PURPOSE: To evaluate the value of breast MRI in analysis of papillomas of the breast. MATERIALS AND METHODS: From 1996 to 2004, 94 patients underwent surgery due to papillomas of the breast. Among them, 21 patients underwent 3D fast low angle shot (FLASH) dynamic breast MRI. Eight masses were palpable and 11 of 21 patients had nipple discharge. Two radiologists indifferently analyzed the location, size of the lesions and shape, margin of the masses, multiplicity and ductal relation. The MRI findings were categorized according to breast imaging reporting and data system (BI-RADS) lexicon. The amount and pattern of enhancement and associated findings were also evaluated according to BI-RADS. We then compared the MRI findings with galactography, mammography and breast ultrasonography (US) and examined histopathologic correlation. RESULTS: On breast MRI, the lesion size was 0.4-1.59 cm, and 18 patients showed subareolar location. On 4.25 cm (mean 1.54) dynamic enhanced images, imaging findings showed mass (n = 10), intracystic mass (n = 3), focus (n = 5), ductal enhancement (n = 2), and segmental enhancement (n = 1). In cases of the masses, the shapes of the masses were round (n = 4), lobulated (n = 3), and irregular (n = 6), and margins were circumscribed (n = 6), microlobulated (n = 5), and indistinct (n = 2). The enhancement patterns were homogeneous enhancement (n = 7), heterogeneous (n = 3) or rim enhancement (n = 3). CONCLUSION: The contrast enhanced dynamic breast MRI was highly sensitive for diagnosis of breast papillomas. MRI could play a key role in the pre-operative work-up for multiple papillomas and papillomatosis.
Adult ; Aged ; Breast Neoplasms/*diagnosis ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Middle Aged ; Papilloma, Intraductal/*diagnosis ; Sensitivity and Specificity

OBJECTIVES: Controversial arguments exists on both the case for and against on the accumulation of mitochondrial DNA (mtDNA) deletion in association to tissue and age. The debate continues as to whether this mutation is a major contributor to the phenotypic expression of aging and common degenerative diseases or simply a clinical insignificant epiphenomenon. The objective of this study was to determine whether the accumulation of mtDNA deletion is correlated with age-related and tissue-specific variation. MATERIALS AND METHODS: One hundred and fifty-seven tissues from blood, ovary, uterine muscle, and abdominal muscle were obtained from patients ranging in age from 31~60 years. After reviewing the clinical reports, patients with mitochondrial disorder were excluded from this study. The tissues were obtained at gynecological surgeries with the consent of the patient. Total DNA isolated from blood, ovary, uterine muscle, and abdominal muscle was amplified by two rounds of PCR using two pairs of primers corresponding to positions 8225-8247 (sense), 13551-13574 (antisense) for the area around deleted mtDNA and 8421-8440 (sense), 13520-13501 (antisense) for nested PCR product. A statistical analysis was performed by c2-test. RESULTS: About 0% of blood, 94.8% of ovary, 71.4% of uterine muscle, and 86.1% abdominal muscle harbored mtDNA deletion. When we examined the proportion of deleted mtDNA according to age deletion rate was 90% of ovary, 63.6% of uterine muscle, 77.7% of abdominal muscle in thirties and 100% of all tissue in fifties. CONCLUSION: The findings of this study suggest that the mtDNA deletion is varied in tissue-specific pattern and increases with aging.
Abdominal Muscles ; Aging ; Animals ; DNA ; DNA, Mitochondrial* ; Female ; Gynecologic Surgical Procedures ; Humans ; Mice ; Mitochondrial Diseases ; Myometrium ; Ovary ; Polymerase Chain Reaction

