PubMed Health⌕ Search

Biomedical subjects

M J Chung

Publications and source records attributed to M J Chung.

At least 19 recordsLinked to original sources

Pulmonary TB and NTM lung disease: comparison of characteristics in patients with AFB smear-positive sputum.

OBJECTIVE: To compare the clinical and radiographic features of pulmonary tuberculosis (PTB) and non-tuberculous mycobacteria (NTM) lung disease in patients with acid-fast bacilli (AFB) positive sputum specimens. DESIGN: The initial clinical and radiographic features of 229 PTB patients were compared with those of 70 patients with NTM lung disease. The most commonly involved organisms in the NTM lung disease cases were Mycobacterium avium complex (n = 38, 54%) and M. abscessus (n = 26, 37%). RESULTS: Clinical and radiographic findings that were more common in patients with NTM lung disease than in PTB patients were: older age (P < 0.001), non-smoker (P < 0.001), history of previous TB treatment (P < 0.001), absence of pleural effusion (P = 0.017), involvement of middle and/or lower lung zones (P = 0.007), and bilateral disease (P = 0.005). Multivariate analysis showed that older age (> or = 40 years), non-smoker, previous TB treatment, absence of pleural effusion and involvement of middle and/or lower lung zones were significant independent predictors for NTM lung disease. CONCLUSIONS: There is considerable overlap in the clinical and radiographic appearances of PTB and NTM lung disease. The isolation and identification of causative organisms are mandatory for a correct diagnosis in patients with AFB-positive sputum specimens.

Coloring Agents↗

Posterior mediastinal paraganglioma with bilateral adrenal pheochromocytoma.

Paraganglioma and adrenal pheochromocytoma are tumors of common origin arising from chromaffin cells. However, it is extremely rare to find mediastinal paraganglioma simultaneously with bilateral adrenal pheochromocytoma. We report a 53-year-old man who was diagnosed with posterior mediastinal paraganglioma and bilateral adrenal pheochromocytoma and who underwent successful excision of the posterior mediastinal mass and bilateral total adrenalectomy.

Adrenal Gland Neoplasms↗

Comparison of contrast-enhanced ct angiography and gadolinium-enhanced MR angiography in the detection of subsegmental-sized pulmonary embolism. An experimental study in a pig model.

PURPOSE: To compare contrast-enhanced CT angiography (CTA) and gadolinium-enhanced MR angiography (MRA) for the detection of subsegmental-sized pulmonary emboli in a pig model. MATERIAL AND METHODS: In 5 anesthetized pigs, 3-mm diameter embolic materials made of Konjac, a semisolid food, were introduced through the internal jugular vein into pulmonary arteries. After embolization, CTA and MRA images were obtained. Respiration was suspended during CTA and MRA image acquisition. Two readers reviewed the CTA and MRA images to detect emboli. The pigs were sacrificed, and sliced specimens of inflated lung served as the gold standard. RESULTS: Thirty-six emboli were detected within peripheral arteries. The sensitivity (and 95% confidence intervals) of CTA for the two readers were 57% (39-74%) and 66% (48-81%), and 88% (69-98%) and 92% (74-94%) for MRA. The specificity of CTA was 95% (91-97%) and 98% (96-99%), and that of MRA was 85% (74-93%) and 90% (80-96%). Interobserver agreement was higher for MRA (kappa 0.898) than CTA (kappa 0.574). CONCLUSION: For the detection of subsegmental pulmonary emboli, MRA was superior to CTA, with a higher sensitivity and interobserver agreement by demonstrating perfusion deficits.

Animals↗

Volatile N-nitrosamine inhibition after intake Korean green tea and Maesil (Prunus mume SIEB. et ZACC.) extracts with an amine-rich diet in subjects ingesting nitrate.

