The usefulness of E-cadherin immunostaining as a marker of malignancy in the body fluids was investigated in the present study. Thirty-three histologically proven cases of cell blocks from the pleural, peritoneal, and pericardial fluids were studied by immunocytochemistry for E-cadherin antibody using LSAB method. These cases were cytologically diagnosed as adenocarcinoma (25 cases) and atypical cells (8 cases). Tumor cells showed strong positive membranous staining for E-cadherin antibody in 21 out of 25 cases (84%) of adenocarcinoma. E-cadherin staining was not found in 6 of 8 cases of suspicious maligancy. The sensitivity and specificity were 84% and 75%, respectively. Reactive mesothelial cells and inflammatory cells scattered were all negative. In conclusion, E-cadherin is an useful adjunctive marker to distinguish reactive mesothelial cells from the carcinoma cells in the body fluids.
Sensitivity and Specificity ; Adenocarcinoma ; Neoplasm Metastasis

OBJECTIVE: We wanted to identify the geographic differences in hepatic fibrosis and their associations with the atrophy-hypertrophy complex in patients with chronic viral hepatitis using the dual-contrast material-enhanced MRI (DC-MRI) with gadopentetate dimeglumine and ferucarbotran. MATERIALS AND METHODS: Patients with chronic C (n = 22) and B-viral hepatitis (n = 35) were enrolled for determining the subjective grade of fibrosis (the extent and thickness of fibrotic reticulations) in the right lobe (RL), the caudate lobe (CL), the medial segment (MS) and the lateral segment (LS) of the liver, with using a 5-grade scale, on the gradient echo T2*-weighted images of DC-MRI. The fibrosis grades of different segments were compared using the Kruskal-Wallis test followed by post-hoc analysis to establish the segment-by-segment differences. The incidences of two pre-established morphologic signs of cirrhosis were also compared with each other between the two groups of patients. RESULTS: There were significant intersegmental differences in fibrosis grades of the C-viral group (p = 0.005), and the CL showed lower fibrosis grades as compared with the grades of the RL and MS, whereas all lobes were similarly affected in the B-viral group (p = 0.221). The presence of a right posterior hepatic notch was significantly higher in the patients with intersegmental differences of fibrosis between the RL and the CL (19 out of 25, 76%) than those without such differences (6 out of 32, 19%) (p < 0.001). An expanded gallbladder fossa showed no significant relationship (p = 0.327) with the segmental difference of the fibrosis grades between the LS and the MS. CONCLUSION: The relative lack of fibrosis in the CL with more advanced fibrosis in the RL can be a distinguishing feature to differentiate chronic C-viral hepatitis from chronic B-viral hepatitis and this is closely related to the presence of a right posterior hepatic notch.
Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Contrast Media/*diagnostic use ; Dextrans/*diagnostic use ; Diagnosis, Differential ; Female ; Gadolinium DTPA/*diagnostic use ; Hepatitis B, Chronic/*diagnosis ; Hepatitis C, Chronic/*diagnosis ; Humans ; Liver Cirrhosis/*diagnosis/*virology ; Magnetite Nanoparticles/*diagnostic use ; Male ; Middle Aged ; Retrospective Studies ; Statistics, Nonparametric

OBJECTIVE: To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis. MATERIALS AND METHODS: The Institutional Review Board approved this retrospective study and waived informed consent. A total of 59 consecutive patients (52 men and 7 women, aged 40-85 years) with grossly defined portal vein thrombus (PVT) on hepatic MRI were retrospectively analyzed. Among them, liver cirrhosis was found in 45 patients, and hepatocellular carcinoma in 47 patients. DWI was performed using b values of 50 and 800 sec/mm2 at 1.5-T unit. A thrombus was considered malignant if it enhanced on dynamic CT or MRI; otherwise, it was considered bland. There were 18 bland thrombi and 49 malignant thrombi in 59 patients, including 8 patients with simultaneous benign and malignant PVT. Mean apparent diffusion coefficients (ADCs) of benign and malignant PVTs were compared by using Mann-Whitney U test. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: The mean ADC ± standard deviation of bland and malignant PVT were 1.00 ± 0.39 × 10(-3) mm2/sec and 0.92 ± 0.25 × 10(-3) mm2/sec, respectively; without significant difference (p = 0.799). The area under ROC curve for ADC was 0.520. An ADC value of > 1.35 × 10(-3) mm2/sec predicted bland PVT with a specificity of 94.6% (95% confidence interval [CI]: 84.9-98.9%) and a sensitivity of 22.2% (95% CI: 6.4-47.6%), respectively. CONCLUSION: Due to the wide range and considerable overlap of the ADCs, DWI cannot differentiate the benign from malignant thrombi efficiently.
Carcinoma, Hepatocellular ; Diagnosis ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Ethics Committees, Research ; Female ; Humans ; Informed Consent ; Liver Cirrhosis ; Magnetic Resonance Imaging* ; Male ; Portal Vein* ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Thrombosis ; Venous Thrombosis*

