Purpose: Recently, new magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) techniques and imaging features of Prostate Imaging and Report and Data System (PI-RADS) 4 or 5 have been reported. The aim of this study was to validate the outcomes of new TRUS-guided biopsy techniques for cancer detection in patients with PI-RADS 4 or 5. Methods: Between June 2018 and November 2018, 94 men underwent TRUS-guided biopsy after PI-RADS 4 (n= 59) or 5 (n= 35) was categorized as an index lesion on MRI. For PI-RADS 4 group, target biopsy was performed in 5 and combination biopsy (target and systematic biopsies) was in 54. For PI-RADS 5 group, target biopsy was performed in 19 and combination biopsy was in 16. Target to combination biopsy ratios and significant cancer detection rates (CDRs) were compared between the groups. Significant cancer was defined as a Gleason score ≥ 7 tumor. Standard reference was biopsy examination. Fisher’s exact were used for statistical analysis. Results: Target to combination biopsy ratios was 5:54 in the PI-RADS 4 group and 19:16 in the PI-RADS 5 group (P< 0.0001). The significant CDR of the target biopsy were 42.4% (25/59) in the PI-RADS 4 group and 82.6% (29/35) in the PI-RADS 5 group (P= 0.0002). The significant CDR of combination biopsy was 44.1% (26/59) in the PI-RADS 4 group and 85.7% (30/35) in the PI-RADS 5 group (P< 0.0001). Conclusion New TRUS biopsy techniques provides high significant CDR patients with PI-RADS 4 or 5. Therefore, TRUS should be performed prior to fusion or in-bore biopsy to determine if these categories are visible.

Purpose: To assess the value of systematic biopsy added to target biopsy for detecting significant cancer in men with Prostate Imaging and Reporting and Data System 5 (PI-RADS 5). Methods: Between March 2014 and November 2018, 186 men had a PI-RADS 5 categorized as an index lesion on magnetic resonance imaging prior to transrectal ultrasound (TRUS)-guided biopsy. Of these patients, 135 (group I) underwent target biopsy alone because of good depiction. The remaining 51 (group II) underwent target and systematic biopsies because of poor depiction. Significant cancer detection rates (CDRs) were compared between the groups. Which type of biopsies contributed to detecting significant cancer was evaluated in the group II. Results: Significant CDRs of the target biopsy were 67.4% (91/135) in the group I and 47.1% (24/51) in the group II (P=0.0173). However, when systematic biopsy was added to target biopsy, the significant CDR of the group II increased to 52.9% (27/51) (P=0.0900). Of the 27 significant cancers missed by target biopsy in the group II, three were detected by systematic biopsy alone. Moreover, systematic biopsy detected higher Gleason scores in two cases than target biopsy. Conclusion Systematic biopsy contributes to detecting additional significant cancers in men with PI-RADS 5 partially visible on TRUS.

Gorham-Stout disease is a rare bone disorder that is characterized by angiomatous proliferation and results in destruction and resorption of the osseous matrix. It has variable presentations and a number of different sites may be affected, including the dermis, soft tissue, and viscera. The involved cutaneous and soft tissue lesions typically present with sponge-like, soft, brown or purple lesions. The clinical course is generally prolonged, with eventual stabilization of the affected bone; however, it is rarely fatal. There is no standard treatment defined for this disease, and variable therapies such as medical, surgical, and radiation therapy have been used. We report a case of 24-year-old man with Gorham disease who presented with progressive cutaneous lesions and severe lymphedema adjacent to the diseased bone.
Dermis ; Humans ; Lymphedema ; Osteolysis, Essential* ; Viscera ; Young Adult

No abstract available.
Child* ; Hand* ; Humans ; Leiomyoma* ; Male*

No abstract available.
Child* ; Hand* ; Humans ; Leiomyoma* ; Male*

A 21-year-old male with no any other diseases presented with fever, chills, and chest discomfort. A chest radiography scan and a transthoracic echocardiogram revealed a large amount of pericardial effusion. An H1N1 viral real-time PCR test confirmed the presence of H1N1 viral infection. Pericardiocentesis was performed to reduce symptoms, and oseltamivir (Tamiflu(TM)) was administered. His symptoms improved during the first 4 days, and there was no relapse of the pericardial effusion. The most common manifestation of influenza A infection is respiratory tract infection. Although a cardiovascular manifestation is possible, it is extremely rare. We have reported here a case of acute pericarditis with a large amount of pericardial effusion in a healthy adult infected with influenza A virus (H1N1, swine-origin).
Adult* ; Chills ; Fever ; Humans ; Influenza A virus ; Influenza A Virus, H1N1 Subtype ; Influenza, Human* ; Male ; Oseltamivir ; Pericardial Effusion* ; Pericardiocentesis ; Pericarditis* ; Radiography ; Real-Time Polymerase Chain Reaction ; Recurrence ; Respiratory Tract Infections ; Swine* ; Thorax ; Young Adult