The formation of carcinogenic nitrosamines under simulated gastric conditions was studied during the incubation of amine rich food and nitrate, and its possible inhibition by adding kumquat, sweet orange, strawberry, garlic, kale juices, Maesil (Prunus mume) and green tea extracts. The strawberry, kale juices, Maesil and green tea extracts were equally effective in reducing the formation of N-nitrosodimethylamine (NDMA). The fruits of P. mume SIEB. et ZACC. (Korean name, Maesil) have been used as a traditional drug and health food in Korea. During four weeks of test (designated EW1, EW2, EW3 and EW4; experiment week 1, 2, 3 and 4 diets) volunteers consumed a diet of low nitrate and amine (EW1) and consumed a fish meal rich in amines as nitrosatable precursors in combination with intake of nitrate-containing drinking water without (EW2) or with Maesil and green tea extracts (EW3 and EW4, respectively). The intake of nitrate-containing drinking water (340 mg nitrate/100 ml) resulted in a significant rise in mean salivary nitrate and nitrite concentrations and in mean urinary nitrate levels. Mean urinary nitrate was increased to 455.0+/-66.2, 334.6+/-67.8 and 333.4+/-50.7 mg/18 h after the nitrate intake of EW2, EW3 and EW4, respectively. Significant increases in urinary dimethylamine and trimethylamine levels were observed in consumption of diets (EW2, EW3, and EW4) rich in amine and nitrate. Maesil and green tea extract in EW3 and EW4 enhanced the increase of urinary dimethylamine and trimethylamine levels. Urinary excretion of N-nitrosodimethylamine in consumption of diet rich in nitrate and amine (EW2) increased to 6504.4+/-2638.7 ng/18 h from 257.0+/-112.0 ng/18 h of low nitrate and amine diet (EW1). Korean green tea and Maesil extracts in nitrate and amine rich diet reduced the excretion of N-nitrosodimethylamine to 249.7+/-90.6 and 752.7+/-595.3 ng/18 h, respectively, compared with 6504.4+/-2638.7 ng /18 h after ingestion of TD1 diet.

Adult↗

Intrathoracic malignant peripheral nerve sheath tumor in von Recklinghausen's disease.

Malignant peripheral nerve sheath tumor (MPNST) is defined as any malignant tumor arising from or differentiating toward the cells of the peripheral nerve sheath. MPNST accounts for about 5-10% of all soft tissue tumors and is often associated with neurofibromatosis type I (NF-1, von Recklinghausen's disease). It is one of the malignant tumors associated with von Recklinghausen's disease. Its common site is the lower and upper extremities, trunk, head and neck. But intrathoracic manifestations are very rare. We report a case of a 40 year-old man with multiple neurofibromatosis who was presented with an intrathoracic malignant peripheral nerve sheath tumor.

Adult↗

A case of bronchiolitis obliterans organizing pneumonia with renal dysfunction after renal transplantation.

A 35-year-old male renal transplant patient was admitted with 3-week history of cough and myalgia after a 3-month post-transplantation. The patient's posttransplant course was uncomplicated and had no rejection. But on admission, the serum creatinine was 3.0 mg/dl and high-resolution computed tomography (HRCT) showed bilateral patchy densities and peripheral consolidations. Renal biopsy revealed mononuclear cell infiltration and non-specific tubular injury without evidence of rejection. An open lung biopsy was performed which showed multiple fibroblast plugs filling airspaces that were typical pathologic features of bronchiolitis obliterans with organizing pneumonia (BOOP). After prednisone therapy, the patient's pulmonary symptoms and radiographic findings rapidly recovered and serum creatinine also decreased from 3.0 to 2.1 mg/dl. Although the cause of renal dysfunction was not elucidated, we herein report a rare case of BOOP with renal dysfunction after renal transplantation.

Adult↗

Utility of thyroid transcription factor-1 and cytokeratin 7 and 20 immunostaining in the identification of origin in malignant effusions.

OBJECTIVE: To estimate the utility of thyroid transcription factor-1 (TTF-1) and the combined cytokeratin 7 (CK7) and 20 (CK20) immunoprofile as a marker for identifying the primary site of metastatic adenocarcinoma in effusions of the serous cavity. STUDY DESIGN: Formalin-fixed, paraffin-embedded cell block specimens of pleural and peritonealfluid diagnosed as metastatic adenocarcinomas with known sites of origin were used for TTF-1, CK7 and CK20 immunohistochemistry. The primary sites of these cases were lung (16 cases), ovary (15), stomach (9), colon (8) and breast (8) and were confirmed by radiologic and/or histologic evaluation. RESULTS: The lung adenocarcinomas showed TTF-1 positivity in 81% (13/16) of cases. All nonpulmonary adenocarcinomas lacked TTF-1 staining. The CK7-/CK20+ immunophenotype was seen in 63% of colonic adenocarcinomas and not seen in lung, ovary, stomach or breast adenocarcinomas. The CK7+/CK20- immunophenotype was seen in 100%, 88% and 87% of cases that originated in the lung, breast and ovary, respectively. CONCLUSION: TTF-7 immunostaining is useful in the differentiation between pulmonary and nonpulmonary origin of adenocarcinomas in malignant effusions. The combination of CK7-/CK20+ immunostaining is useful in identifying colon adenocarcinomas.

