• Journal of Digestive Cancer Research
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• v.9 no.1
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• pp.1-7
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• 2021

The length, the frequency, and the methods of surveillance for intraductal papillary mucinous neoplasm (IPMN) of the pancreas are still debating. According to the recent guidelines, IPMN is stratified into "high-risk stigmata" or absolute indication and "worrisome features" or relative indication as a guide in managing these patients, either those with resection of the lesion or those under surveillance. The risk of malignant transformation was quite low for branch duct-IPMNs without worrisome features or high risk stigmata. However, because the incidence rate of pancreatic cancer in these patients increase linearly with time, continued long-term surveillance is therefore important for patients with low-risk, as well as higher-risk, IPMN. Considering the high prevalence of malignancy, main duct-IPMN should be treated by surgical resection. Among patients with these type IPMNs, segmental dilatation of the main pancreatic duct without any mural nodules and larger than 10 mm of main pancreatic duct might not be immediately resected and need very careful examination and observation. The risk related to a major pancreatic resection must balance the risk of surveillance in patients with IPMN of the pancreas who have co-morbidity and are elderly.

• Korean Journal of Mineralogy and Petrology
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• v.37 no.2
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• pp.35-46
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• 2024

This study investigated the origin and mineralogical-geochemical characteristics of a small ferromanganese (Fe-Mn) nodule sample obtained from the abyssal seafloor of the Magellan Seamount cluster. To this end, X-ray diffraction and X-ray fluorescence analyses were conducted. The dark brown Fe-Mn oxides constituting the nodule had a homogeneous texture without distinguishable layers, forming around three distinct nuclei. The oxides had a low average Mn/Fe ratio of 0.73 (0.24-1.10) and were characterized by high Co content (0.41-0.85 wt.%, average = 0.58 wt.%) as well as low Ni (0.06-1.24 wt.%, average = 0.55 wt.%) and Cu (0.27-1.02 wt.%, average = 0.59 wt.%) concentrations. The maximum age of the nodule was estimated at 0.52 Ma, suggesting that it began forming during the transition from the glacial to the interglacial periods in the middle Pleistocene. The Fe-Mn oxide layer comprised vernadite, smectite, quartz, and feldspar, while the nuclei were composed of soft sediments. The presence of vernadite, a typical hydrogenetic Fe-Mn oxide mineral, along with the low Mn/Fe ratio, high Co content, and low Ni and Cu concentrations, indicates that Fe-Mn nodules on the abyssal seafloor of the Magellan Seamount cluster in the western Pacific Ocean formed through hydrogenetic processes.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.59-68
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• 1997

Background : Tuberculous chest wall abscess is a rare complication of tuberculosis. However, there have been few reports about the variable extents and shapes of tuberculous chest wall abscesses. We analyzed the extent and shape of tuberculous chest wall abscess-es and grouped them according to combined pleuroparenchymal lesions by CT scans. Materials and Methods : CT findings were evaluated in 20 patients of tuberculous chest wall abscesses. We classified 29 abscesses in 20 patients into three types according to pleuroparnechymal lesions. Type 1 was defined when there was no active pleuroparenchymal lesion, Type 2, when intrathoracic tuberculosis was contacted with chest wall abscess, Type 3, when ipsilateral subpleural nodules were not contacted with chest wall abscess. Results : The type 1 included 6 abcesses in 6 patients. They showed rib and/or costal cartilage destruction in their center. They were relatively large and round. The type 2 included 13 abscesses in 10 patients. The abscesses in contact with pleural lesion or mediastinal lesion were mainly located in the outer muscle layer, and they were relatively large in size. However, the abscesses in contact with parenchymal lesion were mainly located in extrapleural space. They were relatively small and they were longest along the long axis of ribs. The type 3 included 10 abscesses in 6 patients. They were located mainly in the extrapleural space. Conclusion : Tuberculous chest wall abscess-es showed variable extents and shapes according 10 pleuroparenchymal lesions. CT is a good diagnostic modality to visualize the extent of tuberculous chest wall abscess and combined pleuroparenchymal lesion.

