Paraganglioma is a benign tumor arising in the paraganglion system scattered throughout the body, but its cytopathologic findings arenot well known. We experienced a case of paraganglioma of carotid body diagnosed by fine needle aspiration. The patient was a 30 year-old female who suffered from the left neck mass for 3 years. The mass was 3x3crn in size without pulsation or bruit. Cytologically, the smear revealed aggregated and singly scattered tumor cells having abundant pale cytoplasm and indistinct cell borders. Their nuclei were round to oval, but enlarged nuclei were occasionally observed. The nuclear membrane was smooth with fine clumping of chromatin. Differentiation from metastatic follicular carcinoma of the thyroid gland was difficult.
Adult ; Biopsy, Fine-Needle ; Carotid Body ; Chromatin ; Cytoplasm ; Female ; Glomerulosclerosis, Focal Segmental* ; Humans ; Neck ; Nephrotic Syndrome* ; Nuclear Envelope ; Paraganglioma ; Thyroid Gland

PURPOSE: To investigate the effect of growth hormone(GH) secretion on serum concentration of leptin, we evaluated the differences in serum concentration of leptin between patients with growth hormone deficiency(GHD) and GH normal short stature in prepubertal male children, and the relationship between GH and serum leptin level. Also, we analyzed the correlation between serum concentrations of leptin and insulin-like growth factor-I(IGF-I), insulin-like growth factor binding protein-3(IGFBP-3), total cholesterol(TC), free fatty acid(FFA) and body mass index(BMI). METHODS: Eight cases with GHD and 10 cases with GH normal short stature were included in this study. Patients were all male, prepubertal children with mean age 10.6 years. Blood samples were collected in these patients by L-dopa GH provocation test. Statistical analysis of the comparisons of serum leptin level and correlation of multiple variables were performed using PC-SAS program. Significance was defined as P<0.05. RESULTS: The mean serum concentration of leptin in GHD(12.27+/-10.63ng/mL) was significantly higher than in GH normal short stature(5.39+/-3.21ng/mL)(P=0.0344). Serum concentration of leptin was negatively correlated to GH(y=-7.7x+43.3, r=-0.23, P=0.0109). Serum concentration of leptin was positively correlated to BMI(y=2.5x-33.3, r=0.75, P=0.0003). Serum concentration of leptin was not correlated to IGF-I, IGFBP-3, TC and FFA. CONCLUSION: Serum concentration of leptin was siginificantly increased in patients with GHD compared to GH normal short stature and was negatively correlated to GH.
Child ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Leptin* ; Levodopa ; Male

A 64-year-old male patient presented with hand numbness and gait disturbance. He had undergone cervical artificial disc replacement (C-ADR) at another hospital nine years earlier. Magnetic resonance imaging (MRI) revealed a protruded disc at the surgical level compressing the spinal cord. The implant and protruded disc were removed. Fusion was then performed. This case report highlights the importance of long-term follow-up of patients who have undergone C-ADR, and the need to be aware of the potential for late complications.In addition, it is important to ensure as complete a disk removal as possible during C-ADR.

The effect of intranasal nifedipine drops in 20 randomly chosen patients with diethyl-ether induced hypertension by inhalation anesthesia was observed. Patients were placed in two groups: the first group received intranasal nifedipine at the time of induction and the second group received intranasal nifedipine at the time to skin incision. The change in mean arterial pressure in the first group was not significant, but in the second group, the increase in mean arterial pressure was significant immediately after intranasal administration of nifedipine at the time of skin incision. An increase in pulse rate was noted with the increase in mean arterial pressure and this is thought to result from the stimulation of catecholamine secretion and baroreceptor reflex. Since the difference in mean arterial pressure between the two groups was minimal at ten minutes and twenty minutes after skin incision, it is suggested that the onset of intranasal nifedipine is quite fast. Based on the authors' experience, intranasal administration of nifedipine is very useful in preventing or treating hypertension during inhalation anesthesia using diethyl-ether.
Administration, Intranasal* ; Anesthesia, Inhalation ; Arterial Pressure ; Baroreflex ; Ether* ; Heart Rate ; Humans ; Hypertension ; Nifedipine* ; Skin

