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It is essential to identify the causative artery in case of active intra-abdominal or gastrointestinal bleeding. A thorough understanding of the basic arterial anatomy is required to identify the causative artery on contrast-enhanced CT angiography and conventional catheter angiography. If one is familiar with the basic arterial anatomy, obtaining access to the bleeding artery will be easier, despite the variations in the origin and course of the vessels. We describe the basic arterial anatomy that will help beginners in diagnostic radiology to identify the blood vessels that can cause active intra-abdominal or gastrointestinal bleeding., Competing Interests: Conflicts of Interest: The authors have no potential conflicts of interest to disclose., (Copyrights © 2020 The Korean Society of Radiology.)

Background: For the detection of transitional cell carcinoma (TCC) of the bladder, we compared the sensitivities and specificities between the ThinPrep test and Melanoma Antigen Gene (MAGE) test with voided urine (V), drained urine (D), and irrigated urine (I)., Methods: We randomly selected 10 patients of a non-cancer group and 20 patients of a cancer group. V, D, and I were obtained preoperatively, and equally divided into two parts for the ThinPrep test and MAGE reverse transcriptase polymerase chain reaction (RT-PCR). The cystoscopic finding was used as the reference standard for detection of bladder cancer. The results of ThinPrep test and MAGE RT-PCR were compared according to cancer grade and stage., Results: The overall sensitivities of ThinPrep test were 45%, 85% and 85% for V, D, and I, respec-tively, while those of MAGE test were 50%, 85%, and 65%. Detection rate from drainage urine was considerably higher than that of voided urine in both methods (P<0.05). The specificities were 100% for all types of urine specimens with ThinPrep test and 100%, 90%, and 90% for V, D, and I, respectively, using MAGE test, without any statistically significant differences., Conclusions: For the detection of bladder cancer, MAGE RT-PCR and ThinPrep test showed a comparable sensitivity and specificity, and drained urine revealed the best detection rate. MAGE RT-PCR might be utilized as another marker of bladder cancer using urine specimens.

Background: The aim of our study was to optimize and establish erythropoietin (EPO) enzyme linked immunosorbent assay (ELISA) system., Methods: We prepared several monoclonal and polyclonal antibodies specific to human-EPO. The best combinations of antibodies for coating and detecting antibodies were selected for the establishment of ELISA. We tested several methods such as a competitive EIA and a sandwich ELISA., Results: The best sandwich ELISA was optimized compared to competitive EIA when purified polyclonal antibody (PoAb) was used as a coating antibody and biotinylated PoAb as a detecting antibody. This sandwich ELISA easily detected EPO when PoAb pairs were used compared to the ELISA using monoclonal antibody and PoAb. There were no significant differences between the effects of various blocking solutions on the performance of sandwich ELISA using biotinylated antibody. The ELISA system using PBST containing 3% BSA as a blocking solution can sensitively detect EPO (10 mU/mL) in a broad range of EPO concentrations (10-2,000 mU/mL) and there were cross-reactions with other cytokines)., Conclusions: EPO can be easily determined by using biotinylated PoAb as a detecting antibody and another PoAb as a coating antibody.

Background/aims: In spite of increasing interests about nonalcoholic steatohepatitis (NASH), there are few reports about the ultrastructure of hepatocyte in this disease. The aim of this study was to clarify abnormal electron microscopic (EM) findings and related factors in NASH., Methods: Total of fourteen patients who underwent liver biopsy due to steatohepatitis were included. Precise personal history was taken and variable blood tests such as liver function test, lipid profile, and serum iron study were done. Pathologic examination with light and electron microscopy was done by single pathologist., Results: Eleven men and three women were included and mean age was 33.7+/-12.8 years. Nine patients drinking less than 40 g/week was grouped as "NASH group" and other 5 patients drinking more than 40 g/week and body mass index less than 25 was grouped as "ASH (Alcoholic Steatohepatitis) group". Polymorphism of mitochondria such as megamitochondria or loss of cristae was major abnormal EM findings and was more common in "NASH group" than "ASH group" (p=0.027). There was no significant clinical or pathological factors related with the presence of these abnormal EM findings., Conclusions: Polymorphism of mitochondria is major abnormal EM finding of steatohepatitis and is more common in NASH than ASH. And there is no significant clinical or pathological factors which could predict the presence of these abnormal EM findings.

Background/aims: Spontaneous esophageal rupture is a life-threatening injury because of delay in diagnosis and rapid progression to septic condition. But acceptable standard treatment strategy has not been established yet. This may be due to its low incidence and lack of published literature. In this study, we evaluated the proper treatment strategy as to decide when and how to manage spontaneous esophageal rupture by analyzing our experiences., Methods: Eleven patients who were diagnosed as spontaneous esophageal perforation in Dongsan Medical Center from 1993 to 2003 were analyzed. Patients WERE divided into survival and death group. Clinical manifestations, rupture site and size, treatment methods and complications were compared., Results: All patients were male and alcoholics. Six patients had survived and five patients died. Age, sites and sizes of ruptures, operation methods were not different in both groups. Before operation, septic condition was present in all patients of death group and more common than survival group (p=0.015). Survival group showed shorter time interval from rupture to initial treatment (p=0.021) and to operation (p=0.019)., Conclusions: Early diagnosis and initial aggressive treatments such as nothing per oral, pleural and mediastinal drainage are important factor for better prognosis. If possible, early operation such as primary repair must be done. Although any difference according to types of operation method was not found in this study, further study with larger groups seems to be necessary.

Background/aims: Gelatinase (matrix metalloproteinase (MMP) -2 and 9) has an important role in the pathogenesis of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). In this study, we evaluated the relationship of gelatinase to chronic liver disease., Methods: Four groups of subjects were examined; healthy control (10 cases), chronic hepatitis (18 cases), LC (15 cases), and HCC (28 cases). The plasma of each subject was obtained, and the equal quantification of plasma protein was done. The plasma activities of MMP-2 and 9 were measured by zymography., Results: The activities of plasma MMP-2 in patients with LC were significantly higher than those in controls (p=0.009) and in patients with chronic hepatitis (p=0.011), but not different from those in patients with HCC. The activities of plasma MMP-9 in patients with LC were significantly higher than those in controls, but not different from those in patients with chronic hepatitis or HCC. In patients with LC (regardless of having HCC), the activities of MMP-2 correlated with total bilirubin (r=0.323, p=0.048) and Child-Pugh score (r=0.414, p=0.012). The activities of MMP-2 and 9 were higher in patients with LC (regardless of having HCC) caused by alcohol than caused by HBV (p=0.009 and 0.002 for each one)., Conclusions: The plasma activity of MMP-2 may be a useful marker for the diagnosis and determination of the severity of LC. The plasma activity of MMP-9 was not useful for HCC, but may be a marker for alcoholic LC. Further study is needed to determine why the plasma activity of gelatinase was higher in patients with LC caused by alcohol than by HBV.