PURPOSE: To investigate changes in the ovary revealed by MR imaging before and after radiotherapy in premenopausal patients with cervical carcinoma. MATERIALS AND METHODS: Thirty-three premenopausal patients with cervical carcinoma underwent radiation therapy at an average dosage of 11,279 (external: 5,352; internal: 5,927) cGy. Before and after this therapy, all underwent pelvic MR imaging using a 1.5T MR scanner (GE Medical Systems, Milwaukee, U.S.A.). The average interval of follow-up MR imaging was 7.2 months, and axial T1-weighted and axial and sagittal T2-weighted MR images were obtained. The presence, size number of follicles, and differentiation of the zonal anatomy of the ovary were determined by two radiologists, who reached a consensus. RESULTS: After radiation therapy, all patients ceased menstruation. For ovaries, the detection rates before and after radiation therapy were 94% (62/66) and 39% (26/66) (p<0.05), respectively, and average ovary size was 2.6x1.9x2.2 cm before and 1.7x1.3x1.4 cm after therapy (p<0.05). The average number of ovarian follicles before and after therapy was 5.1 and 3.1, respectively (p<0.05). T2-weighted imaging, demonstrated differentiation of zonal anatomy in 74% of cases (46/62) before radiotheraphy, and 15% (4/26) after (p<0.05). CONCLUSION: Our study has shown that after radiation therapy in premenopausal patients with cervical cancer, detection rates, average size, and the number of ovaries decreased, findings which are similar to those for normal postmenopausal ovary. MR imaging can reveal structural change in ovaries.
Cervix Uteri* ; Consensus ; Female ; Fluconazole ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Menstruation ; Ovarian Follicle ; Ovary* ; Radiotherapy* ; Uterine Cervical Neoplasms

Embryonic stem cells can be differentiated into various types of cells, requiring a tight regulation of transcription. Biomarkers related to each lineage of cells are used to guide the differentiation into neural or any other fates. In previous experiments, we reported the guided differentiation (GD)-specific genes by comparing profiles of random differentiation (RD). Interestingly 68% of differentially expressed genes in GD overlap with that of RD, which makes it difficult for us to separate the lineages by examining several markers. In this paper, we design a prediction model to identify the differentiation into neural fates from any other lineage. From the profiles of 11,376 genes, 203 differentially expressed genes between neural and random differentiation were selected by random variance T-test with 95% confidence and 5% false discovery rate. Based on support vector machine algorithm, we could select 79 marker genes from the 203 informative genes to construct the optimal prediction model. Here we propose a prediction model for the prediction of neural fates from random differentiation which is constructed with a perfect accuracy.
Embryonic Stem Cells ; Stem Cells ; Support Vector Machine ; Biomarkers

PURPOSE: To report a case of congenital symblepharon associated with No. 3 craniofacial cleft. METHODS: A 40-month old girl with left eyelid lesion underwent an ophthalmologic examination at the department of ophthalmology and a face examination at the department of plastic and reconstructive surgery. RESULTS: Congenital symblepharon associated with No. 3 craniofacial cleft including bifid uvula, partial cleft lip, and coloboma of the lower medial eyelid was found. She did not have amblyopia or strabismus. A MEDLINE search of the literature revealed only one reported case of symblepharon associated with a craniofacial cleft.
Amblyopia ; Child, Preschool ; Cleft Lip ; Coloboma ; Eyelids ; Female ; Humans ; Ophthalmology ; Plastics ; Strabismus ; Uvula

