Background: For patients diagnosed with asymptomatic, non-functional pituitary incidentaloma (PI), periodic follow-up is generally proposed. However, the recommended follow-up period differs among existing guidelines and consensus is lacking. Thus, this study aimed to suggest follow-up periods for PI based on MRI characteristics. Methods: Between 2007 and 2023, 245 patients who were diagnosed with PI were retrospec-tively assessed. Their mean clinical and neuroradiological follow-up periods were 74.2 and 27.3 months, respectively. Their baseline clinical and neuroradiological characteristics were analyzed. These 245 patients were divided into two groups: those with PI size progression and those without PI size progression. Additionally, neuroradiological features of each group were analyzed according to presumptive diagnoses of PI. Results: PI size increased in 33 of 245 patients. For the remaining 212 patients, PI size de-creased or stayed unchanged. Of the 33 patients with PI size progression, ten underwent surgery.Stalk deviation (p<0.001) and lesion enhancement (p=0.001) were significantly more observed in those with PI size progression than in those without PI size progression. MRI morphological factors were not related to changes in PI size in the presumptive Rathke’s cleft cyst group. In the presumptive pituitary adenoma group, absence of tumor enhancement (p<0.001) and stalk deviation (p<0.001) were significantly associated with tumor reduction and progression, respectively. Conclusion Our findings support an additional guideline for patients with asymptomatic non-func-tional PI without stalk deviation and enhancement. For these patients, the clinical and neuroradiological follow-up periods could be reduced.

Bronchogenic cysts are rare congenital anomalies that are most frequently found in the mediastinum along the tracheobronchial tree, especially in the posterior aspect of the superior mediastinum. Bronchogenic cysts have also been reported in intrapulmonary, intrapericardial, abdominal, and retroperitoneal locations. Herein, we report a case of a retroperitoneal bronchogenic cyst in the presacral space. The patient was diagnosed based on a post-operative histopathological examination.

Background : This study was designed to investigate gastrointestinal neuroendocrine tumors with an emphasis on their clinicopathological characteristics. Methods : Sixty-five cases were reviewed and classified as typical carcinoid (TC), atypical carcinoid (AC), large cell neuroendocrine carcinoma (LCNEC) and small cell carcinoma (SmCC). We performed immunohistochemistry to characterize the expression of the immunoreactivity for synaptophysin, chromogranin, gastrin, somatostatin, thyroid transcription factor-1, p53 and Ki-67. Results : Most commonly, the tumors were located in the rectum (54%), followed by the stomach (23%) and colon (9%). Histologically, the tumors were classified as 49 TCs, 4 ACs, 6 LCNECs and 6 SmCCs. Most tumors were stained positive for synaptophysin and/or chromogranin. Four LCNECs and one SmCC were p53-positive. The carcinoids revealed a low level (<5%) of reactivity for Ki-67, while > or =30% of the cells showed reactivity for Ki-67 in the majority of LCNECs and SmCCs. Six patients with metastatic carcinoids were older than those patients without metastasis (64 vs 48 years, respectively, p=0.004). Furthermore, the size of tumors was larger for the patients with metastatic carcinoids than for the patients with nonmetastatic carcinoids (2.3 vs 0.5 cm, respectively, p=0.005). Conclusion : Old age, large tumor size and muscle invasion are associated with high grade neuroendocrine tumor and lymph node metastasis for those patients with carcinoids.
Carcinoid Tumor ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Colon ; Gastrins ; Gastrointestinal Tract ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Neuroendocrine Tumors* ; Rectum ; Somatostatin ; Stomach ; Synaptophysin ; Thyroid Gland

