Purpose: Fish allergy is the ninth common food allergy, and cutlassfish is one of the common allergenic fishes in Korean children.However, there is no commercial diagnostic tool for testing cutlassfish allergy in the world. We evaluated the usefulness of serum cod specific IgE (cod-sIgE) to diagnose cutlassfish allergy and cross-reaction between cutlassfish and cod. Methods: Nineteen children who experienced immediate type reactions after consumption of cutlassfish were enrolled. Cod-sIgE was measured by ImmunoCAP, and serum samples were obtained from 11 allergic patients and 11 controls. Using our own homemade crude extracts, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), anti-parvalbumin (PV) immunoglobulin G immunoblot, enzyme-linked immunosorbent assay (ELISA), and ELISA inhibition were performed. Results: Thirteen patients were clinically allergic to both cutlassfish and cod, and 6 were allergic to cutlassfish alone. The median age and cod-sIgE concentrations were not significantly different between the 2 groups. The clear fish protein bands and PVs were identified on SDS-PAGE and immunoblotting. Serum cod-sIgE was positive in 4 out of 6 cutlassfish mono-allergic patients, however, there was no significant correlation between cod-sIgE by ImmunoCAP and cutlassfish-specific IgE by ELISA. The cutlassfish IgE ELISA was profoundly inhibited by cutlassfish, while the cod IgE ELISA was profoundly inhibited by cod but partially inhibited by cutlassfish. Conclusion We found a potential diagnostic value of cod-sIgE to diagnose cutlassfish allergy and the asymmetric cross-reaction between cutlassfish and cod. These results could help diagnose and provide a dietary guidance in cutlassfish allergic children.

Symptomatic Rathke’s cleft cysts (RCCs) can be treated by surgical procedures, usually through an endonasal transsphenoidal corridor using either a microscope or an endoscope. We report a large suprasellar extended RCC causing obstructive hydrocephalus, which was efficiently managed by a novel surgical route named “reverse” trans-sellar approach using transventricular neuroendoscopy. A 48-yearold woman complained of persistent headache and a tendency to fall that had begun 6 months previously. The images obtained from MRI scan showed intra- and supra-sellar cystic masses occupying the third ventricle with obstruction of the foramina of Monro and the aqueduct of Sylvius. The cystic wall showed a slight enhancement, and the cystic contents showed iso-signal intensity on T1-and T2-weighted images. Instead of trans-nasal trans-sellar surgery, we decided to operate using a conventional transventricular endoscope. A thin cystic capsule, which blocked the foramina of Monro and the aqueduct of Sylvius, was fenestrated and removed and a third ventriculostomy was performed. The defect in the infundibulum between sellar and suprasellar cysts was widened and used as a corridor to drain cystic contents (reverse trans-sellar route). The final pathological finding revealed an RCC with focal metaplasia. We efficiently managed a large RCC by transventricular neuroendoscopic surgery with cyst fenestration and third ventriculostomy and simultaneously drained the sellar contents using a novel surgical route. Reverse trans-sellar neuroendoscopic surgery is a relevant treatment option for selective patients with large suprasellar extensions of RCCs.

Syncope is a common symptom in clinical practice. Rotational vertebral artery occlusion syndrome, also referred to as Bow Hunter’s syndrome (BHS), is a rare condition associated with syncope and is caused by mechanical occlusion or stenosis secondary to mechanical compression of the vertebral artery during head rotation. BHS is associated with a multifactorial etiology; however, in most cases, this condition is attributed to degenerative changes. A 53-year-old man visited our hospital for the evaluation of fainting and dizziness episodes that occurred when he turned his head. Evaluation as an outpatient in the Department of Neurology showed a positive result on the Frenzel goggle test. Transfemoral cerebral angiography performed at the Department of Neurosurgery revealed stenosis of the proximal right vertebral artery. Complete occlusion of the vertebral artery was observed, and the head was turned to the right. Decompression and fusion were performed, and the contributory lesion was completely removed. Postoperative imaging confirmed complete removal of the spur and sufficient vertebral artery decompression; the patient’s symptoms resolved postoperatively.

Radiation-induced cavernous hemangiomas (RICHs) have been increasingly reported as a late complication after conventional radiotherapy. RICH after stereotactic radiosurgery (SRS) is extremely rare and the few cases have been reported to demonstrate their properties. A 72-year-old female patient presented with progressive neurologic deficits. She underwent tumor surgery for meningioma 13 years ago and two times of SRS for treating a residual tumor. Newly-developed mass was 4.3 cm-sized heterogeneously enhancing mass with severe cerebral edema. She underwent surgical resection and the histologic examinations revealed organized hematoma. Finally, it was diagnosed as a RICH following SRS based on radiological and histological findings and a history of multiple radiosurgeries. Clinical, radiological, and histological features of a RICH following SRS were discussed in this report.

