The term “non-ossifying fibroma of bone” was introduced by Jaffe and Lichenstein in 1942 to describe a distinctive benign lesion occuring near the ends of the long bones in young people, and the lesion was subsequently described by Hatcher as a developmental defect rather than a true tumor. This lesion was presented as a clear-cut entity on the basis of pathological, clinical and roentgenographic manifestations. The diagnosis of non-ossifying fibroma was made by the histopathological findings of the curetted tissues. The authors have seen and studied 5 cases of non-ossifying fibroma from February 1976 to September 1981. The average duration of follow up was 2.2 years, with a range from 0.8 to 5 years, and the results of treatment were as follows: l. Of the five cases, two were associated with pathologic fractures. 2. The sites of the lesions in all cases were the long bones in the lower extremity. 3 In all cases, the complaints were of only a few days or weeks duration before admission to the hospital, and no cases were discovered incidentally by roentgenographic examination. 4. Good results were obtained by treatment with curettage and bone graft.
Curettage ; Diagnosis ; Fibroma ; Follow-Up Studies ; Fractures, Spontaneous ; Lower Extremity ; Transplants

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

No abstract available.
Choanal Atresia* ; Microphthalmos*

Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized clinically by headache, seizure, altered mental status and visual impairment. Neuroimaging shows reversible white matter edema predominantly in the parietal and occipital lobes. RPLS has been associated with a variety of conditions, including hypertensive encephalopathy, renal failure, immunosupressive therapy, and autoimmune diseases such as systemic lupus erythematosus (SLE). We report a young woman of SLE presented with headache, generalized tonic-clonic seizure and altered mental status, after taking azathioprine and cyclosporine. The brain magnetic resonance images showed bilateral hyperintensitiy in the posterior parietal, occipital, temporal lobes and cerebellum on T2-weighted images and fluid attenuated inversion recovery images, whereas diffusion-weighted images showed isointensity in the same distribution. The patient was improved clinically and radiologically one week after the control of hypertension and discontinuation of cyclosporine.
Autoimmune Diseases ; Azathioprine ; Brain ; Cerebellum ; Cyclosporine* ; Edema ; Female ; Headache ; Humans ; Hypertension ; Hypertensive Encephalopathy ; Lupus Erythematosus, Systemic ; Neuroimaging ; Occipital Lobe ; Posterior Leukoencephalopathy Syndrome* ; Rabeprazole ; Renal Insufficiency ; Seizures ; Temporal Lobe ; Vision Disorders

PURPOSE: Generally, a mucinous carcinoma (Muc) of the colon show higher rates of microsatellite instability (MSI) than a non-mucinous carcinoma (non-Muc). Mutated methylenetetrahydrofolate reductase (MTHFR) brings about low enzyme activity, which may reduce genomic DNA methylation. These processes may be critical for the oncogenic transformation of human cells. We compared the relationship of MSI and MTHFR polymorphism in Muc to that in non-Muc. METHODS: From March 2003 to August 2007, genomic DNA was isolated from whole blood and tissue specimens of 285 colorectal cancer patients (Muc: 31 cases, non-Muc: 254 cases) and 448 normal control patients. These were subjected to MSI analysis and MTHFR genotyping by using PCR-based restriction fragment length polymorphism analyses. RESULTS: MSI was significantly more frequent in the Muc group (40.7%) than in the non- Muc group (14.8%). The frequencies of polymorphism of MTHFR 677C>T were CC (31.5%), CT (57%), and TT (11.5%) in the patient group and 32.4%, 53.1%, and 14.5% in the control group. In the Muc group, the frequencies of polymorphism of MTHFR 677C>T were CC (36%), CT (56%), TT (8%), and in the non-Muc group, they were 31.1%, 57%, and 11.9%. The frequencies of polymorphism of MTHFR 1298A>C were AA (73%), AC (21.3%), and CC (5.7%) in the patient group and 69.6%, 28.6%, and 1.8% in the control group. In the Muc group, the frequencies of polymorphism of MTHFR 1298A>C were AA (50%), AC (30%), and CC (20%), and in the non-Muc group, they were 76%, 20.3%, and 3.7%. The Muc group showed higher frequencies of the CC variant than the non-Muc group (P-value=0.018). No relation between MSI and MTHFR polymorphisms were seen in any comparison of the Muc and the non-Muc groups. CONCLUSIONS: The Muc group showed higher rates of MSI than the non-Muc group, but no definite difference between the Muc and the non-Muc groups was noted in the case of polymorphism of MTHFR 677C>T. However, the TT-type variant showed slightly lower frequencies in the Muc group than in the non-Muc group. On the contrary, the Muc group showed a higher rate of the CC variant in polymorphism of MTHFR 1298A>C. These inconsistent results seem to be due to the small size of the Muc group, so further study is needed.
Adenocarcinoma, Mucinous ; Colon ; Colorectal Neoplasms ; DNA ; DNA Methylation ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2) ; Microsatellite Instability ; Microsatellite Repeats ; Mucins ; Oxidoreductases ; Polymorphism, Restriction Fragment Length ; Succinimides ; Tetrahydrofolates

PURPOSE: The aim of this study was to examine the expression of E-cadherin, beta-catenin, Cdx2, MMP7 in gastric cancer and to evaluate the clinical significance of these molecules in tumor recurrence within 2 years of pT2 and N1/N2 gastric cancer. METHODS: In 122 patients who underwent radical resection of gastric cancer, we investigated the association between the expression of these molecules and clinicopathologic factors by immunohistochemistry. The included criteria were pT2 and N1 or N2 (6th AJCC TNM). RESULTS: The expression of MMP7 was significantly associated with N stage (N1 vs. N2) (P=0.011). The negative expression of beta-catenin was strongly correlated with tumor recurrence within a 2-year period. However, the expression of these molecules was not related with recurrent sites. Multivariate analysis demonstrated that negative expression of beta-catenin was an independent predictor for tumor recurrence within 2 years (OR 2.366; 95% CI 1.056~5.297; P=0.036). CONCLUSION: Negative expression of beta-catenin may serve as a significant indicator for predicting tumor recurrence within a 2-year period in pT2 and N1/N2 gastric cancer.
beta Catenin ; Cadherins ; Humans ; Immunohistochemistry ; Multivariate Analysis ; Recurrence ; Stomach Neoplasms

BACKGROUND: It is important to maintain adequate intravascular volume during off-pump coronary artery bypass surgery (OPCAB) to prevent hypotension. The aim of this study was to assess the effect of acute volume loading with new colloid solution, 6% hydroxyethyl starch (HES) 130/0.4 on hemodynamics and coagulation in patients undergoing OPCAB. METHODS: With the IRB approval, forty patients undergoing OPCAB were allocated to two groups receiving 10 ml/kg of Plasma solution A (Control group, n = 21) or HES 130/0.4 (HES group, n = 19) for 30 min before pericardiotomy. We measured hemodynamic variables and coagulation parameters at 10 min after anesthesia induction (T1), 10 min after fluid loading (T2), 10 min after Y-graft formation (T3), and after sternum closure. Amount of infused fluid, blood loss, tranfusion and urine output were recorded intraoperatively and for 16 hr after surgery. Thromboelastography and electrolytes were also measured. RESULTS: Both groups were similar in demographic data and fluid/blood volume during and after surgery. Cardiac index and right ventricular ejection fraction were maintained throughout the surgery in HES group but were decreased in Control group. The ratio of arterial oxygen partial pressure to inhaled oxygen fraction was increased in HES group after surgery. Thromboelastography and other parameters didn't demonstrate significant differences between the groups. CONCLUSIONS: Acute HES loading before pericardiotomy could prevent the decrease of cardiac index and right ventricular ejection fraction in OPCAB patients. Additionally, it showed desirable effects on oxygenation without adverse effects on coagulation.
Anesthesia ; Colloids ; Coronary Artery Bypass, Off-Pump* ; Electrolytes ; Ethics Committees, Research ; Hemodynamics ; Hemostasis ; Humans ; Hypotension ; Oxygen ; Partial Pressure ; Pericardiectomy ; Plasma ; Starch* ; Sternum ; Stroke Volume ; Thrombelastography ; Transplants*

Myelodysplastic syndrome (MDS) is a hematologic disorder characterized by peripheral cytopenia and histologic feature of hematologic dysplasia. MDS has rarely been reported in association with Behcet's disease. We describe a patient with MDS associated Behcet's disease and a review of the literature.
Humans ; Myelodysplastic Syndromes*

Congenital hepatic fibrosis (CHF) is a rare developemental abnormality, which is characterized pathologically by periportal fibrosis with irregularly shaped proliferating bile ducts. In most, if not all, cases CHF is associated with autosomal recessive polycystic kidney disease. Recently, we experienced two cases, confirmed by percutaneous needle liver biopsy, of CHF with polycystic kidney disease. The first patient was a 19-year-old man and presented with hematemesis and hepatosplenomegaly. Esophageal varix was noted by an endoscopic examination and an endoscopic variceal ligation was performed. Abdominal CT scanning revealed innumerable cysts of both kidneys. The pateint also had cystic dilation of subarchnoid space in the basal cistern and posterior fossa detected through brain MRI. The second patient was a 24-year-old man admitted for an evaluation of splenomegaly. He had no esophageal varix but, splenic varix and splenorenal shunt were detected through an abdominal CT scanning. Innumerable renal cysts were also present. The diagnosis of CHF was confirmed in both cases by its typical histologic features. We report these cases with a review of the relevant literatures.
Bile Ducts ; Biopsy ; Brain ; Diagnosis ; Esophageal and Gastric Varices ; Fibrosis* ; Hematemesis ; Humans ; Hypertension, Portal ; Kidney ; Ligation ; Liver ; Magnetic Resonance Imaging ; Needles ; Polycystic Kidney Diseases* ; Polycystic Kidney, Autosomal Recessive ; Splenomegaly ; Splenorenal Shunt, Surgical ; Tomography, X-Ray Computed ; Varicose Veins ; Young Adult

Cushing's syndrome results from prolonged exposure to high levels of glucocorticoid hormones. ACTH-dependent Cushing's syndrome accounts for about 85% of endogenous causes. Autonomous pituitary ACTH secretion, called Cushing's disease, is responsible for 80% of these causes, whereas ectopic ACTH secretion is responsible for 20% of them. Appropriate therapy of patients with Cushing's syndrome depends on accurate diagnosis and classification of the disorder. In addition to the history and clinical evaluation, the laboratory evaluation of a patient with Cushingoid appearance is necessary to establish the diagnosis and determine the cause of hypercortisolism. A major problem in the differential diagnosis of ACTH-dependent Cushing's syndrome is distinguishing Cushing's disease from the ectopic ACTH syndrome. Both entities can have similar clinical and laboratory features. In addition, both pituitary microadenoma and ectopic ACTH-secreting tumors may be radiologically occult. Bilateral inferior petrosal sinus and peripheral vein catheterization with simultaneous collection of samples for measurement of ACTH is one of the most specific tests available to localize the source of ACTH production. We report two cases of Cushing's syndrome diagnosed by inferior petrosal sinus sampling associated with normal or low ACTH levels on routine basal hormone assay.
ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone* ; Catheterization ; Catheters ; Classification ; Cushing Syndrome* ; Diagnosis ; Diagnosis, Differential ; Humans ; Petrosal Sinus Sampling ; Plasma* ; Veins