Correlation of Pulmonary Vascular Dilatation on HRCT to Expression of eNOS in a Rabbit Model of Hepatopulmonary Syndrome

PURPOSE: To investigate the correlation between pulmonary vascular dilatation on high-resolution computed tomography (HRCT) and expression of endothelial nitric oxide synthase (eNOS) after common bile duct ligation (CBDL) in the rabbit as a model of hepatopulmonary syndrome. MATERIALS AND METHODS: CBDL was done in 11 rabbits (2 weeks after CBDL, n = 5; 3 weeks after CBDL, n = 6). Four rabbits were done by abdominal incision with peritoneal suture only as a control group. HRCT scans were performed in the both groups. We evaluated peripheral pulmonary vascular dilatation in the upper and lower lobe. Tissue samples were immediately obtained from both upper and lower lobes of the lung and the liver after sacrifice. Dilatation of peripheral pulmonary vessel was correlated with the expression of endothelial nitric oxide synthase (eNOS) determined by Western blot. We also compared the degree of pulmonary vascular dilatation between the groups with administration of L-arginine (n = 5) and without administration of L-arginine (n = 6) after CBDL. RESULTS: Two weeks after CBDL, pulmonary vascular dilatation on HRCT was seen in three rabbits (60%) and the increase of eNOS expression was shown in two rabbits (40%) in the lower lobe. Three weeks after CBDL, pulmonary vascular dilatation on HRCT was seen in four rabbits (66.7%) and five rabbits (83.3%) each upper and lower lobe, respectively. Expression of eNOS was coincidently increased. The pulmonary vascular dilatation was noted more frequently in the lower lobe than in the upper lobe. Pulmonary vascular dilatation on HRCT was highly correlated with increase of expression of eNOS in the upper (r = 1.00, p = .0001) and lower lobe (r = .83, p = .0015). In contrast, control group of four rabbits developed neither pulmonary vascular dilatation on HRCT nor increase of eNOS expression. The grade of pulmonary vascular dilatation in the group with L-arginine administration was higher than that without administration of L-arginine (p < .05). CONCLUSION: Pulmonary vascular dilatation on HRCT is significantly correlated with increase of eNOS expression in a rabbit lung after CBDL. These results suggest that NO, derived from pulmonary eNOS, contributes to pulmonary vascular dilatation in a rabbit model of hepatopulmonary syndrome. Index words : Lung, CT Lung, effect of drugs on Lung, vascular disease

The Value of Ultrasonography Combined with Compression Technique in Differentiation between Benign and Malignant Breast Masses

PURPOSE: To determine whether the compression technique is a valuable additional method for differentiating between benign and malignant breast masses. MATERIALS AND METHODS: The ultrasonographic findings of 95 benign and 53 malignant masses, all pathologically proven, were prospectively analyzed with regard to five diagnostic criteria: shape (regular/irregular), retrotumoral acoustic phenomena (posterior enhancement/posterior attenuation), internal echo pattern (homogeneous/inhomogeneous), compression effect on shape (distortion/no change), and compression effect on internal echo pattern (more homogeneous/no change). RESULTS: The number of cases of benign and malignant masses, respectively, was as follows: regular / irregular shape: 84/11, 9/44; posterior acoustic enhancement/posterior attenuation: 82/13, 16/37; homogeneous/inhomogeneous internal echo pattern: 78/17, 14/39; distortion/no change in shpae: 76/19, 5/48; and more homogeneous/ no change in internal echo pattern: 71/24, 3/50. For all diagnostic criteria for the differentiation of benign and malignant masses, the differences were statistically significant (p<.05). CONCLUSION: Ultrasonography is helpful for differentiating between benign and malignant breast masses. The compression technique is a valuable additional diagnostic method.

Photoelastic evaluation of mandibular posterior crossbite appliance / 대한치과교정학회지

This study was undertaken to demonstrate the forces in the mandibular alveolar bone generated by activation of the mandibular posterior crossbite appliance in the treatment of buccal crossbite caused by lingual eruption of mandibular second molar. A three-dimensional photoelastic model was fabricated using a photoelastic material ( PL-3 ) to simulate alveolar bone. We observed the model from the anterior to the posterior view in a circular polariscope and recorded photographically before and after activation of the mandibular posterior crossbite appliance. The following results were obtained : 1. When the traction force was applied on the buccal surface of the mandibular second molar, stress was concentrated at the lingual alveolar crest and root apex area. The axis of rotation also was at the middle third of the buccal root surface and the root apex, so that uncontrolled tipping and a buccal traction force for the mandibular second molar were developed. 2. When the traction force was applied on the lingual surface of the mandibular second molar, more stress was observed as opposed to those situations in which the force application was on the buccal surface. In addition, stress intensity was increased below the root areas and the axis of rotation of the mandibular second molar was lost. In result, controlled tipping and intrusive tooth movements were developed. 3. When the traction force was applied on either buccal or lingual surface of the second molar, the color patterns of the anchorage unit were similar to the initial color pattern of that before the force application. So we can use the lingual arch for effective anchorage in correcting the posterior buccal crossbite. As in above mentioned results, we must avoid the rotation and uncontrolled tipping, creating occlusal interference of the malpositioned mandibular second molar when correcting posterior buccal crossbite. For this purpose, we recommend the lingual traction force on the second molar as opposed to the buccal traction.

