Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%–99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973–0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as “not specified.” Conclusion Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.

PURPOSE: To compare anterior segment parameters in angle-closure glaucoma (ACG), primary open angle glaucoma (POAG), and normal subjects (N) using a Schiempflug camera. METHODS: Central corneal thickness (CCT), lens thickness (LT), axial length (AL), anterior chamber angle (ACA), anterior chamber depth (ACD), and anterior chamber volume (ACV) were measured in ACG (93 eyes of 92 patients), POAG (90 eyes of 87 patients), and normal (91 eyes of 88 subjects) with Pentacam(R) and A-scan. All of the results and measurements were then compared. RESULTS: Compared to normal and POAG patients, ACG patients presented with significantly different measurements of CCT, LT, AL, and ACA, ACD, and ACV (p<0.05). Further, correlations were high between three measurements (ACA, ACD, ACV) in ACG, and the best correlations were found in acute angle-closure glaucoma (P<0.05). CONCLUSIONS: By using a Schiempflug camera it was possible to assess the correlation between anterior segment parameters (ACA, ACD, ACV) in glaucoma patients. The best correlations were found in acute angle-closure glaucoma, and thus anterior segment parameters can offer reciprocally complementary information.
Anterior Chamber ; Eye ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Growth Hormone ; Humans ; Peptide Fragments

We report here on two cases of a 48-year old woman and a 46-year-old man who both presented with broncholithiasis and obstructive pneumonitis. Removal of the broncholithiasis failed with bronchofibroscopy, and so right middle lobectomy of the lung were done in the 2 patients. The histopathologic diagnosis was thoracic actinomycosis associated with broncholithiasis. Thoracic actinomycosis associated with broncholithiasis is a very rare condition, so we report here on these two cases of thoracic actinomycosis associated with broncholithiasis.
Actinomycosis ; Bronchi ; Female ; Humans ; Lung ; Middle Aged ; Pneumonia

PURPOSE: To study the correlation between the Humphrey standard automated perimetry (SAP) and the Humphrey Matrix Frequency Doubling Technology (FDT) perimetry and diagnostic usefulness of the Humphrey Matrix FDT perimetry. METHODS: This study included 170 eyes of 170 patients. The 170 eyes were classified into 50 normal eyes, 20 ocular hypertensive eyes, 50 glaucoma-suspect eyes and 50 glaucomatous eyes. All subjects were examined with the Humphrey Matrix perimetry and the Humphrey standard automated perimetry. We studied the correlations between mean deviation (MD) and pattern standard deviation(PSD) of the Humphrey SAP and those of the Humphrey Matrix perimetry, respectively, in each of the classified group. RESULTS: Overall, MD and PSD of the Humphrey SAP were significantly correlated with MD and PSD of the Humphrey Matrix perimetry, respectively. However, MD and PSD of the Humphrey Matrix perimetry were not showed a significant correlation in normal subjects (P>0.05). CONCLUSIONS: In this study, there were significant correlations between the MD and PSD of the SAP and those of the Humphrey Matrix perimetry in glaucoma, glaucoma-suspect and ocular hypertension. These finding suggests the Humphrey Matrix perimetry has performance characteristics similar to SAP and diagnostic value.
Glaucoma ; Humans ; Ocular Hypertension ; Visual Field Tests*

A 51-year-old male was admitted three month previously with a cardiac stab injury and he underwent direct cardiac repair. He had no problem after this event. He complained of dyspnea that started 2 months after the original injury. Echocardiography showed severe tricuspid regurgitation and so, chordac replacement and ring annuloplasty was performed. Herein we report on a case of tricuspid valve repair for treating tricuspid insufficiency following a cardiac stab injury.
Dyspnea ; Echocardiography ; Humans ; Male ; Middle Aged ; Tricuspid Valve Insufficiency* ; Tricuspid Valve* ; Wounds, Stab

PURPOSE: To establish a new therapeutic strategy for proliferative vitreoretinopathhy (PVR), we examined the effect of combined treatment with HDAC inhibitor SAHA and proteasome inhibitor lactacystin in human retinal pigment epithelial (RPE) cells, ARPE-19. METHODS: Viability was determined by trypan blue exclusion assay. Mitochondrial membrane potential (MMP) was measured by flow cytometry. Proteasome activity was measured by fluorophotometry. The expression and degradation of apoptosis-related proteins were assesssed by Western blotting. Subcellular location of apoptosis-related factors was monitored by confocal miscroscopy. RESULTS: A single treatment with 5 micro M SAHA or 10 micro M lactacystin did not reduce cell viability. However, combination treatment with 5 micro M SAHA and 10 micro M lactacystin substantially reduced the viability, because the mixture induced the reduction of MMP and nuclear condensation or fragmentation. Moreover, the combination treatment triggered the activation of caspase-3 and the production of PARP cleavage products. These data indicate that the combination treatment efficiently induces apoptosis in ARPE-19 cells. However, co-treatment of SAHA did not augment the proteasome inhibitory activity of lactacystin, nor did co-treatment of lactacystin augment acetylation of histones. It is notable that while p53 and CAD were observed in the mitochondria of cells treated with SAHA, they were translocated into the nucleus after the combination treatment. CONCLUSIONS: These results suggest that the combination treatment of SAHA and lactacystin effectively induced apoptosis in ARPE-19 cells. Further work is warranted to develop this combination therapy as a novel therapeutic strategy for PVR.
Acetylation ; Apoptosis* ; Blotting, Western ; Caspase 3 ; Cell Survival ; Flow Cytometry ; Fluorophotometry ; Histones ; Humans ; Membrane Potential, Mitochondrial ; Mitochondria ; Proteasome Endopeptidase Complex ; Proteasome Inhibitors ; Retinaldehyde ; Trypan Blue

