PURPOSE: To determine diagnostic effects of fine needle aspiration cytology (FNA) and frozen section of thyroid follicular neoplasm and its role in the therapeutic approach. METHOD: We performed a retrospective analysis of the data of patients who underwent thyroid surgery at the Gwangju Christian Hospital, between March 2000 and December 2004, and had a report of preoperative fine needle aspiration (FNA) biopsy of thyroid follicular lesions, which comprises cellular lesion, suspicious for follicular neoplasm or follicular carcinoma. RESULTS: Out of 45 patients with preoperative FNA biopsy diagnosis of follicular neoplasm, reveals true follicular carcinoma in 20 (44.4%), a follicular adenoma in 11 (24.5%), a papillary carcinoma in 7 (15.5%), a papillary carcinoma with follicular variant in 4 (8.9%), an adenomatous goiter in 3 (6.7%). Among the 45 patients having an intraoperative frozen sections, only 7 patients (15.5%) were true follicular carcinoma, suspicious for malignant follicular neoplasm in 14 patients (31.1%) and suspicious for benign follicular neoplasm in 8 patients (17.8%). final diagnosis were changed from suspicious for benign follicular neoplasm at intraoperative frozen section to malignant in 3 patients, from suspicious for malignant follicular neoplasm to benign in 1 patient. Three patients underwent a lobectomy and 1 patients a subtotal thyroidectomy followed by a completion thyroidectomy. CONCLUSION: Fine needle aspiration cytology and frozen section results are not good indicators in making the decision of operative extent. the best way to establish a diagnosis and to predict prognosis is to surgically remove the tumor for a proper histopathologic examination.
Adenoma ; Biopsy ; Biopsy, Fine-Needle* ; Carcinoma, Papillary ; Diagnosis ; Frozen Sections* ; Goiter ; Gwangju ; Humans ; Prognosis ; Retrospective Studies ; Thyroid Gland* ; Thyroidectomy

BACKGROUND/AIMS: Histoacryl forms hard substances in an instance after a brief exposure to polar liquid, blood or body temperature. This often causes obstruction of injector and endoscopic channel. Furthermore, splashed Histoacryl during injection can lead to accidental loss of vision. We propose a new convenient method of Histoacryl-lipiodol sequential injection and report the results. METHODS: From May 2001 to August 2004, sequential injector method was performed in treating consecutive thirty gastric varices patients. Histoacryl (S.G. 1.0) 1 mL and lipiodol (S.G. 1.28) 1~1.5 mL are filled in 2.5 mL disposable syringe with 16 gauge needle, which are separated into two compartments by specific gravity difference. The injector attached side of charged syringe is gently placed upward and the piston is pushed after the lesion site puncture. Then, normal saline is promptly infused to wash out and the needle is withdrawn. RESULTS: There were 26 males and 4 females. 4 had active bleeding and 26 had the stigmata of bleeding. Varices types were Lg-c in 10, Lg-cf in 16 and Lg-f in 4 patients and the Child-Pugh classification were A in 17%, B in 53% and C in 30%. The average amount was 1.53 mL. Initial hemostasis rate was 97%, 3 of patients re-bled in 4 weeks and 2 patients later. One patient died after the procedure and a case of procedure related bacteremia has occurred. CONCLUSIONS: Histoacryl-lipiodol sequential injection by specific gravity difference is convenient and safe. Also, it carries less damage to the instruments.
Bacteremia ; Body Temperature ; Christianity ; Classification ; Enbucrilate ; Esophageal and Gastric Varices* ; Ethiodized Oil ; Female ; Hemorrhage* ; Hemostasis ; Humans ; Male ; Needles ; Punctures ; Specific Gravity ; Syringes ; Varicose Veins

