Diagnostic Performance of Core Needle Biopsy and Fine Needle Aspiration Separately or Together in the Diagnosis of Intrathoracic Lesions Under C-arm Guidance

Purpose: To evaluate and compare the diagnostic accuracy of fine needle aspiration (FNA) and core needle biopsy (CNB) of intrathoracic lesions using the same coaxial guide-needle under a C-arm Cone-Beam computed tomography system. Materials and Methods: Two hundred and eighty-eight patients (181 male, 107 female; 65.8 ± 13.3 years) with 293 lesions underwent 300 procedures, in which both FNA and CNB were performed. After inserting the coaxial guide-needle into the target lesion, we performed 18-gauge CNB, followed by 20-gauge FNA through the same coaxial guide-needle. The comparison of the procedures in which both showed adequate sample was performed with McNemar’s test (n = 229). Results: Of 300 procedures, 293 were technically successful. Adequate samples were obtained in 248/300 FNA and 288/300 CNB cases. The sensitivity and specificity for diagnosis of malignancy were respectively 84.7% (133/157), 100% (72/72) for FNA, when atypical cells included benign entity; 97.5% (153/157), 100% (72/72) for FNA, when atypical cells included malignancy; 97.6% (162/166), 100% (102/102) for CNB; and 100% (166/166), 100% (102/102) for combined FNA and CNB. Diagnosis of malignancy was significantly higher for CNB than for FNA ('p' < 0.001); however, it was not significantly higher when atypical cells included malignancy for FNA. Pneumothorax occurred in 50 (16.7%) and hemoptysis in 18 (6.0%) procedures. Conclusions: Combined use of CNB and FNA using the same coaxial guide-needle showed better diagnostic performance than using one alone. When comparing CNB and FNA, CNB showed significantly better performance, when atypical cells included a benign entity in FNA

MR Imaging of Medullary Streaks in Osteosclerosis: A Case Report

We present a case of medullary sclerosis of the appendicular skeleton in a patient with chronic renal insufficiency for whom MR imaging findings were characteristic. T1- and T2-weighted MR images showed multiple vertical lines (medullary streaks) of low signal intensity in the metaphyses and diaphyses of the distal femur and proximal tibia

Spin-orbit coupling effects on spin-phonon coupling in Cd2Os2O7

Spin-orbit coupling (SOC) is essential in understanding the properties of 5d transition metal compounds, whose SOC value is large and almost comparable to other key parameters. Over the past few years, there have been numerous studies on the SOC-driven effects of the electronic bands, magnetism, and spin-orbit entanglement for those materials with a large SOC. However, it is less studied and remains an unsolved problem in how the SOC affects the lattice dynamics. We, therefore, measured the phonon spectra of 5d pyrochlore Cd2Os2O7 over the full Brillouin zone to address the question by using inelastic x-ray scattering (IXS). Our main finding is a visible mode-dependence in the phonon spectra, measured across the metal-insulator transition at 227 K. We examined the SOC strength dependence of the lattice dynamics and its spin-phonon (SP) coupling, with first-principle calculations. Our experimental data taken at 100 K are in good agreement with the theoretical results obtained with the optimized U = 2.0 eV with SOC. By scaling the SOC strength and the U value in the DFT calculations, we demonstrate that SOC is more relevant than U to explaining the observed mode-dependent phonon energy shifts with temperature. Furthermore, the temperature dependence of the phonon energy can be effectively described by scaling SOC. Our work provides clear evidence of SOC producing a non-negligible and essential effect on the lattice dynamics of Cd2Os2O7 and its SP coupling.Comment: 12 pages, 5 figures, accepted for publication at Rapid Communication in Physical Review

Pulmonary Metastases of Alveolar Soft-Part Sarcoma: CT Findings in Three Patients

Alveolar soft-part sarcoma is a rare soft tissue sarcoma of young adults with unknown histogenesis, and the organ most frequently involved in metastasis is the lung. We report the CT findings of three patients of pulmonary metastases of alveolar soft-part sarcoma, which manifested as clearly enhanced pulmonary nodules or masses. On enhanced scans, some of the masses were seen to contain dilated and tortuous intratumoral vessels

