A 33-year-old man was evaluated because of an incidentally found cyst in the pancreatic tail, which was first seen 6 years ago. The cyst was a unilocular cystic mass, 13.0 cm in diameter, and had increased in size in last 2 months. On F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), the cystic wall showed increased FDG uptake. The patient underwent distal pancreatectomy with suspicion of mucinous cystic neoplasm of the pancreas. The mass turned out to be a squamous carcinoma arising from an epidermoid cyst in an intrapancreatic accessory spleen (ECIPAS). FDG PET/CT may assist recognition of a potential malignant lesion arising from an ECIPAS.

In critically ill patients, disseminated intravascular coagulation (DIC) is a common and fatal hematological disorder. DIC is a physiological response to a variety of underlying stimuli that provoke generalized activation of the hemostatic mechanism and is common in septic patients and those with hematological or non-hematological malignant neoplasms. Bleeding is a common clinical feature, and diffuse or multiple-site mucocutaneous bleeding, such as petechia, ecchymosis and hemorrhage from gastrointestinal tract, is often seen. A 58-year-old male was recently diagnosed with intracranial hemorrhage (ICH) caused by DIC associated with sepsis. Mortality of ICH caused by DIC is very high because the underlying condition cannot be quickly treated. Awareness of the possibility of DIC developing in a critically ill patient and the need for immediate initiation of plasma or platelet replacement therapy are important. To the best of our knowledge, this is the first reported case of intracranial hemorrhage in a Korean patient with DIC associated with sepsis.
Blood Platelets ; Critical Illness ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Ecchymosis ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intracranial Hemorrhages* ; Male ; Middle Aged ; Mortality ; Plasma ; Sepsis*

This work aimed to assess some pharmacological activities of P. leptostachya var. asiatica Hara. The dried roots of P. leptostachya var. asiatica Hara were extracted with 70% ethanol to generate the powdered extract, named PLE. Anti-angiogenic activity was detected using chick chorioallantoic membrane (CAM) assay. In vitro anti-inflammatory activity was evaluated via analyzing nitric oxide (NO) content, inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophage cells. Antioxidant activity was determined by 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay and reactive oxygen species (ROS) level in the stimulated macrophage cells. Matrix metalloproteinase-9 (MMP-9) and -2 (MMP-2) activities in the culture media were detected using zymography. PLE exhibits an anti-angiogenic activity in the CAM assay, and displays an inhibitory action on the generation of NO in the LPS-stimulated macrophage cells. In the stimulated macrophage cells, it is able to diminish the enhanced ROS level. It can potently scavenge the stable DPPH free radical. It suppresses the induction of iNOS and COX-2 and the enhanced MMP-9 activity in the stimulated macrophage cells. Both monooxygenase and oxidase activities of tyrosinase were strongly inhibited by PLE. Taken together, the dried roots of P. leptostachya var. asiatica Hara possess anti-angiogenic, anti-inflammatory, antioxidant and skin whitening activities, which might partly provide its therapeutic efficacy in traditional medicine.
Chorioallantoic Membrane ; Culture Media ; Cyclooxygenase 2 ; Ethanol ; Macrophages ; Matrix Metalloproteinase 9 ; Medicine, Traditional ; Monophenol Monooxygenase ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Oxidoreductases ; Reactive Oxygen Species ; Skin*

Magrjetic resonance (MR) imagings with 0.15 Tesla resistive magnet developed by Korea Advanced Institute of 5cience were performed in 27 patients with various neurologic diseases and compared with X-ray computed tomography (CT). The purpose óf the paper is to evaluate the image quality, the diagnostic value and limitation, and the optimal pulse sequence of MR imagings with a resistive magnet. The MR images were obtained by using a variety of pulse sequence with spin echo technique includïng saturation recovery, T2-weighted spin echo, and/or inversion recovery with various pulse repetition(TR) and echo delay (TE) times. The M R imaging demonstrated the capability of detecting the lesions shown on CT in all cases and also detected an additional finding in one case (multiple sclerosis) which was not seen on CT. The MR imaging appeared to be more useful than CT in the evaluation of syringomyelia of spinal cord and white matter disease, while it failed to demonstrate small calcific lesion or inflammatory nodule (less than 1 cm) shown on CT and has shown somewhat poor contrast resolution in the case of meningioma. The spatial resolution of saturation recovery images was similar or superior to CT, whereas the contrast resolution of saturation recovery was inferior to CT. While the saturation recovery images have shown false negative findings in 5 patients (19%), the inversion recovery and T2-weighted spin echo have shown consistently positive findings. The inversion recovery and T2-weighted spin echo images demonstrated better contrast discrimination between normal and pathologic conditions than the saturation recovery images, but somewhat poorer spatial resolution. Authors suggest that the MR images of both the saturation recovery with 300/30 and T2-weighted spin echo with 1000/90 be used as a routine procedure and additional iversion recovery of 1300/300/30 sequence as a option if white matter disease is suspected.
Discrimination (Psychology) ; Humans ; Korea ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Meningioma ; Spinal Cord ; Syringomyelia ; Tomography, X-Ray Computed

