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Biomedical subjects

M H Han

Publications and source records attributed to M H Han.

At least 91 records · Page 5Linked to original sources

Traumatic pseudoaneurysm of the intracavernous ICA presenting with massive epistaxis: imaging diagnosis and endovascular treatment.

Traumatic pseudoaneurysm of the intracavernous internal carotid artery (ICA) is a very rare cause of epistaxis but is a life-threatening clinical situation when left untreated. The authors have experienced four cases of traumatic pseudoaneurysm involving the intracavernous ICA. Delayed massive epistaxes developed 1 to 8 months after trauma and initial transient epistaxis in all four patients. Three of the cases were successfully managed by the detachable balloon occlusion (DBO) of the ICA along with the aneurysm openings. In one case, a large pseudoaneurysm destroying a large area of the central skull base with peripheral blood clot was demonstrated on computed tomography, magnetic resonance imaging, and angiography; this patient died due to massive epistaxis before the trial of DBO. Imaging findings of pseudoaneurysms involving the intracavernous ICA in the four cases are described, and the role of endovascular treatment is discussed.

Accidental Falls↗

Cerebral paragonimiasis in early active stage: CT and MR features.

OBJECTIVE: Diagnosis of cerebral paragonimiasis in its early active stage is important because curative chemotherapy is possible. Accordingly, this study was undertaken to evaluate the CT and MR features of early active cerebral paragonimiasis. MATERIALS AND METHODS: We retrospectively reviewed the CT scans (n = 29) and MR images (n = 7) of the brain in 20 patients between 7 and 59 years old who had cerebral paragonimiasis in the early active stage. The diagnosis was based on a positive antibody test by enzyme-linked immunosorbent assay (ELISA) for paragonimiasis in serum and CSF. The diagnosis was confirmed surgically in seven patients. RESULTS: The most common and characteristic imaging finding was a conglomerate of ringlike enhancing lesions (grape-cluster appearance) with surrounding edema in one cerebral hemisphere in 11 patients (55%). Other nonspecific findings included a solitary ringlike lesion (n = 4) or irregular enhancing lesions (n = 2), localized hemorrhage with (n = 3) or without (n = 2) enhancing lesions, and a poorly defined non-hemorrhagic, nonenhancing lesion (n = 1). CONCLUSION: CT and MR findings of clustered ring-enhancing lesions, seen in approximately half of the cases of early cerebral paragonimiasis, are suggestive of cerebral paragonimiasis.

Adolescent↗

Germinomas of the basal ganglia and thalamus: MR findings and a comparison between MR and CT.

OBJECTIVE: The purpose of this study was to describe the MR imaging appearance of germinomas in the basal ganglia and thalamus and to compare the MR findings with CT findings. MATERIALS AND METHODS: Eleven MR studies of 10 patients with pathologically proved germinomas in the basal ganglia or thalamus were retrospectively reviewed. In nine of the 10, the MR findings were compared with CT findings. All patients were male, and all except one were in their second decade of life. All the tumors were located in paraventricular areas. RESULTS: Most of the tumors were 4-7 cm in diameter. MR images showed that the tumors were mostly cystic in five patients, mostly solid with cystic components in four, and solid without cystic components in one. The solid portion mostly was isointense relative to the cerebral cortex for all MR pulse sequences. The cystic portion was hyperintense relative to CSF on T1- and T2-weighted images. MR images showed intratumoral hemorrhage in seven patients. It appeared as an area of hyperintensity on T1- and T2-weighted images in five patients and as a fluid-fluid level with marked hypointensity on T2-weighted images in two. Hemorrhage was not visualized on CT scans in any patient. Flecked or amorphous calcifications visualized on CT scans in two patients were hardly detectable on MR images. Peritumoral edema was usually minimal. CT scans and MR images obtained after injection of contrast material both showed heterogeneous and dense enhancement in the solid portions of the tumors. CONCLUSION: MR images of germinoma in the basal ganglia and thalamus show a large paraventricular mass. Cystic areas, focal hemorrhages, and minimal surrounding edema are common. Unlike CT, MR imaging allows characterization of intratumoral hemorrhage.

Adolescent↗

Contrast enhancement of brain tumors at different MR field strengths: comparison of 0.5 T and 2.0 T.

