PURPOSE: To evaluate the usefulness of CT features of appendiceal mucocele in the diagnosis and evaluation of complications. MATERIALS AND METHODS: We retrospectively reviewed CT findings and compared with operative findings in 7 cases of pathologically proven appendiceal mucocele. CT findings such as location and extent of the lesion, Issue density, thickness or calcification of the wall, presence of adjacent inflammatory infiltration, and visualization of normal vermiform appendix were analyzed. RESULTS: Appendiceal mucocele was found as homogeneous low density cystic mass adjacent to the cecum, which has no surrounding inflammatory infiltration except in one case of perforation and one case of intussusception. Mean CT number measured in 4 cases was 21 Hounsfield unit. Thin curvilinear calcifications were noted along the cystic wall in 2 cases. Normal vermiform appendix couldn't be demonstrated in all cases. CONCLUSION: Appendiceal mucocele is characterized by homogeneously low density and thin walled cystic tumor adjacent to cecum without surrounding inflammatory infiltration, and absence of normal vermiform appendix on CT. Therefore, CT is valuable in preventing operative complications of appendiceal mucocele.
Appendix ; Cecum ; Diagnosis ; Intussusception ; Mucocele* ; Retrospective Studies

OBJECTIVES: Restless leg syndrome (RLS) is a common sensorimotor disorder and is frequently associated with periodic limb movement in sleep (PLMS). Also about one third of patient with RLS have periodic limb movement during wakefulness (PLMW). However there is little research on the correlation between PLMW and RLS. We aimed to evaluate difference in sleep characteristics between patients with RLS with PLMW and those without PLMW. METHODS: Our study included twenty eight RLS patients. Subjects underwent suggested immobilization test (SIT) prior to one full-night polysomnography study. Patients were classified into two groups according to the presence of PLMW based on SIT-PLMW index. Polysomnographic findings, subjective sleep quality, and hematologic results were analyzed and compared between the two groups. RESULTS: Mean age of patient with frequent PLMW (SIT-PLMW ≥40/hr) was significantly higher. RLS patients with frequent PLMW were also significantly related to insomnia severity. The PLMS index was higher in patients with PLMW and showed a significant correlation with the PLMW index. CONCLUSIONS: PLMW influence sleep quality such as insomnia and is correlated with movement during sleep.
Extremities ; Humans ; Immobilization ; Polysomnography ; Restless Legs Syndrome ; Sleep Initiation and Maintenance Disorders ; Wakefulness

Sarcomatoid transitional cell carcinoma is a rare malignant epithelial neoplasm arising at the bladder, in which the tumor cells assume a spindle shape. This tumor accounts for approximately 0.3% of all bladder malignancies and has been reported in the renal pelvis and ureter. We encountered a case of histopathologically proven sarcomatoid transitional cell carcinoma of the left kidney in a 76-year-old male. Abdominal CT scans showed a large heterogeneous mass of solid and cystic components, with mural calcification and hematoma in the upper pole of the left kidney.
Aged ; Carcinoma ; Carcinoma, Transitional Cell* ; Hematoma ; Humans ; Kidney Pelvis ; Kidney* ; Male ; Tomography, X-Ray Computed ; Ureter ; Urinary Bladder

Spindle cell carcinoma is a rare variant of squamous cell carcinoma characterized histologically by a biphasic pattern with both squamous and spindle cell component. There is controversy in the histogenesis, biologic behavior, optimal treatment and prognostic factor for tumor. Treatment must be similar for squamous cell carcinoma. With a review of literature, we report a case of a 61-year-old male with spindle cell carcinoma in the larynx, which has been managed by wide excision of tumor and postoperative radiotherapy.
Carcinoma, Squamous Cell ; Cellular Structures ; Humans ; Larynx* ; Male ; Middle Aged ; Radiotherapy

BACKGROUND AND OBJECTIVES: It is important to know the current trend of resistance rate and species of pathogens in order to select appropriate antibiotics in the management of chronic suppurative otitis media. The purpose of this study is to investigate the current bacteriology of chronic supprative otitis media. SUBJECTS AND METHOD: A retrospective study was performed on the bacteriologic results of 169 out-patients of chronic otitis media with otorrhea who visited the department of otolaryngology at the Kyung Hee Medical Center from Jan 2000 to Dec 2002. RESULTS: The most common pathogenic organisms were Staphylococcus, Pseudomonas, Proteus and Providencia. The prevalence of MRSA was found to be 61.0 per cent of isolated Staphylococcus aureus. CONCLUSION: We investigated the current bacteriology of chronic suppurative otitis media and could not find remarkable changes in comparison with the results reported recently. Continuous and periodic studies on bacteriology and sensitivity tests should be performed for effective treatment of chronic suppurative otitis media.
Anti-Bacterial Agents ; Bacteriology* ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Otitis Media ; Otitis Media, Suppurative* ; Otolaryngology ; Outpatients ; Prevalence ; Proteus ; Providencia ; Pseudomonas ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus

BACKGROUND AND PURPOSE: This study aimed to determine the subjective and objective improvements in sleep quality after treatment with gamma-aminobutyric acid (GABA; 300 mg daily) extracted from unpolished rice germ. METHODS: This study was a prospective, randomized, double-blind, and placebo-controlled trial. In total, 40 patients who complained of insomnia symptoms were enrolled and randomly assigned to the GABA treatment group (n=30) or the placebo group (n=10). Polysomnography was performed, and sleep questionnaires were administered before treatment and after 4 weeks of treatment. RESULTS: After 4 weeks of treatment the sleep latency had decreased [13.4±15.7 min at pretreatment vs. 5.7±6.2 min at posttreatment (mean±SD), p=0.001] and the sleep efficacy had increased (79.4±12.9% vs. 86.1±10.5%, p=0.018) only in the GABA treatment group. Adverse events occurred in four subjects (10%). CONCLUSIONS: This study shows that treatment with unpolished-rice-germ-derived GABA improved not only the subjective sleep quality but also the objective sleep efficacy without severe adverse events.
gamma-Aminobutyric Acid* ; Humans ; Polysomnography ; Prospective Studies ; Sleep Initiation and Maintenance Disorders*

OBJECTIVES: Gamma-aminobutyric acid (GABA) has potential benefits in counteracting the sleep disruption and potential therapeutic effects on blood pressure, stress, cancer, and inflammatory diseases. Recently, High-dose GABA can be extracted from fermented rice germ using lactic acid bacteria. This study aimed to evaluate the effects of GABA natural extracts from fermented rice-germ on sleep latency, subjective sleep quality and insomnia symptoms. METHODS: This was a prospective randomized double-blind placebo-controlled trial performed at Kyung-Hee University hospital at Gangdong from June 2013 to October 2013. Adult (age≥30) patients who was diagnosed of insomnia according to DSM-IV criteria was enrolled. They were randomized into three groups: high dose treatment group 300 mg; low-dose treatment group, 100 mg; and placebo group. Questionnaires including Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), WHO-5 Well-Being Index were performed, and 1-week actigraphy was recorded before and 1 week after the treatment. RESULTS: Total of 114 patients were randomized into 3 groups: high-dose treatment (n=37), low-dose treatment (n=38), and placebo treatment group (n=39). At 1 week after the treatment, PSQI total score and C2 (sleep latency) score significantly decreased in low-dose and high-dose treatment group than the placebo groups [Repeated measures analysis of variance (ANOVA), p=0.017, 0.004 respectively]. ISI score also decreased in the two groups in dose-dependent manner (Repeated measures ANOVA, p=0.037). There were five (4.4%) patients who reported medication adverse events. CONCLUSIONS: This study suggests that treatment of low and high-dose GABA from unpolished rice-germ decreases sleep latency and improve insomnia severity without severe adverse events.
Actigraphy ; Adult ; Bacteria ; Blood Pressure ; Diagnostic and Statistical Manual of Mental Disorders ; gamma-Aminobutyric Acid* ; Humans ; Lactic Acid ; Prospective Studies ; Sleep Initiation and Maintenance Disorders ; Therapeutic Uses

