PURPOSE: To assess the efficacy of three-dimensional CT angiography (3D-CTA) using multi-detector row computed tomography (MDCT) in the evaluation of intracranial aneurysms in patients with non-traumatic acute subarachnoid hemorrhage and to describe those aneurysms which were not found 3D-CTA. MATERIALS AND METHODS: 3D-CTA was done in 40 patients with non-traumatic subarachnoid hemorrhage by using a 16-slice MDCT; conventional digital subtraction angiography (DSA) was done in 36 of those patients within 12 hours. The CT and DSA images were reviewed by two radiologists and the site, size and neck of the aneurysms were evaluated. The results from these two modalities were then compared with the operative findings. We calculated the detection rates by 3D-CTA and DSA and evaluated the size differences of aneurysms dignosed with 3D-CTA and those found at surgery. We also analyzed the locations and sizes of aneurysms missed by 3D-CTA and attempted to explain these false negatives. RESULTS: A total of 55 aneurysms were surgically confirmed in 40 patients. 48 of these were detected pre-operatively by 3D-CTA. Thus, the detection rate by 3D-CTA was 87%. The size difference of aneurysms as calculated by 3-D CTA and found operatively was as follows: less than 1 mm in 17 cases, within 1-2 mm in 15 cases, and more than 2 mm in 16 cases. Seven aneurysms were not detected by 3D-CTA. The major cause of these missed aneurysms was their small size. The undetected aneurysms were less than 2 mm in size, except for 2 instances of PCoA aneurysms. One case was not detected due to difficult image evaluation. A possible explanation of the one remaining missed aneurysm was the filling of the aneurismal sac by thrombosis. CONCLUSION: Though there were some limitations in the detection of aneurysms, 3D-CTA using 16-channel MDCT may provide sufficient pre-operative information for the management of patients with intracranial aneurysms in cases of emergency operations or DSA-failure.
Aneurysm ; Angiography ; Angiography, Digital Subtraction ; Emergencies ; Humans ; Intracranial Aneurysm* ; Neck ; Subarachnoid Hemorrhage ; Thrombosis

PURPOSE: We aimed to assess the role of positron emission tomography using fluorodeoxyglucose (FDG-PET) in the diagnosis of recurrence or the assessment of therapeutic response in cervical and ovarian cancer patients through making a comparison between FDG-PET, abdominal computed tomography (CT) and serum tumor marker. Materials and METHODS: We included 103 cases (67 patients) performed FDG-PET and abdominal CT. There were 42 cervical cancers and 61 ovarian cancers. We retrospectively reviewed the interpretations of PET and CT images as well as the level of tumor marker. We calculated their sensitivity, specificity, positive predictive value and negative predictive value for these three modalities. And then we analyzed the differences between these three modalities. RESULTS: Tumor recurrences were diagnosed in 37 cases (11 cervical cancers and 26 ovarian cancers). For PET, CT and tumor marker, in cervical cancer group, sensitivity was 100% (11/11), 54.5% (6/11) and 81.1% (9/11), respectively. And specificity was 93.6% (29/31), 93.6% (29/31) and 100% (31/31). In ovarian cancer group, sensitivity was 96.2% (25/26), 84.6% (22/26) and 80.8% (21/26), and specificity was 94.3% (33/35), 94.3% (33/35), 94.3% (33/35). PET was highly sensitive to detect the intraperitoneal and extraperitoneal metastasis with the help of the CT images to localize the lesions. However, CT had limitations in differentiation of the recurrent tumor from benign fibrotic tissue, identification of viable tumors at the interface of tissues, and detecting extraperitoneal lesions. CONCLUSION: FDG-PET can be an essential modality to detect the recurrent or residual tumors in gynecologic cancer patients because of its great field of the application and high sensitivity.
Humans ; Neoplasm Metastasis ; Neoplasm, Residual ; Ovarian Neoplasms ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Recurrence ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

PURPOSE: The aims of this study were to analyze correlation between the maximum standardized uptake value (SUVmax) of 2-[F-18]-fluoro-2-deoxy-d-glucose (FDG) on positron emission computed tomography (PET-CT) scan and the degree of contrast enhancement on computed tomography (CT) scan in lung cancers, and to recognize the difference in SUVmax and CT enhancement between groups of different histopathologic subtypes. MATERIALS AND METHODS: Our study included 53 patients of pathologically confirmed primary lung cancer, who were performed PET-CT and post-contrast chest CT. We calculated initial and delayed SUVmax (SUV1, SUV2), difference between SUV1 and SUV2 (SUVd), retention index (RI), and the degrees of CT contrast enhancement of lung cancers. We analyzed these variables for subtypes of lung cancers. RESULTS: The values (mean +/- standard deviation) were 8.3+/-4.4 for SUV1, 10.7+/-5.7 for SUV2, 2.4+/-1.6 for SUVd, 30+/-14 for RI and 47.1+/-14.8 HU (Hounsfield Unit) for degree of CT contrast enhancement. The difference of SUV1 and degree of CT enhancement between subtypes was not meaningful. SUV1 showed positive correlations with SUVd (r=0.74, p<0.01) and tumor size (r=0.58, p<0.01), but no significant correlation with degree of CT enhancement (r=0.06, p=0.69). In 10 cases, there was discrepancy in the same mass between the area of highest FDG-uptake and the area of highest contrast enhancement. CONCLUSION: We suggest that FDG uptake in lung cancer does not have a positive linear correlation with degree of CT enhancement. And there is no significant difference in FDG uptake and degree of CT enhancement between different subtypes of lung cancers
Electrons ; Humans ; Lung ; Lung Neoplasms ; Retention (Psychology) ; Thorax ; Tomography, Emission-Computed

BACKGROUND: T-SPOT.TB is a sensitive test that detects interferon-gamma producing T-cells in tuberculosis patients following stimulation with tuberculosis-specific antigens. Our study was aimed to investigate the possible causes of false negative results of the test by analyzing the patients with positive acid-fast bacilli (AFB) culture and negative T-SPOT.TB results. METHODS: We investigated 138 patients with positive AFB culture results reported between January 2009 and April 2010. Medical records of these patients were reviewed for the results of T-SPOT.TB test, AFB culture, PCR for Mycobacterium tuberculosis (TB-PCR), chest X-ray, drug treatment, etc. Diagnosis of tuberculosis was confirmed by positive TB-PCR or identification of Mycobacterium tuberculosis (MTB). Sensitivity of T-SPOT.TB test was calculated and the possible causes of AFB culture positive and T-SPOT.TB negative results were analyzed. RESULTS: T-SPOT.TB test was performed in 63 of the 138 patients with AFB culture positive results. Fifty-six (88.9%) were positive and 7 patients (11.1%) were negative on T-SPOT.TB test. Of these 7 negative cases, 4 were confirmed as nontuberculous mycobacteria (NTM), 2 were suspected as NTM and diagnosis could not be confirmed in 1. Six of these 7 patients were over 70 yr old and 6 patients had lymphocytopenia. T-SPOT.TB negative results were not observed in any of the 44 patients confirmed to have active tuberculosis (sensitivity 100%). CONCLUSIONS: Our results suggest that T-SPOT.TB test is very sensitive for diagnosing active tuberculosis. NTM may be the main cause of AFB culture positive and T-SPOT.TB negative results, but MTB infection in immunocompromised patients also has to be considered.
Adult ; Aged ; Aged, 80 and over ; Bacillus/*isolation & purification ; Culture Media ; Female ; Humans ; Lymphocyte Count ; Lymphopenia/diagnosis/microbiology ; Male ; Polymerase Chain Reaction ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Tuberculosis/*diagnosis/microbiology/radiography

PURPOSE: To clarify the value of mass screening for thyroid cancer by ultrasonography. MATERIALS AND METHODS: We evaluated the incidence of thyroid nodules and the detection rate of malignant nodules in 2856 patients who underwent screening thyroid ultrasonography while undergoing breast ultrasonography. We also analyzed the ultrasonographic characteristics of nodules in the screening (34 patients) and clinical (48 patients) groups which were diagnosed with thyroid cancer. RESULTS: The incidence of thyroid nodules detected by ultrasonography was 39% and the detection rate of thyroid cancer was 1.19% in the screening group and 17% in the clinical group. The mean size of nodules in clinical group was larger than that in the screening group (p<0.05) and the prevalence of nodules with ill-defined margin in the screening group was higher than that in the clinical group (p<0.05). There was no significant difference in internal echogenicity, shape, presence of internal calcifications, lymph node metastasis and extrathyroidal extension between the two groups. CONCLUSION: Although the incidence of thyroid cancer was low, sonographic screening for thyroid cancer while undergoing breast ultrasonography could be valuable.
Breast* ; Early Detection of Cancer ; Humans ; Incidence ; Lymph Nodes ; Mass Screening* ; Neoplasm Metastasis ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Ultrasonography ; Ultrasonography, Mammary*

PURPOSE: We evaluated the usefulness of intracranial stent implantation for treating patients with atherosclerotic stenosis and with recurrent, ischemic, neurological symptoms despite having undergone medical therapy. MATERIALS AND METHODS: Between March 2004 and April 2010, we attempted intracranial, stent-assisted angioplasty in 77 patients with 85 lesions (anterior circulation 73 cases, posterior circulation 12 cases) and who had ischemic neurological symptoms with more than 50% major cerebral artery stenosis. We analyzed the results regarding the technical success rate, complication rate, and restenosis rate during the mean 29.4 month follow-up period. RESULTS: Intracranial stent implantation was successfully performed in 74 cases (87.1%). In nine cases among the 11, failed cases, stent implantation failure was due to the tortuosity of the target vessel. One patient experienced middle cerebral artery rupture during the procedure, and we embolized the vessel using a microcoil. Five patients developed cerebral infarction in three weeks after the procedure, three of whom improved using conservative management, although the other, two patients expired. The mean number of residual stenoses decreased from 72.3% to 14.7%. Three patients demonstrated significant in-stent restenosis, i.e. more than 50%, during the follow-up period. CONCLUSION: As stent-assisted angioplasty in intracranial, atherosclerotic stenosis is effective and relatively safe, it can be considered as an alternative treatment for patients with recurrent, ischemic, neurologic symptoms despite having undergone medical therapy.
Angioplasty ; Cerebral Arteries ; Cerebral Infarction ; Constriction, Pathologic ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Intracranial Arteriosclerosis ; Middle Cerebral Artery ; Neurologic Manifestations ; Rupture ; Stents

Polymyalgia rheumatica is an inflammatory disease affecting elderly and involving the shoulder and pelvic girdles. No epidemiological study of polymyalgia rheumatica was conducted in Korea. We retrospectively evaluated patients with polymyalgia rheumatica followed up at the rheumatology clinics of 10 tertiary hospitals. In total 51 patients, 36 patients (70.6%) were female. Age at disease onset was 67.4 yr. Twenty-three patients (45.1%) developed polymyalgia rheumatica in winter. Shoulder girdle ache was observed in 45 patients (90%) and elevated erythrocyte sedimentation rate (> 40 mm/h) in 49 patients (96.1%). Initial steroid dose was 23.3 mg/d prednisolone equivalent. Time to normal erythrocyte sedimentation rate was 4.1 months. Only 8 patients (15.7%) achieved remission. Among 41 patients followed up, 28 patients (68.3%) had flare at least once. Number of flares was 1.5 +/- 1.6. The frequency of flare was significantly lower in patients with remission (P = 0.02). In Korea, polymyalgia rheumatica commonly develops during winter. Initial response to steroid is fairly good, but the prognosis is not benign because remission is rare with frequent relapse requiring long-term steroid treatment.
Aged ; Aged, 80 and over ; Anti-Inflammatory Agents/administration & dosage/*therapeutic use ; Blood Sedimentation ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Polymyalgia Rheumatica/*drug therapy/epidemiology ; Prognosis ; Recurrence ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons ; Steroids/administration & dosage/*therapeutic use

Butylated hydroxyanisole (BHA) is a synthetic phenolic compound consisting of a mixture of two isomeric organic compounds: 2-tert-butyl-4-hydroxyanisole and 3-tert-butyl-4-hydroxyanisole. We examined the effect of BHA against hydrogen peroxide (H2O2)-induced apoptosis in primary cultured mouse hepatocytes. Cell viability was significantly decreased by H2O2 in a dose-dependent manner. Additionally, H2O2 treatment increased Bax, decreased Bcl-2, and promoted PARP-1 cleavage in a dose-dependent manner. Pretreatment with BHA before exposure to H2O2 significantly attenuated the H2O2-induced decrease of cell viability. H2O2 exposure resulted in an increase of intracellular reactive oxygen species (ROS) generation that was significantly inhibited by pretreatment with BHA or N-acetyl-cysteine (NAC, an ROS scavenger). H2O2-induced decrease of cell viability was also attenuated by pretreatment with BHA and NAC. Furthermore, H2O2-induced increase of Bax, decrease of Bcl-2, and PARP-1 cleavage was also inhibited by BHA. Taken together, results of this investigation demonstrated that BHA protects primary cultured mouse hepatocytes against H2O2-induced apoptosis by inhibiting ROS generation.
Animals ; Apoptosis/*drug effects ; Butylated Hydroxyanisole/chemistry/*pharmacology ; Cell Survival/drug effects ; Cells, Cultured ; Hepatocytes/*drug effects ; Hydrogen Peroxide/*toxicity ; Male ; Mice ; Mice, Inbred ICR ; Molecular Structure

Background: Drug-induced parkinsonism (DIP) is common, but diagnosis is challenging.Although dopamine transporter imaging is useful, the cost and inconvenience are problematic, and an easily accessible screening technique is needed. We aimed to determine whether optical coherence tomography (OCT) findings could differentiate DIP from Parkinson’s disease (PD). Methods: We investigated 97 de novo PD patients and 27 DIP patients using OCT and [ 18 F] N-(3-fluoropropyl)-2b-carbon ethoxy-3b-(4-iodophenyl) nortropane (FP-CIT) positron emission tomography. We compared peripapillary retinal nerve fiber layer thickness (pRNFLT) and macular retinal thickness (mRT) between PD and DIP patients as well as interocular differences in the pRNFLT and the mRT. Asymmetric index (%) for retinal thickness (AIRT) was calculated to measure the interocular differences between pRNFLT and mRT. The correlation between AIRT and total striatal specificon-specific binding ratio asymmetry index (SNBRAI) was investigated in PD and DIP patients. Results: No significant differences in pRNFLT and mRT values were observed between PD and DIP patients (all Pvalues > 0.090). The mean SNBRAI was significantly higher in PD than in DIP (P = 0.008) patients; however, AIRT did not differ between PD and DIP patients in pRNFLT and mRT (all P values > 0.100). SNBRAI did not correlate with AIRT of pRNFL or mRT in PD and DIP patients (all P values > 0.060). Conclusion Our study showed no benefit of retinal thickness and interocular asymmetry measurements using OCT for distinguishing PD from DIP in the early stages. Additional investigations are needed for confirmation.