Pseudocyst of Temporal Bone and Posterior Cranial Fossa Caused by Cholesterol Granuloma

Accurate preoperative diagnosis of temporal bone lesion is critical because the surgical approaches used for this region are different depending upon the specific disease process involved. While CT and MID have improved the accuracy of preoperative diagnosis of temporal bone pathology, these imaging studies are most helpful when used in conjuction with one another. This case showed a pseudocyst of lhe temporal bone and posterior cranial fossa caused by a blockage of aditus ad antrum due to cholesterol granuloma. The patient was a 33-year-old man with a right-sided temporo-occipital headache. Computed tomography revealed a mass involving the temporal bone and posterior cranial fossa with central bony density. On MRI, the mass showed isosignal intensity with respect to the brain on Tl-weighted image, hyperintense signal to the brain on T2-weighted image, peripheral enhancement on gadolinum enhanced image. Histologically, the mass showed a cholesterol cleft, multinucleated giant cells and a fibrotic capsule without endothelial lining. The patient had no postoperative difficulty and was discharged without problems

Nitric oxide induces MUC5AC mucin in respiratory epithelial cells through PKC and ERK dependent pathways

BACKGROUND: Nitric oxide (NO) is generally increased during inflammatory airway diseases. This increased NO stimulates the secretion of mucin from the goblet cell and submucosal glands but the mechanism is still unknown precisely. In this study, we investigated potential signaling pathways involving protein kinase C (PKC) and mitogen-activated protein kinase (MAPK) in the NO-induced MUC5AC mucin gene and protein expression in A549 cells. METHODS: Nitric oxide was donated to the A549 cells by NOR-1. MUC5AC mucin levels were assayed by enzyme-linked immunosorbent assay (ELISA). MUC5AC promoter activity was determined by measuring luciferase activity after the lysing the transfected cells. Activation of PKC isoforms were measured by assessing the distribution of the enzyme between cytosolic and membrane fractions using immunoblotting. Immunoblotting experiments using a monoclonal antibody specific to PKC isoforms were performed in the cytosol and membrane fractions from A549 cells. Western blot analysis for pERK and p38 were performed using the corresponding antibodies from the cell lysates after donating NO to the A549 cells by NOR-1. RESULTS: The transcriptional activity of MUC5AC promoter was maximal at the concentration of 0.1 mM NOR-1 for 1 hour incubation in transfected A549 cells. (±)-(E)-methyl-2-((E)-hydroxyimino)-5-nitro-6-methoxy-3-hexenamide (NOR-1) markedly displaced the protein kinase C (PKC)α and PKCδ from the cytosol to the membrane. Furthermore, the PKC-α,βinhibitors, GÖ6976 (10 nM) and PKCδ inhibitors, rottlerin (4 μM) inhibited the NOR-1 induced migration of PKCα and PKCδ respectively. NOR-1 also markedly increased the MUC5AC promoter activity and mRNA expression, mucin synthesis and ERK1/2 phosphorylation. The PKC inhibitors also inhibited the NOR-1 induced MUC5AC mRNA and MUC5AC protein synthesis by inhibiting the activation of PKCα and PKCδ with ERK1/2 pathways. CONCLUSION: Exogenous NO induced the MUC5AC mucin gene and protein through the PKCα and PKCδ – ERK pathways in A549 cells. Inhibition of PKC attenuated NO-mediated MUC5AC mucin synthesis. In view of this findings, PKC inhibitors might be useful in the treatment of bronchial asthma and chronic bronchitis patients where NO and mucus are increased in the bronchial airways