The primary lymphoma of the liver is a rare disease. We report a case of primary hepatic T-cell lymphoma associated with crescentic glomerulonephritis. The case, a 53-year-old male was presented with a 2-year history of hepatic mass and a 1-month history of foamy urine, rapidly progressive azotemia, and oliguria. The kidney biopsy revealed diffuse crescentic glomerulonephritis. The result of immunohistochemical study of liver biopsy specimen was consistent with non-Hodgkin's lymphoma in T-cell lineage. Because renal function was deteriorated rapidly and there were signs of volume overload, hemodialyses were performed. Although the patient received 2 cycles of combination chemotherapy with CHOP(cyclophosphamide, vincristine, prednisolone, and doxorubicin), he did not respond and died of sepsis.
Azotemia ; Biopsy ; Drug Therapy, Combination ; Glomerulonephritis* ; Humans ; Kidney ; Liver ; Liver Neoplasms ; Lymphoma ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell* ; Male ; Middle Aged ; Oliguria ; Prednisolone ; Rare Diseases ; Renal Dialysis ; Sepsis ; T-Lymphocytes* ; Vincristine

BACKGROUND: Methylmercury (MeHg) easily crosses the blood-brain barrier and accumulates in the brain. Accumulated MeHg will cause neurological symptoms. We report four pediatric cases of neuropsychological findings with high blood MeHg concentrations. CASE PRESENTATION: Four children were admitted for follow-up study because their total mercury (THg) concentration in the blood was found to be high during a national survey. Case 1 was a 9-year-old female with a 16.6 microg/l blood THg concentration in the survey. During admission, the blood THg, hair THg, and blood MeHg concentration(mercury indices) were 21.4 microg/l, 7.2 microg/g, and 20.1 microg/l, respectively. In our neuropsychological examination, cognitive impairment and attention deficit were observed. Her diet included fish intake 2-3 times per week, and she had been diagnosed with epilepsy at 3 years of age. Case 2 was a 12-year-old male with blood THg of 15.4 microg/l in the survey and the mercury indices were 12.7 microg/l, 5.7 microg/g, and 11.8 microg/l, respectively, on admission. He was also observed to have attention-deficit/hyperactivity disorder. Case 3 was a 10-year-old male child with blood THg of 17.4 microg/l in the survey, and the mercury indices on admission were 21.6 microg/l, 7.5 microg/g and 21.5 microg/l, respectively. In his case, mild attention deficit was observed. Case 4 was a 9-year-old male with blood THg of 20.6 microg/l in the survey and the mercury indices were 18.9 microg/l, 8.3 microg/g, and 14.4 microg/l, respectively, on admission. Mild attention difficulty was observed. CONCLUSION: We suggest that fish consumption may be the main source of MeHg exposure, and that MeHg may have been the cause of the neuropsychological deficits in these cases.
Blood-Brain Barrier ; Brain ; Child* ; Diet ; Epilepsy ; Female ; Follow-Up Studies ; Hair ; Humans ; Male

BACKGROUND: Methylmercury is an organic form of mercury that is highly toxic to humans. Here, we present and establish a novel method to detect methylmercury concentrations in the blood of Koreans. METHODS: Methylmercury concentration was analyzed with an automated methylmercury analytic system (MERX, Brooks Rand Co., USA) using cold vapor atomic fluorescence spectrophotometry (CVAFS). A variety of biological materials were digested in methanolic potassium hydroxide solution. The analysis method was validated by examination of certified reference material (955c, National Institute of Standard and Technology, USA). We randomly selected 30 Korean adults (age 20 yr or older) to analyze total blood mercury and methylmercury concentrations. RESULTS: The detection limit and methylmercury recovery rate using this method were 0.1 pg/L and, 99.19% (range: 89.33-104.89%), respectively. The mean blood concentration of methylmercury was 4.54+/-2.15 microg/L (N=30). The mean proportion of methylmercury to the total mercury concentration was 78.27% (range: 41.37-98.80%). CONCLUSIONS: This study is the first report to analyze blood methylmercury concentration using CVAFS in Korea. We expect that this method will contribute to the evaluation of mercury exposure and the assessment of the toxicological impact of mercury in future studies.
Adult ; Humans ; Hydroxides/chemistry ; Mercury/blood ; Methylmercury Compounds/*blood ; Potassium Compounds/chemistry ; Reproducibility of Results ; Republic of Korea ; *Spectrophotometry, Atomic