BACKGROUND: It has been sugested that excessive airway narrowing in asthma may be detected by a decrease in forced vital capacity (FVC). A volume differrence between slow vital capacity (SVC) and FVC may be used as a surrogate index of airway collapse. OBJECTIVE: To investigate the relationship between an airway collapsibility index (CI) and airflow limitation or airway hyperresponsiveness in asthma. METHODS: Forty-six patients with suspected asthma and 21 normal control subjects were enrolled. CI was defined as a difference between SVC and FVC, and measured before and after a methacholine (MCh) bronchoprovocation test. Positive response to MCh was defined as a fall of FEV1 by more than 12%. RESULTS: CI significantly increased from 1.10+/-3.86% to 5.52+/-7.91% after MCh in the positive MCh group (n=19, p<0.01). Not only FVC but also SVC was significantly decreased after MCh. One-fifth of the decrease in FVC was caused by the increase in CI. Both FVC and SVC were significantly related to baseline FEV1 values and in percent change after MCh. Although CI was also significantly related to FEV1 in percent change after MCh. CI was significantly higher in the positive MCh group than in the control and was not significantly related to baseline FEV1 values. Furthermore, the relationship of CI values between before and after MCh was significant (r=0.622, p<0.01). CI was not significantly different according to the severity of MCh-PC20. CONCLUSION: Because the relationship between CI and the severity of airflow limitation or MCh-PC20 was less significant. CI may be better than FVC to represent the characteristic of excessive airway narrowing in asthma.
Asthma* ; Humans ; Methacholine Chloride ; Vital Capacity

Traumatic scars on skin covering areas of high movement, especially areas on the face, can be stressful for patients. We report two cases of traumatic scars that occurred on the chin, and that were successfully treated with a combined therapy of 595-nm pulsed dye laser (PDL) and intramuscular injection of botulinum toxin. After the treatment, good cosmetic results were achieved in both patients. The only adverse effect during and after the treatments was mild pain, which resolved within several days without any additional treatment. In conclusion, the combination of 595-nm PDL and intramuscular botulinum toxin injection was shown to be a safe and effective treatment for traumatic scars on the mobile chin area in Korean patients.
Botulinum Toxins* ; Chin ; Cicatrix* ; Humans ; Injections, Intramuscular ; Lasers, Dye* ; Skin

Milwaukee shoulder syndrome is a rare clinical entity that is a rapid destructive shoulder arthropathy associated with deposition of calcium hydroxyapatite crystals. It mainly affects elderly women. It is characterized by the presence of large amount of noninflammatory synovial fluid containing calcium hydroxyapatite crystals, a complete tear of the rotator cuff and progressive degenerative changes at the humeral head, leading to almost complete functional impairment. We present a case of a 65-year-old woman suffered by Milwaukee shoulder syndrome with literature view.
Aged ; Durapatite ; Female* ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder* ; Synovial Fluid

PURPOSE: To determine useful diagnostic criteria of cubital tunnel syndrome (CTS), using ultrasonographic ulnar nerve cross-sectional areas (UNCSA) measurements. MATERIALS AND METHODS: The CTS group included 28 patients confirmed with nerve conduction study and the control group included 17 healthy adults. Ulnar nerve cross-sectional areas (UNCSA) were measured at the distal 1/3 upper arm level and in the cubital tunnel (CTN). US findings of CTS were ulnar nerve dislocation (n = 2), ulnar nerve subluxation (n = 5), ganglion (n = 1), sever elbow joint osteoarthritis (n = 1) and elbow joint valgus deformity after fracture (n = 1). UNCSA, the ratio of UNCSA in CTN to distal 1/3 upper arm level (CH ratio), and the difference of UNCSA between CTN and distal 1/3 upper arm level (CH difference) were evaluated to obtain the optimal diagnostic cutoff value of CTS, using ROC curve. RESULTS: The mean UNCSA in CTN was 0.168 cm2 in the CTS and 0.067 cm2 in the control. The CTS could be diagnosed when UNCSA, the CH ratio and the CH difference are larger than 0.096 cm2, 1.371 and 0.036 cm2 respectively. The ROC curve area was largest and the sensitivity, specificity was respectively 82.4%, 95.8%, when the CH difference was used as cutoff value. CONCLUSIONS: Ultrasound is useful for the detection of CTS pathogenic lesions in CTN. The highest diagnostic accuracy was acquired when the CH difference is larger than 0.036 cm2.
Adult ; Arm ; Congenital Abnormalities ; Cubital Tunnel Syndrome ; Dislocations ; Diterpenes ; Elbow Joint ; Ganglion Cysts ; Humans ; Neural Conduction ; Osteoarthritis ; ROC Curve ; Sensitivity and Specificity ; Ulnar Nerve

