Neurilemmoma is well-encapsulated tumor of Schwann cell origin. The majority arise in peripheral nerve or cranial nerve, and rare in retroperitoneum. Although it is incidentally detected by the advances in diagnostic procedures, especially in ultrasound and computed tomography, it is confirmed by pathologic findings. The treatment is surgical excision. We report a case of retroperitoneal neurilemmoma arising from adjacent to adrenal gland, in 45 years old female.
Adrenal Glands* ; Cranial Nerves ; Female ; Humans ; Middle Aged ; Neurilemmoma* ; Peripheral Nerves ; Ultrasonography

Kimura's disease is a rare benign disease characterized by subcutaneous or dermal tumors occurring predominantly on the head and the neck. It usually occurs in young adults without constitutional symptoms, except for peripheral blood eosinophilia. The histopathologic features of the tumor are characterized by dense lymphoid aggregates containing a prominent germinal center and by the proliferation of endothelial cells associated with varying degrees of lymphocytic, histiocytic, and eosinophilic infiltration. We report a case of Kimura's disease without peripheral blood eosinophilia in a 24-year-old male who had had a painless and slowly growing tumor-like swelling on his right groin for one year. The mass was excised, and the specimen was confirmed as Kimura's disease. After surgical excision, the lesion recurred, so 30 mg of oral prednisone was given daily for one month and then decreased gradually for another one month. Now, the lesion is completely healed.
Endothelial Cells ; Eosinophilia ; Eosinophils ; Germinal Center ; Groin* ; Head ; Humans ; Male ; Neck ; Prednisone ; Young Adult

It was known that the regenerating liver cytosol accelerated liver regeneration, whereas normal liver cytosol inhibited it during first 28 hours, but promoted it later by the thymidine incorporation test. In experiments, Sprague-Dawley male rats were divided into 3 experimental groups (A, B and C) which had 10 rats in each. Also, each group was equally subdivided into 2 subgroups such as A-8 and A-28 in the A group, B-8 and B-28 in the B group and C-8 and C-28 in the C group. All groups were partially hepatectomized equally. The remnant livers were procured at 8 hours in the 3 subgroups A-8, B-8 and C-8 and at 28 hours in the other 3 subgroups A-28, B-28 and C-28. Another experiment was performed in 10 rats under the same partial hepatectomy to get the average weight of the remnant liver. These data could be taken as the initial weight of the remnant liver in the above experimental animals. The normal saline, normal liver cytosol extract and regenerating liver cytosol extract were injected intraperitoneally after the partial hepatectomies, 4 ml of in the A, B, and C groups, respectively. Since specific structural changes might precede demonstrable functional alterations, morphometric measurements were done in the histological specimens of the 3 subgroups A-8, B-8, and C-8. The remnant livers, obtained in all six subgroups, were weighed to calculate the regeneration rates. The overall results are as follows : 1) The liver regeneration rates in the six subgroups were 4.1% in A-8, 3.8% in B-8, 4.3% in C-8, 28.4% in A-28, 16.7% in B-28, and 32.8% in C-28. 2) The morphometric study showed that the nucleus/cytoplasm ratios in the three subgroups were 0.1389 in A-8, 0.2048 in B-8, and 0.3705 in C-8. These results mean that regenerating liver cytosol extract promotes liver regeneration and that normal liver cytosol extract inhibits it during first 28 hours after a partial hepatectomy, but promotes cell division for subsequent regeneration.
Animals ; Cell Division ; Cytosol* ; Hepatectomy* ; Humans ; Liver Regeneration* ; Liver* ; Male ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Thymidine

Renal angiomyolipoma is composed of mature fats, smooth muscles and abnormal blood vessels which arises mainly from renal parenchyme and compresses the calyx or protrudes the renal cortex, but which extends into the renal cyst is rare. Recently it can be easily diagnosed preoperatively by several diagnostic modalities such as ultrasonography, computed tomography and several clinical signs associated with tuberous sclerosis, although it`s clinical and radiological features are similar with renal cell carcinoma. We report a case of renal angiomyolipoma without tuberous sclerosis, extending into the renalcyst, which was confused with renal pelvis tumor in a 73 years old male.
Aged ; Angiomyolipoma* ; Blood Vessels ; Carcinoma, Renal Cell ; Fats ; Humans ; Kidney ; Kidney Pelvis* ; Male ; Muscle, Smooth ; Tuberous Sclerosis ; Ultrasonography

Fetal thymus may be the organ for NK cell maturation, but the in vivo evidences are few, Here, by analyzing NK cell receptor, we present that NK cells develop in fetal thymus and fetal liver and that NK cell receptor appears earlier than the expression CD16 or CD56. Moreover, the finding that the repertoire of NK cell receptor is different between fetal thymus and fetal liver lymphocytes suggests that the environmental factors may influence the NK cell receptor repertoire during NK cell maturation.
Killer Cells, Natural* ; Liver* ; Lymphocytes* ; Thymocytes* ; Thymus Gland

