We report a case of fine needle aspiration cytology of endodermal sinus tumor of the ovary. A 13-year-old girl complained of abdominal mass and pain. The abdominal sonography revealed a well-demarcated huge mass, which was solid and multiseptated. Percutaneous fine needle aspiration was performed from the mass. The smears revealed moderate cellularity, which was arranged in sheets or clumps of pleomorphic malignant cells on mucoid background. The valuable characteristic features of tumor cells were papillary configuration, vacuolated cytoplasm and intracellular and extracellular hyaline globules. The diagnosis was confirmed later by histologic study of surgical resection of the specimen.
Adolescent ; Biopsy, Fine-Needle ; Cytoplasm ; Diagnosis ; Endodermal Sinus Tumor ; Female ; Humans ; Hyalin ; Infant, Newborn ; Infant, Premature* ; Neurilemmoma ; Ovary ; S100 Proteins ; Urinoma*

OBJECTIVE: To supplement a previous study on the management of medical records with a view to preparing a system capable of ensuring basic patient rights regarding the protection of confidential medical information. The study objectives are to provide detailed guidelines to regulate the access and protection of medical information by analyzing patients' understanding and views regarding the dissemination of medical records. METHODS: A self-administered questionnaire was administered to 781 patients who visited five University hospitals located in Seoul, Busan, Gyeonggi, Chungnam and Jeonnam from July to September, 2008 and asked for copies of medical records to be issued. Data were analyzed by using the statistical program SPSS 13.0. RESULTS: More than 70% of respondents wanted to access their medical records after confirming the required documents. The highest distribution in the range of persons able to receive copies of medical records without the individual patient's consent or required documents was 'only personally' in each variable. Copies of medical records were issued mostly within 1 hour, while the appropriate time of issuing the copies was within one day. Half of respondents approved of a subscription system that did not require a doctor consultation. The results regarding changes in the ways to request/issue copies of medical records to improve the convenience for applicants differed significantly according to age. CONCLUSION: Considering the sensitivity of personal health information, medical records should only be issued with the patient's consent and by confirming the identity of the designated person with required documents. Furthermore, people should be aware of the importance of protecting personal health information, and medical institutes should inform the requirements for bringing the relevant documents. Medical institutes play an important role in protecting personal records, which necessitates generalized guidelines.
Academies and Institutes ; Coat Protein Complex I ; Surveys and Questionnaires ; Hospitals, University ; Humans ; Medical Records ; Patient Rights

OBJECTIVE: Neuroimaging in headache patients identifies clinically significant neurological abnormalities and plays an important role in excluding secondary headache diagnoses. We performed a systematic review and meta-analysis of the existing guidelines and studies surrounding neuroimaging in headache patients. METHODS: The research question involved determining the prevalence of detecting clinically significant neurological abnormalities using neuroimaging in patients suspected of primary headache. Searches of the PubMed and Embase databases were conducted on English-language studies published from 1991 to 2016, and the reference lists of the retrieved articles were also checked manually. All headache subtypes and patients aged ≥15 years were included in the analysis. RESULTS: Ten studies met the selection criteria. The pooled prevalence of detecting clinically significant abnormalities in the neuroimaging of headache patients was 8.86% (95% confidence interval: 5.12–15.33%). Subsequently, diverse subgroup analyses were performed based on the detection method, headache type, study type, study region, age group, and disease type. CONCLUSION: The present findings indicate that limited neuroimaging methods should be carefully considered for headache diagnostic purposes when there are red flag symptoms. Limitations and suggested directions for future studies on neuroimaging in headache patients are described.
Diagnosis ; Headache ; Humans ; Magnetic Resonance Imaging ; Methods ; Neuroimaging ; Patient Selection ; Prevalence ; Tomography, X-Ray Computed

PURPOSE: The follicular variant of papillary thyroid carcinoma (FVPTC) is difficult to diagnose due to pathologic features. There is also debate on the optimal extent of surgery. We separated FVPTC into two groups and compared the clinical features in an attempt to apply the treatment. METHODS: All 40 patients with FVPTC who were diagnosed between 1990 and 2009 were reviewed and separated into two groups, an encapsulated group and an infiltrative group, based on whether a capsule was formed or infiltration occurred. These two different subtypes of FVPTC were compared on the traits of sensitivity of diagnosis and clinicopathologic features. RESULTS: After review by a pathologist, 21 of 40 patients (55%) were found to have encapsulated tumors, and 18 patients (45%) had infiltrative tumors. There was no difference in age, sex, or size. Patients with encapsulated FVPTC had a significantly lower rate of lymph node metastasis (4.5%), multicentric tumors (18.2%), and thyroid capsular invasion (9.1%) compared with the infiltrative tumor group (50%, 50% and 50%, P<0.05). There was no difference in FNA sensitivity between the two groups, but the sensitivity to frozen biopsy was higher in the infiltrative group. There was no recurrence in the encapsulated group, but 4 patients (22.2%) experienced recurrence in the infiltrative group. CONCLUSION: FVPTC can be separated into two subgroups by histologic features, and there are some clinicopathologic differences between the two groups. Patients who had encapsulated FVPTC had a lower rate of lymph node metastasis, multicentric tumors, and thyroid capsular invasion. They also showed a lower rate of recurrence than the infiltrative group. It is suggested that the encapsulated group can be treated with limited surgery and the infiltrative group needs aggressive treatment.
Biopsy ; Diagnosis ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms*