Adenocarcinoma↗

Coadministration of angiopoietin-1 and vascular endothelial growth factor enhances collateral vascularization.

Using growth factors to induce vasculogenesis is a promising approach in the treatment of ischemic legs and myocardium. Because the vasculogenesis requires a cascade of growth factors, their receptors, and intracellular signals, such therapies may require the application of more than a single growth factor. We examined the effect of 2 endothelial cell-specific growth factors, angiopoietin-1 (Ang1) and vascular endothelial growth factor (VEGF), on primary cultured porcine coronary artery endothelial cells. VEGF, but not Ang1, increased DNA synthesis and cell number. Ang1 or VEGF induced migration and sprouting activity, increased plasmin and matrix metalloproteinase-2 secretion, and decreased tissue inhibitors of metalloproteinase type 2 secretion. A combination of the submaximal doses of Ang1 and VEGF enhanced these effects and was more potent than the maximal dose of either alone. In a rabbit ischemic hindlimb model, a combination of Ang1 and VEGF gene delivery produced an enhanced effect on resting and maximal blood flow and capillary formation that was greater than that of either factor alone. Angiographic analyses revealed that larger blood vessels were formed after gene delivery of Ang1 or Ang1 plus VEGF than after VEGF gene delivery. These results suggest that combined treatment of Ang1 and VEGF could be used to produce therapeutic vascularization.

Angiopoietin-1↗

Pale bodies in hepatocellular carcinoma.

Histochemical, immunohistochemical and ultrastructural studies were performed on cases of hepatocellular carcinoma (HCC) with pale bodies (PB). HCC containing PBs was observed in 3 (5.5%) of 55 consecutively resected HCC cases. Histologically, a large number of hepatocytes displayed pale or eosinophilic staining of the cytoplasm, resulting in ground-glass appearance. They were aggregated in nodular pattern, or diffusely intermixed with other malignant hepatocytes. PBs were negative for periodic-acid Schiff and Masson's trichrome staining. The inclusions showed a strong positive reaction for fibrinogen and some of them were weakly positive for albumin but negative for hepatitis B surface antigen, hepatitis B core antigen, alpha-fetoprotein and alpha-1-antitrypsin. Ultrastructurally, PBs were membrane-bound and contained granular materials of moderate electron density, and were closely related to dilated rough endoplasmic reticulum. These findings support that PBs are secretory fibrinogen accumulated in cystic ER and that such intracellular accumulation possibly reflects a defective transport of fibrinogen.

Albumins↗

Functioning islet cell tumor of the pancreas. Localization with dynamic spiral CT.

PURPOSE: The purpose of this study was to evaluate the usefulness of dynamic spiral CT, including multidimensional reformation, in the detection and localization of islet cell tumors of the pancreas. MATERIAL AND METHODS: Seven patients with histopathologically proven functioning islet cell tumors of the pancreas were studied with 2-phase contrast-enhanced spiral CT. Scanning of the arterial phase and late phase was started 30 s and 180 s, respectively, after injection of 100 ml of contrast medium at a rate of 3 ml/s. RESULTS: Axial images in the arterial phase depicted the lesions in 5 patients, but in the late phase in only one patient. Multiplanar reformatted images of the arterial phase depicted the lesions in all 7 patients. Maximal intensity projection images demonstrated all lesions with information of their relationship to the vascular structure. CONCLUSION: Dynamic spiral CT with scanning during the arterial phase and retrospective multidimensional reformation is useful for preoperative detection and localization of small islet cell tumors of the pancreas.

Adenoma, Islet Cell↗

Propofol attenuates ischemia-reperfusion injury in the isolated rat heart.