PURPOSE: The purpose of this study was to report on splenic artery aneurysms (SAAs) treated by transcatheter embolization in our single-center institution and to evaluate the clinical outcomes of patients with SAA by aneurysm location. MATERIALS AND METHODS: The original medical records and imaging results of 52 patients with SAA treated in our center between January 1, 1995 and December 31, 2013 were reviewed. Of these cases, 7 patients (13.5%) underwent surgery, 4 patients (7.5%) underwent serial observation, and 1 patient had stent insertion only, leaving 40 patients (78.9%) who underwent endovascular treatment using a coil, with or without N-butyl-2-cyanoacrylate. RESULTS: Aneurysms were located in the distal third of the splenic artery in 27 patients (67.5%), in the middle third in 9 cases (22.5%), and in the proximal third in 4 cases (10%). Of the 40 included patients, 25 were female (62.5%). Twenty-eight patients (70%) were asymptomatic. The mean aneurysm diameter was 2.48 cm (range, 0.8-6.0 cm). Complications involved pancreatitis (n=1) and early spleen infarction (n=29: <1/3 in 14, 1/3-2/3 in 10, and >2/3 in 5). Postembolization syndrome was noted in 26 patients (65%). There were no significant differences by aneurysm location in the postoperative increase in the values of white blood cells, amylase, lipase, and C-reactive protein (P=0.067, P=0.881, P=0.891, and P=0.188, respectively). CONCLUSION: At our institution, endovascular management is safe, has high technical success, and represents the first-line treatment for SAA, regardless of aneurysm location.
Amylases ; Aneurysm* ; C-Reactive Protein ; Embolization, Therapeutic ; Enbucrilate ; Female ; Humans ; Infarction ; Leukocytes ; Lipase ; Medical Records ; Pancreatitis ; Spleen ; Splenic Artery* ; Stents

BACKGROUND: Inducible nitric oxide synthase (iNOS) has been detected in a number of pathologic conditions in the central nervous system. This study was investigated the patterns of iNOS expression in the neuronal PC12 cell and the effects of nitric oxide on the apoptosis of PC12 cells. METHODS: The stimulating agents for induction of iNOS expression in PC12 cells were bacterial lipopolysaccharide (LPS), tumor necrosis factor-alpha (TNF-), and interferon-gamma (IFN-). RESULTS: The expression iNOS mRNA and protein in PC12 cells stimulated with LPS/TNF-/IFN- were profoundly increased. The expression of iNOS mRNA arose at 6 hours, peaked at 12 hours, and declined to 48 hours after LPS/TNF-/ IFN- treatment. iNOS protein was increased up to 24 hours in LPS/TNF-/IFN- treated PC12 cells while the expression of nNOS was unaffected. Accumulation of NO derivatives in the culture media was markedly increased at least at up to 48 hours after LPS/TNF-/IFN- treatment. The induction of iNOS expression and NO production in differentiated PC12 cells was correlated with apoptotic cell death judged by transmission electron microscopy and DNA fragmentation from the results of the Terminal deoxynucleotidyl-transferase-mediated dUDP biotin nick end-labeling (TUNEL) method. After treatment with NOS inhibitor, N-monomethylarginine (NMMA), a profound decrease in NO production by LPS/TNF-/IFN- treated PC12 cells was noted. And the LPS/TNF-/IFN- induced apoptosis was prevented by the NMMA treatment. CONCLUSIONS: From the above results it is concluded that the expression of iNOS in differentiated PC12 cells is induced by the combined application of LPS, TNF-, and IFN-. And the apoptosis of cultured PC12 cells is mediated by iNOS-derived NO.
Animals ; Apoptosis* ; Biotin ; Cell Death ; Central Nervous System ; Culture Media ; DNA Fragmentation ; Interferon-gamma ; Microscopy, Electron, Transmission ; Necrosis* ; Neurons* ; Nitric Oxide Synthase Type II* ; Nitric Oxide* ; PC12 Cells* ; RNA, Messenger ; Tumor Necrosis Factor-alpha

Free radicals are known as an important factor which may act on reperfusion injury after transient or permanent brain ischemia. Numerous studies about cytotoxic function of free radical have been done. Most of these studies demonstrate the function of free radical in reperfusion injury by using radical scavenger or antioxidant as inhibitor of radicals. We used a modification of Karnovsky's Mn2 /diaminobenzidine (DAB) technique to demonstrate intravascular free radicals following transient occlusion and reperfusion of one middle cerebral artery in Sprague-Dawley rats. The MCA was occluded for 2 hours using an intraluminal suture method. The reperfusion time after transient ischemia was 1 hour, 6 hours, and 24 hours, respectively. Animals were perfused transcardially with solution containing Mn2 and DAB. After DAB perfusion, the brains were removed promptly, sectioned in frozen, and stained with methylene blue for light microscopic examination. Upon light microscopic examination, free radicals were confined within intravascular lumen and the amount of deposits increased according to the duration of reperfusion. Upon electron microscopic examination, free radicals were located in nuclear membrane and membrane of mitochondria and RER, and demonstrated as electron dense deposits. In addition, cell processes of the neuron revealed an electron dense deposits beneath the inner side of the membrane. In conclusion, free radicals demonstrated in the reperfusion injury area indicate that free radical acts as an important cytotoxic factor. Intracellular localization of free radicals may explain the relationship between free radical and delayed neuronal injury.
Animals ; Brain Ischemia* ; Brain* ; Free Radicals* ; Ischemia ; Membranes ; Methylene Blue ; Middle Cerebral Artery ; Mitochondria ; Neurons ; Nuclear Envelope ; Perfusion ; Rats, Sprague-Dawley ; Reperfusion Injury* ; Reperfusion* ; Sutures