Evaluation of Phase-Contrast Microscopic Imaging with Synchrotron Radiation in the Diagnosis of Breast Cancer and Differentiation of Various Breast Diseases: Preliminary Results / 한국유방암학회지

PURPOSE: A significant improvement of imaging using synchrotron radiation (SR) is obtained by introducing phase-contrast technique. This technique provides greatly enhanced contrast and good soft tissue discrimination with high spatial resolution. The aim of this study was to observe microstructures of pathologic breast specimens including invasive breast cancer using phase-contrast technique with SR and to evaluate the feasibility of phase-contrast imaging in clinical application. METHODS: Phase-contrast microscopic image of normal breast tissue and the images of various breast diseases such as fibrocystic change, ductal carcinoma in situ, invasive ductal carcinoma, Paget's disease were obtained using hard X-ray microscopy with an 11.1 keV monochromatic beam from SR source and CsI (TI) scintillation crystal. Zernike phase-shifter was adapted for phase-contrast hard X-ray microscopy. The visual image was magnified 20 times by microscopic objective lens and captured using a full frame charge-coupled device camera. Obtained images were compared with corresponding histopathologic findings in the optical microscopy. RESULTS: The SR images of various breast diseases were obtained with a good contrast and high visibility by phase-contrast technique. It was possible to observe the microstructures with high spatial resolution down to the micron region. The characteristic features of each disease were consistent with the histopathologic findings of corresponding sample and the images of breast cancer and the other diseases were distinct from each other. CONCLUSION: Using phase-contrast technique, SR images of various breast diseases including breast cancer were obtained. These images were comparable with standard histopathologic findings and showed different features for each disease. The results suggest that phase-contrast microscopic imaging with SR has potential as a diagnostic tool and also its clinical application is feasible, especially in breast imaging.

Synchrotron Radiation Imaging of Female Breast Tissues Using Phase Contrast Technique / 한국유방암학회지

PURPOSE: X-ray microscopy with synchrotron radiation might be a useful tool for novel x-ray imaging in the clinical and laboratory settings. This technique provides detailed images of internal structures non-invasively. It also has the potential to resolve some of the limitations of conventional breast imaging. We evaluated high resolution synchrotron imaging of breast tissues from normal breasts and breasts with fibroadenomas and cancer. METHODS: A new x-ray microscope was installed on the 1B2 beamline of a Pohang Light Source, at a third generation synchrotron radiation facility in Pohang, Korea. The phase contrast x-ray energy was set at 6.95 keV and the x-ray beam was monochromatized by a W/B4C monochromator. Formalinfixed or unfixed female breast tissue from normal breast as well as breasts with fibroadenomas and carcinoma were attached onto the Kapton film. The sample was positioned 25 m away from the beam source. The x-ray image of the sample was converted into a visual image on the CsI (TI) scintillation crystal, and magnified 20 times by the microscopic objective lens. After an additional 10 fold digital magnification, this visual image was captured by a full frame CCD camera. RESULTS: The monochromated x-ray microscopic images of female breast tissue from normal breast, fibroadenoma and carcinoma cases were evaluated. The total magnifying power of the microscope was x200. This synchrotron radiation imaging enabled us to observe detailed structures of breast tissue without sample preparation such as staining or fixation. CONCLUSION: Using monochromated synchrotron radiation, the x-ray microscopic images of the normal breast and breasts with fibroadenomas and cancer were obtained. From the images obtained, the x-ray microscopic imaging of breast tissue with synchrotron radiation appears to have great potential for clinical and research purposes such as oncology studies, early detection of cancer and as an aid to the pathological diagnosis in the future.