High-resolution CT Features of Bleeding Foci in Patients with Massive Hemoptysis

PURPOSE: To compare the high-resolution CT features of bleeding foci in patients with massive hemoptysis during embolization with those revealed by angiography. MATERIALS AND METHODS: Between June 1997 and June 1999, we evaluated 25 patients who from among a total of 49 with arterial embolization due to massive hemoptysis underwent HRCT prior to embolization. We retrospectively analyzed medical records, and angiographic and HRCT findings. The time interval between HRCT and arterial embolization varied from two hours to six days. Angiography indicated that the bronchial, intercostal and internal mammary artery, and branches of the subclavian, were the foci of bleeding, and indicated the location of these in each pulmonary lobe. The HRCT findings were evaluated in terms of cavity, air-meniscus sign, bronchial dilatation, consolidation, ground-glass opacity, and fibrotic scar. We analyzed the corresponding sites of HRCT and the angiographic findings of the foci of bleeding. RESULTS: In 24 of 25 patients, the foci of bleeding were angiographically confirmed, their presence being noted in 28 pulmonary lobes. HRCT findings corresponding to the bleeding foci revealed by angiography were the air-meniscus sign (8 of 10 lobes, 80.0%), cavity (7 of 9 lobes, 77.8%), bronchial dilatation (21 of 30 lobes, 70.0%), and fibrotic scar (1 of 23 lobes, 4.3%). The findings in areas of consolidation and/or ground-glass opacity only did not correspond, however. CONCLUSION: As compared with those revealed by angiography, the HRCT features of bleeding foci in patients with massive hemoptysis during embolization are in order of frequency, the air-meniscus sign, cavity, and bronchial dilatation.

Helical CT Findings of Gastric Wall Thickening by Peptic Ulcer: Compared with Gastric Adenocarcinoma with Ulcer

PURPOSE: To compare on the basis of helical CT findings gastric wall thickening of peptic gastric ulcer with that of gastric adenocarcinoma with ulcer. MATERIALS AND METHODS: Thirty-eight patients with athologically proven gastric lesion [17 cases of peptic ulcer and 21 cases of ulcerative or ulceroinfiltrative gastric cancer (Borrman type II, III)] underwent helical CT, and the findings were retrospectively reviewed in terms of maximum abnormal wall thickness, preservation of the inner enhancing layer, the presence of three discriminate layers of gastric wall, and enhancment pattern. The enhancment pattern of abnormally thick wall was compared with that of the portal phase of back muscle, and was defined as low, iso, or high. The Chi-square test and Student t test were used for statistical analysis. RESULTS: In cases of peptic ulcer and gastric cancer with ulceration, maximum abnormal wall thickness was 7-30 (mean, 16.1)mm, and 11-33 (mean, 21.8)mm, respectively. The inner enhancing layer was preserved in 15 of 17 patients (88.2%) and one of 21 (4.8%); three discriminate layers of gastric wall were observed in 8 of 17 patients (47.0%), and one of 21 (4.8%). The enhancement pattern was low in 12 of 17 patients (70.5%), and 3 of 21 (14.3%); iso in 4 of 17 (23.5%), and 4 of 21 (19.0%), and high in one of 17 (5.9%), and 14 of 21 (66.7 % ). All figures refer, respectively, to the two distinct onditioins. In terms of preservation of the inner enhancing layer, three discriminate layers of gastric wall, and a low enhancement pattern, there were statistically significant differences between peptic ulcer and gastric adenocarcinoma with ulcer. Where the enhancement was high, however, the statistically significant difference between the two conditions was even greater. There was no statistically significant difference in terms of gastric wall thickness or iso-attenuation of thickened gastric. CONCLUSION: Helical CT findings of gastric wall thickening, preservation of the inner enhancing layer, and three discriminate layers of gastric wall, as well as the nature of the observed enhancement pattern, may help differentiate between peptic ulcer and gastric adenocarcinoma with ulcer.

