This study aims to evaluate CT (Computed Tomography) characteristics through the estimation of HU (Hounsfield Unit) and the corresponding variations using coefficient of variation values for various materials as a function of physical factor. HU values for various materials with varying densities as a function of physical factor were measured using MDCT (Siemens SOMATOM Sensation 4, Germany). The results showed that the HU values were decreased and increased as a function of kVp and material density, respectively. Especially, the HU values for bone and iodine at 140 kVp were 32% and 42% smaller than those at 80 kVp, respectively. In case of iodine, the HU values also decreased and increased as a function of kVp and concentration, respectively. While the HU values were fixed as a function of mAs. The decreased ratio of HU values between 80 keV and 140 keV was different at various concentration and maximum difference was shown as 1.73 at 3% concentration. These results indicated that it may be possible to separate composition of materials, e.g. iodine and bone, using single source CT. The results showed that dual energy techniques using single source CT can be applied to material separation and expand CT imaging techniques to other practical applications.
Iodine ; Sensation

This study aims to evaluate CT (Computed Tomography) characteristics through the estimation of HU (Hounsfield Unit) and the corresponding variations using coefficient of variation values for various materials as a function of physical factor. HU values for various materials with varying densities as a function of physical factor were measured using MDCT (Siemens SOMATOM Sensation 4, Germany). The results showed that the HU values were decreased and increased as a function of kVp and material density, respectively. Especially, the HU values for bone and iodine at 140 kVp were 32% and 42% smaller than those at 80 kVp, respectively. In case of iodine, the HU values also decreased and increased as a function of kVp and concentration, respectively. While the HU values were fixed as a function of mAs. The decreased ratio of HU values between 80 keV and 140 keV was different at various concentration and maximum difference was shown as 1.73 at 3% concentration. These results indicated that it may be possible to separate composition of materials, e.g. iodine and bone, using single source CT. The results showed that dual energy techniques using single source CT can be applied to material separation and expand CT imaging techniques to other practical applications.
Iodine ; Sensation

INTRODUCTIONThe treatment of tendinosis of elbow can be challenging, yet rewarding. Nevertheless, for the patients who failed conservative management and develop persistent recalcitrant symptoms, surgical intervention should be considered. The hypothesis of this study is iliac bone marrow plasma injection after arthroscopic debridement of degenerative tissue will bring along biological cure. Thus, it will not only reduce pain but also improve function in patients with resistant elbow tendonitis.

MATERIALS AND METHODSTwenty-four patients (26 elbows) with significant persistent pain for a mean of 15 months, despite of standard rehabilitation protocol and a variety of other nonsurgical modalities were treated arthroscopically. We applied autologous iliac bone marrow plasma injection following arthroscopic debridement. This material is produced by centrifugation of iliac bone marrow blood at 1,800 rpm for 20 to 30 minutes. Patients were allowed full range of motion (ROM) exercise after 2 to 3 days. Cytokine analyses for this injective material were done. Outcome was rated by postoperative sonography, visual analog pain scores (VAS) and Mayo elbow performance scores (MEPS) at 8 weeks and 6 months follow-up. Informed consent had been obtained from the subjects, and the study protocol was approved by the ethics committee of Chosun University Hospital, Korea.

RESULTSAll patients in this study noted improvement both in their VAS and MEPS. No complication occurred in any patient. Evidence of tendon healing was observed in postoperative sonographic examination. Predominant cytokines of this study were interleukin-12 (IL-12), interferon-gamma-inducible protein-10 (IP-10) and RANTES.

CONCLUSIONBiologic treatments in orthopaedics are just beginning to evolve. In the present investigation, the injection of iliac bone marrow plasma after arthroscopic debridement in severe elbow tendinosis demonstrated early recovery of daily activities and clear improvement.

