Two cases of skull metastasis from thyroid carcinoma are presented. The one case shows multiple involvement inthe skull base with sphenoid sinus, frontal bone, and rib. The other case is solitary extensive involvement to theright parietal bone. The follicular caroinoma of the thyroid shows a strong tendency toward vascualr invasion and dissemination through blood stream to the lungs, bones, liver, brain, and other distant sites. The sternum, thevetebrae, and the pelvis are the most common sites in bone metastasis of thyroid carcinoma, followed by the femur,shoulder girdle, skull, and rib. Metastatic caroinoma to the skull base, including sphenoid sinus s extremelyrare. Authors experienced recently 2 cases of metastatic carcinoma of the thyroid to the skull and report withreview of literature.
Brain ; Frontal Bone ; Liver ; Lung ; Neoplasm Metastasis ; Parietal Bone ; Pelvis ; Ribs ; Rivers ; Skull Base ; Skull ; Sphenoid Sinus ; Sternum ; Thyroid Gland ; Thyroid Neoplasms

Surgeons have been dependent mainly on the clinical findings in the diagnosis of the empyema of gallbladderrequiring a emergent surgical intervention. Ultrasonographic findings of empyema of gallbladder are similar tothose of acute cholecystitis, but several finding are more frequently seen in empyema than in acute cholecystitis.We reviewed the clinical and ultrasonographic pictures in 15 cases of surgically proven empyema of gallbladder.The results were as follows: 1. Empyema of GB shows relatively high frequency in male and elderly person, comparedwith acute cholecystitis. 2. Right upper abdominal pain with tenderness and leukocytosis are constant findings inempyema. 3. Ultrasonographic findings; (1) GB is distended in 80%. (2) GB wall is thickened all ill defined in80%. (3) Internal echo is seen in 93.3%-diffuse(53.3%), localized (20%) or layered(20%). (4) Gallstones arelocated in CBD causing dilatation proximally.
Abdominal Pain ; Aged ; Cholecystitis, Acute ; Diagnosis ; Dilatation ; Empyema ; Gallbladder ; Gallstones ; Humans ; Leukocytosis ; Male ; Surgeons

The gene encoding E7 oncoprotein of human papillomavirus type 16 was cloned and expressed in Escherichia coli, and the monoclonal antibodies (Mabs) against this expressed protein were generated. For the efficient immunization, two kind of recombinant E7 protein in fusion form were produced. One was maltose binding protein (MBP) fusion type (MBP-E7) and the other was T7 phage gene 10 product fusioa type (gene 10-E7). Immunization with these two fusion protein to mice, finally two Mabs (VD6 and IB10) were obtained. VD6 and IB10 showed reactivities with E7 protein in CaSki cell but not in HeLa by Western blot analysis. In addition, the Mab, VD6, reacted with COS-7 cell transfected with E7 gene majorly in cytoplasm by immunofluorescence test. Also VD6 could detect E7 protein in cytoplasm and nucleus of CaSki ceU by immunogold electron microscopy. Based on these results, the Mab VD6 was could be used for various E7 detection system such as Western blot analysis and immunohistochemical methods.
Animals ; Antibodies, Monoclonal* ; Bacteriophage T7 ; Blotting, Western ; Clone Cells ; COS Cells ; Cytoplasm ; Escherichia coli ; Fluorescent Antibody Technique ; Humans* ; Immunization ; Maltose-Binding Proteins ; Mice ; Microscopy, Electron

It has been well known that several kinds of intracranial lesions can be assoiated with cerebral aneurysms. Among them, each case of cerebral arteriovenous malformation, moyamoya disease and pituitary adnoma has been respectively reported as associated lesions with cerebral aneurysms. And we have added the other two cases of sylvian arachnoid cyst and nodular enhancing lesion, which might be coincidental association with cerebral aneurysms. We have reviewed literatures and discussed associated lesions with cerebral aneurysms.
Arachnoid ; Intracranial Aneurysm* ; Intracranial Arteriovenous Malformations ; Moyamoya Disease ; Pituitary Neoplasms

It has been well known that several kinds of intracranial lesions can be assoiated with cerebral aneurysms. Among them, each case of cerebral arteriovenous malformation, moyamoya disease and pituitary adnoma has been respectively reported as associated lesions with cerebral aneurysms. And we have added the other two cases of sylvian arachnoid cyst and nodular enhancing lesion, which might be coincidental association with cerebral aneurysms. We have reviewed literatures and discussed associated lesions with cerebral aneurysms.
Arachnoid ; Intracranial Aneurysm* ; Intracranial Arteriovenous Malformations ; Moyamoya Disease ; Pituitary Neoplasms