Alveolar bone destruction is a characteristic of periodontal disease. Treponema denticola are found in significantly increased numbers in the sites affected with periodontal disease. In order to clarify the role of T. denticola in destruction of alveolar bone in periodontal disease, this study was undertaken to determine the effect of sonicated extract of T. denticola on osteoclast differentiation in co-culture system of mouse bone marrow cells and calvaria cells. The ability of osteoclast formation was estimated by counting the number of tartrate resistant acid phosphatase(TRAP) positive cells. Sonicated extract of this bacteria stimulated osteoclast formation in a dose dependent manner(p<0.05). Indomathacin, an inhibitor of prostaglandin synthesis, decreased osteoclast formation induced by sonicated extract of this bacteria(p<0.05). Extract-induced osteoclast formation was decreased, when sonicated extract of bacteria was heated(p<0.05). These findings suggest that T. denticola induces osteoclast differentiation, and protein component of this bacteria and PGE2 may play an important role in this process.
Mice ; Animals

Objective: To evaluate the impact of surgical simulation training using a three-dimensional (3D)-printed model of tetralogy of Fallot (TOF) on surgical skill development. Materials and Methods: A life-size congenital heart disease model was printed using a Stratasys Object500 Connex2 printer from preoperative electrocardiography-gated CT scans of a 6-month-old patient with TOF with complex pulmonary stenosis.Eleven cardiothoracic surgeons independently evaluated the suitability of four 3D-printed models using composite Tango 27, 40, 50, and 60 in terms of palpation, resistance, extensibility, gap, cut-through ability, and reusability of. Among these, Tango 27 was selected as the final model. Six attendees (two junior cardiothoracic surgery residents, two senior residents, and two clinical fellows) independently performed simulation surgeries three times each. Surgical proficiency was evaluated by an experienced cardiothoracic surgeon on a 1–10 scale for each of the 10 surgical procedures. The times required for each surgical procedure were also measured. Results: In the simulation surgeries, six surgeons required a median of 34.4 (range 32.5–43.5) and 21.4 (17.9–192.7) minutes to apply the ventricular septal defect (VSD) and right ventricular outflow tract (RVOT) patches, respectively, on their first simulation surgery. These times had significantly reduced to 17.3 (16.2–29.5) and 13.6 (10.3–30.0) minutes, respectively, in the third simulation surgery (p = 0.03 and p = 0.01, respectively). The decreases in the median patch appliance time among the six surgeons were 16.2 (range 13.6–17.7) and 8.0 (1.8–170.3) minutes for the VSD and RVOT patches, respectively. Summing the scores for the 10 procedures showed that the attendees scored an average of 28.58 ± 7.89 points on the first simulation surgery and improved their average score to 67.33 ± 15.10 on the third simulation surgery (p = 0.008). Conclusion Inexperienced cardiothoracic surgeons improved their performance in terms of surgical proficiency and operation time during the experience of three simulation surgeries using a 3D-printed TOF model using Tango 27 composite.

Objective: To evaluate the impact of surgical simulation training using a three-dimensional (3D)-printed model of tetralogy of Fallot (TOF) on surgical skill development. Materials and Methods: A life-size congenital heart disease model was printed using a Stratasys Object500 Connex2 printer from preoperative electrocardiography-gated CT scans of a 6-month-old patient with TOF with complex pulmonary stenosis.Eleven cardiothoracic surgeons independently evaluated the suitability of four 3D-printed models using composite Tango 27, 40, 50, and 60 in terms of palpation, resistance, extensibility, gap, cut-through ability, and reusability of. Among these, Tango 27 was selected as the final model. Six attendees (two junior cardiothoracic surgery residents, two senior residents, and two clinical fellows) independently performed simulation surgeries three times each. Surgical proficiency was evaluated by an experienced cardiothoracic surgeon on a 1–10 scale for each of the 10 surgical procedures. The times required for each surgical procedure were also measured. Results: In the simulation surgeries, six surgeons required a median of 34.4 (range 32.5–43.5) and 21.4 (17.9–192.7) minutes to apply the ventricular septal defect (VSD) and right ventricular outflow tract (RVOT) patches, respectively, on their first simulation surgery. These times had significantly reduced to 17.3 (16.2–29.5) and 13.6 (10.3–30.0) minutes, respectively, in the third simulation surgery (p = 0.03 and p = 0.01, respectively). The decreases in the median patch appliance time among the six surgeons were 16.2 (range 13.6–17.7) and 8.0 (1.8–170.3) minutes for the VSD and RVOT patches, respectively. Summing the scores for the 10 procedures showed that the attendees scored an average of 28.58 ± 7.89 points on the first simulation surgery and improved their average score to 67.33 ± 15.10 on the third simulation surgery (p = 0.008). Conclusion Inexperienced cardiothoracic surgeons improved their performance in terms of surgical proficiency and operation time during the experience of three simulation surgeries using a 3D-printed TOF model using Tango 27 composite.

