PURPOSE: To assess the usefulness of rectal filling using ultrasonographic gel in patients with lower rectal cancer. MATERIALS AND METHODS: Twenty five patients with lower rectal cancer were enrolled. High resolution pelvic MR was performed twice before and after gel filling. Independently and retrospectively, two radiologists reviewed each set of MR images using five-grade scales for sphincter involvement, CRM (circumferential resection margin) involvement and depiction of the tumor. Same two radiologists retrospectively performed consensus review of each set of MR images for tumor distance from the anal verge and T&N staging. RESULTS: Tumor depiction scores from MR with gel filling were significantly higher than those of MR without distention (p<0.001). Compared to MR without distension, MR with gel filling had no significant differences in prediction of CRM or sphincter involvement (p>0.05). Distance from the anal verge was significantly different between MR with gel filling and rigid endoscopy (6.8 +/- 1.6 cm vs. 5.8 +/- 1.6 cm, p=0.001). There were no significant differences between pathological staging and MR staging with or without gel filling. CONCLUSION: MR with gel filling improved tumor depiction. And also MR with gel filling revealed same ability for the predictions of CRM or sphincter invasion in patients with lower rectal cancer, comparing with MR without gel filling.
Consensus ; Endoscopy ; Humans ; Rectal Neoplasms* ; Rectum ; Retrospective Studies ; Weights and Measures

OBJECTIVE: To investigate the relationships between the apparent diffusion coefficients (ADCs) on diffusion-weighted imaging (DWI) and the speed of contrast-enhancement in hepatic hemangiomas. MATERIALS AND METHODS: Sixty-nine hepatic hemangiomas (> or = 1 cm) were evaluated with DWI, by using multiple b values (b = 50, 400, 800 s/mm2), followed by a gadolinium-enhanced dynamic MRI. The lesions were classified into three groups, according to the speed of contrast-enhancement on the portal phase. ADCs were measured on the ADC map automatically, and were calculated by using the two different b values (mADC50-400 with b values = 50 and 400; mADC400-800 with b values = 400 and 800 s/mm2). RESULTS: The mean ADCs (x 10-3 mm2/s) were significantly higher in the rapid group (1.9 +/- 0.44) than in the intermediate (1.7 +/- 0.35, p = 0.046) or the slow groups (1.4 +/- 0.34, p = 0.002). There were significant differences between the rapid and the slow groups in mADC50-400 (2.12 vs. 1.48; p = 0.008) and mADC400-800 (1.68 vs. 1.22, p = 0.010), and between the rapid and the intermediate groups in mADC50-400 (2.12 vs. 1.79, p = 0.049). Comparing mADC50-400 with mADC400-800, there was a significant difference only in the rapid group (p = 0.001). CONCLUSION: Higher ADCs of rapidly-enhancing hemangiomas may be related to richer intralesional vascular perfusion. Also, the restricted diffusion may be attributed to the difference of structural characteristics of hemangioma.
Adult ; Aged ; Contrast Media ; *Diffusion Magnetic Resonance Imaging ; Female ; Gadolinium DTPA/diagnostic use ; Hemangioma, Cavernous/*diagnosis ; Humans ; Image Enhancement ; Liver Neoplasms/*diagnosis ; *Magnetic Resonance Imaging ; Male ; Middle Aged

PURPOSE: This study was conducted to evaluate clinical validity of a zirconia full-coverage crown by comparing zirconia's wear capacity over antagonistic teeth with that of feldspathic dental porcelain. MATERIALS AND METHODS: The subject groups were divided into three groups: the polished feldspathic dental porcelain group (Group 1), the polished zirconia group (Group 2), and the polished zirconia with glazing group (Group 3). Twenty specimens were prepared from each group. Each procedure such as plasticity, condensation, and glazing was conducted according to the manufacturer's manual. A wear test was conducted with 240,000 chewing cycles using a dual-axis chewing simulator. The degree of wear of the antagonistic teeth was calculated by measuring the volume loss using a three-dimensional profiling system and ANSUR 3D software. The statistical significance of the measured degree of wear was tested with a significant level of 5% using one-way ANOVA and the Tukey test. RESULTS: The degrees of wear of the antagonistic teeth were 0.119 +/- 0.059 mm3 in Group 1, 0.078 +/- 0.063 mm3 in Group 3, and 0.031 +/- 0.033 mm3 in Group 2. Statistical significance was found between Group 1 and Groups 2 and between Group 2 and 3, whereas no statistical significance was found between Group 1 and Group 3. CONCLUSION: Despite the limitations of this study on the evaluation of antagonistic teeth wear, the degree of antagonistic tooth wear was less in zirconia than feldspathic dental porcelain, representing that the zirconia may be more beneficial in terms of antagonistic tooth wear.
Analysis of Variance ; Ceramics ; Crowns ; Dental Porcelain ; Mastication ; Plastics ; Tooth ; Tooth Wear ; Zirconium