PURPOSE: This comparative study analyzed the relationship between the preoperative diagnostic tumor size and the postoperative pathologic tumor size for breast cancer patients and benign breast tumor patients. METHODS: We analyzed the clinicopathological information of 191 breast cancer patients and 187 benign breast tumor patients by conducting a retrospective chart review. The preoperative diagnostic tumor sizes were measured using physical examination, mammography and sonography in the benign breast tumor patients and they were additionally measured by computerized tomography and magnetic resonance imaging in the breast cancer patients. Body mass index (BMI) was defined as the ratio of the body weight in kilograms to the square of height in meters. RESULTS: The tumor sizes measured by mammography (r=0.66) and physical examination (r=0.87) were highly correlated to the pathologic tumor size in the breast cancer patients and benign the breast tumor patients, respectively. Physical examination and magnetic resonance imaging had a tendency to overestimate the tumor size and sonography underestimated the pathologic tumor size in the breast cancer patients. The correlation coefficient for the physical examination was increased when the patient age was less than 50 years and the BMI was less than 25. Multiple regression analysis revealed that assessing the tumor size according to physical examination, mammography and sonography were effective for determining estimation of pathologic tumor size in the benign breast tumor patients, but assessing the tumor size by physical examination and sonography was not effective for determining the tumor size in breast cancer patients. CONCLUSION: Mammography and physical examination can be useful to estimate the pathologic tumor size in breast cancer patients and benign breast tumor patients, respectively. Physical examination can be useful to estimate the size when a breast tumor is palpable, the age of a patient is less than 50, and the BMI is less than 25.
Body Mass Index ; Body Weight ; Breast ; Breast Neoplasms ; Humans ; Magnetic Resonance Imaging ; Mammography ; Physical Examination ; Retrospective Studies ; Tumor Burden

PURPOSE: A new therapeutic approach is needed in patients with metastatic renal cell carcinoma (RCC) because of a dismal prognosis. MN/CA9 is a transmembrane glycoprotein that was first identified in the human cervical carcinoma cell line, HeLa. Since MN/CA9 protein is highly expressed in RCC tissues, but not in normal kidney, we constructed a tumor-specific replication-competent adenoviral vector utilizing MN/CA9 promoter (Ad-MN/CA9-E1a) and demonstrated its selective cytotoxicity toward MN/CA9-expressing RCC cells in vitro. MATERIALS AND METHODS: MN/CA9-positive (HeLa, SK-RC-52) and MN/ CA9-negative (SK-RC-29) cells were used. RT-PCR assay for MN/CA9 mRNA was performed in each cells. Ad5 E1a protein production in each cells after infection with Ad-MN/CA9-E1a was determined by western blot analysis. In vitro cytotoxicity assay was performed for assessing the selective cytotoxicity of Ad-MN/CA9-E1a to MN/CA9-expressing cells. RESULTS: RT-PCR assay showed that a distinct 255-bp fragment corresponding to the sequence within MN/CA9 cDNA was detected in HeLa and SK-RC-52 cells, but SK-RC-29 cells did not have MN/CA9 transcripts. Western blot analysis demonstrated that HeLa and SK-RC-52 cells showed much stronger Ad5 E1a protein expressions compared with SK-RC-29. In vitro cytotoxicity assay revealed that the growth of MN/CA9-positive cells was significantly inhibited with 0.1-1MOI of Ad-MN/CA9-E1a, but the growth of MN/CA9-negative cells (SK-RC-29) could only be inhibited by as many as 100MOI. CONCLUSIONS: These results suggest that a novel replication-competent adenoviral vector mediated by MN/CA9 promoter, Ad-MN/CA9-E1a, can selectively replicate in MN/CA9-expressing cancer cells with cytotoxic effects and may be utilized for the treatment of RCC.
Adenoviridae* ; Blotting, Western ; Carcinoma, Renal Cell* ; Cell Line ; DNA, Complementary ; Genetic Therapy* ; Glycoproteins ; Humans ; Kidney ; Prognosis ; RNA, Messenger ; Virus Replication