No abstract available.
Liver Cirrhosis* ; Liver*

No abstract available.
Humans

OBJECTIVE: To compare the objective and subjective image quality indicators and radiation doses of computed tomography (CT) venography performed using model-based iterative reconstruction (MBIR) at 80 kVp and adaptive statistical iterative reconstruction (ASIR)-V at 70 kVp. MATERIALS AND METHODS: Eighty-three patients who had undergone CT venography of the lower extremities with MBIR at 80 kVp (Group A; 21 men and 20 women; mean age, 55.5 years) or ASIR-V at 70 kVp (Group B; 18 men and 24 women; mean age, 57.3 years) were enrolled. Two radiologists retrospectively evaluated the objective (vascular enhancement, image noise, signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR]) and subjective (quantum mottle, delineation of contour, venous enhancement) image quality indicators at the inferior vena cava and femoral and popliteal veins. Clinical information, radiation dose, reconstruction time, and objective and subjective image quality indicators were compared between groups A and B. RESULTS: Vascular enhancement, SNR, and CNR were significantly greater in Group B than in Group A (p ≤ 0.015). Image noise was significantly lower in Group B (p ≤ 0.021), and all subjective image quality indicators, except for delineation of vein contours, were significantly better in Group B (p ≤ 0.021). Mean reconstruction time was significantly shorter in Group B than in Group A (1 min 43 s vs. 131 min 1 s; p < 0.001). Clinical information and radiation dose were not significantly different between the two groups. CONCLUSION: CT venography using ASIR-V at 70 kVp was better than MBIR at 80 kVp in terms of image quality and reconstruction time at similar radiation doses.
Female ; Humans ; Image Enhancement ; Image Processing, Computer-Assisted ; Lower Extremity ; Male ; Noise ; Phlebography ; Popliteal Vein ; Retrospective Studies ; Signal-To-Noise Ratio ; Veins ; Vena Cava, Inferior ; Venous Thrombosis

OBJECTIVES: It was recently reported that the administration of T4 during antithyroid drug(ATD) therapy resulted in a significant decrease of antibodies to TSH receptors as well as the rate of recurrence of active Graves' disease following discontinuance of ATD treatment. But, there is still controversy whether combination therapy is efficient. Therefore, the present study was undertaken to evaluate the effect of T4 administration of patient with Graves' disease who were being treated with ATD. METHODS: We studied 56 patients received methimazole(MMI) alone(Group 1) and 48 patients received methimazole plus T4(Group 2), They are diagnosed active Graves' disease at department of internal medicine, Kwang ju Christian Hospital from January, 1994 to December, 1995. All the patients were treated initially with 30mg of methimazole daily for one month after then, in the Group 1(methimazole alone), the dose of methimazole was adjusted as necessary to achieve normal serum concentrations of T3, T4, and TSH. The patients of Group 2(methimazole plus T4) continue to receive the combination of T4 at a dose of 100 microgram daily. Simultaneously, we estimated the serum concentration of T3, T4, TSH and Thyroid-stimulating immunoglobulin(TSI) antibody at every three months. RESULTS: We obtained the following result. In the group 1, mean TSI values were 50.1%(first visit), 30.6%(6months), and 24.7%(1year). And, in the group 2 mean TSI values were 51.8%(first visit), 33.6%(6months), and 22.7% (1year). After 6 months of discontinuing of therapy, the recurrence rate was no significant difference in the two groups (the recurrence rate were 55.4%, 50.0%, respectively P>0.05). CONCLUSION: These results suggest that T4 administration in combination with MMI therapy have no significant effect in a decrease in levels of TSH receptors antibodies and recurrence rate within 6 months discontinuing MMI therapy as compared with MMI treatment alone.
Antibodies ; Graves Disease* ; Gwangju ; Humans ; Internal Medicine ; Methimazole ; Receptors, Thyrotropin ; Recurrence ; Thyroxine*

