MRI is a crucial tool for diagnosing adenomyosis and identifying its related pathologies. To accurately diagnose adenomyosis, it is necessary to recognize both the typical MRI findings and atypical features of the condition. Recently, a standardized classification system has been developed to facilitate precise presurgical diagnosis of adenomyosis and to determine the appropriate treatment method. Differentiating between various subtypes based on MRI-based classification and identifying different MRI phenotypes can aid in categorizing patients with adenomyosis into specific treatment groups and monitoring their response to therapy.

MRI is a crucial tool for diagnosing adenomyosis and identifying its related pathologies. To accurately diagnose adenomyosis, it is necessary to recognize both the typical MRI findings and atypical features of the condition. Recently, a standardized classification system has been developed to facilitate precise presurgical diagnosis of adenomyosis and to determine the appropriate treatment method. Differentiating between various subtypes based on MRI-based classification and identifying different MRI phenotypes can aid in categorizing patients with adenomyosis into specific treatment groups and monitoring their response to therapy.

MRI is a crucial tool for diagnosing adenomyosis and identifying its related pathologies. To accurately diagnose adenomyosis, it is necessary to recognize both the typical MRI findings and atypical features of the condition. Recently, a standardized classification system has been developed to facilitate precise presurgical diagnosis of adenomyosis and to determine the appropriate treatment method. Differentiating between various subtypes based on MRI-based classification and identifying different MRI phenotypes can aid in categorizing patients with adenomyosis into specific treatment groups and monitoring their response to therapy.

Background: s/Aims: Although access to proton beam therapy (PBT) is limited worldwide, its use for the treatment of hepatocellular carcinoma (HCC) is gradually increasing with the expansion of new facilities. Therefore, we conducted a systematic review and metaanalysis to investigate the updated evidence of PBT for HCC. Methods: The MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were systematically searched for studies that enrolled patients with liver-confined HCC that were treated with PBT for a cure up to February 2024. Results: A total of 1,858 HCC patients receiving PBT from 22 studies between 2004 and 2023 were selected for this meta-analysis. The median proportion of Child-Pugh class A was 86% (range, 41-100), and the median tumor size was 3.6 cm (range, 1.2-9.0). The median total dose ranged from 55 GyE to 76 GyE (median, 69). The pooled rates of 3- and 5-year local progression-free survival after PBT were 88% (95% confidence interval [CI], 85-91) and 86% (95% CI, 82-90), respectively. The pooled 3- and 5-year overall rates were 60% (95% CI, 54-66) and 46% (95% CI, 38-54), respectively. The pooled rates of grade 3 hepatic toxicity, classic radiationinduced liver disease (RILD), and non-classic RILD were 1%, 2%, and 1%, respectively. Conclusions The current study supports PBT for HCC and demonstrates favorable long-term survival and low hepatic toxicities compared with other published studies on other radiotherapy modalities. However, further studies are needed to identify the subgroups that will benefit from PBT.

In November 2021, 14 international travel-related severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant of concern (VOC) patients were detected in South Korea. Epidemiologic investigation revealed community transmission of the omicron VOC. A total of 80 SARS-CoV-2 omicron VOC-positive patients were identified until December 10, 2021 and 66 of them reported no relation to the international travel.There may be more transmissions with this VOC in Korea than reported.

Vitiligo is a commonly acquired cutaneous depigmentation disorder that affects 0.5~1% of the population worldwide. While phototherapy is the primary treatment for vitiligo, surgical methods can be used for treating patients who are refractory to conventional treatments. Herein, we present the case of a 14-year-old Korean girl who developed vitiligo after hematopoietic stem cell transplantation for the treatment of acute lymphoblastic leukemia. She had multiple depigmented patches on her lower legs that did not respond to narrow-band ultraviolet B phototherapy for 7 months. The depigmented patches were successfully treated by transplantation of non-cultured epidermal cell suspension from the epidermal roof of the suction blister in the right inner thigh. No adverse event, such as secondary infection or scarring in both the donor and recipient sites, was noted. We recommended that non-cultured epidermal cell suspension transplantation using the suction blister method would be a safe and effective option for the treatment of refractory vitiligo.
Adolescent ; Blister* ; Cicatrix ; Coinfection ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Leg ; Methods* ; Phototherapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Suction* ; Thigh ; Tissue Donors ; Vitiligo*

