PURPOSE: The purpose of this study was to evaluate the CT findings of thyroglossal duct cysts MATERIALS AND METHODS: Sixteen patients with pathologically proved thyroglossal duct cysts were included in the study. CT scans were assessed'retrospectively for shape, size, location, density of the central portions, septations, rim enhancement, changes in the adjacent fascial planes and investment within the strap muscles in the infrahyoid cysts. RESULT: Thirteen cases of thyroglossal duct cysts were seen as round or oval cystic masses, two cases of them were seen as irregular-shaped Iobulated cystic masses, and one case was seen as ovoid soft tissue mass. The cysts were from 1.4 to 5.7cm in diameter(mean, 2.6cm). The cyst was infrahyoid in 15 cases and suprahyoid in one case. The cyst was located in midline in eight cases, off midline in four cases, and both midline and off midline in four cases. The density of the central portions ranged from 15 to 82HU(mean, 32HU). Septations were noted in four cases. Rim enhancement was seen in 14 cases(93%), and heterogenously enhancing soft tissue mass was seen in one case. In four cases, abnormal fascial planes were observed. All but one of the infrahyoid cysts(14/15) were embedded within the strap muscles, and one case of them was located anteriorly to strap muscles. CONCLUSION: CT permits one to make the diagnosis a thyroglossal duct cyst with a high degree of accuracy, as it can differentiate thyroglossal duct cysts from the other anterior neck masses by their typical location, characteristic morphology, and investment within the strap muscles.
Diagnosis ; Humans ; Investments ; Muscles ; Neck ; Thyroglossal Cyst* ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to identify the patterns of activities of daily living (ADL) functional status and to examine the relationships between sense of coherence (SOC), depression, and uncertainty in gynecologic cancer patients who were receiving chemotherapy. METHOD: A prospective, longitudinal design with repeated measures was utilized. Women reported depression, SOC, and uncertainty at the beginning of the first cycle of chemotherapy, and they recorded ADL functional status everyday for two consecutive treatment cycles. the The instruments used were the Karnofsky Performance Status Index, Orientation to Life Questionnaire, Beck Depression Inventory, and Mishel Uncertainty in Illness Scale-Adult Form. RESULT: Data from 42 women showed that the ADL functional status during the second cycle was better than that of the first cycle with significant improvement each week. However, it did not completely recover to the baseline level even three weeks after the treatment ended in both cycles. SOC was correlated with depression (r=-.64, p< .001) and uncertainty (r=-.62, p< .001). Uncertainty was related to depression (r=.66, p< .001) and to functional status during the second cycle (r=-.45, p< .05), while the scores of the functional status during the two cycles were not related. CONCLUSION: Changing patterns and level of functional status during the treatment phase would be useful information for cancer patients to prepare coping strategies for positive health outcomes.
Activities of Daily Living ; Depression ; Drug Therapy* ; Female ; Humans ; Karnofsky Performance Status ; Prospective Studies ; Surveys and Questionnaires ; Sense of Coherence ; Uncertainty

PURPOSE: The magnetic resonance(MR) appearance of 23 biopsy-proven meningiomas were retrospectively evaluated and correlated with histologic pattern ;fibroblastic, transitional, syncytial, angioblastic. MATERIALS AND METHODS: Twenty three patients with biopsy-proven meningiomas were examined with MR imaging over a 3 years period. Images were assessed for average T1, T2 intensity score(1-5), degree of edema, calcification, cyst formation or necrosis, and dural tail sign. RESULTS: Tl-weighted images showed only one significant correlation between fibroblastic type and angiobiastic type (p<0.04). Angioblastic type was more hypointense than gray matter(1.83/isointense to gray 3) on T1-weighted image. Syncytial and angioblastic tumors had average T2 intensity scores much higher than those of fibroblastic and transitional types. All three cases of angioblastic tumors had shown severe edema. Calcified lesions were much more common in transitional and fibroblastic types than in syncytial and angioblastic types. CONCLUSION: MRI is a helpful diagnostic imaging modality with good correlation between its MR findings and histologic patterns.
Diagnostic Imaging ; Edema ; Fibroblasts ; Humans ; Magnetic Resonance Imaging* ; Meningioma* ; Necrosis ; Retrospective Studies

