A case of malignant eccrine acrospiroma of the anterior chest wall is reported. This mass had been present for 20 years and during rescent 5 years it showed frequent ulceration and bleeding suggesting malignant transformation. Microscopically, several foci malignant transformation from preexisting benign eccrine acrospiroma are seen and in immunohistochemical staining, the tumor cells both benign and malignant portion, show positive reaction to cytokeratin.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are popular in general practice. Their adverse renal effects have been well documented. Common NSAID-related renal side effects range from dysfunctional renal hemodynamic responses, nephrotic syndrome, electrolyte disturbances, acute interstitial nephritis, chronic interstitial nephritis with papillary necrosis, and acute flank pain syndrome to acute renal failure. Decreased prostaglandin synthesis can lead to renal ischemia and hemodynamically related acute renal failure. Cases of acute renal failure syndrome accompanied by severe loin pain after anaerobic exercise (ALPE) or binge drinking have previously been reported in individuals taking NSAIDs. However, severe flank pain after high-dose NSAID treatment in the absence of other conditions (exercise or volume contraction) is rare. We report a case of a 51-year-old man who suffered from severe pain in both flanks after NSAID treatment. Computed tomography revealed hypodense lesions in both kidneys.
Acute Kidney Injury ; Anti-Inflammatory Agents, Non-Steroidal ; Binge Drinking ; Flank Pain ; General Practice ; Hemodynamics ; Humans ; Infarction ; Ischemia ; Kidney ; Middle Aged ; Necrosis ; Nephritis, Interstitial ; Nephrotic Syndrome

OBJECTIVE: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). METHODS: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary's Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim's Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. RESULTS: There was no significant difference in patients' age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients' mean age was 46.1+/-7.0 years (SPA-LAVH) and 45.5+/-6.3 years (MPA-LAVH). The mean operating time was 87.2+/-21.0 minutes (SPA-LAVH) and 83.3+/-20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4+/-139.7 g (SPA-LAVH) and 257.8+/-132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1+/-0.7 g/dL (SPA-LAVH) and 1.2+/-0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6+/-0.6 days [SPA-LAVH] and 3.3+/-0.7 days [MPA-LAVH], P<0.05). CONCLUSION: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.
Adenomyosis ; Blood Transfusion ; Female ; Fever ; Hemoglobins ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Incidence ; Leiomyoma ; Length of Stay ; Medical Records ; Urinary Tract

With the exception of choriocarcinoma, the central nervous system (CNS) is rarely associated with metastases from gynecological malignancy. Cerebral involvement in ovarian carcinoma is generally regarded as occurring in 1% of cases. Overall incidence of cerebellar metestases is 27% of CNS metastases. However higher rates have been reported following initial platinum-based chemotherapy. We experienced a cerebellar metastatic cancer patient treated with craniectomy and radiation therapy. So we report the case with a brief review of literature.
Central Nervous System ; Choriocarcinoma ; Drug Therapy ; Female ; Humans ; Incidence ; Neoplasm Metastasis* ; Pregnancy

Mixed ductal-endocrine carcinoma of the pancreas is composed of ductal and endocrine carcinoma components and each component makes up a significant proportion in the primary tumor as well as in the tumor of metastatic sites. Mixed ductal-endocrine pancreatic carcinoma is exceptionally rare and, to our knowledge, only five cases have been reported in the literature. Recently we experienced a case of mixed ductal-endocrine pancreatic carcinoma with regional lymph node and hepatic metastases in a 63-year-old woman. Here, we report a case of mixed ductal-endocrine pancreatic carcinoma with a review of the literature.
Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Pancreas*

OBJECTIVE: In an effort to develop a more effective therapeutic strategy for ovarian cancer, we examined whether the restoration of the wild-type p53 gene can enhance the therapeutic effect of chemotherapy. METHODS: In this study, Ov-ca-2774 cells, which are known to have p53 point mutation and cisplatin-resistance, were selected and currently used chemotherapeutic agents including cisplatin, carboplatin, paclitaxel, etoposide, topotecan, and doxorubicin were added concurrently or sequentially with adenovirus-mediated p53 gene transfer (Ad5CMV-p53). RESULTS: Transfer of the wild-type p53 cDNA gene into Ov-ca-2774 cells showed 55% cell killing in vitro at a multiplicity of infection (MOI) of 40. Although the combination of carboplatin or paclitaxel followed by p53 gene transfer with an interval of 48 h manifested no enhanced cell killing compared with cells infected with Ad5CMV-p53 alone, the other combinations of chemotherapeutic agents and p53 gene transfer resulted in 15% to 37% further cell killing (P<0.05). Furthermore, p53 gene transfer followed by doxorubicin with an interval of 24 h and concurrent combination of etoposide with p53 gene transfer showed significant difference in cell killing in contrast to the other combination strategies in the respective chemotherapeutic agent exposure groups (P<0.05). CONCLUSION: Our data demonstrated that combination of p53 gene transfer and chemotherapeutic agents had higher cell killing than either of these two modality alone.
Carboplatin ; Cisplatin ; DNA, Complementary ; Doxorubicin ; Drug Therapy* ; Etoposide ; Genes, p53 ; Homicide ; Humans* ; Ovarian Neoplasms* ; Paclitaxel ; Point Mutation ; Topotecan

