Granular cell tumor is not uncommon and is a well recognized entity which may arise at virtually any site of the body. However, occurrence in the thyroid is extremely rare and has not been described well. Only three cases could be found in the English literatures. We report a case of granular cell tumor of the thyroid in a 30 year-old woman. The tumor was illdefined, infiltrative and was composed of diffuse sheets of polygonal to fusiform cells with abundant eosinophilic granular cytoplasm. The tumor showed evidence of Schwann cell differentiation in immunohistochemical and ultrastructural examinations. Differentiation from more common thyroid tumors having oncocytic granular cytoplasm should be made by immunohistochemistry or electron microscopy.
Adult ; Cell Differentiation ; Cytoplasm ; Eosinophils ; Female ; Granular Cell Tumor* ; Humans ; Immunohistochemistry ; Microscopy, Electron ; Thyroid Gland*

Alpha-fetoprotein (AFP) is a well-known tumor marker for hepatocellular carcinoma, hepatoblastoma, and yolk sac tumors. There are several studies on AFP-producing tumors that arose from the gastrointestinal tract, pancreas, lung, kidney, and urachal tract. AFP-producing carcinoma of the gallbladder is extremely rare. We report a case of AFP-producing carcinoma of the gallbladder without liver involvement in a 58-year-old man with a gallstone, on which clinical, morphologic, and immunohistochemical studies were performed.
Male ; Humans ; Carcinoma, Hepatocellular ; Tumor Markers, Biological

Changes in plasma level of arginine vasopressin (AVP), arterial pressure, and urine flow were studied before, during and after cardiopulmonary bypass (CPB) in 11 patients with congenital heart disease. Anesthesia was induced with thiopental sodium (3-5 mg/kg) and was maintained with enflurane (1.0-1.5%), 50% N2O in O2 and morphine (0.5 mg/kg). Concentration of plasma AVP increased slightly from 3.8 +/- 1.5 pg/ml after induction and increased 3-fold after sternotomy. Plasma AVP level increased to 132 +/- 26 pg/ml and 218 +/- 54 pg/ml after 5 and 60 min on CPB, respectively. When the circulation returned to normal, plasma AVP level decreased gradually but was still significantly higher at 24 hr (13.4 +/- 2.5 pg/ml). Marked osmolar diuresis was induced with mannitol in the priming solution used during the CPB: increases in urine flow, Na excretion and osmolar clearance. Possible mechanisms of marked increase in AVP release and differences of AVP responses during CPB reported by other investigators are discussed.
Adolescent ; Adult ; Arginine Vasopressin/*blood/pharmacokinetics ; Blood Pressure ; *Cardiopulmonary Bypass ; Child ; Child, Preschool ; *Enflurane ; Heart Defects, Congenital/surgery ; Humans ; *Morphine ; Osmolar Concentration

BACKGROUND: Recruitment and development of multiple follicles in response to gonadotropin stimulation are the key factors leading to successful treatment by assisted reproductive technologies. Prediction of ovarian responses prior to stimulation is useful in counselling and helpful in adjusting the dosage of gonadotropin to individual patients. OBJECTIVE: To evaluate the number of antral follicles of both ovaries as a predictor of outcome of assisted reproductive technologies. METHODS: Data were collected by a retrospective analysis. A total of 56 consecutive infertile women were undergoing the first cycle using a standard regimen of ovarian stimulation from July, 2000 to June, 2001. Basal FSH, LH, prolactin, and estradiol concentration were measured. The number of follicles (2-5 mm) were recorded. RESULTS: In women with fewer antral follicles, the number of retrieved eggs was significantly decreased and increased the duration and dosage of human menopausal gonadotropin, but pregnancy rate was similar to those with a higher number of antral follicles. CONCLUSION: It is suggested that the total antral follicle number is sensitive ultrasound parameter in predicting the ovarian response.
Eggs ; Estradiol ; Female ; Gonadotropins ; Humans ; Ovary ; Ovulation Induction ; Ovum ; Pregnancy Rate ; Prolactin ; Reproductive Techniques, Assisted* ; Retrospective Studies ; Ultrasonography