The acute tumor lysis syndrome is an acute illness caused by massive cell lysis after chemotherapies. This syndrome is characterized by hyperuricemia, hyperphosphatemia with hypocalcemia and hyperkalemia. Among these electrolyte abnormalities, the most serious complication is the severe hyperphosphatemia (greater than 14mg/dL) that could result in sudden cardiac arrest or respiratory failure. In order to correct the severe hyperphosphatemia, hemodialysis has been used commonly as the renal replacement therapy . However the hemodialysis can make posthemodialysis serum phosphate rebounded unless the patient take this treatment for more than 6 hours. Therefore it is not sufficient to use hemodialysis treatment alone. To solve this problem, hemodialysis has been used with or replaced by the uninterrupted dialysis technique such as CRRT (continuous renal replacement therapy). We report a 33-year-old man with Burkitt lymphoma who showed severe hyperphosphatemia (peak phosphate value was 18.6mg/dL) during the course of chemotherapy. used with 5 day CAVH (continuous arteriovenous hemofiltration) his phosphate level could be maintained without any rebound. Therefore we concluded that CAVH in conjunction with hemodialysis would be a successful way to control severe hyperphosphatemia associated with tumor lysis syndrome.
Adult ; Burkitt Lymphoma ; Death, Sudden, Cardiac ; Dialysis ; Drug Therapy ; Hemofiltration* ; Humans ; Hyperkalemia ; Hyperphosphatemia* ; Hyperuricemia ; Hypocalcemia ; Renal Dialysis* ; Renal Replacement Therapy ; Respiratory Insufficiency ; Tumor Lysis Syndrome*

OBJECTIVES: Glucocorticoids, such as dexamethasone (DEX), increase apoptosis in a variety of white cells in nasal polyps and apoptosis is an important factor in the resolution of inflammation. However, the mechanism of glucocorticoids induced apoptosis in nasal polyp remains unclear. In this study the authors evaluated which pathways were engaged in apoptosis induced by DEX in an ex vivo model of nasal polyps. METHODS: Nasal polyp tissues were cultured using an air-liquid interface method. Cultures were maintained in the absence or presence of DEX (10 or 100 microM) for 24 hours. To investigate the involvement of the apoptotic signaling pathways in nasal polyp, such as caspase cascades, Fas-FasL signaling pathway, mitochondrial pathway and p38 mitogen-activated protein kinase (MAPK)/JNK pathway, the authors performed reverse transcription-polymerase chain reaction and Western blotting. RESULTS: The expression ratios of FasL, activated form of caspase-8, caspase-9, and caspase-3 were significantly higher in DEX-treated polyps (P<0.01). In the Bcl-2 family expression, the anti-apoptotic molecules, Bcl-2 and Bcl-XL decreased, but pro-apoptotic molecules, Bax increased, and Bid and Bad were activated. In the conventional MAPKs, JNK, and the phospho-p38 MAPK were significantly higher, but phospho-extracellular signal-regulated kinase (ERK)1/2 was significantly lower in DEX-treated polyps (P<0.01). CONCLUSION: DEX induces apoptosis of nasal polyp via caspase cascades, Fas-FasL signaling pathway, mitochondrial pathway and p38 MAPK/JNK pathway.
Apoptosis* ; Blotting, Western ; Caspase 3 ; Caspase 8 ; Caspase 9 ; Dexamethasone* ; Glucocorticoids ; Humans ; Inflammation ; Nasal Polyps ; Organ Culture Techniques ; p38 Mitogen-Activated Protein Kinases* ; Phosphotransferases ; Polyps ; Protein Kinases