The role of duodenal reflux and the time required for the development of Barrett's esophagus has remained controversial. We report a case of Barrett's esophagus that developed 6 months after total gastrectomy. A 76-year-old man diagnosed with gastric adenocarcinoma underwent a total gastrectomy and a Rouxen-Y esophagojejunostomy. The gastroesophageal junction in the resected specimen was both grossly and microscopically normal at the time of the operation. A routine follow-up endoscopic examination performed 6 months later revealed a tongue-like projection of redcolored columnar tissue. No reflux symptoms (heartburn or acid regurgitation) had been present during the intervening 6 months. A biopsy specimen from the esophagus showed intestinal-type metaplasia of the columnar epithelium. This case supports the development of Barrett's esophagus solely from duodenal reflux and after a relatively short time in this clinical setting.
Adenocarcinoma ; Aged ; Barrett Esophagus ; Biopsy ; Duodenogastric Reflux ; Epithelium ; Esophagogastric Junction ; Esophagus ; Follow-Up Studies ; Gastrectomy ; Humans ; Metaplasia

Familial adenomatous polyposis (FAP) is an autosomal dominant syndrome, typically characterized by multiple colorectal adenomas and increased incidence of colorectal carcinomas if left untreated. It is caused by germline mutations of the adenomatous polyposis coli (APC) gene, which has been mapped on chromosome 5q21, and is accompanied by various benign and malignant extracolonic manifestations. The prevalence of thyroid tumors developing in patients with FAP is about 1~2%, are associated with FAP and have certain characteristics; mean age of tumor diagnosis at less than 30 years of age, the pathology is the papillary histiotype in more than 90% of cases, including a so-called cribriform- morular pattern, and multifocality is a frequent feature. In a genetic analysis, thyroid cancer in FAP usually has a mutation in the 5-portion of exon 15 between 778 and 1309, on chromosome 5q21. Also, the ret/PTC (especially ret/PTC1 and ret/PTC3) and p53 genes are thought probably to be associated with thyroid cancer in FAP patients. A case of familial adenomatous polyposis, accompanied by thyroid papillary cancer, was experienced in a 29 year-old female. She had hundreds of adenomas throughout the entire colon and congenital hypertrophy of the retinal pigment epithelium (CHRPE). The pathological finding of thyroid cancer was revealed as a mixture of cribriform, trabecular and papillary patterns. In a genetic analysis, she and her brother had a germline mutation of the APC gene at codon 1309. In Korea, there has been no previous case of cribriform-morular pattern and familial genetic analysis in FAP associated with thyroid cancer. Therefore, this case is reported, with a review of the literature
Adenoma ; Adenomatous Polyposis Coli* ; Adult ; Codon ; Colon ; Colorectal Neoplasms ; Diagnosis ; Exons ; Female ; Genes, APC ; Genes, p53 ; Germ-Line Mutation ; Humans ; Hypertrophy ; Incidence ; Korea ; Pathology ; Prevalence ; Retinal Pigment Epithelium ; Siblings ; Thyroid Gland* ; Thyroid Neoplasms

Among the exotoxins produced by V. vulnificus, hemolysin (HS) has been reported to be the most potent one. To investigate the factors up- or down-regulating HS production in the context of pathogenesis, we observed the effects of salinity or/and temperature shifting, glucose, and acidic pH on the production of HS by V. vulnificus C7184 strain in vitro. Significantly more HS was produced when V. vulnificus was cultured in 0.9% salinity and 37 degrees C than in 2.5% and 25 degrees C. When the culture condition reflecting natural habitat of V. vulnificus (2.5% salinity and 25degrees C) was changed into that reflecting human body (0.9% salinity and 37 degrees C), 2.5 fold or more HS was produced than in the V. vulnificus being cultured continuously in 0.9% NaCl at 37 degrees C. This result suggests that V. vulnificus somehow recognizes the shifting in salinity and temperature and stimulate HS production. Glucose addition in the culture medium resulted in a dose- dependent decrease in the HS production. Glucose itself and acidic pH resulting from its metabolism both appeared to inhibit the HS production. Glucose in itself had more dominant role in suppressing the HS production than the lowered pH accompanying the metabolism of glucose. This result suggests that HS production is down-regulated in the presence of glucose and under environmental acidic pH.
Ecosystem ; Exotoxins ; Glucose* ; Human Body ; Hydrogen-Ion Concentration ; Metabolism ; Salinity* ; Vibrio vulnificus* ; Vibrio* ; Virulence

