PURPOSE: The purpose of this study is to evaluate the expression of E-cadherin and cathepsin-B in prostatic carcinomas and correlate with the Gleason grades. MATERIALS AND METHODS: The expressions of E-cadherin and cathepsin B were examined by the immunohistochemical technic using the antibodies against the E-cadherin and cathepsin B on the paraffin block sections of 56 prostatic carcinomas with evaluation of Gleason grading. RESULTS: E-cadherin expression in normal epithelium was membranous intercellular expression and those of prostate carcinomas were aberrant expressions such as negative expression or cytoplasmic presentation. The expressivity of the E-cadherin according to the progression of the Gleason grading revealed negative membranous expression and tendency of gradual increase of aberrant expression. The normal prostate and BPH revealed expression of cathepsin B mostly in the basal layers of acini as cytoplasmic reaction and the stromal macrophages and microvessel wall also showed positive expression. The prostatic carcinoma showed cytoplasmic positivity in the cancer cells and the expression rate was increased from Gleason grade 2 to Gleason grade 4. But the Gleason grade 5 tissue revealed decreased or negative expression. The Gleason grade 4, especially in the invasive cells and invasive edges, revealed the most intense and frequent expression of cathepsin B and this findings were consistent with the nonnal function of the cathepsin B as a protease degrading the extracellular matrix proteins. CONCLUSION: E-cadherin expression was aberrant after Gleason grade 6 related with high histologic grades. It is suggested that the E-cadherin expression could tell the potential cancer progression as a tumor suppression factor. The cathepsin B was most strongly expressed in basal cells of the benign prostatic acini and the cancer nests of Gleason grade 4, which tells the possibility that cathepsin B could be a marker of basocellular differentiation and of assessing stromal invasion of prostatic carcinomas.
Antibodies ; Cadherins* ; Cathepsin B* ; Cathepsins* ; Cytoplasm ; Epithelium ; Extracellular Matrix Proteins ; Macrophages ; Microvessels ; Neoplasm Grading ; Paraffin ; Prostate

Cryptococcosis is a systemic opportunistic infection mostly occurred in immunosuppressed patients. Pulmonary cryptococcosis in immunocompetent host is usually localized and self-limiting disease. Pulmonary nodule or mass is the most common radiologic finding, however involvement of mediastinal lymph nodes is rare. Here we report a case of pulmonary cryptococcosis with massive mediastinal lymph nodes involvement in immunocompetent host.
Cryptococcosis* ; Humans ; Lymph Nodes* ; Opportunistic Infections ; Pneumonia

Background: We recently introduced the Barricor (BD, Franklin Lakes, NJ, USA) plasma separation tube, which uses a mechanical separator instead of a gel. We evaluated the effects of using the Barricor tube in a stat (statin) laboratory on the results and turnaround time (TAT) of routine chemical tests. We verified the impact of Barricor tube on reducing TAT and providing results similar to those obtained using serum separator tubes (SSTs). Methods: We collected venous blood samples from 166 outpatients in Barricor tubes and SSTs and measured 28 routine analytes using an AU5800 instrument (Beckman Coulter, Brea, CA, USA). TAT indexes were compared before and after using Barricor tube. Results: Mean percent differences were < 5%, except for alanine aminotransferase , total CO2, high-density lipoprotein, phosphate, total protein, and direct bilirubin. The median TAT decreased from 45 to 38 minutes, and the rate of a TAT > 60 minutes decreased from 7.84% to 2.66%, which was approximately one-third of that for SST. The reduction in TAT was attributable to a decrease in centrifugation time. Incomplete clotting and repeated centrifugation, which occurred frequently when using SST, also decreased after using the Barricor tubes. Conclusions The Barricor tube is an alternative to SST for routine chemical tests in institutions aiming to reduce TAT, with clinically allowable differences in test results.

OBJECTIVE: To determine which ultrasonographic measurement can be used as an indicator reflecting the severity of carpal tunnel syndrome (CTS), by comparing electrodiagnostic results with ultrasonographic measurements in females. Many previous studies have tried to reveal that the ultrasonography (US) can possibility be used for diagnosis and severity of CTS. However, the criteria are different by gender. Thus far, there have been many efforts towards providing patients with a CTS diagnosis and severity prediction using US, but studies' results are still unclear due to lack of data on gender differences. METHODS: We collected data from 54 female patients. We classified the severity of CTS according to electrodiagnostic results. Ultrasonographic measurements included proximal and distal cross-sectional areas of the median nerve and carpal tunnel. RESULTS: The severity by electrodiagnostic results statistically correlated to the proximal cross-sectional area (CSA) of the median nerve and carpal tunnel. However, there was no relationship between the proximal and distal nerve/tunnel indexes and the severity by electrodiagnostic results. CONCLUSION: In female patients with CTS, the proximal CSAs of the median nerve and carpal tunnel increase. They correlate with the severity by electrodiagnostic findings. The CSA of the proximal median nerve could be particularly used as a predictor of the severity of CTS in female patients. However, the nerve/tunnel index is constant, irrespective of the severity of CTS.
Carpal Tunnel Syndrome* ; Diagnosis ; Electrodiagnosis ; Female* ; Humans ; Median Nerve ; Ultrasonography

