A dedifferentiated liposarcoma of the retroperitoneum is an extremely rare tumor. A 51-year old man was admitted to our department because a retroperitoneal mass was seen on abdominal computed tomography at another hospital. Computed tomography of the abdomen and magnetic resonance imaging showed a large pelvic mass located in the right hemipelvis, and it was pushing the right ureter and invading the right kidney, duodenum, colon and inferior vena cava. The patient underwent right radical nephrectomy, pylorus preserving pancreatoduodenectomy, right hemicolectomy and artificial blood vessel replacement for the inferior vena cava. The histopathological diagnosis was dedifferentiated liposarcoma and the patient was free from recurrence on the computed tomography that was done 6 months after the operation.
Abdomen ; Blood Substitutes ; Colon ; Duodenum ; Glycosaminoglycans ; Humans ; Kidney ; Liposarcoma ; Magnetic Resonance Imaging ; Nephrectomy ; Pancreaticoduodenectomy ; Pylorus ; Recurrence ; Ureter ; Vena Cava, Inferior

PURPOSE: The purpose of this study is to evaluate the characteristics of parotid gland tumors to help in the differentiation between benign and malignant lesions. MATERIAL AND METHODS: The CT findings of 22 patients with surgically proven parotid gland tumors were reviewed. Analysis was focused on the density and margin characteristics of the tumors, and the relationahip between the tumor and surrounding structures. RESULTS: Those tumors were pleomorphic adenoma (n=8), Warthin's tumor (n=5), basal cell adenoma (n=l), lipoma (n=l), dermold cyst (n=l), adenold cystic carcinoma (n=2), mucoepidermoid carcinoma (n=l), epidermold carcinoma (n=l), and carcinoma in pleomorphic adenoma (n=l). Most of benign and malignant tumors were heterogeneous in denstiy on contrast enhanced CT scans. In 5 of 6 malignant cases, the tumors had irregular or ill-defined margin and a tendancy to involve or cross the superficial layer of deep cervical fascia with obliteration of subcutaneous fat. Two malignant tumors invaded surrounding structures. CONCLUSION: Although the heterogeneous density of tumor is not a specific finding for malignancy at CT, following findings, such as, irregular or blurred margin of the lesion, the involvement of fascial plane, and the infiltration of surrounding structures may suggest the possibility of malignant parotid tumor.
Adenoma ; Adenoma, Pleomorphic ; Carcinoma, Mucoepidermoid ; Fascia ; Humans ; Lipoma ; Parotid Gland* ; Subcutaneous Fat ; Tomography, X-Ray Computed

A retrospective analysis of CT and MR findings was performed in five patients with histologically proved chordoma including one with chondroid chordoma. All tumors were mostly isodense to gray matter on unenhanced CT, and the single intensities were iso or low and high on T1 and T2-wgighted MR iages, respectively. The tumors had an increase in their density on enhanced CT and MR in four patients, but a chondroid chordoma was poorly enhanced after injection of contrast medicum on CT. Four tumors contained calcifications in CT images and two lesions showed hemorrhage in MR images. Cavernous sinus was involved in all patients, and brain stem and basilar artery were compressed by the tumors in three cases. Pituitary gland was only displaced upward in three patients. Clivus was destroyed in all cases, and sella turcica and sphenoid bone were involved in three patients. CT is better than MR in demonstrating calcifications and bone destruction. In defining the extension of tumor, MR appears to be superior to CT in evaluation of the relationship between the tumor and the surrounding structures.
Basilar Artery ; Brain Stem ; Cavernous Sinus ; Chordoma* ; Cranial Fossa, Posterior ; Gray Matter ; Hemorrhage ; Humans ; Pituitary Gland ; Retrospective Studies ; Sella Turcica ; Sphenoid Bone

The hepatitis A virus (HAV) has been the leading cause of viral hepatitis in Korea since the 2000s. We aimed to describe the current status and regional differences in hepatitis A incidence. We studied the total number of hepatitis A cases reported to the Korea Centers for Disease Control and Prevention through the National Infectious Diseases Surveillance System between 2011 and 2013. Additionally, National Health Insurance Review and Assessment Service data and national population data from Statistics Korea were used. In total, 7,585 hepatitis A cases were reported; 5,521 (10.9 cases per 100,000 populations), 1,197 (2.3 cases per 100,000 populations), and 867 (1.7 cases per 100,000 populations) in 2011, 2012, and 2013, respectively. Fifty-eight patients were infected outside of the country and 7,527 patients represented autochthonous HAV infection cases. Autochthonous HAV infection occurred more frequently among men than women (4,619 cases, 6.1 cases per 100,000 population vs. 2,908 cases, 3.9 cases per 100,000 population). The incidence rate was higher in the 20-29 yr-old group (2,309 cases, 11.6 cases per 100,000 populations) and 30-39 yr-old group (3,306 cases, 13.6 cases per 100,000 populations). The majority of cases were reported from March to June (53.6%, 4,038/7,527). Geographic analyses revealed a consistently high relative risk (RR) of HAV infection in mid-western regions (2011, RR, 1.25, P=0.019; 2012, RR, 2.53, P<0.001; 2013, RR, 1.86, P<0.001). In summary, we report that hepatitis A incidence has been decreasing gradually from 2011 to 2013 and that some regions show the highest prevalence rates of HAV infection in Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Databases, Factual ; Female ; Hepatitis A/*epidemiology/pathology ; Humans ; Incidence ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk ; Seasons ; Sex Factors ; Young Adult

Object of this study was to make comparison between acetazolamide and dipyridamole activated SPECT for measurement of cerebral vascular reserve capacity. This study was also carried out to evaluate response in acetazolamide and dipyridamole activated SPECT in relation to clinical parameters, such as Glasgow Coma Scale, Hunt & Hess grade, Fisher grade and Glasgow Outcome Scale. It is concluded from study that. Acetazolamide and dipyridamole activated SPECT study proved to be valuable for cerebral vascular reserve capacity. Dipyridamole activated SPECT study was somewhat equivocal because of systemic vascular dilatation effect, but this problem could be resolved by Gamma Count Ratio. Although there were minimal transient side effect of dipyridamole such as dizziness, no complication.
Acetazolamide* ; Dilatation ; Dipyridamole* ; Dizziness ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Subarachnoid Hemorrhage ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Mallory-Weiss syndrome is a laceration of gastroesophageal junction due to abruptly increased intraabdominal pressure. Bleeding from Mallory-Weiss tears stops spontaneously within 2-3 days without specific therapy in 80-90% of cases, but in some cases, aggressive treatment is required due to massive bleeding. METHODS: Among two hundreds and fifteen cases of upper gastrointestinal bleeding from January 1997 to January 1999, twenty three cases (10.7%) were diagnosed as Mallory-Weiss syndrome by endoscopy. We assessed the site, number, coexisting diseases, precipitating factors and bleeding lesion according to the time interval after the tears. After supportive care or specific therapy, we performed follow-up endoscopy to evaluate the healing of the lesions. RESULT: The mean age was 49.1 years and male:female ratio was 4.8:1. The most common precipitating factors were nausea, vomiting and alcohol drinking. In twenty cases, coexisting diseases such as gastritis and esophageal varix were detected. As for the number of tears, one tear was the most common (69.6%), while two tears were identified in five cases and three were in two cases. Thirteen cases of the Mallory-Weiss tears were located on the gastroesophageal junction, seven cases on the lower esophagus, one case on the cardia and two cases from lower esophagus to cardia. Eighteen cases were diagnosed by endoscopy within 24 hours after bleeding, of whom fourteen cases had active bleeding. Among four cases diagnosed after 24 hours, endoscopic finding revealed active bleeding in two cases and blood clots in the other two cases. We treated thirteen cases with supportive care, one case with hypertonic saline injection and nine cases who had active bleeding or deep and long tears with endoscopic band ligation. One or two weeks later, we performed follow-up endoscopy, and no bleeding was detected in all cases. CONCLUSION: We diagnosed twenty three cases of Mallory-Weiss syndrome by endoscopy and treated all cases with supportive care or endoscopic band ligation successfully.
Alcohol Drinking ; Cardia ; Diagnosis* ; Endoscopy ; Esophageal and Gastric Varices ; Esophagogastric Junction ; Esophagus ; Follow-Up Studies ; Gastritis ; Hemorrhage ; Lacerations ; Ligation ; Mallory-Weiss Syndrome* ; Nausea ; Precipitating Factors ; Vomiting

PURPOSE: To investigate synergistic effect of local cryoablation with systemic immunotherapy, the tumor control ability and immunologic responses of combining these two modalities was compared with that of cryoablation, surgical excision, and immunotherapy only group in a tumor re-challenge model. MATERIALS AND METHODS: Preliminary experiments were performed in two stages. The first stage consisted of 36 Balb/c mice with Renca bearing tumors imbedded in the right thigh, and was treated with interleukin-2 (IL-2) and interferon-alpha(IFN-alpha) to evaluate the efficacy of immunotherapy and to determine the adequate dosage. The second stage was performed on 10 mice, to evaluate histological changes and efficacy after cryoablation. The main experiment was performed on 48 mice, divided into 6 groups of control with tumor implantation, excision of tumor, excision combined with immunotherapy, cryoablation of tumor, cryoablation with immunotherapy and control without tumor. After treatment, tumor re-challenge was performed with Renca cell, then the growth pattern was evaluated with physical measurements, and immune response was investigated with fluorescent activated cell sorter and cytotoxicity assay. RESULTS: Preliminary studies on immunologic efficacy revealed that IL-2 and IFN-alpha have a dose dependent inhibition of tumor growth. The main experiment evaluating the efficacy of combination treatment revealed that cryoablation with immunotherapy proved to be most effective in terms of tumor recurrence and tumor growth inhibition, yet the difference was not statistically significant from monotherapy with cryoablation. However, cytotoxicity was significantly increased cryoablation with immunotherapy compared with other groups. CONCLUSIONS: Cryoablation on tumor re-challenge mice model showed advantages with immunotherapy most prominently in cytotoxicity.
Mice ; Animals

