Effects of Banxia Xiexin Decoction () on Cisplatin-Induced Apoptosis of Human A549 Lung Cancer Cells / 中国结合医学杂志

<p><b>OBJECTIVE</b>To examinie the synergistic effects of Banxia Xiexin Decoction (, Known as Banhasasim-tang in Korean) extract (BXDE) on cisplatin-induced cytotoxicity in the A549 human lung cancer cell lines.</p><p><b>METHODS</b>A549 cells were treated with varying concentrations (50-200 μg/mL) of cisplatin and BXDE alone or in combination for 96 h. We used 1-(4,5-dimethylthiazol-2-yl)-3,5-diphenylformazan assay and flow cytometry to analyze cell viability and apoptosis, respectively.</p><p><b>RESULTS</b>The exposure of cells to cisplatin and BXDE alone or in combination decreased cell viability dose- and time-dependently (P<0.05), which was found to be mediated by the apoptotic pathway as confirmed by the increase in the annexin V/propidium iodide- stained cell population and a ladder pattern of discontinuous DNA fragments. Furthermore, the apoptosis was inhibited by the pan-caspase inhibitor, benzyloxycarbonyl-Val-Ala-Asp (OMe) fluoromethylketone (z-VAD-FMK).</p><p><b>CONCLUSIONS</b>BXDE significantly potentiated apoptotic effects of cisplatin in A549 cells. Moreover, apoptosis induced by BXDE might be the pivotal mechanism mediating its chemopreventative action against cancer.</p>

Crotonis Fructus Extract Inhibits 12-O-Tetradecanoylphorbol-13-Acetate-Induced Expression of Matrix Metalloproteinase-9 via the Activator Protein-1 Pathway in MCF-7 Cells / 한국유방암학회지

PURPOSE: Metastatic cancers spread from the primary site of origin to other parts of the body. Matrix metalloproteinase-9 (MMP-9) is essential in metastatic cancers owing to its major role in cancer cell invasion. Crotonis fructus (CF), the mature fruits of Croton tiglium L., have been used for the treatment of gastrointestinal disturbance in Asia. In this study, the effect of the ethanol extract of CF (CFE) on MMP-9 activity and the invasion of 12-O-tetradecanoylphorbol-13-acetate (TPA)-treated MCF-7 cells was examined. METHODS: The cell viability was evaluated using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. The expression of MMP-9 was examined by Western blotting, zymography, and real-time polymerase chain reaction. An electrophoretic mobility gel shift assay was performed to detect activator protein-1 (AP-1) DNA binding activity and cell invasiveness was measured by an in vitro Matrigel invasion assay. RESULTS: CFE significantly suppressed MMP-9 expression and activation in a dose-dependent manner. Furthermore, CFE attenuated the TPA-induced activation of AP-1. CONCLUSION: The results indicated that the inhibitory effects of CFE against TPA-induced MMP-9 expression and MCF-7 cell invasion were dependent on the protein kinase C δ/p38/c-Jun N-terminal kinase/AP-1 pathway. Therefore, CFE could restrict breast cancer invasiveness owing to its ability to inhibit MMP-9 activity.

SPA0355 attenuates ischemia/reperfusion-induced liver injury in mice

Hepatic ischemia/reperfusion (I/R) injury leads to oxidative stress and acute inflammatory responses that cause liver damage and have a considerable impact on the postoperative outcome. Much research has been performed to develop possible protective techniques. We aimed to investigate the efficacy of SPA0355, a synthetic thiourea analog, in an animal model of hepatic I/R injury. Male C57BL/6 mice underwent normothermic partial liver ischemia for 45 min followed by varying periods of reperfusion. The animals were divided into three groups: sham operated, I/R and SPA0355 pretreated. Pretreatment with SPA0355 protected against hepatic I/R injury, as indicated by the decreased levels of serum aminotransferase and reduced parenchymal necrosis and apoptosis. Liver synthetic function was also restored by SPA0355 as reflected by the prolonged prothrombin time. To gain insight into the mechanism involved in this protection, we measured the activity of nuclear factor-kappaB (NF-kappaB), which revealed that SPA0355 suppressed the nuclear translocation and DNA binding of NF-kappaB subunits. Concomitantly, the expression of NF-kappaB target genes such as IL-1beta, IL-6, TNF-alpha and iNOS was significantly downregulated. Lastly, the liver antioxidant enzymes superoxide dismutase, catalase and glutathione were upregulated by SPA0355 treatment, which correlated with the reduction in serum malondialdehyde. Our results suggest that SPA0355 pretreatment prior to I/R injury could be an effective method to reduce liver damage.