PURPOSE: Anatomical change of the prostatic stroma, that is benign prostatic hyperplasia, results in a functional change which manifests as lower urinary tract symptoms (LUTS). We observed/investigated whether there are structural changes in the three-dimensional arrangement of muscle, collagen and elastin fibers of the prostatic urethra which can be another possible mechanism of LUTS. MATERIALS AND METHODS: Hyperplastic nodules, which were surgically en bloc resected, and normal prostate from radical cystectomy specimens were examined. Surgical specimens were fixed in formalin and sectioned serially in a transverse plane along the lumen of the upper segment of the prostatic urethra. Additional sagittal sections were also made serially. All tissue blocks were 2mm thick. All slides were prepared with hematoxylin-eosin, Masson-trichrome and Verhoeff's elastin stain. RESULTS: Muscle and collagen fibers surrounding prostatic acini seemed poorly oriented and blended with the outermost fibers of the urethra. Muscle and stromal fibers surrounding the prostatic urethra seemed to be stretched and oriented mainly in the longitudinal direction with small fibroblastic nodules in the periurethral stroma. A periurethral gland structure was observed between the urethral wall in which the fiber was arranged longitudinally. Circular muscle fibers were not observed in the periurethral area, indicating that the surgical capsule resulted from urethral muscle fibers. CONCLUSIONS: Apparent changes to the 3-dimensional arrangement of collagen, elastin and muscle fibers surrounding the acini and prostatic urethra were not observed in the proximal prostatic urethra or the bladder neck, except that the fibers surrounding the urethra were stretched.
Collagen* ; Cystectomy ; Elastin* ; Fibroblasts ; Formaldehyde ; Lower Urinary Tract Symptoms ; Neck ; Prostate ; Prostatectomy ; Prostatic Hyperplasia* ; Urethra* ; Urinary Bladder

The reversible cerebral vasoconstriction syndromes (RCVS) is a group of conditions, which is characterized by a reversible segmental constriction, typically associated with recurrent thunderclap headaches, and is often complicated by ischemia or hemorrhagic stroke. Clinical situations, associated with the development of RCVS, include pregnancy or the postpartum period, as well as various medications and illicit drugs. However, vasoconstriction syndromes remain poorly characterized, under-recognized, and difficult to diagnose, because of the lack of specific diagnostic tests or diagnostic criteria. Therefore, we present a first case of reversible cerebral vasoconstriction syndrome of pregnancy complicated with preeclampsia, diagnosed by a magnetic resonance image and angiography, which results in chronic cerebral infarction, with a brief review of the relevant literature.
Angiography ; Cerebral Infarction ; Constriction ; Diagnostic Tests, Routine ; Headache ; Humans ; Ischemia ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Postpartum Period ; Pre-Eclampsia ; Pregnancy ; Street Drugs ; Stroke ; Vasoconstriction

Background: Physicians and caregivers are conflicted over whether to inform patients that their disease is terminal. Studies examining the effect of awareness of prognosis on the survival and quality of life of terminally ill cancer patients report conflicting results. This study aimed to assess the effects of prognosis awareness on the survival time and psychological health of terminally ill cancer patients. Methods: Patients in the hospice wards of two general hospitals were asked to complete a questionnaire. All were mentally alert and could express themselves clearly. Awareness of prognosis was defined as knowing both the diagnosis and exact prognosis. Survival time was defined as the time from hospital admission to death. Multiple psychological examinations were conducted to verify the effect of prognosis awareness on psychological health. Results: Of the 98 subjects who met the inclusion criteria, 65 (66.3%) were aware of their terminal status. The patients’ awareness was significantly related to survival time after adjusting for clinical variables with a hazard ratio of 1.70 (95% confidence interval [CI], 1.01–2.86). Furthermore, the unaware group had a higher risk of cognitive impairment (Mini-Mental State Examination <24; adjusted odds ratio [aOR], 3.65; 95% CI, 1.26–10.59) and a poorer quality of life (physical component summary of the Short Form 36-item Health Survey <20; aOR, 3.61; 95% CI, 1.12– 11.60) than the aware group. Conclusion Knowledge of the exact prognosis might have a positive effect on the survival and quality of life of terminally ill cancer patients.