An Analysis of Dietary Intakes and Plasma Biochemical Indices in Female College Students by Skin Types / 대한지역사회영양학회지

This study was done to investigate the nutrient intakes and plasma biochemcial indices in 68 female college students according to their skin types. Nutrient intakes were investigated by quik estimation. The plasma TG and total cholesterol levels were measured by the Spotchem sp-4410. The plasma levels of retinol and alpha-tocopherol were measured by HPLC. In addition, the activities of antioxidant defense enzymes such as plasma glutathione peroxidase(GSH-Px) and glutathione reductase(GHS-Rd) were determined. All data were statistically analyzed by SAS PC package program. The results of this study were as follows : The average age, height, weight, BMI, systolic blood pressure and diastolic blood pressure ofthe subjects were 20.9+/-1.9yr, 160.7+/-4.3cm, 53.0+/-7.1kg, 20.5+/-2.4kg/m2, 105.3+/-11.5mmHg and 70.6+/-7.7mmHg, respectively. Ten students(14.7%) had normal skin type, 19 students(27.9%) had dry skin type, 11 students(16.2%) had oily skin type, 17 students(25.0%) had acne and 11 students(16.2%) had mixed skin type. The intakes of energy and fats in oily skin group were significantly higher(p<0.05) than those of the dry skin group, but vitamin C intake in the mixed skin group was significantly higher(p<0.05) than those of the dry skin group, but vitamin C intake in the mixed skin group was significantly lower(p<0.05) than that in other skin types. The intakes of other nutrients were not significantly different among skin types. The analysis of lipids showed that the plasma total-cholesterol level of mixed skin group was significantly lower(p<0.05) than that of the oily skin group, whereas other lipid levels were not significantly different. The other parameters such as retinol, alpha-tocopherol, GSH-Px and GSH-Rd of plasma were not significantly different among skin types. Overall results indicate that dietary intake pattern may influence skin type and thereby some blood biochemical indices can be different by skin types.

Comparison of Enhancement Pattern of Nodular and Massive Hepatocellular Carcinoma with and without Portal VeinThrombosis in Three-Phase Spiral CT

PURPOSE: To evaluate the enhancement patterns of nodular and massive hepatocellular carcinoma (HCC), with or without portal vein thrombosis, on three-phase spiral CT. MATERIALS AND METHODS: Contrast enhancement patterns in 61 patients with HCC were retrospectively analysed. Three-phase spiral CT images of the hepatic arterial dominant phase, portal dominant phase, and delayed phase were obtained 30, 60-70, and 360 seconds after the injection of contrast material was initiated. Tumors were divided into grossly nodular and massive type and enhancement patterns of HCC, with and without portal vein thrombosis, were compared. These patterns were divided into three groups, as follows: High/High/Low; High/Low/Low; Low/Low/Low. HCC with portal vein thrombosis was found in 21 of 61 cases ; this carcinoma without portal vein thrombosis was found in 40 cases. The nodular type accounted for 39 cases, and the massive type for 22. RESULTS: In 21 cases of HCC with portal vein thrombosis, the most common enhancement pattern was L/L/L, and was seen in 13 cases (62%); H/L/L was seen in eight (38%), but H/H/L was not seen. In 40 cases of HCC without portal vein thrombosis, the most common enhancement pattern was H/L/L, seen in 25 cases (63%) ; this was followed by L/L/L (11 cases ; 27%), and H/H/L (4 cases ; 10%). In the arterial dominant phase, among cases of HCC with portal vein thrombosis, low attenuation was more common (13/21) than high (8/21);among cases of HCC without portal vein thrombosis, high attenuation was more common (29/40) than low (11/40). Among 39 nodular-type cases, HCC with portal vein thrombosis was found in six (H/H/L and L/L/L: three each), and HCCwithout portal vein thrombosis was seen in 33 (H/L/L: 22; L/L/L: 7; H/H/L; 4). Among 22 cases of the massive type, HCC with portal vein thrombosis accounted for 15 (L/L/L: 10, H/L/L: 5), and seven cases without portal vein thrombosis were seen (L/L/L: 4 ; H/L/L : 3). CONCLUSION: On Three-phase spiral CT, HCC showed different enhancing patterns according tumor type and the presence of portal vein thrombosis.

Correlation Between Contrast Enhancement of Portal Vein and Spleen Size in Dual-phase Spiral CT

URPOSE: To evaluate using spiral CT the effect of spleen size on blood flow in the portal venous system andto know the usefulness of this evaluation. MATERIALS AND METHODS: Fifty-one patients without evidence on spiralCT scan of abnormality thought to affect portal venous flow presented between December 1994 and June 1995. We measured spleen size and Hounsfield units of portal vein in dual-phase, and calculated the ratio of the unit inthe portal phase to that in the arterial phase. Spleen size was measured, using the length of X-axis by that of Z-axis on spiral CT scan. We then measured the correlation between the two values. CT was performed with a Somatom Plus-S scanner(Siemens, Erlangen, Germany). A total dose of 120ml of non-ionic contrast material(Ultravist) was administered at a rate of 3ml/sec. Arterial and portal phase were obtained after 30 seconds and 60 seconds fromthe beginning of the contrast agent injection. RESULTS: The correlation between spleen size and contrast enhancement of the portal vein was relatively significant(Pearson's correlation coefficient(r)=0.41801). CONCLUSIONS: Spleen size significantly affects portal venous flow on spiral CT scan. The evaluation of spleensize and contrast enhancement of the portal vein could be useful in the differential diagnosis of diseases which affect portal venous flow.