OBJECTIVE: We wanted to evaluate the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor. MATERIALS AND METHODS: Between January 2003 and December 2004, fine needle aspiration biopsy was performed in 1,036 patients with palpable and non-palpable thyroid lesions. We retrospectively reviewed the ultrasonographic findings of patients with papillary carcinomas (n = 127) and follicular carcinomas (n = 23) that were proven by operation or fine needle aspiration biopsy. We analyzed the ultrasonographic findings of these nodules based on the reported ultrasonographic findings of malignant thyroid tumor: hypoechogenicity, a taller than wide orientation, a microlobulated or irregular margin, a thick hypoechoic rim (halo sign), microcalcification and cystic change. RESULTS: The echogenicity was hypoechoic in 72.4% (92/127) of the papillary carcinomas, but it was isoechoic in 65.2% (15/23) of the follicular carcinomas (p < 0.001). The nodule shape was tall or round in 74.1% of the papillary carcinomas, but it was flat in 72.7% of the follicular carcinomas (p < 0.001). The tumor margin was microlobulated or irregular in 92.9% of the papillary carcinomas and in 60.9% of the follicular carcinomas (p < 0.001). A hypoechoic rim was seen in 26% of the papillary carcinomas (thin rim: 13.4%, thick rim: 12.6%) and in 86.6% of the follicular carcinomas (thin rim: 39.1%, thick rim: 47.8%, p < 0.001). Microcalcifications were demonstrated in 33.9% of the papillary carcinomas and in none of the cases of follicular carcinoma (p < 0.001). A solid mass without cystic change were seen in 98.4% of the papillary carcinomas and in 82.6% of the follicular carcinomas (p < 0.001). CONCLUSION: The previously reported ultrasonography findings of malignant thyroid tumor are in conformity with most of the papillary carcinomas, but not with follicular carcinomas. The current ultrasonographic features for thyroid malignancy should be cautiously applied as the indication for needle aspiration biopsy so that follicular carcinomas are not missed by too narrow and strict biopsy criteria.
Adenocarcinoma, Follicular/*ultrasonography ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; Calcinosis/ultrasonography ; Carcinoma, Papillary/*ultrasonography ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Gland/pathology ; Thyroid Neoplasms/*ultrasonography

No abstract available.
Animals ; Cumulus Cells* ; Mice* ; Zygote*

PURPOSE: Recent studies have revealed recurrent alterations in the cell adhesion gene FAT4, a candidate tumor suppressor gene, in cancer. FAT atypical cadherin 4 (FAT4) is a transmembrane receptor involved in the Hippo signaling pathway, which is involved in the control of organ size. Here, we investigated the loss of FAT4 expression and its association with clinicopathological risk factors in gastric cancer. MATERIALS AND METHODS: We assessed the expression of FAT4 by using immunohistochemistry on three tissue microarrays containing samples from 136 gastric cancer cases, radically resected in the Soonchunhyang University Cheonan Hospital between July 2006 and June 2008. Cytoplasmic immunoexpression of FAT4 was semi-quantitatively scored using the H-score system. An H-score of > or =10 was considered positive for FAT4 expression. RESULTS: Variable cytoplasmic expressions of FAT4 were observed in gastric cancers, with 33 cases (24.3%) showing loss of expression (H-score <10). Loss of FAT4 expression was associated with an increased rate of perineural invasion (H-score <10 vs. > or =10, 36.4% vs. 16.5%, P=0.015), high pathologic T stage (P=0.015), high tumor-node-metastasis stage (P=0.017), and reduced disease-free survival time (H-score <10 vs. > or =10, mean survival 62.7+/-7.3 months vs. 79.1+/-3.1 months, P=0.025). However, no association was found between the loss of FAT4 expression and tumor size, gross type, histologic subtype, Lauren classification, lymphovascular invasion, or overall survival. CONCLUSIONS: Loss of FAT4 expression appears to be associated with invasiveness in gastric cancer.
Cell Adhesion ; Chungcheongnam-do ; Classification ; Cytoplasm ; Disease-Free Survival ; Genes, Tumor Suppressor ; Immunohistochemistry ; Organ Size ; Risk Factors ; Stomach Neoplasms*