Interstitial Photodynamic Therapy (PDT) Set-up for Treating Solid Tumor Using Laser Diode / 의학물리

Photodynamic therapy (PDT) is one of the expectable current cure operation methods. Tumor tissue is treated by abundant oxygen in a body and generated singlet or free radical from exterior laser diode and photosensitizer. Current problem of PDT is the low penetration power of the light beam in a deep seated large tumor and solid tumor thus results in low treatment outcome. In the study, we tried to develop interstitial photodynamics therapy treatment to solve this problem. As the accurate determination of light dosimetry in biological tissue is one of the most important factors affecting the effectiveness of PDT, parameters used in this study are the optical property of biological tissue. Since biological tissues have large scattering coefficient to visible light the penetration depth of a biological tissue in visible light region is only 15~20 mm. We showed that it is possible to measure fluence rate and penetration depth within the biological tissues by Monte Carlo simulation very well. Based on the MC simulation study, the effectiveness of interstitial photodynamic therapy on tumor control in solid tumor was proved through in vivo animal experiment.

In Vitro Proton Magnetic Resonance Spectroscopy Detected a Differential Neurochemical Response in Rabbit Brain Administered Thiopental or Ketamine / 대한마취과학회지

BACKGROUND: Cellular target sites and the neurochemical compounds responsible for anesthetic action remain unclear. This study was designed to detect regional changes in neurochemical compounds by NMR spectroscopy of extracted rabbit brain tissue after anesthetizing with thiopental or ketamine. METHODS: Nine healthy white New Zealand rabbits (2.5-3.0 kg) were studied. A marginal ear vein was punctured for continuous intravenous infusion. Controlled breathing was maintained using a Jackson-Ree circuit after intubation during thiopental (n = 3) or ketamine (n = 3) anesthesia. After maintaining anesthesia for 30 minutes, brains were extracted and placed in liquid nitrogen. Rabbits in the control group (n = 3) were sacrificed using KCl and processed in the same manner. Extracted brain tissues were divided into frontal lobe, temporal lobe, occipital lobe, parietal lobe, pons, midbrain, basal ganglia and spinal cord. The 1H-NMR spectra of extracted regional brain tissues were obtained, and neurochemical compounds such as gamma-aminobutyric acid (GABA), N-acetylaspartate (NAA), choline-containing compounds (Cho), and creatine (Cr) were compared with those of normal control tissues. RESULTS: In the thiopental group, the GABA/Cr and NAA/Cr ratios of brain regions were not significantly different from those of the control group. The Cho/Cr ratios of the frontal lobe, parietal lobe, and basal ganglia were significantly higher than those of the control group. In the ketamine group, the GABA/Cr ratio of the midbrain was significantly lower than that of the control group. However, Cho/Cr ratios of the parietal lobe, temporal lobe, and midbrain were significantly higher than those of the control group, though the NAA/Cr ratio was similar to that of the control. CONCLUSIONS: These results suggest that the anesthetic actions of thiopental, such as, its sedative and hypnotic effects are due to increased GABA activity. Inhibition of acetylcholine induced neurotransmission was observed particularly in the frontal lobe, parietal lobe, and basal ganglia in thiopental anesthesia and in the parietal lobe, temporal lobe and midbrain in ketamine anesthesia. Neurotoxicity was not observed for either drug in anesthetized brain tissue.

Photodynamic Effects of Radachlorin(R) on Cervical Cancer Cells / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Photodynamic therapy (PDT) is a novel treatment modality, which produces local tissue necrosis with laser light following the prior administration of a photosensitizing agent. Radachlorin(R) has recently been shown to be a promising PDT sensitizer. In order to elucidate the antitumor effects of PDT using Radachlorin(R) on cervical cancer, growth inhibition studies on a HPV-associated tumor cell line, TC-1 cells in vitro and animals with an established TC-1 tumor in vivo were determined. MATERIALS AND METHODS: TC-1 tumor cells were exposed to various concentrations of Radachlorin(R) and PDT, with irradiation of 12.5 or 25 J/cm2 at an irradiance of 20 mW/cm2 using a Won-PDT D662 laser at 662 nm in vitro. C57BL/6 mice with TC-1 tumor were injected with Radachlorin(R) via different routes and treated with PDTin vivo. A growth suppression study was then used to evaluate the effects at various time points after PDT. RESULTS: The results showed that irradiation of TC-1 tumor cells in the presence of Radachlorin(R) induced significant cell growth inhibition. Animals with established TC-1 tumors exhibited significantly smaller tumor sizes over time when treated with Radachlorin(R) and irradiation. CONCLUSION: PDT after the application of Radachlorin(R) appears to be effective against TC-1 tumors both in vitro and in vivo.

