Evaluation of serous effusions can include immunocytochemical stains that differentiate reactive mesothelial cell from adenocarcinoma cell. Among several positive mesothelial cell markers, we used desmin, CK5/6, WT1 and calretinin all known to have high sensitivity and specificity as selective mesothelial cell markers. We studied smears obtained with cytospin from 15 malignant and eight benign effusions. The mesothelial cells were positively stained by desmin, CK5/6, WT1 and calretinin in 60.9%, 29.1%, 26.7% and 56.5%, respectively among 8 benign and 15 malignant effusions; the adenocarcinoma cells were positively stained 6.7%, 13.3%, 1.0% and 0.0%, respectively among 15 malignant effusions. The percentage of positively stained mesothelial cells were somewhat lower for all antibodies compared to the results of previous studies. This was likely due to the differences in preparation methods and fixatives among studies. In conclusion, the use of desmin and calretinin were more valuable than CK5/6 and WT1 for distinguishing between reactive mesothelial cell and adenocarcinoma cells in serous effusion; however, choice of the proper preparation methods and fixatives are also important
Adenocarcinoma* ; Antibodies ; Calbindin 2 ; Coloring Agents ; Desmin ; Fixatives ; Sensitivity and Specificity

The effects of taurine, carnitine or glutamine supplementation on endurance exercise performance along with related fatigue factors were evaluated in male college students in the Department of Physical Education, who''s maximal oxygen consumption rates (VO2max) were equivalent to those of endurance athletes. Twenty four subjects were randomly divided into 4 groups (n=6), and given placebo, taurine (4 g/day), carnitine (4 g/day), or glutamine (4 g/day) tablets for 2 weeks. Subjects could run 6.9 min or 9.0 min longer until exhausted on a treadmill at the intensity of 75% VO2max following taurine or camitine supplementation for 2 weeks, respectively, compared to the value measured prior to each supplementation. Glutamine or placebo supplementation did not improve the endurance exercise performance based on the running time until exhausted on a treadmill. Serum lactate concentrations measured 1 hr after the initiation of the endurance exercise, as well as at all-out state tended to be decreased by taurine, carnitine, or glutamine supplementation, and were significantly lowered (43% decrease) by carnitine supplementation (p<0.05). Taurine supplementation significantly reduced the serum inorganic phosphorus concentration measured at all-out state (14% decrease, p<0.05), while carnitine supplementation significantly lowered the resting state serum inorganic phosphorus level (20% decrease, p<0.05). Taurine (32% reduction) or carnitine (23% reduction) supplementation significantly decreased serum ammonia concentration measured at all-out state (p<0.05). From these results, 4 g/day of taurine or carnitine supplementation appears to improve the endurance exercise performance and related human fatigue factors.
Ammonia ; Athletes* ; Carnitine* ; Dietary Supplements* ; Fatigue* ; Glutamine* ; Humans ; Lactic Acid ; Male ; Oxygen Consumption ; Phosphorus ; Physical Education and Training ; Running ; Tablets ; Taurine*

PURPOSE: This study evaluated the nutritional status and effect of nutritional support team (NST) management in critically ill patients.METHOD: From January 2015 to August 2017, the study retrospectively investigated 128 patients aged above 19 years admitted to a medical intensive care unit (MICU). The patients were divided into two groups: NST (n=65) and non-NST (n=63) groups. Nutritional status, classification of bedsore risks, incidence rate of bedsore and clinical outcomes were compared.RESULTS: The study found a higher rate of the use of enteral nutrition in the NST group (χ²=45.60, p < .001). The prescription rate of parenteral nutrition (PN) was found to be lower in the NST group (4.6%) compared to the non-NST group (60.3%). There was a higher PN of total delivered/required caloric ratio in the NST, compared to the non-NST, group (χ²=3.33, p=.025). There were significant differences for higher albumin levels (t=2.50, p=.014), higher total protein levels (t=2.94, p =.004), and higher proportion of discharge with survival rates (χ²=18.26, p < .001) in the NST group.CONCLUSION: Providing NST management to critically ill patients showed an increase in the nutrition support. Further, to achieve effective clinical outcomes, measures such as nutrition education and continuous monitoring and management for the provision of nutritional support by the systemic administration of a nutritional support team should be considered.
Classification ; Critical Care ; Critical Illness ; Education ; Enteral Nutrition ; Humans ; Incidence ; Intensive Care Units ; Methods ; Nutritional Status ; Nutritional Support ; Parenteral Nutrition ; Prescriptions ; Pressure Ulcer ; Retrospective Studies ; Survival Rate