PURPOSE: This study was conducted to evaluate clinical validity of a zirconia full-coverage crown by comparing zirconia's wear capacity over antagonistic teeth with that of feldspathic dental porcelain. MATERIALS AND METHODS: The subject groups were divided into three groups: the polished feldspathic dental porcelain group (Group 1), the polished zirconia group (Group 2), and the polished zirconia with glazing group (Group 3). Twenty specimens were prepared from each group. Each procedure such as plasticity, condensation, and glazing was conducted according to the manufacturer's manual. A wear test was conducted with 240,000 chewing cycles using a dual-axis chewing simulator. The degree of wear of the antagonistic teeth was calculated by measuring the volume loss using a three-dimensional profiling system and ANSUR 3D software. The statistical significance of the measured degree of wear was tested with a significant level of 5% using one-way ANOVA and the Tukey test. RESULTS: The degrees of wear of the antagonistic teeth were 0.119 +/- 0.059 mm3 in Group 1, 0.078 +/- 0.063 mm3 in Group 3, and 0.031 +/- 0.033 mm3 in Group 2. Statistical significance was found between Group 1 and Groups 2 and between Group 2 and 3, whereas no statistical significance was found between Group 1 and Group 3. CONCLUSION: Despite the limitations of this study on the evaluation of antagonistic teeth wear, the degree of antagonistic tooth wear was less in zirconia than feldspathic dental porcelain, representing that the zirconia may be more beneficial in terms of antagonistic tooth wear.
Analysis of Variance ; Ceramics ; Crowns ; Dental Porcelain ; Mastication ; Plastics ; Tooth ; Tooth Wear ; Zirconium

We present a case report to show how manganese-enhanced T1- and T2-weighted MR cholangiography could differentiate cystic parenchymal lesions from cystic abnormalities which communicate with the bile ducts.
Bile Ducts/*pathology ; Cholangiopancreatography, Magnetic Resonance/*methods ; Choledochal Cyst/diagnosis ; Contrast Media/chemistry ; Cysts/diagnosis ; Diagnosis, Differential ; Humans ; Liver/*pathology ; Male ; Manganese/*chemistry ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: The previous studies have demonstrated the superiority of implanting drug eluting stent (DES) for restenosis reduction compared with the implantation of uncoated stents in small coronary arteries. However, the arteries in those studies tended to have short lesions. So, we evaluated the efficacy of a drug eluting stent in small coronary lesions with a relatively long length. SUBJECTS AND METHODS: From July 2003 to March 2005, DESs (Cypher or Taxus) were implanted into 100 consecutive patients with 116 lesions that were less than 2.75 mm in diameter. All patients received aspirin indefinitely and clopidogrel for 6 months. The primary end point was 6 month angiographic in-segment restenosis, and the secondary end points were procedural success and any major adverse cardiac events (MACE: death, non fatal myocardial infarction and target lesion revascularization) at 9 months. RESULTS: The mean age of the patients was 63 years, 53% were male, 24% were diabetics, 34% were current smokers and 55% had hypertension. A total of 121 DESs were implanted into 116 lesions (mean number of DESs/lesion: 1.1/lesion). The mean proximal and distal reference diameters were 2.21+/-0.39 and 2.01+/-0.40 mm, respectively. The mean lesion length was 19.14+/-7.89 mm. The mean pre- and post-minimal lumen diameters were 0.73+/-0.42 mm and 2.26+/-0.41 mm, respectively. The mean size and length of the stents were 2.65+/-0.13 mm and 28.46+/-10.04 mm, respectively. The procedural success rate was 98.3%. The angiographic follow-up rate was 78.4%. The binary in-segment restenosis rate was 15.4% (14 lesions). The MACE at 9 months was 8.0%. CONCLUSION: DES implantation in small coronary lesions with a relatively long length demonstrated favorable results. However, a larger scale study is needed to clarify the efficacy of the DES in small coronary arteries.
Arteries ; Aspirin ; Coronary Restenosis ; Coronary Vessels* ; Drug-Eluting Stents* ; Follow-Up Studies ; Humans ; Hypertension ; Male ; Myocardial Infarction ; Stents

Tuberculosis remains one of the most prevalent and fatal infectious diseases in spite of considerable improvements in medical science. The diagnosis and treatment of extrapulmonary tuberculosis involving the abdomen is still complicated owing to vague or non-specific clinical features. Although rare, isolated splenic involvement is one of the important manifestations of extrapulmonary tuberculosis, and imaging suspicion of the disease is essential. We report a case of surgically confirmed mass-forming splenic tuberculosis showing a layered pattern consisting of caseous necrosis with profound restriction of water molecules surrounded by an irregular rind of granulation tissue with less diffusion restriction on diffusion-weighted magnetic resonance imaging (DWI). In the differential diagnosis of neoplastic or non-neoplastic mass-forming lesions involving the spleen, this unique DWI feature could be helpful in characterizing splenic tuberculosis. The patient has been in clinically disease free status for nearly 20 months after splenectomy.
Diffusion Magnetic Resonance Imaging/*methods ; Female ; Humans ; Middle Aged ; Necrosis ; Splenectomy ; Tuberculosis, Splenic/*pathology