In vivo Proton Magnetic Resonance Spectroscopy Based Study of Metabolic Changes in Rabbit Brain under Intravenous Anesthesia with Thiopental Sodium and Propofol / 대한마취과학회지

BACKGROUND: It is well known that both thiopental sodium and propofol reduce the cerebral metabolic rate. The author investigated whether these drugs have similar effects on neurobiochemical compounds by using 1H-NMR, which enables noninvasive in vivo measurements of brain biochemistry. METHODS: Six healthy white New Zealand rabbits (2.5-3.0 kg) were studied. A marginal ear vein was punctured for continuous intravenous infusion. Spontaneous breathing was maintained during the anesthesia. Neurobiochemical compounds such as N- acetylaspartate (NAA), choline-containing compounds (Cho), creatine plus phosphocreatine (Cr), myoinositol (MI), and lactate were examined at 30, 45 and 60 min during intravenous anesthesia induced with thiopental sodium (n = 3) and propofol (n = 3). RESULTS: The signals of NAA, Cho, Cr and MI were unchanged during thiopental anesthesia, but the NAA signal was reduced at 45 and 60 min, and that of Cr was reduced from 30 min until the end of the propofol anesthesia. The Cho signal was increased at 45 and 60 min during propofol anesthesia. Thiopental sodium signal were detected through the study, but propofol was detected only at 30 min. On comparing metabolic ratios in the two groups, the ratio of NAA/Cr was reduced and those of Cho/Cr and MI/Cr were higher in propofol group than in the thiopental sodium group. CONCLUSIONS: Our results suggest that thiopental sodium has a cerebral protective function. Howerver, further study is needed upon the cerebral protective function of propofol anesthesia. Propofol is more useful for total intravenous anesthesia than thiopental sodium.

Effect of Culture Condition on Chondrocyte Viability Isolated from Articular Cartilage / 대한진단검사의학회지

BACKGROUND: Recent advance in tissue engineering in the biomedical field shed light on the replacement or regeneration of various organs with synthetic substitutes. Currently emerging cartilage tissue engineering therapies involve artificial cartilage fabricated from three dimensional cultures using appro-priate scaffolds. It is mandatory to expand or proliferate the chondrocytes in vitro to prepare the artificial cartilage. The purpose of this study was to find out the most favorable culture conditions for chon-drocyte viability in vitro. METHODS: Articulr chondrocytes or cartilage explants were isolated from the patellofemoral groove of adult pigs. And then we standardized the size and thickness of the cartilage explants as well as preparing alginate-chondrocyte beads for three-dimensional cultures. The cartilage explants, including 10% fetal bovine serum for 10 days, 36 days and passage 6. Cellualr viability was measured by methylthiazol tetrazolium (MTT) assay on monolayer, alginate bead and cartilage explant. SPSS 11.5 was used for data anaylsis. RESULTS: Chondrocytes cultured on monolayers in vitro showed no significant difference in cellular viability until passage 6 following isolation from the patellofemoral groove of adult pigs (P>0.05, n=4). Chondrocyte viability was markedly increased by day 16 both in the monolayer (148%) and three dimensional cultures (245%), and then slightly decreased 126% and 200%, respectively, at day 36. Three dimensional cultures using alginate bead were more favorable for chodrocyte viability than monolayer culture in chondrocyte primary culture (P=0.003, n=6). Chondrocyte viability in the algi-nate bead was increased 300% during 36 days' incubation period (P=0.001, n=3). Cellular viability in the cartilage explant culture was decreased after day 4 in both MTT score (P=0.022, n=10) and MTT OD (P=0.039, n=10). CONCLUSIONS: Three dimensional cultures using alginate bead were the most favorable for chon-drocyte viability in chondrocyte primary cultures.