PURPOSE: To compare the degree of MR contrast enhancement of 0.5 T and 2.0 T in various brain tumors. METHODS: MR images were studied prospectively in each of 31 patients with brain tumors (11 gliomas, 6 meningiomas, 6 neurinomas, and 8 others) before and after intravenous injection of gadopentetate dimeglumine. In every patient, both 0.5-T and 2.0-T MR studies were done within 1 week. Each patient received an initial standard dose (0.1 mmol/kg) of gadopentetate dimeglumine, followed by a subsequent 0.1-mmol/kg dose (total, double dose) in MR of each field strength. MR was done before and after each injection of the contrast agent. Degree of contrast enhancement in the lesions was assessed both visually and quantitatively. RESULTS: With standard-dose study, the tumor enhancement was visually stronger at 2.0 T than at 0.5 T in 9 gliomas. In extraaxial tumors there was visually no or minimal difference between 0.5 T and 2.0 T. Overall mean contrast-enhancement ratio and tumor and brain contrast-to-noise ratio were higher at 2.0 T than at 0.5 T by 53% and 108%, respectively. The double-dose study showed higher contrast-enhancement ratio and contrast-to-noise ratio than the standard-dose study at both field strengths, and the differences between 0.5 T and 2.0 T were almost similar to those of the standard-dose study. The degree of contrast enhancement with the standard dose at 2.0 T was comparable to that of the double dose at 0.5 T in most intraaxial tumors. CONCLUSION: The results suggest that effect of contrast enhancement increases with the field strength. Therefore, reevaluation of optimal doses of contrast media may be needed in a variety of brain lesions at each field strength.

Adolescent↗

[Detection and clinical significance of PPD-IgG antibody in cerebrospinal fluid by ABC-ELISA method].

PPD-IgG antibody in cerebrospinal fluid (CSF) of 55 patients with tuberculous meningitis (TBM) and 37 patients with non-TBM was determined by ABC-ELISA method, and compared with ELISA. The positive rate of ABC-ELISA and ELISA was 96.4% and 83.6% respectively (P < 0.05). Specificity of two methods was 97.3%. Meanwhile the positive rate in CSF (96.4%) is markedly higher than that in sera (85.5%) (P < 0.05). The results showed that this method can be as a supporting method for diagnosis of TBM.

Adolescent↗

Preembolization functional evaluation in supratentorial cerebral arteriovenous malformations with superselective intraarterial injection of thiopental sodium solution.

Superselective intraarterial injections of thiopental sodium solution for evaluation of local brain function were performed before embolization in 38 consecutive patients with supratentorial arteriovenous malformations to evaluate the role of the test using thiopental sodium solution. Thiopental sodium (30-50 mg) was injected in 68 arteries (44 middle cerebral arteries, 13 anterior cerebral arteries, 7 posterior cerebral arteries, 3 external carotid arteries, and 1 thalamo-perforating artery) through superselective microcatheters just before the injection of cyanoacrylate mixture for the embolization. The test was negative in 57 arteries and there were neurologic dysfunctions in 3 of them after embolization. The neurologic deficits in these cases were caused by reflux of embolic material, spasm of the main arterial trunk, or neglected mild sensory change, respectively, and there was no real false-negative test. The embolization could not be performed due to positive test in 9 arteries. Two arteries with positive tests but acceptable symptoms were embolized and the same neurologic deficits developed immediately after embolization. There was no local arterial complication by an injection of the thiopental sodium solution. All neurologic deficits caused by positive tests developed immediately and were completely relieved within 5 min without specific management. Superselective intraarterial injection of thiopental sodium solution is a safe and reliable test for the evaluation of local brain function before embolization of supratentorial arteriovenous malformations.

Adolescent↗

MRI of intracranial subependymoma: report of a case.

Subependymoma is a rare, benign intraventricular tumour and a case of septum pellucidum origin examined with CT and MR is reported. Well demarcated non-enhancing mass with multiple small intratumoral cysts is demonstrated on CT and MR images. The differential diagnosis from ependymoma has some therapeutic implications but may not be possible by CT or MRI.

Cerebral Ventricle Neoplasms↗

Cerebral aspergillosis in immunologically competent patients.

Aspergillosis of the central nervous system is a rare disease, especially if the patient's immune system is not compromised. The authors report three cases of cerebral aspergillosis in the immunocompetent state: a rhinocerebral form in a diabetic patient, a direct extension from chronic Aspergillus otitis media, and a postoperative Aspergillus brain abscess after brain tumor surgery. In spite of the poor prognosis of cerebral aspergillosis, two of the patients survived. The pathogenesis, predisposing factors, radiologic findings including magnetic resonance image, and the outcome are presented. The pertinent literature of cerebral aspergillosis is also reviewed.

Adult↗

Cloning, expression and characterization of a murine-human chimeric antibody with specificity for pre-S2 surface antigen of hepatitis B virus.

