Utility of Neutrophil-to-Lymphocyte Ratio (NLR) as a Predictor of Acute Infarction in New-Onset Acute Vertigo Patients Without Neurologic and Computed Tomography Abnormalities

Background

Neutrophil-to-lymphocyte ratio (NLR) has been used as a predictive marker for various conditions. However, there are no previous studies about NLR as a prognostic marker for acute infarction.

Associations between food insecurity and healthy behaviors among Korean adults

BACKGROUND/OBJECTIVESFood insecurity has been suggested as being negatively associated with healthy behaviors and health status. This study was performed to identify the associations between food insecurity and healthy behaviors among Korean adults.SUBJECTS/METHODSThe data used were the 2011 Community Health Survey, cross-sectional representative samples of 253 communities in Korea. Food insecurity was defined as when participants reported that their family sometimes or often did not get enough food to eat in the past year. Healthy behaviors were considered as non-smoking, non-high risk drinking, participation in physical activities, eating a regular breakfast, and maintaining a normal weight. Multiple logistic regression and multinomial logistic regression analyses were used to identify the association between food insecurity and healthy behaviors.RESULTSThe prevalence of food insecurity was 4.4% (men 3.9%, women 4.9%). Men with food insecurity had lower odds ratios (ORs) for non-smoking, 0.75 (95% CI: 0.68-0.82), participation in physical activities, 0.82 (95% CI: 0.76-0.90), and eating a regular breakfast, 0.66 (95% CI: 0.59-0.74), whereas they had a higher OR for maintaining a normal weight, 1.19 (95% CI: 1.09-1.30), than men with food security. Women with food insecurity had lower ORs for non-smoking, 0.77 (95% CI: 0.66-0.89), and eating a regular breakfast, 0.79 (95% CI: 0.72-0.88). For men, ORs for obesity were 0.78 (95% CI: 0.70-0.87) for overweight and 0.56 (95% CI: 0.39-0.82) for mild obesity. For women, the OR for moderate obesity was 2.04 (95% CI: 1.14-3.63) as compared with normal weight.CONCLUSIONSFood insecurity has a different impact on healthy behaviors. Provision of coping strategies for food insecurity might be critical to improve healthy behaviors among the population.     

Clinical significance of intrahepatic biliary stricture in efficacy of hepatic resection for intrahepatic stones

In the Far East, hepatic resection is the definitive treatment for complicated intrahepatic stones (IHS). However, many investigators have reported that the associated intrahepatic biliary stricture is the main cause of treatment failure. A retrospective comparative study was undertaken to clarify the long-term efficacy of hepatic resection for treatment of IHS and to investigate the clinical significance of intrahepatic biliary stricture in treatment failure after hepatic resection performed in 44 patients with symptomatic IHS. The patients were divided into two study groups: group A, with intrahepatic biliary stricture (n = 28) and group B, without stricture (n = 16). Residual or recurrent stones, recurrence of intrahepatic biliary stricture, late cholangitis, and final outcomes were analyzed and compared statistically between the two groups. The patients were followed up for a median duration of 65 months after hepatectomy. The overall incidence of residual or recurrent stones was 36% and 11%, respectively, in groups A and B. The initial treatment failure rate was 50% in group A and 31% in group B. Intrahepatic biliary stricture recurred in 46% of patients in group A, while none of the group B patients had biliary stricture recurrence (P = 0.001). More than two-thirds of the restrictures in group A were identified at the primary site. The incidence of late cholangitis was higher in group A (54%) than in group B (6%) (P = 0.002). Three-quarters of the patients with cholangitis in group A had severe cholangitis, that was recurrent, and related to stones and strictures (n = 11). They and 2 asymptomatic patients in group B required secondary procedures done at a median of 12 months after hepatectomy. Final outcomes after hepatectomy with or without secondary management were good in 80%, fair in 16%, and poor in 4% of our 44 patients. Most recurrent cholangitis after hepatectomy in patients with IHS was related to recurrent intrahepatic ductal strictures. Therefore, to be effective, hepatic resection should include the strictured duct. However, with hepatectomy alone it is difficult to clear the IHS or relieve the ductal strictures completely, particularly in patients with bilateral IHS, so perioperative team approaches that include both radiologic and cholangioscopic interventions should be combined for the effective management of IHS.     

