PURPOSE: Differential diagnosis of solitary pulmonary nodule with cavity includes lung abscess, tuberculoma, bronchogenic carcinoma, metastasis and trauma, etc. We analyzed the CT appearance of tubercuioma presenting as a solitary pulmonary nodule with cavity and describe the findings which suggest tuberculoma in the differential dignosis of soliary pulmonary nodule with cavity. MATERIALS AND METHODS: 25 patients with solitary pulmonary nodule(diameter less than 4 cm) without surrounding parenchymal consolidation on chest radiograph, who had a cavity within the nodule on CT, were included in our study. Density of the nodule, maximal wall thickness, the character of inner and outer wall margin, location of cavity within the nodule, location of the nodule, presence or absence of satellite lesions and calcification were analyzed. RESULTS: Solitary tuberculoma with cavity showed maximal wall thickness more than 15 mm in 40%(10/25) and 5-14 mm in 56%(14/25), eccentric cavitation in 84%(21/25) and concentric cavitation in 16%(4/25), spiculated outer wall margin in 56%(14/15) and Iobulated margin in 32%(8/25), smooth inner wall margin in 60%(15/25) and nodular margin in 40%(10/25). CT density of the cavity wall compared with the chest wall muscle was low in 84%(21/25) and isodense in 16%(4/25). Accompanying satellite lesions were seen in 84% (21/25) and calcification was visible in 28%(7/25). CONCLUSION: The CT findings of solitary tuberculoma with cavity are relative peripheral location, eccentric cavitation, finely spiculated outer wall margin, and mean maximal wall thickness of 13.2 mm, which are also the common features of malignant nodule. However, relative low density of the nodule compared to the chest wall muscle and surrounding satellite lesions can be additional clues favoring solitary tuberculoma with cavity on CT.
Carcinoma, Bronchogenic ; Diagnosis, Differential ; Humans ; Lung Abscess ; Neoplasm Metastasis ; Radiography, Thoracic ; Solitary Pulmonary Nodule ; Thoracic Wall ; Tuberculoma*

BACKGROUND: There were many studies about the changes of cognitive or non-cognitive domain and behavioral and psychological symptoms with the progression of Alzheimer's disease. But they assessed the changes individually so could not explain comprehensively the global change of disease progression. Also they studied by clinical dementia rating scale(CDR) which could not successfully explain the latest stage. So we have evaluated the cognitive, non-cognitive domain and behavioral and psychological symptoms at the same time and evaluated the changes with the expanded clinical dementia rating scale. Also we evaluated the relationship of each scale and assessed sensitivity change at the different stage of disease. METHODS: Twenty-three mild cognitive impairment(MCI) subjects and eighty-seven patients with Alzheimer's disease were recruited. The Korean version of Mini-Mental State Examination(K-MMSE), the Korean version of the neuropsychiatric inventory(NPI), the Extended version of the Korean Clinical Dementia Rating Scale(CDR), the Activity of Daily Living(ADL), the Severe Dementia Scale(SDS) and the Short form of Samsung Dementia Questionnaire(S-SDQ) were performed. RESULTS: It was found that all of them were well correlated each other(r>-0.73 and p<0.05) except NPI. Physical activity of daily living(P-ADL) was most related to Korean version of instrumental activity of daily living(K-IADL) (r=0.86 and p<0.01), SDS to K-MMSE(r=0.93 and p<0.01) and S-SDQ to K-IADL(r=0.86 and p<0.01). P-ADL and S-SDQ revealed the ceiling effect at CDR 4 and K-IADL at CDR 3. CONCLUSION: The cognitive and non-cognitive function were declined according to disease progression. The changes of behavioral and psychological symptoms were relatively independent of cognitive function. SDS, P-ADL and CDR were proved to be more sensitive in advanced stage of dementia and K-IADL, S-SDQ were more adequate in milder stage of dementia or MCI.
Alzheimer Disease ; Dementia ; Disease Progression ; Humans ; Motor Activity

