No abstract available.
Neuroblastoma*

PURPOSE: Fine needle aspiration cytology (FNAC) has become a standard diagnostic tool for thyroid nodules. The purpose of this study is to analyze the correlation between FNAC and the final histology to improve the diagnostic value. METHODS: We collected 792 patients who had undergone thyroidectomy, and we selected 549 patients who had undergone preoperative FNAC. The FNAC results were classified as non-diagnostic, malignancy, indeterminate and benign. The final pathologic reports were classified into two categories: malignant or benign. The individual histology was also identified. We retrospectively analyzed the pathologic result, the sensitivity, the specificity and the predictive value of the FNAC. RESULTS: Among 549 patients, their FNACs showed 47 non diagnostic results, 189 malignancies,136 indeterminate results and 177 benign results. The false positive rate was 1.1% and the false negative rate was 12.9%. The final pathology reports were 262 malignancies and 287 benign lesions. There were 42 (30.9%) malignancies among the 136 indeterminate cases. Adenomatous hyperplasia was the most common benign lesion and papillary carcinoma (containing micropapillary carcinoma) was the most common benign lesion. CONCLUSION: FNAC is an easy and safe diagnostic tool, but it still has many limitations. It is necessary to reduce the number of non diagnostic results. Technical advances, classification of the advanced categories of cytology and other staining methods can provide more specific results, and this can reduce the rate of performing unnecessary surgery.
Biopsy, Fine-Needle* ; Carcinoma, Papillary ; Classification ; Humans ; Hyperplasia ; Pathology ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Nodule ; Thyroidectomy* ; Unnecessary Procedures

PURPOSE: The effect of global inhomogeneity on quantitative susceptibility mapping (QSM) was investigated. A technique referred to as Simultaneous Unwrapping Phase with Error Recovery from inhomogeneity (SUPER) is suggested as a preprocessing to QSM to remove global field inhomogeneity-induced phase by polynomial fitting. MATERIALS AND METHODS: The effect of global inhomogeneity on QSM was investigated by numerical simulations. Three types of global inhomogeneity were added to the tissue susceptibility phase, and the root mean square error (RMSE) in the susceptibility map was evaluated. In-vivo QSM imaging with volunteers was carried out for 3.0T and 7.0T MRI systems to demonstrate the efficacy of the proposed method. RESULTS: The SUPER technique removed harmonic and non-harmonic global phases. Previously only the harmonic phase was removed by the background phase removal method. The global phase contained a non-harmonic phase due to various experimental and physiological causes, which degraded a susceptibility map. The RMSE in the susceptibility map increased under the influence of global inhomogeneity; while the error was consistent, irrespective of the global inhomogeneity, if the inhomogeneity was corrected by the SUPER technique. In-vivo QSM imaging with volunteers at 3.0T and 7.0T MRI systems showed better definition in small vascular structures and reduced fluctuation and non-uniformity in the frontal lobes, where field inhomogeneity was more severe. CONCLUSION: Correcting global inhomogeneity using the SUPER technique is an effective way to obtain an accurate susceptibility map on QSM method. Since the susceptibility variations are small quantities in the brain tissue, correction of the inhomogeneity is an essential element for obtaining an accurate QSM.
Brain ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Methods ; Volunteers

We report an unusual case of venous thrombosis complicated by pyogenic psoas muscle abscess in a patient with chronic biliary tract disease. A 64-year-old woman presented with high fever and progressive back and left flank pain. She had been admitted because of recurrent cholangitis and liver abscess 7 months ago. Both abscess and blood cultures had revealed Klebsiella pneumoniae and she had improved with treatment of antibiotics and percutaneous drainage of abscess. Computed tomography demonstrated psoas abscess and thrombosis of inferior vena cava and left iliac vein adjacent to abscess. Several days later, abscess culture showed Klebsiella pneumoniae. Because there was no evidence of deep vein thrombosis and the thrombosis was confined only to the vein adjacent to the abscess, we considered that the thrombosis would be associated with the abscess. She was immediately treated with percutaneous drainage of abscess and antibiotics. Follow-up computed tomography demonstrated complete disappearance of both psoas abscess and venous thrombosis.
Abscess* ; Anti-Bacterial Agents* ; Biliary Tract Diseases ; Cholangitis ; Drainage* ; Female ; Fever ; Flank Pain ; Follow-Up Studies ; Humans ; Iliac Vein ; Klebsiella pneumoniae ; Liver Abscess ; Middle Aged ; Psoas Abscess* ; Psoas Muscles ; Thrombosis ; Veins ; Vena Cava, Inferior ; Venous Thrombosis*