Granulocytic Sarcoma in the Head and Neck: CT and MR Imaging Findings

ObjectivesTo evaluate characteristic computed tomography (CT) and magnetic resonance (MR) imaging findings of granulocytic sarcomas of the head and neck.MethodsThe CT (n=11) and MR (n=1) images obtained from 11 patients (7 males and 4 females; mean age, 23.5 yr; age range, 1 to 69 yr) with histologically-proven granulocytic sarcomas of the head and neck were retrospectively reviewed. Histological confirmation was done by bone marrow biopsy in 9 patients, and/or local biopsy in 4 patients. The imaging findings were analyzed with particular attention to location, size, shape, margin, bone destruction, internal architecture, pattern and degree of enhancement, and multiplicity of the lesions.ResultsThe masses were most commonly located in the orbital cavity (n=8); other locations included lymph nodes (n=5) and palatine/pharyngeal/lingual tonsils (n=3). The mass sizes varied from a mean diameter of 1.3 to 5.8 cm (average, 2.6 cm). Multiple lesions were found in 6 patients. The shapes of the tumors were ovoid in 12 patients and irregular in 4 patients. Most lesions had poorly-defined margins (13/16) and invaded adjacent bony structures (5/16). On the pre-contrast CT images, the masses were iso- (5/8) or low-density (3/8) in comparison with muscle. The MRI, which was obtained in one patient in this study, showed that the mass was iso-signal intensity on T1-weighted images and iso-signal intensity on T2-weighted images compared to the gray matter of the brain. On the post-contrast CT images, there was homogenesous (n=12) or heterogeneous (n=4) enhancement, with mild (n=10), moderate (n=4), and marked (n=2) enhancement in the solid portions of the lesions.ConclusionAlthough rare, granulocytic sarcomas arise in various locations in the head and neck area (most commonly in the orbit) in the form of well-demarcated, and mildly- and homogenously-enhancing masses with adjacent bony invasion

Changes in physicochemical characteristics during fruit development in June-bearing strawberry cultivars

Changes in physicochemical characteristics were investigated during fruit development in 'Maehyang', 'Seolhyang', 'Keumhyang', 'Akihime', and 'Red Pearl' strawberries. Fresh weights and color parameters of strawberry fruits changed significantly during the fruit development in all cultivars. Fruit shapes of 'Maehyang' and 'Akihime' were conical, with an index of length to width being 1.5 and that of 'Seolhyang', 'Keumhyang', and 'Red Pearl' were cordate, the index being 1.3. Firmness decreased as the fruit developed in all cultivars. Contents of sugars, organic acids, ascorbic acid, and anthocyanin increased as the fruits developed while the ellagic acid content decreased. Sugars, ascorbic acid, and anthocyanin contents of 'Maehyang', 'Seolhyang', and 'Keumhyang' were higher than those of 'Akihime' and 'Red Pearl'. Results indicate that newly-bred Korean strawberry cultivars containing high levels of bioactive compounds were superior to major Japanese cultivars that have been broadly cultivated in East Asian countries.This work was carried out with the support of Cooperative Research Program for Agriculture Science & Technology Development (Project No. 907002082012)Rural Development Administration, Republic of Korea.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000027607/1SEQ:1PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000027607ADJUST_YN:YEMP_ID:A075898DEPT_CD:517CITE_RATE:0FILENAME:2013-2-heb-발달단계별딸기특성-김성겸.pdfDEPT_NM:식물생산과학부EMAIL:[email protected]_YN:NCONFIRM:

Clear-Cell Meningioma: CT and MR Imaging Findings in Two Cases Involving the Spinal Canal and Cerebellopontine Angle

Clear-cell meningioma is a rare subtype of meningioma which occurs at a younger age and has a higher recurrence rate than other subtypes. We report two cases of clear-cell meningioma, one in the thoracolumbar spinal canal and the other in the cerebellopontine angle. Though the CT and MR imaging findings were not different from those of ordinary meningioma, after surgical removal the condition recurred repeatedly in the patient with spinal canal involvement

Grand Rounds: An Outbreak of Toxic Hepatitis among Industrial Waste Disposal Workers

