Primary malignant lymphomas of bladder are very rare and most of them are secondary neoplasm occurring by direct extension or by metastatic spread. We report a case of malignant lymphoma showing gross involvement of bladder arising from the terminal ileum with a brief review of literature.
Ileum ; Lymphoma* ; Urinary Bladder*

Isolated ACTH deficiency is a rare cause of secondary adrenocortical insufficiency caused by the defect of synthesis or release of ACTH in pituitary gland. The clinical presentation can be simiilar to that of primary adrenal insufficiency, but there is a greater tendency for hypoglycemia and absence of hyperpigmentation. The patient, 80 year-old female, was admitted in chief complaint of deteriorated mental states. On admission, serum sodium was 127mEq/L, potassium 4.4mEq/L, blood glucose 27mg/dL and on routine E.C.G. was atrial fibrillation was revealed. The basal morning serum cortisol level was 9.97 pg/dL it dosent respond to insulin-induced hypoglycemia enoughly, but other pituitary functions were intact in pituitary cocktail stimulation test. In CRH stimulation test, there was no remarkable response in serum ACTH and cortisol level. Brain MRI failed to reveal any anatomic abnormalities of the sellar or suprasellar area consistent with the defect of pituitary ACTH secretion. This case was a isolated ACTH deficiency, So, we conclude that associated with atrail fibrillation and hypoglycemia.
Addison Disease ; Adrenocorticotropic Hormone* ; Aged, 80 and over ; Atrial Fibrillation* ; Blood Glucose ; Brain ; Female ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hypoglycemia* ; Magnetic Resonance Imaging ; Pituitary Gland ; Potassium ; Sodium

Acute scrotum can occur as a complication of various procedures, such as open, laparoscopic surgeries or diagnostic procedures. We present an unusual case of acute hemiscrotum due to inadvertent gallbladder injury following an ultrasound-guided liver biopsy
Biopsy ; Biopsy, Needle ; Gallbladder ; Laparoscopy ; Liver ; Scrotum ; Testicular Hydrocele

OBJECTIVE: Because of the limited penetration into the central nervous system after systemic administration of numerous therapeutic compounds, intratumoral chemotherapy for brain tumors has also been used. However, the efficacy of intratumoral drug administration is restricted by the poor diffusion of drug through tumor and brain interstitium. In order to enhance the diffusion of chemotherapeutic agent and increase the cytotoxicity with minimal dose, the authors report the results of convection-enhanced delivery(CED) of chemotherapeutic agent to the malignant brain tumor as a method of enhancing cerebral drug delivery. METHODS: Authors used "CADD-Micro(R) ambulatory infusion pump" from Deltec, which can be programmed for continuous infusion. Intratumoral injection of chemotherapeutic drug using the pump was applied to eight patients with glioma and one patient with lymphoma. Surgery was done and tumor was removed as much as possible. The tip of catheter was placed in the center of tumor cavity. Adriamycin (0.16~0.32mg) was put in the reservoir which was connected to the proximal catheter and fixed in the pump device. Twenty-four hours after surgery, Adriamycin was infused. RESULTS: There was no adverse reaction of CED technique. Compared with current delivery techniques, the improvement of survival rate has been observed(5 patients: alive, 3 patients: dead, 1 patient: lost(alive to 5 mo.)). CONCLUSION: CED can be useful method for distributing therapeutic molecules in the interstitial space of tumor and can be utilized for chemotherapeutic agents, immunotoxins, and gene etc..
Brain ; Brain Neoplasms ; Catheters ; Central Nervous System ; Diffusion ; Doxorubicin ; Drug Therapy ; Glioma ; Humans ; Immunotoxins ; Lymphoma ; Survival Rate

The goal of this study was to examine the characteristics of the histo- immunological changes following induction of autoimmune prostatic inflammation achieved by subcutaneous allograft injection of the tissue homogenate of mouse ventral prostate. We also investigated the effect of the administration of androgen upon the development of mouse autoimmune prostatitis. Eight week old male C57BL/6 mice were selected and the presence, location and the degree of inflammation were identified after injection. The extent of infiltrations of the inflammatory cells in the prostate following the administration of the exogenous testosterone, the variation of the CD4/CD8 ratio of splenic lymphocyte and the variations of the interleukin-2 and tumor necrosis factor-alpha secreted by the splenic cells were also examined. The autoimmune prostatitis of the mouse induced by subcutaneous allograft injection of the mouse ventral prostate showed histological findings similar to that of human. The degree of induction was in proportion to the amount of tissues injected and showed organ-specificity. Exogenous administration of testosterone resulted in partial inhibitory effect on the induction of inflammation which was thought to be related to the decrease in the CD8+ T lymphocyte count and the functional inhibitory effect of the splenic T lymphocyte on the production of Interleukin- 2. However, tumor necrosis factor-alpha is presumed to be not closely related to the inhibitory effect of the administration of testosterone. In the future, further studies on the variation of cytokine levels and the value of sex hormones within the prostate and, moreover investigations in related to the humoral immune mechanism should be encouraged.
Allografts ; Animals ; Gonadal Steroid Hormones ; Humans ; Inflammation ; Interleukin-2 ; Lymphocyte Count ; Lymphocytes ; Male ; Mice* ; Prostate ; Prostatitis* ; Testosterone* ; Tumor Necrosis Factor-alpha

