¹⁸FFET PET is a useful tool for treatment evaluation and prognosis prediction of anti-angiogenic drug in an orthotopic glioblastoma mouse model / 한국실험동물학회지

O-2-¹⁸F-fluoroethyl-l-tyrosine ([¹⁸F]FET) has been widely used for glioblastomas (GBM) in clinical practice, although evaluation of its applicability in non-clinical research is still lacking. The objective of this study was to examine the value of [¹⁸F]FET for treatment evaluation and prognosis prediction of anti-angiogenic drug in an orthotopic mouse model of GBM. Human U87MG cells were implanted into nude mice and then bevacizumab, a representative anti-angiogenic drug, was administered. We monitored the effect of anti-angiogenic agents using multiple imaging modalities, including bioluminescence imaging (BLI), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET/CT). Among these imaging methods analyzed, only [¹⁸F]FET uptake showed a statistically significant decrease in the treatment group compared to the control group (P=0.02 and P=0.03 at 5 and 20 mg/kg, respectively). This indicates that [¹⁸F]FET PET is a sensitive method to monitor the response of GBM bearing mice to anti-angiogenic drug. Moreover, [¹⁸F]FET uptake was confirmed to be a significant parameter for predicting the prognosis of anti-angiogenic drug (P=0.041 and P=0.007, on Days 7 and 12, respectively, on Pearson's correlation; P=0.048 and P=0.030, on Days 7 and 12, respectively, on Cox regression analysis). However, results of BLI or MRI were not significantly associated with survival time. In conclusion, this study suggests that [¹⁸F]FET PET imaging is a pertinent imaging modality for sensitive monitoring and accurate prediction of treatment response to anti-angiogenic agents in an orthotopic model of GBM.

Arteriovenous Malformation Incidentally Found by Ultrasonography in a Thigh Hematoma after Contusion

Vascular malformations in extremities are difficult to detect in cases of minor trauma. The authors report a case of an arteriovenous malformation (AVM) incidentally found by ultrasonography in a contusion. After a slip down, a 52-year-old man who had undergone total arthroplasty in both hips 10 years earlier complained of an ovoid right hip swelling that had gradually increased in size. Suspecting a simple cyst or hematoma, the swelling was examined by ultrasonography, which revealed a subcutaneous hematoma with arterial flow connected to muscle. Arteriography revealed an AVM around the right hip joint. Due to the presence of multiple arteriovenous shunts, a conservative treatment course was adopted and after 3 weeks of treatment the swelling almost completely resolved. It appears that the small AVM may have existed congenitally before hip surgery and the contusion over the AVM had led to hematoma rather than an arteriovenous fistula. The authors emphasize the usefulness of ultrasonography for the diagnosis of posttraumatic swelling.

Dysphagia in Ramsay Hunt's Syndrome: A Case Report

Ramsay-Hunt syndrome is caused by varicella zoster virus infection in the geniculate ganglion of the facial nerve. It is characterized by facial palsy, otic pain, and herpetic vesicles around the auricle and external auditory canal. Additionally, symptoms may develop related to other cranial nerve involvement, such as dizziness or hearing loss by the vestibulocochlear nerve being invaded. We report a rare case of a Ramsay-Hunt syndrome patient who developed dysphagia due to multiple cranial nerve involvement including the glossopharyngeal nerve and vagus nerve.

Screening Wild Yeast Strains for Alcohol Fermentation from Various Fruits

Wild yeasts on the surface of various fruits including grapes were surveyed to obtain yeast strains suitable for fermenting a novel wine with higher alcohol content and supplemented with rice starch. We considered selected characteristics, such as tolerance to alcohol and osmotic pressure, capability of utilizing maltose, and starch hydrolysis. Among 637 putative yeast isolates, 115 strains exhibiting better growth in yeast-peptone-dextrose broth containing 30% dextrose, 7% alcohol, or 2% maltose were selected, as well as five alpha-amylase producers. Nucleotide sequence analysis of the 26S rDNA gene classified the strains into 13 species belonging to five genera; Pichia anomala was the most prevalent (41.7%), followed by Wickerhamomyces anomalus (19.2%), P. guilliermondii (15%), Candida spp. (5.8%), Kodamaea ohmeri (2.5%), and Metschnikowia spp. (2.5%). All of the alpha-amylase producers were Aureobasidium pullulans. Only one isolate (NK28) was identified as Saccharomyces cerevisiae. NK28 had all of the desired properties for the purpose of this study, except alpha-amylase production, and fermented alcohol better than commercial wine yeasts.

Causes of the Hemiplegic Shoulder Pain

OBJECTIVE: To find out how many causes constitute hemiplegic shoulder pain (HSP) and how they distribute in an individual patient. METHOD: Twenty-three consecutive patients with HSP which had newly developed within 3 months after stroke were enrolled from January 2008 till July, 2008. They all performed a passive range of motion test for adhesive capsulitis, modified Ashworth test for spasticity, simple x-ray for subluxation, ultrasonography for rotator cuff problems and three-phase bone scintigraphy for complex regional pain syndrome (CRPS). The causes of HSP were analyzed in number and distribution. RESULTS: Average 2.26 causes constituted with HSP in an individual patient. Most common causes were adhesive capsulitis and CRPS (respectively 14 patients). Two patients had 4 and eight patients had 3 types of shoulder pathology. CONCLUSION: More than two types of shoulder pathology existed in a patient with HSP. These findings shoulde be carefully considered when treating the patients with HSP.

Assessment of the Quality of Esophago-gastric Anastomosis by Endoscopic Examination Cervical Versus Intrathoracic Anastomosis / 대한흉부외과학회지

BACKGROUND: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. MATERIAL AND METHOD: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up (29+/-23.6 months, range 5~111 months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. RESULT: The median age at the time of repair was 60.3+/-8.87 years (range 39~81 years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis (p=0.64) and reflux esophagitis (p=0.41) between the two groups. Cervical anastomosis was performed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found (p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group (p=0.003). CONCLUSION: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.

Significance of Vascular Endothelial Growth Factor in Pleural Effusion / 대한흉부외과학회지

Background: None of the currently available strategies for diagnosis and management of the pleural effusion are ideal. We tried to evaluate the validity of VEGF in differential diagnosis of the pleural effusion and find out if VEGF were correlated with the established markers. Material and Method: 35 patients with pleural effusion were divided into malignant effusion (n=10), benign effusion (n=5), infectious effusion (n=10), and pneumothorax (n=10), respectively. The pleural fluids from each group were examined for differential cell count, chemistry (glucose, protein, LDH, and ADA), and VEGF. Result: Glucose level was lower in infectious effusion compared with benign effusion (60.5+/-36.09 mg/dL vs. 162.0+/-19.80 mg/dL, p=0.011). ADA level in infectious effusion was higher compared with malignant effusion (87.9+/-42.62 IU/L vs. 27.7+/-31.04 IU/L, p=0.024). Malignant effusion (p=0.026) and infectious effusion (p=0.048) showed significantly higher level of VEGF than that of pneumothorax. VEGF level was substantially higher in malignant effusion compared with benign effusion (364.38+/-433.83 pg/dL vs. 53.3+/-22.20 pg/dL, p=NS). The pleural VEGF level did not correlate with the other markers. Conclusion: The measuring pleural VEGF may be helpful in diagnosing malignant and infectious pleural effusion that increase angiogenesis and vascular permeability, but it can not discriminate between the two. The pleural VEGF may not be correlated with the established markers. The measurement of pleural VEGF might discriminate between malignant and benign effusion.