PURPOSE: To define the CT findings of inflammatory pseudotumor of the lung, and determine pathologiccorrelation. MATERIALS AND METHODS: We retrospectively analyzed the CT scans of seven patients withpathologically-proven (surgery:n=6; automated gun biopsy:n=1) inflammatory pseudotumor of the lung. Postcontrastscans were obtained in six cases, while one underwent only precontrast scanning. In all cases, these resultscorrelated with pathologic findings. RESULTS: In five cases, CT showed that irregular, spiculated nodules ormasses contacted with the pleura; in one, a well-defined nodule contacted with the fissure; and in one, there wasconsolidation. On postcontrast CT images, all six cases showed enhancement, with a central, low-density component. In four cases, ground-glass opacity surrounding the lesion was identified, and in three focal pleural thickeningadjacent to the lesion was noted. The predominant pathologic composition of the enhanced portions of the lesion,as seen on CT, was chronic inflammatory or spindle cells, and the angiogenesis of small vessels was also noted.Non-enhanced, central, low-density areas were accounted for by hemorrhaging, necrosis and the focal aggregation ofacute and chronic inflammatory cells. Surrounding gound-glass opacity corresponded pathologically to organizingpneumonia, cellular infiltration along the alveolar wall, and alveolar collapse. CONCLUSION: The CT features ofinlammatory pseudotumor of the lung were mainly peripheral irregular, spiculated nodule or mass, withcontrast-enhancement and a central low-density component, combined with surrounding ground-glass opacity. Allthese findings correlated well with pathologic findings.
Granuloma, Plasma Cell* ; Humans ; Lung* ; Necrosis ; Pleura ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: The purpose of this study was to survey the nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) among the patients admitted in a medical intensive care unit (MICU) and analyze risk factors associated with the colonization. METHODS: The study was carried out on patients admitted into the MICU in a 1,250-bed tertiary care university hospital from January through December 2006. Nasal surveillance cultures were obtained from patients within 24 hours of admission to the unit. Data were analyzed retrospectively by the review of medical records. RESULTS: A total of 312 patients were screened with active nasal cultures; 36 patients (11.6%) were positive for MRSA. Of these, 22 (7.1%) were positive in the nasal cultures only and 14 (4.5%) were positive in the cultures of other specimens (13, sputum; 1, joint fluid) in addition to the nasal swabs. Among the risk factors for MRSA nasal colonization were sex (man), route of admission (from other ICUs or wards), a history of ICU admission during the recent 12 months, and prolonged hospital days in ICU. CONCLUSION: MRSA nasal carrier rate was found higher in this study than in those reported in the literature. Most of the patients colonized with MRSA in the nostril were not colonized with the organism elsewhere in the body. Whether or not active surveillance for MRSA should be performed would depend on the nasal colonization rate of the patients at the time of admission to the ICU.
Colon* ; Humans ; Intensive Care Units* ; Critical Care* ; Joints ; Medical Records ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Retrospective Studies ; Risk Factors ; Sputum ; Tertiary Healthcare

The segmental spread of epidural analgesia was measured in seventeen surgical patients aged between 17 and 52 years, and in fourteen patients between 60 and 77 years. The upper level in the young was 6.29(+/-1.56) thoracic vertebra level, but in the elderly was 4 (+/-0.65_ thoracic vertebra level at 20 minutes after epidural injection of 1.5% lidocaine 20 ml. A given volume of solution spreads to 0.9, 1.07, 1.54, 2.29 segments greater upper extent at 5, 10, 15, 20 minutes after epidural injection and 0.57, 1.07 segments greater lower extent at 5, 10 minutes in the elder than young. So with increasing age relatively small amounts of solution are required, to produce the same extent of anesthesia in the young.
Aged* ; Analgesia, Epidural* ; Anesthesia ; Humans ; Injections, Epidural ; Lidocaine ; Spine

Central neurocytoma, a cerebral intraventricular tumor, is usually benign. It frequently develops in the area of the foramen of Monro, and is usually attached to the septum pellucidum. Mild to moderate contrast enhancement is common. We encountered a case of central neurocytoma in a 60-year-old woman; the tumor arose from the atrium of the lateral ventricle, and extraventricular extension and malignant transformation were apparent. CT and MRI revealed a well-defined, slightly heterogeneous mass measuring 2.5x3x5cm with surrounding edema. There was strong contrast enhancement of the mass.
Cerebral Ventricles ; Edema ; Female ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging ; Middle Aged ; Neurocytoma* ; Septum Pellucidum