PURPOSE: COX-2 is known to be elevated in breast cancer, but the clinical relevance is still a matter of debate. The purpose of this study was to determine the prognostic significance and relationship of COX-2 to hormone receptors. METHODS: Between January 2005 and February 2007, 80 specimens from breast cancer patients at Korea University Anam Hospital were reviewed by one pathologist. COX-2 was analyzed as overexpressed if >10% of the cells were stained. Clinical characteristics, hormone receptor status, and other prognostic factors were investigated to determine their association with COX-2 expression. RESULTS: COX-2 was overexpressed in 12 patients (15%). Two patients had locoregional recurrence, eight patients had systemic metastasis, and one patient died. There was no statistically significant correlation between COX-2 expression and age, size, nodal status, histological grade, hormone receptor status, and HER-2/neu positivity. Among tumors that had a positive expression of ER and PR, COX-2 expression was related to larger size (P-value 0.001 and 0.009, respectively) and nodal status (P-value 0.048 and 0.009, respectively). However, there was no statistically significant correlation with tumors that had negative ER or PR expression. CONCLUSION: This study suggests that in breast cancer, COX-2 expression has no relationship with clinicopathologic factors; however, a correlation was noted in size and nodal status for ER- and PR-positive tumors. Further prospective study with larger population to clarify the relationship between COX-2 expression and hormone receptor status is necessary.
Breast ; Breast Neoplasms ; Cyclooxygenase 2 ; Humans ; Korea ; Neoplasm Metastasis ; Receptors, Progesterone ; Recurrence

PURPOSE: To determine the incidence and pattern of peritumoral hyperemia at CT after radiofrequency thermal ablation of hepatic tumors, as well as its correlation with local marginal recurrence. MATERIALS AND METHODS: Forty-five tumor nodules in 28 patients with hepatocellular carcinoma (n=34) or metastasis (n=11) were treated by RF thermal ablation. Serial follow-up contrast- enhanced CT scans were reviewed by three radiologists for 1) the presence, 2) the morphological characteristics [circumferential, THAD (transient hepatic attenuation difference), nodular form], and 3) the temporal course (acute, persistent, delayed onset pattern) of peritumoral hyperemia after RF thermal ablation. These findings were correlated with the frequency of recurrence at the margin of the treated tumors. RESULTS: The frequency of acute hyperemia observed on immediate follow-up CT scans after RF ablation was 71% (32/45). There was the local recurrence in nine of 32 tumors (28%) with hyperemia and in one of 13 (8%) without hyperemia (p>0.05). Among 32 tumors, the circumferential form was observed in 22 (69%); the THAD form in eight (25%); and the nodular form in two (6%). Marginal recurrence was noted in five of 22 tumors circumferential tumors (23%), in three of eight (38%) with the THAD form, and in one of two (50%) which were nodular. Among 32 nodules, an acute transient pattern was noted in 21 (66%), a persistent pattern in nine (28%), and a nodular pattern in two (6%). There was marginal recurrence in two (10%) of 21 tumors with acute transient hyperemia, in six (67%) of nine with persistent hyperemia, and in both tumors with delayed-onset hyperemia. There was significant correlation between the pattern of persistent/delayed-onset hyperemia and marginal tumor recurrence of (p=0.001). CONCLUSION: Although peritumoral hyperemia after RF thermal ablation therapy is a frequent transient finding at follow-up imaging studies, its temporal pattern may help detect early marginal tumor recurrence.
Carcinoma, Hepatocellular ; Follow-Up Studies ; Humans ; Hyperemia* ; Incidence ; Liver Neoplasms ; Neoplasm Metastasis ; Recurrence ; Tomography, X-Ray Computed

PURPOSE: Distant metastasis and recurrence are major prognostic factors associated with breast cancer. Both lymphovascular invasion (LVI) and blood vessel invasion (BVI) are important routes for metastasis to regional lymph nodes and for systemic metastasis. Despite the importance of vascular invasion as a prognostic factor, application of vascular invasion as a histopathological criterion is controversial. The aim of this study was to distinguish LVI from BVI in prognosis and recurrence of breast cancer using an endothelial subtype specific immunohistochemical stain (podoplanin, D2-40, and CD31). METHODS: Sections from 80 paraffin-embedded archival specimens of invasive breast cancer were stained for podoplanin, D2-40, or CD31 expression. Immunohistochemical staining results were correlated with clinicopathological features, such as tumor size, status of lymph node metastases, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor-2 expression, and recurrence. Patients with ductal carcinoma in situ and stage IV breast cancer were excluded. RESULTS: A significant correlation was found between D2-40 LVI positivity and lymph node metastasis (p=0.022). We found a significant correlation between D2-40 LVI positivity and recurrence of breast cancer (p=0.014). However, no significant correlation was found between BVI and recurrence. A poorer disease free survival was shown for D2-40 positive LVI (p=0.003). In a multivariate analysis, the presence of D2-40 LVI positivity revealed a significant association with decreased disease-free survival. CONCLUSION: D2-40 LVI positivity was a more prognostic predictor of breast cancer than BVI.
Antibodies, Monoclonal, Murine-Derived ; Antigens, CD31 ; Blood Vessels ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Disease-Free Survival ; Epidermal Growth Factor ; Estrogens ; Glycosaminoglycans ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Receptors, Progesterone ; Recurrence

OBJECTIVES: This study was conducted to investigate the job stress factors, psychosocial stress and their associations in workers engaged in the research and development of vehicles, and according to job role. METHODS: We recruited 4,066 subjects from workers at a research and development center of an automobile company. A total of 2,764 workers answered the questionnaire about socio-demographic factors, health behaviors, work-related factors, subjective labor intensity, KOSS, and SF-PWI. The final analysis included 2,282 male manufacturing and research workers. Univariate analyses and multiple logistic analyses were conducted on the complete questionnaire data to compare the job stress factors, psychosocial stress and their associations between research and manufacturing workers. RESULTS: The adjusted Odds ratios comparing the high risk group to the low risk group regarding PWI group were 2.23(95%CI=1.63-3.04) in "Lack of rewards", 1.64(95%CI=1.20-2.24) in "Interpersonal conflict", 1.59(95%CI=1.15- 2.20) in "Organizational injustice", 1.58(95%CI=1.17-2.14) in "Occupational climate" and 1.43(95%CI=1.05-1.94) in "Job insecurity" among research workers, and 2.46(95%CI=1.59 -3.80) in "Lack of rewards" and 1.94(95%CI=1.17-3.22) in "Organizational injustice" among manufacturing workers. CONCLUSIONS: There are differences in job stress factors between research and manufacturing workers. Further studies and discussions based on quantitative methodology for seeking more fundamental causes of these differences are required to establish job stress intervention plans and policies.
Automobiles ; Health Behavior ; Humans ; Male ; Odds Ratio ; Questionnaires

Objective: Subjective reports of patients with insomnia often show a discrepancy with their objective assessments of sleep. We aimed to assess subjective-objective sleep discrepancy in subjects with insomnia disorder as well as the psychological factors associated with the discrepancy. Methods: This study is a secondary analysis of the baseline data of a randomized controlled study on 110 adults aged 18 years to 59 years with insomnia disorder. Subjective reports on sleep and the objective measures acquired by an overnight polysomnography were used to measure the sleep discrepancy. Smartphone Addiction Proneness Scale (SAPS), Center for Epidemiologic Studies Depression Scale (CES-D), beck anxiety inventory (BAI), and Global Assessment of Recent Stress (GARS) were used to evaluate the psychological factors associated with the sleep discrepancy. Results: Mean total sleep time (TST) discrepancy of the participants was -81.65±97.41 minutes. Multivariable logistic regression analyses revealed that age (adjusted OR=1.07, 95% CI=1.01–1.13, p=0.027), years of education (adjusted OR=0.69, 95% CI=0.48–0.91, p=0.017), and smartphone addiction proneness (adjusted OR=1.14, 95% CI=1.04–1.27, p=0.008) were independent predictors of TST misperception. Mean sleep onset latency (SOL) discrepancy of the participants was 41.28±45.01 minutes. Only anxiety was an independent predictor of SOL misperception (adjusted OR=1.16, 95% CI=1.05–1.31, p=0.006). Conclusion The present study provides empirical evidence to increase our understanding of the various factors that are associated with subjective-objective sleep discrepancy. Screening insomnia patients with smartphone addiction proneness may help predict the potential discrepancy between the patients’ subjective reports and objective measures of sleep duration.

Schwannomas originate from Schwann cells, and they are the most common benign neoplasms of the peripheral nerves. They can occur in most parts of the body but have a predilection for the head, the neck, and the flexor aspects of the extremities. Pancreatic schwannomas are uncommon, and only a few cases have been reported in the English literature. Approximately two-thirds of pancreatic schwannomas undergo cystic degeneration, and they should be considered in the differential diagnosis of solid pancreatic tumors with cystic changes to facilitate accurate diagnosis and optimal treatment. We report a case of a pathologically proven schwannoma in the pancreatic tail with multiple cystic and hemorrhagic changes followed by a review of relevant literature.