A 45-year-old male visited our clinic due to right palmar anhidrosis and contralateral hyperhidrosis. Chest computed tomography (CT) showed a solitary pulmonary nodule with mediastinal lymph node enlargement, but a cause for atypical palmar anhidrosis was not identified. Subsequent fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed (PET/CT) revealed a localized pleural metastasis at the right apex with direct invasion of the paravertebral sympathetic chain. The pleural metastasis, which was not seen on chest CT, evoked ipsilateral anhidrosis independent of a mass effect or direct invasion by the primary lung tumor. 18F-FDG PET/CT can be helpful in identifying the cause of atypical symptoms in patient with small sized lung cancer.
Adenocarcinoma ; Electrons ; Fluorodeoxyglucose F18 ; Humans ; Hyperhidrosis ; Hypohidrosis ; Lung Neoplasms ; Lung ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Solitary Pulmonary Nodule ; Thorax ; Tomography, X-Ray Computed

A 45-year-old male visited our clinic due to right palmar anhidrosis and contralateral hyperhidrosis. Chest computed tomography (CT) showed a solitary pulmonary nodule with mediastinal lymph node enlargement, but a cause for atypical palmar anhidrosis was not identified. Subsequent fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed (PET/CT) revealed a localized pleural metastasis at the right apex with direct invasion of the paravertebral sympathetic chain. The pleural metastasis, which was not seen on chest CT, evoked ipsilateral anhidrosis independent of a mass effect or direct invasion by the primary lung tumor. 18F-FDG PET/CT can be helpful in identifying the cause of atypical symptoms in patient with small sized lung cancer.

BACKGROUND/AIMS: ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been used for preoperative staging of colorectal cancer (CRC). However, the diagnostic accuracy of FDG-PET/CT for detection of lymph node or distant metastasis and its prognostic role have not been well established. We therefore evaluated the diagnostic and prognostic value of FDG-PET/CT in comparison with conventional CT for CRC. METHODS: We investigated 220 patients who underwent preoperative FDG-PET/CT and CT, followed by curative surgery for CRC. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG-PET/CT and CT for detection of lymph node metastasis and distant metastasis were evaluated. In addition, we assessed the findings of FDG-PET/CT and CT according to outcomes, including cancer recurrence and cancer-related death, for evaluation of prognostic value. RESULTS: For detection of lymph node metastasis, FDG-PET/CT had a sensitivity of 44%, a specificity of 84%, and an accuracy of 67%, compared with 59%, 65%, and 62%, respectively, for CT (P=0.029, P=0.000, and P=0.022). For distant metastasis, FDG-PET/CT had a sensitivity of 79%, a specificity of 94%, and an accuracy of 93%, compared with 79%, 87%, and 86%, respectively, for CT (P=1.000, P=0.004, and P=0.037). In addition, positive findings of lymph node metastasis and distant metastasis on FDG-PET/CT were associated significantly with cancer recurrence or cancer-related death (P=0.009, P=0.001, respectively). CONCLUSIONS: Preoperative FDG-PET/CT had a higher specificity and accuracy compared to CT for detection of lymph node metastasis and distant metastasis of CRC. In addition, FDG-PET/CT could be a valuable prognostic tool for CRC.
Colorectal Neoplasms* ; Diagnosis ; Electrons* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Positron-Emission Tomography ; Prognosis ; Recurrence ; Sensitivity and Specificity