OBJECTIVE: To investigate the relationships between the apparent diffusion coefficients (ADCs) on diffusion-weighted imaging (DWI) and the speed of contrast-enhancement in hepatic hemangiomas. MATERIALS AND METHODS: Sixty-nine hepatic hemangiomas (> or = 1 cm) were evaluated with DWI, by using multiple b values (b = 50, 400, 800 s/mm2), followed by a gadolinium-enhanced dynamic MRI. The lesions were classified into three groups, according to the speed of contrast-enhancement on the portal phase. ADCs were measured on the ADC map automatically, and were calculated by using the two different b values (mADC50-400 with b values = 50 and 400; mADC400-800 with b values = 400 and 800 s/mm2). RESULTS: The mean ADCs (x 10-3 mm2/s) were significantly higher in the rapid group (1.9 +/- 0.44) than in the intermediate (1.7 +/- 0.35, p = 0.046) or the slow groups (1.4 +/- 0.34, p = 0.002). There were significant differences between the rapid and the slow groups in mADC50-400 (2.12 vs. 1.48; p = 0.008) and mADC400-800 (1.68 vs. 1.22, p = 0.010), and between the rapid and the intermediate groups in mADC50-400 (2.12 vs. 1.79, p = 0.049). Comparing mADC50-400 with mADC400-800, there was a significant difference only in the rapid group (p = 0.001). CONCLUSION: Higher ADCs of rapidly-enhancing hemangiomas may be related to richer intralesional vascular perfusion. Also, the restricted diffusion may be attributed to the difference of structural characteristics of hemangioma.
Adult ; Aged ; Contrast Media ; *Diffusion Magnetic Resonance Imaging ; Female ; Gadolinium DTPA/diagnostic use ; Hemangioma, Cavernous/*diagnosis ; Humans ; Image Enhancement ; Liver Neoplasms/*diagnosis ; *Magnetic Resonance Imaging ; Male ; Middle Aged

PURPOSE: The purpose of our study was to validate diffusion-weighted MRI (DWI) before and after superparamagnetic iron oxide (SPIO) injection for assessment of hepatic metastases. MATERIALS AND METHODS: Eighty-six hepatic metastases (size range, 0.3-4.7 cm; mean, 1.5 cm) verified pathologically or by follow-up imaging studies in 22 consecutive patients (17 men and 5 women; 44-83 years; mean age, 60 years) during a 13-month period were enrolled. Hepatic MRI, including DWI (b-factors=50, 400, 800 s/mm2) with breath-holding technique of single-shot spin-echo echo-planar imaging (TR/TE=1000/69 ms, average=2) before and after SPIO administration, were retrospectively reviewed by two independent radiologists with a 5-point scale confidence score for each hepatic lesion on pre-contrast DWI (pre-DWI), SPIO-enhanced DWI (SPIO-DWI), and SPIO-enhanced T2*-weighted imaging (SPIO-T2*wI). RESULTS: For all lesions, SPIO-T2*wI showed significantly higher confidence score in the diagnosis of hepatic metastases than pre-contrast or SPIO-DWI regardless of the size of b-factors (p<0.05) with only one exception; using b-factor=50 s/mm2, the score of SPIO-T2*wI was still higher than SPIO-DWI but there was no statistical significance given by observer 1 (p=0.730). For the subcentimeter lesions (n=37), SPIO-T2*wI showed the highest score, and using b-factor=50 or 400 s/mm2 SPIO-DWI showed similar confidence scores to SPIO-T2*wI by both observers (p>0.05). Pre-DWI using b-factor=50 sec/mm2 was also comparable with SPIO-T2*wI by observer 1 (p=0.060). CONCLUSION: Pre-DWI has a limited value for the assessment of hepatic metastases, however, the repetition of DWI after SPIO injection using small b-factors could complement SPIO-T2*wI, especially for subcentimeter lesions.
Adult ; Aged ; Aged, 80 and over ; Contrast Media/chemistry/*diagnostic use ; Diffusion Magnetic Resonance Imaging/*methods ; Female ; Ferric Compounds/chemistry/*diagnostic use ; Humans ; Liver Neoplasms/*diagnosis ; Male ; Neoplasm Metastasis/*diagnosis

We describe a 48-year-old man with family history of rheumatoid arthritis (RA) affected by chronic eosinophilic pneumonia (CEP) with severe peripheral eosinophilia. CEP might develop as a complication of longstanding active RA. The patient with 5 months history of seropositive RA and chronic respiratory symptoms, alveolar and blood eosinophilia, peripheral pulmonary infiltrates and pleural effusion on chest imaging. The lung may be involved as an extraarticular manifestation of RA. However, CEP is not recognized as a typical lung manifestation of RA, and the two diseases rarely coexist. The effusion was an eosinophil predominant exudates and was characterized by low pH, and glucose level and high lactic dehydrogenase. The patient responded rapidly to combination of steroids and disease modifying anti-rheumatic drugs.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Eosinophilia ; Eosinophils* ; Exudates and Transudates ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Lung ; Middle Aged ; Oxidoreductases ; Pleural Effusion* ; Pulmonary Eosinophilia* ; Steroids ; Thorax