Background: Anterior choroidal artery (AchA) aneurysms are usually small in diameter because of the size of the involved artery and are often wide-necked. Coil embolization of AchA aneurysm is thus challenging because of serious risks, such as thromboembolic occlusion of artery and perforation of aneurysm dome. Therefore, aneurysmal neck clipping remains widely performed despite a recent increase in the use of coil embolization for aneurysm treatment. We report the treatment results of AchA aneurysms mostly (92.3%) treated with coil embolization at our institute. Methods: The database and medical records of patients who underwent coil embolization for AchA aneurysms were retrospectively analyzed. The clinical and imaging results and procedure-related complications were investigated after coil embolization performed between January 2006 and March 2022 at our institute. Results: In total, 96 AchA aneurysms comprising 65 unruptured and 31 ruptured aneurysms, including only 1 ruptured aneurysm (1.0%) re-embolized at postoperative day 192 because of coil compaction, were evaluated. After the initial coil embolization, complete occlusion was attained in 41, residual neck in 45, and residual aneurysm in 10 patients. Follow-up radiological studies after 6–174 months were performed for 80 aneurysms. Complete occlusion was noted in 57 patients, residual neck in 22, and residual aneurysm in 1. The dysarthria experienced by one (1.0%) patient was the only symptomatic procedure-related complication. After coil embolization, neither delayed new rupture nor re-rupture was observed. Conclusions The results of this study demonstrate that coil embolization is a safe and effective treatment option for patients with AchA aneurysms.

Objective: As the average life span in modern society continues to increase, much interest is focused on high-risk procedures in elderly patients, including major surgical operations. We investigated the results of endovascular coiling of unruptured intracranial aneurysms (UIA) in patients over 80 years of age. Methods: We retrospectively analyzed 39 patients aged over 80 years who underwent coil embolization for UIA between April 2007 and April 2019 at our hospital. Results: Complete occlusion on digital subtraction angiography (DSA) immediately after surgery was performed in 44 (84.6%) of 52 cases of cerebral aneurysms. Four patients (7.7%) had residual aneurysmal necks, and four (7.7%) had contrast flow in the aneurysmal sac. Follow-up magnetic resonance angiography (mean: 8.2 months) was performed in 37 aneurysms in 24 patients. There was evidence of blood flow in the neck in seven cases (18.9%) and aneurysm in two cases (5.4%). Follow-up DSA (mean: 20.5 months) was performed in 14 aneurysms in 11 patients, and 11 aneurysms (78.6%) had complete occlusion, 1 aneurysm (7.1%) had an aneurysmal neck, and 2 aneurysms (14.3%) had contrast filling into the aneurysmal sac. Coil embolization procedure-related complications occurred in 3 patients (7.7%). Cerebral infarction occurred in 1 (2.6%), arterial dissection in 1 (2.6%), and hypoesthesia in 1 (2.6%). Conclusions Active treatment of UIA in elderly patients over 80 years of age through endovascular coil embolization can be considered.

PURPOSE: Axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) are important for staging of patients with node-positive breast cancer. However, these can be avoided in select micrometastatic diseases, preventing postoperative complications. The present study evaluated the ability of axillary lymph node maximum standardized uptake value (SUVmax) on positron emission tomography-computed tomography (PET-CT) to predict axillary metastasis of breast cancer.METHODS: The records of invasive breast cancer patients who underwent pretreatment (surgery and/or chemotherapy) PET-CT between January 2006 and December 2014 were reviewed. ALNs were preoperatively evaluated by PET-CT. Lymph nodes were dissected by SLNB or ALND. SUVmax was measured in both the axillary lymph node and primary tumor. Student t-test and chi-square test were used to analyze sensitivity and specificity. Receiver operating characteristic (ROC) and area under the ROC curve (AUC) analyses were performed.RESULTS: SUV-tumor (SUV-T) and SUV-lymph node (SUV-LN) were significantly higher in the triple-negative breast cancer (TNBC) group than in other groups (SUV-T: 5.99, P < 0.01; SUV-LN: 1.29, P=0.014). The sensitivity (0.881) and accuracy (0.804) for initial ALN staging were higher in fine needle aspiration+PET-CT than in other methods. For PET-CT alone, the subtype with the highest sensitivity (0.870) and negative predictive value (0.917) was TNBC. The AUC for SUV-LN was greatest in TNBC (0.797).CONCLUSION: The characteristics of SUV-T and SUV-LN differed according to immunohistochemistry subtype. Compared to other subtypes, the true positivity of axillary metastasis on PET-CT was highest in TNBC. These findings could help tailor management for therapeutic and diagnostic purposes.
Area Under Curve ; Breast Neoplasms ; Electrons ; Humans ; Immunohistochemistry ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Needles ; Neoplasm Metastasis ; Postoperative Complications ; ROC Curve ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; Triple Negative Breast Neoplasms

