Objective: We aimed to evaluate the clinical and imaging factors associated with hemorrhagic complications and patient discomfort following ultrasound (US)-guided breast biopsy. Materials and Methods: We prospectively enrolled 94 patients who were referred to our hospital between June 2022 and December 2022 for US-guided breast biopsy. After obtaining informed consent, two breast radiologists independently performed US-guided breast biopsy and evaluated the imaging findings. A hemorrhagic complication was defined as the presence of bleeding or hematoma on US. The patients rated symptoms of pain, febrile sensation, swelling at the biopsy site, and dyspnea immediately, 20 minutes, and 2 weeks after the procedure on a visual analog scale, with 0 for none and 10 for the most severe symptoms. Additional details recorded included those of nausea, vomiting, bleeding, bruising, and overall satisfaction score. We compared the clinical symptoms, imaging characteristics, and procedural features between patients with and those without hemorrhagic complications. Results: Of 94 patients, 7 (7%) developed hemorrhagic complications, while 87 (93%) did not. The complication resolved with 20 minutes of manual compression, and no further intervention was required. Vascularity on Doppler examination (P = 0.008), needle type (P = 0.043), and lesion location (P < 0.001) were significantly different between the groups. Patients with hemorrhagic complications reported more frequent nausea or vomiting than those without hemorrhagic complications (29% [2/7] vs. 2% [2/87], respectively; P= 0.027). The overall satisfaction scores did not differ between the two groups (P= 0.396). After 2 weeks, all symptoms subsided, except bruising (50% 2/4 in the complication group and 25% [16/65] in the no-complication group). Conclusion US-guided breast biopsy is a safe procedure with a low complication rate. Radiologists should be aware of hemorrhagic complications, patient discomfort, and overall satisfaction related to this procedure.

Purpose: We examined the effects of the 8-week moderate-intensity Pilates exercise program on body composition, balance ability, metabolic parameters, arterial condition, and eating habits among overweight and obese women. Methods: From the general sample of overweight or obese Korean women (body mass index ≥ 23 kg/m2 ), those who had not been diagnosed with any chronic degenerative diseases were enrolled in the study (n = 39). After 8 weeks of the Pilates exercise program, the participants were subdivided into adherence and non-adherence groups. Among the study participants, 24 women were matched for age and menopausal status to reduce the bias, and then finally included for the comparison (Pilates-adherence, n = 12; Pilates-non-adherence, n = 12). Results: The body balance measured by the Y-balance test, body mass index, and subcutaneous fat areas were significantly improved in both groups. However, the Pilatesadherence group showed more positive changes in body balance and had significant improvement in body composition parameters such as waist size, visceral fat area, systolic blood pressure, arterial aging index, fasting blood glucose, and glycated hemoglobin than the Pilates-non-adherence group. In addition, the nutrition quotient for Korean adults (balance,moderation, and behavior except diversity) were significantly improved in both groups after dietary education. However, the participants did not show dramatic improvement in the metabolic parameters, because all the study subjects were in relatively good health and did not have any diagnosed diseases. Conclusion This study demonstrated that higher adherence to the Pilates exercise program together with a modification of eating habits may effectively improve body balance, body composition, and obesity-related parameters among overweight and obese women.

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.