Photogem Induces Necrosis in Various Uterine Cervical Cancer Cell Lines by PDT / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: In order to elucidate the antitumor effect of photodynamic therapy (PDT), using a derivative of the photosensitizing agent hematoporphyrin (Photogem) and a diode laser, the cell death of uterine cancer cell lines (CaSki, HT3, HeLa, and SKOV-3), and mice transplanted with TC-1 lung cancer cells, were evaluated. MATERIALS AND METHODS: The morphological changes, MTT assay, flow cytometry, cytotoxicity and tumor growth inhibition study were evaluated at various time intervals after the PDT. RESULTS: The results showed that the survival rates of each cell line decreased with time and dose response after performing the PDT. Also, the PDT-induced damage of cancer cells was almost entirely confined to necrosis of the tumor cells in the early time courses. The irradiation of CaSki cells in the presence of Photogem induced plasma membrane disruption and cell shrinkage, indicating the plasma membrane as the main target for Photogem. In the in vivo experiment, significantly longer survival and a significantly smaller tumor size were seen over the time courses of the Photogem with irradiation compared to the untreated control groups; resorption of the tumor was also observed after the PDT treatment. CONCLUSION: Collectively, our results indicated that Photogem possesses anti-tumor effects, and necrosis-like death, with plasma membrane damage, was postulated to be the principal mechanism of the antitumor effect of the PDT using Photogem.

Photodynamic Therapy for Neoplasms in Intrathoracic Constructed Stomach / 대한흉부외과학회지

Photodynamic therapy (PDT) is a local, endoscopically controlled nonoperative therapeutic technique based on selective sensitization of mucosal, malignant and precancerous lesions of the esophagus, trachea and bronchus prior to light-induced tissue destruction in the department of thoracic and cardiovascular surgery. PDT is effective and safe for palliative treatment of neoplasms in the stomach, esophagus, and lung. But skin phototoxicity is unsatisfactory, therefore optimization of management of post-PDT is necessary for preventing phototoxic side effects of skin. Careful patient education in photoprotection techniques, close patient follow-up, early dermatologic referral and medical treatment are recommended. We performed PDT in a patient with intrathoracic constructed stomach. We report this case with a brief review of literatures, therefore.

The Effect of Photodynamic Therapy on Colon Cancer Cell Line

PURPOSE: Photodynamic therapy (PDT) is a relatively new technology for an alternative modality in the treatment of colorectal cancers. This study was conducted to identify the appropriate dosage and energy level for the photosensitizer as well as effect of PDT on colon cancer cells. METHODS: Colon cancer cell line, COLO 205 (American Type Culture Collection, ATCC) was obtained from Korea Cell Line Bank (KCLB, Seoul, Korea). Cells were cultured on RPMI 1640 medium with 10% fetal calf serum, penicillin, and gentamicin. Cells were incubated at 37 C in a 5% CO2 air environment. Photosense (sulphonated aluminum phthalocyanine, AlPcS4, NIOPIK, State Research Center, Moscow, Russia) was used for the photosensitizer and Fireplace video-3 (Biospec, General Physics Institute, Moscow, Russia, 500 mW/cm2, 670 nm) was used for the light source. 1 104 cells were incubated in 96 well plates with different concentrations of aluminum phthalocyanine: 0.1, 0.3, 0.5 and 1micrometer for 24 hours then photoirradiation was performed at either 24 or 48 J/cm2. The time variations of the viabilities of cells of the four study groups and were measured by using MTT assay according to time were compared to those of the three control groups: control (no treatment), control (AlPcS4, no light), control (light, no AlPcS4), and the study groups (PDT) at one hour, 24 hours, 48 hours and 72 hours after PDT. RESULTS: At, one hour after PDT, the viability of the cells was not changed in the control groups. Viabilities of 117, 40, 35, and 23% in the 24 J group and 76, 31, 52, and 48% in 48 J group were observed, respectively in order of increasing concentration with the value of 87~103% for the control group. 24 hours later, viability of control groups were not changed, By 24 hour after PDT, the viabilities of the control groups had not changed, but those of the 24 J/cm2 and 48 J/cm2 PDT study groups had decreased significantly to 62, 17, 16, and 18% and 24, 15, 13, and 13%, respectively (P=0.00). By 48 hours viability of the 24 J/cm2 and 48 J/cm2 PDT study groups were also significantly decreased being 103, 26, 13, and 13% and 50, 8, 8, and 9%, respectively (P=0.00). By 72 hours, viabilities were 84, 21, 21, and 30 % and 33, 20, 33, and 15%, respectively (P=0.00). CONCLUSIONS: The PDT groups showed a marked cytotoxic effect compared to the control groups, and the effect appeared just after PDT and peaked in 48 hours. The minimum required concentration of the photosensitizer for effective cytotoxicity was at 0.3 micrometer either 24 or 48 J/cm2.

