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.

No abstract available.
Carney Complex* ; Hyperplasia* ; Myxoma* ; Nevus, Blue* ; Testis*

PURPOSE: Neovascularization has been shown to be essential for the growth of solid tumors. Vascular endothelial growth factor (VEGF) is one of the most important mediators of angiogenesis, and recent studies have demonstrated that the p53 tumor suppressor gene plays an important role in controlling tumor angiogenesis. We examined the expression of VEGF and p53 as a function of microvessel density to evaluate its clinical significance in colorectal cancer and to investigate the correlation of VEGF and p53. METHODS: The study material included 20 patients who survived more than 5 years postoperatively without distant metastasis (non-metastasis group) and 21 patients who had synchronous (10 patients) and metachronous (11 patients) metastasis (metastasis group). Immunohistochemical staining for VEGF, p53 protein and factor VIII-related antigen was done. RESULTS: The expression rate of VEGF was 20% in non-metastatic tumors and 71% in metastatic tumors (p<0.05). The VEGF expression was not correlated with microvessel density. Otherwise, the microvessel density were 32.9 9.1 in non-metastatic tumors and 40.1 12.0 in metastatic tumors (p<0.05). VEGF expression was correlated with p53 over expression. CONCLUSION: VEGF expression might be a useful prognostic factor for metastasis in colorectal cancer. Also, our findings suggest the presence of a p53-VEGF pathway in colorectal cancer.
Colorectal Neoplasms* ; Genes, Tumor Suppressor ; Humans ; Microvessels ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A* ; von Willebrand Factor

We report here on a rare case of hepatoid thymic carcinoma in a 34-year-old man. The patient complained of a high fever and headache, and a 6.6cm-sized anterior mediastinal mass was found on chest computed tomography (CT). There was no hepatic mass seen on abdominal CT. The resected mass consisted of epithelioid cells with abundant eosinophilic cytoplasm, pleomorphic vesicular nuclei and prominent nucleoli, and the mass was surrounded by thymic tissue. The tumor cells were immunopositive for cytokeratin 7, alpha-1-antitrypsin, hepatocyte staining, and epithelial membrane antigen, but they were negative for CD5, alpha-fetoprotein (AFP) and placental alkaline phosphatase, and this all led to a diagnosis of hepatoid thymic carcinoma rather than hepatoid yolk sac tumor. This entity should be included in the differential diagnosis of epithelioid thymic tumors.
Adult ; Alkaline Phosphatase ; alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Cytoplasm ; Diagnosis, Differential ; Endodermal Sinus Tumor ; Eosinophils ; Epithelioid Cells ; Fever ; Headache ; Hepatocytes ; Humans ; Keratin-7 ; Mucin-1 ; Thorax ; Thymoma ; Thymus Gland ; Thymus Neoplasms

BACKGROUND: Clinical outcomes and prognosis of large and massive rotator cuff tears are known to be unpredictable not only in degeneration of the rotator cuff, but also due to a high rate of retear. METHODS: Totally, 81 patients who had undergone arthroscopic rotator cuff repair from May 2008 to February 2016 were evaluated in our study. Clinical and functional evaluations were performed with the Constant score and the University of California, Los Angeles (UCLA) score, as well as full physical examination of the shoulder. All patients were confirmed to have magnetic resonance imaging (MRI) of tendon healing at least 1 year postoperatively. RESULTS: The average age at the time of surgery was 65 years (range, 47–78 years). The average duration of postoperative time in which a follow-up MRI was performed was 36.1 months (range, 12–110 months). Large tears were present in 48 cases (59.3%) and massive tears in 33 cases (40.7%). Overall, there were 33 retear cases (40.7%). All the average clinical outcome scores were significantly improved at the last follow-up (p<0.001), although repair integrity was not maintained. Compared to type A, types C, and D of the Collin's classification showed significantly higher retear rates (p=0.036). CONCLUSIONS Arthroscopic rotator cuff repair yields improved clinical outcomes and a relatively high degree of patient satisfaction, despite the repair integrity not being maintained. Involvement of the subscapularis muscle or infraspinatus muscle had no effect on the retear rate.

OBJECTIVES: Many patients with Alzheimer's disease have difficulty in taking their medicine by themselves and their poor drug adherence possibly results in aggravating various symptoms. The aim of this study was to assess the variables influencing drug adherence of Alzheimer's disease patients. METHODS: In a four-week period, 33 outpatients over 65 years old diagnosed with Alzheimer's disease were monitored. Drug adherences were assessed by the Medication Event Monitoring System (MEMS), the pill count, the clinician rating scale, and self-report. Agreements among adherence measures and the relationships between MEMS adherence and other clinical factors were assessed. RESULTS: The adherence rates for the MEMS, the pill count, the clinician rating scale and, self-report were 51.5%, 82.8%, 82.8%, and 87.9%. The Kappa coefficients were 0.382 (pill count vs. MEMS, clinician rating scale vs. MEMS) and 0.256 (self-report vs. MEMS). Males showed better adherence than females but the other clinical variables did not show significant differences between adherence group and non-adherence group. CONCLUSION: These findings suggest that clinicians should be concerned when assessing drug adherence in patients with Alzheimer's disease only by subjective reporting and pill counting since these methods may make patient's adherence underestimate. Clinicians should also take in mind that caregivers play an important role in improving adherence.
Alzheimer Disease ; Caregivers ; Dementia ; Female ; Humans ; Male ; Micro-Electrical-Mechanical Systems ; Outpatients