BACKGROUND/AIMS: This study was performed to investigate the correlation of sodium iodide symporter (NIS) expression with the functionality and loss of phosphatase and tensin homolog deleted on chromosome ten (PTEN) expression in human cholangiocarcinoma (CCA). METHODS: Immunohistochemistry for the expression of NIS and PTEN was performed in 60 biopsy specimens of CCA. The clinicopathological parameters were retrospectively identified from medical records. The expression pattern of NIS and loss of PTEN expression were analyzed in association with the clinicopathological characteristics, including survival. RESULTS: Normal biliary trees displayed NIS expression, but hepatocytes did not. NIS expression was divided into two patterns: cytoplasmic and membranous. Fifty-nine cases, all except for one case, displayed NIS expression in tumor cells. Twenty-two cases (33.3%) were mixed pattern, and 39 cases (65.05%) were cytoplasmic pattern; the pure membranous pattern was not noted. There was no association between the NIS expression pattern and clinicopathological parameters, including age, sex, differentiation grade, T stage and tumor, node, metastasis stage (p>0.05). The survival rates were similar among various NIS expression patterns. Normal hepatocytes and biliary trees exhibited PTEN expression in the nucleus and cytoplasm. CCA cells displayed nuclear staining. Thirty-six (60.0%) of 60 cases displayed a loss of PTEN expression. The loss of PTEN expression was observed in the advanced T-stage group (p=0.0036), but there was no association between the loss of PTEN expression and other clinicopathological parameters (p>0.05). No association between the loss of PTEN expression and survival was noted. CONCLUSIONS: NIS is expressed in most types of human CCA. The expression pattern suggests a role in cancer development. PTEN loss expression is common in the context of human CCA, especially in the advanced T stage.
Biopsy ; Cholangiocarcinoma ; Cytoplasm ; Hepatocytes ; Humans ; Immunohistochemistry ; Ion Transport ; Medical Records ; Microfilament Proteins ; Neoplasm Metastasis ; Retrospective Studies ; Sodium ; Sodium Iodide ; Survival Rate ; Symporters

BACKGROUND: Depression is known to be a risk factor for type 2 diabetes mellitus. Conversely, diabetes is also a risk factor for depression, and patients with diabetes have nearly twice the risk of comorbid depression as the general population. Depression in patients with diabetes may cause poor clinical outcomes through lower adherence to self-care activities such as exercise, diet control, and glucose monitoring. Furthermore, diabetic patients with depression are more likely to suffer from microvascular or macrovascular complications. We explored the prevalence of major depressive disorder in Korean diabetic patients and its impact on self-care activities and glucose control. METHODS: We surveyed depressive symptoms and self-care activities in 191 type 2 diabetic patients from the outpatient clinic of the St. Mary's hospital. Two questionnaires were used for assessment, the Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS) and the Summary of Diabetes Self-Care Activities (SDSCA). RESULTS: Of the 191 respondents who completed questionnaires, 39 (20.4%) patients were categorized as having major depressive disorder. Among the depressed patients, only six (15.3%) had been previously evaluated and managed for their psychiatric problems. The incidence of depression was significantly higher in female diabetic patients compared to patients without depression (74.4% vs. 45.4%, P<0.001). Patients with depression showed significantly poorer diet control (18.5 vs. 15.9, P = 0.046) and less glucose monitoring (4.1 vs. 2.7, P = 0.047). However, there were no differences in exercise, foot care, or smoking status between the two groups. Additionally, metabolic parameters such as HbA1C and lipid profile were not significantly different between the two groups. CONCLUSION: Many diabetic patients are suffering from depression and exhibit poorer self-care activities than patients without depression. Identifying and managing depressed diabetic patients may help improve their self-care activities.
Ambulatory Care Facilities ; Surveys and Questionnaires ; Depression ; Depressive Disorder, Major ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diet ; Female ; Foot ; Glucose ; Humans ; Incidence ; Mass Screening ; Prevalence ; Risk Factors ; Self Care ; Smoke ; Smoking ; Stress, Psychological

