OBJECTIVE: To correlate the MRI findings in acute and chronic stage of Wemicke encephalopathy with the well-known clinical and pathologic findings. Background. Wemicke encephalopathy is an acute phase of Wemicke-Korsakoff syndrome. Pathologic findings change between acute and chronic phases. Only a few MRI studies have been done in this disease to date. METHODS: Ten consecutive patients with Wemicke encephalopathy were evaluated with MRI; seven within 24 hours of thiamine treatment, and three between 2 and 4 days. They presented with confusion, ophthalmoplegia and gait ataxia which improved with intravenous thiamine. Korsakoff psychosis became evident on followup. Tl-, proton- and T2-weighted axial images were obtained with additional 5 mmthick Tl-weighted sagittal and coronal images to evaluate the morphology and size of the mammillary body. RESULTS: Increased T2 signal was seen in the periaqueductal area in seven(sometimes involving superior colliculus); medial thalamus in five; and splenium of the corpus callosum in two. Among the seven patients with T2 signal abnormalities, five had follow-up MRI in 2 to 70 days, which showed complete resolution of the abnormalities. Seven patients showed atrophy of mammillary body on the initial MRI. In the three patients who had normal mammillary body in size on initial scan, follow up MRI revealed atrophic change of mammillary body. Tlweighted sagittal image showed superior cerebellar vermis atrophy in seven. Four patients revealed dilatation of the third ventricle. CONCLUSION: MRI findings of Wernicke encephalopathy appear diagnostic in acute stage and may reflect the pathological evolution in acute and chronic phases of Wernicke-Korsakoff syndrome.
Atrophy ; Corpus Callosum ; Dilatation ; Follow-Up Studies* ; Gait Ataxia ; Humans ; Korsakoff Syndrome ; Magnetic Resonance Imaging* ; Mamillary Bodies ; Ophthalmoplegia ; Thalamus ; Thiamine ; Third Ventricle ; Wernicke Encephalopathy*

OBJECTIVES: This study was undertaken to confirm the clinical characteristics of recurrent pleomorphic adenoma (RPA), and to identify those factors that affect the development of malignant transformation (MT) from RPA. METHODS: The medical records of 270 patients, who were operated upon for parotid PA, were retrospectively reviewed. The pathologic specimens of a selected series of 23 patients were reviewed for histologic subtype and microscopic multi-nodularity. RESULTS: Mean age of initial operation in RPA without MT (RPA(-MT)) group was significantly lower than that of primary PA group. Mean age of the revision operation in RPA with MT (RPA(+MT)) group was significantly greater than that of RPA(-MT) group. Mean interval from operation to recurrence shortened after each revision operation. The risk of MT and additional recurrence increased significantly with recurrence. In RPA(-MT) group tumor recurrence occurred in 21.4% of patients despite a clear resection margin. CONCLUSION: The risk factors for MT may be an age of over 45 yr and multiple recurrences. However, younger patients are more at risk of recurrence. A clear resection margin cannot guarantee a cure in RPA, and it seems that parotid pleomorphic adenomas slowly gain malignant characteristics after repeated recurrences.
Adenoma, Pleomorphic ; Humans ; Medical Records ; Recurrence ; Retrospective Studies ; Risk Factors

Outbreaks of porcine reproductive and respiratory syndrome virus (PRRSV) in vaccinated sow herds from occurrence to stabilization were monitored and analyzed in terms of serology and reproductive performance. Three different conventional pig farms experienced severe reproductive failures with the introduction of a type 1 PRRSV. These farms had adopted mass vaccination of sows using a type 2 PRRSV modified live vaccine (MLV). Therefore, to control the type 1 PRRSV, an alternative vaccination program utilizing both type 1 and type 2 MLV was undertaken. Following whole herd vaccinations with both types of MLV, successful stabilization of PRRS outbreaks was identified based on serological data (no viremia and downward trends in ELISA antibody titers in both sows and suckling piglets) and recovery of reproductive performance. Additionally, through comparison of the reproductive parameters between outbreak and non-outbreak periods, it was identified that PRRSV significantly affected the farrowing rate and the number of suckling piglets per litter at all three pig farms. Comparison of reproductive parameters between periods when the different vaccination strategies were applied revealed that the number of piglets born in total and born dead per litter were significantly increased after the introduction of the type 1 PRRS MLV.
Agriculture ; Disease Outbreaks ; Enzyme-Linked Immunosorbent Assay ; Immunity, Herd ; Immunity, Heterologous ; Mass Vaccination ; Porcine Reproductive and Respiratory Syndrome ; Porcine respiratory and reproductive syndrome virus ; Vaccination ; Viremia

BACKGROUND AND OBJECTIVES: S100 calcium-binding proteins are known to play multiple roles in progression and invasion of various carcinomas. In this study, we focused on two kinds of these proteins, S100A4 and S100A2, and investigated their expressions in thyroid neoplasm. SUBJECTS AND METHOD: We investigated S100A4 and S100A2 expressions in 75 thyroid neoplasms by immunohistochemistry. RESULTS: S100A4 and S100A2 were not expressed in normal thyroid follicles or follicular carcinomas. Positive relationships were established between S100A4 expression and size (p=.014), invasiveness (p=.029) and T stage (p=.004) of papillary carcinomas. Especially, the S100A4 expression was observed more frequently in the peripheral area (p=.046). But there was no correlation between S100A4 expression with multiple tumor formation and lymph node metastasis. Positive relationships were established between S100A2 expression and size (p=.041), invasiveness (p=.008) and T stage (p<.001) of papillary carcinomas. S100A4 expression was also observed more frequently in the peripheral area (p=.001). CONCLUSION: These findings suggest that S100A4 and S100A2 contribute to the progression and local invasion of thyroid carcinoma.
Calcium-Binding Proteins ; Carcinoma, Papillary ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms*

