Cryptorchid testis is correlated with high incidence rate of testicular neoplasm. A 44 year-old male was admitted to our hospital due to huge abdominal mass and dyspnea. Physical examination revealed impalpable right testicle in the scrotum. Abdominal CT scan revealed a huge right retroperitoneal mass with central necrosis. AFP and BHCG were increased. 4 courses induction PVB therapy was performed under diagnosis of unresectable bulky stage IIB nonseminomatous germ cell tumor. Thereafter the tumor size and markers were decreased. But the patient was lost for follow-up. One year later, the tumor size and markers were increased Retroperitoneal excision of intraabdominal mass was performed followed by adjuvant PVB therapy due to persistent increased markers.
Adult ; Diagnosis ; Dyspnea ; Follow-Up Studies ; Humans ; Incidence ; Male ; Necrosis ; Neoplasms, Germ Cell and Embryonal ; Physical Examination ; Scrotum ; Teratocarcinoma* ; Testicular Neoplasms ; Testis* ; Tomography, X-Ray Computed

Cryptorchid testis is correlated with high incidence rate of testicular neoplasm. A 44 year-old male was admitted to our hospital due to huge abdominal mass and dyspnea. Physical examination revealed impalpable right testicle in the scrotum. Abdominal CT scan revealed a huge right retroperitoneal mass with central necrosis. AFP and BHCG were increased. 4 courses induction PVB therapy was performed under diagnosis of unresectable bulky stage IIB nonseminomatous germ cell tumor. Thereafter the tumor size and markers were decreased. But the patient was lost for follow-up. One year later, the tumor size and markers were increased Retroperitoneal excision of intraabdominal mass was performed followed by adjuvant PVB therapy due to persistent increased markers.
Adult ; Diagnosis ; Dyspnea ; Follow-Up Studies ; Humans ; Incidence ; Male ; Necrosis ; Neoplasms, Germ Cell and Embryonal ; Physical Examination ; Scrotum ; Teratocarcinoma* ; Testicular Neoplasms ; Testis* ; Tomography, X-Ray Computed

Polyorchidism is a very rare congenital anomaly and about 100 cases have been documented in the literature until today. Polyorchidism or supernumenary testis is defined as the presence of more than 2 histologically proven testes. In most case, polyorchidism have characteristics of unilateral involvement and three testis and mainly finding in left-side testis. And although patient age was various, average age was about 18-year-old in previous review of article. We report a rare case of polyorchidism that an old age patient had an incidentally found right accessory testis in operating a testicular injury.
Adolescent ; Humans ; Testis

This study was carried out to elucidate the cytokine mRNAs expression and morphological features according to a microglial proliferation and apoptosis in a rat lumbar spinal cord, after a right sciatic nerve transection. The control group was composed of 5 rats (Spraque-Dawley) and the experimental group was composed of 70 rats. On post operation day (pod) 1, 2, 3, 5, and 7 eight rats were sacrificed on those days. On pod 10 five rats were sacrificed as well as five rats sacrificed on post operation weeks 2, 3, 4, 5, and 6. On light microscopy, activated microglia were often found in a perineuronal position around motoneurons in the ventral gray matter and more randomly distributed throughout the neuropil in the dorsal gray matter of lumbar spinal cord. GSA I-B4-positive microglia began to increase from 1 day after transection, and reached peak at 2~3 days and it persisted at 5~7 days and decreased thereafter. TUNEL-positive microglia was not observed in control group and began to increase from 5 days after transection and increased gradually until 3 weeks and decreased thereafter. On in situ RT-PCR, the positive signal for IL-1alpha and IL-6 mRNA was found mainly in the cytoplasm of the activated microglia and astrocytes at 1 day after transection and showed stronger signal at 3 days and decreased gradually until 10 days. TNF-alpha mRNA was detected 1 day after transection and remained for 7 days and localized to activated microglia as well as probably some astrocytes. The signal intensity of IL-1alpha and IL-6 mRNA was generally stronger than TNF-alpha mRNA. On transmission electron microscopy, there were chromatin condensation with margination toward nuclear membrane and condensation of cytoplasm at 3 days after transection. Apoptotic bodies were found after 5 days and increased gradually until 3 weeks. According to the above findings, it is concluded that apoptosis appears to be one mechanism by which activated microglia are gradually eliminated and cytokine expression seems to played an active role in the microglial turnover.
Animals ; Apoptosis* ; Astrocytes ; Chromatin ; Cytokines ; Cytoplasm ; Interleukin-6 ; Microglia ; Microscopy ; Microscopy, Electron, Transmission ; Neuropil ; Nuclear Envelope ; Rats* ; RNA, Messenger ; Sciatic Nerve* ; Spinal Cord* ; Tumor Necrosis Factor-alpha