The Change of Cerebral Metabolites in Patients with Parkinson's Disease Measured by Proton Magnetic Resonance Spectroscopy

BACKGROUND: Parkinson's disease is a progressive, common neuro-degenerative disorder of the extrapyramidal system leading to specific motor symptoms, but there is no specific early diagnostic tool. This study was aimed to investigate the change of cerebral metabolites in patients with parkinson's disease by 1H magnetic resonance spectroscopy (MRS). METHODS: Eighteen patients with idiopathic unilateral symptomatic parkinson's disease underwent MRS study to compare metabolites of basal ganglia and thalamus, in ipsilateral and contralateral to the clinically affected side. RESULTS: In patients with unilateral symptomatic parkinson's disease, N-acetyl aspartate (NAA)/Creatine (Cr) ratio was significantly lower in contralateral side to the clinically affected side than in ipsilateral side (p=0.023). Other cerebral metabolites (Cho, mI, alpha-Glx, beta-Glx, lactate, lipid) were showed no significant difference in patients with parkinson's disease. CONCLUSIONS: The comparison and quantification of cerebral metabolites by using MRS may be helpful to diagnosis and investigation of parkinson's disease.

Assessment of Patency of Coronary Artery Bypass Grafts Using Segmented K-space Breath-hold Cine Cardiovascular Magnetic Resonance Imaging: A Clinical Feasibility Study

PURPOSE: The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). MATERIALS AND METHODS: Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented Kspace cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. RESULTS: MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. CONCLUSION: Evaluation of patency of the bypass graft was clinically feasible by 2DFASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.

Core and Peripheral Temperature Changes with and without Wrapping the Lower Extremity during Open Abdominal Surgery under General Anesthesia / 대한마취과학회지

BACKGROUND: Core hypothermia after the induction of general anesthesia results largely from core-to- peripheral redistribution of body heat and anesthetic-induced inhibition of tonic thermoregulatory vasoconstriction. Because most metabolic heat is lost via the skin surface, covering the skin surface with an insulator is a way of minimizing heat loss. We therefore evaluated core and peripheral temperature changes with and without wrapping the lower extremity in cotton and elastic bandages during open abdominal surgery under general anesthesia. METHODS: Eighty-five patients of ASA physical status 1 or 2 who underwent open abdominal surgery under general anesthesia were investigated in this study. They were randomly assigned based on wrapping of the lower extremity in cotton and elastic bandages (group 2, n = 37) or not (group 1, n = 48). Anesthesia in both groups was induced with propofol and maintained with enflurane and 50% nitrous oxide in oxygen. The temperatures of the nasopharynx, forehead, chest, back, palm and sole were measured before and 10, 30, 60, 90, 120, 150 and 180 min after induction. RESULTS: Core temperature decreased significantly after the induction of anesthesia in both groups (P <0.05), but no significant difference was found between the groups in terms of core, palm, back and forehead skin temperature changes. However, the core and chest temperatures of group 2 at 150 and 180 min after induction were significantly lower than those of group 1 (P <0.05), and sole temperature changes were significantly different between the groups (P <0.05). CONCLUSIONS: Wrapping the lower extremity in cotton and elastic bandages during open abdominal surgery under general anesthesia was not effective at preventing the core temperature from decreasing. It is possible that wrapping the lower extremity causes peripheral vasodilation before anesthesia, stimulating the barorecepter, and shifting the body core temperature threshold for hypothermia inducing peripheral vasoconstriction to lower the body core temperature.

