OBJECTIVE: To determine whether quantitative perfusion parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) correlate with immunohistochemical markers of angiogenesis in rectal cancer. MATERIALS AND METHODS: Preoperative DCE-MRI was performed in 63 patients with rectal adenocarcinoma. Transendothelial volume transfer (Ktrans) and fractional volume of the extravascular-extracellular space (Ve) were measured by Interactive Data Language software in rectal cancer. After surgery, microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression scores were determined using immunohistochemical staining of rectal cancer specimens. Perfusion parameters (Ktrans, Ve) of DCE-MRI in rectal cancer were found to be correlated with MVD and VEGF expression scores by Spearman's rank coefficient analysis. T stage and N stage (negative or positive) were correlated with perfusion parameters and MVD. RESULTS: Significant correlation was not found between any DCE-MRI perfusion parameters and MVD (rs = -0.056 and p = 0.662 for Ktrans; rs = -0.103 and p = 0.416 for Ve), or between any DCE-MRI perfusion parameters and the VEGF expression score (rs = -0.042, p = 0.741 for Ktrans ; r = 0.086, p = 0.497 for Ve) in rectal cancer. TN stage showed no significant correlation with perfusion parameters or MVD (p > 0.05 for all). CONCLUSION: DCE-MRI perfusion parameters, Ktrans and Ve, correlated poorly with MVD and VEGF expression scores in rectal cancer, suggesting that these parameters do not simply denote static histological vascular properties.
Adult ; Aged ; Aged, 80 and over ; Contrast Media/*diagnostic use ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic/diagnosis/metabolism ; Rectal Neoplasms/blood supply/*diagnosis/metabolism ; Retrospective Studies ; Tumor Markers, Biological/biosynthesis ; Vascular Endothelial Growth Factor A/*biosynthesis

A green mold species that has not previously been reported in Korea was isolated from oak log beds used for shiitake (Lentinula edodes) cultivation that were infested by mushroom flies. In this study, we identify the mold species as Gliocladium viride (an anamorph of Hypocrea lutea) and describe its mycological properties. The fungus was cottony on both potato dextrose agar (PDA) and Czapek yeast extract agar (CYA), but was colored white on PDA and became yellowish green and brown on CYA. Mycelial growth on PDA attained a diameter of 73 mm at 30degrees C after 5 days. The fungus grew faster on malt extract agar (> 80 mm, 5 days at 25degrees C) compared to CYA and PDA (< 68 mm, 5 days at 25degrees C). Penicillate conidiophores of the fungus are hyaline, smooth walled, branching above typically in four stages, and 120~240 microm in length. Club-shaped or slender phialides are formed on the metulae. Conidia of the fungus were ovate and elliptic, yellowish brown and green, and 2.5~3.0 microm x 1.8~2.3 microm in size. Typically, slimy conidia are formed in a mass and colored brown to dark green to almost black. The internal transcribed spacer rDNA and translation elongation factor 1 alpha gene sequences of the fungus isolated here show 99% identity with previously identified G. viride strains.
Agar ; Agaricales ; Diptera ; DNA, Ribosomal ; Fungi ; Gliocladium ; Glucose ; Humans ; Hyalin ; Hypocrea ; Korea ; Peptide Elongation Factor 1 ; Shiitake Mushrooms ; Solanum tuberosum ; Spores, Fungal ; Yeasts