Clear cell hidradenoma is an uncommon benign skin appendageal tumor that typically involves the dermal layer of the head, face, and extremities. The breast is a rare site for this lesion, with only two documented cases, which were determined based on mammogram and sonogram findings. We present a case of clear cell hidradenoma of the axillary tail with radiological findings and a literature review.
Adenoma, Sweat Gland/pathology/*radiography/*ultrasonography ; *Axilla ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Mammography ; Middle Aged ; Sweat Gland Neoplasms/pathology/*radiography/*ultrasonography ; Ultrasonography, Doppler

Morning glory syndrome (MGS) is a rare congenital optic disc anomaly with a characteristic fundal finding with severe visual impairment. It may occur in association with various systemic manifestations, even though most of the reported cases were isolated. A 6-year-old male visited the nephrology clinic with a history of microscopic hematuria and at the age of 12 years, he was diagnosed thin glomerular basement membrane nephropathy by kidney biopsy. After the following years, the patient had progressive deterioration of visual acuity, and diagnosed as MGS. Whole Exome Sequencing of this patient and his mother revealed heterozygous COL4A4 mutations [c.81_86del (p.Ile29_Leu30del)]. It is more reasonable to consider MGS seen in this patient as a coincidental finding of autosomal dominant Alport syndrome. To our knowledge, this case represents the first case report of autosomal dominant Alport syndrome associated with MGS.

PURPOSE: We evaluated the usefulness of quantitative analysis of computed tomography (CT) pulmonary angiography as a predictor of the prognosis of acute pulmonary embolism (PTE). METHODS: We performed a retrospective analysis of 55 patients who visited our emergency department from January 2000 to November 2007 who were confirmed with PTE by CT pulmonary angiography. Two radiologists blinded to patient outcome measured CT parameters including the diameter of vessels and chambers, and the quantified pulmonary artery (PA) clot load score on the basis of embolus size and location. CT parameters and other clinical predictors were analyzed to determine their ability to predict major adverse event (MAE). RESULTS: Of the 55 patients, 16 (29.1%) had a MAE PTE related shock, intubation, death, thrombolysis, right ventricular (RV) dysfunction within 30 days). Geneva score (odds ratio 2.5, 95% CI 1.18-5.29, p=0.02) and PA clot load score (odds ratio 1.64, 95% CI 1.18-2.27, p<0.01) were strong independent predictors of MAE. The cut-off value of Geneva and PA clot load scores were 4.5 and 19.0, respectively, and the area under the ROC curve were 0.697 (0.546~0.848) and 0.908 (0.828-0.988), respectively. CONCLUSION: Geneva and PA clot load score are significant predictors of PTE related shock, intubation, death, thrombolysis, and RV dysfunction within 30 days. CT pulmonary angiography is a useful predictor for the prognosis of PTE as well as a useful diagnostic tool.
Angiography ; Embolism ; Emergencies ; Humans ; Intubation ; Prognosis ; Pulmonary Artery ; Pulmonary Embolism ; Retrospective Studies ; ROC Curve ; Shock

PURPOSE: Cellular uptakes of 99mTc-sestamibi (MIBI) and 99mTc-tetrofosmin into cancer cell lines expressing multidrug resistance (MDR) were investigated and compared. The effects of verapamil and cyclosporin A, well-known multidrug resistant reversing agents, on cellular uptakes of both tracers were also compared. MATERIALS AND METHODS: Doxorubicin-resistant HCT15/CL02 human colorectal cell and doxorubicin-resistant K562 (Adr) and vincristine-resistant K562 (Vcr) human leukemic cells were studied. RT-PCR analysis was used for the detection of mdr1 mRNA expression. MDR-reversal effects with verapamil and cyclosporine A were evaluated at different drug concentrations after incubation with MIBI and tetrofosmin for 1, 15, 30, 45 and 60 min, using single-cell suspensions at 1x10 (6) cells/ml incubated at 37 degrees C. Radioactivity in supernatants and pellets were measured with gamma well counter. RESULTS: The cellular uptakes of MIBI and tetrofosmin in K562 (Adr) and K562 (Vcr) were lower than those of parental K562 cell. In HCT15/CL02 cells and K562 (Adr) cells, there were no significant difference in cellular uptakes of both tracers, but cellular uptake of MIBI was higher than that of tetrofosmin in K562 (Vcr) cells. Coincubation with verapamil resulted in a increase in cellular uptakes of MIBI and tetrofosmin. Verapamil increased cellular uptakes of MIBI and tetrofosmin by HCT15/CL02 cell by 11.9- and 6.8-fold, by K562 (Adr) cell by 14.3- and 8-fold and by K562 (Vcr) cell by 7- and 5.7-fold in maximum, respectively. Cyclosporin A increased cellular uptakes of MIBI and tetrofosmin by HCT15/CL02 cell by 10- and 2.4-fold, by K562 (Adr) cell by 44- and 13-fold and by K562 (Vcr) cell by 18.8- and 11.8-fold in maximum, respectively. CONCLUSION: Taking together, MIBI and tetrofosmin are considered as suitable radiopharmaceuticals for detecting multidrug resistance. However, MIBI seems to be a better tracer than tetrofosmin for evaluating MDR reversal effect of the modulators. Since cellular uptakes of both tracers might differ in different cell types, further experiments regarding differences in cellular uptakes between cell types should be explored.
Cell Line* ; Cyclosporine ; Drug Resistance, Multiple* ; Humans ; Parents ; Radioactivity ; Radiopharmaceuticals ; RNA, Messenger ; Suspensions ; Technetium Tc 99m Sestamibi* ; Verapamil

PURPOSE: The aims of this retrospective study were to evaluate the sequential changes of parathyroid hormone (iPTH) and calcium metabolism after renal transplantation (RTP) and to identify risk factors for hypertension (HPT). METHODS: Biochemical bone parameters were reviewed in 264 patients at pre-transplant, 6, 12, 36 and 60 months after RTP. RESULTS: iPTH levels fell significantly during the first six months after RTP and remained substantially stable thereafter. The mean total serum calcium level showed significant increase during the first six months and progressive and significant decline after the first year. The mean serum phosphorus level returned to the normal range during the first six months and remained normal thereafter. The serum alkaline phosphatase (ALP) level increased during the first year and gradually decreased after then. The prevalence of persistent HPT was 17.8%. Patients with persistent HPT had significantly elevated serum levels of iPTH at the time of RTP and had spent a longer time on dialysis. Significant positive correlations were observed between the serum iPTH levels on the one hand and the pre-transplant iPTH, serum ALP, and creatinine levels on the other hand. CONCLUSION: The prevalence of persistent HPT after RTP is not uncommon. The patients with long duration of dialysis showing high serum level of iPTH at the time of transplantation are at risk for persistent HPT.
Alkaline Phosphatase ; Calcium ; Creatinine ; Dialysis ; Hand ; Humans ; Hyperparathyroidism, Secondary ; Hypertension ; Kidney Transplantation* ; Metabolism* ; Parathyroid Hormone* ; Phosphorus ; Prevalence ; Reference Values ; Retrospective Studies ; Risk Factors