Despite the recognized desirability of spenic salvage,forced splenectomy remains the rule in many operative situations,including trauma and pancreatic cancer. The aim of this study was to evaluate the phagocytic function,histologic finding and anatomic change when the perfusion of preserved spleen was done only through short gastric vessels after splenic vessel ligation. In this situation, we evaluate the necessity of mass reduction to improve the perfusion into the residual spleen by 2/3 patial splenectomy. We studied 41 Sprague-Dawley rats by subdiving them into 3 main groups.In HL(;Hilar ligation)group, splenic vessel ligation was done(n=18). In HLS(Hilar ligation + 2/3partial splenectomy), splenic vessel ligation and partial splenectomy were done(n=18), and the others(n=5) were used as a control group. The changes of anatomy,histologic findings, and phagocytic functions in the preserved splenic tissue were observed at 1hour,2weeks, and 5months postoperatively,based on results of the India ink technique for demonstrating phagocytic function and on results of regular histologic examination. In all rats,at least 1 upper short gastric vessel was noted without direct connection to splenic vessel.In HL group,at 2weeks postoperatively,the size and weight of the preserved spleens were severely decreased to 1/3 of those of control group(p=0.0002). But,after 5months,the size and weight recovered to about 70-80% of those of initial spleen parameters.In HLS group,the size and weight changes were not found.At 1hour postoperatively phagocytic activity decreased to 35% in the control group,10% at 2weeks and not improved at 5months in both groups.The white pulps didn't show any specific change. We concluded that in spite of splenic mass reduction,the white pulp did not change, and phagocytic function was not improved.Therefore,the splenic mass reduction is not essential for the recovery of phagocytic function at the preserved spleen.
Animals ; India ; Ink ; Ligation ; Pancreatic Neoplasms ; Perfusion ; Rats* ; Rats, Sprague-Dawley ; Spleen ; Splenectomy

PURPOSE: Lycopene, a carotenoid with anti-oxidant properties, occurs naturally in tomatoes and pink grapefruit. Although the beneficial effects of lycopene on various disorders have been established, little attention has been paid to the possible anti-diabetic effects of lycopene focusing on β-cells. Therefore, this study investigated the potential of lycopene to protect β-cells against apoptosis induced by a cytokine mixture. METHODS: For toxicity experiments, the cells were treated with 0.1 ~ 10 nM of lycopene, and the cell viability in INS-1 cells (a rat β-cell line) was measured using a MTT assay. To induce cytokine toxicity, the cells were treated with a cytokine mixture (20 ng/mL of TNFα+20 ng/mL of IL-1β) for 24 h, and the effects of lycopene (0.1 nM) on the cytokine toxicity were measured using the MTT assay. The expression levels of the apoptotic proteins were analyzed by Western blotting, and the level of intracellular reactive oxidative stress (ROS) was monitored using a DCFDA fluorescent probe. The intracellular ATP levels were determined using a luminescence kit, and mRNA expression of the genes coding for anti-oxidative stress response and mitochondrial function were analyzed by quantitative reverse-transcriptase PCR. RESULTS: Exposure of INS-1 cells to 0.1 nM of lycopene increased the cell viability significantly, and protected the cells from cytokine-induced death. Lycopene upregulated the mRNA and protein expression of B-cell lymphoma-2 (Bcl-2) and reduced the expression of the Bcl-2 associated X (Bax) protein. Lycopene inhibited apoptotic signaling via a reduction of the ROS, and this effect correlated with the upregulation of anti-oxidative stress response genes, such as GCLC, NQO1, and HO-1. Lycopene increased the mRNA expression of mitochondrial function-related genes and increased the cellular ATP level. CONCLUSION: These results suggest that lycopene reduces the level of oxidative stress and improves the mitochondrial function, contributing to the prevention of cytokine-induced β-cell apoptosis. Therefore, lycopene could potentially serve as a preventive and therapeutic agent for the treatment of type 2 diabetes.
Adenosine Triphosphate ; Animals ; Apoptosis* ; B-Lymphocytes ; Blotting, Western ; Cell Survival ; Citrus paradisi ; Clinical Coding ; Luminescence ; Lycopersicon esculentum ; Oxidative Stress ; Polymerase Chain Reaction ; Rats ; RNA, Messenger ; Up-Regulation