PURPOSE: There is no reliable body index to use in estimating adult body weight. The purpose of the study was to develop a body index that can estimate adult body weight and to perform a regression equation of body weight versus the body index METHODS: We performed a prospective study. We measured body weight and various body indexes, including arm, wrist, calf, and ankle circumference, in the patients who visited our emergency department. A correlation analysis was performed between these body indexes and body weight, and a simple linear regression analysis was used to examine the relationship between the most correlative body index and body weight. RESULTS: Two hundred five patients were enrolled. The correlation coefficient between body weight and calf, arm, wrist, and ankle circumference were, respectively, 0.919, 0.792, 0.546, and 0.432 for males and 0.913, 0.781, 0.476, and 0.430 for females. The body index with the greatest correlation to body weight was calf circumference. The regression equations were: male body weight = 2.510 x calf circumference - 25.673, and female body weight = 2.375 x calf circumference - 22.560. CONCLUSION: The most reliable body index for estimating adult body weight is calf circumference.
Adult ; Animals ; Ankle ; Arm ; Body Weight ; Emergencies ; Female ; Humans ; Leg ; Linear Models ; Male ; Prospective Studies ; Wrist

Temporal and subcellular distributions of hyaluronic acid (HA) as a degradable nanoparticle (NP) in animals were investigated to determine if HA-NP could be utilized as an appropriate drug delivery system. After mice were intravenously injected with 5 mg/kg of Cy5.5-labeled HA-NP sized 350–400 nm or larger HA-polymers, the fluorescence intensity was measured in all homogenized organs from 0.5 h to 28 days. HA-NP was greatly detected in spleen, liver and kidney until day 28, while it was maintained at low levels in other organs. HA-polymer was observed at low levels in all organs. HA-NP quantities in spleen and liver were reduced until day 3, but increased sharply between days 3 and 7, then decreased again, while their HA-polymers were maintained at low levels until day 28. In kidneys, both HA-NP and HA-polymer showed high levels after 0.5 h of administration, but steadily decreased until day 28. According to ultrastructural analyses, HA-NP was engulfed in Kupffer cells of liver and macrophages of spleen and kidney at day 1 and was accumulated in the cytoplasm of kidney tubular cells at day 7. Overall, these findings suggest that HA-NP could be considered a desirable drug carrier in the liver, kidney, or spleen.
Animals ; Cytoplasm ; Drug Carriers* ; Drug Delivery Systems ; Fluorescence ; Hyaluronic Acid* ; Kidney ; Kupffer Cells ; Liver ; Macrophages ; Mice* ; Nanoparticles* ; Pharmacokinetics ; Spleen

Subclavian venous catheterization was once widely used for volume resuscitation, emergency venous access, chemotherapy, parenteral nutrition, and hemodialysis. However, its use has drastically reduced recently because of life-threatening complications such as hemothorax, pneumothorax. In this case, a patient admitted for a scheduled operation underwent right subclavian venous catheterization for preoperative, intraoperative, and postoperative volume resuscitation and parenteral nutrition. The procedure was performed by an experienced senior resident. Despite detecting slight resistance during the guidewire insertion, the resident continued the procedure to the point of being unable to advance or remove it, then attempted to forcefully remove the guidewire, but it broke and became entrapped within the thorax. We tried to remove the guidewire through infraclavicular skin incision but failed. So video-assisted thoracoscopic surgery was used to remove the broken guidewire. This incident demonstrates the risks of subclavian venous catheterization and the importance of using a proper and gentle technique.
Catheterization ; Catheterization, Central Venous ; Catheters ; Drug Therapy ; Emergencies ; Hemothorax ; Humans ; Parenteral Nutrition ; Pneumothorax ; Renal Dialysis ; Resuscitation ; Skin ; Thoracic Surgery, Video-Assisted* ; Thorax