The cloning, expression and characterization of a murine-human chimeric antibody with specificity for the pre-S2 surface antigen (Ag) of hepatitis B virus (HBV) is described. The heavy and light chain variable region (VH and VL) genes encoding the murine monoclonal antibody (mAb) were isolated and combined with human gamma 1 and kappa constant region genes, respectively. The expression vectors containing the chimeric heavy and light chain genes were sequentially electroporated into murine Sp2/0 hybridoma cells and transfectomas secreting chimeric antibody were isolated. The chimeric antibody was purified and characterized by ELISA, Western analysis and competition immunoassay, demonstrating that the transfectoma functionally express and secrete murine-human chimeric antibody which retained the specificity and affinity of the parental murine mAb.

Amino Acid Sequence↗

Cerebral sparganosis: MR imaging versus CT features.

Fourteen magnetic resonance (MR) images of 11 patients with cerebral sparganosis were reviewed retrospectively and compared with 13 computed tomographic (CT) scans of 10 of the patients. All patients underwent both nonenhanced and contrast material-enhanced MR imaging. All white matter degenerations, which were slightly hypointense on T1-weighted images and were hyperintense on T2-weighted images, were seen as areas of low attenuation on CT scans. Better contrast between normal and degenerated brain tissues was seen at MR, and two lesions were seen that were missed at CT. The parasitic granuloma was isointense to brain parenchyma on images obtained with all pulse sequences. On two follow-up MR images, location or shape of the enhancing lesions changed, suggesting migration of the worm. A new finding of hyperintensity on T1-weighted images and hypointensity on T2-weighted images in subcortical areas probably due to petechial hemorrhages was demonstrated in eight patients only at MR. Small calcific foci, which were important diagnostic clues of cerebral sparganosis, were detected in four patients only at MR, while they were seen in eight patients at CT.

Adolescent↗

Gliomatosis cerebri: comparison of MR and CT features.

OBJECTIVE: Gliomatosis cerebri is a diffuse infiltrative glial neoplasm frequently involving both cerebral hemispheres. Diagnosis and evaluation of its extent with CT are known to be difficult. The purpose of this study was to compare the MR and CT findings in gliomatosis cerebri. MATERIALS AND METHODS: MR images of nine patients were reviewed retrospectively and compared with CT scans. Pathology was determined by open or stereotaxic biopsy. The MR images included sagittal T1-weighted, axial proton density-weighted, and T2-weighted images. Contrast material was administered in seven patients. Unenhanced and enhanced CT scans were obtained in eight patients. RESULTS: On proton density-weighted and T2-weighted MR images, the most common findings were poorly defined bilateral areas of diffuse high signal intensity in the cerebral hemisphere. On T1-weighted images, the lesions were isointense to hypointense compared with normal brain. Enhanced T1-weighted images showed focal parenchymal enhancement in three patients and meningeal enhancement in one. On CT scans, the lesions showed poorly defined areas of subtle low density or isodensity, and appeared much smaller than those on T2-weighted MR images. Enhancement was seen in only one case. The extent of disease was evaluated much better on T2-weighted MR images than on T1-weighted MR images and CT scans. CONCLUSION: In gliomatosis cerebri, MR imaging is more sensitive than CT for detecting lesions and shows the extent of disease better than CT does. Accordingly, MR imaging should be used as a primary imaging study in the evaluation of gliomatosis cerebri.

Adult↗

Hematogeneous pulmonary metastasis. An experimental study using VX-2 carcinoma in rabbits.

The purpose of this study was to develop an experimental model of pulmonary metastases using VX-2 tumor, and to describe sequential radiologic and pathologic findings with special attention to the interstitial changes around the metastatic nodules. Through ear veins of 25 rabbits, VX-2 tumor cell suspension was injected with 0.8-mm scalp needles. Chest radiographs were taken every other day after tumor injection. The rabbits were sacrificed at scheduled times from 3 to 30 days after tumor injection. The inflated and fixed lungs were examined with visual inspection, low-kV radiography, high resolution CT (HRCT), microradiography of the sliced lung and with histopathologic studies. Hematogeneous pulmonary metastases occurred in 24 of 25 rabbits. In addition to the metastatic nodules, perinodular and peribronchovascular infiltrations were seen on low-kV radiography, HRCT, microradiography and histologic studies.

Animals↗

MR appearance of central neurocytoma.

To provide a detailed description of the MR appearances of central neurocytoma, MR images of 13 patients with central neurocytoma were retrospectively reviewed and compared with CT examinations. The histology was confirmed by ultrastructural and immunohistochemical studies. In 12 patients the tumors were histologically benign and located in the anterior part of the lateral ventricle, 6 of which extended to the 3rd ventricle. There was one case of a histologically malignant variant involving the thalamus and lateral ventricle. The tumors were primarily solid, but contained cysts (85%, 11/13), calcifications (69%, 9/13), and signal void from tumor vessels (62%, 8/13), frequently producing heterogeneous signal intensity on both T1- and T2-weighted images. Most of the solid portion appeared isointense or slightly hyperintense relative to the cerebral cortex on all MR pulse sequences. Calcifications were iso- or hypointense on MR, making them difficult to characterize with MR alone. Intratumoral hemorrhage was seen in 2 patients on MR but not on CT. Contrast enhancement was variable in degree and pattern. Coronal and sagittal MR images were valuable in evaluating the tumor extent and origin site, and in planning the surgical approach. It is concluded that MR imaging appears to be more useful than CT in the overall evaluation of central neurocytoma, even though calcification is better characterized with CT.

