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

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

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*

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

PURPOSE: To determine the efficacy of correction of a malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance. MATERIALS AND METHODS: Between November 1994 and March 1997, we performed 15 manipulations in 12 patients in whom a dual-cuff, straight Tenckhoff peritoneal dialysis catheter had been implanted due to chronic renal failure. The causes of catheter malfunctioning were inadequate drainage of the dialysate (n=14) and painful dialysis (n=1). Under fluoroscopic guidance, adhesiolysis and repositioning of the malfunctioning catheter were performed with an Amplatz Super Stiff guidewire and the stiffener from a biliary drainage catheter. The results of procedures were categorized as either immediate or durable success, this latter being defined as adequate catheter function for at least one month after the procedure. RESULTS: Immediate success was achieved in 14 of 15 procedures (93%), and durable success in 7 of 15 (47%). The mean duration of catheter function was 157 (range, 30 to 578) days. After manipulation, abdominal pain developed in eight patients and peritonitis in two, but with conservative treatment, these symptoms improved. CONCLUSION: The correction of a malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance is an effective means of restoring catheter function and may be an effective alternative to surgical reimplantation of the catheter, or hemodialysis.
Abdominal Pain ; Catheters* ; Dialysis ; Drainage ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis* ; Peritonitis ; Renal Dialysis ; Replantation

OBJECTIVE: Apoptosis or programmed cell death is a normally physiological cell suicide program that is highly conserved among all animals. We previously evaluated overexpression of c-IAP1(Inhibitor of Apoptosis Protein) in ovarian carcinomas compared with normal ovaries. In this study, we demonstrate evidence for the involvement of c-IAP2 in ovarian carcinomas. METHODS: Fresh 9 normal ovaries, 5 benign ovarian cysts and 13 ovarian carcinomas were obtained from routine gynecologic surgeries carried out for benign and malignant ovarian tumors. They were examined for the presence of c-IAP2 by RT-PCR(Reverse Transcriptase Polymerase Chain Reaction), Western blot analysis and immunohistochemical stains. RESULTS: Nine of 14 normal and benign ovarian tumors were negative and 11 of 13 ova rian carcinomas were positive for c-IAP2 by RT-PCR. Positive RT-PCR for c-IAP2 was seen in 11/13 of ovarian carcinomas, a significantly higher percentage than in normal and benign ovarian tumors(5/14). All of these tumors showed strong positive for c-IAP2 by western blot and immunohistochemical staining. Whereas negative RT-PCR for c-IAP2 was seen in 9/14 of normal and benign ovarian tumors, a significantly higher percentage than ovarian carcinomas(2/13). Of these 9 negative samples, 6 had positive Western blot and immunohistochemical stains. There was weak concordance of the result. But expression of c-IAP2 in normal ovarian tissue was localized exclusively in the corpus luteum. Therefore, c-IAP2 may play important role in determining the fate of the follicular destiny. There was no expression in normal ovarian stroma cells for c-IAP2. CONCLUSIONS: These findings suggest that c-IAP2 is expressed in ovarian carcinomas and emerging role in cancer. The c-IAP2 expression has been investigated in the normal ovary, where apoptosis is thought to play an important role in ovulation.
Animals ; Apoptosis ; Blotting, Western ; Cell Death ; Coloring Agents ; Corpus Luteum ; DNA-Directed RNA Polymerases ; Female ; Gynecologic Surgical Procedures ; Ovarian Cysts ; Ovary ; Ovulation ; Ovum ; Suicide

PURPOSE: Bronchial asthma is an inflammatory respiratory disease characterized by the activation of inflammatory cells and its infiltration. It has been recently reported that MMP- 9 dose an importance role in the movement of inflammatory cells through basal membrane, that the function may be suppressed by TIMP-1. We studied to know the change of MMP-9 and TIMP-1 in sputum before and after corticosteroid (CS) therapy, and the relation with MMP-9/TIMP-1 ratio and improvement of FEV1. METHODS: Seventeen acute moderate to severe asthmatics were selected as was a control group of 17 healthy children. MMP-9 and TIMP-1 in sputum were measured on the 0 day, 7 days and 3 months later and observed as to the flow of time. FEV1 was measured before the CS therapy and 3 months later, and the change of FEV1 & FEV1 at 3 months were compared with the relation of MMP-9/TIMP-1 ratio. RESULTS: Sputum MMP-9 was lowered more at 7 days and 3 months compared with 0 day (P< 0.05). Sputum TIMP-1 was significantly high on 7 days (P< 0.05) and then had a tendency to decrease until 3 months (P< 0.05). MMP-9/TIMP-1 ratio decreased according to the flow of time (P< 0.05). MMP-9/TIMP-1 ratio at 3 months closely correlated with the change of FEV1 (r=0.65, P< 0.05). CONCLUSION: These data suggest that the overproduction of MMP-9 after asthma exacerbation correlates with airway inflammation and TIMP-1 production might contribute to airway fibrosis. MMP-9/TIMP-1 ratio at 3 months correlates with improvement of pulmonary function after CS therapy.
Asthma* ; Child ; Fibrosis ; Gelatinases ; Humans ; Inflammation ; Matrix Metalloproteinase 1* ; Matrix Metalloproteinase 9* ; Membranes ; Prednisolone ; Sputum* ; Tissue Inhibitor of Metalloproteinase-1

PURPOSE: This study was conducted to analyze the features of poisoning in individuals aged 0-18 years to understand the characteristics of potential victims and eventually prevent poisoning. METHODS: We retrospectively analyzed poisoned children and adolescents (0–18 years) who visited the emergency department of one tertiary hospital from January 2003 through December 2013. We collected data including their age, sex, reason for poisoning, components and dose of poison, results of treatment, and psychiatric diagnosis. RESULTS: During the study period, there were 436 cases of poisoning (male 47.2% (n=206); female 52.8% (n=230)). Subjects were classified into four groups (0–1 years, 2–5 years, 6–12 years, 13–18 years). The most common cause of poisoning in all age groups was accidental poisoning (72.9%), but intentional poisoning increased as age increased (p < 0.001). Moreover, females were more often subject to intentional poisoning than males (p < 0.001). The most common poisoning material was drugs (41.7%). Among intentional poisoning patients, 62.7% patients had consulted a psychiatrist, and their most common diagnosis was adjustment disorder (44.6%). CONCLUSION: The most common cause of poisoning in individuals aged 0–18 years was accidental poisoning, while intentional poisoning was most common among adolescents. Guardians should take care to prevent accidental poisoning, while psychiatric consultation and national moderation will be needed to prevent intentional poisoning.
Adjustment Disorders ; Adolescent* ; Child* ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Mental Disorders ; Poisoning* ; Psychiatry ; Retrospective Studies ; Tertiary Care Centers

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