Activities of Daily Living ; Adult ; Aged ; Arthralgia ; surgery ; Arthroscopy ; Bone Marrow ; Debridement ; Elbow Joint ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Postoperative Period ; Prospective Studies ; Range of Motion, Articular ; Tendinopathy ; pathology ; surgery ; therapy ; Treatment Outcome ; Young Adult

Clinically, patients with pancreatic cancer and focal autoimmune chronic pancreatitis share many features, such as being elderly, painless jaundice, new-onset diabetes mellitus, and weight loss. Hence, it is difficult to differentiate between the two conditions. Nevertheless, it is very important to distinguish between focal autoimmune chronic pancreatitis and pancreatic cancer because they have different treatment modalities and prognoses. We encountered a case of a 72-year-old man who developed painless jaundice. The patient was diagnosed with focal autoimmune chronic pancreatitis instead of pancreatic cancer from the CT, ERCP, MRCP findings accompanying with an increased IgG4 level. The abnormalities in the clinical, laboratory, and radiological findings improved after 2 weeks of oral steroid treatment. After 3 months of oral steroid treatment, his disease showed further improvement. To our knowledge, this is a rare case of focal autoimmune chronic pancreatitis that improved with oral steroid treatment.
Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Diabetes Mellitus ; Humans ; Immunoglobulin G ; Jaundice ; Pancreatic Neoplasms ; Pancreatitis, Chronic* ; Prognosis ; Weight Loss

Duodenal mucosa-associated lymphoid tissue (MALT) lymphoma is a very rare neoplasm. We report here a case of a 67-year-old woman with a diffuse large B cell lymphoma arising in a low grade MALT lymphoma in the duodenal bulb. She was asymptomatic and on a general health evaluation an upper endoscopy showed an extensive erosive lesion on the duodenal bulb. The biopsy specimen showed lymphocyte infiltration with lymphoepithelial lesions suggesting a low grade MALT lymphoma. A second upper endoscopy with biopsy discovered a focal diffuse large B cell lymphoma in the background of a low grade MALT lymphoma. A meticulous staging work-up revealed that the lymphoma was confined to the duodenum and regional lymph nodes. Finally, the patient was diagnosed as having a diffuse large B cell lymphoma transformed from a duodenal low grade MALT lymphoma. The patient was undergoing combination chemotherapy including the use of an anti-CD20 monoclonal antibody.
Aged ; Biopsy ; Drug Therapy, Combination ; Duodenum ; Endoscopy ; Female ; Humans ; Lymph Nodes ; Lymphocytes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone*

Small cell carcinoma of the urinary bladder is a rare finding. It is characterized by an aggressive clinical course with early metastasis and it tends to affect the elderly who have significant comorbidities. The mean age of these patients is 67.8 years. The prognosis of small cell carcinoma of the urinary bladder is poor because its behavior is more aggressive than bladder transitional cell carcinoma. On the pathologic finding, small cell carcinoma of the urinary bladder is usually combined with transitional cell carcinoma or adenocarcinoma in approximately 40% of cases. We reported here on a case of the primary pure small cell carcinoma of the urinary bladder in a 26 year-old man who was managed with partial cystectomy and combined chemotherapy using cisplatin.
Adenocarcinoma ; Adult ; Aged ; Carcinoma, Small Cell* ; Carcinoma, Transitional Cell ; Cisplatin ; Comorbidity ; Cystectomy ; Drug Therapy ; Humans ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder*