BACKGROUND AND OBJECTIVES: Parapharyngeal space tumors are extremely rare head and neck tumors. Therefore, there are just a few reports about them. The purpose of this study was to report our experiences of parapharyngeal space (PPS )tumors regarding clinicopathological features and management. SUBJECTS AND METHOD: This study included 51 patients with PPS tumors which were diagnosed from January 1990 through June 2004. Medical records were reviewed retrospectively. RESULTS: The male-to-female ratio was close to 1:1. The mean age was 47 years (6 mo -83 Y ). The most frequent presenting manifestation was asymptomatic neck mass. All patients were subjected to CT scan, while 31 patients underwent MRI in addition. Diagnostic accuracy of fine needle aspiration cytology of 28 cases matched with pathologic reports by 50%. Salivary gland neoplasms occupied the biggest parts (43.1%, 53.8%)of both benign and malignant PPS tumors. Thirteen patients (25.5%)had malignant lesions. Surgical excision was performed in 39 cases (76.5%). The transcervical (30.8%)and the transcervical-transparotid approaches (38.5%)were commonly performed surgical procedures. Overall postoperative morbidity rate was 23.1%. There were 3 recur-rences (42.8%)in malignant tumors and no recurrence in benign ones after surgical excision during the mean follow-up period of 35 months (13 -89 mo ). Close observation, sclerotherapy and radiotherapy were only applicable for a few selected benign lesions. CONCLUSION: Most benign PPS tumors could be removed surgically with low complication and recurrence rates. Optimal surgical approach based on transcervical approach allows safe removal of various types of PPS tumors.
Biopsy, Fine-Needle ; Follow-Up Studies ; Head ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Neck ; Neurilemmoma ; Paraganglioma ; Parotid Neoplasms ; Radiotherapy ; Recurrence ; Retrospective Studies ; Salivary Gland Neoplasms ; Sclerotherapy ; Tomography, X-Ray Computed

OBJECTIVE: Suicide is a significant public health concern worldwide. Social media data have a potential role in identifying high suicide risk individuals and also in predicting suicide rate at the population level. In this study, we report an advanced daily suicide prediction model using social media data combined with economic/meteorological variables along with observed suicide data lagged by 1 week. METHODS: The social media data were drawn from weblog posts. We examined a total of 10,035 social media keywords for suicide prediction. We made predictions of national suicide numbers 7 days in advance daily for 2 years, based on a daily moving 5-year prediction modeling period. RESULTS: Our model predicted the likely range of daily national suicide numbers with 82.9% accuracy. Among the social media variables, words denoting economic issues and mood status showed high predictive strength. Observed number of suicides one week previously, recent celebrity suicide, and day of week followed by stock index, consumer price index, and sunlight duration 7 days before the target date were notable predictors along with the social media variables. CONCLUSION: These results strengthen the case for social media data to supplement classical social/economic/climatic data in forecasting national suicide events.
Forecasting ; Public Health ; Social Media* ; Suicide* ; Sunlight

Outbreaks of porcine reproductive and respiratory syndrome virus (PRRSV) in vaccinated sow herds from occurrence to stabilization were monitored and analyzed in terms of serology and reproductive performance. Three different conventional pig farms experienced severe reproductive failures with the introduction of a type 1 PRRSV. These farms had adopted mass vaccination of sows using a type 2 PRRSV modified live vaccine (MLV). Therefore, to control the type 1 PRRSV, an alternative vaccination program utilizing both type 1 and type 2 MLV was undertaken. Following whole herd vaccinations with both types of MLV, successful stabilization of PRRS outbreaks was identified based on serological data (no viremia and downward trends in ELISA antibody titers in both sows and suckling piglets) and recovery of reproductive performance. Additionally, through comparison of the reproductive parameters between outbreak and non-outbreak periods, it was identified that PRRSV significantly affected the farrowing rate and the number of suckling piglets per litter at all three pig farms. Comparison of reproductive parameters between periods when the different vaccination strategies were applied revealed that the number of piglets born in total and born dead per litter were significantly increased after the introduction of the type 1 PRRS MLV.

BACKGROUND/AIMS: Since patients with human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) have favorable outcomes after treatment, treatment de-escalation for these patients is being actively investigated. However, not all HPV-positive HNSCCs are curable, and some patients have a poor prognosis. The purpose of this study was to identify poor prognostic factors in patients with HPV-positive HNSCC. METHODS: Patients who received a diagnosis of HNSCC and tested positive for HPV from 2000 to 2015 at a single hospital site (n = 152) were included in this retrospective analysis. HPV typing was conducted using the HPV DNA chip assay or liquid bead microarray system. Expression of p16 in the tumors was assessed by immunohistochemistry. To determine candidate factors associated with overall survival (OS), univariate and multivariable Cox regression analyses were performed. RESULTS: A total of 152 patients with HPV-positive HNSCC were included in this study; 82.2% were male, 43.4% were current or former smokers, and 84.2% had oropharyngeal cancer. By univariate analysis, old age, performance status ≥ 1, non-oropharyngeal location, advanced T classification (T3–4), and HPV genotype 18 were significantly associated with poor OS. By multivariable analysis, performance status ≥ 1 and non-oropharyngeal location were independently associated with shorter OS (hazard ratio [HR], 4.36, p = 0.015; HR, 11.83, p = 0.002, respectively). Furthermore, HPV genotype 18 positivity was also an independent poor prognostic factor of OS (HR, 10.87, p < 0.001). CONCLUSIONS Non-oropharyngeal cancer, poor performance status, and HPV genotype 18 were independent poor prognostic factors in patients with HPV-positive HNSCC. Patients with these risk factors might not be candidates for de-escalation treatment.