Elevations of serum PSA concentrations have been widely reported due to prostatic cancer, but other causes haute not been formally characterized or quantified. So that, we evaluated the causes of elevated serum PSA concentrations in men whose prostate biopsy showed no cancer. The effects of prostate volume, inflammation, echogenecity on ultrasound and calculi were examined in 43 men that serum PSA concentrations greater than 4.0 ng/ml with negative biopsy. These men were compared with 16 men who had suspicious rectal examinations, negative biopsy and serum PSA concentrations of 4.0 ng/ml. or less. Prostate volume (22.5%, p<0.005) and inflammation (3%, p<.05) were significantly associated with elevated serum PSA concentrations (>4.0 ng/ml) than control group (< or = 4.0 ng/ml) and age echogenecity on ultrasound and calculi were statistically less significant (p> or =0.05). In summary, prostate volume and inflammation were the most important factors contributing to increase serum PSA concentration in men that clinically undetectable prostatic cancer.
Biopsy ; Calculi ; Humans ; Inflammation ; Male ; Prostate ; Prostatic Neoplasms ; Ultrasonography

PURPOSE: Appendicitis is the most common abdominal surgical emergency. The diagnosis of appendicitis can be difficult, occasionally taxing the diagnostic skills of even the most experienced surgeon, and especially for diagnosing reproductive women. This study was designed to evaluate the various pathologies of the appendix and the other intraabdominal organs in patients who were preoperatively diagnosed with acute appendicitis, and we wanted to analyze the difference of the perioperative results between the reproductive women and the other patients. METHODS: The study was a retrospective analysis of 1,108 appendectomies that were performed from September 2003 to August 2006. The data were analyzed for the following parameters: the age-related and sex-related incidence of acute appendicitis, the rates of negative appendectomy, negative operation and appendicular perforation, and the incidence of other encountered pathologies. In addition, we present the clinical results of the reproductive women. RESULTS: The diagnostic accuracy for acute appendicitis was 87.2%. The negative appendectomy rate was 11.6% and it was significantly higher (20.8%) in the reproductive women than in the male patients of the same age (P=0.001). On the clinical analyses of the reproductive aged appendicitis group showed they a shorter pain duration and a higher WBC count, and more frequent epigastric discomfort, nausea, vomiting and RLQ tenderness (P< 0.05). CONCLUSION: We noted a high rate of negative appendectomy among reproductive female patients, so more care should be taken to diagnose these patients.
Appendectomy ; Appendicitis* ; Appendix ; Diagnosis ; Diagnosis, Differential ; Emergencies ; Female ; Humans ; Incidence ; Male ; Nausea ; Pathology ; Retrospective Studies ; Taxes ; Vomiting

PURPOSE: Malignant rhabdoid tumor (MRT) is a rare and highly aggressive tumor that affects young children. Due to its extreme rarity, most of the available data are based on retrospective case series. To add to the current knowledge of this disease, we reviewed the patients treated for extra-cranial MRT in our institute. MATERIALS AND METHODS: A retrospective medical record review was conducted on children treated for pathologically confirmed extra-cranial MRT at Seoul National University Children's Hospital between January 2003 and May 2013. RESULTS: Eleven patients (7 boys, 4 girls) were diagnosed with extra-cranial MRT at a median age of 9 months old. INI1 staining was important in the pathological confirmation. Six patients (55%) had renal MRT and five (45%) had soft tissue MRT. Five patients (45%) had metastases at diagnosis. All patients underwent chemotherapy, eight patients (73%) underwent surgery, six patients (55%) received therapeutic radiotherapy, and four patients (36%) underwent high dose chemotherapy with autologous stem cell rescue (HDCT/ASCR) with melphalan, etoposide, and carboplatin. Five patients (45%) died of disease following progression (n=3) or relapse (n=2), however, there was no treatment related mortality. The overall survival of the cohort was 53.0% and the event-free survival was 54.5% with a median follow-up duration of 17.8 months (range, 2.3 to 112.3 months). CONCLUSION: Extra-cranial MRT is still a highly aggressive tumor in young children. However, the improved survival of our cohort is promising and HDCT/ASCR with melphalan, etoposide, and carboplatin may be a promising treatment option.
Carboplatin ; Child* ; Cohort Studies ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Etoposide ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; Medical Records ; Melphalan ; Mortality ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Rhabdoid Tumor* ; Seoul ; Soft Tissue Neoplasms ; Stem Cells

BACKGROUND: Nasopharyngeal carcinoma (NPC) is very rare in children and adolescents. The aim of this study was to evaluate clinical characteristics and treatment outcomes of pediatric NPC.METHODS: Medical records of 9 patients treated for NPC at the Seoul National University Children's Hospital between 1988 and 2012 were analyzed retrospectively.RESULTS: The median age at diagnosis was 11 years (range, 9-13 years). One patient had stage II disease, 3 had stage III disease, and 5 had stage IV disease. The histologic subtypes were undifferentiated carcinoma and squamous cell carcinoma in 7 and 2 patients, respectively. All patients were initially treated with cisplatin (100 mg/m2 intravenous [IV] every 4 weeks for 4-6 months), bleomycin (15 unit/m2 IV every 1 weekx7), and fluorouracil (1,000 mg/m2 IV every 4 weeks for 1 year). Eight patients received radiotherapy with doses of 45-59.4 Gy at the primary site and neck nodes. Seven patients (77.8%) achieved complete remission, 1 (11.1%) achieved partial remission, and 1 (11.1%) showed disease progression. Six patients developed fluorouracil-related neurotoxicity; the regimen was changed to cisplatin, epirubicin, and bleomycin in five of the 6 patients. One patient died of progressive disease without responding to treatment. Treatment-related mortality occurred in 1 patient owing to septic shock. Secondary osteosarcoma developed in 1 patient 6 years after treatment. The overall survival was 77.8%, with a median follow-up of 40.8 months (range, 4.5-287.6 months).CONCLUSION: Children and adolescents with advanced NPC treated with combined chemotherapy and radiotherapy have a good survival rate.
Adolescent ; Bleomycin ; Carcinoma ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Child ; Cisplatin ; Diagnosis ; Disease Progression ; Drug Therapy ; Epirubicin ; Fluorouracil ; Follow-Up Studies ; Humans ; Korea ; Medical Records ; Mortality ; Nasopharyngeal Neoplasms ; Neck ; Osteosarcoma ; Pediatrics ; Radiotherapy ; Retrospective Studies ; Seoul ; Shock, Septic ; Survival Rate

Human adipose tissue-derived mesenchymal stem cell (hATMSC) have emerged as a potentially powerful tool for bone repair, but an appropriate evaluation system has not been established. The purpose of this study was to establish a preclinical assessment system to evaluate the efficacy and safety of cell therapies in a nude rat bone defect model. Segmental defects (5 mm) were created in the femoral diaphyses and transplanted with cell media (control), hydroxyapatite/tricalcium phosphate scaffolds (HA/TCP, Group I), hATMSCs (Group II), or three cell-loading density of hATMSC-loaded HA/TCP (Group III-V). Healing response was evaluated by serial radiography, micro-computed tomography and histology at 16 weeks. To address safety-concerns, we conducted a GLP-compliant toxicity study. Scanning electron microscopy studies showed that hATMSCs filled the pores/surfaces of scaffolds in a cell-loading density-dependent manner. We detected significant increases in bone formation in the hATMSC-loaded HA/TCP groups compared with other groups. The amount of new bone formation increased with increases in loaded cell number. In a toxicity study, no significant hATMSC-related changes were found in body weights, clinical signs, hematological/biochemical values, organ weights, or histopathological findings. In conclusion, hATMSCs loaded on HA/TCP enhance the repair of bone defects and was found to be safe under our preclinical efficacy/safety hybrid assessment system.
Adipose Tissue/*cytology ; Animals ; Biocompatible Materials/therapeutic use ; Bone Diseases/pathology/radiography/*therapy ; Bone Regeneration/physiology ; Calcium Phosphates/therapeutic use ; Diaphyses/radiography/surgery/ultrastructure ; Disease Models, Animal ; Durapatite/therapeutic use ; Femur/*pathology/radiography/surgery ; Humans ; Male ; *Mesenchymal Stem Cell Transplantation ; Mesenchymal Stem Cells/*cytology ; Rats ; Rats, Nude ; Tissue Engineering ; Tomography, X-Ray Computed ; Transplantation, Heterologous

BACKGROUND: Heat shock proteins (HSPs) induced by variable kinds of stress produce tolerance to a variety of adverse conditions. However, the protective effect of HSP on ischemia/reperfusion injury (I/R injury) of kidney in vivo remains unclear. The present study was designed to evaluate whether HSP70 induced by hyperthermic preconditioning had renoprotective effect on I/R injury of the kidney in vivo. METHODS: 82 Sprague-Dawley male rats were used. Animals in control group (n=24) were subjected to bilateral occlusion of renal pedicles for 30 or 60 minutes followed by 24-hour reperfusion. In amphetamine (Amp, n=18) and quercetin (Q, n=16) group, amphetamine sulfate, a sympathomimetic drug which can elevate the body temperature as a result of enhanced endogenous lipolysis, and quercetin, a biflavonoid which inhibit the expression of HSP, were injected 4 hours prior to renal ischemia, respectively. In quercetin-amphetamine (QAmp, n=7) group, quercetin was injected 1 hour before administration of amphetamine. AA (n=8) or QQ (n=9) group was identical to Amp or Q group except that sham operation was performed instead of ischemic insult. In all groups, animals were sacrificed prior to or 24 hours after I/R injury. HSP70 induction was confirmed by immunohistochemistry. To assess the I/R injury of kidney, BUN, Cr, histopathologic change of tubular cell and HSP70 expression were evaluated. RESULTS: In Amp group, an increase of BUN and Cr were significantly lower than other groups and less severe renal tubular injury was also observed. In addition, HSP70 was strongly expressed in Amp group, whereas HSP70 was weakly expressed in control group and not expressed in QAmp and Q group. There were no differences in the functional and histologic injuries of kidney after I/R injury between AA, QQ and control group. CONCLUSION: These data demonstrate that the renoprotective effect by amphetamine preconditioning to I/R injury is linked with the expression of HSP70.
Amphetamine* ; Animals ; Body Temperature ; Heat-Shock Proteins ; Humans ; Immunohistochemistry ; Ischemia ; Kidney ; Lipolysis ; Male ; Quercetin ; Rats* ; Rats, Sprague-Dawley ; Reperfusion