Chondrocyte Viability in the Three Dimensional Culture Using Natural Alginate / 대한류마티스학회지

OBJECTIVE: Articular cartilage has a highly limited capacity to repair because of lack of blood supply. There have been no effective modality to regenerate the articular cartilage and prevent degenerative changes. It is necessary to proliferate the cells in vitro, however the cells lose their phenotype during in vitro monolayer culture. Although it is not enough to increase the number of the cells in the three dimensional culture, it is a effective way to maintain their original phenotype expression. Alginate has been used as a good source of scaffold in chondrocyte three dimensional culture. The objective of this study was to find the most favorable scaffold for chondrocyte viability among various alginate extracted from natural source in chondrocyte three dimensional culture. METHODS: The alginate extracted from brown seaweed, Undaria pinnatifida and sea tangle, Laminaria japonica inhabitating near Korean sea and commercially available alginate were used. Chondrocytes isolated from adult pig were used. Three kinds of chondrocyte-alginate bead were made and incubated for forty-four days. Cellular viability and glycosaminoglycan (GAG) content were measured and compared. SPSS Version 10.0 was used for data analysis. RESULTS: Viability of chondrocyte and GAG content were increased as a function of time. Alginate from brown seaweed, U. pinnatifida appeared more favorable to maintain chondrocyte viability than others. The total GAG content was similar among three kinds of alginate CONCLUSION: Alginate extracted from natural see weed, especially brown seaweed, may be a good source to maintain chondrocyte viability in three dimensional culture.

The Evaluation of the Quality of Life in Epileptic Patients : The Study of QOLIE(Quality of Life in Epilepsy)-89 / 대한간질학회지

PURPOSE: Patients with epilepsy experience the impairment of Quality of life (QOL). The objective of this study was to investigate the 'Quality of Life' in epileptic patients and the influences of clinical factors upon QOL in epileptic patients. METHODS: Total 138 epileptic patients (male : 77, female : 61) were recruited for the study. The Quality of Life in Epilepsy (QOLIE)-89 was applied to evaluate QOL in epileptic patients. We gathered data about clinical variables (seizure type, frequency, duration of disease, number of antiepileptic drug, and depression) and socio-demographic variables (age, sex, marriage, employment, and education), and compared each variables in use of QOLIE-89 score. RESULTS: Depression influenced negatively the most of all subscales (16 of 20 subscales) and overall score (p or =16 year) had higher score at overall score and emotional well-being (p<0.05). However, age, marital state, employment, seizure type, and duration of disease did not affect QOL significantly. CONCLUSIONS: Sex, education, number of AEDs, depression, and seizure free state were major socio-clinical factors affecting QOL in patients with epilepsy. It is suggested that physician should recognize these factors and manage appropriately for improving the QOL.

1H-Magnetic Resonance Spectroscopy in Prostatitis Syndrome / 대한비뇨기과학회지

PURPOSE: To evaluate the specific metabolic patterns of the prostatic tissue with prostatitis syndrome 1H-magnetic resonance spectroscopy was performed on the patients with prostatitis syndrome. MATERIALS AND METHODS: Between 1996 and 2001, 24 men aged 19-59 (mean 36.9) were evaluated for the impression of prostatitis syndome. Image and spectrum were obtained with GE Signa 1.5T MRI/MRS unit using a GP flexible surface coils. Scout images were obtained at axial plane with T2-weighted fast spin echo sequence, and 1H spectra were acquired in the localized single-voxel elements of the prostatic tissue with stimulated echo-acquisition mode sequence before and after therapy. RESULTS: Elevated levels of amino acids and decreased citrate were detected in the prostatic tissue with prostatitis syndrome in comparison with normal tissue. Spectral variations of amino acids metabolic signal were found between different patient groups, and recovery of spectral pattern after 1 month or 3 months of antimicrobials therapy was found. In chronic noninflammatory pelvic pain syndrome, amino acids levels were elevated as in other prostatitis, but patterns were different. CONCLUSIONS: 1H-magnetic resonance spectroscopy using external body surface coil can be a useful and non-invasive method to evaluate and to monitor therapeutic efficacy of prostate diseases including the prostatitis syndrome.