On chromosome Xp21 region, several genes such as glycerol kinase (GK) gene, adrenal hypoplasia congenita gene and Duchenne muscular dystrophy gene are located contiguously. Xp21 contiguous gene deletion syndrome involves the glycerol kinase gene deletion together with the adrenal hypoplasia congenita and/or Duchenne muscular dystrophy gene. The clinical features of a patient with a Xp21 contiguous gene deletion syndrome are sum of each disease,psychomotor retardation and lethargy for glycerol kinase deficiency, hyperpigmentation and salt wasting dehydration for congenital adrenal hypoplasia and muscular weakness and hypotonia for Duchenne muscular dystrophy. We experienced and reviewed two cases of Xp21 contiguous gene deletion syndrome with literatures.
Dehydration ; Gene Deletion* ; Glycerol Kinase ; Humans ; Hyperpigmentation ; Lethargy ; Muscle Hypotonia ; Muscle Weakness ; Muscular Dystrophy, Duchenne

Anaplastic thyroid cancer is the most aggressive form of cancer found in humans. Usually it is easily diagnosed; however at times other diseases are mistaken for anaplastic thyroid cancer. We present a case of primary lung adenocarcinoma presenting with features that appeared as anaplastic thyroid cancer. The 43-year-old female patient was diagnosed with anaplastic thyroid cancer at a local clinic just before presenting to our hospital. At the clinic she had a neck node excisional biopsy and was informed of the diagnosis of anaplastic cancer. On admission to our hospital, very large bilateral thyroid masses, and lymphadenopathy involving multiple cervical lymph nodes was observed; therefore, we started chemoradiotherapy. The patient showed dramatic improvement and we began to think of other potential etiologies. A FDG-PET study showed increased uptake at the left lower lung area corresponding to a pneumonic consolidation; a TBLB was performed, and reported as poorly differentiated adenocarcinoma. We referred the patient to the oncology department. The patient died after two cycles of systemic chemotherapy.
Adenocarcinoma ; Adult ; Biopsy ; Chemoradiotherapy ; Diagnosis ; Drug Therapy ; Female ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Lymphatic Diseases ; Neck ; Thyroid Gland* ; Thyroid Neoplasms*

Eosinophilic fasciitis (EF) is a rare disorder of unknown etiology characterized by eosinophilia, indurations of the skin, and inflammation of the fascia. Magnetic resonance imaging (MRI) has been used to assist the diagnosis and to monitor the response to treatment, and the commonly used therapy has been corticosteroids. However, the use of ultrasonography (US) in the diagnosis and the management of EF has not been reported previously in Korea. In addition, the effects of methotrexate (MTX) treatment have rarely been reported in corticosteroid-resistant patients with EF. Here, we describe two cases of EF resistant to corticosteroid therapy alone where the combination of MTX and corticosteroids was effective. Furthermore, we show that US is useful modality in supporting the clinical diagnosis and monitoring the response to treatment of patients with EF.
Adrenal Cortex Hormones ; Diagnosis ; Eosinophilia ; Eosinophils* ; Fascia ; Fasciitis* ; Humans ; Inflammation ; Korea ; Magnetic Resonance Imaging ; Methotrexate* ; Skin ; Ultrasonography*