An ipsilateral supraclavicular lymph node recurrence of breast cancer after surgery has been considered a predecessor to distant metastases. There still is a debate as to whether breast carcinoma patients with the isolated supraclavicular lymph node recurrence should be considered to have disseminated disease or if aggressive treatment, with curative intent, is justified. We report two cases of an isolated ipsilateral supraclavicular lymph node recurrence following modified radical mastectomy, and multimodality treatments with modified radical neck dissection, systemic chemotherapy and involved field radiotherapy. These patients have lived without locoregional recurrence or distant metastases for 3 and 2 years, respectively. Conclusively, we recommend aggressive combined multimodality treatments, including surgery, such as modified radical neck dissection or complete excision of the involved lymph nodes, systemic chemotherapy, and involved field radiotherapy, in patients with isolated supraclavicular lymph node recurrence, but with no other evidence of distant metastases.
Breast Neoplasms ; Drug Therapy ; Humans ; Lymph Nodes ; Mastectomy, Modified Radical ; Neck Dissection ; Neoplasm Metastasis ; Radiotherapy ; Recurrence

Testicular epidermoid cyst is a rare benign tumor, accounting for 1-2% of all testicular tumors. It can be cured by organ preserving surgery, so accurate preoperative diagnosis is very important for preventing unneccessary and extensive orchiectomy. We experienced a case of an 18-year-old man who presented with a painless lump in his right testis. The testicular mass showed an onion ring sign on ultrasonography. Computed tomography images showed the mass as a low attenuating lesion with curvilinear calcification. On Magnetic resonance imaging (MRI), the mass appeared as high signal intensity with internal alternating low signal intensity patterns on T2-weighted images. The mass was displayed as having homogeneous high signal intensity on diffusion magnetic resonance imaging and showed lower apparent diffusion coefficient values than normal testis parenchyma, similar to intracranial epidermoid cysts. Testicular MRI with DWI and ADC map can help to more accurately diagnose testicular epidermoid cyst.
Accounting ; Adolescent ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Epidermal Cyst ; Humans ; Magnetic Resonance Imaging ; Onions ; Orchiectomy ; Testicular Neoplasms ; Testis

BACKGROUND/AIMS: We evaluated the management and educational status of adult anaphylaxis patients at emergency departments (EDs). METHODS: Anaphylaxis patients who visited ED from 2011 to 2013 were enrolled from three hospitals. We analyzed clinical features, prior history of anaphylaxis, management and provided education for etiology and/or prevention. For analyzing associated factors with epinephrine injection, Pearson chi-square test was used by SPSS version 21 (IBM Co.). RESULTS: A total of 194 anaphylaxis patients were enrolled. Ninety-nine patients (51%) visited ED by themselves. Time interval from symptom onset to ED visit was 62 ± 70.5 minutes. Drug (56.2%) was the most frequent cause of anaphylaxis. Forty-seven patients (24.2%) had prior history of anaphylaxis and 33 patients had same suspicious cause with current anaphylaxis. Cutaneous (88.7%) and respiratory (72.7%) symptoms were frequent. Hypotension was presented in 114 patients (58.8%). Mean observation time in ED was 12 ± 25.7 hours and epinephrine was injected in 114 patients (62%). In 68 patients, epinephrine was injected intramuscularly with mean dose of 0.3 ± 0.10 mg. Associated factor with epinephrine injection was hypotension (p = 0.000). Twenty-three patients (13%) were educated about avoidance of suspicious agent. Epinephrine auto-injectors were prescribed only in five patients. Only 34 (19%) and 72 (40%) patients were consulted to allergist at ED and outpatient allergy department respectively. CONCLUSIONS: We suggested that management and education of anaphylaxis were not fully carried out in ED. An education and promotion program on anaphylaxis is needed for medical staff.
Adult* ; Anaphylaxis* ; Education ; Educational Status* ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Epinephrine ; Humans ; Hypersensitivity ; Hypotension ; Medical Staff ; Outpatients ; Patient Care Management

Stereotactic radiosurgery has become excellent alternative treatment for cerebral arteriovenous malformations (AVM). This technique has expanded to treatment of larger AVM which is not amenable to surgical management. However, its variable adverse effects should be also taken into considerations sincerely because of radiobiological characteristics such as delayed onset and progressive neurological deteriorations. Herein, we report a case in which progressively expanding hemorrhagic cyst with repeated bleedings so called chronic encapsulated expanding hematoma was developed on several years after radiosurgery treatment. Neurological and radiological findings were improved by surgical removal.
Arteriovenous Malformations ; Hematoma ; Intracranial Arteriovenous Malformations ; Radiosurgery

Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently. the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively, Their cytologic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows: 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2. Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans} type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found. 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.
Biopsy, Fine-Needle* ; Breast Diseases* ; Breast* ; Diagnosis, Differential ; Dilatation, Pathologic ; Epithelial Cells ; Epithelioid Cells ; Fat Necrosis ; Female ; Giant Cells ; Granuloma ; Granulomatous Mastitis ; Histiocytes ; Leukocytes, Mononuclear ; Mastitis ; Neutrophils

BACKGROUND: Acne vulgaris has been linked to the Western diet. Hyperglycemic diet increases insulin and insulin-like growth factor (IGF)-1. Deeper insights into IGF-1-mediated signal pathway are critical importance to understand the impact of Western diet. OBJECTIVE: We investigated the effect of IGF-1 on the expression of inflammatory biomarkers and sebum production in cultured sebocytes. METHODS: Polymerase chain reaction and enzyme-linked immunosorbent assay were performed to measure changes in the expression of inflammatory biomarkers including interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), IGF1R, IGFBP2, sterol response element-binding protein (SREBP), and phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PI3KCA) after the treatment of cultured sebocytes with 10⁻⁷ M or 10⁻⁵ M IGF-1. Sebum production was evaluated after the treatment of cultured sebocytes with 10⁻⁷ M or 10⁻⁵ M IGF-1 using lipid analysis. RESULTS: The expression levels of IL-1β, IL-6, IL-8, and TNF-α in cultured sebocytes after treatment with 10⁻⁷ M or 10⁻⁵ M IGF-1 were increased. Increased gene expression levels of NF-κB in cultured sebocytes were also shown after 10⁻⁷ M or 10⁻⁵ M IGF-1 treatments. Gene expression of these inflammatory biomarkers was decreased after 10⁻⁷ M or 10⁻⁵ M IGF-1 treatment in the presence of 100 nM NF-κB inhibitor. Treatment with 10⁻⁷ M or 10⁻⁵ M IGF-1 increased the gene expression levels of IGF1R, IGFBP2, SREBP and PI3KCA in cultured sebocytes. Sebum production from cultured sebocytes treated with 10⁻⁷ M or 10⁻⁵ M IGF-1 was also increased. CONCLUSION: It is suggestive that IGF-1 might be involved in the pathogenesis of acne by increasing both expression of inflammatory biomarkers and also sebum production in sebocytes.
Acne Vulgaris ; B-Lymphocytes ; Biomarkers* ; Catalytic Domain ; Diet ; Diet, Western ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Insulin ; Insulin-Like Growth Factor I ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Polymerase Chain Reaction ; Sebum* ; Signal Transduction ; Tumor Necrosis Factor-alpha

We compared the effects of genistein and daidzein on the expression of chemokines, cell adhesion molecules (CAMs), and endothelial nitric oxide synthase (eNOS) in tumor necrosis factor (TNF)-alpha-stimulated human umbilical vascular endothelial cells (HUVECs). TNF-alpha exposure significantly increased expression of monocyte chemoattractant protein (MCP)-1, vascular adhesion molecule (VCAM)-1, and intercellular adhesion molecule-1. Genistein significantly decreased MCP-1 and VCAM-1 production in a dose-dependent manner, whereas CAM expression was not significantly lowered by genistein treatment. However, daidzein slightly decreased MCP-1 production. The effects of genistein and daidzein on MCP-1 secretion coincided with mRNA expression. Pre-treatment with either genistein or daidzein elevated eNOS expression and nitric oxide production disturbed by TNF-alpha exposure. A low concentration of isoflavones significantly inhibited nuclear factor (NF)kappaB activation, whereas a high dose slightly ameliorated these inhibitive effects. These results suggest that genistein had a stronger effect on MCP-1 and eNOS expression than that of daidzein. Additionally, NFkappaB transactivation might be partially related to the down-regulation of these mRNAs in TNF-alpha-stimulated HUVECs.
Cell Adhesion ; Cell Adhesion Molecules ; Chemokines ; Down-Regulation ; Endothelial Cells ; Genistein ; Humans ; Intercellular Adhesion Molecule-1 ; Isoflavones ; Monocytes ; Nitric Oxide ; Nitric Oxide Synthase Type III ; RNA, Messenger ; Transcriptional Activation ; Tumor Necrosis Factor-alpha ; Vascular Cell Adhesion Molecule-1