Silibinin Enhances Ultraviolet B-Induced Apoptosis in MCF-7 Human Breast Cancer Cells / 한국유방암학회지

PURPOSE: Chemotherapies for breast cancer generally have strong cellular cytotoxicity and severe side effects. Thus, significant emphasis has been placed on combinations of naturally occurring chemopreventive agents. Silibinin is a major bioactive flavonolignan extracted from milk thistle with chemopreventive activity in various organs including the skin, prostate, and breast. However, the mechanism underlying the inhibitory action of silibinin in breast cancer has not been completely elucidated. Therefore, we investigated the effect of silibinin in MCF-7 human breast cancer cells and determined whether silibinin enhances ultraviolet (UV) B-induced apoptosis. METHODS: The effects of silibinin on MCF-7 cell viability were determined using the MTT assay. The effect of silibinin on PARP cleavage, as the hallmark of apoptotic cell death, and p53 protein expression in MCF-7 cells was analyzed using Western blot. The effect of silibinin on UVB-induced apoptosis in MCF-7 cells was analyzed by flow cytometry. RESULTS: A dose- and time-dependent reduction in viability was observed in MCF-7 cells treated with silibinin. Silibinin strongly induced apoptotic cell death in MCF-7 cells, and induction of apoptosis was associated with increased p53 expression. Moreover, silibinin enhanced UVB-induced apoptosis in MCF-7 cells. CONCLUSION: Silibinin induced a loss of cell viability and apoptotic cell death in MCF-7 cells. Furthermore, the combination of silibinin and UVB resulted in an additive effect on apoptosis in MCF-7 cells. These results suggest that silibinin might be an important supplemental agent for treating patients with breast cancer.

CT Imaging Findings of Ruptured Ovarian Endometriotic Cysts: Emphasis on the Differential Diagnosis with Ruptured Ovarian Functional Cysts

OBJECTIVE: The purpose of this study is to assess the prevalence of abnormal CT findings in patients with surgically proven ruptured endometriotic cysts, as compared with those abnormal CT findings of ruptured ovarian functional cysts. MATERIALS AND METHODS: This study included 13 retrospectively identified patients with surgically confirmed ruptured ovarian endometriotic cysts and who had also undergone preoperative CT scanning during the previous seven years. As a comparative group, 25 cases of surgically confirmed ruptured ovarian functional cysts were included. We assessed the morphologic features of the cysts and the ancillary findings based on CT. RESULTS: For the endometriotic cysts, the mean maximum cyst diameter was significantly larger than that of the functional cysts (70.1 mm versus 36.4 mm, respectively, p < 0.05). The endometriotic cysts frequently had a multilocular shape and a thicker cyst wall, as compared to that of functional cysts, and these differences were statistically significant. Among the ancillary findings, endometriotic cysts showed a significantly higher prevalence of loculated ascites, ascites confined to the pelvic cavity without extension to the upper abdomen, and peritoneal strandings and infiltrations (p < 0.05). Although 11 of the 25 cases of functional cysts showed active extravasation of contrast material at the ovarian bleeding site, only one of 13 cases of endometriotic cysts showed active extravasation. CONCLUSION: The diagnosis of ruptured endometriotic cyst should be suspected for a woman in whom CT reveals the presence of multilocular or bilateral ovarian cysts with a thick wall and loculated ascites confined to the pelvic cavity with pelvic fat infiltrations.