PURPOSE: To assess the preliminary findings of Mn-enhanced T1-weighted MR cholangiography for the evaluation of intrahepatic choledocholithiasis. MATERIALS AND METHODS: Seven patients with recurrent pyogenic cholangitis underwent conventional heavily T2-weighted and manganese-enhanced T1-weighted MR cholangiography. For the former, the two reviewers focused on intrahepatic ductal dilatation, calculi, and stricture; and for the latter, ductal enhancement. RESULTS: In seven patients, 13 diseased segments were depicted and intrahepatic bile ductal dilatation was present in all 13 of these in all seven patients. Calculi were present in eight segments in six patients, and stricture in four segments in three patients. Of the 13 diseased segmental ducts, six were seen at manganese-enhanced imaging to be filled with contrast material, suggesting a functioning bile duct. CONCLUSION: Combined T2-weighted and mangafodipir trisodium-enhanced T1-weighted MR cholangiography provides both anatomic detail and functional detail of the biliary system. Combined MR cholangiography is useful for the evaluation of intrahepatic choledocholithiasis, demonstrating the stricture and function of the segmental ducts involved.
Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Calculi ; Cholangiography* ; Cholangitis ; Choledocholithiasis* ; Constriction, Pathologic ; Diagnosis* ; Dilatation ; Humans

Acute invasive small bowel anisakiasis is an extremely rare cause of small bowel obstruction. The authors report a case of surgically verified small bowel anisakiasis resulting in small bowel obstruction. A 54-year-old man presented with suddenly developed diffuse abdominal pain after ingestion of raw fish. The peripheral blood examination showed leukocytosis without eosinophilia. CT showed a long segment of thickened small bowel accompanied by a focal narrowed portion and combined with ascites. When these findings are noted in patients with a history of recent ingestion of raw or undercooked fish, the diagnosis of small bowel anisakiasis should be considered in order to avoid application of unnecessary surgical treatment, in spite of the severity of the abdominal pain and bowel obstruction.
Anisakiasis/complications/*radiography/surgery ; Humans ; Intestinal Obstruction/*parasitology/*radiography/surgery ; Intestine, Small/*parasitology/radiography ; Male ; Middle Aged ; *Tomography, X-Ray Computed

OBJECTIVE: Fragile X syndrome is the most common form of familial mental retardation, attributable to (CGG)n expansion in the FMR1 gene. This study was undertaken to ascertain the distribution of FMR1 CGG repeat in the general Korean women and to identify ethnic difference in FMR1 CGG repeat number. Material and METHOD: Between January 1999 and December 1999, we evaluated 1,000 low risk women who visited Gachon Medical School Hospital. DNA samples were extracted from the venous bloods by routine methods, and G-C specific Polymerase Chain Reaction (PCR)s were performed to evaluate FMR1 CGG repeat number. RESULTS: Mean FMR1 CGG repeat number was 26.9 (6-50), single PCR bands were detected in 776 cases (77.7%). There were two more bands in 22.3% of the cases. Most of the cases are located between 21 and 35 repeats, especially 21-25 repeats. The pattern of distribution of CGG repeat is dispersed. In 13 cases, we could not obtain the PCR results. CONCLUSION: Low risk of transmission rate of the FRX in Korea can be expected.
Alleles* ; Blotting, Southern ; DNA ; Female ; Fragile X Syndrome ; Humans ; Intellectual Disability ; Korea ; Polymerase Chain Reaction ; Schools, Medical

BACKGROUND: The fragile X syndrome is the most common cause of inherited mental retardation, is almost always caused by abnormal CGG trinucleotide amplication within the FMR1(fragile X mental retardation) gene located in Xq27.3 METHODS: DNA samples were obtained from the amniotic fluids of known carrier mother and 35 mothers without risk factors of the fragile X syndrome. Polymerase chain reaction(PCR) and Southern blot analysis were performed to evaluate the number of CGG repeats in the FMR1 gene. RESULTS: The DNA samples from the carrier mother gave a large fragment over 300 repeats by PCR. All 35 control samples showed fragments sized under 35 repeats. CONCLUSIONS: Prenatal diagnosis of the fragile X syndrome could be done with mid-trimester amniotic fluid using PCR and Southern blot method.
Amniotic Fluid* ; Blotting, Southern ; DNA* ; Female ; Fragile X Syndrome* ; Humans ; Intellectual Disability ; Mothers ; Polymerase Chain Reaction ; Prenatal Diagnosis* ; Risk Factors