Young Jun Cho

The effectiveness of erythromycin in reducing stent-related tissue hyperplasia: an experimental study with a rat esophageal model.

Background Erythromycin is not only a potent antibiotic; it also has effects of reduction of inflammation and suppression of protein synthesis. Purpose To evaluate the impact of erythromycin on tissue hyperplasia after stent placement in a rat esophageal model. Material and Methods A total of 21 rats were included. After placement of self-expanding stents in the mid esophagus, the rats were divided into two experimental groups and one control group. The rats in the experimental groups received daily intraperitoneal injections of erythromycin for 5 weeks; 4 mg/kg (group A, n = 7) and 8 mg/kg (group B, n = 7). Those in the control group (n = 7) received 1 mL of saline intraperitoneally. After sacrifice, histologic analysis was done for thickness of the papillary projection, granulation tissue area, percentage of granulation tissue area, and degree of inflammatory cell infiltration. The statistical significance of differences between groups was assessed by Mann-Whitney U test. Results Tissue hyperplasia as reflected in thickness of papillary projection, granulation tissue area, and percentage of granulation tissue area, was higher in the control group than in the experimental groups, although there was no statistical significance (P = 1.00, 0.332, and 0.263, respectively). However, degree of inflammatory cell infiltration was significantly lower in the experimental groups than the control group (P = 0.025), and the higher dosage of erythromycin reduced inflammatory cell infiltration significantly (P = 0.037). Conclusion Intraperitoneal administration of erythromycin is very effective in reducing inflammation after stent placement in a rat esophageal model but has no significant effect on granulation tissue formation.

Persistent trigeminal artery variant terminating in the posterior inferior cerebellar artery: a case report

Persistent trigeminal artery (PTA) is a rare cerebrovascular variation of remnant fetal carotid-vertebrobasilar anastomoses. The PTA variant terminates in the cerebellar artery with no direct connection to the basilar artery. We present a rare case of a PTA variant that terminated directly into the ipsilateral posterior inferior cerebellar artery.

Ultrasonographic Features of Papillary Thyroid Carcinomas According to Their Subtypes

Background The ultrasonographic characteristics and difference for various subtypes of papillary thyroid carcinoma (PTC) are still unclear. The aim of this study was to compare the ultrasonographic features of PTC according to its subtype in patients undergoing thyroid surgery. Methods In total, 140 patients who underwent preoperative thyroid ultrasonography (US) and thyroid surgery between January 2016 and December 2016 were included. The ultrasonographic features and the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) category of each thyroid nodule were retrospectively evaluated by a single radiologist, and differences in ultrasonographic features according to the PTC subtype were assessed. Results According to histopathological analyses, there were 97 classic PTCs (62.2%), 34 follicular variants (21.8%), 5 tall cell variants (3.2%), 2 oncocytic variants (1.3%), 1 Warthin-like variant (0.6%), and 1 diffuse sclerosing variant (0.6%). Most PTCs were classified under K-TIRADS category 5. Among the ultrasonographic features, the nodule margin and the presence of calcification were significantly different among the PTC subtypes. A spiculated/microlobulated margin was the most common type of margin, regardless of the PTC subtype. In particular, all tall cell variants exhibited a spiculated/microlobulated margin. The classic PTC group exhibited the highest prevalence of intranodular calcification, with microcalcification being the most common. The prevalence of multiplicity and nodal metastasis was high in the tall cell variant group. Conclusion The majority of PTCs in the present study belonged to K-TIRADS category 5, regardless of the subtype. Our findings suggest that ultrasonographic features are not useful for distinguishing PTC subtypes.

