BACKGROUND: In this study on fibrinogen/fibrin degradation products (FDPs), we evaluated the performance of a quantitative immunoturbidimetric assay (ITA) using the new Nanopia P-FDP reagent kit (Sekisui Medical Co., Japan) in comparison with a semiquantitative latex agglutination assay (LA) currently performed using the FDP PLASMA kit (Diagnostica Stago SAS, France). METHODS: The quantitative Nanopia P-FDP method using the STA-R EVOLUTION automated coagulation analyzer (Diagnostica Stago SAS) was evaluated with respect to precision, linearity, carryover, and reference interval. The correlations were measured for each of the 145 samples by using the Nanopia P-FDP method and the semiquantitative FDP PLASMA method. RESULTS: The coefficients of variation with regard to precision in low and high control concentrations were 2.97% and 5.77%, respectively. The correlation coefficient of linearity (r) was 0.990 in the measurement range of 2.4-122.8 microg/mL. The level of carryover was 0.83%, while the reference interval range was 0.22-4.32 microg/mL. The results of FDP assay showed an acceptable accord in 115 samples (79%) among the 145 samples by both LA method and ITA method. Seventeen samples (12%) showed relatively lower FDP values in the LA method than those in the ITA method. Thirteen cases (9%) showed relatively higher FDP values in the LA method than those in the ITA method. CONCLUSIONS: The quantitative Nanopia P-FDP method showed good precision, linearity, carryover, reference interval, and an acceptable concordance rate with the semiquantitative FDP PLASMA method. Thus, the Nanopia P-FDP reagent using the STA-R EVOLUTION automated coagulation analyzer can replace the FDP PLASMA reagent for the quantitative analysis of FDPs.
Agglutination ; Blood Coagulation ; Formycins ; Latex ; Phenothiazines ; Plasma ; Ribonucleotides

Background: The anti-oxidative, anti-inflammatory, and anti-apoptotic effects of erythropoietin may provide neuroprotective effects. Erythropoietin also modulates autophagy signaling that may play a role in anesthesia-induced neurotoxicity (AIN). Herein, we investigated whether AIN can be attenuated by the neuroprotective effect of erythropoietin in the Caenorhabditis elegans (C. elegans). Methods: Synchronized worms were divided into the control, Iso, EPO, and EPO-Iso groups. The chemotaxis index (CI) was evaluated when they reached the young adult stage. The lgg-1::GFP-positive puncta per seam cell were used to determine the autophagic events. The erythropoietin-mediated pathway of autophagy was determined by measuring the genetic expression level of let-363, bec-1, atg-7, atg-5, and lgg-3. Results: Increased lgg-1::GFP puncta were observed in the Iso, EPO, and EPO-Iso groups. In the Iso group, only the let-363 level decreased significantly as compared to that in the control group (P = 0.009). bec-1 (P < 0.001), atg-5 (P = 0.012), and lgg-3 (P < 0.001) were expressed significantly more in the EPO-Iso group than in the Iso groups. Repeated isoflurane exposure during development decreased the CI. Erythropoietin could restore the decreased CI by isoflurane significantly in the EPO-Iso group. Conclusions Erythropoietin showed neuroprotective effects against AIN and modulated the autophagic pathway in C. elegans. This experimental evidence of erythropoietin-related neuroprotection against AIN may be correlated with the induced autophagic degradation process that was sufficient for handling enhanced autophagy induction in erythropoietin-treated worms.