Purpose: This study morphologically compared and analyzed various measurements from initial radiograph and computed tomography scans of posterior malleolar fractures (PMFs) in tibial spiral fractures and ankle fractures. Materials and Methods: The measurements of PMFs in 31 TSFs and 53 AFs were analyzed. PMFs were classified using Bartoníček’s classification. The initial displacement (ID), cross angle (CA), fragment length ratio (FLR), fragment width ratio (FWR), fragment height ratio (FHR), fragment height (FH), sagittal angle (SA), articular step-off (AS), and inter-fragment distance (IFD) were measured. The presence of intercalary fragments and articular incongruity were identified. Results: Bartoníček types 2 and 3 in the AF group, type 3 in the supination-external rotation (SER) group, type 2 in the pronation-external rotation (PER) group, and type 4 in the TSF group accounted for the largest proportion. In the TSF group, the mean ID, FWR, SA, AS, and IFD were significantly smaller than in the AF group (p<0.001, p=0.003, p<0.001, p<0.001, and p<0.001, respectively). The CA, FLR, FH, and FHR were significantly larger than the AF group (p<0.001, p=0.019, p<0.001, and p<0.001, respectively). Conclusion In TSFs, posterior malleolar fragments tend to have longer anteroposterior lengths and heights, but shorter horizontal lengths than AFs. Most have minimal displacement, congruous joint, and no intercalary fragments. Understanding these morphological differences is necessary for the clinical approach to PMFs in TSFs and AFs.

Purpose: This study examined the outcomes of additional medial locking plate fixation and autogenous bone grafting in the treatment of nonunions that occurred after initial fixation for distal femoral fractures using lateral locking plates. Materials and Methods: The study involved eleven patients who initially underwent minimally invasive lateral locking plate fixation for distal femoral fractures between January 2008 and December 2020. The initial procedure was followed by additional medial locking plate fixation and autogenous bone grafting for clinically and radiographically confirmed nonunions, while leaving the stable lateral locking plate in situ. A clinical evaluation of the bone union time, knee joint range of motion, visual analog scale (VAS) pain scores, presence of postoperative complications, and functional evaluations using the lower extremity functional scale (LEFS) were performed. Results: In all cases, bone union was achieved in an average of 6.1 months after the secondary surgery. The range of knee joint motion, weight-bearing ability, and VAS and LEFS scores improved at the final follow-up compared to the preoperative conditions. All patients could walk without walking assistive devices and did not experience pain at the fracture site. On the other hand, three patients complained of pain in the lateral knee joint caused by irritation by the lateral locking plate; hence, lateral hardware removal was performed. One patient complained of mild paresthesia at the anteromedial incision site.Severe complications, such as deep infection or metal failure, were not observed. Conclusion For nonunion with stable lateral locking plates after minimally invasive lateral locking plate fixation of distal femur fractures, additional medial locking plate fixation and autogenous bone grafting, while leaving the lateral locking plate intact, can achieve successful bone union.

BACKGROUND AND OBJECTIVES: Ultrasonography (USG)-guided sclerotherapy using a sclerotherapic agent such as ethanol, OK-432, recently has gained popularity as a treatment for nonfunctioning benign thyroid nodules. The study evaluates the efficacy and safety of the USG-guided sclerotherapy for that purpose. SUBJECTS AND METHOD: Included in the study were 23 patients who had complaints of applied pressure or cosmetic problems due to cystic thyroid nodules, which had been diagnosed as benign and nonfunctioning by fine-needle aspiration biopsy and thyroid function test. Sclerotherapy was performed with OK-432 or 99.9% ethanol following nearly complete evacuation of the fluid from the cystic portion of thyroid nodule. At each USG follow-up, we measured the volume of cysts, symptom scores, cosmetic scores using a visual analog scale, and related complications were examined at postoperative dates of one and six months. RESULTS: The volume of thyroid cysts were significantly reduced (p<0.01) with mean volume reduction rates of 77.3+/-21.2% at postoperative 6 months. The cosmetic score and symptom score were significantly improved following sclerotherapy (p<0.01). Major complications related to sclerotherapy, such as vocal cord paralysis, thyrotoxicosis and tissue necrosis, did not happen during the follow-up observation. CONCLUSION: USG-guided sclerotherapy could be a simple and effective treatment modality for benign cystic thyroid nodules.
Biopsy, Fine-Needle ; Chronology as Topic ; Cosmetics ; Ethanol ; Follow-Up Studies ; Humans ; Necrosis ; Picibanil ; Prospective Studies ; Sclerotherapy ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Nodule ; Thyrotoxicosis ; Vocal Cord Paralysis