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.311-319
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• 2004

Background : It has been well known that bronchiectasis (BE) is a predisposing condition for pulmonary NTM infection, whereas there are some suggestions that BE, especially nodular BE, may be a result of NTM pulmonary infection. This retrospective study was done to investigate the prevalence of NTM pulmonary infection in the patients with BE. Methods : Eight hundred sixty-six patients, who underwent chest CT and sputum AFB examination and had BE detected by chest CT at Asan Medical Center in 2002, were included in this study. They were divided into Group I (bilateral BE, especially in RML, lingular or both lower lobes; 134), Group II (BE accompanied with fibrocavitary lesions commonly found in tuberculosis, usually both upper lobes; 233) and Group III (except Group I, II; 499) according to the radiological findings. Group I was subdivided into Group I+ (62) or Group I- (72) according to the presence or absence of centrilobular nodules, respectively. The sputum AFB examination, clinical and radiological findings were analyzed and compared between groups. Results : The number of patients who had at least one positive NTM culture was significantly higher in Group I+ compared with others (p<0.05); 24.2% in Group I+, 6.9% in Group I-, 9.9% in Group II, 6.0% in Group III and 4.1% in control. The number of patients who had true NTM infection defined by ATS guideline was higher in Group I+ (5, 8.1%) compared with others (p<0.05). In all groups, M. avium-intracellulare comlex was the most common isolates. Conclusion : Even though true NTM pulmonary disease was more prevalent in the patients with nodular BE, especially located in RML, left linguar, or both lower lobes, only a small population of the patients with nodular BE met the ATS diagnostic criteria for NTM pulmonary disease. The other patients in nodular BE group may have subclinical stage of NTM infection or completely different diseases from NTM infection. Long-term clinical studies are needed to clarify this issue.

• Economic and Environmental Geology
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• v.52 no.6
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• pp.509-517
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• 2019

The birnessite (7Å manganate, δ-MnO₂) which is a manganese oxide and comprises manganese nodules, is a major manganese mineral on the earth surface and a precursor in the synthesis of todorokite. In this study birnessite was synthesized by three different methods: Feng et al. (2004) and Luo et al. (1998) based on redox reaction and Ma et al. (1999) based on reduction reaction. 12 birnessite samples were synthesized by different combinations of Na⁺ and K⁺ cations based on the base (OH^-) and permanganate (MnO₄^-) reagents in the synthesis. The mineral compositions of synthesized birnessite were identified by XRD, and the two cation ratio in the mineral was measured by ICP. The products obtained after hydrothermal treatment of Mg-buserite, by the precursor of birnessite, was examined by XRD, and then phase transition to todorokite and their characteristics were compared. Our results show that the byproducts and the characteristics of phase transition by each synthetic method have different trends. Hausmannite (γ-Mn₃O₄) and feitknechtite (β-MnOOH) were formed by both methods in the redox reaction mechanism. By Feng et al. (2004)'s method, manganite (γ-MnOOH) phase only appeared when cation was predominantly Na⁺. Two birnessite samples synthesized by redox reaction mechanism showed phase transition to todorokite (10Å manganate, OMS-1) when both NaOH and KMnO₄ were used together. However, single-phase birnessite was formed by Ma et al. (1999)'s method, and phase transition was confirmed only for the sample when the cation was only composed of Na⁺.

• Tuberculosis and Respiratory Diseases
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• v.64 no.1
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• pp.15-21
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• 2008

Background: The melanoma antigen-encoding (MAGE) genes are known to be expressed in various cancer cells, including non-small cell lung cancer (NSCLC), and are silent in all normal tissues except for the testis. In patients with peripheral NSCLC, bronchial washing fluid can be used to detect the MAGE genes, suggesting a diagnosis of lung cancer. In order to evaluate the diagnostic utility of the MAGE test in patients with peripheral NSCLC, bronchial washing fluid was investigated in patients with peripheral pulmonary nodules, which were invisible as detected by bronchoscopy. Methods: Bronchial washing fluid from 37 patients was used for cytological examinations and MAGE gene detection, using RT-nested-PCR of common A1-A6 mRNA. Results were compared to a final diagnosis of patients as confirmed by pathology. Results: Among the 37 subjects, NSCLC was diagnosed in 21 patients, and benign pulmonary diseases were diagnosed in 16 patients. MAGE mRNA was detected in 10 of 21 (47.6%) NSCLC patients, while conventional cytology examinations were positive for MAGE expression in 2 of 21 (9.5%) cases. MAGE expression was observed in 4 of 16 (25%) benign pulmonary disease patients. Conclusion: The MAGE test of bronchial washing fluid can be used as a sensitive predictor of peripheral NSCLC patients.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.183-189
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• 2009