No abstract available.
Fetal Macrosomia*

PURPOSE: Ileus is the most common complication following radical cystectomy. Ileus causes prolonged fasting, significant patient discomfort and prolongation of the hospital stay. We retrospectively examined the risk factors for ileus following radical cystectomy MATERIALS AND METHODS: Between January, 2000 and June, 2007, 59 patients underwent radical cystectomy with urinary diversion at our institution. 30 patients underwent creation of an ileal conduit and 29 patients underwent orthotopic bladder substitution with using ileum. Ileus was defined as the persistent absence of flatus on postoperative day 7 or the generalized findings of ileus on simple abdominal film. The potential risk factors were analyzed between the ileus and non ileus groups, including the patient's age and gender, the American Society of Anesthesiologists score, the preoperative serum albumin level, prior abdominal surgery, the operative time, combined operation, the estimated blood loss, the type of urinary diversion, use of N2O, use of intestinal stapler, complications, the ICU stay and the pathologic stage and grade. RESULTS: 24%(14/59) of patients had postoperative ileus. The difference of the ASA score between the two groups was statistically significant (p=0.03). Patients with ileus(67.5+/-7.2) were older than the non-ileus patients(63.0+/-9.4)(p=0.103). Ileus was more frequent in men(29.5%, 13/ 44) than in women(6.6%, 1/15)(p=0.09). CONCLUSIONS: Ileus following radical cystectomy was more frequent in patients with a high ASA score. Older aged men tend to have ileus after radical cystectomy.
Cystectomy* ; Fasting ; Flatulence ; Humans ; Ileum ; Ileus* ; Intestinal Obstruction ; Length of Stay ; Male ; Operative Time ; Retrospective Studies ; Risk Factors* ; Serum Albumin ; Urinary Bladder ; Urinary Diversion

No abstract available.
Adenoma* ; Humans ; Pyelonephritis*

PURPOSE: PSMA (prostate specific membrane antigen) is a transmembrane glycoprotein, which is isolated from LNCaP. It is reported that PSMA is expressed in the vascular endothelium of various tumor. It has been suggested that PSMA can be related to angiogenesis. Herein, the effect of PSMA on angiogenesis was investigated with the HUVEC (human umbilical vein endothelial cell) line transfected with PSMA. MATERIALS AND METHODS: mRNA was extracted from LNCaP. RT-PCR for PSMA ORF (open reading frame) was performed. PSMA ORF cDNA was subcloned into PcDNA 3.1(-) (BamH1 and Xba1 site) and transfection of PSMA on HUVEC was performed. HUVEC was plated onto a Matrigel coated 6 well plate and incubated at 37oC in a CO2 incubator for 18 hours. The HUVEC tube formation was observed every 2 hours using an inverted microscope. HUVEC cell protein was extracted immediately, and 3 and 6 hours after transfection. Western blot for VEGF (vascular endothelial growth factor) was performed. RESULTS: The tube formation stage of HUVEC transfected with PSMA was observed 10 hours after incubation on Matrigel coating, whereas in the control HUVEC, the cord formation stage was observed after up to 10 hours incubation. The HUVEC transfected with PSMA showed an earlier tube formation stage than the control. Western blot analysis showed that PSMA transfection on HUVEC increased the expression of VEGF 2.5 fold in 3 hours and 1.89 fold in 6, as measured by densitometry. CONCLUSIONS: PSMA transfection on the HUVEC cell line induced an initial increase in the expression of VEGF, and subsequently stimulated an earlier tube formation in the HUVEC cell line. These data suggest PSMA is related to angiogenesis.
Animals ; Blotting, Western ; Densitometry ; DNA, Complementary ; Ecthyma, Contagious ; Endothelial Cells ; Endothelium, Vascular ; Glycoproteins ; Human Umbilical Vein Endothelial Cells ; Incubators ; Membranes* ; Prostate* ; RNA, Messenger ; Transfection ; Umbilical Veins ; Vascular Endothelial Growth Factor A

PURPOSE: PSMA (prostate specific membrane antigen) is a transmembrane glycoprotein, which is isolated from LNCaP. It is reported that PSMA is expressed in the vascular endothelium of various tumor. It has been suggested that PSMA can be related to angiogenesis. Herein, the effect of PSMA on angiogenesis was investigated with the HUVEC (human umbilical vein endothelial cell) line transfected with PSMA. MATERIALS AND METHODS: mRNA was extracted from LNCaP. RT-PCR for PSMA ORF (open reading frame) was performed. PSMA ORF cDNA was subcloned into PcDNA 3.1(-) (BamH1 and Xba1 site) and transfection of PSMA on HUVEC was performed. HUVEC was plated onto a Matrigel coated 6 well plate and incubated at 37oC in a CO2 incubator for 18 hours. The HUVEC tube formation was observed every 2 hours using an inverted microscope. HUVEC cell protein was extracted immediately, and 3 and 6 hours after transfection. Western blot for VEGF (vascular endothelial growth factor) was performed. RESULTS: The tube formation stage of HUVEC transfected with PSMA was observed 10 hours after incubation on Matrigel coating, whereas in the control HUVEC, the cord formation stage was observed after up to 10 hours incubation. The HUVEC transfected with PSMA showed an earlier tube formation stage than the control. Western blot analysis showed that PSMA transfection on HUVEC increased the expression of VEGF 2.5 fold in 3 hours and 1.89 fold in 6, as measured by densitometry. CONCLUSIONS: PSMA transfection on the HUVEC cell line induced an initial increase in the expression of VEGF, and subsequently stimulated an earlier tube formation in the HUVEC cell line. These data suggest PSMA is related to angiogenesis.
Animals ; Blotting, Western ; Densitometry ; DNA, Complementary ; Ecthyma, Contagious ; Endothelial Cells ; Endothelium, Vascular ; Glycoproteins ; Human Umbilical Vein Endothelial Cells ; Incubators ; Membranes* ; Prostate* ; RNA, Messenger ; Transfection ; Umbilical Veins ; Vascular Endothelial Growth Factor A

