PURPOSE: To elucidate high-resolution CT(HRCT) findings and their pathologic basis in pulmonary oil embolism induced by LipiodoI-Adriamycin emulsion. MATERIALS AND METHODS: Pulmonary oil embolism was induced by infusing LipiodoI-Adriamycin emulsion through a peripheral vein in twelve Yorkshire pigs. Serial HRCT scans were performed on 2rid, 4th, 7th, 14th, and 28th day after the procedure. The pigs were sacrificed immediately after HRCT and histologic specimens were prepared in the same plane and level with HRCT. RESULTS: The basic pathology was reversible hemorrhagic edema of the lung. On HRCT, intraalveolar hemorrhage and edema in the acute stage manifested as ground-glass opacity or air-space consolidation of the whole secondary Iobule. The lesions were predominantly distributed over the dependent posterior lung fields because the specific gravity of Lipiodol is 1.28. Interlobular septal thickening due to edematous fluid collection was also associated. With the elapse of time, the extent and severity of the acute lesions resolved and, sometimes, changed into small nodular opacities. Pulmonary opacity was most severe on the post-embolization 2nd day and completely resolved within 2 weeks. CONCLUSION: Pulmonary embolization of LipiodoI-Adriamycin emulsion causes reversible hemorrhagic edema of the lung and Lipiodol toxicity seems to play a major role. HRCT findings of pulmonary oil embolism are quite different from those of pneumonia and pulmonary metastasis, which suggests the possibility of clincal application.
Edema ; Embolism* ; Ethiodized Oil ; Hemorrhage ; Lung ; Neoplasm Metastasis ; Pathology ; Pneumonia ; Specific Gravity ; Swine ; Veins

PURPOSE: To evaluate ethanolamine oleate (EAO)-microfibrillar collagen (MFC) mixture as a new scleroembolic material for the interventions requiring both permanent obliteration of vascular lumen and atrophy of mass, such as for the facial AVM and other hypervascular soft tissue masses. MATERIALS AND METHODS: Twenty-nine transcatheter transarterial embolizations of renal arteries were performed in six groups of rabbits classified by the EAO concentration and the addition of MFC. Postembolization angiography, gross morphological and microscopic examinations of embolized kidneys were performed immediately, 3 days, 2 weeks and 4 weeks after embotization. Analysing points were the usefulness as a scleroembolic material (endovascular retention, thrombogenic-sclerosing effect, perivascular fibrosis and inflammatory reaction), effects of the EAO concentration and the addition of MFC. RESULTS: EAO-MFC mixture satisfied all ideal conditions of scleroembolic agent;persistent endovascular retention, good thrombogenic-sclerosing effect with a mild inflammatory reaction and significant atrophy of kidney. The effect of increasing concentration of EAO was proximal embolization. The effects of MFC were promotion of proximal embolization, endovascular retention and sclerosing effect. CONCLUSION: EAO-MFC mixture can be used as a new effective scleroembolic material for the various hemodynamic situations in which embolic level can be controlled by EAO concentration and the addition of MFC.
Angiography ; Atrophy ; Collagen* ; Ethanolamine* ; Fibrosis ; Hemodynamics ; Kidney ; Oleic Acid* ; Rabbits* ; Renal Artery

PURPOSE: To evaluate histopathologic correlation of the component of the lesion on CT and MR of retinoblastomas. MATERIALS AND METHODS: Gross pathologic findings of 24 enucleated eyeballs in 24 patients with retinoblastomas were compared with preoperative CT (n=19) and MR (n=5) findings. In eight eyeballs, in which there were findings other than mass, histopathologic findings were reviewed and correlated with image findings. RESULTS: Retinal detachment and subretinal hemorrhage which were not detected on CT were demonstrated in two of eight eyeballs on histopathologic examination. In one eyeball, retinal detachment and subretinal effusion were detected on both CT and in a pathologic specimen. In two eyeballs with peripheral heterogeneous MR enhancement of the masses, tumor necrosis and calcification were demonstrated in the central non-enhancing portion of the mass. In two eyeballs, linear soft tissue along the retina apart from the main mass were revealed as tumor spread along the retinal surface. In one patient, retinal thickening on MR was presumed to be an MR artifact and no lesion was found in the gross specimen. CONCLUSION: On CT, retinal detachment and subretinal hemorrhage associated with retinoblastoma can mimic mass, and tumor spread along the retinal surface can be seen as a linear retinal lesion. On MR, tumor necrosis and calcification can be a cause of heterogeneous enhancement.
Artifacts ; Hemorrhage ; Humans ; Necrosis ; Retina ; Retinal Detachment ; Retinaldehyde ; Retinoblastoma*