UNLABELLED: The purpose of this study was to examine the direct effects of propofol on ischemia-reperfusion injury using an isolated Langendorff rat heart preparation. Hearts were perfused with Krebs-Henseleit (K-H) solution (control); intralipid; or 10, 30, and 100 microM propofol. Hearts were rendered globally ischemic for 25 min, then reperfusion was begun with K-H solution for 30 min. Treatment with 100 microM propofol delayed the onset of contracture during ischemia compared with control or intralipid treatments (6.4 +/- 2.1 vs 4.4 +/- 1.4 or 4.1 +/- 0.7 min, respectively; P < 0.05). During reperfusion, 100 microM propofol increased coronary flow and reduced lactate dehydrogenase release compared with control or intralipid treatments. After 30 min of reperfusion, left ventricular developed pressure (LVDP) returned to 55 and 76 mm Hg in the 30 and 100 microM propofol-treated groups, respectively, whereas LVDP was 39 mm Hg in the control group. The hearts treated with 100 microM propofol showed significantly lower left ventricular end-diastolic pressure compared with the control or intralipid groups 30 min after reperfusion (29 +/- 13 vs 48 +/- 5 or 48 +/- 11 mm Hg, respectively; P < 0.05). In histological evaluation, control and intralipid hearts had increased injury severity scores compared with hearts treated with 100 microM propofol (1.8 +/- 0.9 and 1.7 +/- 0.8 vs 1.0 +/- 0.7, respectively; P < 0.05). In conclusion, we suggest that propofol administered before and during global myocardial ischemia has cardioprotective effects on ischemia-reperfusion injury. IMPLICATIONS: It is important to protect the heart from injury by ischemia and reperfusion. The current study demonstrates that in the isolated rat heart, propofol attenuates mechanical, biochemical, and histological changes causes by ischemia and reperfusion.

Anesthetics, Intravenous↗

Pericaval fat collection that mimics thrombosis of the inferior vena cava: demonstration with use of multi-directional reformation CT.

PURPOSE: To evaluate the causes for localized fat collection that seemed to be within the subdiaphragmatic inferior vena cava (IVC) on axial computed tomographic (CT) scans. MATERIALS AND METHODS: Six consecutive patients with presumed intracaval fat collection at routine abdominal CT (n = 2) or thin-section CT of the lung (n = 4) were studied prospectively with helical CT. Three patients had chronic liver diseases. Multi-directional, two-dimensional, reformatted images were obtained from the helical CT data for identification of the relation between the IVC and fat collection. Six patients without intracaval fat collection were studied as control subjects. RESULTS: On axial CT scans, the fat collection had a round or oval shape (in four of six patients) and was located posteromedial to the IVC (in four of six patients). On coronal reformatted images, the fat collection was outside the IVC between the diaphragm and subdiaphragmatic IVC, which was contiguous to the fat around the subdiaphragmatic esophagus. In the fat collection group, the IVC angled toward the right and narrowed to half in diameter as it passed down to the diaphragm. In the control group, the IVC was straight, although the diameter decreased similarly. CONCLUSION: A localized fat collection adjacent to the subdiaphragmatic IVC that mimics intracaval fat on axial CT scans is due to acute angulation of the IVC, which is probably a result of anatomic variation, chronic liver disease, or both.

Adipose Tissue↗

Spiral CT angiography of the thoracic aorta.

Computed tomographic (CT) angiography is a new minimally invasive vascular imaging modality. FOr its clinical use to increase, the advantages and potential applications of this modality must be understood. The clinical applications of CT angiography in the thoracic aorta and its branches include evaluation of congenital aortic anomalies, aortic aneurysm, aortic dissection, Takayasu arteritis, penetrating aortic atherosclerotic ulcer, traumatic aortic injury, the postoperative aorta, arch vessels, and pulmonary sequestration. The advantages of CT angiography over conventional angiography are as follows: (a) high-quality, thin axial sections that demonstrate mural changes, extraluminal pathologic conditions, and spatial relationships with adjacent organs; (b) high contrast resolution and high sensitivity for detecting calcified lesions; (c) angiographic or three-dimensional display of vascular structures and adjacent organs in any projection with a single spiral acquisition; and (d) demonstration of extrinsic causes of vascular compromise. CT angiography has the potential to replace conventional catheter angiography in the diagnosis of many pathologic conditions of the thoracic aorta.

Aortic Dissection↗

Multiple sequence alignment using simulated annealing.

Multiple sequence alignment is a useful technique for studying molecular evolution and analyzing structure-sequence relationships. Dynamic programming of multiple sequence alignment has been widely used to find an optimal alignment. However, dynamic programming does not allow for certain types of gap costs, and it limits the number of sequences that can be aligned due to its high computational complexity. The focus of this paper is to use simulated annealing as the basis for developing an efficient multiple sequence alignment algorithm. An algorithm called Multiple Sequence Alignment using Simulated Annealing (MSASA) has been developed. The computational complexity of MSASA is significantly reduced by replacing the high-temperature phase of the annealing process by a fast heuristic algorithm. This heuristic algorithm facilitates in minimizing the solution set of the low-temperature phase of the annealing process. Compared to the dynamic programming approach, MSASA can (i) use natural gap costs which can generate better solution, (ii) align more sequences and (iii) take less computation time.

Algorithms↗

Helical CT anatomy of pancreatic arteries.