BACKGROUND: This study was done to obtain comprehensive data on changes in the structural components of the enteric nervous system in pediatric patients with intestinal pseudo-obstruction (IPO). We evaluated routinely processed, in formalin-fixed tissues by quantitative morphometric analysis. In addition, we used formalin-fixed tissue to explore the possibility of using previously proposed diagnostic criteria to evaluate frozen serial sections for intestinal neuronal dysplasia (IND) type B and hypoganglionosis. METHODS: We analyzed data for 19 IPO cases. Morphometric analysis for quantification of ganglia and ganglion cells (GCs) was done for the myentric and the submucous plexus. In addition, we determined the presence of immature GCs and the distribution of nerve fibers and interstitial cells of Cajal (ICC). RESULTS: Nine patients showed combined hypoganglionosis, IND, and decreased ICC; others showed various combinations of these. Several morphometric factors were significantly different between patient groups as well as being different than the control group. CONCLUSIONS: Our pediatric IPO cases showed extensive overlapping of pathological findings. And the findings suggest the utility of using previously proposed morphometrically measured factors in multiple frozen sections as diagnostic criteria for IND type B and hypoganglionosis in formalin-fixed tissue.
Enteric Nervous System ; Frozen Sections ; Ganglia ; Ganglion Cysts ; Humans ; Interstitial Cells of Cajal ; Intestinal Pseudo-Obstruction ; Nerve Fibers ; Neurons ; Submucous Plexus

BACKGROUND: Regulatory T cells (Tregs) may contribute to the immunological hyporesponsiveness against hepatitis B virus (HBV), and this can result in chronic infection. Tregs suppress the T cell responses directed against HBV and they protect hepatocytes by down-regulating the immune responses that cause liver damage, but the role of Tregs has not been well characterized. METHODS: Fifty four patients were selected and classified into three groups (12 were in the immune-tolerance phase, 35 were in the immune-clearance phase and 7 were in the asymptomatic virus carrier phase). We examined the frequency of CD3+, CD4+ & CD8+ T cells and forkhead box P3 (FoxP3)+ Tregs in the needle-biopsied liver tissue by performing immunohistochemistry. RESULTS: The FoxP3+ Tregs were mainly located at the portal tracts. In the immune-clearance phase, the frequency of FoxP3+ Tregs was significantly increased compared to that of the immune-tolerance group and the asymptomatic carrier group. Increased FoxP3+ T cells were observed in the patients with a higher histologic inflammatory index. No correlation was observed among the numbers of FoxP3+ Tregs, the serum alanine aminotransferase level, detection of HBeAg and the HBV-DNA viral load. CONCLUSIONS: FoxP3+ Tregs may play important roles in suppressing the immune response to HBV and the complete elimination of HBV.
Alanine Transaminase ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Hepatocytes ; Humans ; Liver ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Viruses

BACKGROUND: This study was done to see if there were correlations between anatomic and molecular parameters such as microvessel density (MVD), lymphatic vessel density (LVD), and vascular endothelial growth factor receptor (VEGFR)-3 expression and various clinical parameters for papillary thyroid carcinomas of size > 1.0 cm (PTCs) and size < or = 1.0 cm (papillary thyroid microcarcinomas, PTMCs). PTMCs were divided into two subgroups (0-5 mm and 6-10 mm). METHODS: We analyzed 197 thyroid carcinomas including 113 PTCs and 84 PTMCs. Tissue samples form 30 patients from each group matched for clinical characteristics were selected for immunostaining. RESULTS: Although PTCs and PTMCs showed significant differences in clinical characteristics, they did not show significant difference in MVD, LVD, or VEGFR-3 expression. There was a significantly higher LVD in the PTMC subgroup with the larger tumors but no difference in clinical characteristics. LVD was higher in patients > 45 years old (more apparent in the PTC group) and LVD had suggestive correlations with multicentricity and extrathyroidal extension depending on analytic conditions. CONCLUSIONS: Since LVD showed variable correlations with clinical variables for papillary carcinoma of the thyroid depending on analytic conditions, the individually planned treatments based on overall clinicopathological factors are advised.
Carcinoma ; Carcinoma, Papillary ; Factor IX ; Glycosaminoglycans ; Humans ; Lymphangiogenesis ; Lymphatic Vessels ; Microvessels ; Neovascularization, Pathologic ; Receptors, Vascular Endothelial Growth Factor ; Thyroid Gland ; Thyroid Neoplasms ; Vascular Endothelial Growth Factor Receptor-3

The brown bowel syndrome (BBS) is an uncommon disorder, which is characterized by brown pigmentation of the intestine due to the accumulation of lipofuscin in the smooth muscle cells. Vitamin E deficiency has generally been considered as the cause of this malady. BBS has been reported in a wide variety of malabsorptive diseases involving the pancreas, liver and gastrointestinal tract. We report here on a case of brown bowel syndrome that occurred in a 73-year-old man who had undergone total gastrectomy 11 years ago for gastric adenocarcinoma. He has complained about intestinal obstructive symptoms for several years, and these symptoms were recently aggravated. He showed a low serum concentration of total protein, albumin and cholesterol, and he had been treated for megaloblastic anemia due to vitamin B12 and folate deficiency several months ago. The resected small bowel showed lipofuscin deposition in the muscle layer of the intestine and large vessels. The electron microscopic examination revealed multiple electron dense lipofuscin deposits with irregular shapes and sizes in the cytoplasm.
Male ; Humans