Authors experienced a rare adenocarcinoma arising in presacral sacrococcygeal teratoma in a adult and herein reported. The patient was a 52 year old female admitted because of lower abdominal pain for 5 to 6 months. Past and familial history were unremarkable. On rectal examination a mass was palpated 3 cm above the anal verge. The large bowel was displaced by an extrinsic mass but there was no evidence of intrinsic tumor lesion on barium enema, CT was done and showed a large presacral tumor attached to the sacrum. Clinical impression was sacrococcygeal teratoma. Resected tumor mass was a relatively well circumscribed cystic mass, measuring 11 x 11 cm and the cystic content was previously evacuated. Inner surface showed ragged appearance, and focal nodular solid area was noted. On microscopic examination, the tumor revealed the derivatives of three germ layers and main components were tissues of respiratory tract. Sections from the solid area showed a well differentiated adenocarcinoma and with stromal, capsular and perineural invasion. Borderline malignant epithelial lesions are also noted suggesting the pathogenesis and progression of this tumor. There was no recurrence for one year after surgery in the follow up.
Adult ; Male ; Female ; Humans ; Adenocarcinoma

Herein reported were three cases of papillary eccrine adenoma also called as tubular apocrine adenoma, characterized by dilated ducts containing eosinophilic secretion or kerain and intraluminal papillations. Case 1. A 23 year old male had a well defined erythematous nodule, measuring 1x1 cm. On the ankle of right leg over ten years. Clinical impression was dermatofibroma. Microscopic features were those of papillary ecrine adenoma. Case 2. A 53 year old female had a well demarcated dermal nodule, measuring 1.5x1 cm. On the buttock. Cut surface exhibited relatively well circumscribed tumor with yellowish brown color, Microscopic features were those of papillary eccrine adenoma with alcian blue positive materials in their lumens. Case 3. A 22 year old female had a showly growing hard painless small bean sized nodule at the metatarsal head area of right sole, measuring 2.3x1.8x0.7 cm. Clinical impression was calcinosis cutis. Microscopic features were those of papillary eccrine adenoma with foreign body granuloma and dystrophic calcification.
Female ; Male ; Humans ; Adenoma

Medulloepithelioma(diktyoma) is a uncommon congenital tumor that is generally believed to arise from the embryonic neuroepithelium of the medullary tube. This tumor usually arises from the ciliary body epithelium. But medulloepitheliomas of the retina and optic nerve may also occur, although it is extremely rare, because the embryonal medullary epithelium that lines the optic vesicle is continuous with the epithelium lining the cavity of the optic nerve during the early embryonal period. The occurrence of medulloepithelioma of the optic nerve is exceptionally rare, with only a few cases have been previously reported. We report a first case of medulloep-ithelioma of the optic nerve head in Korea in a 5-year-old girl who presented with a poor vision and squint of the left eye.
Child, Preschool ; Ciliary Body ; Epithelium ; Female ; Humans ; Korea ; Neuroectodermal Tumors, Primitive* ; Optic Disk* ; Optic Nerve* ; Retina ; Strabismus

BACKGROUND: Use of corticosteroid appears to increase the risk of upper gastrosintestinal side effects associated with NSAIDs. But, there is no study for the effects of these drugs to NSAID induced small intestinal damage. Therefore, we examed the effects of corticosteroid to NSAID induced enteropathy and bacterial translocation. METHODS: Rat received no drug, NSAID alone (diclofenac 80 mg/kg per os), corticosteroid alone (dexamethasone 5 mg/kg intraperitoneal, 2 times) or NSAID with corticosteroid. Amounts of food intakes, body weight, intestinal permeability, enteric aerobic bacterial counts in small and large intestine, serum biochemical profiles, and pathologic findings of ileum were measured. Cultures of the mesenteric lymph nodes, as well as liver, spleen and systemic blood were taken. RESULTS: Diclofenac or dexamethasone alone administration caused gut barrier damage, enteric bacterial overgrowth and increased bacterial translocation. The supplements with dexamethasone increased NSAID induced gut barrier damage, villous atrophy, enteric bacterial overgrowth and bacterial translocation to mesenteric lymph nodes, liver, spleen and systemic blood. Also, these increased diclofenac induced body weight loss, but not hypoproteinemia. CONCLUSION: Corticosteroid increase NSAID induced body weight loss, gut barrier dysfunction, villous atrophy, enteric bacterial overgrowth and bacterial translocation in experimental animals.
Animals ; Anti-Inflammatory Agents, Non-Steroidal ; Atrophy ; Bacterial Load ; Bacterial Translocation* ; Body Weight ; Dexamethasone ; Diclofenac ; Hypoproteinemia ; Ileum ; Intestine, Large ; Intestine, Small ; Liver ; Lymph Nodes ; Permeability ; Rats* ; Spleen

