A variety of malignant neoplasms have been shown to induce neovascularization, and in some cases the degree of vascularization appears to correlate with an aggressive behavior and risk of metastasis. We compared the degree of vascularization in 11 benign and 33 cancerous lesions of the cervix. The microvessels were identified by immunohistochemistry using antibody to Factor VIII-related antigen in 44 hystrectomy specimens. Three highly vascularized microscopic fields were selected and counted the number of microvessels in 400 magnification. The proportion of the endothelial cell area was also quantified by using the CAS 200 image analysis system. All 33 cases of carcinomas demonstrated a significantly higher microvessel count and an endothelial cell area than those of the benign lesions (p<0.01). There were no significant difference in microvessel count and endothelial cell area among carcinoma in situ, microinvasive carcinoma and invasive carcinoma (p>0.05). Microvessel count and an endothelial cell area in invasive cancers were not correlated with tumor size, depth of invasion, or histologic type (p>0.05).This study showed cervical cancer induces neovascularization in an early stage but it is difficult to predict prognosis and metastasis with microvessel count and an endothelial cell area.
Carcinoma in Situ ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Endothelial Cells ; Female ; Immunohistochemistry ; Microvessels ; Neoplasm Metastasis ; Prognosis ; Uterine Cervical Neoplasms ; von Willebrand Factor

Pseudomyxoma peritonei often have synchronous appendiceal and ovarian mucinous tumors. There has been considerable debate as to whether the ovarian tumors are secondary to the appendiceal tumor or they are independent primary ovarian tumors. It is important to reveal the primary site for treatment and prognosis of a patient. Five cases of synchronous mucinous tumors of the ovary and appendix were studied. Four cases had pseudomyxoma peritonei and pseudomyxoma ovarii. The ovarian tumors were bilateral in two cases, right in two, and left in one. The ovarian tumors were four mucinous cystadenoma of borderine malignancy and one mucinous cystadenocarcinoma, and the appendiceal tumors consisted of four mucinous tumors of borderline malignancy and one mucinous adenocarcinoma. The histology of the ovarian and appendiceal tumors was similar. Rupture of the tumor was seen in all appendiceal tumors and two ovarian tumors. It has been reported that cytokeratin 7 is a useful marker for distinguishing primary ovarian neoplasms from metastases of intestinal origin. All ovarian and appendiceal tumors showed positive reaction for broad-spectrum cytokeratin, but negative for cytokeratin 7. Based on the clinicopathologic and immunohistochemical features, it should be considered that the appendiceal tumors are primary and ovarian tumors are secondary in the synchronous presentation of the ovarian and appendiceal mucinous tumors.
Adenocarcinoma, Mucinous ; Appendix* ; Cystadenocarcinoma, Mucinous ; Cystadenoma, Mucinous ; Female ; Humans ; Keratin-7 ; Keratins ; Mucins* ; Neoplasm Metastasis ; Ovarian Neoplasms ; Ovary* ; Prognosis ; Pseudomyxoma Peritonei* ; Rupture

Cytokeratin 7 has been known to be present in various types of human epithelial cells including the ovarian neoplasms, but not in colon cancers. The antibody to colon ovarian tumor antigen (COTA) has been introduced as a marker of colon and ovarian tumors. The aim of this study was to evaluate the usefulness of cytokeratin 7 and COTA in the differential diagnosis between ovarian primary and metastatic tumors. Nineteen primary ovarian epithelial tumors, seven metastatic carcinomas of the ovary from the stomach, three metastatic carcinomas of the ovary from the colon, one mucinous tumor of the ovary associated with a mucinous tumor of the appendix and pseudomyxoma peritonei, and nineteen colonic and twenty gastric adenocarcinomas were stained with monoclonal antibodies to cytokeratin 7 and COTA. The results are summerized as follows; In the primary ovarian tumors, 94.4% were positive for cytokeratin 7 and 50% were positive for COTA. In the primary colonic adenocarcinomas, 94.7% were negative for cytokeratin 7 and 68% were positive for COTA. In the metastatic ovarian tumor from the colonic adenocarcinomas, 100% were negative for cytokeratin 7 and positive for COTA. In the primary gastric adenocarcinomas, 40% were negative for cytokeratin 7 and 85% were negative for COTA. In the metastatic ovarian tumor from the gastric adenocarcinomas, 43% were negative for cytokeratin 7 and 14% were negative for COTA. From the results of this study, it could be concluded that in the differential diagnosis of primary ovarian tumors from metastatic colonic carcinomas, positive reaction for cytokeratin 7 suggests a primary ovarian tumor but a negative reaction for cytokeratin 7 and positive reaction for COTA suggest metastatic colonic carcinomas. The results of this study also reveal that cytokeratin 7 and COTA are not useful in the differential diagnosis of primary ovarian tumors from metastatic gastric carcinomas.
Adenocarcinoma ; Antibodies, Monoclonal ; Appendix ; Colon* ; Colonic Neoplasms ; Diagnosis, Differential* ; Epithelial Cells ; Female ; Humans ; Keratin-7* ; Keratins* ; Mucins ; Ovarian Neoplasms ; Ovary ; Pseudomyxoma Peritonei ; Stomach