OBJECTIVE: The aim of this study was to analyze the effect of supplementing vitrification and warming solutions with two types of antifreeze proteins (AFPs) and the combination thereof on the follicular integrity of vitrified-warmed mouse ovaries. METHODS: Ovaries (n=154) were obtained from 5-week-old BDF1 female mice (n=77) and vitrified using ethylene glycol and dimethyl sulfoxide with the supplementation of 10 mg/mL of Flavobacterium frigoris ice-binding protein (FfIBP), 10 mg/mL of type III AFP, or the combination thereof. Ovarian sections were examined by light microscopy after hematoxylin and eosin staining, and follicular intactness was assessed as a whole and according to the type of follicle. Apoptosis within the follicles as a whole was detected by a terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling assay. RESULTS: The proportion of overall intact follicles was significantly higher in the type III AFP-supplemented group (60.5%) and the combination group (62.9%) than in the non-supplemented controls (43.8%, p<0.05 for each). The proportion of intact primordial follicles was significantly higher in the FfIBP-supplemented (90.0%), type III AFP-supplemented (92.3%), and combination (89.7%) groups than in the non-supplemented control group (46.2%, p<0.05 for each). The proportions of non-apoptotic follicles were similar across the four groups. CONCLUSION: Supplementation of the vitrification and warming solutions with FfIBP, type III AFP, or the combination thereof was equally beneficial for the preservation of primordial follicles in vitrified mouse ovaries.
Animals ; Antifreeze Proteins* ; Apoptosis ; Deoxyuridine ; Dimethyl Sulfoxide ; DNA Nucleotidylexotransferase ; Eosine Yellowish-(YS) ; Ethylene Glycol ; Female ; Fertility Preservation ; Flavobacterium ; Hematoxylin ; Humans ; Mice* ; Microscopy ; Ovary* ; Vitrification

OBJECTIVES: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. METHODS: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. RESULTS: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. CONCLUSION: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.
Aged* ; Aging ; Anger ; Angina Pectoris ; Arthritis ; Asthma ; Cataract ; Cognition ; Cohort Studies ; Comorbidity ; Dementia ; Depression ; Education ; Epidemiologic Studies ; Follow-Up Studies* ; Glaucoma ; Hepatitis B ; Humans ; Hyperlipidemias ; Hypertension ; Hypertrophy ; Korea ; Logistic Models ; Mass Screening ; Myocardial Infarction ; Osteoporosis ; Prevalence ; Prostate ; Sleep Initiation and Maintenance Disorders ; Stroke ; Tuberculosis, Pulmonary ; Urinary Incontinence

OBJECTIVES: Stress is a psychological reaction to stimuli such as anxiety or threat felt by a person either physically or mentally when placed in a difficult situation. Although a relationship between stress and dry mouth has been reported, it remains understudied. The purpose of this study was to investigate the association between stress and subjective dry mouth among the elderly living in a rural region. METHODS: A total of 214 people aged ≥60 years living in a rural area were recruited with an informed consent for a cross-sectional analysis. Information about stress and subjective dry mouth was obtained by an interview survey with a constructed questionnaire. Data on other potential confounding factors (including oral factors) such as socio-demographic data, health-related behaviors, the number of remaining teeth, and subjective chewing ability were also gathered at the same time. Logistic regression models were used to analyze the relationship of stress and dry mouth using SPSS. RESULTS: The Crude odds ratio (OR) of stress awareness affecting subjective dry mouth was 2.59 (95% confidence interval: 1.43–4.68). After adjusting for sex, education, income, smoking, and alcohol intake, the adjusted OR was 2.52 (95% confidence interval: 1.30–4.87) which was statistically significant. CONCLUSIONS: Elderly people who were stressed had an approximately 2-fold increase in experiencing subjective dry mouth when compared to their stress-free counterparts.
Aged* ; Anxiety ; Cross-Sectional Studies ; Education ; Humans ; Informed Consent ; Logistic Models ; Mastication ; Mouth ; Odds Ratio ; Pilot Projects* ; Smoke ; Smoking ; Tooth