Interaction and ordering of vacancy defects in NiO

By using a first-principles method employing the local density approximation plus Hubbard parameter approach, we study point defects in NiO and interactions between them. The defect states associated with nickel or oxygen vacancies are identified within the energy gap. It is found that nickel vacancies introduce shallow levels in the density of states for the spin direction opposite to that of the removed Ni atom, while the oxygen vacancy creates more localized in-gap states. The interaction profiles between vacancies indicate that specific defect arrangements are strongly favored for both nickel and oxygen vacancies. In the case of nickel vacancies, defect ordering in a simple-cubic style is found to be most stable, leading to a half-metallic behavior. The ionized oxygen vacancies also show a tendency toward clustering, more strongly than neutral pairs. The microscopic origin of vacancy clustering is understood based on overlap integrals between defect states. &#169; 2008 The American Physical Society.open343

Properties of spin 1/2 triangular lattice antiferromagnets: CuRE2Ge2O8 (RE=Y, La)

We found new two-dimensional (2D) quantum (S=1/2) antiferromagnetic systems: CuRE2Ge2O8 (RE=Y and La). According to our analysis of high-resolution X-ray and neutron diffraction experiments, the Cu-network of CuRE2Ge2O8 (RE=Y and La) exhibits a 2D triangular lattice linked via weak bonds along the perpendicular b-axis. Our bulk characterizations from 0.08 to 400 K show that they undergo a long-range order at 0.51(1) and 1.09(4) K for the Y and La systems, respectively. Interestingly, they also exhibit field induced phase transitions. For theoretical understanding, we carried out the density functional theory (DFT) band calculations to find that they are typical charge-transfer-type insulators with a gap of Eg = 2 eV. Taken together, our observations make CuRE2Ge2O8 (RE=Y and La) additional examples of low-dimensional quantum spin triangular antiferromagnets with the low-temperature magnetic ordering.Comment: 15 pages, 6 figures, and 1 tabl

Development of Standard Digital Images for Pneumoconiosis

We developed the standard digital images (SDIs) to be used in the classification and recognition of pneumoconiosis. From July 3, 2006 through August 31, 2007, 531 retired male workers exposed to inorganic dust were examined by digital (DR) and analog radiography (AR) on the same day, after being approved by our institutional review board and obtaining informed consent from all participants. All images were twice classified according to the International Labour Office (ILO) 2000 guidelines with reference to ILO standard analog radiographs (SARs) by four chest radiologists. After consensus reading on 349 digital images matched with the first selected analog images, 120 digital images were selected as the SDIs that considered the distribution of pneumoconiosis findings. Images with profusion category 0/1, 1, 2, and 3 were 12, 50, 40, and 15, respectively, and a large opacity were in 43 images (A = 20, B = 22, C = 1). Among pleural abnormality, costophrenic angle obliteration, pleural plaque and thickening were in 11 (9.2%), 31 (25.8%), and 9 (7.5%) images, respectively. Twenty-one of 29 symbols were present except cp, ef, ho, id, me, pa, ra, and rp. A set of 120 SDIs had more various pneumoconiosis findings than ILO SARs that were developed from adequate methods. It can be used as digital reference images for the recognition and classification of pneumoconiosis