A 64-year-old man was treated with sunitinib as a first-line therapy for metastatic renal cell carcinoma. He was given oral sunitinib in cycles of 50 mg once daily for 2 weeks followed by a week off. During the 5th week of treatment right upper quadrant pain developed, but this resolved spontaneously during the 6th week (off treatment). However, on the 8th week of treatment, he was admitted to hospital because the acute right upper quadrant pain recurred with nausea, vomiting, and fever. Acute acalculous cholecystitis was then diagnosed by ultrasonography and CT. In addition, his laboratory findings indicated disseminated intravascular coagulation. Accordingly, sunitinib therapy was discontinued and broad-spectrum antibiotics initiated. He subsequently recovered after emergent percutaneous cholecystostomy. His Naranjo Adverse Drug Reaction Probability Scale score was 7, indicaing a probable association of the event with sunitinib. Suspicion of sunitinib-related acute cholecystitis is required, because, although uncommon, it can be life-threatening.
Acalculous Cholecystitis ; Anti-Bacterial Agents ; Carcinoma, Renal Cell ; Cholecystitis, Acute ; Cholecystostomy ; Disseminated Intravascular Coagulation ; Drug-Related Side Effects and Adverse Reactions ; Fever ; Humans ; Middle Aged ; Nausea ; Ultrasonography ; Vomiting

Coronary stent dislodgement during percutaneous coronary intervention, which occurs when the stent is passed through tortuous and calcified lesions, is not a rare complication. Without proper treatment, such as fixing with another stent in the coronary artery or removing the undeployed stent from the coronary artery or systemic artery system, this complication can cause serious problems. We experienced the unusual situation of a dismounted and dislodged coronary stent, in which retrograde retrieval to the radial artery was impossible during transradial coronary intervention. We report on use of a rendezvous and snare technique at the brachial artery level via femoral puncture, which resulted in resolution without surgery.
Arteries ; Brachial Artery* ; Coronary Vessels ; Endovascular Procedures ; Percutaneous Coronary Intervention ; Punctures ; Radial Artery ; SNARE Proteins* ; Stents*

35 cases of Mallory-Weiss syndrome among 277 cases of upper gastrointestinal bleeding were ascertained by endoscopy at department of internal medicine St. Columban's hospital. The mean age was 41.6 years. All of 35 cases were found in male. Combined disease were gastritis(15 cases), peptic ulcer(7 cases) and esophageal varix(3 cases). The most common precipitating factor was vomiting, 22 cases among the 28 cases of vomiting(80%) developed after drinking. Endoscopic finding revealed active bleeding in 5 cases, blood clot without active bleeding in 22 cases, and scar change without bleeding evidence in 8 cases. Most cases had had hematemesis after active bleeding but 5 cases had had only melena without hematemesis. The Mallory-Weiss lacerations were located at stomach in 16 cases(46%), at esophagogastric junction in 11 cases(31%) and at esophagus in 8 cases. On the view of gastric direction, 14 cases were on anterior wall side, 9 cases were on posterior wall side, 11 cases were on lesser curvature side and one case was on great curvature side. Single lacerations were more common than multiple lacerations.
Cicatrix ; Drinking ; Endoscopy* ; Esophagogastric Junction ; Esophagus ; Hematemesis ; Hemorrhage ; Humans ; Internal Medicine ; Lacerations ; Male ; Mallory-Weiss Syndrome ; Melena ; Precipitating Factors ; Stomach ; Vomiting

PURPOSE: Recently, the American Thyroid Association (ATA) dynamic risk stratification (DRS) has been verified to be more valuable than the static anatomical staging system for predicting prognosis in patients with differentiated thyroid carcinoma (DTC). The purpose of this retrospective study was to compare the clinical usefulness of DRS, which is based on the response to initial treatment, with that of ATA initial risk stratification in pediatric patients. METHODS: A total of 144 pediatric patients underwent thyroid operation from August 1982 to December 2013 at Yonsei University Hospital (Seoul, Korea). Among them, 128 patients with complete clinical data were enrolled in this study. Clinicopathologic features and surgical outcomes were retrospectively analyzed by medical chart review. The mean follow-up duration was 11.5 years. RESULTS: The mean tumor size was 2.1 cm; 80.4% of patients were diagnosed with conventional papillary thyroid carcinoma, and 7.0% of patients were diagnosed with follicular thyroid carcinoma. Low-risk patients had the highest probability of an excellent response to initial treatment (66.6%). High-risk patients had the highest probability of a structural incomplete response (100%) and the lowest probability of an excellent response (11.1%). The ATA risk stratification and the DRS system were independent risk factors for disease-free survival (DFS) (P = 0.041 and P < 0.001, respectively). CONCLUSION: The DRS system, which is based on the response to initial treatment, can offer more useful prognostic information compared with ATA risk stratification in pediatric patients with DTC.
Adenocarcinoma, Follicular ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Pediatrics ; Prognosis ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. MATERIALS and METHODS: We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. RESULTS: The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). CONCLUSION: US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception.
Child* ; Diagnosis ; Emergencies ; Gastrointestinal Tract ; Humans ; Intussusception* ; Retrospective Studies ; Seizures ; Ultrasonography