BACKGROUND: Type 2 diabetes is one of the most common diseases with devastating complications. However, genetic susceptibility of diabetic complications has not been clarified. The vitamin D endocrine system is related with calcification and lipolysis, insulin secretion, and may be associated with many complicated disease including diabetes and cardiovascular disease. Recent studies reported that single nucleotide polymorphisms of vitamin D receptor (VDR) gene were associated with diabetic complications. METHODS: In present study, we evaluated the association of BsmI polymorphism of VDR with diabetic complications in Korean diabetes patients. Total of 537 type 2 diabetic subjects from the Endocrinology Clinic of Chungbuk National University Hospital were investigated. Polymerase chain reaction-restriction fragment length polymorphism was used to test the genotype and allele frequency of BsmI (rs1544410; BB, Bb, bb) polymorphisms. RESULTS: Mean age was 62.44+/-10.64 years and mean disease duration was 13.65+/-7.39 years. Patients with B allele (BB or Bb) was significantly associated with lower risk of diabetic retinopathy (severe non-proliferative diabetic retinopathy or proliferative retinopathy; 7.4%, 5/68) compared with patients without B allele (bb; 17.3%, 81/469; P=0.035). This association was also significant after adjusting for hemoglobin A1c level, body mass index, age, sex, and diabetes mellitus duration, concurrent dyslipidemia and hypertension (odds ratio, 2.99; 95% confidence interval, 1.08 to 8.29; P=0.035) in logistic regression analysis. CONCLUSION: Our findings suggest that B allele of Bsm1 polymorphism in VDR gene is associated with lower risk of diabetic retinopathy in type 2 diabetic patients. Bsm1 genotype could be used as a susceptibility marker to predict the risk of diabetes complication.
Alleles ; Body Mass Index ; Cardiovascular Diseases ; Chungcheongbuk-do ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetic Retinopathy* ; Dyslipidemias ; Endocrine System ; Endocrinology ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Hypertension ; Insulin ; Lipolysis ; Logistic Models ; Polymorphism, Single Nucleotide ; Receptors, Calcitriol* ; Vitamin D* ; Vitamins*

OBJECTIVE: To evaluate correlations between serum anti-Mullerian hormone (AMH) levels, phenotypes of polycystic ovary syndrome (PCOS), obesity, and metabolic parameters in patients with PCOS. METHODS: A total of 175 patients with PCOS were diagnosed according to the Rotterdam Consensus were included. Exclusion criteria were age over 40, FSH>25 mIU/mL, and 17a-OHP>1.5 ng/mL. The Phenotypes of PCOS were divided into a severe form (oligo-anovulation, ANOV/hyperandrogenism/polycystic ovary morphology [PCOM]; n=59) and a mild form without HA (ANOV/PCOM, n=105). The serum AMH levels were classified into 3 groups (<5 vs. 5-10 vs. >10 ng/mL). Obesity was defined as body mass index (BMI) > or =25 kg/m2 (n=34). RESULTS: The mean age was 25.9+/-5.7 year and mean AMH level was 10.1+/-5.4 ng/mL. The BMI (kg/m2) was higher in group 1 (24.2+/-6.3) than in group 2 (21.9+/-4.3, p=0.046) or group 3 (21.6+/-3.3, p=0.019). There was no difference among the three groups in age, menstrual interval, antral follicle counts, androgens, or other metabolic parameters. The obesity group showed significantly lower AMH (7.7+/-3.9 ng/mL vs. 10.7+/-5.6 ng/mL), p=0.004) and low-density lipoprotein levels (93.1+/-21.2 mg/dL vs. 107.5+/-39.3 mg/dL, p=0.031), and showed higher total T (0.74+/-0.59 ng/mL vs. 0.47+/-0.36 ng/mL, p=0.001), free T (2.01+/-1.9 vs. 1.04+/-0.8 pg/mL, p=0.0001), and free androgen index (6.2+/-7.9 vs. 3.5+/-3.0, p=0.003). After controlling for age factors and BMI, the serum AMH levles did not show any significant correlations with other hormonal or metabolic parmeters. CONCLUSION: For PCOS patients under the age 40, serum AMH is not negatively correlated with age. High serum AMH levels can not predict the phenotype of PCOS and metabolic disturbances in PCOS patients in the non-obese group. Further study might be needed to define the relation more clearly.
Age Factors ; Androgens ; Anti-Mullerian Hormone ; Body Mass Index ; Carbamates ; Consensus ; Female ; Humans ; Hyperandrogenism ; Lipoproteins ; Obesity ; Organometallic Compounds ; Ovary ; Phenotype ; Polycystic Ovary Syndrome

