Sentinel Node Biopsy (SNB) is beneficial for reducing axillary functional impairment and lymphedema due to extended lymph node dissection. We used the Indigo Carmine dye instead of radioisotope, since it can simplify the complicated multistep identifying procedures and has economic benefit because it requires no radioisotope detection equipment. The operation for small breast cancer is continuously changing from a modified radical mastectomy to various type of breast conserving operations. Among these we performed a partial mastectomy with rotation flap using remnant breast tissue (RFB). This method needs small operation field, so we could reduce trauma to the patient, shorten the operation time, and use natural blood supplies and tissues without destructing other organ structures. The cosmetic effect is desirable to Korean women considering their relatively small breast size as to that of western people. In SNB, 5cc indigocarmine was injected intradermally just around main lesion. Sentinel node was able to be identified easily if a proper dose was used. Its approach was achieved in 15 to 20 minutes. Partial mastectomy (quadrantectomy) was done with cancer free margins. Rotation flap which is covering the defect included as much breast tissue as possible sparing the nipple areolar complex. Sentinel node biopsy and rotation flap brought out both satisfactory cosmetic result and cost effective outcome, so this breast conserving method is recommendable to small breast cancers.
Biopsy ; Breast Neoplasms* ; Breast* ; Equipment and Supplies ; Female ; Humans ; Indigo Carmine ; Lymph Node Excision ; Lymphedema ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Nipples

OBJECTIVES: Tourette's Disorder (TD) is a chronic neuropsychiatric disorder characterized by multiple motor and vocal tics with onset in childhood. The aim of this study was to ascertain the increased cortical information transmission in frontal area during tic suppression in drug naive boys with TD using new nonlinear analysis of EEGs, be called Transfer Entropy (TE) which can detect the directed exchange of information between two systems. METHODS: Subjects were 11 drug naive boys with DSM-IV diagnosis of TD and 10 control boys. Clinical assessments were performed, and EEGs were recorded from 19 scalp loci of the international 10-20 systems. TE was estimated by EEG timeseries data after noise reduction. TE difference between TD and control during resting state and between tic suppression and resting state in TD were investigated. RESULTS: Elevated TE was found in extensive channels, including frontal, central and temporal channels (F7, Fz, F8,Cz, C3, P3, T3, and T4) in resting state of Tourette's disorder compared to normal controls. During tic suppression elevated TE was found in more extensive and asymmetrical channels especially prefrontal area (Fp1, Fp2, F3, Fz, F7, F8, Cz, C4, C5, T3, and T4). CONCLUSION: These findings suggest that pathogenesis of Tourette's disorder involve impaired cortical neuronal modulation in subcortical neural circuits. EEG analysis of TE may be a useful tool to investigation of cortical mechanism of psychiatric illness.
Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Electroencephalography ; Entropy ; Neurons ; Noise ; Scalp ; Tics* ; Tourette Syndrome*

Stress induces degeneration of brain structures and functions. Particularly, hippocampus is sensitive to stressful stimulations. In the present study, the change of synaptic related molecules in the mouse dentate gyrus was examined with immunohistochemistry after restraint stress. We subjected mice to restraint stress for 6 h per day for 4 days. As a result, the number of Ki-67, a marker for proliferation, and doublecortin (DCX), a marker for neurogenesis, immunoreactive cells was decreased in the stress group. On the other hand, the intensity of calbindinD-28k, a marker of pre-existing granule cells, immunoreactivity was increased in the granule cell layer after 4 days restraint stress. As well as, the immunoreactivity of synaptic related molecules, postsynaptic density-95 (PSD-95), growth association protein-43 (GAP-43) and beta-NADPH-d reactivity were increased in the inner molecular layer of dentate gyrus after 4 days restraint stress. In conclusion, this study shows that repeated restraint stress suppresses neurogenesis in dentate gyrus and strengthens synaptic plasticity of existing granule cells.
Animals ; Brain ; Dentate Gyrus* ; Hand ; Hippocampus ; Immunohistochemistry ; Mice* ; Neurogenesis ; Plastics*

