Pericardial defect is a rare congenital cardiac disorder. Most patients were asymptomatic but some patients with partial pericardial defect occasionally complain acute symptoms such as angina, syncope, rarely sudden cardiac death. So, differential diagnosis with other ischemic or structural heart disease is crucial in the management of such patients. But there is no consistently successful diagnostic method. In the past, artificial diagnostic pneumothorax was used to document the absence of pericardium. However, it is not easily accepted due to excess morbidity and failure rate. Recently, echocardiography and more often, computed tomography, magnetic resonance imaging are used to confirm the diagnosis. We experienced a 52 years old male patient with atypical chest pain, who was diagnosed as complete left pericardial defect with computed tomography.
Chest Pain ; Death, Sudden, Cardiac ; Diagnosis ; Diagnosis, Differential ; Echocardiography ; Heart Diseases ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pericardium ; Pneumothorax ; Syncope

The fMRI signals are composed of many various signals. It is very difficult to find the accurate parameter for the model of fMRI signal containing only neural activity, though we may estimating the signal patterns by the modeling of several signal components. Besides the nose by the physiologic motion, the motion of object and noise of MR instruments make it more difficult to analyze signals of fMRI. Therefore, it is not easy to select an accurate reference data that can accurately reflect neural activity, and the method of an analysis of various signal patterns containing the information of neural activity is an issue of the post-processing methods for fMRI. In the present study, fMRI data was analyzed with the Independent Component Analysis(ICA) method that doesn't need a priori-knowledge or reference data. ICA can be more effective over the analytic method using cross-correlation analysis and can separate the signal patterns of the signals with delayed response or motion related components. The Principal Component Analysis (PCA) threshold, wavelet spatial filtering and analysis of a part of whole images can be used for the reduction of the freedom of data before ICA analysis, and these preceding analyses may be useful for a more effective analysis. As a result, ICA method will be effective for the analysis of signal patterns in fMRI and the pre-filtering may be necessary for the reduction of the degree of freedom of the data.
Freedom ; Magnetic Resonance Imaging* ; Noise ; Nose ; Principal Component Analysis

Coronary arteriovenous fistulas (CAVF) are rare malformations of the coronary circulation. They are seen in approximately 0.1% to 0.2% of all patients undergoing selective coronary angiography. We experienced a 58-years old male patient with bilateral coronary AV fistulas whoes diagnosis was confirmed by selective coronary angiography.
Arteriovenous Fistula* ; Coronary Angiography ; Coronary Circulation ; Diagnosis ; Fistula ; Humans ; Male ; Middle Aged

The present study was performed to observe the time course of behavioral signs of painful sensations in sciatic neurectomy animal model and to test the effects of sympathectomy and saphenous nerve section on these behavioral signs. Sciatic nerve was ligated and cut at the mid-thigh level under gaseous anesthesia. The application of von Frey filaments to the medial plantar surface of foot revealed weak and long-lasting mechanical allodynia (until end of test period, 20 weeks PO). Acetone application to the plantar surface of foot was used ti measure the sensitivity to cold stimulation. Cold allodynia which is interpreted as increased response to acetone application developed fairly well and lasted the end of test period (20 weeks PO). The cumulative duration of foot lifts off neutral or cold plate was used to test spontaneous, ongoing pain and was increased until 16 weeks PO and 20 weeks PO respectively. These results suggest that sciatic neurectomy which has been widely used as chronic pain model shows behavioral signs suggsting painful sensations except autotomy, which has been used as index of pain in experimental animal. Surgical sympathectomy performed 1 week after sciatic neurectomy partially reduced the behavioral signs of mechanical allodynia and cold allodynia, suggesting behavioral changes developed following section of sciatic nerve was partially sympathetic dependent. Saphenous nerve section 1 week after sciatic neurectomy almost completely reduced mechanical allodynia and cold allodynia, but did not change spontaneous, ongoing pain. These results suggest that evoked responses such as mechanical and cold allodynia are mediated by saphenous nerve activity and activating and/or maintaining mechanisms of spontanous, ongoing pain and evoked pain may be different.
Acetone ; Anesthesia ; Animals ; Chronic Pain ; Cold Temperature ; Foot ; Hyperalgesia ; Models, Animal ; Neuralgia ; Rats ; Sciatic Nerve ; Sensation ; Sympathectomy