Appropriate Frequency and Interval of Neck Ultrasonography Surveillance during the First 10 Years after Total Thyroidectomy in Patients with Papillary Thyroid Carcinoma

Background No previous study has employed the frequency and interval of follow-up ultrasonography (US) during the first 10 years after total thyroidectomy in patients with papillary thyroid carcinoma (PTC). The aim of this study was to determine the appropriate frequency and interval of follow-up US during the first 10 years in patients who have undergone total thyroidectomy for PTC. Methods Two hundred seventy-two patients underwent total thyroidectomy for PTC at our institution from January 2006 to December 2007. Nineteen patients were excluded because of lack of US follow-up data for the neck. Follow-up US was performed by one of two radiologists in all patients. Tumor recurrence/persistence was confirmed by histopathology. Results The mean interval between surgery and the final follow-up US examination was 79.0 months, and the mean number of follow-up US sessions was 5.9 in the 253 evaluable patients. Eleven patients (4.3%) developed tumor recurrence/persistence, which was detected on follow-up US within 5 years after total thyroidectomy in all cases. T and N stages were independently associated with tumor recurrence/persistence. The interval between surgery and first suspicion of tumor recurrence/persistence on follow-up US was ≤12 months in six patients and 20, 35, 41, 53, and 60 months in the remaining five patients. Conclusion For detection of tumor recurrence/persistence after total thyroidectomy in patients with PTC, one or two sessions of follow-up US during the first 2 years, depending on T and N stages and one session of follow-up US in every second year during the following 8 years may be appropriate.

Computed Tomography Features of Follicular Thyroid Adenoma and Carcinoma

Background: No previous study has investigated the computed tomography (CT) characteristics of follicular thyroid adenoma (FTA) and follicular thyroid carcinoma (FTC). This study aimed to compare the CT features of FTA and FTC. Methods: Eighty-seven consecutive patients with FTA or FTC that underwent preoperative neck CT from January 2006 to December 2013 were included. In each case, single radiologist retrospectively examined the corresponding neck CT under blinded conditions for the histopathological results. The CT features of FTA and FTC were evaluated, as well as the specific CT features for differentiating FTC from FTA. Results: After matching the CT and histopathological results, 55 FTAs and 25 FTCs in 80 patients were analyzed. No statistically significant differences were detected in patient age, gender, nodular size, or location between FTA and FTC patients. The most common CT features in both FTA and FTC included low attenuation, intraglandular configuration, smooth margin, round shape, absence of calcifications, and inhomogeneous enhancement. In particular, the prevalence of decreased, iso-, and increased enhancement was similar in both FTA and FTC. The prevalence of homogeneous attenuation in FTC was higher, whereas the prevalence of inhomogeneous attenuation in FTA was higher. The logistic regression analysis revealed no significant differences between FTA and FTC in any CT features, except for the pattern of attenuation (p = 0.002). Conclusion: No specific CT features of FTA and FTC were identified, and CT may be unhelpful for distinguishing FTC from FTA.

Comparison of computed tomography features between follicular neoplasm and nodular hyperplasia

BackgroundTo date, appropriate management for Bethesda IV thyroid nodules is controversial, and no specific features of follicular neoplasm and nodular hyperplasia on ultrasonography, computed tomography (CT), or other imaging modalities have been reported. This study aimed to compare CT features of follicular neoplasm and nodular hyperplasia and to determine the specific CT features that could be used to distinguish follicular neoplasm from nodular hyperplasia.MethodsIn 122 patients who underwent preoperative CT of the neck and thyroid surgery, 59 follicular neoplasms and 65 nodular hyperplasias were included. In each case, non-enhanced and contrast-enhanced CT images were obtained, and a single radiologist retrospectively analyzed CT images, including degree and pattern of attenuation, nodular configuration, margin, shape, pattern of calcification, degree and pattern of nodular enhancement, and CT halo sign. A univariate and multivariate logistic regression analyses were used to evaluate the predictive power of each variable and CT features with a high predictive power, respectively.ResultsAccording to the univariate analysis, iso-attenuation, intraglandular configuration, smooth margin, ovoid shape, decreased enhancement, and absence of CT halo sign were more frequently observed in nodular hyperplasia (p < 0.05), whereas low attenuation, expansile configuration, lobulated margin, taller-than-wide shape, increased enhancement, and presence of computed tomography halo sign were more frequently observed in follicular neoplasm (p < 0.05). Multivariate analysis revealed significant differences in configuration (OR: 2.73, 1.13–6.57), degree of enhancement (OR: 2.14, 1.21–3.78), and presence of CT halo sign (OR: 7.97, 2.74–23.37) between follicular neoplasm and nodular hyperplasia (p < 0.05).ConclusionsNeck CT may be helpful for distinguishing follicular neoplasm from nodular hyperplasia.Trial registrationRretrospectively registered.