Primary thymic mucinous adenocarcinoma is an extremely rare aggressive subtype of thymic carcinoma. With a review of literatures, only nine cases have been reported up to present. A 36-year-old woman was admitted for further evaluation and treatment of a mediastinal mass. The patient had no medical history of cancer. The clinicoradiological examination disclosed no tumor elsewhere. After the surgical excision of mediastinal mass, it was grossly a round semi-solid mass with mucin-filled cystic areas. Microscopically solid areas showed cords, small nests and dilated glands infiltrating the fibrotic parenchyma, while the cystic areas were lined by mucinous epithelium with tumor cells floating in extracellular-mucin pools. Some cystic walls underwent malignant transformation of the benign thymic epithelium. Immunohistochemically, the tumor cells were positive for cytokeratin (CK) 7, CK20, CD5, and CDX-2, and negative for thyroid transcription factor-1. In conclusion, the mucinous thymic adenocarcinoma should be recognized as a separate histopathological entity and considered in the differential diagnosis of mediastinal carcinomas.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Adult ; Diagnosis, Differential ; Epithelium ; Female ; Humans ; Immunohistochemistry ; Keratins ; Mediastinal Cyst ; Mucins ; Thymoma ; Thymus Gland ; Thyroid Gland

The effectiveness of percutaneous embolotherapy in cases of hemoptysis due to pulmonary tuberculosis from increasing severity of lung parenchymal injury was compared. The pattern of pleural involvement, as seen on chest radiography and angiography, were comparatively analyzed in 230 patients who were available for follow-ups from March 1992 to December 2003. Chest radiography findings were classified into 4 types based on levels of complicated lesions and pleural involvement. Angiography findings were divided into 4 groups based on the level of blood supply to lesions. Early hemostasis with respect to radiographic group were as follows: Type I-92% (73/79), Type II-80% (52/65), Type III-70% (42/60), and Type IV-56% (52/92); there was an average success rate of 73% (219/296), and continued hemostasis was found in 80% of Type I patients (62/77), 77% of Type II patients (41/53), 62% of Type III patients (25/40), and 45% of Type IV patients (27/60), with an average long-term hemostatic rate of 67% (155/230). Increasing severity of pleural involvement and associated complications correlated with increasing development of systemic collateral arteries other than the bronchial artery. The severely increased circulation in systemic collateral arteries makes it difficult to predict good hemostatic results following embolization. Therefore, we recommend aggressive treatment, such as surgical intervention, after embolization in such instances.
Tuberculosis, Pulmonary/*complications/radiography ; Treatment Outcome ; Severity of Illness Index ; Middle Aged ; Male ; Humans ; Hemoptysis/*microbiology/radiography/*therapy ; Follow-Up Studies ; Female ; *Embolization, Therapeutic ; Angiography ; Aged, 80 and over ; Aged ; Adult ; Adolescent

The effectiveness of percutaneous embolotherapy in cases of hemoptysis due to pulmonary tuberculosis from increasing severity of lung parenchymal injury was compared. The pattern of pleural involvement, as seen on chest radiography and angiography, were comparatively analyzed in 230 patients who were available for follow-ups from March 1992 to December 2003. Chest radiography findings were classified into 4 types based on levels of complicated lesions and pleural involvement. Angiography findings were divided into 4 groups based on the level of blood supply to lesions. Early hemostasis with respect to radiographic group were as follows: Type I-92% (73/79), Type II-80% (52/65), Type III-70% (42/60), and Type IV-56% (52/92); there was an average success rate of 73% (219/296), and continued hemostasis was found in 80% of Type I patients (62/77), 77% of Type II patients (41/53), 62% of Type III patients (25/40), and 45% of Type IV patients (27/60), with an average long-term hemostatic rate of 67% (155/230). Increasing severity of pleural involvement and associated complications correlated with increasing development of systemic collateral arteries other than the bronchial artery. The severely increased circulation in systemic collateral arteries makes it difficult to predict good hemostatic results following embolization. Therefore, we recommend aggressive treatment, such as surgical intervention, after embolization in such instances.
Tuberculosis, Pulmonary/*complications/radiography ; Treatment Outcome ; Severity of Illness Index ; Middle Aged ; Male ; Humans ; Hemoptysis/*microbiology/radiography/*therapy ; Follow-Up Studies ; Female ; *Embolization, Therapeutic ; Angiography ; Aged, 80 and over ; Aged ; Adult ; Adolescent

PURPOSE: The purpose of this study was to develop PC-based perfusion software using Microsoft Windows. This software was developed to reformat perfusion maps including CBV (Cerebral Blood Volume), MTT (Mean Transit Time), and CBF (Cerebral Blood Flow) maps and to analyze perfusion quantitatively. MATERIALS AND METHODS: Windows-based perfusion software was developed using IDL (Interactive Data Language) as the development tool. The perfusion software was written to load the source image from dynamic first-pass cerebral perfusion CT and to reformat perfusion maps. Mean perfusion values in gray matter and white matter were calculated and compared to previously calculated data reported in literature. RESULTS: This software reformatted first pass perfusion maps in a user-friendly PC and calculated CBV, MTT, and CBF values. The values were within the normal range of the mean values when compared to previous studies. CONCLUSION: CT perfusion maps and perfusion values can be obtained by using the newly developed PC-based perfusion software. Further study is needed to achieve more precise values. However, we believe that in the future, this program may be used in various clinical settings.
Perfusion* ; Reference Values

Mineral trioxide aggregate (MTA) would influence healing of periapical tissues by modulating the production of growth factors and cytokines from PDL fibroblasts, however, the studies are insufficient. Therefore, the purpose of this study was to monitor the expression of transforming growth factor-beta1 (TGF- beta1), fibroblast growth factor-2 (FGF-2), and interleukin-6 (IL-6) from PDL fibroblasts in the presence of MTA. The human PDL fibroblasts were seeded onto the set MTA or IRM at a level of 1 x 10(5) cells per unit well, and further incubated for 6, 12, 24, and 48 hours. The levels of TGF-beta1, FGF-2, and IL-6 from the supernatant were measured by enzyme-linked immunosorbent assay (ELISA). The data were analyzed using one-way ANOVA. The level of TGF-beta1 was down-regulated when the cells were grown in the presence of MTA except at 6 hours. The levels of FGF-2 release were significantly suppressed when PDL fibroblasts were grown in the presence of MTA or IRM at all time intervals (p < 0.05). The expressions of IL-6 from MTA treated cells were comparable to those of untreated control cells throughout the observation periods. We presume that this material inhibits the stimulatory function of growth factors on granulation tissue formation and in turn, it promotes the healing process modulated by other bone-remodeling cells.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Fibroblast Growth Factor 2 ; Fibroblasts* ; Granulation Tissue ; Humans* ; Intercellular Signaling Peptides and Proteins* ; Interleukin-6 ; Periapical Tissue ; Periodontal Ligament* ; Transforming Growth Factor beta1 ; Pemetrexed

Mineral trioxide aggregate (MTA) would influence healing of periapical tissues by modulating the production of growth factors and cytokines from PDL fibroblasts, however, the studies are insufficient. Therefore, the purpose of this study was to monitor the expression of transforming growth factor-beta1 (TGF- beta1), fibroblast growth factor-2 (FGF-2), and interleukin-6 (IL-6) from PDL fibroblasts in the presence of MTA. The human PDL fibroblasts were seeded onto the set MTA or IRM at a level of 1 x 10(5) cells per unit well, and further incubated for 6, 12, 24, and 48 hours. The levels of TGF-beta1, FGF-2, and IL-6 from the supernatant were measured by enzyme-linked immunosorbent assay (ELISA). The data were analyzed using one-way ANOVA. The level of TGF-beta1 was down-regulated when the cells were grown in the presence of MTA except at 6 hours. The levels of FGF-2 release were significantly suppressed when PDL fibroblasts were grown in the presence of MTA or IRM at all time intervals (p < 0.05). The expressions of IL-6 from MTA treated cells were comparable to those of untreated control cells throughout the observation periods. We presume that this material inhibits the stimulatory function of growth factors on granulation tissue formation and in turn, it promotes the healing process modulated by other bone-remodeling cells.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Fibroblast Growth Factor 2 ; Fibroblasts* ; Granulation Tissue ; Humans* ; Intercellular Signaling Peptides and Proteins* ; Interleukin-6 ; Periapical Tissue ; Periodontal Ligament* ; Transforming Growth Factor beta1 ; Pemetrexed

In this report, we present a rare case of traumatic carotid cavernous fistula that was occluded during the interventional procedure by incidentally formed blood clot. Sudden occlusion of the fistula and the resolution process of the precarious blood clot can be clearly seen on the serial angiogram.
Vascular Surgical Procedures/*adverse effects ; Treatment Outcome ; Male ; Incidental Findings ; Humans ; Craniocerebral Trauma/*complications ; Carotid-Cavernous Sinus Fistula/etiology/*radiography/*surgery ; Carotid Artery Thrombosis/*etiology/*radiography ; Adult

Placental transmogrification is a very rare lung disease, where the alveoli resemble the chorionic villi of placenta, and this change is a characteristic finding. A 31-year-old female patient presented with cough and dyspnea that had begun 2 weeks prior to admission. Along with giant bulla found in the left upper lung field, subsegmental consolidation was also identified in the lingular segment on plain chest radiograph and CT scan. Wedge resection was performed to remove the bulla. Pathologic examination of the resected bulla revealed destruction of the normal structures and characteristic villous and papillary changes. These changes led to a diagnosis of placental transmogrification. We made an encounter of an unusual placental transmogrification which had different image findings from other reported transmogrification cases. Thus, we report an atypical placental transmogrification case where both consolidation and giant bulla coexist.
Adult ; Chorionic Villi/*pathology ; Diagnosis, Differential ; Female ; Humans ; Lung/*pathology/radiography/surgery ; Lung Diseases/pathology/*radiography/surgery ; Pneumonectomy ; Tomography, X-Ray Computed/*methods

OBJECTIVE: The purpose of this study was to compare the results of different agents for bronchial artery embolization of hemoptysis. MATERIALS AND METHODS: From March 1992 to December 2006, a bronchial artery embolization was performed on 430 patients with hemoptysis. The patients were divided into three groups. Group 1 included 74 patients treated with a gelfoam particle (1x1x1 mm), while group 2 comprised of 205 patients treated with polyvinyl alcohol (PVA) at 355-500 micrometer, and group 3 included 151 patients treated with PVA at 500-710 micrometer. We categorized the results as technical and clinical successes, and also included the mid-term results. Retrospectively, the technical success was compared immediately after the procedure. The clinical success and mid-term results (percentage of patients who were free of hemoptysis) were compared at 1 and 12 months after the procedure, respectively. RESULTS: Neither the technical successes (group 1; 85%, 2; 85%, 3; 90%) nor the clinical successes (group 1; 72%, 2; 74%, 3; 71%) showed a significant difference among the 3 groups (p > 0.05). However, the mid-term results (group 1; 45%, 2; 63%, 3; 62%) and mid-term results excluding the recurrence from collateral vessels in each of the groups (group 1; 1 patient, 2; 4 patients, 3; 2 patients) showed that group 1 was lower than the other two groups (p < 0.05). No significant difference was discovered for the mid-term results between groups 2 and 3. Moreover, the same results not including incidences of recurrence from collateral vessels also showed no statistical significance between the two groups (p > 0.05). CONCLUSION: Polyvinyl alcohol appears to be the more optimal modality compared to gelfoam particle for bronchial artery embolization in order to improve the mid-term results. The material size of PVA needs to be selected to match with the vascular diameter.
Adolescent ; Adult ; Aged ; Angiography ; *Bronchial Arteries ; Embolization, Therapeutic/*methods ; Female ; Gelatin Sponge, Absorbable/*therapeutic use ; Hemoptysis/etiology/radiography/*therapy ; Hemostatics/*therapeutic use ; Humans ; Male ; Middle Aged ; Polyvinyl Alcohol/*therapeutic use ; Treatment Outcome

BACKGROUND AND OBJECTIVES: We studied the correlation between radiologically identified bony osteitis and prognosis of the functional endoscopic sinus surgery in chronic rhinosinusitis patients. SUBJECTS AND METHOD: A retrospective review of medical records were carried out on 77 patients who had been diagnosed as chronic paranasal sinusitis and undergone endoscopic sinus surgery from 2002 through 2003 at our institution. Computed tomography scans were used for grading according to the Lund-Mackay radiologic grading system and diagnosis the pansinusitis coexistence. Medical records were used for grading according to the Lund-Mackay surgical grading system and for follow-up observation and age. Statistical analysis was done for correlation between radiologically identified indices and post-operative prognosis. RESULTS: The study revealed that radiologically identified bony osteitis need a longer post-operative medical management period and also found that if pansinusitis coexist with osteitis, poorer outcome would be accompanied. CONCLUSION: This study provides further evidence that radiologically identified bony osteitis and pansinusitis may act as poor prognostic factors.
Diagnosis ; Follow-Up Studies ; Humans ; Medical Records ; Osteitis* ; Prognosis* ; Retrospective Studies ; Sinusitis ; Tomography, X-Ray Computed