No abstract available.
Carney Complex* ; Humans ; Neurilemmoma*

BACKGROUND: Statins are used to treat hypercholesterolemia; however, major cardiovascular events are decreased only 30% by statin treatment. Treatment with an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor has been reported to decrease serum glucose levels and improved insulin sensitivity in mice and humans, but there was no study in serum cholesterol levels. This study examined the effect of gefitinib, an EGFR tyrosine kinase inhibitor, on cholesterol metabolism in humans. METHODS: We retrospectively reviewed the medical records of 299 patients with primary lung cancer treated with gefitinib for ≥1 month and 72 patients with other treatments. Serum cholesterol, serum triglycerides, and body mass index were measured before and after treatment. The changes in serum cholesterol, serum triglycerides, and body mass index were compared between the gefitinib treatment group and the control group and were also analyzed according to the presence or absence of EGFR mutations. RESULTS: Serum cholesterol levels decreased significantly from 178.9 to 164.4 mg/dL after 1-month of gefitinib treatment. A total of 54 of the 299 patients underwent examination for the presence of the EGFR mutations. Serum cholesterol was significantly decreased in the group with the activating EGFR mutation (Δ=21.3 mg/dL) compared to that of those without the EGFR mutation (Δ=-3.1 mg/dL) after treatment with gefitinib. In contrast, there was no significantly difference between the two groups in control patients. CONCLUSION: Treatment with gefitinib decreased serum cholesterol in lung cancer patients, particularly in those with activating mutations in EGFR. These data suggest that EGFR tyrosine kinase inhibitors provide a novel and attractive strategy for the treatment of hypercholesterolemia.
Animals ; Blood Glucose ; Body Mass Index ; Cholesterol ; Epidermal Growth Factor ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Insulin Resistance ; Lung Neoplasms ; Lung ; Medical Records ; Metabolism ; Mice ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Triglycerides

BACKGROUND: Slit2 is a new secreted protein from adipose tissue that improves glucose hemostasis in mice; however, there is no study about the serum levels and precise role of Slit2 in human. The aim of this study is to explore the serum level of Slit2 in human, and to identify the role of Slit2 in diabetes mellitus (DM). METHODS: The participants of this study consist of 38 subjects with newly diagnosed DM, and 75 healthy subjects as a control group. Serum Slit2 levels were measured using an enzyme-linked immunosorbent assay. Relationship between circulating Slit2 and diabetic related factors was investigated in diabetic group compared with non-diabetic group. Additionally, the correlations between the serum level of Slit2 and diverse metabolic parameters were analyzed. RESULTS: Circulating Slit2 level was more decreased in diabetic group than in control group, but there was no significant difference statistically. Interestingly, serum levels of Slit2 were significantly negatively correlated to the serum concentrations of fasting glucose (coefficient r=–0.246, P=0.008), the serum concentrations of postprandial glucose (coefficient r=–0.233, P=0.017), and glycosylated hemoglobin (HbA1c; coefficient r=–0.357, P<0.001). CONCLUSION: From our study, the first report of circulating Slit2 levels in human, circulating Slit2 level significantly negatively correlated with serum glucose and HbA1c. Our results suggest that the circulating Slit2 may play a role in maintainence of glucose homeostasis in human, even though exact contribution and mechanism are not yet known.
Adipokines ; Adipose Tissue ; Adipose Tissue, Brown ; Animals ; Blood Glucose ; Diabetes Mellitus* ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Glucose ; Healthy Volunteers ; Hemoglobin A, Glycosylated ; Hemostasis ; Homeostasis ; Humans* ; Mice

PURPOSE: The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. MATERIALS AND METHODS: From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. RESULTS: The 1- and 3-year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. CONCLUSION: Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patientsespecially with the risk factor of neck node dissection.
Female ; Follow-Up Studies ; Head ; Head and Neck Neoplasms ; Humans ; Hypopharynx ; Hypothyroidism ; Incidence ; Larynx ; Male ; Mouth ; Multivariate Analysis ; Neck ; Neck Dissection ; Oropharynx ; Retrospective Studies ; Risk Factors ; Thyroid Gland

BACKGROUND AND OBJECTIVES: Sirtuins (SIRTs) play important roles in cellular and organismal homeostasis. They have distinct gene expression patterns in various cancers; however, the relationship between SIRT expression and the progression of thyroid cancer is unclear. We investigated the expression of SIRTs in patients with papillary thyroid carcinoma (PTC) and their role as biomarkers for predicting the aggressiveness of this disease. MATERIALS AND METHODS: We used immunohistochemical staining to evaluate the expression of SIRT1 and SIRT3 in tumor specimens from 270 patients with PTC. We also evaluated the potential association between SIRT expression and diverse clinicopathological features. RESULTS: High SIRT1 expression was negatively correlated with lymphovascular invasion, central lymph node metastasis, and lateral lymph node metastasis. Multivariate analyses revealed that high SIRT1 expression was a negative independent risk factor for lateral lymph node metastasis. By contrast, high SIRT3 expression was positively correlated with locoregional recurrence. Interestingly, when patients were grouped by tumor SIRT expression patterns, the group with low SIRT1 expression and high SIRT3 expression was correlated with more aggressive cancer phenotypes including central lymph node metastasis and lateral lymph node metastasis. CONCLUSION: Our results suggest that SIRTs play dual roles in tumor progression, and the combination of decreased SIRT1 expression and increased SIRT3 expression is significantly associated with a poor prognosis in patients with PTC.
Biomarkers ; Gene Expression ; Homeostasis ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Phenotype ; Prognosis ; Recurrence ; Risk Factors ; Sirtuins ; Thyroid Gland ; Thyroid Neoplasms