Erratum: US-Guided Radiofrequency Ablation for Low-Risk Papillary Thyroid Microcarcinoma: Efficacy and Safety in a Large Population.

This corrects the article on p. 1653 in vol. 20, PMID: 31854153.

US-Guided Radiofrequency Ablation for Low-Risk Papillary Thyroid Microcarcinoma: Efficacy and Safety in a Large Population.

OBJECTIVE: To evaluate the efficacy and safety of radiofrequency ablation (RFA) for low-risk papillary thyroid microcarcinoma (PTMC) in a large population. MATERIALS AND METHODS: Cases of 152 biopsy-proven PTMCs from 133 patients who had undergone RFA for PTMC between May 2008 and January 2017 were included in this study. All patients were either of high surgical risk or refused to undergo surgery. They were followed up for at least 6 months after initial RFA. Ultrasonography (US) and computed tomography were performed to evaluate the PTMC and the presence of neck metastasis before treatment. RFA was conducted using an internally cooled thyroid-dedicated electrode system. Follow-up US was performed at 1 week, and 2, 6, and 12 months, after the initial RFA, and then at every 6-12 months. We evaluated serial changes of ablated tumors, newly developed cancers, lymph node (LN) or distant metastasis and complications. RESULTS: Complete disappearance was found in 91.4% (139/152) of ablated tumors. Among the 13 tumors in patients who did not show complete disappearance, no tumor displayed any regrowth of the residual ablated lesion during the follow-up period. The mean follow-up period was 39 months. During the follow-up period, there were no local recurrence, no LN or distant metastasis, and no newly developed thyroid cancers. No patients were referred to surgery. The overall complication rate was 3% (4/133) of patients, including one voice change. There were no life-threatening complications or procedure-related deaths. CONCLUSION: Our results suggest that RFA is an effective and safe option for treating low-risk PTMC patients who are of high surgical risk or refuse surgery.

Giant left anterior descending artery aneurysm resulting in sudden death.

Coronary artery aneurysm is a rare congenital or vascular inflammation-based anomaly for which the clinical course and optimal timing of treatment remain unclear. Here, we report a case of sudden death caused by a giant coronary artery aneurysm of the left anterior descending artery that presented with chest pain. This case suggests that urgent interventional or surgical repair is needed when a large coronary aneurysm presents with acute ischemic symptoms.

Aneurysm of sinus of valsalva dissecting into the interventricular septum after aortic valve replacement: diagnosis by echocardiography and magnetic resonance imaging and treatment with surgical sealant.

Aneurysm of the sinus of Valsalva that causes dissection of the interventricular septum is an extremely rare entity. In this report we describe a case of aneurysm of the sinus of Valsalva dissecting into the interventricular septum, from the base to mid septum, after aortic valve replacement. After the diagnosis was made by transthoracic echocardiography and magnetic resonance imaging, the patient was successfully treated with surgical sealant-mediated occlusion of the aneurysmal sac and cardiac resynchronization therapy used for the first time.

Acquired long QT syndrome and ventricular tachycardia in a patient on flecainide therapy.

This case report describes a 54-year-old man presenting with loss of consciousness due to acquired long QT syndrome shortly after flecainide therapy. The patient had no common risk factors for acquired long QT syndrome. Prior to onset of ventricular tachycardia, bradyarrhythmia and short-long-short sequence were observed with a prolonged QT interval of 710 ms. However, the morphology of induced tachycardia was uniform rather than torsades de pointes. We presumed that the properties of flecainide, such as slowing conduction, contribute partly in a use-dependent manner to development of uniform tachycardia. In addition, we believe that prolongation of QT by flecainide is exceedingly rare; however, it may be one of the mechanisms of flecainide-induced proarrhythmia.

Massive left atrial calcification associated with mitral valve replacement.

Calcification of the left atrium can be observed in patients with a long-lasting rheumatic heart disease. However, massive calcification of the atrial wall, so called porcelain or coconut atrium is very rare and has been generally reported only as incidental radiographic findings. We report a case of massive and firm calcifications at the left atrium in patient who underwent mitral valve replacement.

A case of huge thrombus in the aortic arch with cerebrovascular embolization.

Pedunculated thrombus in the aortic arch that is associated with cerebral infarction is very rare requires prompt diagnosis and treatment to prevent occurrence of another devastating complication. Transesophageal echocardiography is useful for detecting source of embolism including aortic thrombi. The treatment options of aortic thrombi involves anticoagulation, thrombolysis, thromboaspiration, and thrombectomy. Here we report a case of huge thrombus in the aortic arch, resulting in acute multifocal cerebellar embolic infarct in patient without any risk factors for vascular thrombosis. Thrombi in the aortic arch were diagnosed by transesophageal echocardiography and treated with anticoagulants successfully.

Antiosteoporotic effect of Polycan, beta-glucan from Aureobasidium, in ovariectomized osteoporotic mice.

OBJECTIVE: We investigated the anti-osteoporotic effects of Polycan, a beta-glucan from Aureobasidium pullulans, in ovariectomized mice at doses of 31.25, 62.5, and 125 mg/kg. METHODS: Polycan was administered orally once a day for 28 d to bilateral ovariectomized mice, beginning 4 wk after surgery. Changes in body weight, bone weight, bone mineral content, bone mineral density, failure load, histologic profiles, and histomorphometric analyses were determined, in addition to serum osteocalcin, calcium, and phosphorus levels. Alendronate was used as a reference drug. RESULTS: Polycan significantly and dose-dependently suppressed decreases in bone weight, bone mineral content, failure load, bone mineral density, and serum calcium and phosphorus levels and the increase in serum osteocalcin levels. In addition, Polycan significantly suppressed decreases in histomorphometric parameters such as volume, length, and thickness of trabecular bone and thickness of cortical bone and the increase in osteoclast cells in the femur and tibia. CONCLUSION: Although the effects of Polycan were generally modest and smaller than those of alendronate, the effects on cortical bone thickness were more favorable for Polycan than for alendronate. In addition, Polycan exhibited favorable effects on ovariectomy-induced osteoporosis. However, more long-term studies are needed to confirm the effects of Polycan on osteoporosis.

Production of high molecular weight pullulan by Aureobasidium pullulans HP-2001 with soybean pomace as a nitrogen source.

The production of pullulan by Aureobasidium pullulans HP-2001 was enhanced by yeast extract as a nitrogen source as well as soybean pomace. The highest production of pullulan by A. pullulans HP-2001 with yeast extract was 5.5 g/l whereas that of pullulan with soybean pomace was 7.5 g/l. The gas chromatogram of pullulan produced by A. pullulans HP-2001 with soybean pomace as a nitrogen source showed that the major and minor components were glucose and mannose. The FTIR spectra of pullulans produced with yeast extract, a mixture of yeast extract and soybean pomace, and soybean pomace alone exhibited similar features. The increase in content of reducing sugars after pullulanase treatment of pullulans produced with different nitrogen sources indicated that all the pullulans had alpha-(1,6) glucosidic linkages of alpha-(1,4) linked maltotriose units. The average molecular weights of pullulans produced with various concentrations of yeast extract and soybean pomace ranged from 0.17 to 1.32x10(6) and from 1.32 to 5.66x10(6), respectively. All pullulans produced by A. pullulans HP-2001 in this study had the same basic structures, but their ratios of monomeric components were a little different, which might result in the production of pullulans with different molecular weights.