Adult↗

Cloning and characterization of cDNAs coding for heavy and light chains of a monoclonal antibody specific for pre-S2 antigen of hepatitis B virus.

Binding specificity of a monoclonal antibody (mAb) (kappa, gamma 2b) H8 which can react with the pre-S2 peptide of hepatitis B virus (HBV) was determined by Western blot analyses. From the hybridoma cell line secreting mAb H8, poly(A)+ RNA was prepared and used as a template for cDNA synthesis and cloning. Full-length cDNAs coding for the heavy and kappa light chains of the mAb were cloned from the cDNA library and characterized by nucleotide (nt) sequence analyses and N-terminal amino acid sequencing. The sequence analyses revealed that both heavy and light chain-specific cDNAs are functional, and the variable regions of the heavy and light chains are members of mouse heavy chain subgroup III(c) and light chain group I, respectively. Comparison of the nt sequences with mouse immunoglobulin genes listed in the GenBank data base show that the cDNAs have not been previously reported. The cDNAs will be used for the construction of a therapeutic antibody for HBV infection.

Amino Acid Sequence↗

Cerebral sparganosis: analysis of 34 cases with emphasis on CT features.

Cerebral sparganosis is a rare parasitic CNS disease, producing chronic active granulomatous inflammation. We retrospectively reviewed the clinical data, CT scans and histopathologic specimens in 34 patients with cerebral sparganosis. The majority of the patients (89%) were rural inhabitants; 75% had a history of ingestion of frogs and/or snakes. The major presenting symptoms were seizure (84%), hemiparesis (59%) and headache (56%) of chronic course. On CT scans, the disease most frequently involved the cerebral hemispheres, particularly frontoparietal lobes, with occasional extension to the external and internal capsules and basal ganglia. The cerebellum was rarely involved. Bilateral involvement was seen in 26%. The main CT findings consisted of white matter hypodensity with adjacent ventricular dilatation (88%), irregular or nodular enhancing lesion (88%), and small punctate calcifications (76%). In combination, the CT triad above appears to be specific for this disease, and was noted in 62% of cases. Of 16 follow-up CT scans, 5 (38%) showed a change in the location of the enhancing nodule. With a single CT scan, it does not appear to be possible to determine whether the worm is alive or dead, information important for deciding whether to intervene surgically. Change in the location of the enhancing nodule and/or worsening of the other CT findings on sequential CT scans would suggest that the worm is alive and that the patient is a candidate for surgery.

Adult↗

Marchiafava-Bignami disease: serial changes in corpus callosum on MRI.

Serial MRI findings of changes in corpus callosum lesions in two cases of Marchiafava-Bignami disease are presented. In both, MRI displayed diffuse swelling of the corpus callosum in the acute stage, thought to represent oedema and demyelination. In the chronic stage, in addition to atrophy of the corpus callosum with presumed focal necrosis, previously undescribed focal hypointensity on T2-weighted images, of unknown cause, was observed in the corpus callosum.

Alcoholism↗

Delayed encephalopathy after acute carbon monoxide intoxication: MR imaging features and distribution of cerebral white matter lesions.

Magnetic resonance (MR) images obtained in 15 patients with delayed encephalopathy after acute carbon monoxide (CO) intoxication were reviewed. Images had been obtained 4-9 weeks after exposure to CO, during the relapse of neuropsychiatric symptoms after initial recovery. Bilateral symmetric confluent high signal intensity in the periventricular white matter and centrum semiovale was seen on long-repetition-time images (n = 15). The high intensity extended into the corpus callosum (n = 11), subcortical U fibers (n = 12), and external (n = 9) and internal (n = 7) capsules. Bilateral diffuse low-intensity signal in the thalamus and putamen on T2-weighted images, suggesting iron deposition, was demonstrated in 10 patients. Bilateral ischemia or necrosis of the globus pallidus was seen in nine patients. In three of four patients with follow-up MR imaging studies, a decrease in extent and signal intensity of white matter lesions accompanied lessening of clinical symptoms. These results suggest that the main pathologic feature of delayed encephalopathy associated with CO intoxication is a reversible demyelinating process of the cerebral white matter.

Adult↗