Pulmonary pleomorphic carcinomas are rare malignant tumors that account for 0.1 to 0.4% of all lung cancers. They are notable for their aggressive clinical behavior and poor prognosis. We report here on a patient who is alive and disease-free 12 years after receiving surgical treatment for the rib recurrence of pulmonary pleomorphic carcinoma.
Humans ; Lung Neoplasms ; Prognosis ; Recurrence* ; Ribs

PURPOSE: To compare 3D ultrasound (3D-US) with 2D ultrasound (2D-US) in terms of their usefulness and limitations in the diagnosis of breast masses. MATERIALS AND METHODS: We obtained 2D and 3D US images of 37 breast lesions present in 20 cases of fibroadenoma, nine of cancer, and eight of fibrocystic disease proven in a total of 26 cases [fibroadenoma (n=13), breast cancer (n=9), fibrocystic disease (n=4)] by histologic examination, and by clinical evaluation and clinical evaluation with sonographic imaging in eleven. When comparing 3D and 2D-US images we had no prior information regarding detection rate according to the size of lesions, whether or not internal and boundary echo patterns could be interpreted, accurate differentiation between tumorous and non-tumorous lesions, or the accuracy with which benign and malignant tumors could be differentiated. RESULTS: For lesions of 1 cm or less in diameter the detection rate of 3D-US was lower than that of 2D-US, but for lesions over 1 cm there was no difference between the two modalities. In fibroadenoma and breast cancer, 3D-US was more useful than 2D-US for the evaluation of both internal and boundary echo, but with fibrocystic disease and in the diagnosis of tumor/non-tumor, there was no significant difference. In breast cancer, however, 3D-US more accurately determined malignancy, and in fibroadenoma, because of the pseudospicule revealed by 3D-US, this modality was less exact in determining benignancy. CONCLUSION: In the evaluation of internal and boundary echo in breast mass diagnosis, 3D-US was more useful than its 2D counterpart. For lesions of 1 cm or less in diameter, however, the detection rate of 3D-US was low, and since in some benign cases a pseudospicule was apparent, the possibiliy of confusion with malignancy arose. For these reasons, the usefulness of 3D-US was limited.
Breast Neoplasms ; Breast* ; Diagnosis* ; Fibroadenoma ; Ultrasonography

OBJECTIVE: To compare the pregnancy outcomes of transvaginal multifetal pregnancy reduction (MFPR) according to the gestational period when the procedure was performed METHODS: From January l995 to February 1998, total 27 patients with multiple pregnancy were included in this study. The patients were grouped to early MFPR group (<8 weeks, n=16) and delayed MFPR group (>8 weeks, n=ll) according to the gestational age that MFPRs were performed. All MFPRs were performed by transvaginal sonography-guided fetal aspiration or mechanical trauma. The complete pregnancy loss rate before 24 weeks of gestation, spontaneous loss of embryo, procedure-related complication, gestational age at delivery, and pregnancy complication were compared between the two groups. Statistical analysis of data was performed using Students t-test and Fishers exact test as appropriate. Statistical significance was defined as p<0.05. RESULTS: There was no significant difference in the complete pregnancy loss rate between the early MFPR group (6.3%) and the delayed MFPR group (27.3%). The incidence of partial spontaneous loss of embryo in the two groups were not differed significantly (6.3% vs. 18.2%). The procedure-related complication of the delayed MFPR group (36.4%) seemed to be higher than that of the early MFPR group (6.3%), however there was no statistical difference (p=0, 07). Especially, all 3 patients in whom the MFPR was performed after 10 weeks suffered from the procedure-related complication. The mean gestational age at delivery of the two groups were not differed significantly (36.3+2.8 weeks vs. 37.0+1.3 weeks). There was also no significant difference in the mean birth weights of the two groups (2378.8+563.7 gm vs. 2427.1+436.2 gm). CONCLUSION: Although there was no statistically significant difference, the early transvaginal MFPR might be a safe and useful method without significant adverse complications compared to the delayed MFPR.
Birth Weight ; Embryonic Structures ; Female ; Gestational Age ; Humans ; Incidence ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Pregnancy Reduction, Multifetal* ; Pregnancy, Multiple

OBJECTIVE: To evaluate the regulatory mechanism of cyclooxygenase(COX)-2 by estrogen and progesterone in uterine cell lines of rodents MATERIALS AND METHODS: CUE-P cells, originated from the uterine endometrial epithelial cells, and CUE-V2 cells, originated from the uterine endometrial stromal cells, were incubated in the Dulbecco's modified Eagle's medium(DMEM) and F12 medium. The cellular proliferation were evaluated every 24 hours. The expression of COX-2 was measured after estrogen and progesterone supplementation by western blot. RESULTS: CUE-P cells have cuboidal morphology and CUS-V2 cells resemble fibroblast and exhibit a spindle-like morphology. When CUE-P and CUS-V2 cells were co-cultured with estrogen and progesterone supplementation, the expression of COX-2 was decreased after 24 hours of estrogen supplementation. The decreased expression of COX-2 was observed only when estrogen was supplemented after 9 hours of initial progesterone supplementation. CONCLUSION: The sex steroid, such as estrogen and progesterone could regulate COX-2 expression in uterine cell lines.
Blotting, Western ; Cell Line* ; Cell Proliferation ; Cyclooxygenase 2 ; Epithelial Cells ; Estrogens* ; Fibroblasts ; Progesterone* ; Rodentia* ; Stromal Cells

PURPOSE: In major burns, deep vein thrombosis (DVT) is frequently diagnosed as a major complication of burns. But the risk factors and prophylaxis remain controversial. This study was designed to evaluate the incidence and risk factors of DVT in major burn patients. METHOD: We reviewed all major burn patients (>40% of TBSA) admitted to our burn center from June 1998 to August 2003 and assessed each affected patients with an in-hospital diagnosis of DVT for DVT risk factors. RESULT: There were 9 symptomatic DVT detected among 606 severe burn patients (1.45% incidence). Patients diagnosed with DVT had no risk factors of morbid obesity, previous DVT, congestive heart failure or neoplastic disease, except one patient who had a polycythemia vera diagnosed incidentally. In eight of 9 patients, DVT occurred in veins draining burned extremities. All patients had burn wound infections as a complication of burns. Eight of 9 patients had longer hospital stays than patients without DVTs. In all patients, DVT was developed after operations for skin graft. CONCLUSION: DVT should be suspected in patients with delayed wound healing and unresolved edema of extrimites. Wound infection, long bed-ridden state and operations are significant risk factors for DVT formation in major burn patients.
Burn Units ; Burns* ; Diagnosis ; Edema ; Extremities ; Heart Failure ; Humans ; Incidence ; Length of Stay ; Lower Extremity* ; Obesity, Morbid ; Polycythemia Vera ; Risk Factors ; Skin ; Transplants ; Veins ; Venous Thrombosis* ; Wound Healing ; Wound Infection

Recently, various studies evaluating percutaneous cervical nucleoplasty have reported good results. Percutaneous cervical nucleoplasty has been commonly used for treating contained herniated disc or protrusion, but a posterolateral extruded disc has not been considered to be an indication. The tip of the L'DISQ(R) wand can be curved to the desired angles by the rotation of the control wheel. Therefore, L'DISQ(R) can directly access the extruded disc. We report the application of percutaneous cervical nucleoplasty by using the L'DISQ(R) in three patients with an extruded disc. Decompression was successfully performed, and the symptoms improved immediately. In one patient, a 6-month follow-up magnetic resonance imaging study showed disappearance of the extruded cervical disc. Percutaneous cervical nucleoplasty using the L'DISQ(R) can be an effective, low complication, minimally invasive procedure for treating cervical disc herniation.
Decompression ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging

PURPOSE: Chemerin has been suggested to be linked to insulin resistance and type 2 diabetes mellitus (T2DM). However, the relationship between visceral adiposity and chemerin levels remains unclear in subjects with T2DM. In this study, we investigated the relationship between serum chemerin levels and visceral adiposity. MATERIALS AND METHODS: This study included 102 subjects newly diagnosed with T2DM. The relationships between serum chemerin levels and clinical and biochemical parameters were examined. Multiple linear regression analysis was performed to determine the predictable factors of serum chemerin levels. RESULTS: Serum chemerin levels showed significant positive correlations with body mass index (BMI), waist circumference (WC), visceral fat thickness (VFT), insulin levels, the homeostasis model assessment of insulin resistance, and levels of triglycerides (log-transformed) and high-sensitivity C-reactive protein, while showing significant negative correlations with high-density lipoprotein cholesterol. After adjusting for BMI and WC, VFT showed a significant relationship with serum chemerin levels (r=0.222, p=0.027). Moreover, VFT was an independent predictive factor of serum chemerin levels (β=0.242, p=0.041). CONCLUSION: We demonstrated that chemerin is linked to metabolic syndrome components. Moreover, serum chemerin levels were associated significantly with obesity, especially visceral adipose tissue, in subjects with T2DM.
Adiposity* ; Body Mass Index ; C-Reactive Protein ; Cholesterol ; Diabetes Mellitus, Type 2 ; Homeostasis ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Linear Models ; Lipoproteins ; Obesity ; Triglycerides ; Waist Circumference*

PURPOSE: This study aimed to evaluate the disease severity of children suffering from gastroenteritis using different scales. The results are compared and subsequently classified on the basis of the type of virus causing the disease in order to investigate the differences in clinical characteristics and disease severity according to pathogen. METHOD: This study was conducted prospectively with patients under 5 years of age diagnosed with acute gastroenteritis and hospitalized at 9 medical institutions in 8 regions across the Republic of Korea. Disease severity was evaluated using the Vesikari Scale, the Clark Scale, and the modified Flores Scale. Fecal samples collected from patients were used to detect rotavirus and enteric adenovirus by enzyme immunoassay, and for RT-PCR of norovirus, astrovirus, and sapovirus. RESULTS: There were a total of 214 patients with a male : female ratio of 1.58 : 1, of which 35 were under the age of 6 months (16.4%), 105 were aged 6-23 months (49.1%), and 74 were aged 24-59 months (34.5%). The rate of concordance between the Vesikari and Clark Scales was 0.521 (P<0.001) and, in severe cases, the Vesikari Scale was 60.7% and Clark Scale was 2.3%, indicating that the Clark Scale was stricter in the evaluation of severe cases. CONCLUSIONS: In children with gastroenteritis, there were differences in disease severity based on the scale used. Therefore, to achieve consistent results among researchers, either only a single scale or a measure of all scales should be used to determine disease severity.
Adenoviridae ; Child* ; Female ; Gastroenteritis* ; Humans ; Immunoenzyme Techniques ; Male ; Norovirus ; Prospective Studies ; Republic of Korea ; Rotavirus ; Sapovirus ; Weights and Measures*

PURPOSE: Genetic factors and environmental exposures are recognized as important risk factors for atopic dermatitis (AD) in children. Inflammatory responses by molds can be mediated via Toll-like receptor 4 (TLR4). The aims of this study were to investigate mold as risk factor of AD and gene-environment interaction on AD in preschool children. METHODS: We undertook a cross-sectional survey with 986 preschool children. We investigated five mold exposure measures (dampness stain, dampness damage, visible mold, mold odor, and house repair). The TLR4 polymorphism (rs1927911) was genotyped by TaqMan assay. RESULTS: The prevalence of AD was as follows: AD diagnosis by questionnaire, 35.1%; current AD (lifetime diagnosis together with symptoms in the last 12 months), 21.5%. When children with parental history of AD were exposed to mold odor during infancy and house repair during the last 12 months, the risk for current AD (adjusted odds ratio [aOR], 6.826; 95% confidence interval [CI], 2.511 to 18.554 vs. aOR, 6.143; 95% CI, 2.348 to 16.074) was further increased than only with parental history of AD. In children with the CC genotype of TLR4 polymorphism, the risk of AD was increased by mold exposure. CONCLUSION: This investigation identified that mold exposure is potential risk factor for AD in preschool children. Parental history of AD and mold exposure during infancy and the last 12 months had synergistic effect on high prevalence of AD. We identified that mold exposure and TLR4 polymorphism have an effect on the development of atopic dermatitis.
Child ; Child, Preschool ; Cross-Sectional Studies ; Dermatitis, Atopic ; Environmental Exposure ; Fungi ; Gene-Environment Interaction ; Genotype ; Humans ; Odds Ratio ; Odors ; Parents ; Prevalence ; Risk Factors ; Toll-Like Receptor 4 ; Toll-Like Receptors ; Surveys and Questionnaires

Rotavirus (RV) is one of the most important viral etiologic agents of acute gastroenteritis (AGE) in children. Although effective RV vaccines (RVVs) are now used worldwide, novel genotypes and outbreaks resulting from rare genotype combinations have emerged. This study documented RV genotypes in a Korean population of children with AGE 5 yr after the introduction of RVV and assessed potential genotype differences based on vaccination status or vaccine type. Children less than 5-yr-old diagnosed with AGE between October 2012 and September 2013 admitted to 9 medical institutions from 8 provinces in Korea were prospectively enrolled. Stool samples were tested for RV by enzyme immunoassay and genotyped by multiplex reverse-transcription polymerase chain reaction. In 346 patients, 114 (32.9%) were RV-positive. Among them, 87 (76.3%) patients were infected with RV alone. Eighty-six of 114 RV-positive stool samples were successfully genotyped, and their combinations of genotypes were G1P[8] (36, 41.9%), G2P[4] (12, 14.0%), and G3P[8] (6, 7.0%). RV was detected in 27.8% of patients in the vaccinated group and 39.8% in the unvaccinated group (P=0.035). Vaccination history was available for 67 of 86 cases with successfully genotyped RV-positive stool samples; RotaTeq (20, 29.9%), Rotarix (7, 10.4%), unvaccinated (40, 59.7%). The incidence of RV AGE is lower in the RV-vaccinated group compared to the unvaccinated group with no evidence of substitution with unusual genotype combinations.
Child, Preschool ; Feces/virology ; Gastroenteritis/immunology/prevention & control/virology ; Genotype ; Humans ; Infant ; *Mass Vaccination ; RNA, Viral/genetics ; Republic of Korea ; Reverse Transcriptase Polymerase Chain Reaction ; Rotavirus/*classification/*genetics/isolation & purification ; Rotavirus Infections/immunology/*prevention & control/virology ; Rotavirus Vaccines/*immunology ; Vaccines, Attenuated/immunology