The authors introduced flip back spin echo (FBSE) technique for MR imaging of the temporomandibular joint (TMJ) instead of conventional spin echo (SE) technique, and evaluated whether FBSE technique in MRI of TMJ is adequate for the diagnosis of the disorders or not. FBSE T1 parasagittal images in closed mouth state and sequential opening and closing mouth states using patient's own finger(s) were obtained and then FBSE T1 paracoronal image in closed mouth state and STAGE(short tip angle gradient echo) parasagittal T2WI were followed. All 30 images of the symptomatic TMJs using FBSE technique were excellent in the visualization of articular and their displacement, and we could easily diagnose the internal derangement. FBSE technique was adequate for the diagnosis of internal derangement of the TMJ, and the modified cine display from images using FBSE technique was advantageous in the diagnosis of the disorders by visualization of the dynamic motion of the TMJ.
Diagnosis ; Magnetic Resonance Imaging* ; Mouth ; Temporomandibular Joint*

In 10 cases with intracranial arterivenous malformation (AVMs) diagnosed by MR spin echo images, MR angiography was evaluated and compared with conventional angiography in regard to depiction of nidus, arterial feeders, and draining veins. Spin echo images demonstrated the nidus of the AVM in all cases, but displayed the feeding vassels inadequately. These vessels were directly visualized with 3 dimensional STAGE(small tip angle gradient echo) MR angiography using rephasing/dephasing pulse sequences. In 5 cases MR angiography and conventional angiography showed the same results. However, in the others, MR angiography showed lower resolution than conventional angiography. MR angiography is useful in preangiographic evaluation of intracranial AVM but improvement in image resolution, which is dependent on MR hard ware and pulse sequence, is still to be desired.
Angiography* ; Intracranial Arteriovenous Malformations* ; Veins

Fetal lung development normally occurs in a hypoxic environment. Hypoxia-inducible factor (HIF)-1alpha is robustly induced under hypoxia and transactivates many genes that are essential for fetal development. Most preterm infants are prematurely exposed to hyperoxia, which can halt hypoxia-driven lung maturation. We were to investigate whether the HIF-1alpha inducer, deferoxamine (DFX) can improve alveolarization in a rat model of bronchopulmonary dysplasia (BPD). A rat model of BPD was produced by intra-amniotic lipopolysaccharide (LPS) administration and postnatal hyperoxia (85% for 7 days), and DFX (150 mg/kg/d) or vehicle was administered to rat pups intraperitoneally for 14 days. On day 14, the rat pups were sacrificed and their lungs were removed and examined. A parallel in vitro study was performed with a human small airway epithelial cell line to test whether DFX induces the expression of HIF-1alpha and its target genes. Alveolarization and pulmonary vascular development were impaired in rats with BPD. However, DFX significantly ameliorated these effects. Immunohistochemical analysis showed that HIF-1alpha was significantly upregulated in the lungs of BPD rats treated with DFX. DFX was also found to induce HIF-1alpha in human small airway epithelial cells and to promote the expression of HIF-1alpha target genes. Our data suggest that DFX induces and activates HIF-1alpha, thereby improving alveolarization and vascular distribution in the lungs of rats with BPD.
Animals ; Bronchopulmonary Dysplasia/*drug therapy/*metabolism/pathology ; Deferoxamine/*administration & dosage ; Female ; Hypoxia-Inducible Factor 1, alpha Subunit/*metabolism ; Male ; Pulmonary Alveoli/drug effects/*growth & development/metabolism/pathology ; Pulmonary Veins/drug effects/*growth & development/pathology ; Rats ; Rats, Sprague-Dawley ; Treatment Outcome ; Up-Regulation/drug effects

Hypoxia-inducible factor-1 (HIF-1) is composed of HIF-1alpha and HIF-1beta, and is a master regulator of oxygen homeostasis, playing critical roles in physiological and pathological processes. Normally, the formation and transcriptional activity of HIF-1 depend on the amount of HIF-1alpha, and the expression of HIF-1alpha is tightly controlled by the cellular oxygen tension. Recent progress in the study of its regulation mechanism provided clues as to how HIF-1alpha is regulated by oxygen. It appears that HIF-1alpha is not regulated only by the oxygen tension, but also by various other stimuli, such as transition metals, nitric oxide, reactive oxygen species, growth factors, and mechanical stresses. In this review, we summarize the oxygen-dependent and -independent regulation of HIF-1alpha, and the respective physiological and pathological meanings.
Animals ; Growth Substances/metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; Molecular Structure ; Nitric Oxide/metabolism ; Oxygen/*metabolism ; Reactive Oxygen Species/metabolism ; Stress, Mechanical ; Transcription Factors/chemistry/genetics/*metabolism ; Transition Elements/metabolism