CONTEXT: Industrial waste (which is composed of various toxic chemicals), changes to the disposal process, and addition of chemicals should all be monitored and controlled carefully in the industrial waste industry to reduce the health hazard to workers. CASE PRESENTATION: Five workers in an industrial waste plant developed acute toxic hepatitis, one of whom died after 3 months due to fulminant hepatitis. In the plant, we detected several chemicals with hepatotoxic potential, including pyridine, dimethylformamide, dimethylacetamide, and methylenedianiline. The workers had been working in the high-vapor-generating area of the plant, and the findings of pathologic examination showed typical features of acute toxic hepatitis. DISCUSSION: Infectious hepatitis and drug-induced hepatitis were excluded by laboratory findings, as well as the clinical course of hepatitis. All cases of toxic hepatitis in this plant developed after the change of the disposal process to thermochemical reaction–type treatment using unslaked lime reacted with industrial wastes. During this chemical reaction, vapor containing several toxic materials was generated. Although we could not confirm the definitive causative chemical, we suspect that these cases of hepatitis were caused by one of the hepatotoxic agents or by a synergistic interaction among several of them. RELEVANCE TO CLINICAL OR PROFESSIONAL PRACTICE: In the industrial waste treatment process, the danger of developing toxic hepatitis should be kept in mind, because any subtle change of the treatment process can generate various toxic materials and threaten the workers’ health. A mixture of hepatotoxic chemicals can induce clinical manifestations that are quite different from those predicted by the toxic property of a single agent

Comparison of Operative Mortality and Complications between Bronchoplastic Lobectomy and Pneumonectomy in Lung Cancer Patients

Bronchoplastic lobectomy is a lung-saving procedure indicated for central tumors, for which the alternative is pneumonectomy. We compared operative mortality and complications between bronchoplastic lobectomy and pneumonectomy in lung cancer patients. From March 1993 through December 2005, 1,461 patients were surgically resected for non-small cell lung cancer, including 73 who underwent bronchoplastic lobectomy and 258 who underwent pneumonectomy. Bronchoplastic lobectomy was performed on any lesion that could be completely resected by this technique, whereas pneumonectomy was only performed on lesions that could not be removed by bronchoplastic lobectomy. Operative deaths occurred in 1 of 73 (1.4%) bronchoplastic lobectomy and 26 of 258 (10.1%) pneumonectomy patients (p=0.014). Major complications occurred in 16 of 73 (21.9%) bronchoplastic lobectomy and 58 of 258 (22.5%) pneumonectomy patients (p=1.0). Bronchoplastic lobectomy has a lower risk of operative mortality than pneumonectomy. Although the complication rates were similar, bronchoplastic lobectomy was associated with improved postoperative cardiopulmonary status and a low prevalence of fatal complications after bronchial anastomosis. These findings indicate that bronchoplastic lobectomy is a valuable alternative to pneumonectomy for anatomically appropriate patients, regardless of underlying cardiopulmonary function

Analysis of Clinical Presentations of Bruton Disease: A Review of 20 Years of Accumulated Data from Pediatric Patients at Severance Hospital

PURPOSE: X-linked agammaglobulinemia (XLA) is a humoral immunodeficiency disease caused by a mutation in the Bruton tyrosine kinase (BTK) gene resulting in defective B cell differentiation. Because it is a relatively rare disorder, it is difficult for clinicians to have a comprehensive understanding of XLA due to a lack of exposure to the disease. Clinical presentations of patients with XLA were analyzed and discussed to improve care plans. MATERIALS AND METHODS: During a 20 year period, from January 1987 to June 2006, a total of 19 patients were diagnosed as XLA in the Department of Pediatrics at Severance Hospital, Seoul, Korea. A retrospective analysis of the clinical presentations of those patients was performed. RESULTS: The mean age of the XLA patients included in the study was 4.89 years, with a range of 6 months to 13 years. Twelve patients were diagnosed before age 5, while the other 7 patients were diagnosed after age 5. Recurrent infections observed in the patients included pneumonia, acute otitis media, septic arthritis, skin infection, sepsis, sinusitis, acute gastroenteritis, cervical lymphadenitis, epididymitis, meningitis, osteomyelitis, urinary tract infection and encephalitis. Frequency of admissions was variable from 0 to 12 times, depending on the time at which immunoglobulin therapy was started. Six cases had family histories positive for XLA. BTK gene mutations were found in 8 cases. CONCLUSION: The overall prognosis of XLA is good as long as patients are diagnosed and treated early with regular intra venous gamma globulin therapy before the sequelae of recurrent infections appear.ope