In-vivo MR spectroscopy was performed on a 4.7T Biospec System(Bruker, Switzerland). A home-made surface coil(diameter : 1.5cm) was used to receive31p signals from the myocardium underwent ischemic and reperfusion damage. RESULTS: Decrease of PCr during ischemic period was not different between each groups : PCr showed less than 30% of the baseline value at L-30 in group 1 and group 2 and at L-20 in group 3. More than 90% recovery of PCr was achieved at R-30 in group 2 and group 3, whereas less than 50% of PCr was recovered in group 1. Decrease of ATP during ischemic period was less pronounced in group 2 than in group 1 : in group 2 ATP depleted down to 25% of the baseline at L-90, whereas in group 1 ATP decreased to 50% of the baseline. Recovery of ATP during reperfusion period was not signiflcant in all three groups. On TTC staining, evidence of infarct was seen in all cases of group 1 : the area of infarct was 12.3+/-2.7% of the left ventricular mass and 23.9+/-6.1% of the area at risk. On the contrary, there was no evidence of infact in any case of group 2 and group 3. CONCLUSION: In this study, we found that lidocaine has myocardial protecitve effects on ischemia-reperfusion in cats. Lidocaine improves high energy phosphorous metabolism during ischemia and reperfusion as well as reduces infarct size.
Adenosine Triphosphate ; Animals ; Cats* ; Ischemia ; Lidocaine* ; Ligation ; Magnetic Resonance Spectroscopy ; Metabolism ; Myocardial Ischemia ; Myocardium ; Polymerase Chain Reaction ; Reperfusion ; Reperfusion Injury

Pulmonary artery sling is a rare vascular anomaly in which the left pulmonary artery arises from the right pulmonary artery and then traverses between the esophagus and the trachea toward the hilum of the left lung. Despite the availability of a corrective operation, the mortality rate remains very high due to the high incidence of associated obstructive anomalies of tracheobronchial trees. We experienced a 8 month old female infant who was admitted because of recurrent pneumonia and expiratory wheezing. She was diagnosed as pulmonary sling by esophagography, echocardiography, computed tomography. We report this with a brief review and related literature.
Echocardiography ; Esophagus ; Female ; Humans ; Incidence ; Infant ; Lung ; Mortality ; Pneumonia ; Pulmonary Artery* ; Respiratory Sounds ; Trachea

Pancreatoblastoma has been described in children and characterized by unique histologic features and excellent clinical course. Ultrastructural and immunohistochemical studies of pancreatoblastoma reveal either exocrine alone or both endocrine and exocrine differentiation. We present two cases of pancreatoblastoma in children in which immunohistochemical and ultrastructural examination failed to demonstrate features of either enzyme or hormone production and which became worse in clinical course. We assume that pancreatoblastomas are tumors which differentiate more toward acinar or ductal elements than toward islet cell.
Carcinoma/*pathology/ultrastructure ; Child, Preschool ; Female ; Humans ; Pancreatic Neoplasms/*pathology/ultrastructure

BACKGROUND: Neuronal cell death after brain ischemia occurs predominately by necrosis, whereas only a minor fraction of cell death may occur through apoptosis. Authors investigated DNA fragmentation and apoptotic morphology in the brain cell to determine whether apoptosis contributes to the progression of an ischmic lesion. This study was conducted to determine the effects of dexamethasone and hypothermia on moderate brain ischemic injury by middle cerebral artery occlusion (MCAO) in rats. METHODS: Thirty Sprague-Dawley rats (220 - 280 g) were used. Anesthesia was induced and maintained with isoflurane in oxygen. MCAO was induced by intraluminal monofilament nylon. All rats were divided randomly into three groups. In group I (n = 10), normal saline 1 ml was injected intravenously 10 minutes before MCAO. In group II (n = 10), dexamethasone 3 mg/kg was administered and in group III (n = 10), body temperature was maintained at 32degreesC. After 60 minutes of MCAO, all rats that recovered from anesthesia were returned to cages. After 24 hour reperfusion, brain tissue was quickly removed and cerebral hemispheres were separated. Lesion volumes were measured by TTC staining. TUNEL reactivity was examined in the cortical infarction lesion, and rat brain DNA was run on agarose gel electrophoresis to detect DNA fragmentation. RESULTS: Apoptosis and DNA fragmentation in the nucleus developed in the hippocampal area after transient ischemia in rats. Dexamethasone did not prevent the development of apoptosis and DNA fragmentation in transient brain ischemic rats. Moderate hypothermia could prevent the development of apoptosis and DNA fragmentation in transient brain ischemic rat. CONCLUSIONS: Apoptosis may represent a mode of ischemic cell death, and dexamethasone couldn't prevent apoptotic change in the ischemic brain insult. Moderate hypothermia (32degreesC) was a specifically effective procedure to reduce the development of apoptotic change in ischemic insults.
Anesthesia ; Animals ; Apoptosis* ; Body Temperature ; Brain ; Brain Ischemia ; Cell Death ; Cerebrum ; Dexamethasone ; DNA Fragmentation* ; DNA* ; Electrophoresis, Agar Gel ; Hypothermia* ; In Situ Nick-End Labeling ; Infarction ; Infarction, Middle Cerebral Artery ; Ischemia ; Isoflurane ; Necrosis ; Neurons ; Nylons ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion