We describe a case of fine needle aspiration cytology of metastatic nasopharyngeal carcinoma in the lymph node of the neck presenting a predominantly spindle cell pattern. A 36 year-old male patient complained of dysesthesia on the right face and a palpable neck mass. Fine needle aspiration was done on the neck mass. Tumor cells were present in syncytial groups or singly with mainly spindle shaped nuclei, vesicular chromatin, thin and regular nuclear membrane, occasional prominent nucleoli and a few foci of cellular cohesiveness. The cytoplasm was scant and pale with ill-defined borders. Mature lymphocytes were present in the background of aspirates and within the tumor cell clusters. Histologically, the tumor of nasopharynx showed several areas of spindle cell pattern. Because the tumor cells showed a predominantly spindle shape with vesicular nuclear chromatin, the differential diagnosis of spindle cell sarcoma or granuloma of epithelioid cells were considered, but the characteristic morphology of the nuclei with vesicular chromatin and prominent nucleoli, and cellular cohesiveness were important in making the diagnosis of nasopharyngeal carcinoma. The possibility of metastatic carcinoma should always be considered in fine needle aspiration cytology of the lymph node in the neck because the incidence of metastatic carcinoma, particularly of the nasopharyngeal carcinoma in the lymph nodes of the neck is relatively high.
Child ; Male ; Female ; Humans ; Diagnosis, Differential ; Incidence ; Neoplasm Metastasis

We report a 57-year-old man with bilateral cranial nerve IX and X palsies who presented with severe dysphagia. After a mild head injury, the patient complained of difficult swallowing. Physical examination revealed normal tongue motion and no uvular deviation. Cervical X-ray findings were negative, but a brain computed tomography revealed a skull fracture involving bilateral jugular foramen. Laryngoscopy indicated bilateral vocal cord palsy. In a videofluoroscopic swallowing study, food residue remained in the vallecula and pyriform sinus, and there was reduced motion of the pharynx and larynx. Electromyography confirmed bilateral superior and recurrent laryngeal neuropathy.
Brain ; Brain Injuries* ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Deglutition ; Deglutition Disorders ; Electromyography ; Glossopharyngeal Nerve ; Humans ; Laryngoscopy ; Larynx ; Middle Aged ; Paralysis* ; Pharynx ; Physical Examination ; Pyriform Sinus ; Skull Fracture, Basilar ; Skull Fractures ; Tongue ; Vocal Cord Paralysis

PURPOSE: The purpose of this study is to describe the patterns of enhancement of the herniated lumbar disc with Gd-DTPA enhanced MR imaging. MATERIALS AND METHODS: Out of 65 patients, 103 lumbar discs diagnosed to be herniated by MR image were retrospectively analyzed. The MR imaging was performed with 1.5 T MR unit, using T1- and T2- weighted sagittal and axial spin echo techniques. Contrast- enhanced T1 weighted sagittal and axial images were performed after intravenous injection of Gadopentetate-dimeglumine(Magnevist, Shering) (0.1 mmol/kg). RESULTS: Contrast enhancement was seen in 66 cases(64%). Thirteen cases of bulging disc were not enhanced. Twenty-eight cases of protruded disc showed intraannular enhancement in 23 cases, peripheral linear and irregular enhancement in each of one case, and nonenhancement in three cases. Fifty-seven cases of extruded disc showed irregular enhancement in 14 cases, peripheral linear enhancement in 12 cases, peripheral ring enhancement in five cases and intraannular enhancement in five cases. All five cases of sequestered disc showed peripheral ring enhancement. CONCLUSION: Protruded discs show intraannular enhancement frequently and sequestered discs usually show peripheral ring enhancement. Enhanced MR imaging may be helpful to evaluate the type of herniated lumbar disc and relationship among disc material, nerve root and thecal sac.
Gadolinium DTPA ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging ; Retrospective Studies

Intralabyrinthine schwannomas are rare benign tumors, which arise from neural portions within the labyrinth. These are subclassified into seven groups according to the affected inner ear structures. Intracochlear schwannomas (ICS) are tumors confined to the cochlea, and these can cause progressive unilateral sensorineural hearing loss, tinnitus, vertigo and aural fullness. Here, we report a 49-year-old female patient with left sudden sensorineural hearing loss. There was no improvement of hearing despite steroid and hyperbaric oxygen therapy. Space occupying lesion in the basal turn of the left cochlea was identified in MRI with enhancement. She underwent tumor removal through an extended round window approach, and cochlear implantation was performed successfully. This is the first case report of cochlear implantation after tumor removal in a patient with ICS in Korea, and we discuss management options with a review of the literature.

The aim of this study was to investigate the prevalence and correlates of depressive symptoms in the largest number of Korean individuals examined to date. We analyzed cross-sectional data collected from 229,595 Korean adults aged 19 yr and above who participated in a Korean Community Health Survey conducted in 2009. The Center for Epidemiologic Studies Depression Scale (CES-D) was used as the measurement tool for depressive symptoms (CES-D score over 16) and definite depression (CES-D score over 25). Multivariate logistic regression analysis was performed to identify associations between sociodemographic factors and depressive symptoms. The percentages of depressive symptoms and definite depression in the total study population were 11% (7.8% for men, 14.0% for women) and 3.7%, (2.4% for men, 5.0% for women), respectively. Female gender, older age, disrupted marital status, low education and income level, multigenerational household composition and metropolitan residence were associated with greater risk of depressive symptoms. The present study provides a valid prevalence and correlates of depressive symptoms, using the largest representative sample of the Korean general population to date. Various sociodemographic factors contribute to the prevalence and effects of depressive symptoms in Korea.
Adult ; Age Factors ; Aged ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Depression/*epidemiology ; Female ; Health Surveys ; Humans ; Logistic Models ; Male ; Marital Status ; Middle Aged ; Odds Ratio ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Social Class ; Socioeconomic Factors ; Young Adult

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of 3.0-T breast MRI for detecting additional breast cancer soon after the initial diagnosis of breast cancer. MATERIALS AND METHODS: From March to June 2009, 101 patients recently diagnosed breast cancer underwent breast MRI and surgery. Parameters analyzed on MRI were total extent of tumor, suspicious findings of multifocal, multicentric, or contralateral cancer. The diagnosis of MRI-detected cancer was confirmed by means of biopsy or surgical specimen evaluation after the localization. RESULTS: MRI showed 37 additional suspicious findings in 34 patients. Twenty nine findings were true-positive (29/37, 78.4%), including 16 cases of multifocality, 11 cases of multicentricity and 2 cases of contralateral cancer. Among these cancers, 13 (44.8%) were ductal carcinoma in situ (DCIS) and 16 (55.1%) were infiltrating cancer. Eight findings were false-positive (8/37, 21.6%) including 6 cases of benign disease and 2 cases of high-risk lesions. CONCLUSION: In women with recently diagnosed breast cancer, 3.0-T MR imaging showed additional suspicious findings in 33.7%. The sensitivity and specificity for detecting additional breast cancer was 100% and 89.3%, respectively.
Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Magnetic Resonance Imaging ; Sensitivity and Specificity

PURPOSE: To evaluate the feasibility and usefulness of the waist circumference-to-height ratio (WHTR) in screening for obesity in Korean children and adolescents. METHODS: Data, including body mass index (BMI), waist circumference (WC), and height, were obtained from the national growth surveys for children and adolescents in 2005. The WHTR was calculated dividing WC by height in subjects 2~18 years of age. Overweight and obese were defined by BMI percentiles for age and gender. The receiver operating characteristic (ROC) analysis was performed to find out the optimal cutoff values of WHTR that matched BMI-determined overweight and obesity using the STATA program. The area under the curve (AUC), a measure of diagnostic power, of WHTR was compared to WC. The influence of age on WHTR was analyzed by the SAS program. RESULTS: The WHTR significantly decreased with age, and had less correlation with age in the 6~18-year-old age group than the 2~5-year-old age group. Furthermore, the WHTR also had less correlation with age than WC in the 6~18-year-old age group. The AUC of WHTR in identifying overweight and obesity was significantly higher than the AUC of WC in the 6~18-year-old age group. The optimal cutoff values were 0.51 in boys and 0.49 in girls for obesity, and 0.48 in boys and 0.47 in girls for overweight, with all having the AUC>0.9. The optimal cutoff values of WHTR had a higher sensitivity for diagnosing obesity than WC> or =90th percentiles. CONCLUSION: The WHTR is an easy, accurate, and less age-dependent index with high applicability in screening for obesity in children and adolescents.
Adolescent ; Area Under Curve ; Body Mass Index ; Child ; Humans ; Mass Screening ; Obesity ; Overweight ; Phenothiazines ; ROC Curve ; Waist Circumference

PURPOSE: To evaluate the feasibility and usefulness of the waist circumference-to-height ratio (WHTR) in screening for obesity in Korean children and adolescents. METHODS: Data, including body mass index (BMI), waist circumference (WC), and height, were obtained from the national growth surveys for children and adolescents in 2005. The WHTR was calculated dividing WC by height in subjects 2~18 years of age. Overweight and obese were defined by BMI percentiles for age and gender. The receiver operating characteristic (ROC) analysis was performed to find out the optimal cutoff values of WHTR that matched BMI-determined overweight and obesity using the STATA program. The area under the curve (AUC), a measure of diagnostic power, of WHTR was compared to WC. The influence of age on WHTR was analyzed by the SAS program. RESULTS: The WHTR significantly decreased with age, and had less correlation with age in the 6~18-year-old age group than the 2~5-year-old age group. Furthermore, the WHTR also had less correlation with age than WC in the 6~18-year-old age group. The AUC of WHTR in identifying overweight and obesity was significantly higher than the AUC of WC in the 6~18-year-old age group. The optimal cutoff values were 0.51 in boys and 0.49 in girls for obesity, and 0.48 in boys and 0.47 in girls for overweight, with all having the AUC>0.9. The optimal cutoff values of WHTR had a higher sensitivity for diagnosing obesity than WC> or =90th percentiles. CONCLUSION: The WHTR is an easy, accurate, and less age-dependent index with high applicability in screening for obesity in children and adolescents.
Adolescent ; Area Under Curve ; Body Mass Index ; Child ; Humans ; Mass Screening ; Obesity ; Overweight ; Phenothiazines ; ROC Curve ; Waist Circumference

The association of thymoma with pure red cell aplasia has been well documented, but amegakaryocytic thrombocytopenia is not a recognized paraneoplastic syndrome complicating thymoma. We report a case of thymoma-complicated pure red cell aplasia and amegakaryocytic thrombocytopenia in a 73-yr-old woman. Pure red cell aplasia was diagnosed seven months after the detection of thymoma. One year after the diagnosis of pure red cell aplasia and seven months after thymectomy, bone marrow aspiration and biopsy showed an absence of megakaryocytes, marked erythroid hypoplasia with normal myeloid series. A diagnosis of amegakaryocytic thrombocytopenia and pure red cell aplasia was made. Oral steroid maintenance therapy resulted in recovery of platelet count. She has still transfusion-dependant anemia but platelet and neutrophil counts had been maintained in normal range for more than five months, until the last follow-up. We think that autoreactive T cells may induce a clinical autoimmune response even after eradication of thymoma, and aplastic anemia as a late complication following thymectomy was described in previous cases. This patient also has to be under a close observation because of the possibility to evolve into aplastic anemia.
Aged ; Bone Marrow/pathology ; Female ; Humans ; Imidazoles/therapeutic use ; Megakaryocytes/pathology ; Pregnadienetriols/therapeutic use ; Red-Cell Aplasia, Pure/complications/*diagnosis ; Thrombocytopenia/*diagnosis/drug therapy/*etiology ; Thymectomy/*adverse effects ; Thymoma/*complications/diagnosis/surgery ; Thymus Neoplasms/*complications/diagnosis/surgery

PURPOSE: We assessed the usefulness of resistive index(RI) on spectral analysis of Doppler sonography for differential diagnosis of benign and malignant breast lesions. MATERIALS AND METHODS: We retrospectively reviewed 29 benign and 22 malignant lesions of breast, which were examined preoperatively with color and duplex Doppler andwere confirmed by histopathologically after operation. We analyzed the average and distribution of RI in benignand malignant lesions. RESULTS: Although, there was no difference in the average values of RI in benign and malignant breast lesions, the distribution of RI was below 0.7 in eighteen cases (62%) of benign lesions, and above 0.7 in eighteen cases (82%) of malignant lesions. Thus, RI is valuable for differentiation between benignand malignant lesions of breast. CONCLUSIONS: Measurement of RI in breast disease using color and duplex Dopplerstudy is useful modality adjunct to the conventional ultrasonographic differentiation of benign and malignantlesions.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Diagnosis ; Retrospective Studies