Arytenoid dislocation is an unusual complication of endotracheal intubation. We reported a case of a 48-year-old female with arytenoid dislocation after uneventful endotracheal intubation, which was successfully treated with arytenoid reduction. The patient complained of persistent hoarseness until the fourth day after an uneventful gynecologic surgery under general anesthesia. On laryngoscopic examination, paralyzed left vocal cord with minimal arytenoid movement was observed. An anteromedial dislocation of the left arytenoid cartilage was suspected and surgical reduction was performed by the laryngologist. The hoarseness was immediately resolved after surgical intervention. Anesthesiologists should be careful not to cause laryngeal trauma in anesthetized patients. In addition, early diagnosis and prompt surgical reduction are essential for a better prognosis for arytenoid dislocation.
Anesthesia, General ; Arytenoid Cartilage ; Dislocations* ; Early Diagnosis ; Female ; Gynecologic Surgical Procedures ; Hoarseness ; Humans ; Intubation ; Intubation, Intratracheal* ; Middle Aged ; Prognosis ; Vocal Cords

Acardiac fetus in triplet pregnancy is a very rare, fatal congenital anomaly that had not been reported in Korea. It only occurs in multiple gestations associated with placental vascular anastomoses between the affected fetus and its co-twin. The major complications associated with acardiac fetus in triplet pregnancy are congestive heart failure in normal pumping fetus, maternal polyhydramnios, preterm labor, intrauterine fetal death, etc, and perinatal diagnosis can be made with the perinatal ultrasonographic examination. We report a case of acardiac fetus in a spontaneous triplet pregnancy at 23 weeks of gestational age with a brief review of the literature.
Diagnosis ; Female ; Fetal Death ; Fetus* ; Gestational Age ; Heart Failure ; Humans ; Korea ; Obstetric Labor, Premature ; Polyhydramnios ; Pregnancy ; Pregnancy, Triplet* ; Triplets*

PURPOSE: To evaluate the effect of magnetization transfer(MT) in contrast-enhanced brain MR imaging of the various intracranial diseases. MATERIALS AND METHODS: We prospectively studied the effect of MT incontrast-enhanced brain MR imaging 101 patients with a variety of intracranial diseases. In all patients contrast-enhanced T1-weighted(TR/TE = 550/14) SE MR images with and without MT were obtained on a 1.5 Tsuper conducting unit(Magnetom, Siemens). The MT pulse used for MT images was an 8.1 msec(=250 Hz band width) syncpulse, 1000 Hz off-resonance. We randomly divided the patients into two groups : group I and group II. Group I consisted of 54 patients in whom contrast-enhanced images without MT and then images with MT were obtained just ofter the injection of Gd-DTPA(0.1 mmol/kg). In group II(47 patients), contrast-enhanced images with MT and then the images without MT were obtained, considering the delayed-enhancement effect. The effect of MT was assessed visually and quantitatively. For quantitative assessment, contrast to noise ratios(CNR) were calculated in 27 cases with enhancing intracranial tumors larger than 1 cm. We then compared CNRs of contrast-enhanced images with and without MT. The paired t-test was used for statistical analysis. RESULTS: On visual assessment, only11.9%(12/101) of normally enhancing structures and only 20.3%(14/69) of enhancing lesions showed improved enhancement in images with MT. There was however, no case in which the enhancing lesion was seen only in MR image with MT but not in that without MT. On quantitative analysis there was no statistically significant difference between overall images with MT and those without MT(p>0.05). The average CNR of images with MT was higher than that of images without MT in group I, but not in group II. CONCLUSION: MT in contrast-enhanced brain MR imaging resulted in contrast improvement in a limited number(less than approximately 20%) of patients. Routine application of MT images to contrast-enhanced brain MR imaging may be of limited value. Further studies on the clinical usefulness of MT technique with more refined MT pulse are thus needed.
Brain* ; Humans ; Magnetic Resonance Imaging* ; Noise ; Prospective Studies

Esmolol is a cardioselective beta-blocker with a very rapid onset of action and a short half-life. Labetalol is a combined alpha- and beta-adrenoceptor blocking agent. It is a nonselective antagonist at beta-adrenoceptors and a competitive antagonist of postsynaptic alpha 1-adrenoceptors. A 51 year old female patient was transferred to the operating room for performing spinal fusion under general anesthesia. She had no operation and medication history. The initial heart rate was 150 beats/min. Despite administering several bolus injections of esmolol, the heart rate was not decreased to under 130 beats/min. But the heart rate was decreased to 100 beats/min after the administration of labetalol 5 mg and this rate was maintained without an additional injection. The vital signs were stable until the operation was finished and the patient recovered uneventfully in the recovery room. The postoperative laboratory findings revealed that she had hyperthyroidism. We report here on an anesthetic experience of effective labetalol treatment for esmolol-resistant tachycardia in a patient who was under general anesthesia.
Anesthesia, General ; Female ; Half-Life ; Heart Rate ; Humans ; Hyperthyroidism ; Labetalol ; Operating Rooms ; Propanolamines ; Recovery Room ; Spinal Fusion ; Tachycardia ; Vital Signs