A Case of Hepatic Cyst Infection Diagnosed by 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Autosomal Dominant Polycystic Kidney Disease / 대한신장학회지

Infection of hepatic cyst is a serious complication of autosomal dominant polycystic kidney disease (ADPKD). Early diagnosis of infected cyst is crucial and usually requires conventional modalities, including ultrasound and computed tomography. However, their contribution is limited because of nonspecific results. We report a case of hepatic cyst infection for which 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) scan allowed the exact localization of the infected cyst and the precise drainage procedure. A 48-year-old woman with ADPKD presented with fever and RUQ pain. Contrast enhanced computed tomography did not show any evidence of complicated or infected cysts in both kidneys and liver. Though she had been treated by antibiotics for 7 days, patient's symptoms were not improved. However, 18F-FDG PET-CT scan revealed infected cyst in the left lobe of liver exactly. After percutaneous drainage based on 18F-FDG PET-CT imaging, the hepatic cyst infection was controlled. Therefore, 18F-FDG PET-CT imaging could be a valuable tool to identify the exact localization of cyst infection, which may contribute to drain the infected cyst. We report this case with a brief review of relevant literature.

Cordycepin inhibits UVB-induced matrix metalloproteinase expression by suppressing the NF-kappa B pathway in human dermal fibroblasts

Cordycepin (3'-deoxyadenosine) has been shown to exhibit many pharmacological activities, including anti-cancer, anti-inflammatory, and anti-infection activities. However, the anti-skin photoaging effects of cordycepin have not yet been reported. In the present study, we investigated the inhibitory effects of cordycepin on matrix metalloproteinase-1 (MMP-1) and -3 expressions of the human dermal fibroblast cells. Western blot analysis and real-time PCR revealed cordycepin inhibited UVB-induced MMP-1 and -3 expressions in a dose-dependent manner. UVB strongly activated NF-kappa B activity, which was determined by I kappa B alpha degradation, nuclear localization of p50 and p65 subunit, and NF-kappa B binding activity. However, UVB-induced NF-kappa B activation and MMP expression were completely blocked by cordycepin pretreatment. These findings suggest that cordycepin could prevent UVB-induced MMPs expressions through inhibition of NF-kappa B activation. In conclusion, cordycepin might be used as a potential agent for the prevention and treatment of skin photoaging.

A Case of Tuberous Sclerosis Complicated with Massive Bleeding of Renal Angiomyolipoma / 대한신장학회지

Tuberous sclerosis (TSC) is a systemic, autosomal dominant disorder resulting from mutations in one of two genes, TSC1 (encoding hamartin) or TSC2 (enconding tuberin). TSC causes seizure, mental retardation and hamartomatous tumors in multiple organs, including facial angiofibromas, cortical tubers, pulmonary lymphangiomatosis, renal angiomyolipomas and polycystic kidney disease. Renal angiomyofibromas may cause serious complications such as life threatening retroperitoneal hemorrhage or hematuria. The following is a report concerning a 41-year-old man with TSC who suffered spontaneous hemorrhage within the angiomyofibroma of the left kidney and underwent curative selective renal embolization. Then larger angiomyolipoma was suggested to be more likely to bleed, so secondary prophylactic selective renal embolization was done into five angiomyolipomas of the right kidney. After selective embolization, tumor size decreased and renal function was preserved. This patient did not show neurologic abnormality and family history of tuberous sclerosis. However, the brain magnetic resonance imaging revealed typical signs of tuberous sclerosis, and the computerized tomography of the abdomen showed bilateral renal angiomyolipomas and polycystic renal lesion. Herein we present a rare case of bilateral renal angiomyolipomas with spontaneous hemorrhage and preserved renal function after curative and prophylactic selective embolization.

TNF-alpha upregulates PTEN via NF-kappaB signaling pathways in human leukemic cells

TNF-alpha plays a variety of biological functions such as apoptosis, inflammation and immunity. PTEN also has various cellular function including cell growth, proliferation, migration and differentiation. Thus, possible relationships between the two molecules are suggested. TNF-alpha has been known to downregulate PTEN via NF-kappaB pathway in the human colon cell line, HT-29. However, here we show the opposite finding that TNF-alpha upregulates PTEN via activation of NF-kappaB in human leukemic cells. TNF-alpha increased PTEN expression at HL-60 cells in a time- and dose-dependent manner, but the response was abolished by disruption of NF-kappaB with p65 anisense phosphorothioate oligonucleotide or pyrrolidine dithiocarbamate. We found that TNF-alpha activated the NF-kappaB pathways, evidenced by the translocation of p65 to the nucleus in TNF-alpha-treated cells. We conclude that TNF-alpha induces upregulation of PTEN expression through NF-kappaB activation in human leukemic cells.