OBJECTIVES: This study aimed to investigate the association between depression with atypical features and metabolic syndromes in Korean adults using the 2016 Korean National Health and Nutrition Examination Survey (KNHANES) data. METHODS: We used the 2016 KNHANES data to enroll 277 participants with a score of 10 or higher on Patient Health Questionnaire-9. Depression with atypical features was diagnosed when at least two of the following criteria were met : 1) sleeping more than 10 hours a day ; 2) weight gain of more than 3 kg in a year ; and 3) fatigue/anergia. Depression was divided into two groups based on the presence/absence of atypical features. Physical and mental health, and risk of metabolic syndrome were compared between the groups. RESULTS: Among the 277 participants, 91 had depression with atypical features. We identified significant differences in age, sex, income, and education between the two groups. After adjusting for these variables, depression with atypical features had lower EuroQol-5D index scores (p<0.001) and higher prevalence of metabolic syndromes (p=0.035) compared to the depression without atypical features. Depression with atypical features had higher odds ratio (OR) in association with metabolic syndromes after adjusting for confounding variables (OR=1.923 ; 95% confidence interval : 1.069–3.460). CONCLUSIONS Depression with atypical features increases the risk of metabolic syndromes and lowers the quality of life.

Postoperative pathological diagnosis of differentiated thyroid cancer (DTC) is important to confirm the diagnosis and predict the risk of recurrence and death. Further treatment plans, such as completion thyroidectomy, radioiodine remnant ablation, or external beam radiation therapy, are then opted for to reduce the predicted risk of recurrence or death. The World Health Organization has classified thyroid cancers into seven distinct categories based on the molecular profile and tumor cell origin. Our recommendation is applicable to differentiated follicular cell-derived carcinoma, the most common form of thyroid cancer, and cribriform morular thyroid carcinoma. Postoperative clinical and pathological staging is recommended for all patients with DTC to determine their prognosis and subsequent treatment decisions. In particular, the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging system is recommended for staging DTCs for disease mortality prediction and national cancer registries. The information in the pathology report, including histologic features of the tumor that are necessary for AJCC/UICC staging and recurrence prediction, can help assess the patient’s risk.

PURPOSE: The purpose of this study was to determine the diagnostic value of a sign of early enhancing superior ophthalmic vein (SOV), as seen on helical CT images in patients with carotid-cavernous fistula (CCF). MATERIALS AND METHODS: This study involved 16 patients with CCF and 28 control patients. Axial CT images with scanning delays of 30 seconds following bolus injection of contrast material (90 mL, 3 mL/sec) were obtained, and this procedure was followed by coronal CT imaging. To determine the presence or absence of early enhancement or, dilatation of the SOV, bulging of the cavernous sinus, and enlargement of extraocular muscle, CT images were analysed by three observers in a blinded, random manner. Early enhancement of SOV was determined to be present where enhancement of the SOV was similar to or stronger than that of the ipsi-lateral posterior cerebral artery. RESULTS: A sign of early enhancing SOV was seen in 14 of the 16 patients with CCF but in no control patients (88% sensitivity and 100% specificity). The respective sensitivity and specificity of other CT features were 71% and 100% (dilatation of the SOV, as seen on axial images), 60% and 83% (dilatation of the SOV, as seen on coronal images), 71% and 89% (dilatation of the cavernous sinus), and 65% and 98% (enlargement of extraocular muscle). CONCLUSION: A sign of early enhancing SOV is a characteristic and specific CT finding of CCF, and is useful for the diagnosis of CCF.
Cavernous Sinus ; Diagnosis ; Dilatation ; Fistula* ; Humans ; Posterior Cerebral Artery ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Veins*