A 42-year-old female was admitted to our hospital complaining of a dyspnea. Chest X-ray showed left atelectasis. A mass was detected in left main bronchus by computed tomography and bronchoscopy. The mass was diagnosed as a endobronchial leiomyoma by biopsy exam. After open thoracotomy and bronchotomy, mass removal was done and middle lobe was ventilated normally. Aberrant arterial supply from descending aorta to left lower lobe of the lung was detected and left lower lobectomy was done. The lower lobe of the left lung was pathologically diagnosed as intralobar pulmonary sequestration. Herein we report a rare coexistent case of endobronchial leiomyoma and intralobar pulmonary sequestration.
Adult ; Aorta, Thoracic ; Biopsy ; Bronchi ; Bronchial Neoplasms ; Bronchopulmonary Sequestration* ; Bronchoscopy ; Dyspnea ; Female ; Humans ; Leiomyoma* ; Lung ; Pulmonary Atelectasis ; Thoracotomy ; Thorax

A 60-year-old male was admitted to our hospital complaining of general weakness. Chest radiography showed lung mass on left lower lobe. After left lower lobectomy and mediastinal lymph node dissection, The mass was pathologically diagnosed as large cell neuroendocrine carcinoma. Pulmonary large cell neuroendocrine carcinoma is rare. Herein we report a case of large cell neuroendocrine carcinoma in lung.
Carcinoma, Neuroendocrine* ; Humans ; Lung ; Lung Neoplasms ; Lymph Node Excision ; Male ; Middle Aged ; Radiography ; Thorax

The purpose of this study was to assess the expression of ICAM-1, VCAM-1 and PECAM-1 in allergic and chemical conjunctivitis. The allergic and chemical conjunctivitis were induced in C57BL/6 mouse by compound 48/80(C48/80) and 2% characterized clinically by blepharospasm 100%, chemosis 80%, injection AgNO3, respectively. The allergic conjunctivitis was characterized clinically by blepharospasm 100%, chemosis 80%, injection, 40%, mucous discharge 20%, but the chemical conjunctivitis by blepharospasm 80%, chemosis 60%, infection 40% and no mucous discharge at 30 minute after topical application. On the endothelial cells, ICAM-1 was expressed from 1 to 48 hours, VCAM-1 from 6 to 72 hours and PECAM-1 from 1 to 72 hours in allergic conjunctivitis. In chemical conjuctivitis, the expression of ICAM-1 was observed from 6 to 72 hours. The expression of VCAM-1 was observed from 24 and 72 hours. The expression of PECAM-1 was demonstrated from 6 to 72 hours. The expression of cell adhesion molecules, particulary VCAM-1 and PECAM-1, was slighter in chemical conjunctivitis compared to allergic conjunctivitis. In conclusion, experimental allergic and chemical conjunctivitis demonstrate that cell adhesion molecules play a role in part in ocular inflammation and that there are differences between the adhesion molecule expression of two types of confunctivitis.
Animals ; Antigens, CD31 ; Blepharospasm ; Cell Adhesion Molecules ; Conjunctivitis* ; Conjunctivitis, Allergic ; Endothelial Cells ; Inflammation ; Intercellular Adhesion Molecule-1 ; Mice ; Vascular Cell Adhesion Molecule-1

In recent years, the use of allograft conduits in repair of congenital cardiac disease is widely accepted. Howerer, the supply of homograft is currently limiting their increased clinical application, especially small cryopreserved homografts for use in neonates and infants. We used a technique to surgically reduce the size of the more readily available large-diameter allografts, making them suitable for right ventricular outflow tract reconstruction in small infants and children. From December 1994 to March 1996, a total of 11 patients ranging in age from 10 months to 6 years (mean age, 27.3 months) and ranging in weight from 5.6 to 18.5 kg (mean 11.5 kg) underwent reconstruction of the right ventricular outflow tract using this surgical technique (pulmonary atresia with ventricular septal defect, 9 cases; tetralogy of Fallot, 2 cases). The diameter after downsizing ranged from 14 to 19 mm with a mean of 16.8 mm. There was one operative death due to rupture of the infected homograft. Evaluation of these patients between 2 and 15 months(mean 6.9 months) after homograft implantation reveals excellent clinical and echocardiographic results. There were no significant homograft insufficiency and RVOT obstructions. Although a longer follow-up is certainly required to evaluate the long term fate of the surgically modified bicuspid homografts, we believe that this technique may represent a valuable therapeutic alternative, at least in the short term, to the use of synthetic grafts when an appropriately sized homograft is not available.
Allografts* ; Bicuspid* ; Child ; Cryopreservation ; Echocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Infant ; Infant, Newborn ; Rupture ; Tetralogy of Fallot ; Transplants