A novel thiol compound, N-acetylcysteine amide, attenuates allergic airway disease by regulating activation of NF-kappaB and hypoxia-inducible factor-1alpha

Reactive oxygen species (ROS) play an important role in the pathogenesis of airway inflammation and hyperresponsiveness. Recent studies have demonstrated that antioxidants are able to reduce airway inflammation and hyperreactivity in animal models of allergic airway disease. A newly developed antioxidant, small molecular weight thiol compound, N-acetylcysteine amide (AD4) has been shown to increase cellular levels of glutathione and to attenuate oxidative stress related disorders such as Alzheimer's disease, Parkinson's disease, and multiple sclerosis. However, the effects of AD4 on allergic airway disease such as asthma are unknown. We used ovalbumin (OVA)-inhaled mice to evaluate the role of AD4 in allergic airway disease. In this study with OVA-inhaled mice, the increased ROS generation, the increased levels of Th2 cytokines and VEGF, the increased vascular permeability, the increased mucus production, and the increased airway resistance in the lungs were significantly reduced by the administration of AD4. We also found that the administration of AD4 decreased the increases of the NF-kappaB and hypoxia-inducible factor-1alpha (HIF-1alpha) levels in nuclear protein extracts of lung tissues after OVA inhalation. These results suggest that AD4 attenuates airway inflammation and hyperresponsiveness by regulating activation of NF-kappaB and HIF-1alpha as well as reducing ROS generation in allergic airway disease.

Low-density lipoprotein protects Vibrio vulnificus-induced lethality through blocking lipopolysaccharide action

Lipoprotein plays a role in the host defense against bacterial infection, and its serum level has been demonstrated to be an important prognosis factor of survival. We have previously demonstrated that LDL directly inactivates the hemolytic activity of Vibrio vulnificus cytolysin (VVC) in vitro. The object of this study was therefore to examine whether the LDL-mediated inactivation of VVC leads to protection against lethal infection of V. vulnificus in vivo, using wild and VVC-deficient V. vulnificus strains. Unexpectedly, we found that LDL protects mouse lethality induced by VVC-deficient as well as wild V. vulnificus strain. We also demonstrated that LDL blocks V. vulnificus LPS-induced lethality in mice. These results suggest that LDL preferentially act on endotoxin rather than exotoxin in the protection against V. vulnificus-induced mice lethality.

Ferucarbotran-Enhanced MR Imaging of the Radiofrequency Ablation Zones in the Normal Rabbit Liver: Comparison with the Conventional MR Imaging

PURPOSE: We wanted to evaluate the findings of ferucarbotran-enhanced MR imaging of the radiofrequency (RF) ablation zones in normal rabbit livers and we compared the findings with the conventional MR imaging. MATERIALS AND METHODS: RF ablation zones were created in the livers of 12 rabbits in vivo by using a 17-gauge internally cooled electrode with 1-cm active tip, and RF energy (maximum power: 30 Watt) was applied for three minutes. Three rabbits were sacrificed immediately and then at three days, two weeks and six weeks after RF ablation. Before sacrifice, the T1- and T2-weighted images (WI) and the ferucarbotran-enhanced T2*WIs were obtained and compared regarding the signal intensity of ablation zone, the laminar pattern of the signal intensity and the contrast-to-noise ratio (CNR) of the ablation zone to the liver parenchyma. RESULTS: On T1- and T2WIs, the RF ablation zones showed two to four laminar patterns of signal intensity according to the time. Meanwhile, on the ferucarbotran-enhanced T2WIs, the RF ablation zones showed high signal intensity without a laminar pattern regardless of time. The CNRs of the ablation zones to the liver parenchyma on the ferucarbotran-enhanced T2*WIs (18.2+/-5.9) were significantly higher than those of the TIWIs (1.6+/-1.5) and T2WIs (2.7+/-1.9) (p < 0.05). CONCLUSION: On the ferucarbotran-enhanced T2*WI, the RF ablation zones showed high signal intensity without a distinct laminar pattern and significantly higher lesion conspicuity than did the conventional T1- and T2WIs. Therefore, the ferucarbotran-enhanced T2*WI shows the RF ablation zone more accurately and clearly than do the conventional T1- and T2WIs.