Radiofrequency (RF) radiation at the frequency of mobile phones has been not reported to induce cellular responses in in vitro and in vivo models. We exposed HEI-OC1, conditionally-immortalized mouse auditory cells, to RF radiation to characterize cellular responses to 1763 MHz RF radiation. While we could not detect any differences upon RF exposure, whole-genome expression profiling might provide the most sensitive method to find the molecular responses to RF radiation. HEI-OC1 cells were exposed to 1763 MHz RF radiation at an average specific absorption rate (SAR) of 20 W/kg for 24 hr and harvested after 5 hr of recovery (R5), alongside sham-exposed samples (S5). From the whole-genome profiles of mouse neurons, we selected 9 differentially-expressed genes between the S5 and R5 groups using information gain-based recursive feature elimination procedure. Based on support vector machine (SVM), we designed a prediction model using the 9 genes to discriminate the two groups. Our prediction model could predict the target class without any error. From these results, we developed a prediction model using biomarkers to determine the RF radiation exposure in mouse auditory cells with perfect accuracy, which may need validation in in vivo RF-exposure models.
Absorption ; Animals ; Cellular Phone ; Gene Expression* ; Mice ; Neurons ; Support Vector Machine ; Biomarkers

BACKGROUND: PTCA is often unsuccessful in a patient with chronic total occlusion of coronary arteries with success rates varying from 60 to 70%. Success rates are related to the duration of total occlusion, longer occlusions being associated with lower success rates. Chronic total occlusion may be associated with thrombi superimposed on the stenotic lesion. We used an intra-coronary bolus of urokinase followed by a prolonged urokinase infusion in an attempt to lyse the lesion and allow for passage of the PTCA wire during subsequent angioplasty. The purpose of prolonged durokinase infusion was to reduce the clot sufficiently to recanalize the coronary artery and make it more amenable to PTCA. METHODS: Study patients: We were included six patients who developed total occlusion for more than 3 weeks and good collateral channels of Grade 2 or more and previous attempts at angioplaty had failed. Procedures: All patients underwent dual catheter system and incremental dose protocol of intracoronary urokinase infusion. RESULTS: The mean duration of occlusion was calculated to be 65.3+/-2.7 weeks and urokinase dose ranged from 130,000 to 200,000U/hr and treatment lasted 21.7+/-1.4 hours in our study. The prolonged urokinase infusion resulted in reperfusion of the occluded dvessel in 5 of the 6 patients(83%), with or without the complementary balloon inflation. One patient failed to recanalize the occluded vessel because cardiac tamponade was developed during the prolonged urokinase infusion. CONCLUSION: We concluded that the prolonged urokinase infusion in occluded coronary artery appeared to increase the likelihood of successful PTCA in patients with chronic total occlusion of coronary arteries.Also, in carefully selected patients, prolonged urokinase infusion in occluded coronary artery was relatively safe and well tolerated.
Angioplasty ; Cardiac Tamponade ; Catheters ; Coronary Vessels* ; Humans ; Inflation, Economic ; Reperfusion ; Urokinase-Type Plasminogen Activator*