Gardner's syndrome is a familial disease consisting of gastrointestinal adenomatous polyposis, osteomas of the mandible, skull, and long bones, and a variety of sol tissue lesions, including sebaceous cysts, fibromas, lipomas, and desmoid tumors. The colon is the most common site for polyposis, but the stomach, duodenum, small bowel, and periampullary area may also be involved. The diagnostic evaluation, malignant potential, and management is identical to that for familial adenomatous polyposis. The extracolonic manifestations of Gardner's syndrome are frequent and varied. Gardner's syndrome is inherited as autosomal dominant traits. Authors experienced one case that is a 32 year old female patient who had colonic and duodenal multiple polyposis, desmoid tumor in abdominal wall and right mesocolon and odontoma on mandible.
Abdominal Wall ; Adenomatous Polyposis Coli ; Adult ; Colon ; Duodenum ; Epidermal Cyst ; Female ; Fibroma ; Fibromatosis, Aggressive ; Gardner Syndrome* ; Humans ; Lipoma ; Mandible ; Mesocolon ; Odontoma ; Osteoma ; Skull ; Stomach

PURPOSE: We evaluated the prevalence and characteristics of breakthrough cancer pain (BTcP) in Korean patients admitted with cancer pain. MATERIALS AND METHODS: In-hospital patients with cancer pain completed a questionnaire concerning severity of background cancer pain (BCP), prevalence and treatment for BTcP, sleep disorders, and satisfaction with cancer pain treatment. Medical records showing medications for BCP and BTcP were also evaluated. RESULTS: Total 609 patients with controlled BCP enrolled. Mean age of the patients was 59.5 years old, and 59% were male. Of all patients, 177 (29%) complained of BTcP. No clinical characteristic predicted BTcP. Of the 177 patients with BTcP, 56% did not receive treatment for BTcP. Patients with BTcP showed significant association with a sleep disorder and dissatisfaction with pain control, compared to those without BTcP (p < 0.0001 and p=0.0498, respectively). Oxycodone-immediate release was the most commonly used short-acting analgesic, followed by intravenous morphine. CONCLUSION: The prevalence of BTcP was 29% in patients admitted with controlled BCP. Although the patients had well-controlled BCP, BTcP showed association with a lower quality of life in patients with cancer. More medical attention is needed for detection and management of BTcP.
Humans ; Inpatients* ; Male ; Medical Records ; Morphine ; Prevalence ; Quality of Life ; Sleep Disorders

PURPOSE: Carcinomas of the male breast constitutes only 1% of all breast cancer and less than 1.5% of all malignant tumors in men. The low incidence of this disease prevents therapeutic questions from being addressed in prospective randomized trials. Our aim was to cover the characteristics of the etiology, presentation and treatment of male breast cancer; and therefore provide an overview of knowledge in this area. METHODS: We retrospectively analyzed 16 male breast cancer patients, who had been treated between 1983 and 1992 at the Department of Surgery, College of Medicine, The Catholic university of Korea. RESULTS: The peak age of incidence was in the 7th and 8th decades. The most common symptom was a palpable mass in the breast (75.1%), and the duration of symptom varied between 3 days and 10 years. According to the TNM staging system, there were 18.8%, 31.3%, 18.8%, 12.5%, 6.3%, at stages 0, I, II, III and IV, respectively, and 12.5% with an unknown stage. A modified radical mastectomy was performed in 11 patients (68.8%) and postoperative adjuvant therapy in 12 patients (75.1%). The mean duration of following up was 41.2 months, during which time 2 patients were lost. CONCLUSION: Sixteen male breast cancer patients were encountered and men with breast cancer were observed to be older, have a longer duration of symptom, and more likely to have a familial tendency. However, our review revealed that male breast cancer was not as far advanced and had more chance of cure than initially thought. Therefore, the early detection and aggressive treatment of breast cancer are important for improving the survival.
Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Humans ; Incidence ; Korea ; Male ; Male* ; Mastectomy, Modified Radical ; Neoplasm Staging ; Retrospective Studies