SENSE (Sensitivity Encoding) for Diffusion Tensor Imaging of the Brain

PURPOSE: The sensitivity encoding (SENSE) technique is increasingly being used with clinical MRI scanners. The object of this study is to compare the normative human data and image quality of the diffusion tensor imaging (DTI) with sensitivity encoding (SENSE) and standard single-shot EPI techniques. MATERIALS AND METHODS: 16 normal volunteers underwent single-shot echo-planar DTI with both standard and SENSE sequences using a 1.5 T Philips Intera MR scanner (TR/TE=6755/74 or 5871/66 ms, echo train length 127 or 67, NEX=3, matrix=128x128, FOV=220x220 mm, slice thickness=4 mm, b value=600 s/mm2, six orthogonal diffusion gradients). The diffusion tensor-encoded MR images were transferred to a PC workstation and analyzed using in-house software. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps were calculated. The presence of artifacts (ghost susceptibility, eddy current) was graded with a two- or three-point scale. The ADC and FA values were measured in the major white matter tract and gray matter nuclei. The signal-to-noise ratio was also measured. Fisher's exact test and the Mann-Whitney test were used for the statistical analysis. RESULTS: With SENSE, the acquisition time was reduced from 2 min 57 sec to 1 min 22 sec for DTI. Susceptibility artifacts (around the brain stem and temporal base) and eddy current artifacts were significantly reduced on the SENSE DTI as compared with those on the standard DTI (p<0.05). No ghost artifacts were observed on the SENSE DTI, whereas such artifacts were observed in 14 cases (87.5%) on the standard DTI. The ADC value was not significantly different between the SENSE DTI and the standard DTI, whereas the FA values in the cerebral cortex and white matter were significantly higher on the SENSE DTI than on the standard DTI (p<0.05). The signal-to-noise ratio was 8.44 on the standard DTI and 11.40 on the standard DTI. CONCLUSION: The use of SENSE DTI significantly reduces the geometric distortion caused by artifacts, shortens the acquisition time, and allows a relatively high SNR to be maintained, but tends to erroneously increase the FA value of the tissue. Therefore, DTI with SENSE may provide better white matter fiber tracking and diffusivity indices when the imaging parameters for SENSE are optimized.

Ablation of Symptomatic Cysts Using Absolute Ethanol in 11 Patients with Autosomal-Dominant Polycystic Kidney Disease

OBJECTIVE: To evaluate the effects of cyst ablation with absolute ethanol in autosomal-dominant polycystic kidney disease (ADPKD) patients with symptomatic cysts. MATERIALS AND METHODS: Using absolute ethanol, cyst ablation was performed in 11 patients with documented ADPKD who suffered cyst pain refractory to medical treatment. An ethanol solution was instilled into the largest symptomatic cysts through a catheter. We assessed the therapeutic efficacy of the procedure by tracking subjective pain relief during a 3 to 24-month follow-up period after ablation. RESULTS: At follow-up, we found that the duration of subjective pain relief was 12 to 24 months in seven patients, 4 to11 months in one, and less than 3 months in three. CONCLUSION: Selective ablation of a symptomatic cyst may be a valid option in managing chronic pain caused by one or a few large cysts in ADPKD patients.