PURPOSE: Proliferation, differentiation, and survival of hippocampal dentate granule cells have been reported to be influenced by epileptic seizures in rodent epilepsy models. However, most studies have been done in adult rat models. This study was designed to investigate hippocampal dentate granule cell neurogenesis after pilocarpine-induced seizures in young mice. METHODS: Fifteen male ICR mice at postnatal day 21 were divided into pilocarpine-treated (n=7) and control (n=8) groups. Seizures were chemically induced by intraperitoneal injection of pilocarpine (300 mg/kg). Bromodeoxyuridine (BrdU, 50 mg/kg) was subsequently administered once a day for 6 consecutive days, starting at 24 hours after pilocarpine or saline treatment. We then examined BrdU-positive cells in the hippocampal dentate gyrus by immunohistochemistry and by double-labeled immunofluorescence with confocal microscopy. RESULTS: After pilocarpine administration, every seizure behavior was grade 3 or more. Quantitative analysis revealed that BrdU-positive cells were significantly increased in the pilocarpine-treated group compared to control (230.5+/-59.5 vs. 148.6+/-40.0, P<0.001). The majority of these mitotic cells were differentiated into neurons. CONCLUSION: Our results indicated that mitotic activity in the hippocampal dentate gyrus was enhanced after pilocarpine-induced seizures in young mice, and the majority of BrdU-positive cells showed the phenotypic differentiation to neuronal cells.
Adult ; Animals ; Bromodeoxyuridine ; Dentate Gyrus ; Epilepsy ; Fluorescent Antibody Technique ; Humans ; Immunohistochemistry ; Injections, Intraperitoneal ; Male ; Mice ; Mice, Inbred ICR ; Neurogenesis ; Neurons ; Pilocarpine ; Rats ; Rodentia ; Seizures

PURPOSE: During hemodialysis, various methods are used to evaluate adequate water removal; however, few of them are currently clinically applicable. To evaluate the differences of body fluid changes, we have compared changes of ICW (intracellular water) and ECW (extracellular water) before and after hemodialysis in diabetic and non-diabetic patients with MF-BIA. Also various factors influencing in this transcellular body fluid shift were evaluated. METHODS: TBW (total body water), ICW, ECW were measured before and after hemodialysis by using MF-BIA in 85 stable maintenance hemodialysis patients in a university hospital. Among these patients, 30 patients (mean age 55.6+/-12.4 year-old, average dialysis duration 26 months) were diabetic, while 55 patients (mean age 47.1+/-13.0 year-old, average dialysis duration 69 months) were non-diabetic. RESULTS: ECW/TBW in diabetic and non-diabetic patients were 0.338+/-0.02, 0.334+/-0.02, respectively. There was no significant difference between two groups. There were also no significant differences in the sex, age, duration of dialysis, BMI, hemoglobin, total protein, osmolarity of ICW loss/TBW removal. But there was a significant positive correlation between the increase in ultrafiltration volume (UFV:%) and ICW loss in diabetic patients (R=0.51, p=0.019); however, such correlation was not observed in non-diabetic patients. CONCLUSION: We found that ICW of diabetic patients moved to extracellular spaces even before achieving appropriate dry body weight or less amount of fluid was removed compared to non-diabetic patients. This finding might imply diabetic ESRD patient has relatively low cellular membrane integrity and oncotic pressure maintenance ability to physical transmembrane pressure.
Body Fluids ; Body Weight ; Diabetes Mellitus ; Dialysis ; Electric Impedance ; Extracellular Space ; Hemoglobins ; Humans ; Kidney Failure, Chronic ; Maintenance ; Membranes ; Osmolar Concentration ; Renal Dialysis ; Ultrafiltration

Lichen spinulosus is a benign follicular eruption seen primarily in younger persons and is frequently classified a disorder of keratinization. The lesion is characterized by the development of patches of small perifollicular papules that have a central horny spine. We report a case of lichen spinulosus developed in an 8-year-old male patient who had atopic dermatitis.
Child ; Dermatitis, Atopic ; Humans ; Lichens* ; Male ; Spine