BACKGROUND: Cortactin and focal adhesion kinase (FAK) are two important components among actin cross-linking proteins that play a central role in cell migration. METHODS: The aims of this study were to evaluate the expression of cortactin and FAK in normal colorectal mucosa and colorectal adenocarcinoma (CRC) using tissue microarray of 2 mm cores to correlate their expression with other clinicopathological factors and, investigate their prognostic significance. RESULTS: Twenty (9%) and 24 cases (11%) of normal colorectal mucosa were immunoreactive for cortactin and FAK. In addition, 184 (84%) and 133 cases (61%) of CRCs were immunoreactive for cortactin and FAK, respectively. Cortactin expression was associated with histologic differentiation and FAK expression. Cortactin, but not FAK expression was also correlated with poor overall and relapse-free survival and served well as an independent prognostic factor for poor survival. CONCLUSIONS: Cortactin expression, in association with FAK expression, may plays an important role in tumor progression. Furthermore, it may also be a satisfactory biomarker to predict tumor progression and survival in CRC patients.
Actins ; Adenocarcinoma ; Calcium Hydroxide ; Colorectal Neoplasms ; Cortactin ; Focal Adhesion Protein-Tyrosine Kinases ; Focal Adhesions ; Humans ; Immunohistochemistry ; Mucous Membrane ; Proteins ; Zinc Oxide

PURPOSE: The purpose of this study was to analyze the clinical courses of patients with gastric cancer and positive resection margins after a gastrectomy for gastric cancer who did not undergo subsequent surgery. MATERIALS AND METHODS: Among 4,452 patients who underwent surgery for gastric cancer from January 2001 to December 2007, 20 patients with positive resection margins after gastrectomy for gastric cancer who did not undergo subsequent surgery were included. The recurrence patterns were confirmed by postoperative computed tomography and gastroscopy, which were performed on a planned schedule. All recurrence patterns after gastrectomy were classified as loco-regional, peritoneal, or distant metastases. RESULTS: The patients with confirmed recurrence all had advanced stage cancer (III-IV), and the recurrence sites were variable. However, peritoneal and distant recurrences were more common than loco-regional recurrences. The patients with loco-regional recurrence also had peritoneal and/or distant recurrence. CONCLUSIONS: Patients with gastric cancer and a positive resection margin showed more frequent peritoneal and distant metastases than loco-regional recurrence. In addition, patients with loco-regional recurrence also had peritoneal and distant recurrence. A positive resection margin of gastric cancer was related with poor histological differentiation, diffuse type, and advanced stage (III-IV).
Appointments and Schedules ; Gastrectomy ; Gastroscopy ; Humans ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms

BACKGROUND: In 2000~2001 there was a nationwide outbreak of measles in the Republic of Korea. Since supplementary vaccination program was implemented in 2001, the control strategy of this measles outbreak has been stepped up from the control phase to the elimination phase. We here present the result of survey for the epidemiologic characteristics of the nationwide outbreak of measles in 2000~2001. METHODS: Using the data based on the sheet of epidemiologic investigation, incidences rates per 100,000 population and distributions of cases with vaccination history were investigated by the age. The seasonal or regional distribution were also studied with the onset days of cases. RESULTS: In 2000~2001, a measles outbreak occurred with 52,897 reported cases. The incidence rate per 100,000 population of measles was 111.9 cases and that of geopolitical unit (province) was high nationwide, 35.9~386.3 cases. The incidence rates were very high in less than 12 months and 10 years of age, 954.4 and 714.9, respectively. The 1st vaccination rate of measles/mumps/rubella (MMR) in 1~3 years old was 26.3~77.1%, and especially, that of 1 year old showed very low coverage, 26.3%. However, there was no special propensity in the 1st vaccine coverage in the age of 7~15 years, which had 87.7~91.4%. On the other hand, the 2nd MMR vaccination rate of the cases was very low, 17.7% at the age of 7~10 years. From the 21st May, 2001 a mass catch-up campaign with measles/rubella (MR) vaccine was launched, resulting in prominent reduction in the incidence of measles case. CONCLUSION: This survey showed that the measles outbreak in 2000~2001 had a high incidence nationwide from October 2000 to April 2001 and in less than 12 month and 10 years of age. Our results also showed that no routine immunization made the age group under 1 year vulnerable to measles infection. In cases of school-age group after 7 years of age, some cases with vaccination history were also infected. The characteristics of recent outbreaks indicates the need for the introduction of a specific vaccination programme at that age group. This survey was helpful to establish the effective vaccination strategy and it would be used as reference data on survey continuously for the epidemiologic characteristics of measles case for elimination of indigenous measles transmission in Republic of Korea.
Disease Outbreaks ; Epidemiology ; Hand ; Humans ; Immunization ; Incidence ; Korea* ; Measles* ; Republic of Korea ; Seasons ; Vaccination