PURPOSE: The AT-rich interactive domain 1A (ARID1A) gene encodes BRG1-associated factor 250a, a component of the SWItch/Sucrose NonFermentable chromatin remodeling complex, which is considered a tumor suppressor in many tumors. We aimed to investigate the prognostic significance of ARID1A expression in gastric cancers and explore its relationship with clinicopathologic parameters such as mismatch repair protein expression. MATERIALS AND METHODS: Four tissue microarrays were constructed from 191 resected specimens obtained at Soonchunhyang University Cheonan Hospital from 2006 to 2008. Nuclear expression of ARID1A was semiquantitatively assessed and binarized into retained and lost expression. RESULTS: Loss of ARID1A expression was observed in 62 cases (32.5%). This was associated with more frequent vascular invasion (P=0.019) and location in the upper third of the stomach (P=0.001), and trended toward more poorly differentiated subtypes (P=0.054). ARID1A loss was significantly associated with the mismatch repair-deficient phenotype (P=0.003). ARID1A loss showed a statistically significant correlation with loss of MLH1 (P=0.001) but not MSH2 expression (P=1.000). Kaplan-Meier survival analysis showed no statistically significant difference in overall survival; however, patients with retained ARID1A expression tended to have better overall survival than those with loss of ARID1A expression (P=0.053). In both mismatch repair-deficient and mismatch repair-proficient groups, survival analysis showed no differences related to ARID1A expression status. CONCLUSIONS: Our results demonstrated that loss of ARID1A expression is closely associated with the mismatch repair-deficient phenotype, especially in sporadic microsatellite instability-high gastric cancers.
Chromatin Assembly and Disassembly ; Chungcheongnam-do ; DNA Mismatch Repair* ; Humans ; Microsatellite Instability ; Microsatellite Repeats ; Phenotype ; Stomach ; Stomach Neoplasms*

BACKGROUND: Recently, an elevated serum homocysteine level has been reported to be associated with increased fracture risk and reduced bone mineral density (BMD). So far, little research has been done to evaluate such association in Korean population. Therefore, we investigated the association between serum homocysteine levels and BMD in Korean adults. METHODS: The subjects consisted of 2,750 adults who visited a health promotion center at a university hospital from January 2005 to March 2006. Self-administered questionnaires provided information about lifestyle and medical history. Fasting plasma samples were collected and BMD of the lumbar spine and femoral neck were obtained by dual energy X-ray absorptiometry. To adjust for menopausal state, the female subjects were divided into three groups according to age (< or =45 yrs, 46~55 yrs, 55 yrs <). Multiple linear regression analysis was used to evaluate the association between serum homocysteine levels and BMD in each gender and age group. RESULTS: The results adjusted for alcohol and smoking history showed significant association between serum homocysteine levels and BMD in women (Lumbar spine: beta=-0.006, P=0.015, Femoral neck: beta=-0.065, P=0.012) but not in men (Lumbar spine: beta=0.001, P=0.240, Femoral neck: beta=0.001, P=0.242). With analyses by three age groups, plasma homocysteine level was associated with both lumbar and femoral BMD in age 46~55 women (Lumbar spine: beta=-0.014, P=0.024, Femoral neck: beta= -0.007, P=0.019). CONCLUSION: Our study suggests that increased serum homocysteine level is an independent risk factor for low BMD among women, especially perimenopausal women. Further studies about the sexual differences and the mechanisms linking serum homocysteine level to BMD are needed.
Absorptiometry, Photon ; Adult ; Bone Density ; Fasting ; Female ; Femur Neck ; Health Promotion ; Homocysteine ; Humans ; Life Style ; Linear Models ; Male ; Osteoporosis ; Plasma ; Risk Factors ; Smoke ; Smoking ; Spine ; Surveys and Questionnaires

A woman aged 40 years presented with symmetric band of depigmented patches on her hand dorsum and forearms. Under the diagnosis of focal vitiligo, we initially treated her with oral and topical steroids and local UVB irradiation. However, the wrist lesions were recalcitrant. Therefore, we tried a non-cultured epidermal cellular graft using autologous melanocyte-keratinocyte suspension. Twelve months after the procedure, higher than 70% of repigmentation was observed. This procedure seems to be an effective and practical treatment for recalcitrant vitiliginous lesions.
Aged ; Female ; Forearm ; Hand ; Humans ; Steroids ; Transplants ; Vitiligo ; Wrist

BACKGROUND: The molecular profile of peritumoral non-neoplastic liver parenchyma (PNLP) has recently been suggested as predictive factor of early and late recurrence of hepatocellular carcinoma (HCC). However, there is no definite cut-off point for tumor-free PNLP in terms of either histological or molecular changes. Therefore, our aim is to determine the numerical cut-off point for separating adjacent PNLP and remote PNLP in histopathologic perspective. METHODS: Peritumoral tissues from 20 resected HCC patients were sampled from 0 to 40 mm distance from the tumor border (divided into 5-mm columns). Histopathologic parameters such as necroinflammatory activity, fibrosis, bile ductular reaction, hepatic venulitis, peliosis, and steatosis were compared between each column. RESULTS: The morphologic changes just adjacent to the tumor were notably severe and faded with distance. The parenchyma within 10 mm of the tumor showed significantly severe inflammation, fibrosis, peliosis and hepatic venulitis compared with those from farther areas. The histopathologic changes of the parenchyma became stable beyond 20 mm. CONCLUSIONS: Results of this study revealed that the parenchyma within 10 mm distance from the tumor, or adjacent PNLP, has histopathologic changes that are directly affected by the tumor, and the parenchyma beyond 20 mm as the remote PNLP without tumor effect.
Bile ; Carcinoma, Hepatocellular ; Fibrosis ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Inflammation ; Liver ; Recurrence