Previous studies implied association of osteoporosis with estrogen deficiency, immobilization and low calcium absorption only through epidemiological studies. There have been only a few experimental studies verifying the etiologic factors of osteoporosis in vivo condition. Authors conducted an experimental study using white rats(Sprague Dawley) in order to find out what the endocrinological and biochemical changes of experimentally induced osteoporosis are and how they behave with or against each other. White rats, eighty five in number of 3 to 6 months females and weighing 220±12.7gm were divided into four groups. They consisted of Group I(n=10) for control, Group II(n=25) for bilateral oophorectomy, Group III(n=25) for bilateral division of sciatic nerve and hip spica cast immobilization, and Group IV(n=25) for bilateral oophorectomy and bilateral division of sciatic nerve plus hip spica cast immobilization. Blood samples were taken preoperatively and postoperatively at six weeks to check Estradiol and Osteocalcin levels there of. And then, rats were sacrified immediately after the second sampling to retrieve femora for bone mineral density measurement and torsional stress test. Estradiol levels before operation were 21.4±13.3pg/ml for Group I, 31.6±3.1pg/ml for Group II, 25.6±4.5pg/ml for Group III and 33.7±4.5pg/ml for Group IV, respectively. There were no significant differences observable among the groups. Estradiol levels at six weeks postoperatively were 42.3±18.8pg/ml for Group I, 5.4±2.7pg/ml for Group II, 40.8±5pg/ml for Group III and 6.2±2.3 pg/ml for Group IV, respectively. Apparent reductions in group II and IV were proved of statistical significance. Osteocalcin levels preoperatively were 1.2±0.6ng/ml for Group I, 1.7±0.4ng/ml for Group II, 1.5±0.1lng/ml for Group III and 1.5±0.1.lng/ml for Group IV, respectively. At six weeks postoperatively they were 1.6±0.1lng/ml for Group I, 1.7±0.3ng/ml for Group II, 1.8±0.3ng/ml for Group III and 1.2±0.1lng/ml for Group IV, respectively. The differences and changes among the groups and measurements were not of statistical significance. Bone mineral contents at six weeks postoperatively were 0.248±0.03g for Group I, 0.177±0.03g for Group II, 0.226±0.04g for Group III and 0.092±0.01g in Group IV, respectively. Low values of Group II and IV compared to those of Group I and III were of statistical significance.(P=0.0001) Torsional strength of bones at six weeks postoperatively were 4.0±0.2N/m for Group I, 1.5±0.1N/m for Group II, 1.5±0.1N/m for Group III and 1.4±0.1N/m for Group IV, respectively. Decreases of experimental groups(II, III, IV) compared to that of control group(I) were of statistical significance, but differences among the experimental groups were not of significance(p>0.05). For above observations, it was possible to conclude that osteoporosis measurable by bone mineral content and torsional stress test was caused by oophorectomy and immobilization in vivo, the former of which was more rapid and profound than the latter during early phase. When both factors, i.e., oophorectomy and immobilization are exerated simultaneously. the resultant osteoporosis was found in higher degree than either factor only, but not at incremental degree as one may expect.
Absorption ; Animals ; Bone Density ; Calcium ; Epidemiologic Studies ; Estradiol ; Estrogens ; Exercise Test ; Female ; Hip ; Humans ; Immobilization ; Osteocalcin ; Osteoporosis ; Ovariectomy ; Rats ; Sciatic Nerve

Uterine papillary serous carcinoma is a morphologically distinct variant of endometrial carcinoma that is associated with an aggressive behavior with rapid progression and high recurrence, and poor response to salvage treatment. The most common type of malignancy developing in the uterus after radiation therapy is the malignant mixed mullerian tumor, however, the papillary serous carcinomas have rarely been reported.Here we report a case of uterine papillary serous carcinoma which had developed 7 years after radiation therapy for invasive cervical cancer.
Endometrial Neoplasms ; Female ; Recurrence ; Uterine Cervical Neoplasms ; Uterus