OBJECTIVE: The purpose of this study was to investigate the efficacy and tolerability of atypical antipsychotics (AAPs) with augmentation by blonanserin in schizophrenic patients. METHODS: aA total of 100 patients with schizophrenia who were partially or completely unresponsive to treatment with an AAP were recruited in this 12-week, open-label, non-comparative, multicenter study. Blonanserin was added to their existing AAP regimen, which was maintained during the study period. Efficacy was primarily evaluated using the Positive and Negative Syndrome Scale (PANSS) at baseline and at weeks 2, 4, 8, and 12. Predictors for PANSS response (≥20% reduction) were investigated. RESULTS: The PANSS total score was significantly decreased at 12 weeks of blonanserin augmentation (-21.0±18.1, F=105.849, p<0.001). Moreover, 51.0% of participants experienced a response at week 12. Premature discontinuation of blonanserin occurred in 17 patients (17.0%); 4 of these patients dropped out due to adverse events. The patients who benefited the most from blonanserin were those with severe symptoms despite a treatment with a higher dose of AAP. CONCLUSION: Blonanserin augmentation could be an effective strategy for patients with schizophrenia who were partially or completely unresponsive to treatment with an AAP.
Antipsychotic Agents* ; Humans ; Prospective Studies* ; Schizophrenia

BACKGROUND: There have been many in vitro evidences that interleukin-4(IL-4) might be the most important cytokine inducing IgE synthesis from B-cells, and interferon-gamma(IFN-gamma) might be a main cytokine antagonizing IL-4-mediated IgE synthesis. Recently some reports demonstrated that IFN-gamma might be used as a new therapeutic modality in some allergic diseases with high serum IgE level, such as atopic dermatitis or bronchial asthma. To evaluate the in vivo, effect of IFN-gamma in bronchial asthma we tried a clinical study. METHODS: Fifty bronchial asthmatics(serum, IgE level over 200 IU/ml) who did not respond to inhaled or systemic corticosteroid treatment, and 17 healthy nonsmoking volunteers were included in this study. The CD 23 expressions of peripheral B-cells, the IL-4 activities of peripheral T-cells, the serum soluble CD23(sCD23) levels, and the superoxide anton(O2-) generations by peripheral PMN were compared between bronchial asthmatics and normal subjects. The IL-4 activities of peripheral T-cells were analyzed by T-cell supernatant (T-sup)-induced CD23 expression from tonsil B-cells. In bronchial asthmatics the serum IgE levels and histamine PC. in addition to the above parameters were also compared before and after IFN-gamma treatment. IFN-gamma was administered subcutaneously with a weekly dose of 30,000 IU per kilogram of body weight for 4 weeks. RESULTS: The O2-, generations by peripheral PMNs in bronchial asthmatics were higher than normal subjects(8.23+/-0.94 vs 5.00+/-0.68 nmol/l x10(6) cells, P<0.05), and significantly decreased after IFN-gamma treatment compared to initial values(3.69+/-0.88 vs 8.61 +/- 1.53 nmol/l x 106 cells, P<0.05). CD23 expression of peripheral B-cells in bronchial asthmatics was higher than normal subjects(47.47 +/- 2.96% vs 31.62+/-1.92%, P<0.05), but showed no significant change after IFN-gammatreatment. The serum sCD23 levels in bronchial asthmatics were slightly higher than normal subjects( 191.04+/-23.3 U/ml vs 162.85+/-4.85 U/ml). and 11(64.7%) of 17 patients showed a decreasing pattern in their serum sCD23 levels after IFN-gamma treatment. However the means of serum sCD23 levels were not different before and after IFN-gamma treatment The IL-4 activities of peripheral T-cells in bronchial asthmatics were slightly higher than normal subjects 22.48 +/-6.81% vs 18.90+/-2.43%), and slightly increased after IFN-gamma treatment(27.90+/-2.56%). Nine(60%) of 15 patients showed a decreasing pattern in their serum IgE levels after IFN-gamma treatment. And the levels of serum IgE were significantly decreased after LEN-y treatment compared to initial values (658.67 +/- 120.84 IU/ml vs 1394.32 +/- 31442 IU/ml, P<0.05). Ten(83.3%) of 12 patients showed an improving pattern in bronchial hyperresponsiveness after IFN-gamma treatment, and the means of histamine PC20 were significantly increased after IFN-gamma treatment compared to initial values (1.22+/-0.29mg/ml vs 0.69+/-0.17mg/ml P<0.05). CONCLUSION: Our results suggest that IFN-gamma may k useful as well as safety in the treatment of bronchial asthmatics with high serum IgE level and that in vivo effects of IFN-gamma may be different from its in vitro effects on the regulations of IgE synthesis or the respiratory burst of PMN.
Asthma* ; B-Lymphocytes ; Body Weight ; Dermatitis, Atopic ; Family Characteristics ; Histamine ; Humans ; Immunoglobulin E ; Interferon-gamma* ; Interleukin-4 ; Palatine Tonsil ; Respiratory Burst ; Social Control, Formal ; Superoxides ; T-Lymphocytes ; Volunteers