No abstract available.
Fasting* ; Glucose*

Pseudohypoparathyroidism (PHP) is a rare clinical syndrome characterized by hypocalcemia, hyperphosphatemia and increase of serum parathyroid hormone in association with unique clinical features. We recently experienced a typical PHP type Ia patient who presented with recurrent seizure and muscle spasms and electroencephalogram (EEG) showed generalized spike-and-wave discharges. With the correction of hypocalcemia, seizures did not recur and epileptiform discharges disappeared. We suggest that the possibility of PHP should be considered in patients with seizures showing hypocalcemia and hyperphosphatemia.
Electroencephalography ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Parathyroid Hormone ; Pseudohypoparathyroidism ; Seizures ; Spasm

Voluntary running is known to dramatically increase the cell proliferation and neurogenesis in the dentate gyrus of the adult mouse hippocampus. However, it is crucial to realize that adding excitatory neurons could result in serious maladaptive outcomes for hippocampal circuit function. To investigate the response of mature granule cells on the increase of cell proliferation during voluntary running, we investigated the temporal change of calbindin-D28k (a marker for mature granule cells) using immunohistochemistry during voluntary running with upregulated neurogenesis. By using immunohistochemsitry for Ki-67 and doublecortin (DCX), we observed that the cell proliferation and differentiation of granule cells increased at 1 week of voluntary running. We found that, at 6 weeks of voluntary running, the cell proliferation and differentiation of granule cells returned to sedentary control levels. On the other hand, calbindin-D28k immunoreactivity decreased in the granular cell layer of the dentate gyrus and CA3 region of hippocampus after 1 week of voluntary running. At 6 weeks of voluntary running, the density of the calbindin-D28k in the granular cell layer and CA3 region was returned to the sedentary control level. These results demonstrate that the cell proliferation and differentiation are increased at early point of voluntary running, and the granule cell activity in the dentate gyrus is temporally changed for response to the increase of cell proliferation and differentiation during voluntary running.
Adult ; Animals ; Calbindin 1* ; Cell Proliferation ; Dentate Gyrus* ; Hand ; Hippocampus ; Humans ; Immunohistochemistry ; Mice* ; Neurogenesis ; Neurons ; Running*

Paracrine interactions are imperative for the maintenance of adipose tissue intercellular homeostasis, and intracellular organelle dysfunction results in local and systemic alterations in metabolic homeostasis. It is currently accepted that mitochondrial proteotoxic stress activates the mitochondrial unfolded protein response (UPRmt) in vitro and in vivo. The induction of mitochondrial chaperones and proteases during the UPRmt is a key cell-autonomous mechanism of mitochondrial quality control. The UPRmt also affects systemic metabolism through the secretion of cell non-autonomous peptides and cytokines (hereafter, metabokines). Mitochondrial function in adipose tissue plays a pivotal role in whole-body metabolism and human diseases. Despite continuing interest in the role of the UPRmt and quality control pathways of mitochondria in energy metabolism, studies on the roles of the UPRmt and metabokines in white adipose tissue are relatively sparse. Here, we describe the role of the UPRmt in adipose tissue, including adipocytes and resident macrophages, and the interactive roles of cell non-autonomous metabokines, particularly growth differentiation factor 15, in local adipose cellular homeostasis and systemic energy metabolism.

BACKGROUND: Fine needle aspiration(FNA) is an accurate and safe method for the diagnosis of thyroid nodules. One of the limitations of FNA is the variable rate of unsatisfactory specimens, especially in small sized, deep seated or complex cystic nodules. To overcome this problem, ultrasound-guided FNA(US-FNA) has been widely used. In this study, the adequacy of cytologic specimens by US-FNA was compared with that of conventional palpation-guided FNA(P-FNA). METHODS: The medical records of all patients who were engaged in FNA due to thyroid nodules at Chungnam National University Hospital from January 2003 to July 2004 were retrospectively examined. The US-FNA and P-FNA were performed in 114 and 185 patients, respectively. RESULTS: Comparison of the adequacy of the two techniques in providing sufficient material for the cytologic diagnosis showed that specimens in 24(13.0%) and 6(5.3%) patients collected by P-FNA and US-FNA, respectively, were unsatisfactory(P=0.031). A total of 23 patients underwent thyroid surgery due to strong suspicion of malignancy at cytologic finding and/or on clinical judgement. Seventeen patients belonged to the P-FNA group and 6 patients to the US-FNA group. In the P-FNA group, a histologic diagnosis revealed two false-negative cytologic findings, but no false-negative findings were found in the US-FNA group. CONCLUSION: Compared with P-FNA, US-FNA may reduce the possibility of unsatisfactory cytologic specimens and the rate of false-negative diagnosis, and may improve the diagnostic accuracy in investigating thyroid nodules
Biopsy, Fine-Needle* ; Chungcheongnam-do ; Diagnosis ; Humans ; Medical Records ; Needles ; Retrospective Studies ; Thyroid Gland* ; Thyroid Nodule*