Purpose: We assessed prognostic implication of bone marrow uptake on baseline F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with advanced-stage diffuse large B-cell lymphoma (DLBCL). Methods: We retrospectively reviewed 140 patients with stage III and IV DLBCL, who underwent baseline F-18 FDG PET/CT at diagnosis. Bone marrow uptake on F-18 FDG PET/CT (BM FDG) was compared with findings on bone marrow biopsy (BMB), and patients were grouped based on these results: BMB-positive and BM FDG-positive (group 1), BMB-positive and BM FDG-negative (group 2), BMB-negative and BM FDG-positive (group 3), and BMB-negative and BM FDG-negative (group 4). The prognostic value of clinicopathologic factors and BM FDG for predicting progression-free survival (PFS) and overall survival (OS) was assessed using a Cox proportional hazards model. Differences in PFS and OS were examined by the Kaplan-Meier method. Results: BMB was the only significant indicator in predicting PFS, and age, IPI score higher than 3, and BM FDG significantly predicted OS. Group 1 showed inferior PFS than group 2 (median PFS, 7.4 vs. 13.9 months; p = 0.04). In contrast, there was no significant difference either in PFS or OS between group 2 and group 3. Conclusion We showed that BM FDG-positive predicted a poorer survival in patients with advanced stage DBLCL. We also found that BMB-negative and BM FDG-positive patients had similar PFS or OS to BMB-positive and BM FDG-negative patients. Further study in a larger population is needed to clarify clinical significance of BM FDG in these patients.

Purpose: Predicting human papillomavirus (HPV) status is critical in oropharyngeal squamous cell carcinoma (OPSCC) radiomics. In this study, we developed a model for HPV status prediction using magnetic resonance imaging (MRI) radiomics and18F-fluorodeoxyglucose ( 18F-FDG) positron emission tomography (PET)/computed tomography (CT) parameters in patients withOPSCC. Materials and Methods: Patients with OPSCC who underwent 18F-FDG PET/CT and contrast-enhanced MRI before treatment between January 2012 and February 2020 were enrolled. Training and test sets (3:2) were randomly selected. 18F-FDG PET/CT parameters and MRI radiomics feature were extracted. We developed three light-gradient boosting machine prediction models using the training set: Model 1, MRI radiomics features; Model 2, 18F-FDG PET/CT parameters; and Model 3, combination of MRI radiomics features and 18F-FDG PET/CT parameters. Area under the receiver operating characteristic curve (AUROC) values were used to analyze the performance of the models in predicting HPV status in the test set. Results: A total of 126 patients (118 male and 8 female; mean age: 60 years) were included. Of these, 103 patients (81.7%) were HPV-positive, and 23 patients (18.3%) were HPV-negative. AUROC values in the test set were 0.762 [95% confidence interval (CI), 0.564–0.959], 0.638 (95% CI, 0.404–0.871), and 0.823 (95% CI, 0.668–0.978) for Models 1, 2, and 3, respectively. The net reclassification improvement of Model 3, compared with that of Model 1, in the test set was 0.119. Conclusion When combined with an MRI radiomics model, 18F-FDG PET/CT exhibits incremental value in predicting HPV status in patients with OPSCC.

PURPOSE: There are few studies evaluating the usefulness of dedicated high-resolution scintimammography and no studies using delayed washout with this dedicated high resolution scintimammography for the evaluation of breast lesions. We underwent this study to evaluate the clinical usefulness of Tc-99m MIBI in evaluating patients with palpable breast lesions using dedicated high-resolution scintimammography. MATERIALS AND METHODS: This study included 19 patients with 23 palpable breast lesions who underwent mammography. Tc-99m MIBI was taken to further characterize these lesions. Scintimammography images were acquired with standard craniocaudal and mediolateral oblique views and delayed images were additionally taken. Final conclusions were based on histopathology, either by biopsy or mastectomy results. RESULTS: Eighteen lesions were malignant and five were benign. Mammography was indeterminate for thirteen lesions, nine of those were malignant. Mammography also categorized one lesion as benign in a dense breast, but scintimammography and pathology results showed malignancy. Of the five benign lesions, two were visible on scintimammography, but delayed images showed washout. CONCLUSION: Based on our preliminary results, dedicated high resolution scintimammography seems to be very useful in characterizing palpable lesions that were indeterminate or negative on mammography.
Biopsy ; Breast ; Breast Neoplasms ; Humans ; Mammography ; Mastectomy

BACKGROUND: Carotid intima media thickness (CIMT) and the presence of carotid plaque have been used for risk stratification of cardiovascular disease (CVD). To date, however, the association between multi-directional functional properties of carotid artery and CVD has not been fully elucidated. We sought to explore the multi-directional mechanics of the carotid artery in relation to cardiovascular risk. METHODS: Four hundred one patients who underwent carotid ultrasound were enrolled between January 2010 and April 2013. A high risk of CVD was defined as more than 20% of 10-year risk based on the Framingham risk score. Using a speckle-tracking technique, the longitudinal and radial movements were analyzed in the B-mode images. Peak longitudinal and radial displacements, strain and strain rate were also measured. Beta stiffness and elastic modulus index were calculated from the radial measurements. RESULTS: Of the overall sample, 13% (52) of patients comprised the high-risk group. In multivariate logistic regression, CIMT and elastic modulus index were independently associated with a high-risk of CVD {odds ratio (OR): 1.810 [95% confidence interval (CI) 1.249–2.622] and OR: 1.767 (95% CI: 1.177–2.652); p = 0.002, 0.006, respectively}. The combination of CIMT and elastic modulus index correlated with a high-risk of CVD more so than CIMT alone. CONCLUSION: The elastic modulus index of the carotid artery might serve as a novel surrogate marker of high-risk CVD. Measurement of the multi-directional mechanics of the carotid artery using the speckle tracking technique has potential for providing further information over conventional B-mode ultrasound for stratification of CVD risk.
Biomarkers* ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Intima-Media Thickness ; Elastic Modulus* ; Humans ; Logistic Models ; Mechanics ; Ultrasonography*

In critically ill patients, disseminated intravascular coagulation (DIC) is a common and fatal hematological disorder. DIC is a physiological response to a variety of underlying stimuli that provoke generalized activation of the hemostatic mechanism and is common in septic patients and those with hematological or non-hematological malignant neoplasms. Bleeding is a common clinical feature, and diffuse or multiple-site mucocutaneous bleeding, such as petechia, ecchymosis and hemorrhage from gastrointestinal tract, is often seen. A 58-year-old male was recently diagnosed with intracranial hemorrhage (ICH) caused by DIC associated with sepsis. Mortality of ICH caused by DIC is very high because the underlying condition cannot be quickly treated. Awareness of the possibility of DIC developing in a critically ill patient and the need for immediate initiation of plasma or platelet replacement therapy are important. To the best of our knowledge, this is the first reported case of intracranial hemorrhage in a Korean patient with DIC associated with sepsis.
Blood Platelets ; Critical Illness ; Dacarbazine ; Disseminated Intravascular Coagulation ; Ecchymosis ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Male ; Middle Aged ; Mortality ; Plasma ; Sepsis

A hemodialysis arteriovenous fistula may cause high output cardiac state by volume overload and decreased systemic vascular resistance. Arteriovenous fistulas for hemodialysis consist usually of either a radiocephalic fistula at the wrist or a more proximal brachiocephalic fistula at the antecubital fossa. In this study the contribution of arteriovenous fistula to cardiac function has been evaluated by comparing cardiac performance before and after the point occlusion of the anastomotic site. The results suggest that the occlusion of arteriovenous fistula may decrease end-diastolic left ventricular volume (VOLd), increase end-systolic left ventricular volume (VOLs), decrease stroke volume (SV), decrease ejection fraction (EF) and decrease cardiac output (CO). This study shows that arteriovenous fistula influences directly to cardiac performance, so careful determination of dialysis option is required for the end stage renal failure patients with marginal heart function.
Arteriovenous Fistula ; Cardiac Output ; Dialysis ; Fistula ; Heart ; Humans ; Renal Dialysis ; Renal Insufficiency ; Stroke Volume ; Vascular Resistance ; Wrist