Extratendinous migration of calcific tendinitis of the rotator cuff: imaging findings and clinical characteristics with temporal changes

Purpose@#The aim of this study was to analyze the imaging findings and clinical characteristics of extratendinous migration of calcific tendinitis of the shoulder with temporal changes. @*Methods@#Seventy-six patients with extratendinous calcific tendinitis of the shoulder diagnosed by ultrasonography (US) or magnetic resonance imaging (MRI) were enrolled in this retrospective study. Clinical symptoms and imaging findings (on radiography, US, and MRI) of extratendinous calcific tendinitis during an acute painful attack were analyzed. Temporal changes were analyzed in 28 patients before an acute attack and 40 patients after an acute attack. For comparison, 65 patients with intratendinous calcific tendinitis were included. @*Results@#Patients with extratendinous calcific tendinitis had a significantly higher average visual analogue scale (VAS) score (8.8±1.6) than the intratendinous group (6.4±2.2) (P<0.001). The fragmented type (80.5%) was the most common shape on US; sonographic black hole appearance (14.6%) and echogenic fluid (9.8%) were characteristic findings of intrabursal calcifications. In 28 patients with previous radiographs, radiographic type III (78.6%) was dominant and the location of calcific deposits changed (82.1%) during the acute painful attack, which was also perceivable in 12 patients with previous US or MRI. In follow-up radiographs of 40 patients, calcifications shrunk by more than 50% or became invisible in 82.5% of patients, with symptom improvement (VAS score, 8.9±1.5 to 1.9±1.2). Follow-up US and MRI of 16 patients also showed decreased size (56.3%) or disappearance (43.7%) of calcific deposits. @*Conclusion@#Extratendinous calcific tendinitis has distinctive imaging features, the temporal changes of which correlate well with clinical symptoms.

Primary Lymphoma of Pancreatic Mucosa-Associated Lymphoid Tissue (MALT) / 대한내과학회지

Primary lymphoma of pancreatic mucosa-associated lymphoid tissue (MALT) is extremely rare. Initial suspicion of primary pancreatic lymphoma is hampered by its low incidence. However, it should always be included in a differential diagnosis of pancreatic mass with unusual features, because an accurate diagnosis can avoid unnecessary surgical intervention. A 70-year-old woman presented with melena associated with a mass on the pancreatic head. Endoscopic ultrasonography-guided core-needle biopsy of the pancreatic mass revealed MALT lymphoma. The patient is currently undergoing radiation therapy. We present a case of primary lymphoma of the pancreatic MALT with a review of the literature.

Coexisting Mucinous Cystic Neoplasm of the Pancreas and Type 1 Autoimmune Pancreatitis

Type 1 autoimmune pancreatitis (AIP1) is an IgG4-related systemic disease that mimics tumors. We report a rare case of AIP1 accompanied by mucinous cystic neoplasm (MCN). A pancreatic lesion was incidentally detected in a woman in her 60s. After 6 years of follow-up, the lesion abruptly increased in size. Computed tomography showed a 3.5 cm unilocular cyst in the tail of the pancreas and distal pancreatectomy was performed. On microscopic examination, the cyst was lined by mucinous and non-mucinous epithelial cells with mild cytologic atypia. The surrounding stroma comprised ovarian-type spindle cells with progesterone receptor positivity. The pericystic pancreas exhibited multifocal lymphoid follicles, lymphoplasmacytic infiltrations, obliterative phlebitis, and storiform fibrosis. IgG4-positive plasma cell infiltration (215 cells high-power field) and the IgG4/IgG ratio (57%) were increased. Cases of MCN coexisting with AIP1 are extremely rare; only two such cases have been reported in the English-language literature. This third case featured low-grade MCN with AIP1.