BACKGROUND: To perform the successful dendritic cell-based cancer immunotherapy one of the main issues to be solved is the source of antigen for DC pulsing. Limitations occur by using auto-tumor lysate due to the difficulties obtaining enough tumor tissue(s) quantitatively as well as qualitatively. In this study the possibility of allogeneic tumor cell lysate as a DC pulsing antigen has been tested in mouse melanoma pulmonary metastasis model. METHODS: B16F10 melanoma cells (1x10(5)/mouse) were inoculated intravenously into the C57BL/6 mouse. Therapeutic DCs were cultured from the bone marrow myeloid lineage cells with GM-CSF and IL-4 (1,000 U/ml each) for 7 days and pulsed with lysate of either autologous B16F10 (B-DC), allogeneic K1735 (C3H/He origin; K-DC) or CloneM3 (DBA2 origin; C-DC) melanoma cells for 18 hrs. Pulsed-DCs (1x10(6)/mouse)[CGP1] were injected i.p. twice with one week interval starting from the day 1 after tumor cell inoculation. RESULTS: Without observable toxicity, allogeneic tumor cell lysate pulsed-DC induced the significantly better anti-tumor response (tumor scale: 2.7+/-0.3, 0.7+/-0.3 and 0.3+/-0.2 for saline, B-DC and C-DC treated group, respectively). Along with increased tumor specific lymphocyte proliferations, induction of IFN-gamma secretion against both auto- and allo-tumor cell lysates was observed from the DC treated mice. (w/B16F10-lysate: 44.97+/-10.31, 1787.94+/-131.18, 1257.15+/-48.27, w/CloneM3 lysate: 0, 1591.13+/-1.83, 1460.47+/-86.05 pg/ml for saline, B-DC and C-DC treated group, respectively) Natural killer cell activity was also increased in the mice treated with tumor cell lysate pulsed-DC (8.9+/-[CGP2]0.1, 11.6+/-0.8 and 12.6+/-0.7% specific NK activity for saline, B-DC and C-DC treated group, respectively). CONCLUSION: Conclusively, promising data were obtained that allogeneic-tumor cell lysate can be used as a tumor antigen for DC-based cancer immunotherapy.
Animals ; Bone Marrow ; Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Immunotherapy ; Interleukin-4 ; Killer Cells, Natural ; Lymphocytes ; Melanoma* ; Mice ; Neoplasm Metastasis*

Xanthogranulomatous cholecystitis is an extremely rare benign inflammatory disease of the gall bladder characterized by yellowish focal nodular appearance with tissue necrosis and lipid-containing histiocyte (xanthomacell). Recently, we experienced a case of xanthogranulomatous cholecystitis. A 71-year old woman was admitted with the complaints of RUQ pain for 1 month. On abdominal ultrasound examination, there were diffuse gallbladder wall thickening, echogenic nodule with acoustic shadow, the calculous cholecystiti and the gall badder cancer were strongly suspected and the operation was performed. At operation the gall bladder was marked enlarged and wall thickening with two brownish, oval shaped, smooth surfaced stones. The specimen was revealed a xanthogranulomatous cholecystitis by the pathology.
Acoustics ; Aged ; Cholecystitis* ; Female ; Gallbladder ; Histiocytes ; Humans ; Necrosis ; Pathology ; Ultrasonography ; Urinary Bladder

E6 and E7 proteins produced by oncogenic HPV bind to the protein products of cellular tumor suppressor genes p53 and Rb, respectively. This mechanism has been suggested to contribute to the oncogenesis of HPV-infected carcinoma. The cells which are blocked the function of p53 and pub protein continue to divide by bypassing Ml stage known as antiproliferative mechanism but telomeres, the genetic elements at the ends of chromosomes, continue to shorten until the telomeres are so short that further replication is prevented(M2 stage). But telomeres can be maintained if telomerase is derepressed, giving rise to a immortal cell. The present study has been investigated the presence of HPV, telomere length and telomerase activation in cervical carcinomas. HPV DNA were detected by polymerase chain reaction in 17 of 19 precancerous lesions and cervical carcinoma specimens; HPV16 was detected in 12 cases, HPV18 in one case, HPV33 in two cases, and HPV58 in two cases. Overall, the prevalence of HPV was 89.5%. To study the difference of telomere length in cervical carcinomas and each normal counterpart, DNAs were digested with Hinf III and Rsa I to liberate the terminal restriction fragments(TRF). TRFs were resolved on agarose gels and detected by hybridization to the telomeric probe. This result indicated that there were no significant difference of TRF length in samples tested except two cases. TRF length of one carcinoma specimen was found to be significantly increased as compared with normal counterpart, but the other was found to be significantly decreased. Telomerase activity was detected in 4 of dysplasia specimens(5 cases), all of carcinoma in situ(CIS), and 6 of 8 invasive carcinoma. Overall, telomerase activity was detected in 84%. The degree of telomerase activity was high in 2 of dysplasia, 3 of CIS, and 3 of invasive carcinoma. And then there was no apparent association between HPV types and levels of telomerase activity. However, telomerase activity was depressed in invasive carcinoma as compared to dysplasia and CIS. These results suggest that HPV may be a possible causative agent in cervical carcinoma. In addition, telomerase activation may be necessary for the immortalization of cells and the progression of malignancy in cervical carcinoma.
Carcinogenesis ; Cervix Uteri* ; DNA ; Female ; Gels ; Genes, Tumor Suppressor ; Humans* ; Papilloma* ; Polymerase Chain Reaction ; Prevalence ; Sepharose ; Telomerase* ; Telomere*

This study examined the influence of the storage methods on the viability of oral epithelial cells using conventional cell freezing storage, slow freezing preservation, rapid freezing preservation, and slow freezing preservation with a pressure of 2 Mpa or 3 Mpa. The cell viability was evaluated by cell counting, WST-1 and the clonogenic capacity after 6 days of freezing storage. After 6 days, the frozen cells were thawed rapidly, and the cell counting, WST-1, and clonogenic capacity values were measured and compared. 1. The results from cell counting demonstrated that conventional cryopreservation, slow freezing under a 2 Mpa pressure and slow freezing under a 3 Mpa pressure showed significantly higher values than slow freezing preservation and rapid freezing preservation (p<0.05). 2. The results from the optical density by WST-1 demonstrated that slow freezing under a 2 Mpa pressure showed significantly higher values than slow freezing preservation and rapid freezing preservation (p<0.05). 3. The clonogenic capacity demonstrated that slow freezing under a 2 Mpa pressure showed significantly higher values than slow freezing preservation and rapid freezing preservation (p<0.05).
Cell Count ; Cell Survival ; Cryopreservation ; Epithelial Cells ; Freezing

PURPOSE: The visual analogue scale (VAS) pain score is widely and frequently used to evaluate the severity of pain. However, statistically significant differences in the VAS scores may not always mean differences in pain severity. This study is to determine clinically meaningful reductions in pain severity as measured by the VAS and by a verbal categorical rating of pain. METHODS: Three hundred adult patients presenting to the emergency department (ED) with acute pain resulting from trauma or non-traumatic diseases were enrolled in this prospective, descriptive study. A 100-mm non-hatched, horizontal visual analogue scale was used to measure pain severity. The VAS measurements were obtained two times 1 minute apart at admission, 30 minutes after admission, and 1 hour after treatment. At each VAS measurements, patients also gave verbal ratings of their pain as "more pain,""the same pain," or "less pain." Data from the groups reporting "the same pain" or "less pain" were compared with their preceding descriptions and yielded a VAS difference. The mean VAS change was calculated, from which a grand means and 95% confidence intervals (95% CI) were determined. RESULTS: At 30 minutes after admission and 1 hour after treatment, 256 and 31 patients, respectively described their pain as "the same pain,"and 33 and 269 patients described it as "less pain." The mean reduction in VAS for the group reporting that pain was "the same pain" was 13 to 16 mm (95% CI, 8 to 20 mm) instead of 'zero.'For the group reporting that pain was "less pain," the mean reductions in VAS score were 24 mm (95% CI, 20 to 28 mm) at 30 minutes after admission and 44 mm (95% CI, 42 to 46 mm) at 1 hour after treatment. CONCLUSION: When evaluating management for acute pain in the ED, a difference in VAS score of less than 20 mm without regard to the presence or absence of treatment is unlikely to signify a clinically meaningful reduction in pain severity. This study provides guidance to those who design and interpret clinical studies of the acute pain experience in the ED.
Acute Pain ; Adult ; Emergency Service, Hospital ; Humans ; Pain Management ; Prospective Studies

