No abstract available.
Embryonic Structures* ; Extremities*

Primary hypertrophic osteoarthropathy is a rare hereditary disease without evidence of underlying diseases. We report a very unusual case of primary HOA accompanied by Crohn's disease with the primary HOA mimicking secondary HOA, which is a rare manifestation of Crohn's disease. We also review the literature to find the correlation, if any, between the two.
Adult ; Case Report ; Crohn Disease/radiography ; Crohn Disease/pathology ; Crohn Disease/complications* ; Human ; Male ; Osteoarthropathy, Primary Hypertrophic/radiography ; Osteoarthropathy, Primary Hypertrophic/complications*

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of [18F]FDG PET in the diagnosis of recurrent head and neck cancer after the completion of surgery and radiotherapy in patients with head and neck cancers. MATERIALS AND METHODS: In fifty-nine patients with head and neck cancers, whole body [18F]FDG PET studies were performed. According to the different therapeutic modalities, patients were divided into four groups (Group I; pre-treatment, Group II; surgery, Group III; radiotherapy, Group IV; both surgery and radiotherapy). [18F]FDG PET images were compared with clinical, CT and histopathologic findings. RESULTS: For detection of metastatic lymph nodes in 14 patients of pre-treatment group (group I), the sensitivity and specificity of PET were 100% (10/10) and 75% (3/4), and those of CT were 80% (8/10) and 100% (4/4). For detection of recurrence in 45 patients of post-treatment group, overall sensitivity and specificity of PET were 96.2% (25/26) and 78.9% (15/19) [(100% and 75% in group II, 80% and 50% in group III, and 100% and 100% in group IV)] without significant difference from pre-treatment group (p>0.1). In detecting recurrence, the sensitivity and specificity of [18F]FDG PET were 90.9% (10/11) and 20% (1/5) in 16 patients who underwent [18F]FDG PET within 2 months after the completion of treatment. The specificity of these patients was significantly lower than that of 29 patients (100% of sensitivity and specificity) who underwent [18F]FDG PET 2 months after treatment (p<0.05). CONCLUSION: [18F]FDG PET is an accurate diagnostic modality for the detection of recurrence in head and neck cancer. Post-therapy [18F]FDG PET should be obtained at least 2 months after the completion of surgery or radiotherapy.
Diagnosis ; Head and Neck Neoplasms ; Head* ; Humans ; Lymph Nodes ; Neck* ; Radiotherapy* ; Recurrence ; Sensitivity and Specificity

In performing general anesthesia, the endotracheal tubes are most commonly used and the space between trachea and tubes are sealed with inflatable cuffs to apply positive pressure ventilation. But in children, especially small children, a plain oral-tracheal tube is to be used. The subglottic region is very narrow and the tubes of the small diameter are used. The endotracheal tub. cuffs are not used and the largest correct sized tubes may cause air leak around them. The V-pack, designed by Vickery and Burton and manufactured at Dentmad Ltd, England was used to seal the laryngeal inlet to control air leak during intermittent positive ventilation. This attempt seems to be very successful to prevent air leaks around trachea in case of ruptured inflatable cuffs of the adult during surgery. The damage of tracheal wall by increasing pressure of endotracheal cuff with nitrous oxide-oxygen anesthesia will be prevented when using V-packs. The V-packs were inserted with plain endotracheal tubes to throat to evaluate the efficacy of sealing the air leak around trachea and the post-operative sore throat with 10 adults(age between 21 and 72) and 10 children (age between 2 and 6). In the all cases, 1) The sealing of air leakage around throat with V-pack use was satisfactory. 2) Three out of ten adult cases, slight sore throat were complained but there were none such cases in children. 3) The V-pack was shown to te especially effective and convenient to seal the air leak around trachea when plain-endotracheal tubes were intubated through nasotracheal route. 4) Additionally, in two adult cases with the punctured endotracheal cuffs during surgery, the V-pack was satisfactory to seal the air leak around trachea during positive pressure ventilation.
Adult ; Anesthesia ; Anesthesia, General ; Bays ; Child ; Clinical Study* ; England ; Humans ; Pharyngitis ; Pharynx* ; Positive-Pressure Respiration ; Trachea ; Ventilation

PURPOSE: To compare the survival rates of patients with hepatoma using different methods of transcatheter arterial chemoemblization(THAE). MATERIALS AND METHODS: Four hundred and eighty three patients with hepatoma diagnosed by biopsy, serum alpha-fetoprotein, abdominal CT scan, abdominal ultrasonography or hepatic angiography were included, but not all had reccived surgical treatment. They were divided into two groups according to Child's classification and into subgroups according to different methods of THAE. Five-year survival rates among these groups were retrospectively Compared. The patients were aged between 24 and 85(mean, 58) ; male to female ratio was 324:61 for those who received THAE (396:87 when only hepatic angiography was considered). RESULTS: In the group with more than a single episode of chemoembolization, regardless of Child's classification, a better survival rate compared to the other groups with or without concommitant radiotherapy or without chemoembolization was noted. There was no difference in the survival rate of patients with multiple chemoembolization. Moreover, no difference in this rate was observed no matter what chemotherapeutic agents, including Adriamycin, Cis-Diaminedichloroplatinum or 1-131-Lipiodol, were used. Embolization by gelfoam in conjuction with Adriamycin resulted in no difference in survival rate regardless of requency of chemoembolization. CONCLUSIONS: An improved survival rate was seen when multiple episodes of chemoembolization were applied, but no difference was seen when there was concomitant application of either gelfoam or radiotherapy. Two different chemotherapeutic agents,Adriamycin and Cis-Diaminedichloroplatinum, were used, but there was no difference between them in their effect on survival rates.
alpha-Fetoproteins ; Angiography ; Biopsy ; Carcinoma, Hepatocellular* ; Classification ; Female ; Gelatin Sponge, Absorbable ; Humans ; Male ; Radiotherapy ; Retrospective Studies ; Survival Rate* ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND/AIMS: The aims of this study were to investigate whether a broccoli sprout extract containing sulforaphane (BSES) inhibited the Helicobacter pylori infection density and exerted an antioxidative effect on gastric mucosal damage. METHODS: The enrolled subjects were randomized in a double-blinded manner into three groups. Finally, 33 H. pylori (+) BSES treatment subjects (group A), 28 H. pylori (+) placebo subjects (group B), and 28 H. pylori (-) BSES treatment subjects (group C) were studied. H. pylori infection density was indirectly quantified by a 13C-urea breath test (UBT), and the ammonia concentration in gastric juice aspirates was measured through gastroscopic examination. Malondialdehyde (MDA), an oxidative damage biomarker, and reduced glutathione (GSH), an antioxidant biomarker, were measured in the gastric mucosa by an enzyme-linked immunosorbent assay. RESULTS: BSES treatment did not significantly affect the UBT values or ammonia concentration in group A (p=0.634 and p=0.505, respectively). BSES treatment did significantly reduce mucosal MDA concentrations in group A (p<0.05) and group C (p<0.001), whereas the gastric mucosal GSH concentrations did not differ before and after treatment in any of the groups. CONCLUSIONS: BSES did not inhibit the H. pylori infection density. However, BSES prevented lipid peroxidation in the gastric mucosa and may play a cytoprotective role in H. pylori-induced gastritis.
Adult ; Ammonia/metabolism ; Antioxidants/*pharmacology ; Biomarkers/analysis ; Brassica/*chemistry ; Breath Tests ; Double-Blind Method ; Enzyme-Linked Immunosorbent Assay ; Female ; Gastric Juice/enzymology ; Gastric Mucosa/*drug effects/metabolism ; Glutathione/analysis ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Humans ; Isothiocyanates/*pharmacology ; Lipid Peroxidation/*drug effects ; Male ; Malondialdehyde/analysis ; Middle Aged ; Plant Extracts/chemistry/*pharmacology ; Urea

PURPOSE: To described the MR findings in the periodic changes of the size and signal intensity ofreconstructed anterior cruciate ligament (ACL) of the knee and the efficacy of oblique axial imaging in patientswho underwent arthroscopic ACL reconstruction using autogenous patellar tendon. MATERIALS AND METHODS: Twenty-onepatients who had undergone ACL reconstruction were evaluated by follow-up MRI at postoperative 1 week, 1, 2, 3 and6 months, and 1 year, Conventional Fast-Spin-Echo (FSE) sagittal and coronal images and oblique axial images(proton density and T2-WI; VEMP TR/TE, 2000/20/70) were obtained perpendicular to the ligament, and using an ROIcurve in the intra-articular area, periodic changes in the cross-sectional area were evaluated by proton densityimaging and signal intensity by T2WI imaging. Cross-sectional morphology was categorized as either smooth, andround or notch-shaped and periodic changes in configuration were observed. In three cases, we evaluated the retearof reconstructed ACL by comparing the oblique axizl image obtained by conventional sagittal and coronal imaging. RESULTS: The cross-sectional area and signal intensity of grafted ACL increased significantly (p<0.05) after 3months and at 1 year, respectively. Cross-sectional morphology was smooth and round in 86% of cases, and notchedin 14%, and during follow-up MR studies, no periodic changes were seen. Notch-shaped ACL and decreased perigraftsignal intensity, as seen on sagittal images, could lead to a misdiagnosis of partial tear ; on oblique axialimages, ACL and perigraft signal intensity were found to be normal. CONCLUSION: During the natural evolution ofgrafted ACL, cross-sectional area and signal intensity increased significantly after 3 months and at 1 year,respectively ; on follow-up MR studies, cross-sectional morphology did not change, however. Oblique axial imagingprovides important information for evaluating whether the reconstructed ACL is torn or not.
Anterior Cruciate Ligament* ; Cross-Sectional Studies ; Diagnostic Errors ; Follow-Up Studies* ; Knee* ; Ligaments ; Magnetic Resonance Imaging ; Patellar Ligament ; Prospective Studies* ; Protons ; Transplants*