MR Imaging of Slow-flow Using a Flow Phantom

Purpose : To find sensitivity of MRI imaging methods to slow flow phantom study was performed with conventional Spin-Echo, gradient echo based Phase Contrast, fast GLASS, and heavily T2-weighted Fast Spin Echo pulse sequences. MATERIALS AND METHODS: A siphon driven flow phantom was constructed with a ventriculo-peritoneal shunt catheter and a GE phantom to achieve continuous variable flow. Four different pulse sequences including Spin-Echo, Phase Contrast, GRASS and Heavily T2-weighted Fast Spin Echo were evaluated to depict slow flow in the range from 0.08 ml/min to 1.7 ml/min and to compare signal intensities between static fluid and flowing fluid. RESULTS: In the slow flow above 0.17 ml/min conventional Spin-Echo showed superior apparent contrast between static and flowing fluid while GRASS was more sensitive to the very slow flow below 0.17 ml/min. It was not accurate to calculate flow and velocity below 0.1 ml/min with a modified PC imaging. CONCLUSION: Four different MR pulse sequences demonstrated different sensitivity to the range of slow flow from 0.08 ml/min to 1.7 ml/min. This finding may be clinically useful to measure CSF shunt flow or detecting CSF collection and thrombosis.

In Vitro Analysis of Apoptotic Cell Death Using Proton Nuclear Magnetic Resonance Spectroscopy / 대한암학회지

PURPOSES: Cells undergoing apoptosis display profound morphologic and biochemical changes in the nucleus and cytoplasm, loss of membrane phospholipid asymmetry, resulting in the exposure of phosphatidylserine (PS) at the surface of the cell, membrane blebbing, and decreased membrane microviscosity. Proton nuclear magnetic resonance spectroscopy ('H NMR spectroscopy) is able to detect the mobile fraction of lipids contained in the cell, and thus is sensitive to membrane fluidity modifications related to lipid composition changes. We have used 'H NMR spectroscopy in HL-60 cell line to detect and characterize the changes in plasma membrane lipid associated with apoptotic cell death. MATERIALS AND METHODS: We performed annexin-FITC and propidium iodide dual fluorescence flow cytometry, DNA gel electrophoresis, and obtained 200 MHz 'H NMR spectra of the HL-60 cell cultures before and at 6, 12, 18, 24, 36 and 48 hours after the addition of doxorubicin (100 ng/mL). RESULTS: The onset of apoptosis is accompanied by a greater than four fold increase in signal intensity ratio of the membrane lipid methylene (-CH2) resonance (at 1.2 ppm) to the methyl (-CH3) resonance (at 0.9 ppm). The quantitative relationship between apoptosis and the H NMR signal intensity was determined by fluorescein-annexin V flow cytometry, and showed that increases in the CH2/CH3 resonance signal intensity ratio paralleled the surface expression of PS as an early marker of apoptosis ( y =0.80, N 18 samples). The gradual decrease in the ratio of choline resonance (at 3.2 ppm) to CH3 signal intensity after 12 hours in the time course' experiment is directly proportional to the percentage of apoptotic cells ( y =0.96, N=18 samples). CONCLUSIONS: Monitoring of the CH2 and choline resonance signal intensity may therefore be useful in detecting apoptosis. Further studies using various stimuli to induce apoptotic cell death will be necessary to better determine the capabilities of 'H NMR spectroscopy for the detection and estimation of apoptosis in vitro.