Metastatic or septic endogenous endophthalmitis is a rare, but devastating complication of systemic septicemia. This condition may become more common as the number of chronically debilitated patients and the use of invasive procedures increase. Many etiologic organisms (gram-positive, gram-negative and fungi) and many clinical conditions (pyelonephritis, endocarditis, meningitis, pneumonia) have been reported to cause endogenous endophthalmitis. Risk factors include most of the known reasons for immune suppression and chronic illness. A high clinical suspicion is required in early diagnosis and treatment. Early antibiotics and vitrectomy are more widely accepted as therapeutic modalities.
Abscess* ; Anti-Bacterial Agents ; Chronic Disease ; Early Diagnosis ; Endocarditis ; Endophthalmitis* ; Escherichia coli* ; Escherichia* ; Humans ; Meningitis ; Pneumonia* ; Risk Factors ; Sepsis* ; Vitrectomy

PURPOSE: This study was designed to compare the effectiveness of intrarectal lidocaine gel versus periprostatic lidocaine injection during TRUS-guided biopsies. MATERIALS AND METHODS: From April 2003 to September 2003, 90 men undergoing a transrectal prostate biopsy were randomized into three groups. In group 1, 30 patients intrarectally received 20ml of 2% lidocaine gel; and group 2, 30 patients received 5ml(2.5ml per side) of 2% lidocaine solution injected along each side of the prostate, near the junction of the seminal vesicle and the base of the prostate(along the neurovascular bundles); in group 3, 30 patients received 5ml(2.5ml per side) of normal saline injected along the neurovascular bundles. The pain level after the biopsy was assessed using a 10-point linear visual analog pain scale(VAS). A statistical analysis was performed using the Wilcoxon Rank Sum test, and the results compared. RESULTS: Patient who received lidocaine solution injections along the neurovascular bundles (Group 2) had significantly lower VAS scores compared to the control group(mean score 3.56+/-2.13 versus 5.83+/-1.94, p<0.0001), but patients who received intrarectal lidocaine gel did not (mean score 5.46+/-2.70 versus 5.83+/-1.94, p=0.671). Gross hematuria, rectal bleeding and hemospermia occurred in 36(40.0%), 6(6.7%) and 5(5.6%) subjects, respectively. One patient had a vasovagal syncope. No patient reported febrile UTI or urinary retention. CONCLUSIONS: Bilateral nerve blockade with local anesthetic is a safe technique that significantly reduces pain during a prostate biopsy. However, in this study, intrarectal lidocaine injection did not reduce the pain compared to the control group during the prostate biopsy.
Anesthesia, Local* ; Anesthetics, Local ; Biopsy* ; Hematuria ; Hemorrhage ; Hemospermia ; Humans ; Lidocaine ; Male ; Nerve Block ; Prospective Studies* ; Prostate* ; Seminal Vesicles ; Syncope, Vasovagal ; Urinary Retention

This study aimed to evaluate the imaging and pathological findings in axillary lymph nodes in patients with breast cancer who received concurrent ipsilateral coronavirus disease 2019 (COVID-19) vaccination. Of the 19 women with breast cancer who received concurrent COVID-19 vaccination shot in the arm ipsilateral to breast cancer, axillary lymphadenopathy was observed in 84.2% (16 of 19) of patients on ultrasound (US) and 71.4% (10 of 14) of patients on magnetic resonance imaging (MRI), and 21.0% (4 of 19) of patients were diagnosed with metastasis. Abnormal US and MRI findings of cortical thickening, effacement of the fatty hilum, round shape, and asymmetry in the number or size relative to the contralateral side were noted in more than half of the non-metastatic and metastatic lymph nodes; however, statistical significance was not noted. Axillary lymphadenopathy is commonly observed in patients with breast cancer who receive concurrent ipsilateral COVID-19 vaccination without specific differential imaging features. Thus, understanding the limitations of axillary imaging and cautious interpretation is necessary to avoid overestimation or underestimation of the axillary disease burden.