OBJECTIVES: We investigated the association of SNP A and P1763 polymorphisms on dystrobrevin binding protein 1(DTNBP1) gene with smooth pursuit eye movement(SPEM) abnormality in Korean schizophrenic patients. METHODS: We measured SPEM function in 217 Korean schizophrenics(male 116, female 101) and divided them into two groups, one is a good SPEM function group and the other is a poor SPEM function group. We then analyzed SNP A polymorphism and P1763 polymorphism on DTNBP1 gene from their DNAs extracted from their blood. We compared the differences of genotype and allele distributions of the two polymorphisms on DTNBP1 gene between the two groups. RESULTS: The Ln S/N ratio(mean+/-SD) of the good SPEM function group was 4.39+/-0.33 and the ratio of poor SPEM function group was 3.17+/-0.71. There were no statistically significant differences of age and male/female ratio between the two groups. There were no significant differences of genotype or allele distributions of the SNP A polymorphism and P1763 polymorphism on DTNBP1 gene between the two schizophrenic groups divided by SPEM function. CONCLUSION: The results suggest that SNP A polymorphism and P1763 polymorphism on DTNBP1 gene might not be related to SPEM function abnormality in schizophrenia.
Alleles ; Carrier Proteins* ; DNA ; Female ; Genotype ; Humans ; Polymorphism, Genetic ; Pursuit, Smooth* ; Schizophrenia

BACKGROUND/AIMS: Pneumatic dilation is the most effective non-surgical treatment option for the patients with achalasia. The aim of this study was to determine the predictors of outcome after pnematic dilation in patients with primary achalasia. METHODS: Thrity-five patients with primary achalasia between May 1996 and April 2001 were included. They were divided into two groups; responder and nonresponder. Esophageal manometry, scintigraphy and barium esophagogram was performed before dilation and 4 weeks after dilation. RESULTS: Seven patients having symptomatic relapse were treated with repeated pneumatic dilation. Remaining 28 patients (83%) had no recurrence during follow-up period (mean duration 16 month, range 6~43 month). Among the factors evaluated in the initial examination, only young age affected outcome (p=0.039). The post treatment retention fraction at 5, 20 minutes were the most valuable factors for predicting the clinical response (p<0.05). CONCLUSIONS: Older patients are more likely to have sustained response. Radionuclide esophageal emptying test remains a useful objective study evaluating esophageal transit before and after pneumatic dilation in the patients with achalasia and may have an important role in the follow-up evaluation of treatment for achalasia.
Barium ; Esophageal Achalasia* ; Follow-Up Studies ; Humans ; Manometry ; Radionuclide Imaging ; Recurrence

Vocal cord dysfunction (VCD) is respiratory disorder characterized by paradoxical closure of the vocal cord during the respiratory cycle leading to obstructive airway symptoms. The clinical presentation of VCD is often dr amatic and its misdiagnosis as asthma of exercise-induced brochospasm(EIB) has led to inappropriate treatment including high dose corticosteroids, intubation, and tracheostomy. Many VCD patients are asympromatic at rest and require exercise challenge to elicit symptoms and vocal cord abnormalities. The "gold standard" for the diagnosis of VCD remains laryngoscopy of bronchoscopy with direct visualization of paradoxical adduction of the vocal cords. We report a case of exercise-induced Vocal cord masqueraded as exercise-induced asthma unresponsive to corticosteroids. And bronchodilator confirmed by typical bronchoscopic findings with paradoxial adduction of the vocal cords.
Adrenal Cortex Hormones ; Asthma* ; Asthma, Exercise-Induced ; Bronchoscopy ; Diagnosis ; Diagnostic Errors ; Humans ; Intubation ; Laryngoscopy ; Tracheostomy ; Vocal Cord Dysfunction* ; Vocal Cords*

Treatment modalities for lower gastrointestinal bleeding are thermal methods, injections, and mechanical devices. Every methods have advantages and disadvantages. The width of selection for the patients with risk factors (liver disease, coagulopathy, or ingestion of anticoagulant or NSAID) is narrow. We experienced a patient with severe bleeding from a sigmoid colonic huge mass. He had hepatic encephalopathy and bleeding tendency associated with liver cirrhosis. Endoscopic ligation using detachable snare was performed successfully. Fortunately, the patient was recovered from hepatic encephalopathy and had a good chance for liver transplantation.
Colon, Sigmoid* ; Eating ; Hemorrhage* ; Hepatic Encephalopathy ; Humans ; Ligation ; Liver Cirrhosis* ; Liver Transplantation ; Liver* ; Risk Factors ; SNARE Proteins*