Background: There has been controversy regarding the association between primary aldosteronism (PA) and dyslipidemia and few studies considered the effects of diabetes and renal function on lipid metabolism. We analyzed lipid profiles of PA patients and compared them to propensity-score (PS)-matched essential hypertension (EH) patients adjusting for glycemic status and renal function. Methods: Patients who were diagnosed with PA using a saline-infusion test at Seoul National University Hospital from 2000 to 2018 were retrospectively analyzed. EH patients who had aldosterone-renin ratio (ARR) results were selected as controls. Covariates, including diabetes, were PS-matched for patients with PA, lateralized PA, non-lateralized PA, and high ARR to EH patients, respectively. Results: Among a total of 80 PA and 80 EH patients, total cholesterol (TC) and triglyceride (TG) levels were significantly lower in the PA patients than in the EH patients (least-squares mean±standard error: 185.5±4.4 mg/dL vs. 196.2±4.4 mg/dL, P=0.047, for TC; and 132.3±11.5 mg/dL vs. 157.4±11.4 mg/dL, P=0.035, for TG) in fully adjusted model (adjusting for multiple covariates, including diabetes status, glycosylated hemoglobin level, and estimated glomerular filtration rate). There were no significant differences in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels between the two groups. According to increments in aldosterone levels, an increasing tendency of HDL-C and decreasing tendencies of TG and non-HDL-C were observed. Conclusion PA patients had lower TC and TG levels than EH patients, independent of glycemic status and renal function.

The incidence of small and asymptomatic pancreatic neuroendocrine neoplasms (PNENs) has been increased due to the widespread use of high-resolution imaging techniques and endoscopic procedures in screening programmes. Most of PNENs are indolent neoplasms with slow-growing. However, sometimes, PNENs show local invasion or metastasis with poor prognosis. The management of small, nonfunctioning PNENs remain under debate. The National Comprehensive Cancer Network guidelines recommend observation in selected cases of small PNENs less than 2 cm. Pancreatic surgeons are divided into two factions: “the hawks,” who indicate the high risk of malignancy even in small PNENs and, therefore, the need for an aggressive surgical treatment, and the “the doves,” who accepts the risk of malignancy in some ≤ 2 cm PNENs, advocate that the risk of overtreating many benign ≤ 2 cm PNENs would be much higher. As the pancreatic surgery remains a high-risk operation with a 28–30% morbidity and 1% mortality, the decision for small PNENs is challenging.

Background: There has been controversy regarding the association between primary aldosteronism (PA) and dyslipidemia and few studies considered the effects of diabetes and renal function on lipid metabolism. We analyzed lipid profiles of PA patients and compared them to propensity-score (PS)-matched essential hypertension (EH) patients adjusting for glycemic status and renal function. Methods: Patients who were diagnosed with PA using a saline-infusion test at Seoul National University Hospital from 2000 to 2018 were retrospectively analyzed. EH patients who had aldosterone-renin ratio (ARR) results were selected as controls. Covariates, including diabetes, were PS-matched for patients with PA, lateralized PA, non-lateralized PA, and high ARR to EH patients, respectively. Results: Among a total of 80 PA and 80 EH patients, total cholesterol (TC) and triglyceride (TG) levels were significantly lower in the PA patients than in the EH patients (least-squares mean±standard error: 185.5±4.4 mg/dL vs. 196.2±4.4 mg/dL, P=0.047, for TC; and 132.3±11.5 mg/dL vs. 157.4±11.4 mg/dL, P=0.035, for TG) in fully adjusted model (adjusting for multiple covariates, including diabetes status, glycosylated hemoglobin level, and estimated glomerular filtration rate). There were no significant differences in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels between the two groups. According to increments in aldosterone levels, an increasing tendency of HDL-C and decreasing tendencies of TG and non-HDL-C were observed. Conclusion PA patients had lower TC and TG levels than EH patients, independent of glycemic status and renal function.

The incidence of small and asymptomatic pancreatic neuroendocrine neoplasms (PNENs) has been increased due to the widespread use of high-resolution imaging techniques and endoscopic procedures in screening programmes. Most of PNENs are indolent neoplasms with slow-growing. However, sometimes, PNENs show local invasion or metastasis with poor prognosis. The management of small, nonfunctioning PNENs remain under debate. The National Comprehensive Cancer Network guidelines recommend observation in selected cases of small PNENs less than 2 cm. Pancreatic surgeons are divided into two factions: “the hawks,” who indicate the high risk of malignancy even in small PNENs and, therefore, the need for an aggressive surgical treatment, and the “the doves,” who accepts the risk of malignancy in some ≤ 2 cm PNENs, advocate that the risk of overtreating many benign ≤ 2 cm PNENs would be much higher. As the pancreatic surgery remains a high-risk operation with a 28–30% morbidity and 1% mortality, the decision for small PNENs is challenging.