OBJECTIVES: The MVV reflects subjective dyspnea, exercise capacity, postoperative complication. But, the MVV embodies certain disadvantages and is dependent on coordination, endurance and motivation. A timed vital capacity for calculation of an indirect maximal voluntary ventilation is used. We evaluated differences in prediction formulas for the MUV according to the status of ventilatory function. METHODS: Forty-seven normal subjects, 68 patients with obstructive ventilatory impairment, and 23 patients with restrictive ventilatory impairment were studied. The relationships between the MVV and Flow or time parameters in forced expiratory volume and flow volume curves were compared among normal subjects and patients with obstructive or restrictive ventilatory impairment. RESULTS: 1) High correlation coefficients(R>or=0.87) were found between the FEV0.5, 0.75, 1 and the MVV in 47 normal subjects and 91 patients with ventilatory impairment. 2) The MVV can be conveniently estimated from the FEV1 values. The following regression formulas for the prediction of the MVV were obtained. Normal: MVV=44.01 X FEV1-21.09(r(2)=0.771, SEE=11.085) Obstructive ventilatory impairment: MVV=38.34 X FEV1-4.58(r(2)0.812, SEE=4.816) Restrictive ventilatory impairment: MVV=45.20 X FEV1-3.80(r(2)=0.899, SEE=6.929). 3) There were significant differences in prediction formulas for the MVV obtained by FEV1 between each group (P<0.05). CONCLUSION: These results suggest that different prediction formulas for the MVV, by multiplying the FEV1 by a constant, are respectively required in normal subjects and patients with obstructive or restrictive ventilatory impairment.
Dyspnea ; Forced Expiratory Volume ; Humans ; Maximal Voluntary Ventilation ; Motivation ; Postoperative Complications

Primary pulmonary artery sarcoma is a rare tumor and commonly misdiagnosed as pulmonary embolism. The prognosis of these tumors is very poor. The Median length of survival without surgical resection is approximately 1.5 months, but surgical resection has lengthened survival time to approximately 1 year. We encountered a case of primary pulmonary artery sarcoma, with a 55 year-old woman whose symptoms were exertional dyspnea, right chest pain, and hemoptysis. A preoperative chest CT scan revealed mass lesion mimicking pulmonary embolism. Pulmonary angioplasty and right pneumonectomy were performed on partial cardiopulmonary bypass. Postoperatively the mass was confirmed as undifferenciated sarcoma histopathologically. The symptoms were somewhat improved, but the patient died of unknown causes about 3 months after surgery.
Angioplasty ; Cardiopulmonary Bypass ; Chest Pain ; Dyspnea ; Female ; Hemoptysis ; Humans ; Middle Aged ; Pneumonectomy ; Prognosis ; Pulmonary Artery* ; Pulmonary Embolism ; Sarcoma* ; Tomography, X-Ray Computed

Migration of an intrauterine contraceptive device (IUD) into the urinary bladder is very rare. We experienced a case of a foreign-body migrating into the bladder of a 35-year-old women who has been suffering from frequency and dysuria for the recent 5 months. The IUD had originally been inserted 10 years ago. Removal of the IUD had been performed for achieving pregnancy, but the IUD was not detected at the correct site 7 years ago. One year later, the patient had given birth without complication. It is thought that it took less than 6 years for the IUD to invade the bladder wall.
Adult ; Dysuria ; Female ; Foreign-Body Migration ; Humans ; Intrauterine Devices* ; Parturition ; Pregnancy ; Urinary Bladder*