Purpose : To evaluate the usefulness of three-dimensional (3D) maximal intensity projection (MIP) reconstruction method in breast MRI. Materials and Methods : Total 54 breasts of consecutive 27 patients were examined by breast MRI. Breast MRI was performed using GE Signa Excite Twin speed (GE medical system, Wisconsin, USA) 1.5T. We obtained routine breast MR images including axial T2WI, T1WI, sagittal T1FS, dynamic contrast-enhanced T1FS, and subtraction images. 3D MIP reconstruction images were obtained as follows; subtraction images were obtained using TIPS and early stage of contrast-enhanced TIPS images. And then 3D MIP images were obtained using the subtraction images through advantage workstation (GE Medical system). We detected and analyzed the lesions in the 3D MIP and routine MRI images according to ACR $BIRADS^{(R)}$ MRI lexicon. And then we compared the findings of 3D MIP and those of routine breast MR images and evaluated whether 3D MIP had additional information comparing to routine MR images. Results : 3D MIP images detect the 43 of 56 masses found on routine MR images (76.8%). In non-mass like enhancement, 3D MIP detected 17 of 20 lesions (85 %). And there were one hundred sixty nine foci at 3D MIP images and one hundred nine foci at routine MR images. 3D MIP images detected 14 of 23 category 3 lesions (60.9%), 11 of 16 category 4 lesions (68.87%), 28 of 28 Category 5 lesions (100%). In analyzing the enhancing lesions at 3D MIP images, assessment categories of the lesions were correlated as the results at routine MR images (p-value < 0.0001). 3D MIP detected additional two daughter nodules that were descriped foci at routine MR images and additional one nodule that was not detected at routine MR images. Conclusion : 3D MIP image has some limitations but is useful as additional image of routine breast MR Images.

• Tuberculosis and Respiratory Diseases
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• v.53 no.1
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• pp.17-26
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• 2002

Background : The detection and early elimination of the causes for acute respiratory distress syndrome(ARDS) at the initial stage can result in a more favorable prognosis. Miliary tuberculosis as a cause of the ARDS is quite rare. A diagnosis of miliary tuberculosis is difficult due to the diversity of radiological patterns and non-specific clinical finfings, and low sensitivity of sputum examinations for acid-fast bacilli(AFBs). An analysis of the clinical data is the first step in diagnosing these unusual, rare cases. Materials and Methods : In this study the clinical features, laboratory data, radiological findings and diagnostic methods were analyzed in 9 cases with an initial presentation of ARDS due to miliary tuberculosis. The ARDS was defined by the definition of the American-Europian consensus conference 1992. Results : The mean age of the patients was $67{\pm}18$ years (F:M=7:2). The chief complaints were dyspnea(5/9), coughing (3/9) and fever(5/9). On a physical examination, fine or coarse crackles were noted(6/9). The ARDS developed on average 6.7 days after the initial respiratory symptoms. The mean $PaO_2/FiO_2$ of the patients was $133.5{\pm}53.4$, the number of cases with a WBC<5000/$mm^3$ was 4 out of 9 cases. A platelet count<70,000/$mm^3$ was observed in 2 out of 9 cases, and the serum albumin level was $2.6{\pm}0.6$ g/dL. The initial simple chest PA showed ground glass appearances and consolidation in all cases, However, the miliary nodular densities were observed in only 4 out of the 9 cases. HRCT revealed alveolar densities and a consolidation in 5 out of 6 cases, and miliary nodules in 5 out of 6 cases, The diagnosis of tuberculosis was made by a liver biopsy (4/4, 100% sensitivity), a bone marrow biopsy (1/2, 50% sensitivity), and an open lung biopsy (1/1), the sputum AFB was positive in only 2 out of 9 cases. The patient was treated with INH, RFP, EMB, PZA, and steroids. The survival rate was 55.5%. Conclusion : Miliary tuberculosis should be considered as one of the causes for ARDS in areas where there is a high prevalence of tuberculosis. The chief complaints of the patients on admission are dyspnea, fever and coughing without any specific riskfactors. A liver biopsy is particularly useful in ARDS patients with mechanical ventilation to determine the causes of the ARDS if miliary tuberculosis is suspected as being the underlying disease.