PURPOSE: This study was conducted to estimate the prevalence of osteoporosis and to identify the related factors of bone mineral density (BMD) in rural postmenopausal women. METHODS: Three hundred ninety postmenopausal women in a rural area were examined in 1999 Their BMDs of the lumbar spine (L1-L3) were measured by a quantitative computerized tomography (QCT) and their height and weight were measured. A questionnaires interviewing method was used to collect risk factor data. PESULTS: The prevalence of osteoporosis in postmenopausal women of 40-69 years old was 89.2% by reference value of UCSF(University of California, Sanfrancisco), however, changed to 63.1% by that of Korean. From simple analyses, age(p<0.01), duration after menopause (p<0.01), menstrual regularity(p<0.05), delivery frequencies (p<0.01), breast feeding years (p<0.01), alcohol intake(p<0.01), and smoking(p<0.05) were significant risk factors relating to BMD. In multiple linear regression analysis, duration after menopause(p<0.01), menstrual regularity(p<0.05), and breast feeding years (p<0.05) proved to be significant risk factors. However dietary factors and life style were not significantly associated with BMD. CONCLUSIONS: The significant risk factors of postmenopausal women in a rural area relating to BMD were duration after menopause, menstrual regularity, and breast feeding duration.
Bone Density* ; Breast Feeding ; California ; Female ; Humans ; Life Style ; Linear Models ; Menopause ; Osteoporosis ; Postmenopause ; Prevalence ; Reference Values ; Risk Factors ; Spine ; Surveys and Questionnaires

OBJECTIVE: Magnetic resonance imaging (MRI) is useful for staging endometrial cancer. The treatment and prognosis of MRI-invisible endometrial cancer remain unclear. The purpose of this study was to retrospectively evaluate the long-term outcomes of patients with MRI-invisible endometrial cancer. METHODS: Between February 1995 and December 2011, we reviewed the medical records of 433 patients with endometrial cancer, which was staged IA on MRI. Of these patients, 89 had MRI-invisible cancer and 344 had MRI-visible cancer. Both cancers were treated with simple hysterectomy with or without lymph node dissection according to the surgeon's decision. Both cancers were compared regarding pathologic findings, recurrence rates, and survival rates. RESULTS: The median sizes of MRI-invisible and MRI-visible cancers were 4 mm (0 to 40 mm) and 20 mm (0 to 89 mm), respectively (p<0.001). Myometrial invasion of these groups were detected in 20.2% (18/89) and 56.7% (195/344), respectively (p<0.001). Lymphadenectomy and follow-up imaging revealed no lymph node metastasis in patients with MRI-invisible cancers, while those revealed in 4.7% (16/344) of patients with MRI-visible cancers (p=0.052). The recurrence rates of MRI-invisible and MRI-visible cancers were 1.1% (1/89) and 7.8% (27/344), respectively (p=0.026). The recurrence-free survival rates of these groups were 98.9% (88/89) and 91.6% (315/344), respectively (p=0.022). CONCLUSION: MRI-invisible endometrial cancer can be treated with less invasive surgery because of its lower tumor burden and better prognosis. This cancer may not require lymphadenectomy because of no metastasis or recurrence in lymph nodes.
Adult ; Aged ; Aged, 80 and over ; Endometrial Neoplasms/diagnostic imaging/*pathology ; Female ; Humans ; Lymphatic Metastasis ; *Magnetic Resonance Imaging ; Middle Aged ; Retrospective Studies

OBJECTIVE: Magnetic resonance imaging (MRI) is useful for staging endometrial cancer. The treatment and prognosis of MRI-invisible endometrial cancer remain unclear. The purpose of this study was to retrospectively evaluate the long-term outcomes of patients with MRI-invisible endometrial cancer. METHODS: Between February 1995 and December 2011, we reviewed the medical records of 433 patients with endometrial cancer, which was staged IA on MRI. Of these patients, 89 had MRI-invisible cancer and 344 had MRI-visible cancer. Both cancers were treated with simple hysterectomy with or without lymph node dissection according to the surgeon's decision. Both cancers were compared regarding pathologic findings, recurrence rates, and survival rates. RESULTS: The median sizes of MRI-invisible and MRI-visible cancers were 4 mm (0 to 40 mm) and 20 mm (0 to 89 mm), respectively (p<0.001). Myometrial invasion of these groups were detected in 20.2% (18/89) and 56.7% (195/344), respectively (p<0.001). Lymphadenectomy and follow-up imaging revealed no lymph node metastasis in patients with MRI-invisible cancers, while those revealed in 4.7% (16/344) of patients with MRI-visible cancers (p=0.052). The recurrence rates of MRI-invisible and MRI-visible cancers were 1.1% (1/89) and 7.8% (27/344), respectively (p=0.026). The recurrence-free survival rates of these groups were 98.9% (88/89) and 91.6% (315/344), respectively (p=0.022). CONCLUSION: MRI-invisible endometrial cancer can be treated with less invasive surgery because of its lower tumor burden and better prognosis. This cancer may not require lymphadenectomy because of no metastasis or recurrence in lymph nodes.
Adult ; Aged ; Aged, 80 and over ; Endometrial Neoplasms/diagnostic imaging/*pathology ; Female ; Humans ; Lymphatic Metastasis ; *Magnetic Resonance Imaging ; Middle Aged ; Retrospective Studies

OBJECTIVE: This study was performed to evaluate the overall survival and the change in treatment modalities in patients with uterine endometrial cancer in Korea. METHODS: From January 1990 to March 2005, medical records of 740 patients with endometrial cancer in nine hospitals were reviewed. The overall survival was determined supported by the death statistics of Korea National Statistical Office. RESULTS: The mean age of patients was 51.5 years (range: 21-82 years). The mean gravidity and parity were 3.3 and 2.1 (range: 0-18, 0-9), respectively. The most common stage, grade and histological type at diagnosis were FIGO stage I, grade 1 and endometrioid adenocarcinoma (76.5%, 56.4% and 87.2%), respectively. The main treatment modalities was surgery on stage I (59.8%), surgery-adjuvant radiotherapy on stage II (55.1%), surgery-adjuvant radiotherapy or surgery-adjuvant chemoradiation on stage III (38.3%) and surgery-adjuvant chemotherapy on stage IV (55.6%). The preferred treatment modality was surgery only on grade 1 (69.0%) and surgery-adjuvant radiotherapy on grade 2-3 (43.4% and 53.2%). Surgery had been the most common method of therapy before 1998 but its prevalence gradually decreased. As a result, surgery-adjuvant radiotherapy and surgery-adjuvant chemotherapy were most widely performed in 2004-2005 and surgery-adjuvant chemoradiation also increased more than a twofold. The overall 5 years survival rate (5YSR) for all 740 patients was 81.3%. The overall 5YSR of stage I was 89.0%. The overall 5YSR of grade 1, grade 2, grade 3 were 96.0%, 92.0%, 80.0%. Before 1998, the survival rate was 77.0%. Since then it increased to 83-88% and in 2000-2001 it increased to 88.0%, and it was the highest survival rate. CONCLUSION: The survival rate of endometrial cancer has been improving for the past 15 years and the method of treatment is also being changed currently. In order to improve the survival rate of endometrial cancer, a close investigation including genetic and environmental factors of the pathophysiology of endometrial cancer along with the epidemiology of risk factors, should be carried out.
Carcinoma, Endometrioid ; Diagnosis ; Drug Therapy ; Endometrial Neoplasms* ; Epidemiology ; Female ; Gravidity ; Humans ; Korea* ; Medical Records ; Parity ; Prevalence ; Radiotherapy ; Risk Factors ; Survival Rate

OBJECTIVE: We investigated whether microarray-based gene expression profiling of primary tumor biopsy material could be used to predict lymph node (LN) metastasis in patients with uterine squamous cell carcinoma by comparing this approach with magnetic resonance imaging. METHODS: Forty three primary cervical cancer samples (16 with LN metastasis and 27 without LN metastasis) from radical hysterectomy with pelvic LN dissection were obtained, RNA was isolated, and oligonucleotide gene chips (Macrogen, Seoul, Korea) were hybridized. The samples were randomly divided into training (31 samples) and test (12 samples) sets. A prediction model for LN metastasis from the training set was developed by support vector machine methods using a 10-fold cross-validation and it was tested for its prediction accuracy by applying it to the test set. We evaluated pelvic LN status by MRI with newly designed criteria in these patients and compared the accuracy of MRI with microarray. In addition, we created a new approach by a combination of both. RESULTS: The "LN prediction model" derived from the signature of 156 distinctive genes had a prediction accuracy of 83% when applied to the independent test set. MRI showed an accuracy (69%) for the prediction of LN metastasis. The combination model with MRI findings and microarray improved prediction accuracy over MRI alone but the improvement was not statistically significant (74% and 69%, respectively; p=0.688). CONCLUSION: Current data show that the prediction of LN metastasis can be allowed by DNA microarray of the primary tumor biopsy, alone or in combination with MRI.
Biopsy ; Carcinoma, Squamous Cell* ; Gene Expression Profiling ; Humans ; Hysterectomy ; Lymph Nodes* ; Magnetic Resonance Imaging* ; Neoplasm Metastasis* ; Oligonucleotide Array Sequence Analysis ; RNA ; Seoul ; Support Vector Machine ; Uterine Cervical Neoplasms