PURPOSE: An ideal bony construct can be divided into two broad categories: (1) the design and fabrication of biodegradable, biomimetic scaffolds that provide correct signals to induce osteogenesis: (2) the identification of an ideal source of osteoprogenitor cells to seed onto the scaffold. We selected poly-glycolic acid as a synthetic scaffold among various scaffolds because of these properties. Meanwhile, culture medium is supplemented with fetal bovine serum(FBS): such serum contains essential elements such as proteins, hormones, growth factors and trace minerals. The composition of FBS can be ideal for various cell growth in vitro. We supposed that we could enhance bone growth at a fractured site if FBS was mixed with synthetic scaffold-PGA. METHODS: We cultured human osteoblasts in five different prepared culture dishes made with FBS and PGA mixture. The mixtures contained different ratio of FBS, that is, 0, 1.5, 3, 7, and 10%. We cultured human osteoblasts for seven days and examined the growth and attachment of the cells at the 1st, 3rd, 5th, 7th days, respectively. RESULTS: In the mixture of 0% FBS and PGA, the growth of the cells lasted for one day. In 1.5 and 3% FBS and PGA, the growth of the cells was examined at the 3rd day, then minimally declined at the 5th and 7th days. In 7% FBS and PGA, the growth of the cells lasted for 5 days, then declined at the 7th day. In 10% FBS and PGA, the growth of the cells lasted for 5 days, then declined at the 7th day. Staining status of the osteoblasts with alkaline phosphatase showed pale pink color in 0% FBS and PGA groups, but bright pink color in 1.5, 3, 7, 10% FBS and PGA groups, especially in 3%, 7%. CONCLUSION: In consequence, the growth of human osteoblast was higher in the mixture of FBS and PGA groups than in pure PGA ones. It is assumed that the mixture of FBS and PGA affects the proliferation of human osteoblasts.
Alkaline Phosphatase ; Biomimetics ; Bone Development ; Humans* ; Intercellular Signaling Peptides and Proteins ; Minerals ; Osteoblasts* ; Osteogenesis

Insulin resistance, which implies impairment of insulin signaling in the target tissues, is a common cause of type 2 diabetes. Adipose tissue plays an important role in insulin resistance through the dysregulated production and secretion of adipose-derived proteins, including tumor necrosis factor-alpha, plasminogen activator inhibitor-1, leptin, resistin, angiotensinogen, and adiponectin. Adiponectin was estimated to be a protective adipocytokine against atherosclerosis, and also to have an anti-inflammatory effect. In this study, the relationship between fasting plasma adiponectin concentration and adiposity, body composition, insulin sensitivity (ITT, HOMAIR, QUICK), lipid profile, fasting insulin concentration were examined in Korean type 2 diabetes. The difference in the adiponectin concentrations was also examined in diabetic and non-diabetic subjects, with adjustment for gender, age and body mass index. 102 type 2 diabetics and 50 controls were examined. After a 12-h overnight fast, all subjects underwent a 75gram oral glucose tolerance test. Baseline blood samples were drawn for the determinations of fasting plasma glucose, insulin, adiponectin, total cholesterol, triglyceride, LDL-cholesterol, and HDL-cholesterol. The body composition was estimated using a bioelectric impedance analyzer (Inbody 2.0). The insulin sensitivity was estimated using the insulin tolerance test (ITT), HOMAIR and QUICK methods. In the diabetic group, the fasting adiponectin concentrations were significantly lower in men than in women. They were negatively correlated with BMI (r=-0.453), hip circumference (r=-0.341), fasting glucose concentrations (r=-0.277) and HOMAIR (r=-0.233). In addition, they were positively correlated with systolic blood pressure (r=0.321) and HDL-cholesterol (r= 0.291). The systolic blood pressure and HDL-cholesterol were found to be independent variables, from a multiple logistic regression analysis, which influenced the adiponectin concentration. Compared with the non-diabetic group, the adiponectin concentrations were significantly lower in the diabetic group, with the exception of obese males. In conclusion, the plasma adiponectin concentrations were closely related to the insulin resistance parameters in Korean type 2 diabetic patients.
Adult ; Aged ; Biological Markers ; Diabetes Mellitus, Type 2/*blood ; Female ; Humans ; *Insulin Resistance ; Intercellular Signaling Peptides and Proteins/*blood ; Korea ; Male ; Middle Aged