PURPOSE: Breast cancer has been reported as the most common cancer of women in the United States, Western Europe and Korea and about 210,000 and 10,000 women in United States and Korea every year, respectively are diagnosed with it. Breast cancer is curable with an early diagnosis, and many researchers have made efforts to find a marker for this malady, heat shock protein (HSP) consists of 6 groups, it is highly preserved throughout both the prokaryotic and eukaryotic cells and it acts as a molecular chaperone that's involved in protein folding. HSPs have been recently reported to be related with breast cancer. In this study, we investigated the changes of expression of HSP60 in tissues and cell lines of breast cancer. METHODS: We obtained breast cancer tissues and normal tissues from breast cancer patients, and we purchased several cancer cell lines from American tissue culture correction. We treated the tissues and the cell lines of human breast cancer with heat shock protein. Proteins and mRNAs were isolated from the tissues and the cells and then we performed Western blotting, reverse transcriptase-Polymerase chain Reaction and fluorescence activated cell sorter analysis on them. RESULTS: On Western blot, HSP60 was more overexpressed in the tissues and the cell lines of breast cancer than in the normal breast tissues and cell lines. The expression of HSP60 showed 2 types of molecular weight differences in the tissues and cell lines of breast cancer, and specifically, low HSP60 was over-expressed in the cancer tissues. There was no difference between the breast cancer cell lines and the normal cell lines in the expressions of HSP60 mRNA, according to the treatment with heat shock. Also, there was no relationship between phosphorylation and the structural difference of HSP60 protein, according to HSP60 protein's molecular weight. The expression of HSP60 has been mostly reported at the mitochondria; however, in this study, it was more predominantly detected at the cytoplasm than at the mitochondria in the breast cancer cell lines. CONCLUSION: We conclude that HSP60 may be used as a diagnostic marker for breast cancer. Detailed investigation of the usefulness and significance of the HSP60 expression as a prognostic factor is required in further studies.
Blotting, Western ; Breast ; Breast Neoplasms ; Cell Line ; Chaperonin 60 ; Cytoplasm ; Early Diagnosis ; Eukaryotic Cells ; Europe ; Female ; Fibrinogen ; Fluorescence ; Heat-Shock Proteins ; Hot Temperature ; Humans ; Korea ; Mitochondria ; Molecular Chaperones ; Molecular Weight ; Phosphorylation ; Protein Folding ; Proteins ; RNA, Messenger ; Shock ; United States

The present study was undertaken to investigate the infection status of Cryptosporidium parvum in the villagers and the reservoir hosts in several rural areas in Korea. A total 5, 262 fecal samples were collected from the inhabitants residing at Gangwon-do, Chungcheongbuk-do, Jeollanam-do, and Gyeongsangnam-do between the dates of September, 2001 to June, 2002. In addition, 1, 453 fecal samples were collected from livestock reared in Gokseong-gun, Jeollanam-do and Chungju-si, Chungcheongbuk-do. All the fecal smears were prepared by formalin-ether sedimentation, and examined by light microscopy after modified acid-fast staining. The overall positive rate of human cryptosporidiosis was 3.3%. Gokseong-gun, Jeollanam-do showed a 8.2% positive rate and appeared as the highest endemic area among the surveyed areas. Haman-gun, Gyeongsangnam-do showed a 0.4% positive rate and was the lowest endemic area. The positive rate of livestock infection in Gokseong-gun, Jeollanam-do was 94%, which was more than ten times higher than that of Chungju-si, Chungcheongbuk-do (9.3%). From these results, it was revealed that cryptosporidiosis was an endemic disease in some rural areas of Korea, and the livestock could be an important source of human infection.
Adolescent ; Adult ; Age Distribution ; Aged ; Animals ; Animals, Domestic/*parasitology ; Cattle ; Cattle Diseases/*epidemiology/parasitology ; Child ; Child, Preschool ; Cryptosporidiosis/*epidemiology/parasitology/veterinary ; Cryptosporidium parvum/*isolation & purification ; Feces/parasitology ; Female ; Human ; Infant ; Infant, Newborn ; Korea/epidemiology ; Male ; Middle Aged ; Parasite Egg Count ; Prevalence ; *Rural Population ; Support, Non-U.S. Gov't ; Swine ; Swine Diseases/*epidemiology/parasitology

PURPOSE: To determine differential points, if any, on MR imaging between cerebellar cystic hemangioblastoma and cystic astrocytoma. MATERIALS AND METHODS: MR images of patients with surgically proven cerebellar cystic hemangioblastomas (n=12) and cystic astrocytomas (n=14) were retrospectively reviewed with regard to the following points: size, location and signal intensity of the tumor ; tumor margin; presence, size and location of the enhancing mural nodule; vascular signal voids, internal septations, enhancing feature of the cyst wall, secondary findings (degree of peritumoral edema and presence of hydrocephalus) and the patient's age. RESULTS: The significant (p<0.5) differential points were vascular signal voids, which were the most important clue, as well asthe presence of an enhancing mural nodule, tumor margin, enhancing feature of the cyst wall and the patient's age.If the patient was an adult and presented an enhancing mural nodule with adjacent vascular signal voids and smooth tumor margin, then cystic hemangioblastoma was suggested, While the presence of an irregular-margined thick enhancing cyst wall, mural nodule without adjacent vascular signal voids and pediatric age were suggestive of cystic astrocytoma. CONCLUSION: On MR imaging, there are certain significant differential points between these similar-appearing tumors and these would be useful for a more accurate diagnosis.
Adult ; Astrocytoma* ; Diagnosis ; Edema ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies