A 37-year-old male presented with a mass measuring 2.5 cm in size in the midbrain and obstructive hydrocephalus, which had manifested as a headache and dizziness. Magnetic resonance (MR) imaging of the brain showed intermediate enhancement on T1-weighted MR imaging and a high intensity of enhancement on T2-weighted MR. Neurosurgeons performed an occipital craniotomy with partial removal of the tumor and the postoperative diagnosis was a pineal parenchymal tumor with intermediate differentiation. He had undergone irradiation with 54 Gy of radiation on 27 fractions for removal of the remaining tumor approximately one month after surgery. However, in follow-up imaging performed four months after radiotherapy, a remnant mass in the superoposterior aspect of the midbrain was found to have extended to the hypothalamus and the third ventricle. He was treated with six cycles of procarbazine, lomustine, vincristine chemotherapy. At five months since the completion of chemotherapy, the brain MR imaging showed no evidence of any remaining tumor and he no longer displayed any of his initial symptoms.
Adult ; Brain ; Craniotomy ; Dizziness ; Follow-Up Studies ; Headache ; Humans ; Hydrocephalus ; Hypothalamus ; Lomustine ; Magnetics ; Magnets ; Male ; Mesencephalon ; Pinealoma ; Procarbazine ; Third Ventricle ; Vincristine

A wide variety of pulmonary disorders related to hemodialysis or pre-existing renal disease occurs in hemodialysis patients. The disorders may be classified as 1) pulmonary abnormalities associated with chronic renal failures; 2) pulmonary complications arising during hemodialysis; 3) pulmonary infection; or 4) pulmonary-renal syndrome. An awareness of the various possible pulmonary disorders arising in hemodialysis patients may be helpful for the proper and timely management of such patients. We describe and illustrate various radiographic and CT findings of variable pulmonary disorders in hemodialysis patients.
Humans ; Renal Dialysis* ; Renal Insufficiency ; Vasculitis

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*

BACKGROUND: This study evaluated the effects of family type and sociodemographic factors on medical treatment, health behavior, and subjective health status in Koreans 60 years and older. METHODS: This study was based on data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES), a nationwide health interview survey using a rolling sampling design involving complex, stratified, multistage, probability cluster. Our subjects included those > or =60 years of age (n=1,946) participating in the KNHANES 2010. Family type was categorized into 7 groups according to cohabitation: alone, couple cohabitation (living with a spouse), parent(s) cohabitation (couple living with parent(s)), offspring cohabitation (no spouse, living with offspring), couple offspring cohabitation (couple living with offspring), couple offspring parents cohabitation (couple living with parent(s) and offspring), and others. Logistic regression analyses were used to examine the association of family type and sociodemographic factors with health care. RESULTS: The most common family type was couple cohabitation (38.26+/-1.8%). In this group, the percentage of non-receipt of needed medical care (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.42 to 0.87) and current smoking rate (OR, 0.32; 95% CI, 0.20 to 0.50) were significantly lower than those living alone. Among the sociodemographic charicteristics, male gender, apartment dwelling, high middle household income, 2 member family, education higher than middle school, and possessing own house were associated with good health care behavior. CONCLUSION: This study shows that couples have better health care behavior than other family types, in particular, limited smoking, appropriate medical treatment, and positive subjective health status. Those living alone visit medical clinics less often and have a negative subjective health status.
Delivery of Health Care ; Family Characteristics ; Health Behavior ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Parents ; Smoke ; Smoking ; Spouses

Scatter radiation considerably affects radiographic image quality by reducing image contrast and contributing to a non-uniform background. Images containing a large portion of scatter radiation may result in an incorrect diagnosis. In the past few years, many efforts have been made to reduce the effects of scatter radiation on radiographic images. The purpose of this study is to accurately measure scatter fractions and evaluate the effectiveness of beam-stop arrays. To measure scatter fraction accurately, a beam-stop array and the SFC (Scatter Fraction Calculator) program were developed. Images were obtained using the beam-stop array for both an anti-scatter technique with an anti-scatter grid and an air gap technique. The scatter fractions of the images were measured using the SFC program. Scatter fractions obtained with an anti-scatter grid were evaluated and compared to scatter fractions obtained without an anti-scatter grid. Scatter fractions were also quantitatively measured and evaluated with an air gap technique. The effectiveness of the beam-stop array was demonstrated by quantifying scatter fractions under various conditions. The results showed that a beam-stop array and the SFC program can be used to accurately measure scatter fractions in radiographic images and can be applied for both developing scatter correction methods as well as systems.
Radiographic Image Enhancement

PURPOSE: The purpose of the present study was to assess the biological effects of TNF-alpha in Caco-2 well-differentiated colon adenocarcinoma cells and to determine radiation sensitivity in order to develop TNF-alpha into a cancer therapeutic agent. MATERIALS AND METHODS: A cell viability test was conducted via a colorimetric and colony forming assay after 1 day and 3 days of incubation with TNF-alpha. Western blotting analysis and immunofluorescence staining were conducted to explore TNF-alpha-induced morphological and molecular changes in the adhesion molecules, E-cadherin and claudin-4. The effects of gamma-irradiation at a dose of 2 Gy on cell survival were evaluated by a clonogenic assay. The molecular changes in apoptosis-regulatory proteins were assessed by Western blotting. RESULTS: Caco-2 cells were highly resistant to TNF alpha-induced cell death and 2 Gy of gamma-irradiation. However, we observed the downregulation of the adherens junctional protein, E-cadherin and translocation of tight junctional protein, claudin-4 from the membrane to the cytosol induced by TNF-alpha treatment which would indicate cell-cell junction disruptions. These alterations of junctional proteins influenced the regulation of cell death in response to 2 Gy of gamma-irradiation. The combined treatment of TNF-alpha with 2 Gy of gamma-irradiation reduced the survival of Caco-2 cells by down-regulating bcl-xl and activating JNK pathways. CONCLUSION: These results suggest that TNF-alpha might be potentially applied as a therapeutic agent in order to enhance sensitivity to 2 Gy of gamma-irradiation administered in radiotherapy for the treatment of human colon cancer.
Adenocarcinoma ; Blotting, Western ; Caco-2 Cells ; Cadherins ; Cell Death ; Cell Survival ; Claudin-4 ; Colon ; Colonic Neoplasms ; Cytosol ; Down-Regulation ; Fluorescent Antibody Technique ; Humans ; MAP Kinase Signaling System ; Membranes ; Proteins ; Radiation Tolerance ; Tumor Necrosis Factor-alpha

Pancreatic arteriovenous malformations (AVMs) are rare, and most cases occur as congenital anomalies. Many patients with AVM are asymptomatic, but occasionally present with abdominal pain or gastrointestinal bleeding. The increased portal vein flow that forms these malformations can lead to portal hypertension and gastrointestinal bleeding in the absence of primary liver pathology. Early diagnosis can lead to successful surgical resection or percutaneous transarterial embolization. We report a case of a patient with pancreatic AVM in the tail of the pancreas, in which endoscopic ultrasonography was helpful. This patient presented with abdominal pain and was subsequently treated with distal pancreatectomy.
Abdominal Pain ; Arteriovenous Malformations ; Early Diagnosis ; Endosonography ; Hemorrhage ; Humans ; Hypertension, Portal ; Liver ; Pancreas ; Pancreatectomy ; Pancreatitis ; Portal Vein

PURPOSE: Catastrophic bleeding of the gastric varices has been considered a life threatening emergency. Sclerotherapy cannot easily control the bleeding, and there is a high risk of rebleeding despite successful intervention. Surgery is often necessary to save the life. The purpose of this study was to elucidate the role of surgery and analyze the factors determining operative mortality in gastric variceal bleeding. METHODS: A retrospective study was performed of 30 patients who underwent operation for gastric variceal bleeding with portal hypertension at Ewha Womans University Mok-Dong Hospital from Jul. 1994 to Feb. 2001. Among them, 23 patients received perigastric devascularization with fundectomy and the remainder received perigastric devascularization alone. RESULTS: There was one case of recurrent bleeding from esophageal varix at 8 months postoperative. This was controlled with sclerotherapy. The overall operative mortality rate was 30.0%. Preoperative hepatic functional reserve was a significant factor. The mortality rate was 0% (0/5) in Child-Pugh group A, 27.8% (5/18) in group B, and 57.1% (4/7) in group C (p<0.05). The preoperative success of intervention influenced postoperative outcomes. There was no mortality in the successfully controlled group (0/5). In the failure group, 5 of 7 patients expired (p<0.05). Preoperative transfusion amount was also a significant factor in determining survival. There was 15.8% (3/19) mortality rate in patients trans fused less than 10 units, and a 54.5% (6/11)rate in those receiving more than 10 units (p<0.05). CONCLUSION: This operative approach was effective for saving lives from an otherwise uniformly fatal disease. The rebleeding rate at the follow-up period was low. Proper selection of patients and an early surgical decision could lower the operative mortality.
Emergencies ; Esophageal and Gastric Varices* ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension, Portal ; Mortality ; Retrospective Studies ; Sclerotherapy

The processus vaginalis within the inguinal canal forms the canal of Nuck, which is a homolog of the processus vaginalis in women. Incomplete obliteration of the processus vaginalis causes indirect inguinal hernia or hydrocele of the canal of Nuck, a very rare condition in women. Here, we report 2 cases of hydrocele of the canal of Nuck that were diagnosed with ultrasonography in both cases and magnetic resonance imaging in 1 case to confirm the sonographic diagnosis. High ligation and hydrocelectomy were conducted in both patients. In 1 patient, 14 months later, the occurrence of contralateral inguinal hernia was suspected, but did not require surgery. The other patient had a history of surgery for left inguinal hernia 11 months before the occurrence of right hydrocele of the canal of Nuck. In both cases, the occurrence of an inguinal hernia on the contralateral side was noted.
Female ; Hernia, Inguinal ; Humans ; Inguinal Canal ; Ligation ; Magnetic Resonance Imaging

Ectopic pancreas is a congenital anomaly and the most common type of ectopic tissue in the gastrointestinal tract. Most patients with an ectopic pancreas are asymptomatic and rarely have complications. Ectopic pancreatitis after an endoscopic biopsy has not been reported. We report a patient who developed acute ectopic pancreatitis in the stomach after an endoscopic biopsy. A 71-year-old male patient presented with a subepithelial tumor (SET) in the stomach and had no symptoms. Endoscopic ultrasonography demonstrated a 30-mm hypoechoic mural mass, lobulated margins, and anechoic duct-like lesions. To obtain proper tissue specimen, endoscopic biopsy was performed through the opening on the surface of the mass. The pathologic results confirmed an ectopic pancreas. One day after the endoscopic biopsy, he developed persistent epigastric pain. His serum amylase and lipase elevated. Computed tomography of the abdomen showed swelling of the SET and diffuse edema of the gastric wall. His condition was diagnosed as acute ectopic pancreatitis occurring after endoscopic biopsy.
Abdomen ; Aged ; Amylases ; Biopsy* ; Choristoma ; Edema ; Endosonography ; Gastrointestinal Tract ; Humans ; Lipase ; Male ; Pancreas* ; Pancreatitis* ; Stomach