Primary Lymphoma of Pancreatic Mucosa-Associated Lymphoid Tissue (MALT) / 대한내과학회지

Primary lymphoma of pancreatic mucosa-associated lymphoid tissue (MALT) is extremely rare. Initial suspicion of primary pancreatic lymphoma is hampered by its low incidence. However, it should always be included in a differential diagnosis of pancreatic mass with unusual features, because an accurate diagnosis can avoid unnecessary surgical intervention. A 70-year-old woman presented with melena associated with a mass on the pancreatic head. Endoscopic ultrasonography-guided core-needle biopsy of the pancreatic mass revealed MALT lymphoma. The patient is currently undergoing radiation therapy. We present a case of primary lymphoma of the pancreatic MALT with a review of the literature.

Suppressive Effect of 4-Hydroxy-2-(4-Hydroxyphenethyl) Isoindoline-1,3-Dione on Ovalbumin-Induced Allergic Asthma

4-Hydroxy-2-(4-hydroxyphenethyl)isoindoline-1,3-dione (PD1) is a synthetic phthalimide derivative of a marine compound. PD1 has peroxisome proliferator-activated receptor (PPAR) γ agonistic and anti-inflammatory effects. This study aimed to investigate the effect of PD1 on allergic asthma using rat basophilic leukemia (RBL)-2H3 mast cells and an ovalbumin (OVA)-induced asthma mouse model. In vitro, PD1 suppressed β-hexosaminidase activity in RBL-2H3 cells. In the OVA-induced allergic asthma mouse model, increased inflammatory cells and elevated Th2 and Th1 cytokine levels were observed in bronchoalveolar lavage fluid (BALF) and lung tissue. PD1 administration decreased the numbers of inflammatory cells, especially eosinophils, and reduced the mRNA and protein levels of the Th2 cytokines including interleukin (IL)-4 and IL-13, in BALF and lung tissue. The severity of inflammation and mucin secretion in the lungs of PD1-treated mice was also less. These findings indicate that PD1 could be a potential compound for anti-allergic therapy.

Therapeutic effect of oregano essential oil on subclinical bovine mastitis caused by Staphylococcus aureus and Escherichia coli / 대한수의학회지

Oregano (Origanum vulgare) is an aromatic herb belonging to the Lamiaceae family. This study evaluated the therapeutic effect of oregano essential oil (OEO) on clinical bovine mastitis caused by Staphylococcus (S.) aureus and/or Escherichia (E.) coli. Thirty-two quarters from 18 lactating cows with subclinical mastitis were selected from a dairy farm and were divided into 4 groups (8 quarters/group): negative control (CON), positive control (GEN) and two OEO-treated groups (OEO-1 and OEO-2). Each group was intramammarily treated with saline, 10 g/tube of gentamicin ointment, and single and double doses of 0.9 mL OEO ointment twice a day for three days, respectively. After the treatments, physical udder conditions were greatly improved in GEN and OEO groups. In CON group, somatic cell counts (SCCs), number of white blood cells (WBC) and bacteria were increased. However, in OEO groups, SCCs and number of WBC were significantly decreased and S. aureus and E. coli were not detected in milk as compared with those before the treatments as well as GEN group. These results suggest that OEO may be a useful alternative to antibiotics for the control of subclinical bovine mastitis caused by S. aureus and/or E. coli.

Inhibition of Lethal Toxin Expression in Bacillus anthracis Using Antisense Technology

Bacillus anthracis is the causative agent of anthrax primarily in animals and rarely in humans. B. anthracis producing 'anthrax toxin', however, could be a major agent of biological warfare. Anthrax toxin is produced from the pXO1 plasmid encoding the lethal toxin (LeTx) consisted of the protective antigen (PA) and the lethal factor (LF). In this study, we tested whether specific antisense oligonucleotide could inhibit the gene expression in B. anthracis. The antisense oligonucleotide was forced into bacterial cells either by lipofection or heat shock method. The expression of LeTx in B. anthracis was analyzed by the Western blot analysis and the MTT assay using to Raw 264.7 cells. The LeTx protein was purified and used for the production of specific antibodies. The expression of LeTx could be confirmed only in B. anthracis strains haboring pXO1 plasmid. B. anthracis treated with the antisense oligonucleotide through heat shock method markedly inhibited the production of PA. In the Western blot analysis, the expression of PA was inhibited from 25 micrometer and was completely inhibited at 50 micrometer of the antisense oligonucleotide. In the MTT assay, the cytotoxicity was reduced to 20% at 20 micrometer of the antisense oligonucleotide. Above results suggest that the antisense technology would be applied for the research on gene function in B. anthracis.