Three Dimensional Digital Rotational Imaging in the Evaluation of the Fractures

PURPOSE: To evaluate the usefulness and the application of three dimensional digital rotational imaging (3D DRI) by the evaluation of fractures. MATERIALS AND METHODS: Sixteen patients with clinically diagnosed or suspicious fracture were involved in this study. The lesion or suspicious sites of all 16 cases were spines (n=7), pelvis (n=3) and so on (n=6; knee, elbow, ankle, wrist and foot). In all cases, conventional radiography, multiplanar 2D (slice thickness/pitch=3 or 5 mm/1:1)and volume rendering 3D reconstructed single detector helical CT (HiSpeed Advantage, GE Medical Systems, Milwaukee, WIS) scans and 3D DRI (Integris V-5000,Philips Medical Systems, The Netherlands) with multiplanar intersection and gray scaling as postprocessing technique were performed. 3D DRI was evaluated and compared with conventional radiography, multiplanar 2D CT and volume rendering 3D CT. RESULTS: 3D DRI provided more detail and additional information in 14 cases (88%), comparing with 2D and 3D CT scans. Two fractures were revealed only on 3D DRI other than conventional radiography and CT scans and one case was revealed on 2D CT and 3D DRI. In all cases, we could acquired more detail and additional information from 3D DRI than from 3D CT in the acquisition of 3D imaging. 3D DRI didn't change the classification of fracture in 12 of 13 cases (92%),which revealed the fracture on the conventional radiography or CT. CONCLUSION: 3D DRI can diagnose and evaluate the fracture rapidly and easily with anatomical and spatial resolution by acquisition of 3D imaging with postprocessing using DRI.

The Usefulness of STIR Image in Breast MRI

PURPOSE: To assess the usefulness of STIR (short tau inversion recovery) imaging in breast MRI (magnetic resonance imaging). MATERIALS AND METHODS: We retrospectively reviewed T1- and T2-weighted (T1WI, T2WI), STIR, and dynamically enhanced images of 44 pathologically confirmed breast lesions (benign, 13; malignant, 31) in 36 patients. We selected the dynamically image which best depicted a particular lesion, and then made hard copy of the corresponding T1WI, T2WI, and STIR images. Using the dynamically enhanced image as a standard, we analysed these in terms of parenchymal pattern, lesion detectability, differentiation between benign and malignant lesions, extent, multifocality, and the ductal system. The results were statistically analyzed. RESULTS: In 33 of 44 cases (75%), detectability was greater at STIR imaging than at T1- and T2WI, especially in fibrofatty or fatty breast (14/14 cases, p<0.05). STIR images did not always differentiate between benign and malignant lesions, and extent (50%) and multifocality (46%) were commonly exaggerated compared with T1- and T2WI. In 18 of 44 cases (41%), STIR images suggested the presence of ductal structures. CONCLUSION: For the detection of lesions, STIR imaging was more useful than T1- and T2WI, though STIR did not differentiate between benign and malignant lesions. The extent and multifocality of a lesion were exaggerated on STIR images, compared with T1- and T2WI.

Acute Appendicitis: Sensitivity, Specificity and Diagnostic Accuracy of Thin-Section Contrast-Enhanced CT Findings

PURPOSE: To assess the sensitivity, specificity, and diagnostic accuracy of individual contrast-enhanced helical CT findings of acute appendicitis. MATERIALS AND METHODS: We retrospectively reviewed the appendiceal helical CT scans, obtained after intravenous contrast administration (abdomen; 7-mm collimation, abdominopelvic junction; 5-mm collimation), of 50 patients with surgically proven acute appendicitis and 112 with alternative diagnoses. The following parameters were analysed by three radiologists: enlarged appendix (> 6 mm in diameter), appendiceal wall thickening, appendiceal wall enhancement, no identification of the appendix, appendicolith(s), (appendiceal) intraluminal air, (appendiceal) intraluminal air extraluminal air, periappendiceal fat stranding, extraluminal fluid, phlegmon, abscess, lymphadenopathy, terminal ileal wall thickening, focal cecal apical thickening, focal colonic wall thickening, and segmental colonic wall thickening. RESULTS: The CT findings of acute appendicitis that statistically distinguished it from alternative diagnoses were an enlarged appendix (sensitivity; 92%, specificity; 93%, diagnostic accuracy; 93%), appendiceal wall thickening (for these three parameters: 68%, 96% and 88%, respectively), periappendiceal fat stranding (90%, 79%, 82%), appendiceal wall enhancement (72%, 86%, 82%), appendicolith (16%, 100%, 74%), and focal cecal apical thickening (14%, 100%, 74%) (for each, p < 0.05). CONCLUSION: On thin-section contrast-enhanced helical CT, an enlarged appendix and periappendiceal fat stranding were found in 90% or more patients with acute appendicitis. Appendiceal wall thickening and enhancement were clearly demonstrated and significant findings for diagnosis. Less common but specific findings include appendicolith, focal cecal apical thickening and intramural air, can also help us establish a diagnosis of acute appendicitis.