Spontaneous total necrosis of hepatocellular carcinoma: report of a case

We report on a 50-year-old man with a liver mass that, when surgically resected, was found to be a hepatocellular carcinoma that had undergone spontaneous complete necrosis without previous treatment. Histologically, no viable tumor cells were observed. The postoperative course was uneventful, and the patient is alive without evidence of recurrence about 5 years after surgery. Spontaneous total necrosis of hepatocellular carcinoma without previous treatment is rare. In particular, spontaneous total necrosis of a hepatocellular carcinoma that has been proven by histologic examination of a surgically resected liver specimen is extremely rare; only three cases of spontaneous complete necrosis of hepatocellular carcinoma have been reported previously. In this report, we present our unusual case and discuss possible causes of spontaneous total necrosis or regression of hepatocellular carcinoma.     

Follicular bronchiolitis in surgical lung biopsies: clinical implications in 12 patients

BACKGROUND: Follicular bronchiolitis is a histopathologic finding that occurs in diverse clinical contexts. The current study was conducted to characterize clinico-radiologic features, and assess outcomes associated with follicular bronchiolitis. SUBJECTS AND METHODS: Twelve subjects with follicular bronchiolitis on lung biopsy were seen over a 9-year period, between 1996 and 2005. Medical records, biopsy and radiographic findings, and details of outcome at the time of last follow-up were recorded. RESULTS: The study population included 4 men and 8 women; the median age at diagnosis was 54 years (range, 33-81 years). Four patients had underlying systemic diseases that included: 2 with common variable immunodeficiency, 1 Sj?gren's syndrome and 1 undifferentiated connective tissue disease. The diagnosis was obtained by surgical lung biopsy in all cases. Follicular bronchiolitis was the major histologic pattern in 9 patients; organizing pneumonia, nonspecific interstitial pneumonia and usual interstitial pneumonia was seen in 1 patient each with follicular bronchiolitis being an associated secondary histopathologic component. Computed tomographic findings included reticular opacities, small nodules and ground-glass opacities. Clinical course was characterized by relative stability with partial response to immunosuppressive agents. During a median follow-up period of 47 months, only one death occurred--out of 9 patients where the outcome information was available--and was unrelated to lung disease. CONCLUSIONS: The histologic lesion of follicular bronchiolitis may be seen as the predominant finding or a relatively minor feature in interstitial pneumonias. The clinical course and prognosis for most patients with follicular bronchiolitis is relatively good, and progressive lung disease is uncommon.     

Bronchiolar disorders

Bronchiolar abnormalities are relatively common and occur in a variety of clinical settings. Various histopathologic patterns of bronchiolar injury have been described and have led to confusing nomenclature with redundant and overlapping terms. Some histopathologic patterns of bronchiolar disease may be relatively unique to a specific clinical context but others are nonspecific with respect to either etiology or pathogenesis. Herein, we present a scheme separating (1) those disorders in which the bronchiolar disease is the predominant abnormality (primary bronchiolar disorders) from (2) parenchymal disorders with prominent bronchiolar involvement and (3) bronchiolar involvement in large airway diseases. Primary bronchiolar disorders include constrictive bronchiolitis (obliterative bronchiolitis, bronchiolitis obliterans), acute bronchiolitis, diffuse panbronchiolitis, respiratory bronchiolitis, mineral dust airway disease, follicular bronchiolitis, and a few other rare variants. Prominent bronchiolar involvement may be seen in several interstitial lung diseases, including hypersensitivity pneumonitis, respiratory bronchiolitis-associated interstitial lung disease, cryptogenic organizing pneumonia (idiopathic bronchiolitis obliterans organizing pneumonia), and pulmonary Langerhans' cell histiocytosis. Large airway diseases that commonly involve bronchioles include bronchiectasis, asthma, and chronic obstructive pulmonary disease. The clinical relevance of a bronchiolar lesion is best determined by identifying the underlying histopathologic pattern and assessing the correlative clinico-physiologic-radiologic context.     

The association between serum uric acid and asymptomatic intracranial arterial stenosis in middle-aged Koreans

Background and aims

Intracranial arterial stenosis (ICAS) is one of the most common causes of stroke, especially in Asians. Hyperuricemia has been associated with an increased risk of comorbidities such as metabolic syndrome or cardiovascular diseases. However, there are few studies focusing on the association between serum uric acid (SUA) levels and asymptomatic ICAS. The aim of this study was to explore the association between SUA and the prevalence of ICAS in middle-aged Korean health screening examinees.

Comparison of efficiency of ex vivo expansion of whole blood, mononuclear cells and purified CD34+ cells from human umbilical cord blood

We used a dual-chamber culture system separated by a dialysis membrane to test the efficiency of expansion of whole cord blood and cell fractions. We found that expansion of progenitor cells was more efficient from whole blood than from purified CD34+ or partially purified mononuclear cell fractions.