Thioredoxin reductase (TrxR), a component of the thioredoxin system, including thioredoxin (Trx) and NADPH, catalyzes the transfer of electrons from NADPH to Trx, acts as a reductant of disulfide-containing proteins and participates in the defense system against oxidative stresses. In this study, the regulation pattern of TrxR in the presence of various stressful reagents was compared between Chang (human normal hepatic cell) and HepG2 (human hepatoma cell) cell lines. Aluminum chloride (0.5 mM) and zinc chloride (0.5 mM) enhanced the TrxR activity in the Chang cell line to a higher degree than in the HepG2 cell line, but cupric chloride (0.2 mM) and cadmium chloride (0.1 mM) enhanced the TrxR activity in the HepG2 cell line to a greater degree. The TrxR activities in both Chang and HepG2 cell lines were similarly induced by treatment with sodium selenite (0.02 mM) and menadione (0.5 and 1.0 mM). Lipopolysaccharide (2microgram/m1) increased the TrxR activity upto 4.02- and 2.2-fold in the Chang and HepG2 cell lines, respectively, in time-dependent manners. Hydrogen peroxide (5 mM) markedly enhanced the TrxR activity in the HepG2 cell line, but not in the Chang cell line. NO-generating sodium nitroprusside (3.0 and 6.0 mM) induced TrxR activities in both human liver cell lines. The TrxR activity was also induced in human liver cells under limited growth conditions by serum deprivation. These results imply that the TrxR activities in normal hepatic and hepatoma cell lines are subject to different regulatory responses to various stresses.
Cell Line, Tumor ; Comparative Study ; Hepatocytes/cytology/*enzymology ; Human ; Oxidative Stress/*physiology ; Support, Non-U.S. Gov't ; Thioredoxin Reductase (NADPH) /*metabolism

Early diagnosis of childhood cancer is very important for the prognosis. Ultrasonography of routine examination for pregnant woman is now a popular method. We experienced two cases of congenital Wilms tumor suspected by prenatal ultrasonography from mothers and confirmed by nephrectomy soon after birth. One of the cases was stage II with favorable histology and was treated with vincristine(2.0 mg/m2) and actinomycin D(45 microgram/kg) for 60 weeks by National Wilms Tumor Study(NWTS) IV treatment protocol, K-4 A regimen. The other was stage I with favorable histology and was treated with vincristine(1.5 mg/m2) and actinomycin D(15 microgram/kg) for 24 weeks by NWTS IV, EE regimen. The post-chemotherapy follow-up evaluation of these two children for 3 years and 2 months and 1 year and 7 months respectively were quite normal with 100% of Karnovsky scores. Early diagnosis, especially in prenatal, is very important for the prognosis of childhood cancer. Routine ultrasonographic examination in pregnant women is also desirable for the detection of solid tumor of fetus if it does not harmful for the fetus.
Child ; Clinical Protocols ; Dactinomycin ; Early Diagnosis ; Female ; Fetus ; Follow-Up Studies ; Humans ; Mothers ; Nephrectomy ; Parturition ; Pregnant Women ; Prenatal Diagnosis* ; Prognosis ; Ultrasonography ; Ultrasonography, Prenatal ; Wilms Tumor*

BACKGROUND AND OBJECTIVES: We investigated the expression of glucose uptake transporter-1 (GLUT-1) and epidermal growth factor receptor (EGFR) in the head and neck squamous cell cancer (HNSCC) and their influence on survival rate. We also aimed to demonstrate the relationships between the expressions of GLUT-1 and EGFR and the maximal standardized uptake values (mSUV) of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET). SUBJECTS AND METHOD: Surgical specimens from 50 patients with HNSCC, who had undergone surgical intervention, were first processed for tissue array and then for immunochemistry for GLUT-1 and EGFR. Expressions of GLUT-1 and EGFR were analyzed according to the differentiation of tumor, T&N stage and invasiveness of the tumor etc. The relationship between PET-mSUV and the expressions of EGFR and GLUT-1 was evaluated as well as its possibility as a prognostic factor of SUV. RESULTS: The expression of EGFR was significantly high in the lymph node of the positive group. Associated with the expression of GLUT-1, a tendency of increased index score (IS) values in the advanced T stages was observed but it was not statistically significant. The mSUV in FDG-PET showed statistically significant association with the maximal tumor size (pearson correlation 0.569, p=0.023); however, no association with GLUT-1 and EGFR was observed. A universal strong expression of GLUT-1 could have made it difficult to figure out statistically significant correlations. Disease free survival was to be influenced by T stage, moderate and poor differentiation and GLUT-1 expression. Only the T stages had independent significance in the multivariate analysis using the Cox regression model. CONCLUSION: We found that the expression of GLUT-1 could not show statistically significant correlation with PET-mSUV. Since the expression of EGFR has significant correlation with lymph node metastasis, EGFR may have the possibility of being a target for anticancer molecular therapy.
Carcinoma, Squamous Cell ; Collodion ; Disease-Free Survival ; Glucose ; Head ; Humans ; Immunochemistry ; Lymph Nodes ; Multivariate Analysis ; Neck ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Positron-Emission Tomography ; Receptor, Epidermal Growth Factor ; Survival Rate