BACKGROUND: To assess the frequency of visualization of pancreatic arteries in the arterial phase of helical computed tomography (CT). METHODS: The visibility of pancreatic and peripancreatic arteries in helical CT images was evaluated in 20 consecutive patients who had no evidence of pancreatic disease. CT examinations were performed by using a continuously rotating CT scanner and intravenous injection of contrast media. The scans were taken 35 s after the start of injection and with a table speed of 3 mm/s. Images were reconstructed in 3-mm section increments. RESULTS: Frequently visualized arteries were the gastroduodenal, anterior and posterior superior pancreaticoduodenal, and right gastroepiploic arteries. Infrequently visualized arteries were the dorsal pancreatic, pancreatica magna, caudal pancreatic, transverse pancreatic, and common, anterior, and posterior inferior pancreaticoduodenal arteries. CONCLUSION: Helical CT enabled us to recognize small pancreatic arteries, and the evaluation of these arteries should be considered in the staging of pancreatic carcinoma.

Arteries↗

Detection of pancreatic adenocarcinoma: relative value of arterial and late phases of spiral CT.

BACKGROUND: Spiral computed tomography (CT) allows the pancreas to be imaged during peak contrast levels owing to the capability of fast data acquisition. The objective of this study was to evaluate the relative value of the arterial and late phases of spiral CT for detecting pancreatic adenocarcinomas. METHODS: Twenty-two patients with pathologically proved pancreatic adenocarcinomas underwent two-phase spiral CT. The CT scans were performed with 5 mm collimation and 5 mm/s table speed. Images during the arterial and late phases were obtained at 30- and 180-second delays, respectively. The images of the arterial phase were compared with those of the late phase in terms of tumor conspicuity from surrounding pancreatic parenchyma and tumor detectability by means of a 3-point grading system: 1 (poor), 2 (fair), and 3 (good). RESULTS: In terms of tumor conspicuity from surrounding pancreatic parenchyma, 16 lesions (73%) were good, 5 lesions (23%) were fair, and 1 lesion (4%) was poor during the arterial phase, whereas 6 lesions (27%) were good, 9 lesions (41%) were fair, and 7 lesions (32%) were poor during the late phase (p = 0.0007). The arterial phase was superior to the late phase in 16 patients (73%) and equal in 6 patients (27%). For tumor detectability, 18 lesions (82%) were good, 3 lesions (14%) were fair, and 1 lesion (4%) was poor during the arterial phase, whereas 10 lesions (45%) were good, 7 lesions (32%) were fair, and 5 lesions (23%) were poor during the late phase (p = 0.0033). For detectability, the arterial phase was superior to the late phase in 14 patients (64%) and equal in 8 patients (36%). CONCLUSION: The arterial phase of spiral CT is superior to the late phase, which is equivalent to conventional CT for detecting pancreatic adenocarcinoma.

Adenocarcinoma↗

Lobular low attenuation of the lung parenchyma on CT: evaluation of forty-eight patients.

PURPOSE: Our goal was to analyze patients with pulmonary lobular low attenuation (LLA) on thin section CT with regard to the underlying pulmonary diseases and the dynamic changes occurring in the low attenuation regions during respiration. METHOD: Forty-eight consecutive patients with LLA on thin section CT were analyzed retrospectively. Forty-six patients (95%) had symptoms related to respiratory disease, such as productive cough (n = 25) and hemoptysis (n = 18). Only two patients, one with chronic pulmonary embolism and one with Takayasu arteritis combined with bronchiectasis, had pulmonary vascular disease. Six patients, four with bronchiectasis and two with vascular disease, were studied with dynamic CT during forced vital capacity maneuver. Attenuation values for LLA areas and adjacent lung were measured and time-density curves were plotted. RESULTS: Forty-one (85%) patients had bronchiectasis, typically in other than the regions of the LLA. Areas with proximal bronchiectasis showed low attenuation but without notable lobular distribution. Pulmonary vessels in the LLA areas were smaller than those of adjacent normal lung (n = 45). Of 22 patients who underwent pulmonary function tests, 15 had obstructive pattern of impairment. Respiratory dynamic CT showed expiratory air trapping in LLA areas in all six patients. The mean attenuation values of LLA areas were lower than those of the adjacent normal lung by 67 HU at end-inspiration and by 165 HU at end-expiration (p = 0.002). CONCLUSION: The majority of the patients with LLA shown by thin section CT had bronchiectasis elsewhere in the lung, and evidence of air trapping in the LLA was clearly demonstrated. Bronchiolar obstruction may be the most prevalent cause for the development of LLA.

Adult↗