Radiofrequency Ablation of Thyroid Nodules: Basic Principles and Clinical Application

Radiofrequency (RF) ablation has been gaining popularity as a minimally invasive treatment for benign thyroid nodules regardless of the extent of the solid component. RF ablation of benign nodules demonstrated volume reductions of 33–58% after one month and 51–85% after six months, while solving nodule-related clinical problems. RF ablation has recently shown positive short-term results for locoregional control as well as symptom improvement in patients with recurrent thyroid cancers. This paper reviews the basic physics, indications, patient preparation, devices, procedures, clinical results, and complications of RF ablation

Methicillin-Resistant Staphylococcus aureus Blood Isolates Harboring a Novel Pseudo-staphylococcal Cassette Chromosome mec Element

The aim of this work was to assess a novel pseudo-staphylococcal cassette chromosome mec (ΨSCCmec) element in methicillin-resistant Staphylococcus aureus (MRSA) blood isolates. Community-associated MRSA E16SA093 and healthcare-associated MRSA F17SA003 isolates were recovered from the blood specimens of patients with S. aureus bacteremia in 2016 and in 2017, respectively. Antimicrobial susceptibility was determined via the disk diffusion method, and SCCmec typing was conducted by multiplex polymerase chain reaction. Whole genome sequencing was carried out by single molecule real-time long-read sequencing. Both isolates belonged to sequence type 72 and agr-type I, and they were negative for Panton-Valentine leukocidin and toxic shock syndrome toxin. The spa-types of E16SA093 and F17SA003 were t324 and t2460, respectively. They had a SCCmec IV-like element devoid of the cassette chromosome recombinase (ccr) gene complex, designated as ΨSCCmecE16SA093. The element was manufactured from SCCmec type IV and the deletion of the ccr gene complex and a 7.0- and 31.9-kb portion of each chromosome. The deficiency of the ccr gene complex in the SCCmec unit is likely resulting in mobility loss, which would be an adaptive evolutionary mechanism. The dissemination of this clone should be monitored closely

Spinal Cord Infarction in a Patient Undergoing Veno-arterial Extracorporeal Membrane Oxygenation

Spinal cord infarction is an uncommon, but serious disorder characterized by severe motor impairment and bladder and bowel dysfunction. Spinal cord infarction is likely caused by hypoperfusion at the thoraco-lumbar spinal cord due to diverse reasons. An 81-year-old woman without motor or neurologic dysfunction presented with cardiogenic shock due to acute myocardial infarction. We performed veno-arterial extracorporeal membrane oxygenation (VA ECMO) to maintain adequate organ perfusion. Lower limb weakness was noted on day 1 of ECMO support. Although the symptom persisted, we could not carry out further evaluation because of her hemodynamic instability. After removal of ECMO, spinal magnetic resonance imaging was performed and showed a signal abnormality extending from the level of T5 to the conus medullaris. The patient underwent conservative management, but eventually experienced limb paralysis. Herein, we report a case of spinal cord infarction in a patient with myocardial infarction during VA ECMO support

Suppression of STAT3 and HIF-1 Alpha Mediates Anti-Angiogenic Activity of Betulinic Acid in Hypoxic PC-3 Prostate Cancer Cells

Background: Signal transducer and activator of transcription 3 (STAT3) is a transcription factor that regulates various cellular processes such as cell survival, angiogenesis and proliferation. In the present study, we examined that betulinic acid (BA), a triterpene from the bark of white birch, had the inhibitory effects on hypoxia-mediated activation of STAT3 in androgen independent human prostate cancer PC-3 cells. Methodology/Principal Findings: BA inhibited the protein expression and the transcriptional activities of hypoxia-inducible factor-1a (HIF-1a) under hypoxic condition. Consistently, BA blocked hypoxia-induced phosphorylation, DNA binding activity and nuclear accumulation of STAT3. In addition, BA significantly reduced cellular and secreted levels of vascular endothelial growth factor (VEGF), a critical angiogenic factor and a target gene of STAT3 induced under hypoxia. Furthermore, BA prevented in vitro capillary tube formation in human umbilical vein endothelial cells (HUVECs) maintained in conditioned medium of hypoxic PC-3 cells, implying anti-angiogenic activity of BA under hypoxic condition. Of note, chromatin immunoprecipitation (ChiP) assay revealed that BA inhibited binding of HIF-1a and STAT3 to VEGF promoter. Furthermore, silencing STAT3 using siRNA transfection effectively enhanced the reduced VEGF production induced by BA treatment under hypoxia. Conclusions/Significance: Taken together, our results suggest that BA has anti-angiogenic activity by disturbing th

Evaluation of Food Web Structure and Complexity in the Process of Kelp Bed Recovery Using Stable Isotope Analysis

Kelp forests have declined gradually all over the world. Understanding the trophic structure of such a productive and diverse ecosystem is crucial for its restoration and effective management. Few studies, however, have focused on the trophic structure and functional recovery of kelp forests in the process of restoration. This study was conducted in the eastern coast of Korea where kelp bed restoration was in process with the removal of sea urchins. In addition to quantitative measurement for recovery using common community parameters, we investigated how fast the stability of a food web structure could be established in the newly restored kelp beds with an initially barren condition, using stable isotope analysis, in comparison with a nearby natural bed and barren site. At the restored bed, total algal biomass and diversity reached the levels of the natural bed within 1 year. While the δ13C and δ15N values of macroalgae and organic matter were separated isotopically, they were similar among sites, excluding organic matter at the natural bed in 2019. Most consumers showed similar isotopic values among sites, with overlapping range for δ13C of producers. However, some herbivores showed higher δ15N values as predators/omnivores, particularly at barrens, which could be explained by trophic plasticity depending on the macroalgal structure. In the restored bed, for the first year, higher trophic diversity (CR, CD) and lower trophic redundancy (MNND, SDNND) showed non-overlapping >50% CIs among sites. However, this distinctive stage moved toward the natural bed upon entering the second year as trophic diversity decreased and trophic redundancy increased while natural bed overlapped at<50% CIs. The recovery speed in this system was fast (1 year for quantitative perspectives and 2 years for functional completion). After removing the sea urchins, recruitment of macroalgae quickly increased concomitantly with consumer groups, boosting the diversity and trophic structure of the restored bed. The trophic structure of the first year of restoration was not an intermediate stage toward the completion, but a transient over-shooting state. This might have been triggered by the fast introduction of diverse macroalgae to the urchin-free bare rock space, providing an interesting finding needed to be tested in other temperate marine systems

CSF Otorrhea Resulting from Osteoradionecrosis of the Temporal Bone in a Patient with Recurrent Meningioma

Osteoradionecrosis of the temporal bone is a very rare but potentially lethal complication of radiotherapy for head and neck or skull base tumors. Only two cases of osteoradionecrosis of the temporal bone complicating cerebrospinal fluid (CSF) otorrhea have been reported in the literature. This report describes a case of CSF otorrhea and osteoradionecrosis of the temporal bone in a patient with meningioma who was treated with tympanomastoid surgery and autologous fat obliteration in the mastoid

Optical cavity with a double-layered cholesteric liquid crystal mirror and its prospective application to solid state laser

The authors have fabricated an optical cavity with silver (Ag) and double-layered cholesteric liquid crystal (CLC) mirrors facing each other. This CLC mirror consists of left-handed CLC and right-handed CLC films for high light reflection irrespective of polarization states. A single-mode lasing was observed in dye-doped CLC sandwiched between Ag and double-layered CLC mirrors. The authors also fabricated a flexible solid state device with a spin-coated dye molecular film sandwiched between Ag and double-layered CLC mirrors. Amplified spontaneous emission was observed from the solid state device, suggesting a possible structure for a flexible and tunable solid state laser.open

Supratentorial Gangliocytoma Mimicking Extra-axial Tumor: A Report of Two Cases

We report two cases of supratentorial gangliocytomas mimicking an extra-axial tumor. MR imaging indicated that the tumors were extra-axial, and meningiomas were thus initially diagnosed. Relative to gray matter, the tumors were hypointense on T1-weighted images and hyperintense on T2-weighted images. On contrast-enhanced T1-weighted images, homogeneous enhancement was observed, while CT scanning revealed calcification in one of the two cases

Syringocystadenocarcinoma Papilliferum: A Case Report

Syringocystadenocarcinoma papilliferum (SCACP) is a rare form of adenocarcinoma of the skin. This is the malignant counterpart of syringocystadenoma papilliferum (SCAP) and usually develops on the scalp in a long-standing lesion identified clinically as SCAP. We describe a 65-yr-old Korean man with a nodule on the right supra-pubic area with a 2-yr duration. Histologically this tumor had a similar overall configuration as in SCAP, but the tumor was asymmetric and poorly circumscribed, extending into the deep dermis and showed cytologic atypia. The tumor cells showed positive reaction to GCDFP-15, but negative reaction to CEA and HMFG-1. We established the diagnosis of SCACP in the patient, and a wide excision was performed to remove the tumor. The patient has been well without relapse or metastasis for 2 yr