The Diagnostic Value of Contrast Enhanced Power Doppler US on Small Breast Lesions

PURPOSE: To evaluate the usefulness of contrast-enhanced power Doppler ultrasonography (PDUS) in differentiating small benign from small malignant breast lesions. MATERIALS AND METHODS: Thirty-one solid breast lesions (<2 cm in size; 17 benign and 14 malignant) prospectively underwent US and PDUS before and after the injection of contrast agent (SH U 508A). Morphologic analysis involved independent assessment of the findings of US and the patterns of Doppler signals before and after contrast enhancement at PDUS, and sensitivity and specificity were thus evaluated. The diagnostic accuracy of US accompanied by PDUS was also determined before and after contrast enhancement. Hemodynamic analysis involved measurement of the time lapse between contrast injection at PDUS and observed change in Doppler signals. For this, a sonic VIOR computer-assisted program was used and the results were correlated with the pathologic findings. RESULTS: The sensitivities of US before and after contrast enhanced PDUS were 100%, 35.7%, and 57%, with specificities of 47%, 88.2% and 76%, respectively. The diagnostic accuracy of US was 35% with noncontrast PDUS, and 77% before and after contrast enhanced PDUS. The recorded time lapse between contrast injection at PDUS and observed change in Doppler signals did not correlate closely with the pathologic findings. CONCLUSION: In that it improved visualization of the morphology of vascular Doppler signals, microbubble contrast-enhanced PDUS complemented US and PDUS in differentiating between small benign and small malignant breast lesions.

A Case of Congenital Nephrogenic Diabetes Insipidus with Megaureter and Megabladder / 대한신장학회잡지

A case of a 37 year-old man of congenital diabetes insipidus is reported. He complained of polydipsia, which began from his youth, drinking about 10 L of water every day. He didn't look ill or mentally retarded. In his family, his only brother has shown similar symptoms and his older sister had no symptom. On radiologic study, both kidneys showed severe hydronephrosis and the bladder was markedly distended. Water deprivation test was performed. The result was consistent with diabetes insipidus and the urine osmolality didn't respond to antidiuretic hormone injection, and he was diagnosed as nephrogenic diabetes insipidus. We began to treat him with thiazide and amiloride. The amount of water he's been drinking daily has decreased to 3-4 L per day. We discuss this case with a brief review of literature.

MR Imaging of Pelvic Floor in Stress Urinary Incontinence

PURPOSE: To demonstrate the anatomy of the female pelvic floor and to determine the anatomic differences between normal controls and women with stress urinary incontinence, using MRI. MATERIALS AND METHODS: Five healthy, young, nulliparous women and 12 with stress urinary incontinence un-derwent MR imaging. We obtained FSE T2-weighted axial images, 3mm thick, of the region extending from the urethrovesical junction to the perineal membrane. The following parameters were determined : angle, asymmetry and signal intensity of the levator ani muscles, the distance between the urethra and symphysis, and the presence, shape and angulation of urethropelvic ligament. RESULTS: In contrast to normal controls, frequent findings in women with stress incontinence were as follows : increased angle(43%), asymmetry(43 %) and higher signal intensity(67%) of the levator ani muscles; increased distance between the urethra and symphysis; loss(43 %), discontinuity (60 %) and dorsal angulation(43%) of the urethropelvic ligament. CONCLUSION: In women with stress urinary incontinence, MRI clearly demonstrates the anatomy of the female pelvic floor, changes in the levator ani muscles, the distance between the urethra and symphysis, and the ure-thropelvic ligament. The modality can therefore be used to evaluate the anatomical changes occurring in cases of stress urinary incontinence.