Protothecosis is an unusual cutaneous soft tissue infection caused by the Prototheca, which is a genus of the unicelluar, achloric algae. We report a case of cutaneous protothecosis in a 66-year-old female, who showed erythematous, purulent patches and plaques with ulcerations on the right forearm for 2 months. Biopsy specimen revealed the characteristic thick-walled morulalike sporangia in the dermis. Prototheca wickerhamii was isolated in the culture and the biochemical study. Electron microscopic examination showed the thick-walled spores containing dark dense bodies and amyloplasts. After two months of oral itraconazole 200mg/day, skin lesions were improved.
Aged ; Biopsy ; Dermis ; Female ; Forearm ; Humans ; Itraconazole ; Plastids ; Prototheca ; Skin ; Soft Tissue Infections ; Sporangia ; Spores ; Ulcer

BACKGROUND: Recently, the prevalence of diabetes mellitus and its complications have been increased in Korea and they cause many socioeconomic losses in both patients and their families. But, there are neither sufficient medical assistance including concern of medical personnel nor social assistance in Korea nowadays. OBJECTIVES: In this study, we tried to reduce the risk of amputation and preserve the function of the foot by an early evaluation, proper treatment and consultation by dermatologists. METHODS: We randomly chose 18 cases of diabetic foot ulcer and took care of them with proper and earlier debridement, dressing, antibiotics and cooporation with departments of internal medicine, especially endocrinology, nephrology and division of infectious disease. After healing of the ulcer, we recommended specially designed shoes and foot care products to prevent the recurrence of the foot problems. RESULTS: The average duration of diabetes was 18 years and preexisting complications were neuropathy, nephropathy, vasculopathy and/or foot deformities. The precipitating factors of foot ulcer were burn, callus, fungal infection, bony deformity or trauma. Three cases underwent toe amputation and one case with severe vasculopathy was transferred to the vascular surgery. Average healing time was 14 weeks. CONCLUSION: Proper evaluation and management of diabetic foot ulcer patients with multidisciplinary approach should achieve good wound healing. Consequently, it can reduce the risk of amputation and improve the quality of life in the patient with diabetic foot ulcer. Among them, dermatologists who has a point of view of both a medical and surgical doctor may play a pivotal role in the management of diabetic foot ulcer.
Amputation ; Anti-Bacterial Agents ; Bandages ; Bony Callus ; Burns ; Communicable Diseases ; Congenital Abnormalities ; Debridement ; Diabetes Mellitus ; Diabetic Foot* ; Endocrinology ; Foot ; Foot Deformities ; Foot Ulcer ; Humans ; Internal Medicine ; Korea ; Medical Assistance ; Nephrology ; Precipitating Factors ; Prevalence ; Quality of Life ; Recurrence ; Shoes ; Toes ; Ulcer* ; Wound Healing

Pityriasis versicolor is a mild chronic superficial fungal infection, usually involving the seborrheic area of the neck, upper arms, and back. In a few instances, however, the eruption has been confined to highly atypical areas, such as one palm, the soles, the face, the scalp, the penis, and the groin. Inverse pityriasis versicolor refer to clinical disease located predominantly in flexural areas. We report three cases of inverse pityriasis versicolor in a 55-year-old man, in a 47-year-old man, in a 27-year-old man. The lesion were manifested by slightly scaly, brownish macules on the groin. Potassium hydroxide (KOH) prepatation showed numerous short hyphae and spores, and Wood's lamp examination showed yellowish brown fluorescence of involved skins. Fungal culture on Leeming and Notman's media grew out the typical colonies of M. globosa and M. sympodialis after 2 weeks at 34 degrees C. The patients were treated with 200 mg of itraconazole daily for 1 week and topical antifungals.
Adult ; Arm ; Fluorescence ; Groin ; Humans ; Hyphae ; Itraconazole ; Male ; Middle Aged ; Neck ; Penis ; Pityriasis* ; Potassium ; Scalp ; Skin ; Spores ; Tinea Versicolor*