PURPOSE: The purpose of this study is to investigate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and plasma cytokines and angiogenic factors (CAFs) as pharmacodynamic and prognostic biomarkers of bevacizumab monotherapy in colorectal cancer with liver metastasis (CRCLM). MATERIALS AND METHODS: From July 2011 to March 2012, 28 patients with histologically confirmed CRCLM received bevacizumab monotherapy followed by combined FOLFOX therapy. The mean age of the patients was 57 years (range, 30 to 77 years). DCE-MRI (K(trans) and IAUC₆₀) was performed at baseline, first follow-up (3 days after bevacizumab monotherapy), and second follow-up (3 days after combined therapy). CAF levels (vascular endothelial growth factor [VEGF], placental growth factor [PlGF], and interleukin-8) were assessed on the same days. Progression-free survival (PFS) time distributions were summarized using the Kaplan-Meier method and compared using log-rank tests. RESULTS: The median PFS period was 11.2 months. K(trans), IAUC₆₀, VEGF, and PlGF values on the first follow-up day were significantly different compared with baseline values. No differences were observed on the second follow-up day. A > 40% decrease in K(trans) from baseline to first follow-up was associated with a longer PFS (hazard ratio, 0.349; 95% confidence interval, 0.133 to 0.912; p=0.032). Changes in CAFs did not show correlation with PFS time. CONCLUSION: DCE-MRI parameters and CAFs are pharmacodynamic biomarkers of bevacizumab for CRCLM. In our study, change in K(trans) at 3 days after bevacizumab monotherapy was a favorable prognostic factor; however, the value of CAFs as a prognostic biomarker was not found.
Angiogenesis Inducing Agents ; Bevacizumab* ; Biomarkers ; Colorectal Neoplasms* ; Cytokines ; Disease-Free Survival ; Endothelial Growth Factors ; Follow-Up Studies ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Methods ; Neoplasm Metastasis* ; Plasma ; Vascular Endothelial Growth Factor A

Three cases of pituitary apoplexy in patients with pituitary tumors are described. This uncommon condition is characterized by the sudden onset of headache, nausea, vomiting, visual impairement, diplopia, disturbance of consciousness and autonomic or hormonal dysfunction. The diagnosis is strengthened by a radiologically abnormal pituitary fossa & clinical symptoms and confirmed by the operative findings of hemorrhage necrotic tissue. Recently, CT enables the early diagnosis of pituitary apoplexy. Since CT can detect blood, it can document acute or chronic hemorrhage in pituitary adenoma. In addition, CT can discriminate between densities other than blood and can therefore be used to diagnosis those cases of pituitary apoplexy in which infarction & necrosis predominate. Finding of acute bleeding within tumor in enlarged sellar on plain CT establishes the diagnosis of pituitary apoplexy. Following three cases of pituitary apoplexy had special findings which was fluid level with faint rim enhancement of high density of dependent portion. Conculsively We agree that CT can help the early diagnosis and prompt surgical intervention of pituitary apoplexy.
Consciousness ; Diagnosis ; Diplopia ; Early Diagnosis ; Headache ; Hemorrhage ; Humans ; Infarction ; Nausea ; Necrosis ; Pituitary Apoplexy* ; Pituitary Neoplasms ; Tomography, X-Ray Computed ; Vomiting

No abstract available.
Lung

E.S.T. is performed not only for the treatment but also for the diagnosis of biliary tract diseases. E.S.T. serves as a diagnostic aid for some of biliary tract diseases which require such procedures as a peroral cholangioscopy or biopsy of the biliary duct for precise diagnosis and further differential diagnosis. The diseases of our patients were diagnosed by clinical findings and such diagnostic maneuvers as abdominal ultrasonography, intravenous cholangiography, percutaneous transhepatic chorangiography(P.T.C.), endoscopic retrograde chorangiopancreatography(E.R.C.P.), In all the two cases, abdominal ultrasonography revealed dilated extrahepatic duct, but biliary trees were not visualized at E.R.C.P. In one of the two cases, P.T.C. revealed a filling defect with dilated common bile ducts(CBD) but we could not make a differential diagnosis of CBD stone from CBD cancer. In another of the two cases, on which intravenous cholangiography was done, we could not see CBD. For the purpuse of precise diagnosis and further differential diagnosis, we performed EST and then ERCP thraugh widened papillae. With those procedures, CBD stones were shown.
Bile ; Biliary Tract Diseases ; Biopsy ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diagnosis, Differential ; Humans ; Ultrasonography