The explanation of isolated-organ tuberculosis rests on the assumption that in the course of the lymphatic or hematogenous dissemination of bacilli, organisms may be rapidly destroyed in all other sites save for the particular tissue involved in the isolated tuberculous process. Tuberculosis can arise in all tissues having lymphatics or blood supply, but the disease causing biliary tract obstruction has been known to be rare. Recently, we experi-enced a case of isolated-organ tuberculosis causing common bile duct obstruction and periductal lymph node enlargement in a 46-year-old Korean male. An ultrasonography-guided percutaneous needle biopsy revealed a granulomatous inflammation of the lymph node. After 7 months of anti-tuberculous medication, the common bile duct obstruction and periductal lymph node enlargement disappeared completely in a follow up abdominal CT and ERCP.
Biliary Tract ; Biopsy, Needle ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis ; Common Bile Duct* ; Follow-Up Studies ; Humans ; Inflammation ; Lymph Nodes ; Lymphadenitis* ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Tuberculosis*

OBJECTIVE: To assess the correlation between the anorectal function and bladder detrusor function in patients with complete spinal cord injury (SCI) according to the type of lesion. METHODS: Medical records of twenty-eight patients with SCI were included in this study. We compared the anorectal manometric and urodynamic (UD) parameters in total subjects. We analyzed the anorectal manometric and UD parameters between the two groups: upper motor neuron (UMN) lesion and lower motor neuron (LMN) lesion. In addition, we reclassified the total subjects into two groups according to the bladder detrusor function: overactive and non-overactive. RESULTS: In the group with LMN lesion, the mean value of maximal anal squeeze pressure (MSP) was slightly higher than that in the group with UMN lesion, and the ratio of MSP to maximal anal resting pressure (MRP) was statistically significant different between the two groups. In addition, although the mean value of MSP was slightly higher in the group with non-overactive detrusor function, there was no statistical correlation of anorectal manometric parameters between the groups with overactive and non-overactive detrusor function. CONCLUSION: The MSP and the ratio of MSP to MRP were higher in the group with LMN lesion. In this study, we could not identify the correlation between bladder and bowel function in total subjects. We conclude that the results of UD study alone cannot predict the outcome of anorectal manometry in patients with SCI. Therefore, it is recommended to perform assessment of anorectal function with anorectal manometry in patients with SCI.
Humans ; Manometry ; Medical Records ; Motor Neurons ; Neurogenic Bowel ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics*

OBJECTIVE: To assess the correlation between the anorectal function and bladder detrusor function in patients with complete spinal cord injury (SCI) according to the type of lesion. METHODS: Medical records of twenty-eight patients with SCI were included in this study. We compared the anorectal manometric and urodynamic (UD) parameters in total subjects. We analyzed the anorectal manometric and UD parameters between the two groups: upper motor neuron (UMN) lesion and lower motor neuron (LMN) lesion. In addition, we reclassified the total subjects into two groups according to the bladder detrusor function: overactive and non-overactive. RESULTS: In the group with LMN lesion, the mean value of maximal anal squeeze pressure (MSP) was slightly higher than that in the group with UMN lesion, and the ratio of MSP to maximal anal resting pressure (MRP) was statistically significant different between the two groups. In addition, although the mean value of MSP was slightly higher in the group with non-overactive detrusor function, there was no statistical correlation of anorectal manometric parameters between the groups with overactive and non-overactive detrusor function. CONCLUSION: The MSP and the ratio of MSP to MRP were higher in the group with LMN lesion. In this study, we could not identify the correlation between bladder and bowel function in total subjects. We conclude that the results of UD study alone cannot predict the outcome of anorectal manometry in patients with SCI. Therefore, it is recommended to perform assessment of anorectal function with anorectal manometry in patients with SCI.
Humans ; Manometry ; Medical Records ; Motor Neurons ; Neurogenic Bowel ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics*