Orphan nuclear receptor estrogen-related receptor γ (ERRγ) regulates cell growth and tumorigenesis in various cancers. However, the clinical relevance of ERRγ to hepatocellular carcinoma (HCC) remains unclear. Here we examined the clinical significance of ERRγ in HCC and its potential as a therapeutic target. ERRγ levels in tissues from completely resected specimens from 190 HCC patients were examined immunohistochemically and their association with clinical stage and pathological grade was analyzed. Small interfering RNA (siRNA)-mediated knockdown of ERRγ (siRNA-ERRγ) or an ERRγ inverse agonist, GSK5182, were also used to examine the effects of ERRγ inhibition on the proliferation and growth of a human hepatoma cell line, PLC/PRF/5. Immunohistochemical analysis revealed that tumor tissues showed higher levels of ERRγ-positivity than adjacent non-tumor lesions. Tumors showing high levels of ERRγ immunoreactivity also had advanced tumor node metastasis (TNM) and Barcelona Clinic Liver Cancer stages and a higher Edmondson–Steiner grade. In addition, high-level expression of ERRγ in tumors of advanced TNM stage correlated with poorer overall survival. Treatment of PLC/PRF/5 cells with siRNA-ERRγ or GSK5182 inhibited proliferation through G1 arrest, increased expression of p21 and p27 and decreased expression of phosphorylated retinoblastoma protein. GSK5182-induced reactive oxygen species also suppressed the proliferation of PLC/PRF/5 cells. The present study showed that ERRγ expression is clinically significant in HCC; therefore, it can be considered a biomarker for HCC diagnosis. Moreover, the results provide a rationale for the use of ERRγ inhibitors such as GSK5182 as potential therapeutic agents.
Carcinogenesis ; Carcinoma, Hepatocellular ; Cell Line ; Cell Proliferation* ; Child ; Child, Orphaned ; Diagnosis ; Humans ; Liver Neoplasms* ; Liver* ; Neoplasm Metastasis ; Reactive Oxygen Species ; Retinoblastoma Protein ; RNA, Small Interfering

BACKGROUND: Fine-needle aspiration (FNA) of the thyroid is a widely accepted confirmatory test for thyroid cancer with high sensitivity and specificity. FNA is a simple procedure that is learned by many clinicians to enable accurate diagnosis of thyroid cancer. However, it is assumed that because the FNA test is a relatively simple procedure, its cytologic results are reliable regardless of the operator's experience. The aim of this study was to evaluate the differences in the diagnostic indices of FNA between operators with different levels of experience. METHODS: A total of 694 thyroid FNA specimens from 469 patients were reviewed, and were separated based on the experience of the clinicians who performed the procedure. One hundred and ninety were categorized in the experienced group, and 504 in the inexperienced group. All FNA results were then compared with histological data from surgically resected specimens, and the sample adequacy and diagnostic accuracy of the groups were compared. RESULTS: The age, gender, and nodule size and characteristics were similar in both groups. The sample adequacy rate was not significantly different between the experienced and nonexperienced groups (96.3% vs. 95.4%, P=0.682). However, the non-experienced group had a higher false-negative rate than the experienced group (6.4% vs. 17.2%, P=0.038), and the sensitivity of the FNA test also tended to be lower in the nonexperienced group (95.6% vs. 88.9%, P=0.065). CONCLUSION: These results suggest that FNA operators who have less experience may miss cases of thyroid cancer by performing the procedure incorrectly. As such, the experience of the FNA operator should be considered when diagnosing thyroid cancer. When clinicians are being trained in FNA, more effort should be made to increase the accuracy of the procedure; therefore, enhanced teaching programs and/or a more detailed feedback system are recommended.
Biopsy, Fine-Needle* ; Diagnosis ; Diagnostic Errors* ; Humans ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Neoplasms*

BACKGROUND: Serum Gamma-glutamyltransferase (GGT) has been used clinically as a marker for excessive alcohol consumption or liver diseases, but it was reported recently that GGT is associated with cardiovascular disease. This study was done to verify the association between GGT and the metabolic syndrome in Korean male workers. METHODS: Total cholesterol, triglycerides, HDL cholesterol, body mass index (BMI), waist circumference, blood pressure, fasting glucose, uric acid, and GGT were measured and liver US was performed in 1,215 male workers who underwent annual health check up in a university health promotion center from May to October 2003. The association of GGT with the metabolic syndrome was assessed. RESULTS: The mean age of subjects was 41.9 +/- 7.2 years and the mean BMI was 24.1 +/- 2.7 kg/m2. A raised GGT level (GGT > 75 IU/L) was seen in 172 of 1,136 (15.1%) and the prevalence of the metabolic syndrome was 9.9% (112/1,136). Individuals with the metabolic syndrome had a higher mean GGT concentration (53.4 IU/L) than individuals without the metabolic syndrome (34.4 IU/L; P < 0.001). The subjects with increased GGT showed more risk of metabolic syndrome than the subjects with normal GGT by multivariate analysis (OR=2.835). Subgroup analyses did not change the association between the GGT and the metabolic syndrome. CONCLUSION: This study showed that the serum GGT was associated with the metabolic syndrome and that increased GGT was another feature of the metabolic syndrome.
Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Fasting ; gamma-Glutamyltransferase* ; Glucose ; Health Promotion ; Humans ; Liver ; Liver Diseases ; Male* ; Multivariate Analysis ; Prevalence ; Triglycerides ; Uric Acid ; Waist Circumference