OBJECTIVE: To evaluate the utility of cardiovascular magnetic resonance (CMR)-derived myocardial strain measurement for the prediction of poor outcomes in patients with acute myocarditis. MATERIALS AND METHODS: We retrospectively analyzed data from 37 patients with acute myocarditis who underwent CMR. Left ventricular (LV) size, LV mass index, ejection fraction and presence of myocardial late gadolinium enhancement (LGE) were analyzed. LV circumferential strain (Ecc(SAX)), radial strain (Err(SAX)) from mid-ventricular level short-axis cine views and LV longitudinal strain (Ell(LV)), radial strain (Err(Lax)) measurements from 2-chamber long-axis views were obtained. In total, 31 of 37 patients (83.8%) underwent follow-up echocardiography. The primary outcome was major adverse cardiovascular event (MACE). Incomplete LV functional recovery was a secondary outcome. RESULTS: During an average follow-up of 41 months, 11 of 37 patients (29.7%) experienced MACE. Multivariable Cox proportional hazard regression analysis, which included LV mass index, LV ejection fraction, the presence of LGE, Ecc(SAX), Err(SAX), Ell(LV), and Err(Lax) values, indicated that the presence of LGE (hazard ratio, 42.88; p = 0.014), together with ErrLax (hazard ratio, 0.77 per 1%, p = 0.004), was a significant predictor of MACE. Kaplan-Meier analysis demonstrated worse outcomes in patient with LGE and an Err(Lax) value ≤ 9.48%. Multivariable backward regression analysis revealed that Err(Lax) values were the only significant predictors of LV functional recovery (hazard ratio, 0.54 per 1%; p = 0.042). CONCLUSION: CMR-derived Err(Lax) values can predict poor outcomes, both MACE and incomplete LV functional recovery, in patients with acute myocarditis, while LGE is only a predictor of MACE.
Echocardiography ; Follow-Up Studies ; Gadolinium ; Heart Ventricles ; Humans ; Kaplan-Meier Estimate ; Magnetic Resonance Imaging ; Myocarditis* ; Retrospective Studies ; Ventricular Dysfunction

BACKGROUND: The durability of the tissue valve is important in choice between a mechanical valve and a tissue valve in cardiac surgery. We studied the mid-term results of tissue valve in the aortic position. MATERIAL AND METHOD: The subjects were 380 patients who had undergone aortic prosthesis replacement between May 1990 and March 2009. We retrospectively analyzed hospital and outpatient records: the mean age was 69+/-9 years; the male to female ratio was 227 : 162; and the mean follow-up duration was 46.7+/-40.8 months (range 0~196 months). RESULT: 389 surgical cases in total had been taken with 380 patients. Early death occurred in 15 patients (3.9%). Overall survival rate at 1, 5 and 10 years were 92.3%, 78.1% and 54.2% respectively. Freedom from reoperation at 1, 5 and 10 years were 98.4%, 97.1% and 91.7% respectively. Freedom from structural valvular deterioration at 1, 5 and 10 years were 96.1%, 92.3% and 88.0% respectively. In the multivariate analysis of preoperative risk factors, young age (p<0.001) was significant risk factor for reoperation. High peak velocity in the postoperative period (p=0.034) and young age (p=0.029) were significant risk factors for structural valvular deterioration. Old age (p=0.001), long bypass time (p=0.035), concomitant coronary artery bypass graft surgery (p=0.003) and preoperative low left ventricular ejection fraction (p=0.003) were significant factors for early mortality. Preoperative estimated glomerular filtration rate (<60 mL/min) (p=0.025) and persistent left ventricular hypertrophy (p=0.032) were the risk factors for late mortality. CONCLUSION: This study showed that the freedom from reoperation and the freedom from structural valvular deterioration in aortic tissue valve replacement were acceptable. It will be necessary to conduct further studies with long-term follow-up and more patients.
Aortic Valve ; Coronary Artery Bypass ; Female ; Follow-Up Studies ; Freedom ; Glomerular Filtration Rate ; Heart Valve Prosthesis ; Humans ; Hypertrophy, Left Ventricular ; Male ; Multivariate Analysis ; Outpatients ; Postoperative Period ; Prostheses and Implants ; Reoperation ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Survival Rate ; Thoracic Surgery ; Transplants

Dieulafoy-like lesion is a relatively uncommon disease which is a potential source of life-threatening gastrointestinal bleeding. The lesion comprises mainly of an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is frequently found at distal portion of gastroesophageal junction but may occur anywhere in gastrointestinal tract including small bowel, colon and rectum. Moreover bleeding from dieulafoy-like lesion of rectum is very reae. It has been reported that rectal Dieulafoy-like lesion is very rare source of lower gastrointestinal bleeding and its pathogenesis may be associated with constipation. Recently, endoscopy has an important role in the diagnosis and treatment (including injection and coagulation therapy) of bleeding from Dieulafoy-like lesion. We herein report a case of a patient who presented wih massive hemorrhage from a small rectal ulcer with adherent blood clots. Bleeding was controlled with endoscopic treatment by utilizing bipolar electrocoagulation without complication and recurrence.
Arteries ; Colon ; Constipation ; Diagnosis ; Electrocoagulation ; Endoscopy* ; Esophagogastric Junction ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Rectum ; Recurrence ; Ulcer

