A Case of Papillary Thyroid Cancer Recurring as an Esophageal Submucosal Tumor

A 75-year-old woman who underwent a total thyroidectomy for papillary thyroid cancer 7 years previously presented with a palpable neck mass. Computed tomography (CT) showed two metastatic masses on the thyroid bed and another mass that looked benign originating from the esophageal wall. Endoscopic ultrasonography (EUS) showed a hypoechoic mass in the esophageal wall that looked similar to a gastrointestinal stromal tumor. The mass on the esophagus had intense fluorodeoxyglucose (FDG) uptake in positron emission tomography-computed tomography (PET-CT), which suggested the possibility of malignancy. Subsequently, after surgery, the mass in the esophagus was confirmed as a metastasis from the thyroid papillary carcinoma. Here we report this unusual case of papillary thyroid cancer that recurred as an esophageal submucosal tumor

A case of bilateral submandibular gland mucoceles in a 16-month-old child

Mucoceles are common benign cystic lesions of the oral cavity that develop following extravasation or retention of mucous material from the major or minor salivary glands. Mucoceles are usually located in the lower lip (60 to 70% of cases), and the floor of the mouth is only involved in 6 to 15% of cases. Submandibular gland mucocele is extremely rare but should be considered in the differential diagnosis of swelling at the submandibular triangle in young children. We present the rare case of a 16-month-old child who was diagnosed with bilateral submandibular gland mucocele, presenting as serial swellings in both submandibular regions. We removed the cystic mass with the submandibular and sublingual glands to prevent recurrence

Development of Anthropometry-Based Equations for the Estimation of the Total Body Water in Koreans

For developing race-specific anthropometry-based total body water (TBW) equations, we measured TBW using bioelectrical impedance analysis (TBWBIA) in 2,943 healthy Korean adults. Among them, 2,223 were used as a reference group. Two equations (TBWK1 and TBWK2) were developed based on age, sex, height, and body weight. The adjusted R2 was 0.908 for TBWK1 and 0.910 for TBWK2. The remaining 720 subjects were used for the validation of our results. Watson (TBWW) and Hume-Weyers (TBWH) formulas were also used. In men, TBWBIA showed the highest correlation with TBWH, followed by TBWK1, TBWK2 and TBWW. TBWK1 and TBWK2 showed the lower root mean square errors (RMSE) and mean prediction errors (ME) than TBWW and TBWH. On the Bland-Altman plot, the correlations between the differences and means were smaller for TBWK2 than for TBWK1. On the contrary, TBWBIA showed the highest correlation with TBWW, followed by TBWK2, TBWK1, and TBWH in females. RMSE was smallest in TBWW, followed by TBWK2, TBWK1 and TBWH. ME was closest to zero for TBWK2, followed by TBWK1, TBWW and TBWH. The correlation coefficients between the means and differences were highest in TBWW, and lowest in TBWK2. In conclusion, TBWK2 provides better accuracy with a smaller bias than the TBWW or TBWH in males. TBWK2 shows a similar accuracy, but with a smaller bias than TBWW in females

Occurrence and characterization of oseltamivir-resistant influenza virus in children between 2007-2008 and 2008-2009 seasons

PurposeThere was a global increase in the prevalence of oseltamivir-resistant influenza viruses during the 2007-2008 influenza season. This study was conducted to investigate the occurrence and characteristics of oseltamivir-resistant influenza viruses during the 2007-2008 and 2008-2009 influenza seasons among patients who were treated with oseltamivir (group A) and those that did not receive oseltamivir (group B).MethodsA prospective study was conducted on 321 pediatric patients who were hospitalized because of influenza during the 2007-2008 and 2008-2009 influenza seasons. Drug resistance tests were conducted on influenza viruses isolated from 91 patients.ResultsThere was no significant difference between the clinical characteristics of groups A and B during both seasons. Influenza A/H1N1, isolated from both groups A and B during the 2007-2008 and 2008-2009 periods, was not resistant to zanamivir. However, phenotypic analysis of the virus revealed a high oseltamivir IC50 range and that H275Y substitution of the neuraminidase (NA) gene and partial variation of the hemagglutinin (HA) gene did not affect its antigenicity to the HA vaccine even though group A had a shorter hospitalization duration and fewer lower respiratory tract complications than group B. In addition, there was no significant difference in the clinical manifestations between oseltamivir-susceptible and oseltamivir-resistant strains of influenza A/H1N1.ConclusionEstablishment of guidelines to efficiently treat influenza with oseltamivir, a commonly used drug for treating influenza in Korean pediatric patients, and a treatment strategy with a new therapeutic agent is required

Comparison of Anthropometric Data between End-stage Renal Disease Patients Undergoing Hemodialysis and Healthy Adults in Korea

Protein-calorie malnutrition is prevalent in hemodialysis (HD) patients. The prevalence of obesity in healthy Korean adults has increased rapidly during the last 10 years. However, there are few large scale data collections available about the current weight status of Korean HD patients. The weight statuses of 10,304 HD patients (data from the Insan Memorial Dialysis Registry 2002, Korean Society of Nephrology) were compared to those of 12,436 control subjects (age > 18) by using body mass index (BMI). Weight status was assessed by WHO classification for Asian-Pacific region [underweight (UW): < 18.5; normal weight (NW): 18.5-22.9; overweight (OW): 23-24.9; obese (OB): 25-29.9; and extremely obese (EOB): > 30 kg/m2] in both the control and HD patients. HD patients had significantly lower body weight and BMI than the controls in all age groups and in both sexes. For the male controls, the proportions of OW and OB showed a reversed U-shape, peaking at the 5th and 6th decades. of the numbers of those classified as NW and UW were relatively small. For the female controls, the proportions of OW and OB progressively increased with age. On the contrary, in HD patients, the proportions of NW and UW were large, up to more than 70%, and those of OW and OB were small in both sexes. In each age group, UW was seen significantly more in the HD group than in the control group. The 6th decade age group showed the highest prevalence ratio for UW in the HD group for both sexes, compared to the controls (Male: 17.33, Female: 17.68). The percentages of UW were related to HD duration and age in both sexes. In conclusion, Korean HD patients seem to have small proportions of OW and OB, compared to the general population, and protein-calorie malnutrition may still be an important nutritional condition

Pressure-induced transition from J(eff)=1/2 to S=1/2 states in CuAl2O4

The spin-orbit entangled (SOE) J(eff) state has been a fertile ground to study quantum phenomena. Contrary to the conventional weakly correlated J(eff) = 1/2 state of 4d and 5d transition metal compounds, the ground state of CuAl2O4 hosts a J(eff) = 1/2 state with a strong correlation of Coulomb U. Here, we report that, surprisingly, Cu2+ ions of CuAl2O4 overcome the otherwise usually strong Jahn-Teller distortion and instead stabilize the SOE state, although the cuprate has relatively small spin-orbit coupling. From the x-ray absorption spectroscopy and high-pressure x-ray diffraction studies, we obtained definite evidence of the J(eff )= 1/2 state with a cubic lattice at ambient pressure. We also found the pressure-induced structural transition to a compressed tetragonal lattice consisting of the spin-only S = 1/2 state for pressure P-c > 8 GPa. This phase transition from the Mott insulating J(eff) = 1/2 to the S = 1/2 states is a unique phenomenon. Our study offers an example of the SOE J(eff) state under strong electron correlation and its pressure-induced transition to the S = 1/2 state