PURPOSE: We have previously cloned three enhancer factor genes encoding proteins that bind to long terminal repeats (LTRs) of Rous sarcoma virus. Among these genes, RSV- EF-I gene is expressed in rat hepatoma tissues and several proliferating cell lines but not in normal rat liver tissues. We have isolated the human homologue of RSV-EF-I gene and examined its expression in human hepatocellular carcinoma tissues. MATERIALS AND METHODS: We have screened the human genomic library and cDNA library of Hep G2 cell line derived from human hepatocellular carcinoma to isolate the human homologue of RSV-EF-I gene. RESULTS: We have isolated one cDNA clone containing about 1.5 kb insert and sequenced. Sequence analysis reveals that this human homologue of RSV-EF-I gene has a high similarities to human YB-1 mRNA, human DNA-binding protein B (dbpB) gene and other Y-box protein genes. It is expressed in human hepatocellular carcinoma but very slightly in normal human liver tissues in Northern blot analysis. CONCLUSION: Our data suggest that the human homologue of RSV-EF-I gene presumably belongs to Y-box protein family genes and plays a role in the transformation of the human hepatoma cells.
Animals ; Blotting, Northern ; Carcinoma, Hepatocellular* ; Cell Line ; Clone Cells ; DNA, Complementary ; Gene Library ; Genomic Library ; Hep G2 Cells ; Humans* ; Liver ; Rats ; RNA, Messenger ; Rous sarcoma virus* ; Sarcoma, Avian* ; Sequence Analysis ; Terminal Repeat Sequences

BACKGROUND/AIMS: Repeat endoscopy with biopsy is often performed in patients with previously diagnosed gastric cancer to determine further treatment plans. However, biopsy results may differ from the original pathologic report. We reviewed patients who had a negative biopsy after referral for gastric cancer. METHODS: A total of 116 patients with negative biopsy results after referral for biopsy-proven gastric cancer were enrolled. Outside pathology slides were reviewed. Images of the first and second endoscopic examinations were reviewed. We reviewed the clinical history from referral to the final treatment. RESULTS: Eighty-eight patients (76%) arrived with information about the lesion from the referring physician. Among 96 patients with available outside slides, the rate of interobserver variation was 24%. Endoscopy was repeated at our institution; 85 patients (73%) were found to have definite lesions, whereas 31 patients (27%) had indeterminate lesions. In the group with definite lesions, 71% of the lesions were depressed in shape. The most common cause of a negative biopsy was mistargeting. In the group with indeterminate lesions, 94% had insufficient information. All patients with adequate follow-up were successfully treated based on the findings in the follow-up endoscopy. CONCLUSIONS: A negative biopsy after referral for biopsy-proven gastric cancer is mainly caused by mistargeting and insufficient information during the referral.
Adult ; Aged ; Aged, 80 and over ; Biopsy/statistics & numerical data ; Diagnostic Errors/*statistics & numerical data ; Female ; Gastroscopy/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Observer Variation ; Referral and Consultation/statistics & numerical data ; Reoperation/statistics & numerical data ; Republic of Korea ; Retrospective Studies ; Stomach/*pathology ; Stomach Neoplasms/*pathology ; Young Adult

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the 6th Clinical Practice Guidelines in 2019. Targets of glycemic, blood pressure, and lipid control in type 2 diabetes mellitus (T2DM) were updated. The obese and overweight population is increasing steadily in Korea, and half of the Koreans with diabetes are obese. Evidence-based recommendations for weight-loss therapy for obesity management as treatment for hyperglycemia in T2DM were provided. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations.
Blood Pressure ; Diabetes Mellitus, Type 2 ; Diagnosis ; Glucagon-Like Peptide 1 ; Humans ; Hyperglycemia ; Korea ; Obesity ; Overweight

A 48 year-old man was referred to our Department with a headache, and also presented with an elevated serum ACTH level, but without an elevated serum cortisol. Although there was no clinical evidence of Cushing's syndrome, a brain CT and MRI showed a 4x4.5 cm sized pituitary mass, which was successfully removed by a transsphenoidal approach (TSA). A histopathological examination revealed the mass to have an ACTH positive reaction. Therefore, through hormonal and pathological evaluation, a silent corticotroph-cell adenoma (SCCA), with an elevated serum ACTH level, was diagnosed. Although reports on SCCA have been recently increased, this case is reported because these kinds of tumor are still rare, and those SCCA with an elevated serum ACTH even more so
Adenoma* ; Adrenocorticotropic Hormone* ; Brain ; Cushing Syndrome ; Headache ; Humans ; Hydrocortisone ; Magnetic Resonance Imaging ; Middle Aged ; Pituitary Neoplasms