Utility of Diffusion-weighted MR Imaging in Acute Stage of Small Cerebral Infarction

PURPOSE: To demonstrate the usefulness of diffusion-weighted MR imaging(DWI) in patients with small acuteinfarction by comparing it with fast spin-echo T2-weighted MR imaging(FSE T2WI). MATERIAL AND METHOD: Weretrospectively analyzed the results of FSE T2WI in 26 consecutive patients who on DWI showed small discretehyperintensities of less than 1.5cm and whose final clinical diagnosis, within one week of clinical attack, wasacute inforction. Lacunar infarcts accounted for 24 cases and 2 small cortical infarcts for two. The onset ofsymptoms occurred within 12 hours (hyperacute stage) in two patients, within 24 hours in seven, within 3 days innine, and within one week in eight. Infarcts as seen on FSE T2WI were categorized as follows : (-) for cases ofimpossible localization with non-visualization ; (+/-) for cases of equivocal localization with faint visualizationand/or poor differentiation from combined chronic infarcts and chronic ischemic changes, or from subarachnoid CSFin cases of cortical infarction ; and (+) for cases of adequate localization with clear visualization andmoderately good differentiation from the associated brain changes, or from subarachnoid CSF in cases of corticalinfarction. These infarcts were analyzed according to the time of onset of symptoms. RESULT: For the localizationof small acute infarctions, DWI was markedly superior to the category(-), moderately superior to the category(+/-).With regard to the onset of symptoms, DWI was markedly or moderately superior to FSE T2WI in 2/2 (100%) ofhyperacute stage diagnosed within 12 hour of clinical attack, in 4/7(57%) diagnosed within 24 hours, in 5/9 (56%)diagnosed within 3 days, and in 1/8 (13%) diagnosed within 1 week(p<0.05). In 12/26 cases(46%), small acuteinfarcts were localized by DWI better than by FSE T2WI. CONCLUSION: Because the signal was unchanged or itsintensity was poor, small infarcts at the acute stage were frequently difficult to localize by FSE T2WI. Inaddition, differentiation of these from combined chronic infarcts and chronic ischemic change was poor. DWI canlocalize small acute infarcts even when the results of FSE T2WI are negative or inconclusive.

Differential Diagnosis between Malignant and Benign Breast Diseases Using Localized Proton Magnetic Resonance / 한국유방암학회지

Proton magnetic rcsonance spectroscopy (1H MRS) has demontrated its abilities to detect an increase of choline containing compounds (Cho) in various brain tumors and prostatic cancer tissues. Based on preclinical works done by other authors using multinuclei MRS, it is reasonable to assume malignant breast tumors will have elevated level of Cho compared to that of normal tissues and benign breast lesions. Several challenges must be met to obtain clinically useful 1H breast spectrum. Good water and fat suppression, Bo homogeneity are required to detect low level metabolic signals like choline if any. In this study, we investigated the clinical utility of 1H MRS with simultaneous suppression of water and fat signals, using breast imaging surface coil for evaluating breast cancer with small lesions. All studies were performed using a GE signa MRI unit (1.5 T, Ver 5.5) and 2-channel breast coil (GE). Water suppression was achieved by chemical selective saturation, and fat signal was attenuated using inversion recovery sequence. Spectroscopic data were acquired with PRESS sequence. Twenty-three patients, age 14-75, were examined. Eleven of these patients presented with invasive ductal carcinoma. The remaining patients presented with benign processes including fibroadenoma, fibrocystic change, galactocele, adenosis, ductal ectasia and dystrophic calcification. The size of lesions were variable (8-90 mm in diameter). Choline at 3.25 ppm was visible in the spectra of all cancer patients, while invisible in the spectra of all benign lesions except a lesion of dystrophic calcification. We concluded that in vivo detection of choline containing compounds in breast carcinomas using proton magnetic resonance spectroscopy demonstrated its potential as a noninvasive tool for differential diagnosis of malignant and benign breast lesions larger than 7 mm in diameter.