PURPOSE: To assess the role of contrast-enhanced dynamic Magnetic Resonance Imaging in evaluating disease activity of rheumatoid arthritis. MATERIALS AND METHODS: Forty-seven wrist joints with rheumatoid arthritis were examined prospectively. coronal images of the wrist were obtained using fat-suppression Fast multi-planar spoiled gradient recalled(FMPSPGR) acquisition in the steady state ; TR/TE=102/6.4m sec, flip angle=60.4 slices persequence, FOV=8cm, matrix=256X192 at 1.5 Tesla. Scans were carried out once before and five to eight times after an intravenous Gd-DPTA injection, at 30-second-intervals. The enhancement of synovium were measured, the enhancement ratio was calculated(postcontrast SNR/precontrast SNR) and time-enhancement ratio curves were plotted patients were divided into three groups according to the ratio of inital to peak enhancement: less than 30%; 30-80%; morethan 80%. Differences among the three groups were statistically tested using clinical indices and laboratory data as variables. RESULTS: Comparing one group with another, there were no significant differences in clinical indices and laberatory data except for the parameter of grip strength. CONCLUSION: Enhancement pattern measured in a single wrist joint was not comparable to a clinical index in predicting disease activity in rheumatoid arthritis.
Arthritis, Rheumatoid ; Hand Strength ; Magnetic Resonance Imaging* ; Prospective Studies ; Synovial Membrane ; Wrist Joint* ; Wrist*

BACKGROUND: Pathologic grading, one of the most important prognostic factors of papillary urothelial neoplasia (PUN) of the urinary bladder, has been revised continuously. The current study focused on the analysis of interobserver agreement on PUN of the urinary bladder bet- ween 1973 WHO classification (WHO 1973) and 1998 WHO/ISUP classification. METHODS: Seventy five cases from 15 institutions were collected, and after review by Korean Society of Urogenital Pathology (KSUP), 30 cases were selected as follows; group I, WHO grade 1 and papillary urothelial neoplasm of low malignant potential by ISUP (7 cases), group II, WHO grade 2 and low-grade papillary urothelial carcinoma (16 cases), and group III, WHO grade 3 and high-grade papillary urothelial carcinoma (7 cases). Seventy five general surgical pathologists who participated in this study were asked to grade the tumors based on WHO/ISUP classification. Interobserver agreement between the participants' diagnosis and KSUP consensus diagnosis was analyzed by kappa value. RESULTS: Interobserver agreement assessed by kappa value for all diagnostic groups was very low; for group I, kappa value was -0.900893722; for group II, -0.944650025, and for group III, -0.876728996. The overall kappa value of pathology residents was better than that of practicing pathologists. CONCLUSIONS: The 1998 WHO/ ISUP classification could not be easily translated from the 1973 WHO classification and because of poor interobserver agreement, it appears that further work would be needed before it can be practically applied.
Carcinoma, Transitional Cell ; Classification* ; Consensus* ; Diagnosis ; Pathology* ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: The purpose of this study was to review the clinical and mammographic findings of pure mucinousbreast carcinoma. MATERIALS AND METHODS: In ten patients diagnosed as suffering from pure mucinous breastcarcinoma, we reviewed the clinical and mammographic findings. They were aged between 36 and 72(mean 46.3)years;nine were female and one was male. To describe breast mass, we used the terminology of the BreastImaging-Reporting and Data System developed by the American College of Radiology. RESULTS: All patients hadpalpable masses. The long-axis diameter of the tumors was between 1.0 and 7.0(mean, 2.81)cm, and in two patients,tumors were multiple. No cases involved metastatic axillary lymph nodes. During the follow-up period of 2 to78(mean, 36.3) months, no patient died. Mammographic findings included lobular circumscribed masses in fourpatients, round or oval circumscribed masses in three a lobular microlobulated mass in one, a round microlobulatedmass in one and a round spiculated mass in one. Microcalcifications were noted in two cases. Architecturaldistortion and nipple retraction were each found in one patient. CONCLUSION: On mammography, pure mucinous breastcarcinoma was most commonly seen as a lobular or round circumscribed mass; these masses were palpable and clinicalprognosis was relatively good.
Breast* ; Female ; Follow-Up Studies ; Humans ; Information Systems ; Lymph Nodes ; Male ; Mammography ; Mucins* ; Nipples