Local Rifampicin Instillation Therapy for Suppurative Bacillus Calmette-Guerin Lymphadenitis

PURPOSE: Bacillus Calmette-Guerin(BCG) lymphadenitis is one of the most common complications of BCG vaccination. The involved lymph nodes usually subside spontaneously, but they may become enlarged and form an abscess. Treatment of these infants is controversial. The Pan American Health Organization recommends local isoniazid or rifampicin instillation for patients with suppurative BCG lymphadenitis. METHODS: The study group comprised 37 patients who presented with BCG lymphadenitis over the last three years. BCG lymphadenitis was diagnosed if the affected patient developed an ipsilateral axillary or supraclavicular lymphadenitis, with no other identifiable cause for the lymphadenitis. We used rifampicin instillation therapy for patients with suppurative BCG lymphadenitis. RESULTS: Lymphadenitis regressed spontaneously in three patients. Thirty four patients showed a progression to abscess formation. Among 34 patients with suppurative lymphadenitis, drainage developed spontaneously during the follow-up period in nine patients before therapy. Twenty five patients received needle aspiration and local rifampicin instillation therapy. Reaspiration was performed in seven patients. One of these patients still has large lymph nodes after the second attempt. CONCLUSION: Needle aspiration and local rifampicin instillation therapy into the node is a safe and effective form of treatment for suppurative BCG lymphadenitis.

A Case of Wolf-Hirschhorn Syndrome with Long Term Survival Diagnosed by Fluorescent In-situ Hybridization (FISH)

Wolf-Hirschhorn syndrome is a multiple malformation syndrome associated with mental and developmental retardation, resulting from a deletion at the short arm of chromosome 4 (4p16.3). We report a 11-year-old girl with Wolf-Hirschhorn syndrome, who was presented with severe growth and mental retardation along with characteristic features-frontal bossing, hypertelorism, downslanting of the palpebral fissures and fishlike lips. The diagnosis was confirmed by fluorescent in-situ hybridization (FISH).

A Case of Wolf-Hirschhorn Syndrome with Long Term Survival Diagnosed by Fluorescent In-situ Hybridization (FISH)

Wolf-Hirschhorn syndrome is a multiple malformation syndrome associated with mental and developmental retardation, resulting from a deletion at the short arm of chromosome 4 (4p16.3). We report a 11-year-old girl with Wolf-Hirschhorn syndrome, who was presented with severe growth and mental retardation along with characteristic features-frontal bossing, hypertelorism, downslanting of the palpebral fissures and fishlike lips. The diagnosis was confirmed by fluorescent in-situ hybridization (FISH).

A Case of Cervical Neuroblastoma Complained Chiefly with Stridor / 소아알레르기및호흡기학회지

Primary cervical neuroblastoma is very rare disease in neonates and should be distinguished with other diseases, which cause stridor in neonate, including laryngomalacia, vocal cord paralysis, laryngeal web, laryngotracheal esophageal cleft, laryngotracheal stenosis, etc. It is characterized by cough, stridor, dysphagia, neck mass, Horner syndrome and heterochromia iridis. Survival rate is high even in the advanced cases, in which the residual mass is remained after partial resection, without further therapy. A 1-day-old girl showed severe dyspnea with inspiratory stridor after birth. At first, she was misdiagnosed as a case of laryngomalacia, but later proved to have stage I primary neuroblastoma by plain X-ray film of lateral view of the neck, flexible nasolaryngoscopy, and computerized tomography. She has been well without relapse after total resection for 1 (1/2) year. We report this case as the first case in Korea.