Emodin is an anthraquinone derivative from the roots of Rheum officinale Baill that possesses a variety of biological activities, including inhibition of 5α-reductase and prostaglandin D2. In this study, we investigated whether emodin promotes hair growth. After emodin was topically applied to the shaved dorsal skin of telogenic C57BL/6 N mice, the hair growth rate and morphological analysis were evaluated in dorsal skin for 15 days. After 13 days of treatment, minoxidil or emodin (0.01% or 0.1%)-treated groups showed remarkable regrowth of hairs relative to the vehicle control group. Scoring of the hair growth and rate of hair growth area for 15 days revealed that groups treated with minoxidil and 0.1% emodin were significantly higher than the vehicle control group. Histological examination revealed the emodin and minoxidil groups markedly recovered the number and morphology of hair follicles, including the subcutis depth, relative to the vehicle group. These results suggest that emodin has an excellent promoting effect in hair growth similar to that of minoxidil and might be useful for treatment of baldness or alopecia.
Alopecia ; Animals ; Emodin* ; Hair Follicle ; Hair* ; Mice* ; Minoxidil ; Prostaglandin D2 ; Rheum ; Skin

Subclavian venous catheterization was previously frequently performed, but because of life-threatening complications such as hemothorax, pneumothorax, mediastinal hematoma, and myocardial injury, its use has become less common. However, this practice has some advantages in patient mobility, secured dressing, and rapidity and adequacy of vascular access. In some situations where patient comfort is an especially important consideration, such as with totally implantable venous port insertion for chemotherapy, the subclavian route can be a good choice if an experienced and well-trained faculty is available. The authors have had recent experience with pinch-off syndrome-in other words, spontaneous catheter fracture-in 3 patients who had undergone venous port implantation through the right subclavian route. Through these cases, we intend to review the dangers of subclavian venous catheterization, the causes of pinch-off syndrome, and its clinical presentation, progress, treatments, and prevention.
Bandages ; Catheterization ; Catheters ; Hematoma ; Hemothorax ; Humans ; Pneumothorax

OBJECTIVE: To investigate the real condition of pulmonary rehabilitation for patients with advanced neuromuscular diseases (NMDs) on mechanical ventilation in Korea. METHOD: In order to estimate current state of pulmonary rehabilitative management, chart review and pulmonary function evaluation were conducted in a total of 267 NMD patients who had applied mechanical home ventilator in our center from March 2001 to December 2008. RESULTS: Total 267 patients were included: 95 with Duchenne muscular dystrophy, 69 with other types of myopathy, 83 with amyotrophic lateral sclerosis (ALS), 20 with spinal muscular atrophy. Among them, 18 who were previously intubated and 17 patients who had undergone tracheostomy were switched into volume-limited non-invasive ventilation (NIV). At the time of hospital discharge, 234 patients were applied NIV successfully. Twenty other patients who once used continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) ventilators inappropriately were switched into volume-limited NIV. However, 20 patients who had successfully applied NIV first underwent tracheostomy due to exacerbation of underlying disease. CONCLUSION: Adequate pulmonary management is the only promising method to prevent lethal complications, and to prolong life span of advanced NMD patients. We assume that more NMD patients can improve their quality of life and prolong their life through proper pulmonary rehabilitation including regular pulmonary function check-ups and ventilatory state monitoring as well as early NIV application.
Amyotrophic Lateral Sclerosis ; Continuous Positive Airway Pressure ; Humans ; Korea ; Muscular Atrophy, Spinal ; Muscular Diseases ; Muscular Dystrophy, Duchenne ; Neuromuscular Diseases ; Noninvasive Ventilation ; Quality of Life ; Respiration, Artificial ; Tracheostomy ; Ventilators, Mechanical