BACKGROUND: Both human leukocyte antigen (HLA) class I and programmed death-ligand 1 (PD-L1) molecules are known to play important roles in cancer immunity. In this study, we evaluated HLA class I expression in resected adenocarcinoma of the lung, and investigated its prognostic impact in correlation with PD-L1 expression. METHODS: HLA class I and PD-L1 expression was evaluated by immunohistochemistry in a total of 403 resected lung adenocarcinomas using tissue microarray. Correlations between the expression of HLA class I/PD-L1 and clinicopathologic features and prognostic significance were analyzed. RESULTS: HLA class I expression was reduced in 91.6% of adenocarcinoma, and more frequently reduced in patients with younger age, absence of vascular invasion, and low pathologic stage (p = .033, p = .007, and p = .012, respectively). Positive PD-L1 expression in tumor cells was 16.1% (1% cut-off), and associated with poor differentiation, presence of vascular invasion and nodal metastasis (p < .001, p = .002, and p = .032, respectively). On survival analysis, HLA class I or PD-L1 expression alone did not show any statistical significance. On the integrated analysis, HLA class I (+)/PD-L1 (+) subgroup showed a significantly shorter overall survival than other groups (p = .001). Multivariate analysis revealed that coexpression of HLA class I and PD-L1 was an independent poor prognostic factor of lung adenocarcinoma. (p < .001; hazard ratio, 6.106; 95% confidence interval, 2.260 to 16.501). CONCLUSIONS: Lung adenocarcinoma with coexpression of HLA class I and PD-L1 was associated with poor prognosis. This subgroup may evade immune attack by expressing PD-L1 protein despite HLA expression.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Humans ; Immunohistochemistry ; Leukocytes ; Lung ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis

BACKGROUND/AIMS: Paraquat is a potentially lethal herbicide that induces acute renal failure, hepatic dysfunction, and progressive respiratory failure. This study examined the usefulness of hemoperfusion in paraquat poisoning. METHODS: We reviewed the medical records of 27 patients who underwent hemoperfusion after paraquat poisoning at Eumseong Keumwang Hospital from January 2009 to January 2010. RESULTS: All 27 paraquat-poisoning patients underwent hemoperfusion therapy within 6 hours of ingestion, and 13 patients survived. Patients who had ingested more than four mouthfuls died with 24 hours despite hemoperfusion. The mean arrival time at the emergency room and the plasma paraquat concentration in the survivors was 3.08 hours and 1.30 microg/mL, respectively; after hemoperfusion, the mean elapsed time was 8.92 hours and the plasma paraquat level was 0.14 microg/mL. The mean arrival time at the emergency room and plasma paraquat concentration in the non-survivors was 2.93 hours and 50.52 microg/mL, respectively; after hemoperfusion, the mean elapsed time was 9.36 hours, and the plasma paraquat level was 40.52 microg/mL. CONCLUSIONS: Urgent hemoperfusion therapy is essential for complete recovery from paraquat poisoning in patients who do not have metabolic acidosis or renal failure. However, hemoperfusion is not effective in those who ingested large amount of paraquat or have a urine dithionite of 4+, metabolic acidosis, or acute renal failure.
Acidosis ; Acute Kidney Injury ; Dithionite ; Eating ; Emergencies ; Hemoperfusion ; Humans ; Medical Records ; Mouth ; Paraquat ; Plasma ; Renal Insufficiency ; Respiratory Insufficiency ; Survivors