Tamoxifen is widely used for the treatment of breast cancer and currently proposed for preventive strategies. However. there is evidence that tamoxifen may affect other hormone sensitive organs, such as uterus and ovary. It has been documented that tamoxifen treatment is associated with development of endometrial polyp, endometrial hyperplasia, ovarian and endometrial cancer. Uterine malignant mixed mullerian tumor is a neoplasm which apparently arises from undifferentiated mullerian stroma and is composed of a mixture of malignant epithelial and stromal component. We report a case of malignant mixed mullerian tumor of uterus which was developed in a patient treated with tamoxifen for 5 years following a modified radical mastectomy due to breast cancer.
Breast Neoplasms* ; Breast* ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Female ; Humans ; Mastectomy, Modified Radical ; Ovary ; Polyps ; Tamoxifen* ; Uterus*

Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class Ⅲ malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

Background: The purpose of this retrospective study was to evaluate the postoperative change in the position and stability of the mandibular condyle after bilateral sagittal split ramus osteotomy (BSSRO) and BSSRO with distal segmental ostectomy (DSO) in patients with facial asymmetry using 3D computed tomography. Methods: The condyles of the patient diagnosed with facial asymmetry were divided into the deviated side (DS) and the non-deviated side (NDS). Group I, which was treated with BSSRO only, and Group II, which additionally received DSO along with BSSRO, were superimposed on the condyle using the pre-and postoperative 3D CT. The amount of condylar change in anteroposterior displacement, mediolateral displacement, and rotation was measured. The clinical symptoms of temporomandibular joint were also evaluated before and after surgery for each patient. Results: Between Groups I and II, there was no statistically significant difference in the anteroposterior condylar position on both DS and NDS.And also, there was no statistical difference between the two groups in the mediolateral change on DS but, statistically significant difference on NDS. The change in the rotation of the condyle was observed to rotate inward from both condylar heads of Groups I and II, and a statistically significant difference was observed between the two groups on both DS and NDS. Moreover, no difference in clinical temporomandibular joint symptoms was observed after surgery in each DS and NDS condyle of the two groups. Conclusions As a result of analyzing the condylar position change of the group treated with BSSRO alone and the group treated with BSSRO and DSO in patients with facial asymmetry, there were statistically significant differences in the mediolateral displacement of NDS and the condyle rotation of NDS and DS. However, the anteroposterior condylar position did not show any difference in the bilateral condyles. In addition, since worsening clinical symptoms of bilateral temporomandibular joint were not observed before and after surgery in both groups, it is concluded that it is not necessary to accompany DSO in patients with facial asymmetry (minimum 3 mm, maximum 7 mm).

PURPOSE: Few studies have examined acute prostatitis in Korea. To initiate the investigation of this topic, a multi-center retrospective analysis of acute prostatitis was conducted. MATERIALS AND METHODS: The clinical records of 335 patients from 13 hospitals, diagnosed with acute prostatitis, between January of 1994 and October of 2004, were reviewed. For each patient, the urine culture, changes in the PSA (prostate-specific antigen) value and the prostate volume, the incidence of prostate abscess, the use of antibiotics, and whether the disease went into remission or progressed to chronic prostatitis were analyzed. RESULTS: The mean age of the patients, time from the onset of symptom to admission and number of days of admitted were 54.9+/-15.1 (16-85) years, 2.4+/-3.4 (16-85) days and 7.5+/-3.9 (1-25) days, respectively. The chief symptoms of the patients were high fever, dysuria and urinary frequency. Routine urinalysis found pyuria in 82% and hematuria in 70% of patients. The causative organisms of 43.0% of the patients were cultured, with the chief organisms found to be E. coli (67%) and P. aeruginosa (13%), et al. The mean PSA and prostate volume on initial diagnosis were 24.6+/-30.2ng/ml and 45.8 +/-17.4ml, respectively, and a prostate abscess was found in 4 patients (3.1%). The antibiotics injected during patient admission were: cephalosporin family (68%), aminoglycosides (70%) and quinolone family (43%). An additional alpha blocker was used in 49% of cases. Oral quinolone (91%), cephalosporin (9%) and alpha blocker (44%) were prescribed for a mean 32.5 (2-180) days after discharge. 259 (77%) of the patients were available for follow-up. Of these, 21% took antibiotics over an 8 week treatment period, and 8% over a 12 week period. The disappearance of pyuria after treatment was observed in a mean of 13 days after the end of treatment. After 13 weeks of treatment, 11 (50%) of the 22 patients who received prostate massage (4.2% of all follow up patients) were found to have chronic prostatitis. The mean PSA and prostate volume declined during follow up, to 6.13+/-10.38ng/ml and 37.5+/-13.5ml, respectively. CONCLUSIONS: In our study, the most common chief symptom of acute prostatitis was a high fever, with the most common causative organism being E. coli. Patients were admitted for approximately one week, and treated with antibiotic for about one month, after which time PSA elevation was observed in 80% of patients. Although all acute prostatitis patients were treated with proper antibiotics, progression to chronic prostatitis was observed in 4.2% of patients.
Abscess ; Aminoglycosides ; Anti-Bacterial Agents ; Diagnosis ; Dysuria ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Incidence ; Korea ; Massage ; Patient Admission ; Prostate ; Prostate-Specific Antigen ; Prostatitis* ; Pyuria ; Retrospective Studies ; Urinalysis