BACKGROUND: Cushing syndrome is characterized by glucose intolerance, cardiovascular disease, and an enhanced systemic inflammatory response caused by chronic exposure to excess cortisol. Eosinopenia is frequently observed in patients with adrenal Cushing syndrome, but the relationship between the eosinophil count in peripheral blood and indicators of glucose level in patients with adrenal Cushing syndrome has not been determined. METHODS: A retrospective study was undertaken of the clinical and laboratory findings of 40 patients diagnosed with adrenal Cushing syndrome at Chungnam National University Hospital from January 2006 to December 2016. Clinical characteristics, complete blood cell counts with white blood cell differential, measures of their endocrine function, description of imaging studies, and pathologic findings were obtained from their medical records. RESULTS: Eosinophil composition and count were restored by surgical treatment of all of the patients with adrenal Cushing disease. The eosinophil count was inversely correlated with serum and urine cortisol, glycated hemoglobin, and inflammatory markers in the patients with adrenal Cushing syndrome. CONCLUSION: Smaller eosinophil populations in patients with adrenal Cushing syndrome tend to be correlated with higher levels of blood sugar and glycated hemoglobin. This study suggests that peripheral blood eosinophil composition or count may be associated with serum glucose levels in patients with adrenal Cushing syndrome.
Blood Cell Count ; Blood Glucose* ; Cardiovascular Diseases ; Chungcheongnam-do ; Cushing Syndrome* ; Eosinophils* ; Glucose ; Glucose Intolerance ; Hemoglobin A, Glycosylated ; Humans ; Hydrocortisone ; Leukocytes ; Medical Records ; Pituitary ACTH Hypersecretion ; Retrospective Studies

BACKGROUND: Nausea and vomiting are predominant accompanying symptoms of migraine attacks. Although the underlying mechanism is not yet clear, gastric stasis is assumed to be the main factor. However, few studies have used direct methods to establish delayed gastric emptying of migraine patients. We compared interictal gastric motility between migraine patients and normal controls with the aid of gastric scintigraphy. METHODS: The study population comprised patients who had been diagnosed with episodic migraine, according to the International Classification of Headache Disorders, edition II. The entire study population was completely free of gastrointestinal symptoms during the headache-free period. Gastric scintigraphy was performed to determine the time to half emptying (T 1/2) and the percentage of radioactive material remaining in the stomach (%RMR) at 30, 60, 90, and 120 min. RESULTS: Twenty-six migraine patients and 12 normal controls were recruited. The mean T 1/2 did not differ between the two groups (101.8 vs 95.2 min; p=0.432). The %RMR values in the stomach at 30, 60, 90, and 120 min also did not differ significantly between the two groups [87.5% vs 88% (p=0.900), 70.8% vs 71.2% (p=0.950), 54.2% vs 53.3% (p=0.753), and 39.0% vs 37.3% (p=0.583), respectively]. CONCLUSIONS: There is no gastric stasis in patients with episodic migraine during headache-free periods. Our results suggest that the main mechanism underlying the nausea and vomiting in migraine patients is not a gastric stasis in interictal periods, but rather a central process, as a result of changes occurring in the brainstem during acute migraine attacks.
Brain Stem ; Gastric Emptying ; Gastroparesis ; Headache Disorders ; Humans ; Migraine Disorders ; Nausea ; Stomach ; Vomiting