• Korean Journal of Poultry Science
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• v.35 no.4
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• pp.341-350
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• 2009

The research work was carried out to study the pathogenesis covering the clinical signs, gross and histopathological lesions in different organs, and reisolation and identification of the organisms after experimental infection with the local isolate of Salmonella enterica serovar. enterica subspecies (S.) Pullorum at different time interval of the experiment during the period February 2006 to December 2006. One hundred pullets (seronegative to S. Pullorum of 12 weeks age were purchased and divided into 5 (A, B, C, D and E) groups and each group consisted of 20 birds. Four groups (A, B, C and D) were infected orally with a dose of $10^6\;CFU$, $10^7\;CFU$, $2{\times}10^7\;CFU$, $10^8\;CFU$ of S. Pullorum, respectively, and one group (E) was treated as uninfected control. The used methods were necropsy and histopathology, culture of bacteria, staining and biochemical test of Salmonella. Five birds from each group were randomly selected and sacrificed $1^{st}$ week, $2^{nd}$, $3^{rd}$ and $4^{th}$ weeks of post infection (PI). From all the groups, the bacteriological samples (crop, liver, lung, heart, spleen, bile duodenum, ceca and blood) were collected with pre enriched in buffered peptone water in sterile poly bags. Liver, lungs, heart, spleen, intestine, etc. were collected in 10% buffered-formalin for histopathological examination. No clinical signs, gross and histopathological lesions were found in control group and no S. Pullorum was reisolated. Clinical sign of experimentally infected with S. Pullorum in pullets were loss of appetite (100%), slight depression (75%), ruffled feathers (85%), diarrhea (60%) and loss of weight (100%) in chickens. The feed intake and body weight at different weeks after PI differed significantly (p<0.01) among the groups. Grossly, the highest recorded lesion was button-like ulcer in the ceca (80%) and the lowest was white nodules in lungs (1.25%). S. Pullorum were reisolated from crop (91.25%), liver (91.25%), lung (83.75%), heart (71.25%), spleen (87.75%), bile (33.25%), duodenum (92.50%), ceca (97.50%) and from different group of infection (61.25%). The highest microscopic findings were intestinal and cecal mucosa and submucosa exhibited infiltration of mononuclear cells and congestion (96.25%), and the lowest finding was nodule formation in the lungs (3.75%). The pattern of the disease production by local isolate of S. Pullorum in Bangladesh is almost similar with other isolates in different countries.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.163-171
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• 2008

Purpose: We analyze the characteristics of soft tissue sarcomas presented with hematoma, which were misdiagnosed as simple hematoma initially and the proper management were delayed. Materials and Methods: The 7 patients with histologically proven soft tissue sarcoma with hematoma presented since February 1997 were evaluated retrospectively. Neither patient had a medical history of bleeding tendency nor anticoagulant therapy. Two of them had minor traumas. There were 2 men and 5 women. Average follow up period was 58 months. MRI findings, provided treatments and oncologic outcome were reviewed with the reference of related articles. Results: Retrospective review of initial MR images revealed deep seated intramuscular masses with focal solid enhanced nodules at the peripheral margin. The diagnoses were delayed at least 1 month in 3 of them which included 2 cases of simple hematoma evacuation without biopsy initially. After histologic diagnosis of soft tissue sarcoma, wide resections were performed in 4 cases. one patient underwent above knee amputation and the remained 2 patients were managed with wide resection followed by amputation due to local recurrence. At last follow up there were CDF and NED in 2 cases, respectively and AWD in 3 cases. Conclusion: To avoid the delay of diagnosis and treatment of soft tissue sarcomas presented with hematoma, high degree of clinical suspicion, careful analysis of MR images and early biopsy were important.