To evaluate of the relationship between basal ganglia lesion and portal-systemic encephalopathy, eleven patients who had clinically proved liver cirrhosis with superior mesenteric vein larger than 10mm in diameter on ultrasonogram underwent brain MR imaging. No evidence of clinical or neuropsychiatric disturbance was observed in any patient at the time of the MR examination. Brain MR imaging revealed basal ganglia lesion characterized by bilateral, symmetric, high signal intensity without edema or mass effect on spin echo T1-weighted images in nine patients which included three patients with the past history of portal-systemic encephalopathy. It was concluded that excepted in the circumstances of other causes of the high signal intensity in basal ganglia on T1-weighted images such as fat, methemoglobin, melanin, neurofibromatosis, dense calcification, and parenteral nutrition, bilateral and symmetric high signal intensity lesion, in basal ganglia would be a useful MR finding of subclinical portal-systemic encephalopathy in liver cirrhosis patients with no clinical or neuropsychiatric symptoms and larger than 10mm diameter of superior mesenteric vein in ultrasonography.
Basal Ganglia* ; Brain ; Edema ; Hepatic Encephalopathy* ; Humans ; Liver Cirrhosis* ; Liver* ; Magnetic Resonance Imaging* ; Melanins ; Mesenteric Veins ; Methemoglobin ; Neurofibromatoses ; Parenteral Nutrition ; Ultrasonography

Single breath-hold gradient echo images with Small Tip. Angle Gradient Echo(STAGE) were evaluated in the study of liver in 16 patients(4 normal liver, 5 hepatoma, 5 cholangiocarcinoma, 1 hemangioma, 1 cavernous transformation of portal vein). We obtained one slice of gradient echo during single breath-hold at the level of pathology defined on conventional spin echo inage. Single breath-hold gradient echo images were compared with spin echo images for image quality and artifacts. Single breath-hold gradient image showed improved resolution of vascular detail and excellent contrast between lesion and adjacent normal liver in hepatoma. Cholangiocarcinoma showed decreased contrast between lesion and biliary trees but improved contrast between lesion and blood vessel. Cavernous transformation of porta vein was noted as tortuous vessel of high signal intensity. Single breath-hold gradient echo scan increased vascular artifact, but decreased respiratory artifact leading to improved image quality. Single breath-hold technique can reduce can reduce imaging time and improve image quality and may be used as complementary method to the spin echo scan.
Artifacts ; Blood Vessels ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Hemangioma ; Liver* ; Magnetic Resonance Imaging* ; Methods ; Pathology ; Trees ; Veins

BACKGROUND: Most recently, there is an increased use of EGD (esophagogastroduodenoscopy) for primary care among family physicians, which tends to promote EGD training programs in the course of Family Practice Residency. This study determined to survey current status of EGD training programs among residents in family medicine, identify relevant problems, and present some suggestions for their improvement. METHODS: The subjects were residents selected among family medicine training hospitals, which were registered in the KAFM (Korean Academy of Family Medicine). The residents were in their 3rd year of training or had already completed the EGD training program. Surveys were sent out to those hospitals by mail and electronic mail surveys were performed by researchers. RESULTS: Among 66 subject hospitals a total of 27 surveys (40.9%) were returned. Most EGD training were performed in the department of internal medicine. The mean duration of training period was 8 weeks. The averale number of hands on experience of the procedure was 62. It was found that most residents thought that EGD training period and the number of hands on experience of the procedure were insufficient. The longer period of actual experience of the procedure and the more number of EGD caseloads they had, the more they were satisfied with their EGD training programs. It was also found that there was a high demand for a follow-up learning opportunities for EGD (p<.05), because the residents who had already had many EGD caseloads further wanted to receive continuous education even, after they acquired license. There were no relationships observation period, period of actual experience of the procedure, and number of EGD caseloads during residency with demand for follow-up learning opportunities. CONCLUSION: In summary, there was insufficient EGD training period and actual experience of the EGD procedure in family practice residency. There was low satisfaction of EGD training programs and high demand for continuous education. Therefore, it is recommended to establish EGD training program, proper practice training, and regular continuing education after completing residency.
Education ; Education, Continuing ; Electronic Mail ; Endoscopy, Digestive System* ; Family Practice* ; Hand ; Humans ; Internal Medicine ; Internship and Residency* ; Learning ; Licensure ; Physicians, Family ; Postal Service ; Primary Health Care

BACKGROUND: It has been known that the prevalence of depression is increasing and depressive mood is accompanied with various physical symptoms in the elderly. In this research, we studied various physical symptoms of the elderly patients and how many of those symptoms were associated to depressive mood. We also investigated how much their doctors were concerned about depressive symptoms of the patients. METHODS: The subjects were 135 patients over 60 years old, who visited geriatric center and department of family medicine in a university hospital from December 2002 to May 2003. Individual interviews were conducted among the subjects and all symptoms who suffered from within a month from the time of inter view, depression score, stress score, functional status and their sociodemographic factors were assessed. Finally, doctor's diagnosis or comments on depressive mood were assessed based on the medical documents of the elderly patients with depression. RESULTS: 56% of the subjects had depressive mood. Common symptoms of subjects were memory impairment, visual disturbance, fatigue, arthralgia, and thirsty sense. The more depressive mood the elderly have, the more physical symptoms they have. The physician paid their attention to depressive mood in 13% of the cases among the elderly with depressive mood. Depressive mood was affected by whom they lived together with, regular exercise and stress. CONCLUSION: This study shows that most of the elderly patients had depressive mood and their common symptoms were associated to depressive mood. The stress and living together with their children were risk factors for depression of the elderly. However, depressive mood was less found among those patients who had spouse and who exercised regularly. Though physicians more likely recognize the depressive mood of the elderly as depression was severer, still little attention was paid to depressive mood in the elderly.
Aged* ; Arthralgia ; Child ; Depression* ; Diagnosis ; Fatigue ; Humans ; Memory ; Prevalence ; Risk Factors ; Spouses ; Vision Disorders

Purpose of the present study was to find the optimal ovulation induction medicine for the maturation and development of immature oocytes and culture media for 2-cell embryos in the mouse model. ICR female mouse aged 6 to 8 weeks, were stimulated with 5 IU PMSG injection. At 47 to 50 hour post-PMSG injection, ovaries were dissected out and oocytes-cumulus complexes were punctured. The oocyte-cumulus complexes were cultured in media containing various ovulation induction medicine, CC, HMG and Metrodin for 18 hours. Female ICR mice were stimulated with 5 IU PMSG and 48 hours later were injected 5 IU of hCG, then female and male mice were mated. At 48 hour post-hCG injection, oviducts were dissected out and 2-cell embryos were flushed. The 2-cell embryos were cultured in various media, Ham's F-10 media of milli-Q water (3degrees), Ham's F-10 media of HPLC (high performance liquid chromatography, Baxter) water, Medicult media, HTF (human tubal fluid) media for 96hours. The results were as follows. 1. When the oocytes-cumulus complexes were cultured in 10(-9)microgram/ml~ 10(-8)microgram/ml of CC, those were suppressed in meiotic maturation (28.2~ 33.7%). Whereas the oocytes-cumulus complexes were cultured in 10(-7)microgram/ml~10(-4)microgram/ml, these were not effected in meiotic maturation (54.5~72.7%). 2. When the oocytes-cumulus complexes were cultured in 10(-4)microgram/ml~ 10(-1)microgram/ml of Metrodin, those were suppressed in meiotic maturation (35.7~ 41.5%). Meanwhile the oocytes-cumulus complexes were cultured in 10(-7)microgram/ml~10(-5)microgram/ml, those were not effected in meiotic maturation (54.2~ 70.3%). 3. When the oocytes-cumulus complexes were cultured in 10(-5)microgram/ml~ 10(-4)microgram/ml of HMG, those were suppressed in meiotic maturation (48.2~ 50.4%). As being cultured in 10(-7)microgram/ml~10(-6)microgram/ml, increased in meiotic maturation (75.8~80.7%). 4. When the 2-cell embryos were cultured in Ham's F-10 media of milli-Q wats. ( 3degrees), Ham's F-10 media of HPLC (high performance liquid chromatograpy, Banter) water, Medicult media, HTF (human tubal fluid) media, developmental rates to blastocyst and hatching for 96 hour were 50.0%, 45.2%, 71.5% and 95.6%, respectively.
Animals ; Blastocyst ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Culture Media ; Embryonic Structures* ; Female ; Humans ; Male ; Mice* ; Mice, Inbred ICR ; Oocytes* ; Ovary ; Oviducts ; Ovulation Induction* ; Ovulation* ; Urofollitropin ; Water

Hypoxia-inducible factor 1alpha (HIF-1alpha), which transactivates a variety of hypoxia-induced genes, is rapidly degraded under nomoxia through the hydroxylation-ubiquitination-proteasome pathway. In this study, we addressed how HIF-1alpha is stabilized by proteasome inhibitors. The ubiquitin pool was rapidly reduced after proteasome inhibition, followed by the accumulation of non-ubiquitinated HIF-1alpha. The poly-ubiquitination of HIF-1alpha was resumed by restoration of free ubiquitin, which suggests that the HIF-1alpha stabilization under proteasome inhibition is attributed to depletion of the free ubiquitin pool. Ni2+ and Zn2+ also stabilized HIF-1alpha with depletion of the free ubiquitin pool and these effects of metal ions were attenuated by restoration of free ubiquitin. Ni2+ and Zn2+ may disturb the recycling of free ubiquitin, as MG132 does. Based on these results, the state of the ubiquitin pool seems to be another critical factor determining the cellular level of HIF-1alpha.
Cell Hypoxia/physiology ; Cell Line, Tumor ; HCT116 Cells ; HEK293 Cells ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit/biosynthesis/*metabolism ; Leupeptins/pharmacology ; Nickel/chemistry ; Proteasome Endopeptidase Complex/*metabolism ; Proteasome Inhibitors/*pharmacology ; Ubiquitin/*metabolism ; Ubiquitination/*physiology ; Up-Regulation ; Zinc/chemistry