BACKGROUND: Spinal cord ischemic injury occurring after surgical repair of thoracoabdominal aortic disease leaves a devastating complication. The purpose of this study was to evaluate the effects of anesthetic preconditioning on neurologic outcome and Bcl-2 family protein gene expression in transient spinal ischemia. METHODS: In first experiment rats were divided by 4 groups and anesthetized with intraperitoneal propofol, enflurane, sevoflurane, or isoflurane. In second experiment, all rats were anesthetized with intraperitoneal propofol and enflurane, sevoflurane, isoflurane were given during 30 minutes and 14 minutes of spinal ischemia was induced 30 minutes later. Spinal ischemia was produced by both induced hypotension and thoracic aortic cross clamping. Neurologic scores were assessed 1, 3, 24, 48 hours after transient spinal ischemia. After 48 hours, rats were killed under anesthesia and spinal cords were removed for the assay of Bcl-2 family protein mRNA expression. RESULTS: The neurologic injury of S and I group were significantly lesser than P group. 30 minutes of anesthetic preconditioning with enflurane, sevoflurane, and isoflurane showed significantly better neurologic outcome compared to propofol, enflurane, sevoflurane, or isoflurane anesthetized rats. Bcl-2 family protein mRNA expression of I group and IP group were lesser than the other groups. CONCLUSIONS: Anesthetic preconditioning with volatile anesthetics for 30 minutes could reduce ischemic injury during transient spinal ischemia. The degree of neurologic injury may not be related to the expression of pro-apoptotic protein Bax. Isoflurane may have different influence on apoptosis after spinal ischemia compared to enflurane or sevoflurane.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Animals ; Aortic Diseases ; Apoptosis ; Constriction ; Enflurane ; Gene Expression ; Humans ; Hypotension ; Ischemia* ; Isoflurane ; Propofol ; Rats* ; RNA, Messenger* ; Spinal Cord ; Spinal Cord Ischemia

BACKGROUND: Spinal cord ischemic injury occurring after surgical repair of thoracoabdominal aortic disease leaves a devastating complication. The purpose of this study was to evaluate the effects of anesthetic preconditioning on neurologic outcome and Bcl-2 family protein gene expression in transient spinal ischemia. METHODS: In first experiment rats were divided by 4 groups and anesthetized with intraperitoneal propofol, enflurane, sevoflurane, or isoflurane. In second experiment, all rats were anesthetized with intraperitoneal propofol and enflurane, sevoflurane, isoflurane were given during 30 minutes and 14 minutes of spinal ischemia was induced 30 minutes later. Spinal ischemia was produced by both induced hypotension and thoracic aortic cross clamping. Neurologic scores were assessed 1, 3, 24, 48 hours after transient spinal ischemia. After 48 hours, rats were killed under anesthesia and spinal cords were removed for the assay of Bcl-2 family protein mRNA expression. RESULTS: The neurologic injury of S and I group were significantly lesser than P group. 30 minutes of anesthetic preconditioning with enflurane, sevoflurane, and isoflurane showed significantly better neurologic outcome compared to propofol, enflurane, sevoflurane, or isoflurane anesthetized rats. Bcl-2 family protein mRNA expression of I group and IP group were lesser than the other groups. CONCLUSIONS: Anesthetic preconditioning with volatile anesthetics for 30 minutes could reduce ischemic injury during transient spinal ischemia. The degree of neurologic injury may not be related to the expression of pro-apoptotic protein Bax. Isoflurane may have different influence on apoptosis after spinal ischemia compared to enflurane or sevoflurane.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Animals ; Aortic Diseases ; Apoptosis ; Constriction ; Enflurane ; Gene Expression ; Humans ; Hypotension ; Ischemia* ; Isoflurane ; Propofol ; Rats* ; RNA, Messenger* ; Spinal Cord ; Spinal Cord Ischemia