PURPOSE: This study aimed to examine the outcomes of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastasis (PM) of advanced gastric cancer (AGC). MATERIALS AND METHODS: Between May 2015 and June 2017, 38 CRS and HIPEC procedures were performed in patients with PM of AGC at the Dankook University Hospital. We prospectively collected and analyzed data regarding PM grade, morbidity and mortality rates, and short-term follow-up results (median, 13.5 months). RESULTS: The mean peritoneal cancer index was 15 (range, 0–39). Complete cytoreduction was achieved in 21 patients (55.2%), whereas complications occurred in 16 (42.1%) and 2 (5.7%) patients died. The overall median patient survival time was 19 months. The patients who underwent complete cytoreduction had a median survival time of 26 months, which was significantly longer than the median survival time of 16 months in the patients who did not undergo complete cytoreduction (P=0.006). CONCLUSIONS: CRS with HIPEC may have a beneficial effect in patients with PM of AGC. However, the rates of complications and mortality associated with this combined therapeutic approach are high. Therefore, this treatment should be performed only in selected patients by surgeons experienced in the field of gastric cancer with PM.
Drug Therapy* ; Follow-Up Studies ; Humans ; Mortality ; Neoplasm Metastasis* ; Prospective Studies ; Stomach Neoplasms* ; Surgeons

PURPOSE: We investigated the relationship of prostate volume with metabolic and anthropometric parameters in men who visited a health promotion center. MATERIALS AND METHODS: From January 2004 to July 2007, among 16,236 men between 30 to 69 years old who visited our health promotion center for a general check-up, 1,033 men(6.4%) agreed to have their prostate evaluation included in this study. They underwent anthropometric measurements, basic laboratory tests, and transrectal ultrasonography. We evaluated the relationship of prostate volume with metabolic and anthropometric factors. RESULTS: In bivariate analysis, prostate volume positively correlated with height, weight, body mass index(BMI), body surface area(BSA), serum prostate-specific antigen(PSA), triglyceride, and blood pressure, and negatively correlated with high-density lipoprotein cholesterol(HDL-C). In multivariate analysis, age, BSA, serum PSA and HDL-C significantly correlated with prostate volume, whereas BMI did not(p=0.765). Prostate volume in patients with metabolic syndrome(28.0ml) was significantly larger than those without(25.4ml), but there was no difference in PSA (p=0.976). CONCLUSIONS: Because height positively correlated with prostate volume (p=0.010), BSA(calculated as height(0.725)xweight(0.425)x0.007184) but not BMI (as: weight/height2) correlated with prostate volume in multivariate analysis. Metabolic syndrome increased prostate volume.
Blood Pressure ; Body Mass Index ; Body Surface Area ; Body Weight ; Health Promotion ; Humans ; Lipoproteins ; Male ; Metabolic Syndrome X ; Multivariate Analysis ; Prostate ; Prostatic Hyperplasia

PURPOSE: In spite of its high sensitivity, the D-dimer test has a limited role in diagnosis of pulmonary thromboembolism (PTE) due to its low specificity. This study was designed to evaluate the diagnostic accuracy of an index for PTE with addition of C-reactive protein (CRP) in patients showing increased D-dimer level. METHODS: We carried out a retrospective study in a tertiary emergency department and enrolled patients who did blood sampling for D-dimer and CRP at the same time among patients suspected of PTE between December 2000 and October 2008. PTE was confirmed by imaging studies, chest computed tomography and angiography. We analyzed D-dimer and CRP levels and correlated them with PTE. RESULTS: A total of 362 patients were enrolled; 67 had PTE. Areas under the curve (AUC) of the Receiver Operating Characteristic (ROC) curve of D-dimer for PTE were smaller than those for a relative increase in the ratio of D-dimer to CRP (RDDCRP). CONCLUSION: The diagnostic accuracy of D-dimer for PTE can be increased by normalizing D-dimer levels to CRP levels.
Angiography ; C-Reactive Protein ; Emergencies ; Fibrin Fibrinogen Degradation Products ; Humans ; Pulmonary Embolism ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Thorax

Nasopharyngeal teratomas are rare congenital tumors which mainly cause neonatal respiratory difficulty or feeding problems. We report an extremely rare case of nasopharyngeal teratoma in which a 34-year-old woman experienced a foreign body sensation. Simple radiographs and CT scans revealed the presence of an exophytically growing mass with a region of fatty attenuation and a well-formed tooth in the nasopharyngeal wall. The mass was surgically removed, and found at histopathology to be a mature teratoma.
Adult* ; Female ; Foreign Bodies ; Humans ; Sensation ; Teratoma* ; Tomography, X-Ray Computed ; Tooth

BACKGROUND AND OBJECTIVES: Analyzing the association between multiple SNPs and the disease outcomes will provide new insight into the disease's etiology. However, this presents an analytic difficulty due to the large number of SNPs and the complex relationships among them. We proposed using the mixed model approach to identify the significant multi-locus genotypes and the high-order gene-to-gene interactions. SUBJECTS AND METHODS: We described the mixed effects model and applied this approach to real world data. For the purpose of these analyses, we examine the association of four types of SNPs (AGT5, APOB, CETP3 and ACE6) with the lipid profiles and the measures related with cardiovascular disease. We used data from 672 healthy individuals (283 males and 389 females) who were without cardiovascular diseases. RESULTS: The results of our analysis suggested that there were significant random genotype patterns and genotype groups according to the gender effect on the lipid profiles. In other words, there was significant variability across the genotype groups because of the effect of gender on the lipid profiles. CONCLUSION: The mixed model approach provided a flexible statistical framework for controlling potential confounding variables and for identifying a significant genetic contributions that may come about through the effects of multi-locus genotypes or through an interaction between the genotype and environmental variables (e.g. gender) with the variations in quantitative traits (e.g. lipid profiles). There were significant genetic contributions to the variability in the lipid profiles, and these were explained by the 4 SNPs described in our real data.
Apolipoproteins B ; Cardiovascular Diseases ; Confounding Factors (Epidemiology) ; Genotype ; Humans ; Male ; Polymorphism, Single Nucleotide