A case of pancreatic pseudocysts and bloody pancreatic ascites as complications of chronic pancreatitis in eleven-year-old girl was reported. She was admitted to the pediatric ward with chief complaints of abdominal distension and bloody ascites. About nine months prior to admission, when she was stuck by a bicycle, she had sustained a blow on her abdomen. She has been apparently well until four months prior to admission, when she began to feel colidy and intermittent abdominal pain and her appetits became poor. About a week prior to admission, her mother noticed that the girl's abdomen was distended. One day prior to admission, bloody ascites was revealed by paracenteis at a local clinic. Clinical and laboratory pictures were observed for 3 months. Ascites amylase at preoperative state were 496~705 u/dl and 740~772 u/dl Protein in ascites was 2,390mg%~4,820mg%. On the fifty fifth hospital day, an exploratory laparotomy was performed. About 7,000cc of bloody ascites was drained. A 30 x 20cm sized pseudocyst with thin wall was found between stomach and transverse colon. The portion of disrupted pancreatic duct was drained with sump tube. Abdomen distension and pain was markedly relieved after operation. On the 60 th postoperative day, ultrasonography of abdomen revealed no cysts. So sump tube was removed. A brief review of the literature was done.
Abdomen ; Abdominal Pain ; Amylases ; Ascites* ; Colon, Transverse ; Female ; Humans ; Laparotomy ; Mothers ; Pancreatic Ducts ; Pancreatic Pseudocyst* ; Pancreatitis, Chronic* ; Stomach ; Ultrasonography

Hantavirus infection occuring during pregnancy is rarely progressing to adult respiratory distress syndrome (ARDS), which is accompanied by thrombocytopenia, leukocytosis, fever, oliguria, aggravation of bleeding, hematuria, lactacedemia. Pregnancy may have an unfavorable impact on the pathophysiologic characteristics of ARDS. The high oxygen demands of pregnancy are unable to be matched by oxygen delivery in ARDS and may predispose the patient to multiple organ failure, as well as fetal oxygen deprivation. We present the case with hantavirus pulmonary syndrome complicating pregnancy.
Fever ; Hantavirus Infections ; Hantavirus Pulmonary Syndrome* ; Hantavirus* ; Hematuria ; Hemorrhage ; Humans ; Leukocytosis ; Multiple Organ Failure ; Oliguria ; Oxygen ; Pregnancy* ; Respiratory Distress Syndrome, Adult ; Thrombocytopenia

Nonsteroidal anti-inflammatory drugs (NSAIDs) are popular in general practice. Their adverse renal effects have been well documented. Common NSAID-related renal side effects range from dysfunctional renal hemodynamic responses, nephrotic syndrome, electrolyte disturbances, acute interstitial nephritis, chronic interstitial nephritis with papillary necrosis, and acute flank pain syndrome to acute renal failure. Decreased prostaglandin synthesis can lead to renal ischemia and hemodynamically related acute renal failure. Cases of acute renal failure syndrome accompanied by severe loin pain after anaerobic exercise (ALPE) or binge drinking have previously been reported in individuals taking NSAIDs. However, severe flank pain after high-dose NSAID treatment in the absence of other conditions (exercise or volume contraction) is rare. We report a case of a 51-year-old man who suffered from severe pain in both flanks after NSAID treatment. Computed tomography revealed hypodense lesions in both kidneys.
Acute Kidney Injury ; Anti-Inflammatory Agents, Non-Steroidal ; Binge Drinking ; Flank Pain ; General Practice ; Hemodynamics ; Humans ; Infarction ; Ischemia ; Kidney ; Middle Aged ; Necrosis ; Nephritis, Interstitial ; Nephrotic Syndrome

OBJECTIVE: To report our experience with laparoscopically assisted vaginal hysterectomy (LAVH) and evaluate the advantages of LAVH. This is a retrospective study. METHODS: From Jan. 2001 to Aug. 2002, 204 LAVHs were performed at the Department of Obstetrics and Gynecology, Our Lady of Mercy Hospital, The Catholic University of Korea. We studied the results with regard to the age, parity, previous abdominal surgery, surgical indications, operation time, weight of uterus, change of hemoglobin, hospital stay, concomitant procedures, and complications. RESULTS: The mean age was 43.9+/-6.4 years. The mean parity was 2.1+/-1.3. Tubal ligation was most common previous abdominal surgery. As a surgical indication, leiomyoma (52.9%) and adenomyosis (33.3%) were more common indications than any other gynecological problem. The mean operation time was 85.7+/-22.4 minutes. The mean uterine weight was 206.2+/-103.7 g. The mean hemoglobin change was 1.2+/-0.7 g/dl. The mean hospital stay was 3.3+/-0.8 days. Unilateral salpingoophorectomy was most common operation as concomitant procedure. Surgical complication rate was 3.4%. CONCLUSION: LAVH is a safe and effective alternative to abdominal hysterectomy with advanced technologic development in laparoscopic instruments and skills.
Adenomyosis ; Female ; Gynecology ; Hysterectomy ; Hysterectomy, Vaginal* ; Korea ; Leiomyoma ; Length of Stay ; Obstetrics ; Parity ; Retrospective Studies ; Sterilization, Tubal ; Uterus