Incidence of cardiac tumor is low among all tumors, but cardiac myxoma is a frequent benign tumor of the heart. Though cardiac myxoma has the classic triad (obstructive cardiac signs, embolism and constitutional manifestations), cardiac investigations may not be performed until the presence of cerebral embolism or cardiac problems, as in the case reported here. It is the reason that constitutional symptoms like myalgia, muscle weakness, arthralgia, fever and weight loss may be overlooked in the absence of any history of cardiac problems or may be confused as other specific immunological diseases. We present a case of a 26-year-old woman whose clinical manifestations of left atrial myxoma were multiple arthralgia, fever caused by constitutional symptoms, hemiplegia and aphasia caused by embolic cerebral infarction.
Adult ; Aphasia ; Arthralgia ; Cerebral Infarction ; Embolism ; Female ; Fever ; Heart ; Heart Neoplasms ; Hemiplegia ; Humans ; Immune System Diseases ; Incidence ; Intracranial Embolism ; Muscle Weakness ; Myxoma ; Weight Loss

Two cases of redundant nerve root syndrome of cauda equina in patient was described. The general clinical features were the intermittent neurologic claudication with improvement at rest, low back pain of long duration and radicular pain in one or both legs, sensory & motor change in one or both legs. Myelography revealed a partial to complete block with characteristic serpentine filling defects above or below the block simulating a vascular malformation. One case was associated with lumbar H.N.P and the other cases were associated with L-H.N.P and pseudospondylolithesis. In addition to, we reviewed the literature of redundant nerve root syndrome of the cauda equina.
Cauda Equina* ; Humans ; Leg ; Low Back Pain ; Myelography ; Vascular Malformations

BACKGROUND AND OBJECTIVES: As a preliminary study, authors tried to verify clinical and side effects of Radachlorin in a photodynamic therapy for recurrent head and neck malignancy. Radachlorin shows an absorption peak at 662 nm, which indicates that it penetrates up to 10 mm. SUBJECTS AND METHOD: We treated 12 sites for 9 treatments in 6 recurrent head and neck malignacies, 4 cases of squamous cell cancers and each of adenoid cystic cancer, and undifferentiated nasopharyngeal cancer. A dose of 1 mg/kg or 2-5 mL of Radachlorin was i.v. injected into the mass according to the mass size. We used a diode laser, MILON-662 (Milon Laser Company, Russia) and Medlight cylindrical 10/20 radial diffuser and frontal diffuser as light delivery devices. About 3 hrs after intravenous injection, or 30 min after intralesional injection, a light dose of 200-300 J/cm2 or cm of laser was irradiated onto the tumor or intralesionally with the light dose of 200-300 J/cm2, or cm. RESULTS: There was partial tumor regression in three of the five primary tumors. In one case of metastatic node treated by intralesional injection and irradiation, tumor showed complete necrosis. But there was no effect in 2 cases of subcutaneous metastases. There were no side effects such as fever, chill and photosensitivity in any of the cases. CONCLUSION: The clinical effect of photodynamic therapy (PDT) using Radachlorin with 662 nm of laser light is not clear yet, but it seems to be a safe treatment for head and neck malignancy. We need to investigate the effect of this PDT system in untreated head and neck malignancies.
Absorption ; Adenoids ; Fever ; Head ; Injections, Intralesional ; Injections, Intravenous ; Lasers, Semiconductor ; Light ; Nasopharyngeal Neoplasms ; Neck ; Necrosis ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Photochemotherapy ; Triazenes

Lung cancer frequently metastasizes to distant organs. However, solitary metastasis to the pancreas, with lung cancer as the source, is very rare. Most metastatic cases of the pancreas tend to be discovered in patients with widely disseminated malignant disease. In addition, patients with pancreatic metastases are often asymptomatic, the metastatic lesions are found incidentally, and are misdiagnosed as primary pancreatic tumors. We described the case of a 63-year-old man who presented with abdominal pain and a pancreatic nodule. The patient underwent resection of primary lung cancer followed by pylorus preserving pancreatoduodenectomy. The pancreatic nodule was confirmed as a solitary metastasis from lung cancer.
Abdominal Pain ; Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Neoplasms ; Middle Aged ; Neoplasm Metastasis ; Pancreas ; Pancreaticoduodenectomy ; Pylorus