NPM1 as a potential therapeutic target for atypical teratoid/rhabdoid tumors

Background Atypical teratoid/rhabdoid tumors (AT/RTs) are highly malignant brain tumors with inactivation of the SMARCB1 gene, which play a critical role in genomic transcriptional control. In this study, we analyzed the genomic and transcriptomic profiles of human AT/RTs to discover new druggable targets. Methods Multiplanar sequencing analyses, including whole exome sequencing (WES), single nucleotide polymorphism (SNP) arrays, array comparative genomic hybridization (aCGH), and whole transcriptome sequencing (RNA-Seq), were performed on 4 AT/RT tissues. Validation of a druggable target was conducted using AT/RT cell lines. Results WES revealed that the AT/RT genome is extremely stable except for the inactivation of SMARCB1. However, we identified 897 significantly upregulated genes and 523 significantly downregulated genes identified using RNA-Seq, indicating that the transcriptional profiles of the AT/RT tissues changed substantially. Gene set enrichment assays revealed genes related to the canonical pathways of cancers, and nucleophosmin (NPM1) was the most significantly upregulated gene in the AT/RT samples. An NPM1 inhibitor (NSC348884) effectively suppressed the viability of 7 AT/RT cell lines. Network analyses showed that genes associated with NPM1 are mainly involved in cell cycle regulation. Upon treatment with an NPM1 inhibitor, cell cycle arrest at G1 phase was observed in AT/RT cells. Conclusions We propose that NPM1 is a novel therapeutic target for AT/RTs.This research was supported by the Bio & Medical Technology Development Program (NRF-2018M3A9H3021707) and the Basic Science Research Program (NRF-2019R1A2C2005144) through the National Research Foundation of Korea (NRF) funded by the Ministry of Science & ICT of Republic of Korea and a grant from the Samsung SDS. The funders collaboratively provided grants to complete the sequencing, data analysis, in vitro experiments, and publication

Implantable Cardioverter-Defibrillator Implantation in a Patient with Atrial Standstill

We report a 55-year-old female patient who presented with no P waves but with a wide QRS complex escape rhythm at 44 beats/min and prolonged QTc of 0.55 seconds on ECG. The patient had recurrence of ventricular fibrillations and loss of consciousness, and underwent defibrillation and cardiopulmonary resuscitation (CPR) several times because of cardiac arrest. The transthoracic echocardiography showed dilated cardiomyopathy and enlargement of both atria. The Doppler echocardiography documented the absence of A wave in the tricuspid and mitral valve flow. An electrophysiologic study demonstrated electrical inactivity in the right and left atria. Atrial pacing with maximum output did not capture the atria. These findings together with her electrocardiographic finding indicated atrial standstill. Sudden cardiac death was her first clinical manifestation of ventricular arrhythmia. The patient remained asymptomatic after receiving a single chamber implantable cardioverter-defibrillator (ICD) with VVI pacemaker function

Thyroid dysfunction in patients with childhood-onset medulloblastoma or primitive neuroectodermal tumor

Purpose We investigated the clinical characteristics of patients who developed thyroid dysfunction and evaluated the risk factors for hypothyroidism following radiotherapy and chemotherapy in pediatric patients with medulloblastoma or primitive neuroectodermal tumor (PNET). Methods The medical records of 66 patients (42 males) treated for medulloblastoma (n=56) or PNET (n=10) in childhood between January 2000 and December 2014 at Seoul National University Children’s Hospital were retrospectively reviewed. A total of 21 patients (18 high-risk medulloblastoma and 3 PNET) underwent high-dose chemotherapy and autologous stem cell rescue (HDCT/ASCR) Results During the median 7.6 years of follow-up, 49 patients (74%) developed transient (n=12) or permanent (n=37) hypothyroidism at a median 3.8 years of follow-up (2.9–4.6 years). Younger age (<5 years) at radiation exposure (P=0.014 vs. ≥9 years) and HDCT (P=0.042) were significantly predictive for hypothyroidism based on log-rank test. However, sex, type of tumor, and dose of craniospinal irradiation (less vs. more than 23.4 Gy) were not significant predictors. Cox proportional hazard model showed that both younger age (<5 years) at radiation exposure (hazard ratio [HR], 3.1; vs. ≥9 years; P=0.004) and HDCT (HR, 2.4; P=0.010) were significant predictors of hypothyroidism. Conclusions Three-quarters of patients with pediatric medulloblastoma or PNET showed thyroid dysfunction, and over half had permanent thyroid dysfunction. Thus, frequent monitoring of thyroid function is mandatory in all patients treated for medulloblastoma or PNET, especially, in very young patients and/or high-risk patients recommended for HDCT/ASCR