PURPOSE: Considering that renal biopsy is not routinely indicated in nephrotic syndrome in children and the risk of the procedure, we studied that it is possible to predict steroid responsiveness in nephrotic syndrome and the difference in responsivenss is related with the histopathologic type using urinary beta2-microglobulin and N-Acetyl-beta-D-Glucosaminidase activity as a safe and noninvasive method. METHODS: We measured serum creatinine, albumin, cholesterol and urinary creatinine, protein, B2M, NAG at the time of admission and after 2 weeks of treatment in 37 cases of primary nephrotic syndrome in children who were admitted to the Pediatric department of Chung-Ang Medical Center between March 1, 1994 and June 30, 1996. RESULTS: The results were as follows : 1) When urinary B2M value of less than 1000microgram/g creatinine was used as the cut-off value, the test identified steroid responsiveness with a sensitivity of 100%, a specificity of 80%. When urinary NAG activity of less than 100U/hr/mg creatinine was used as the cut-off value, the test identified steroid responsiveness with a sensitivity of 100%, a specificity of 81.8%. 2) Pretreatment urinary B2M levels in Good-response and Poor-response group were 559.8+/-718.5microgram/g creatinine, 3599.1+/-4956.7microgram/g creatinine, respectively. There was statistical significance between the two groups (P<0.05). 3) Pretreatment urinary NAG activity in Good-response and Poor-response group were 42.6+/-23.6U/hr/mg creatinine, 79.6+/-80.1U/hr/mg creatinine, respectively. There was statistical significance between the two groups (P<0.05). CONCLUSIONS: In conclusion, measurement of urinary B2M level and NAG activity for early detection of renal tubular damage is helpful in prediction of steroid responsiveness of primary nephrotic syndrome. If the urinary B2M level and NAG activity are elevated, the patient is suspected to steroid resistance. Therefore, prolonged steroid therapy should be avoided in such patients because of their greater chance of not responding. This approach would reduce the many serious side effects of prolonged treatment in patients who are unlikely to benefit.
Acetylglucosaminidase* ; Biopsy ; Child ; Cholesterol ; Creatinine ; Humans ; Nephrotic Syndrome* ; Sensitivity and Specificity

The authers reported one case of manic episode that occured after retirement in a 63 year old male patient. There was no psychiatric past history and family history. Also there was no abnormal finding on laboratory examination. This patient had received small doses of antidepressants anxiolytic and hypnotic (amitriptyline 10 mg, lorazepam 0.5 mg, triazolam 0.25 mg) to control insomnia since 3 months ago before admission. This patient showed manic symptoms such as grandious idea, expansive and irritable mood, increased psychomotor activity and insomnia after retirement. Pharmacotherapy (lithium and chloropromazine) supportive psychotherapy and family therapy were administered. Excessive motivation for work after retirement and small dose of antidepressant were suspected to trigger a manic episode in this elderly patient. We also reviewed literatures about pathophysiology of elderly manic disorder.
Aged* ; Antidepressive Agents ; Bipolar Disorder ; Drug Therapy ; Family Therapy ; Humans ; Irritable Mood ; Lorazepam ; Male ; Middle Aged ; Motivation ; Psychotherapy ; Retirement* ; Sleep Initiation and Maintenance Disorders ; Triazolam

No abstract available.
Malignant Atrophic Papulosis*

BACKGROUND: Traumatic diaphragmatic rupture is not common, but it requires swiftly performing an emergency operation. This study was conducted to evaluate the prognostic factors for mortality after surgically treating traumatic diaphragmatic rupture. MATERIAL AND METHOD: From Jan 2001 to Dec. 2008, we experienced 37 cases of multiple traumas with diaphragmatic injuries that were confirmed by surgical procedures. We evaluated various factors, including the type of injury, the associated injuries, the preoperative vital signs, the ISS, the time until surgery and the rupture size. RESULT: There were 30 patients with blunt trauma and 7 patients with penetrating trauma. Thirty-four patients had associated injuries and the mean ISS was 20.8. Postoperative complications occurred in 11 patients and hospital mortalities occurred in 6 patients. The prognostic factors that had an influence on the postoperative mortalities were the preoperative intubation state, the patient who exhibited hypotension and a high ISS. CONCLUSION: Traumatic diaphragmatic rupture is just one part of multiple traumas. The postoperative mortalities might depend on not only on the diaphragmatic rupture itself, but also on the severity of the associated injuries.
Diaphragm ; Emergencies ; Hospital Mortality ; Humans ; Hypotension ; Intubation ; Multiple Trauma ; Postoperative Complications ; Prognosis ; Rupture ; Vital Signs