BACKGROUND AND OBJECTIVES: Percutaneous cardiopulmonary support (PCPS) provides hemodynamic stability for the treatment of patients suffering with cardiogenic shock or cardiac arrest, and it can be used in a wide variety of clinical settings without the need for chest exploration. In this study, we summarize a single center's experience with performing PCPS in the patients who suffered with severe cardiopulmonary failure. SUBJECTS AND METHODS: We retrospectively reviewed 30 consecutive patients with cardiac arrest or severe cardiogenic shock who received PCPS for cardiac resuscitation from November 2003 to July 2005. The self-priming, heparin-coated circuit of the Emergency Bypass System(R) was used in all the patients. Cannulation was performed via the femoral artery and vein with using an arterial (17 to 21 French) and venous cannula (21 to 28 French), percutaneously or with a small incision. RESULTS: The Indications for PCPS were: ischemic heart disease before coronary revascularization, myocardial disease, PCI-associated complications and post-operative hemodynamic collapse. Of the 30 patients we evaluated, 19 patients (63%) were successfully weaned off of the PCPS; 14 of these patients (47%) were later discharged from the hospital. For the survivors, the time interval from cardiac arrest or severe cardiogenic shock to the onset of PCPS was significantly shorter (p=0.01), and the urine output for the initial 24 hours was significantly higher (p=0.04). CONCLUSION: This retrospective analysis demonstrates the effectiveness of using PCPS for the treatment of critically unstable patients with cardiac arrest or cardiogenic shock. Larger scale studies of PCPS are now needed to confirm these findings.
Catheterization ; Catheters ; Emergencies* ; Femoral Artery ; Heart Arrest* ; Hemodynamics ; Humans ; Myocardial Ischemia ; Myocardial Revascularization ; Resuscitation ; Retrospective Studies ; Shock, Cardiogenic* ; Survivors ; Thorax ; Veins

The aim of this study was to provide a basis for the molecular mechanism underlying the pharmacological action of ethanol. We studied the effects of 1-propanol on the location of n-(9-anthroyloxy)palmitic acid or stearic acid (n-AS) within the phospholipids of synaptosomal plasma membrane vesicles (SPMV). The SPMV were isolated from the bovine cerebral cortex and liposomes of total lipids (SPMVTL) and phospholipids (SPMVPL). 1-Propanol increased the rotational mobility of inner hydrocarbons, while decreasing the mobility of membrane interface, in native and model membranes. The degree of rotational mobility varied with the number of carbon atoms at positions 16, 12, 9, 6 and 2 in the aliphatic chain of phospholipids in the neuronal and model membranes. The sensitivity of increasing or decreasing rotational mobility of hydrocarbon interior or surface by 1-propanol varied with the neuronal and model membranes in the following order: SPMV, SPMVPL and SPMVTL.
1-Propanol* ; Carbon ; Cell Membrane ; Cerebral Cortex ; Ethanol ; Hydrocarbons ; Liposomes ; Membranes* ; Neurons* ; Phospholipids

Most T-cell lymphomas arise from mature alpabeta T-cells and commonly involve the nodes. Lymphomas bearing the gamadelta T-cell receptor (TCR) are very rare, and involve the lymph nodes minimally, if at all. Hepatosplenic gamadelta T-cell lymphoma is a recently identified, rare entity in which lymphoma cells bearing the gamadelta TCR infiltrate the sinusoids of the liver, splenic red pulp, and bone marrow. Its leukemic transformation is even more rare. Recently, we experienced a case of hepatosplenic gamadelta T-cell lymphoma in a 19-year-old woman who presented with epigastric pain, fever, massive splenomegaly, andpancytopenia. The splenectomy specimen and excisional biopsy of the liver revealed the infiltration of atypical T lymphocytes with the immunophenotypic markers of CD3 (+), CD45RO (pan-T antigen) (+), TIA-1(+), CD4(-),CD8 (-), CD56 (-), and S100 (-) in the sinusoids of the liver and splenic red pulp. Polymerase chain reaction (PCR) showed that these cells had the expression of the TCR gama gene rearrangements. Though the pancytopenia had improved after the splenectomy, the response of chemotherapy was transient. Her disease progressed rapidly and she expired in the leukemic phase. We report a case of hepatosplenic gamadelta T-cell lymphoma that developed in a young woman, along with a brief review of the literature.
Biopsy ; Bone Marrow ; Drug Therapy ; Female ; Fever ; Gene Rearrangement ; Glycogen Storage Disease Type VI ; Humans ; Liver ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell* ; Pancytopenia ; Polymerase Chain Reaction ; Receptors, Antigen, T-Cell ; Splenectomy ; Splenomegaly ; T-Lymphocytes* ; Young Adult