BACKGROUND: Fine needle aspiration (FNA) of the thyroid is a useful tool for the evaluation of benign or malignant thyroid nodules. The improvements in the quality of cytological preparations using the liquid-based cytology (LBC) method have been well-documented. The principal objective of this study was designed to evaluate the diagnostic adequacy, sensitivity, and specificity of the thyroid FNA comparing a conventional smear with the LBC adapted with the filtration method described herein. METHODS: One hundred ninety eight cases of FNA samples obtained from May 2009 to September 2009 were included in this study. All patients were subjected to ultrasound-guided aspiration twice at a target lesion by a radiologist and two types of slides were prepared using conventional smear and LBC. RESULTS: When compared with conventional method, the cellularity was reduced in LBC. However, the malignant tumor cells evidenced the larger and more vesicular nuclei, prominent nucleoli, and distinct nuclear membranes in LBC. Thirty two cases (16.16%) of conventional smear were inadequate, but 96 cases (48.49%) of LBC were inadequate. CONCLUSIONS: Most of the slides using CellprepPlus(R) LBC evidenced lower cellularity and clearer background. However, the conventional smears were found to generate much more applicable samples than CellprepPlus(R) LBC.
Biopsy, Fine-Needle ; Filtration ; Humans ; Needles ; Nuclear Envelope ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Nodule

PURPOSE: Prophylactic central compartment node dissection is gaining acceptance in the treatment of papillary thyroid carcinoma (PTC). However, its benefits remain controversial. The aim of study was to evaluate the effects of prophylactic central compartment node dissection on the complication rate and the short-term disease-free survival rate. METHODS: Our treatment strategy for PTC without clinical evidence of lymph node metastasis has been changed from total thyroidectomy alone (group I) to total thyroidectomy with prophylactic central compartment node dissection (group II) since January 2007. Before and after 2007, 70 consecutive patients were selected in each group. RESULTS: The average age of patients was 46.3±11.8 years. Average follow-up period was 51.9±10.9 months. The average size of maximum diameters of the tumors was 1.3±0.8 cm. Lymph node metastasis was identified in 22.9% of patients in group II. Recurrent laryngeal nerve injury occurred in one patient in each group. Temporary and permanent hypoparathyroidism occurred in 32.9% and 2.9% in group I, 40.0% and 7.1% in group II respectively (P=0.483 and P=0.441, respectively). Locoregional recurrences developed in seven patients in group I. Fifty month disease-free survival rate was 90.0% and 100% in group I and group II, respectively (P=0.0078). CONCLUSION: Prophylactic central compartment node dissection did not seem to increase the risk of recurrent laryngeal nerve injury, but may increase the risk of temporary and permanent hypoparathyroidism. Prophylactic central compartment node dissection decreased the risk of locoregional recurrences, especially in central compartment. However, the size of metastatic lymph nodes in central compartment in the present study was relatively small and their clinical implication remains to be evaluated.
Disease-Free Survival ; Follow-Up Studies ; Humans ; Hypoparathyroidism ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Recurrent Laryngeal Nerve Injuries ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

No abstract available.
Humans ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

Diabetes is a common medical condition in hospitalized patients and is associated with increased requirement for operation and increased postoperative morbidity and mortality. The stress of surgery induces catabolic changes that alter glucose and lipid levels, as well as protein metabolism. Persistent hyperglycemia can lead to ketoacidosis in type I diabetic patients or hyperosmolar syndrome in type 2 diabetic patients. Also, hyperglycemia is a risk factor for endothelial dysfunction, impaired immunity, wound healing and embolism. The ultimate goal in the management of diabetic patients is to optimize glucose control through monitoring, fluid replacement and use of insulin.
Diabetes Mellitus ; Embolism ; Glucose ; Humans ; Hyperglycemia ; Insulin ; Ketosis ; Risk Factors ; Wound Healing

No abstract available.
Humans ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule