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

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

A 44-year-old man, who had a history of myocardial infarction (MI) due to thrombotic occlusion of right coronary artery (RCA) aneurysm, visited emergency department presenting with ST-segment elevation myocardial infarction (STEMI). The patient had been on oral anticoagulant therapy (warfarin) from the first thrombotic event, but the medication had been recently changed to aspirin 4 months before the second event. Emergent coronary angiography revealed thrombotic total occlusion of RCA with heavy thrombotic burden from middle RCA to the ostium of the posterior descending branch. Combination pharmacotherapy was performed with anticoagulants (heparin), fibrinolytics (urokinase), and Glycoprotein IIb/IIIa antagonists (abciximab), in addition to mechanical thrombosuction. However, on hospital day 2, the patient complained recurrent chest pain and again underwent coronary angiography, which revealed distal embolization of large thrombus to the posterior lateral branch. Coronary flow was recovered after repeated mechanical thrombosuction was performed. This case has shown the importance of aggressive combination drug therapy, accompanied by mechanical thrombosuction in patient with myocardial infarction due to thrombotic occlusion of coronary artery aneurysm and the importance of unceasing life-long anticoagulant therapy in those particular patients.
Adult ; Aneurysm* ; Anticoagulants ; Aspirin ; Chest Pain ; Coronary Aneurysm ; Coronary Angiography ; Coronary Occlusion* ; Coronary Vessels* ; Drug Therapy ; Drug Therapy, Combination ; Emergency Service, Hospital ; Glycoproteins ; Humans ; Myocardial Infarction* ; Thrombectomy ; Thrombosis ; Warfarin*

Patients undergoing maintenance dialysis show an increased susceptibility to tuberculosis because host immunity is decreased secondary to malnutrition, impaired cellular immunity, acidosis and etc. Extrapulmonary tuberculosis is more prevalent in patients with end stage renal disease than in normal subjects. Among the extrapulmonary tuberculosis in patients receiving hemodialysis, the diagnosis of tuberculous spondylitis is difficult because the symptoms are non specific and attributable to uremia, and the appearance of plain radiographs is often normal during the early phase of the disease. We experienced a case of tuberculous spondylitis in a hemodialysis patient. A 55 years old female admitted with fever, weight loss and back pain. Conventional radiograph of T-spine showed no definite abnormal finding. However, chest CT revealed heterogeneously enhancing soft tissue around the T8 vertebral body and T-spine MRI showed compatible finding to tuberculous spondylitis. She received radical excision of involved vertebra and confirmed tuberculous spondylitis with histologic finding from a surgical specimen. Following the administration of anti-tuberculosis medication(isoniazid, rifampin, pyraziamide, ethambutol) and radical excision, patient's symptom and sign were improved. The patient is maintaining dialysis with anti-tuberculosis medication for 5 months.
Acidosis ; Back Pain ; Diagnosis ; Dialysis ; Female ; Fever ; Humans ; Immunity, Cellular ; Kidney Failure, Chronic ; Magnetic Resonance Imaging ; Malnutrition ; Middle Aged ; Renal Dialysis* ; Rifampin ; Spine ; Spondylitis* ; Tomography, X-Ray Computed ; Tuberculosis ; Uremia ; Weight Loss

OBJECTIVE: The aim of this study is to investigate the clinical outcomes of surgery and coiling and analyze the predicting factors affecting the clinical outcomes of ruptured posterior inferior cerebellar artery (PICA) aneurysms. METHODS: During the last 15 years, 20 consecutive patients with ruptured PICA aneurysms were treated and these patients were included in this study. The Fisher's exact test was used for the statistical significance of Glasgow Outcome Scale (GOS) according to initial Hunt-Hess (H-H) grade, treatment modalities, and the presence of acute hydrocephalus. RESULTS: Eleven (55%) and nine (45%) patients were treated with surgical clipping and endovascular treatment, respectively. Among 20 patients, thirteen (65.0%) patients had good outcomes (GOS 4 or 5). There was the statistical significance between initial poor H-H grade, the presence of acute hydrocephalus and poor GOS. CONCLUSION: In our study, we suggest that initial H-H grade and the presence of acute hydrocephalus may affect the clinical outcome rather than treatment modalities in the ruptured PICA aneurysms.
Aneurysm ; Arteries ; Glasgow Outcome Scale ; Humans ; Hydrocephalus ; Pica ; Subarachnoid Hemorrhage ; Surgical Instruments

Extracolonic manifestations which occur in approximately 10-20% of patients with ulcerative colitis most commonly affect joints, skin, liver and eyes. In contrast, pulmonary involvement in ulcerative colitis is very rare. However, a variety of respiratory disorders has been associated with ulcerative colitis, including pulmonary vasculitis, bronchiectasis, chronic bronchitis, interstitial fibrosis, pleural effusion. Since the first observation of pulmonary involvement in ulcerative colitis by Kraft in 1976, a few cases have been reported, and probably no such case have been reported in Korea yet. Here we report an experience concerning 56 year-old man interstitial lung disease in ulcerative colitis, who was diagnosed by clinical, radiographic, endoscopic, histologic findings.
Bronchiectasis ; Bronchitis, Chronic ; Colitis, Ulcerative* ; Fibrosis ; Humans ; Joints ; Korea ; Liver ; Lung Diseases, Interstitial* ; Middle Aged ; Pleural Effusion ; Skin ; Ulcer* ; Vasculitis

BACKGROUND: The normal functions of the cell cycle inhibitor p16INK4a are frequently inactivated in many human cancers. Over 80% of hepatocellular carcinoma (HCC) cases lack a functional p16/Rb pathway. p16/Rb pathway, as well as p53 pathway, is considered as one of key components of tumor suppression. METHODS: To study the roles of p16INK4a in HCC, a stable cell line expressing exogenous p16 was generated from SNU-449 hepatocellular carcinoma cells lacking endogenous p16, and suppression subtractive hybridization (SSH) was performed in parallel with the control cells. RESULTS: 1) SSH identifies fibronectin (FN1), crystallin alphaB (CRYAB), Rac1, WASP, RhoGEF, and CCT3 as differentially-expressed genes. 2) Among the selected genes, the up- regulation of FN1 and CRYAB was confirmed by Northern blot, RT-PCR and by proteomic methods. CONCLUSION: These genes are likely to be associated with the induction of stress fiber and stabilization of cytoskeleton. Further studies are required to clarify the possible role of p16 in the signal transduction pathway.
Blotting, Northern ; Carcinoma, Hepatocellular* ; Cell Cycle ; Cell Line ; Crystallins ; Cytoskeleton ; Fibronectins ; Gene Expression* ; Humans ; Rho Guanine Nucleotide Exchange Factors ; Signal Transduction ; Stress Fibers ; Wasps

Pleomorphic adenoma in nasal cavity is rare and mainly occurs in the major salivary gland. We have experienced a case of a 25 years old woman complaining recurrent nasal bleeding and nasal obstruction. She showed a tumor in the left nasal cavity. We treated the nasal cavity tumor by endoscopic sinus surgery. The tumor was 4.5X3.0X2.5 cm in size and firm, parenchymatous and pale in contour. The pathologic diagnosis was pleomorphic adenoma. We report in this case of pleomorphic adenoma in the nasal septum.
Adenoma, Pleomorphic* ; Adult ; Diagnosis ; Epistaxis ; Female ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum* ; Salivary Glands

Carboplatin, an advanced anticancer drug with excellent efficacy against ovarian cancer, was developed to alleviate the side effects that often occur with cisplatin and other platinum-based compounds. Our study reports the in vitro characteristics, viability, and activity of cells expressing the inducible nitric oxide synthase (iNOS) gene after carboplatin was conjugated with polysuccinimide (PSI) and administered in combination with other widely used anticancer drugs. PSI, which has promising properties as a drug delivery material, could provide a platform for prolonging carboplatin release, regulating its dosage, and improving its side effects. The iNOS gene has been shown to play an important role in both cancer cell survival and inhibition. Herein, we synthesized a PSI-carboplatin conjugate to create a modified anticancer agent and confirmed its successful conjugation. To ensure its solubility in water, we further modified the structure of the PSI-carboplatin conjugate with 2-aminoethanol groups. To validate its biological characteristics, the ovarian cancer cell line SKOV-3 and normal ovarian Chinese hamster ovary cells were treated with the PSI-carboplatin conjugate alone and in combination with paclitaxel and topotecan, both of which are used in conventional chemotherapy. Notably, PSI-carboplatin conjugation can be used to predict changes in the genes involved in cancer growth and inhibition. In conclusion, combination treatment with the newly synthesized polymer-carboplatin conjugate and paclitaxel displayed anticancer activity against ovarian cancer cells but was not toxic to normal ovarian cancer cells, resulting in the development of an effective candidate anticancer drug without severe side effects.