BACKGROUND: Tumor-related white matter change is detected at late stages with magnetic resonance imaging (MRI), when mass effect or prominent edema is present. We analyzed if diffusion tensor imaging (DTI) white matter change earlier than conventional MRI. METHODS: Twenty-six patients with gliomas (World Health Organization grade II, 5; grade III, 12; and grade IV, 9) within 2 cm from the posterior limb of the internal capsule (IC) were studied. Fifteen normal adults were enrolled as controls. Fluid attenuation inversion recovery MRI showed a high signal change at the posterior limb of the IC (HSIC) in 9 patients with grade III or IV gliomas. We classified the gliomas as WHO grade II (gliomas II), grade III or IV without HSIC [gliomas III/IV(-)] and grade III or IV with HSIC [gliomas III/IV(+)], as an indicator of the increase in the severity of the white matter changes. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) were calculated for the pyramidal tract. Tumor progression along pyramidal tract was evaluated by follow-up MRI in 16 patients at 40±18 months. RESULTS: FA showed no significant difference between gliomas II and control (p=0.694), but was lower in gliomas III/IV(-) and gliomas III/IV(+) (p<0.001). ADCs were higher in gliomas II, gliomas III/IV(-) and gliomas III/IV(+) than control (p<0.001). Tumor progression was detected in 2/16 patients. CONCLUSION: DTI detected white matter changes that appeared to be normal in MRI. ADC changed even in low grade glioma, indicating ADC may be a better parameter for the early detection of white matter change.
Adult ; Anisotropy ; Diffusion Tensor Imaging* ; Diffusion* ; Edema ; Extremities ; Follow-Up Studies ; Glioma* ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Pyramidal Tracts ; White Matter*

PURPOSE: Population based structural and functional maps of the brain provide effective tools for the analysis and interpretation of complex and individually variable brain data. Brain MRI and PET standard templates and statistical probabilistic maps based on image data of Korean normal volunteers have been developed and probabilistic maps based on cytoarchitectonic data have been introduced. A quantification method using these data was developed for the objective assessment of regional intensity in the brain images. Materials and METHODS: Age, gender and ethnic specific anatomical and functional brain templates based on MR and PET images of Korean normal volunteers were developed. Korean structural probabilistic maps for 89 brain regions and cytoarchitectonic probabilistic maps for 13 Brodmann areas were transformed onto the standard templates. Brain FDG PET and SPGR MR images of normal volunteers were spatially normalized onto the template of each modality and gender. Regional uptake of radiotracers in PET and gray matter concentration in MR images were then quantified by averaging (or summing) regional intensities weighted using the probabilistic maps of brain regions. Regionally specific effects of aging on glucose metabolism in cingulate cortex were also examined. RESULTS: Quantification program could generate quantification results for single spatially normalized images per 20 seconds. Glucose metabolism change in cingulate gyrus was regionally specific: ratios of glucose metabolism in the rostral anterior cingulate vs. posterior cingulate and the caudal anterior cingulate vs. posterior cingulate were significantly decreased as the age increased. 'Rostral anterior'/ 'posterior' was decreased by 3.1% per decade of age (P< 10 (-11), r=0.81) and 'caudal anterior'/ 'posterior' was decreased by 1.7% (P< 10 (-8), r=0.72). CONCLUSION: Ethnic specific standard templates and probabilistic maps and quantification program developed in this study will be useful for the analysis of brain image of Korean people since the difference in shape of the hemispheres and the sulcal pattern of brain relative to age, gender, races, and diseases cannot be fully overcome by the nonlinear spatial normalization techniques.
Aging ; Brain* ; Continental Population Groups ; Glucose ; Gyrus Cinguli ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Metabolism ; Tomography, Emission-Computed, Single-Photon

Pediatric differentiated thyroid cancers (DTCs), mostly papillary thyroid cancer (PTC, 80-90%), are diagnosed at more advanced stages with larger tumor sizes and higher rates of locoregional and/or lung metastasis. Despite the higher recurrence rates of pediatric cancers than of adult thyroid cancers, pediatric patients demonstrate a lower mortality rate and more favorable prognosis. Considering the more advanced stage at diagnosis in pediatric patients, preoperative evaluation is crucial to determine the extent of surgery required. Furthermore, if hereditary tumor syndrome is suspected, genetic testing is required. Recommendations for pediatric DTCs focus on the surgical principles, radioiodine therapy according to the postoperative risk level, treatment and follow-up of recurrent or persistent diseases, and treatment of patients with radioiodine-refractory PTCs on the basis of genetic drivers that are unique to pediatric patients.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.