In adenomatous polyposis coli there are many colonic and extracolonic manifestations, and various combinations of these induce different clinical presentations and syndromes. We experienced a unique case of adenomatous polyposis of the large intestine and stomach in a 39-year-old man. In the colon, small cell neuroendocrine carcinoma rather than adenocarcinoma had developed, which did not contain adenomatous or carcinomatous foci. The adenomatous polyps in the colon were all small and sessile with no cancerous or precancerous change two years after the resection of the symptomatic gastric adenomas, even though the gastric adenomas were larger and showed dysplastic change. We think this case is another variant of adenomatous polyposis syndrome.
Adenocarcinoma ; Adenoma

Primary carcinoma arising in the diverticular wall of the urinary bladder is the most serious complication. The clinical importance is that the carcinoma is difficult to diagnose early, widespread at diagnosis and has poor prognosis. Recently, vigilant studies including bladder mapping reveal premalignant changes and carcinoma in situ adjacent to carcinoma and suggest these premalignant changes evolve to flank carcinoma. For early detection and improving the prognosis, be required through cystoscopic examination including diverticular wall and multiple punch biopsies as well as consecutive urine cytologic examination. Author report two cases of primary carcinoma arising in bladder diverticulum. One revealed carcinoma in situ accompanied with adjacent atypical hyperplasia in diverticula mucosa incidentally found at the pathologic examination on the divertiuclectomy specimen. The other case showed invasive transitional cell carcinoma(Grade IV, Stage D) of diverticulum. The two cases described suggest that vesical diverticulum should be removed into to with a good amount of surrounding bladder wall.
Biopsy ; Carcinoma in Situ ; Diagnosis ; Diverticulum* ; Hyperplasia ; Mucous Membrane ; Prognosis ; Urinary Bladder

OBJECTIVE: To investigate the clinical impact of absent or reversed end-diastolic (ARED) umbilical artery flow detected before the 34th week of pregnancy in high-risk pregnancies. METHODS: Fifty-eight singleton pregnant women with high-risk factors were included in this retrospective study. Based on the umbilical artery Doppler finding, pregnant women were divided into 3 groups: group 1 (12 subjects) with normal Doppler systolic/diastolic (S/D) ratios; group 2 (30 subjects) with significant abnormal umbilical artery S/D ratios, and group 3 (16 subjects) with ARED flow in the umbilical artery between the 25+0 and 33+6 gestational weeks. Incidence of intrauterine growth retardation (IUGR) and pregnancy-induced hypertension, detection week, diagnosis-to-delivery interval, birth weight and gestational ages at delivery, Apgar scores, emergency cesarean section, neonatal intensive care unit (NICU) admission, admission-to-discharge interval, perinatal mortality (PNM) and morbidity, and neonatal morbidity were registered. Perinatal outcomes were assessed. The data was analyzed using the Mann-Whitney U-test and X-square test. A significant difference was considered present if p was<0.05. RESULTS: The PNM in group 3 in the study was 25% (4/16). Sixteen had ARED flow. Our study shows that fetuses with ARED flow tend to be more severely growth-retarded. Our results also show ARED flow to be associated with poor perinatal outcome. There was a higher incidence of cesarean section for fetal distress, neonatal intensive care unit admission, and lower Apgar scores. Birth weight and gestational age at delivery were lower. The diagnosis-to-delivery interval was shorter. The admission-to-discharge interval was longer. CONCLUSION: An early ARED finding before the 34th week in the umbilical artery is a very serious sign of likely fetal compromise. The perinatal mortality and morbidity rate were high, and there was evidence of acute or chronic hypoxia in most fetuses. It is an indication that extremely careful surveillance should be followed but not necessarily an indication for an emergency delivery.
Anoxia ; Birth Weight ; Cesarean Section ; Emergencies ; Female ; Fetal Distress ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Perinatal Mortality ; Pregnancy* ; Pregnancy, High-Risk ; Pregnant Women ; Retrospective Studies ; Umbilical Arteries*

Both primary choriocarcinoma and endodermal sinus tumor of the stomach are very rare entities. Combination of these two tumors is even rarer, and only a single such case has been reported in English literature. The case had gastric adenocarcinoma in addition to these tumors. We experienced a case of combined, pure choriocarcinoma and endodermal sinus tumor in the stomach of a 74 year-old man. He had no gonadal or any other primary tumor. Huge exophytic tumor was located in the lesser curvature of the body. Two components of the tumor was separated and clearly defined. Human chorionic gonadotropin(HCG) was demonstrated in serum and in tissue sections. Alpha-fetoprotein(alpha-FP) was also demonstrated in serum and in tissue sections. Alpha-fetoprotein(alpha-FP) was also elevated in the serum. Possible tumor origin was speculated.
Humans ; Adenocarcinoma

No abstract available.
Blood Platelets* ; Hemagglutination*

BACKGROUND AND OBJECTIVES: Epidermal growth factor (EGF), directly stimulates epidermal growth and differentiation. The combination of EGFR activation and genetic alternations may lead to neoplasia and metaplasia. To study the change of chromosomal number and the aberrations of chromosomal structure of KUMA3 cell line treated with high dose EGF. MATERIALS AND METHODS: The high dose EGF treated cell clones were obtained from KUMA3 cell line which was established from squamous cell carcinoma of the lower lip by culturing cells in medium containing high dose EGF for 6 months. The chromosomal analysis and subculture were performed at subsequent passage of 1 month interval. RESULTS: In high dose EGF treated cell clones, there was no apparent change in chromosomal number, but the ratio of the number of chromosome 7 to mode chromosome number was similar to normal value (0.043). The new chromosomal structural aberrations appeared first from 30 passage of IR-200 cell clone. The chromosomal aberrations were del(1)(q23-->qter) and del(4)t(1:4)(1qter-->1q23: : 4p16-->4qter). CONCLUSION: There was no change in chromosomal number, but the ratio of the number of chromosome 7 to mode chromosome number was similar to normal value (0.043), and the new chromosomal structural aberrations were appeared.
Carcinoma, Squamous Cell ; Cell Line ; Chromosome Aberrations ; Chromosomes, Human, Pair 7 ; Clone Cells* ; Cytogenetics* ; Epidermal Growth Factor* ; Lip ; Metaplasia ; Reference Values

No abstract available.
Arteries* ; Atherectomy*

In a patient presenting with clinical features of obstructing hydrocephalus, stenosis of aqueduct of Sylvius was demonstrated by contrast ventriculography and C-T scan. The case of aqueduct stenosis in a dult has been described by spiller and Allen, 1907. Ventriculoperitoneal shunting resulted in clinical improvement with significant change in ventricular size and subarachnoid space.
Cerebral Aqueduct ; Constriction, Pathologic* ; Humans ; Hydrocephalus ; Subarachnoid Space ; Ventriculoperitoneal Shunt*

The clinical triad of Behcet's Disease is relapsing iritis and ulcers of the mouth and genitalia. The diagnosis of Behcet's Disease is based only on clinical grounds, as there are no pathognomic or histologic features. A reported case of Behcet's Disease with neurologic manifestations that have undergone computerized tomography of the brain have demonstrated lesion of decreased density with negative contrast enhancement in basal ganglia which is similar with the other reported cases.
Basal Ganglia ; Brain ; Diagnosis ; Genitalia ; Iritis ; Mouth ; Neurologic Manifestations ; Ulcer

BACKGROUND: The purpose of this study was to evaluate mivacurium in the pharmacokinetics of onset and offset. METHODS: In 127 adult patients of ASA physical status I or II without any factors involving the neuromuscular function under general anesthesia, onset time (lag and manifest time) and clinical duration were measured after bolus or divided doses of ED95 x 2 of succinylcholine (SCC), rocuronium (ROC), atracurium (ATR), mivacurium (MIV), pancuronium (PAN) or vecuronium (VEC). Recovery time was defined as the recovery index and total duration measured after subsequent ED95 of MIV at 25% recovery of control twitch height from neuromuscular block induced by ED95 x 2 of ATR, MIV, PAN or VEC. Plasma cholinesterase (PChE) levels were measured following PAN or ATR. RESULTS: Onset time was faster with SCC and ROC, the low potency drugs, than with ATR, MIV, PAN or VEC, the high potent drugs. Manifest time was shorter in low potency drugs but longer in high potency drugs than lag time after bolus or divided doses of muscle relaxants given. Divided doses of various drugs induced a shortened onset time, but the patterns of relationship between lag and manifest time associated with drug potency did not alter. The recovery times with administered MIV were slowest after PAN pretreatment, and fastest after MIV pretreatment. PChE levels decreased significantly from 3 min to over 180 min after PAN administeration but not ATR. CONCLUSIONS: The onset time of MIV was not improved due to high drug potency as other nondepolarizing neuromuscular blockers. However, in spite of high potency, the recovery time of MIV was faster than other drugs. This results may be depend upon PChE activity rather than drug potency. Additionally, the prolonged recovery of MIV was not only under the influence of low PChE activity but also other some factors such as: the first relaxants administered before MIV dominated the neuromuscular block so that the duration of MIV given subsequently changed to resemble that of the first. The longer elimination half-life of the underlying relaxant prolonged the effects of subsequentshorter acting MIV. Structural similarities or dis-similarities between the interacting MIV and other drugs may have effects more potent in dis-similarity than in similarity.
Adult ; Anesthesia, General ; Atracurium ; Cholinesterases ; Half-Life ; Humans ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pancuronium ; Pharmacokinetics* ; Plasma ; Succinylcholine ; Vecuronium Bromide