PURPOSE: We wanted to determinate the value of a dynamic volumetric interpolated breath-hold examination (VIBE) as a supplement to MR cholangiography for differentiating biliary stones from tumors when patient are suspected of having intraluminal filling defects on direct cholangiography. MATERIALS AND METHODS: A retrospective analysis was performed for 49 patients who underwent MRI among all the patients who showed intraluminal filling defects on direct cholangiography for evaluating the cause of their jaundice from June 2002 to June 2003. After dividing these patients into two groups, i.e., the group with stones and the group with tumors, we analyzed and compared each MR patterns of 1) signal intensity, 2) shape, and 3) enhancement. RESULTS: High signal intensity on T1-weighted images (p< 0.001, chi-square test), dark signal intensity on T2-weighted images (p< 0.01, Fisher's exact test) or smooth contour of intraluminal filling defects (p< 0.001, chi-square test) could be significantly suggestive findings of stone rather than a tumor mass. Dynamic VIBE is the most specific sequence for differentiating non-enhancing stone from an enhancing mass (p< 0.001, Fisher's exact test). CONCLUSION: We showed that MR cholangiography, when added to the dynamic VIBE sequences, could be an important imaging technique for patients who are suspected of having intraluminal filling defects on direct cholangiography to differentiate stones from tumors. Especially, the addition of dynamic VIBE images can provide the increased level of confidence in the diagnosis.
Bile Ducts* ; Bile* ; Cholangiography* ; Diagnosis ; Gadolinium* ; Humans ; Jaundice ; Magnetic Resonance Imaging ; Retrospective Studies

PURPOSE: Bisphosphonates have been used to treat osteoporosis for more than ten years. However, complications associated with long-term administration of bisphosphonates, such as nonunion after pelvic insufficiency fracture or osteonecrosis of the jaw, have been recently reported in the literature. We investigated the relationships among the mechanical properties of the intact rat femur as well as healing fracture calluses and the intraosseous concentration of pamidronate (ICP), after long-term administration of pamidronate in a rat osteoporosis model. MATERIALS AND METHODS: We performed bilateral ovariectomy in 25 3-month-old female Sprague-Dawley rats. Beginning three months after ovariectomy, disodium pamidronate (0.5mg/kg) was injected every month. After the six-month administration period, the left femoral shaft was fractured using the closed fracture technique. Five weeks after fracture, 23 rats were euthanized and both femora were removed. We checked the mechanical properties of the intact (right) and fractured (left) femora using a three-point bending technique. Intraosseous concentration of pamidronate was checked by high-performance liquid chromatography. RESULTS: The mean ICP was 61.8+/-15.7ng/mg of bone. High ICP decreased the ultimate load to failure, stiffness, and ultimate stress of the intact femora (p=0.015, 0.027, 0.039, respectively). There was a tendency to decrease the ultimate load to failure in the healing callus when the ICP increased (p= 0.183). High ICP decreased the bone mineral density of the femoral head (p=0.005). CONCLUSION: High concentrations of pamidronate in intact bone decreased the bone mineral density and weakened the mechanical strength of the rat femora. The mechanical strength of the early healing callus was not correlated with concentration of pamidronate in the bone.
Animals ; Bone Density Conservation Agents/*pharmacology ; Diphosphonates/*pharmacology ; Disease Models, Animal ; Female ; Femur/*drug effects/physiology ; Fracture Healing/physiology ; Osteoporosis/*metabolism ; Rats ; Rats, Sprague-Dawley ; Stress, Mechanical

PURPOSE: To determine the efficacy and safety of the intra-arterial administration of glycoprotein IIb/IIIa inhibitor for resolving acute in-stent thrombosis complicating stent-assisted angioplasty for intracranial atherosclerosis. MATERIALS AND METHODS: We placed 60 therapeutic stents (24 internal carotid arteries, 20 vertebrobasilar arteries, and 16 middle cerebral arteries) for the treatment of symptomatic intracranial atherosclerosis. Among the 60 stenting procedures, acute in-stent thrombosis occurred after stent deployment in 11 cases (18.3%). As the method of dissolving the acute in-stent thrombosis, 2 mg abciximab were intra-arterially administered through a guiding catheter. Angiography was then performed after 10-20 minutes to identify any undissolved material resulting from the thrombosis. If the thrombosis was still observed on the angiography, an additional 2 mg of abciximab were administered, and this procedure was repeated until complete thrombolysis was obtained. Post-procedural non-enhanced brain CT was performed for the evaluation of possible hemorrhagic complications. RESULTS:After each intra-arterial administration of 2 mg of abciximab, successive angiographies showed the process of resolution of the acute thrombosis. All 11 acute in-stent thromboses were completely dissolved within 40 to 80 minutes. The total dosage of infused abciximab was 8 mg in one case, 10 mg in eight cases, and 16 mg in two cases. Post-procedural non-enhanced brain CT revealed no hemorrhagic complications. CONCLUSION: The intra-arterial administration of abciximab can be a safe and effective therapeutic method for acute in-stent thrombosis complicating the stenting of stenotic intracranial arteries.
Angiography ; Angioplasty ; Arteries ; Brain ; Carotid Artery, Internal ; Catheters ; Glycoproteins ; Intracranial Arteriosclerosis ; Stents ; Thromboembolism ; Thrombosis*