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

We report a rare case of severe hypoglycemia after sunitinib treatment for pancreatic neuroendocrine carcinoma. We describe the initial clinical presentation, laboratory results, pathologic findings, and managment in a patient with a nonfunctioning pancreatic neuroendocrine carcinoma with liver metastases who developed life threatening hypoglycemia after 2 months of sunitinib therapy. A 46-year-old woman presented to the emergency department with loss of consciousness from hypoglycemia. Serum C-peptide and insulin levels at fasting state revealed that the hypoglycemia resulted from endogenous hyperinsulinemia. She had been diagnosed with nonfunctioning pancreatic neuroendocrine carcinoma based on a biopsy of metastatic cervical lymph node and was being treated with sunitinib, a small molecule tyrosine kinase inhibitor. Immunohistochemical stain of the metastatic liver mass demonstrated that the initially nonfunctioning neuroendocrine carcinoma cells had changed into insulin-producing cells after sunitinib therapy. Transarterial chemoembolization of the liver masses and systemic chemotherapy with streptozotocin/adriamycin relieved the hypoglycemia. A nonfunctioning pancreatic neuroendocrine carcinoma was transformed into an insulin-producing tumor after treatment with sunitinib, causing endogenous hyperinsulinemia and severe hypoglycemia.
Biopsy ; C-Peptide ; Carcinoma, Neuroendocrine ; Emergencies ; Fasting ; Female ; Humans ; Hyperinsulinism ; Hypoglycemia ; Indoles ; Insulin ; Insulinoma ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Pyrroles ; Unconsciousness

PURPOSE: To define the causes of obstructive azoospermia (OA) and evaluate the possibility and efficacy of microsurgical correction. MATERIALS AND METHODS: Sixty-seven patients diagnosed as OA with normal spermatogenesis preoperatively and initially planned to microsurgical vasoepididymostomy from December 2003 and November 2009 were retrospectively analyzed. Causes of OA were analyzed and patency rate and pregnancy outcomes of their female partners were measured. RESULTS: Thirty-one patients (46.3%) could not correct their OA because of obstruction of the distal vas deferens, epididymal atrophy and/or hypotrophy and vasal injury due to previous surgery. Among the 36 patients undergone microsurgical vasoepididymostomy (mean age of patients and their female partners were 32.9 and 31.3 years, respectively), 32 patients (88.9%) were corrected bilaterally and 4 patients (11.1%) unilaterally. The overall patency rate was 17 patients (47.2%); being 15 and 2 patients for bilateral and unilateral procedure, respectively. Among the 17 patients regained the patency after surgery, except 3 cases without followed up, 6 cases achieved natural pregnancy and also 6 cases achieved the pregnancy using the assisted reproduction. CONCLUSIONS: According to the affected point of reproductive tract, not all men with obstructive azoospermia were candidates for microsurgical reconstruction. However, reasonable outcomes were achieved in the microsurgical reconstruction cases and it should be primary therapeutic method in obstructive azoospermia. For those in whom reconstruction is not a viable option, surgical methods for sperm retrieval are available to have their own biological children.
Atrophy ; Azoospermia ; Child ; Epididymis ; Female ; Humans ; Male ; Microsurgery ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Sperm Retrieval ; Spermatogenesis ; Vas Deferens

Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint(TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth, but the new procedure of bone lengthening which was presented by McCarthy et al. represents a limited surgical intervention and therefore open up a new perspective of treatment, especially in younger children with severe deformities. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, a tilted occlusal plane, and a short mandible. A 14-years-old boy with facial asymmetry, who was fractured on both condyle and mandibular symphysis before 8 years ago, was treated by mandibular ramus lengthening, symphysial widening and surgically assisted rapid palatal expansion with corticotomy. After allowing 1 week for the healing of the periosteum, the distraction was performed at the rate of 0.5-1.0mm per day for 7 days on maxilla and 14 days on mandible. The device was maintained on maxilla and mandible for 12 weeks following distraction. The difference in ramus and mandibular transverse deficiency were corrected and facial asymmetry was improved with complex distraction osteogenesis.
Bone Lengthening ; Child ; Congenital Abnormalities ; Dental Occlusion ; Facial Asymmetry ; Goldenhar Syndrome ; Humans ; Male ; Mandible ; Maxilla ; Osteogenesis, Distraction* ; Periosteum ; Transplants

Pancreatic heterotopia and adenomyoma are variants of the same process. Pancreatic heterotopia is characterized by the presence of pancreatic acinar, islet, and/or ductular elements, usually associated with smooth muscle proliferation, outside the topographic boundaries of the pancreas. Adenomyoma differs from pancreatic heterotopia in that acinar and islet-like tissue are not present. The common sites are stomach, duodenum, and jejunum, but ectopic pancreatic tissue may also be encountered in Meckel's diverticulum, the ampulla of Vater, gallbladder, umbilicus, fallopian tube, and mediastinum. Most examples are encountered incidentally during surgery, and on rare occasions, epigastric pain, weight loss, hemorrhage, gastric outlet obstruction, and intussusception have been attributable directly to the presence of the heterotopic pancreas. But intestinal obstruction of small bowel by pancreatic adenomyoma has not been reported as of yet. The authors have experienced one case of intestinal obstruction by pancreatic adenomyoma requiring operation in a 28-year-old female. We found the 3-fold distened proximal jejunal loop, about 1 meter length, and abrupted narrowed point, and a normal sized distal loop. We treated this case by performing longitudinal incision and transverse suture of the narrowed point, so that the diameter of narrowed point was enlarged. At that time we found the 0.7Cm sized intraluminal mass at the narrowed point. We concluded that intestinal obstruction in this case was made by contraction of circular muscle due to pancreatic adenomyoma, not by a mass effect.
Adenomyoma* ; Adult ; Ampulla of Vater ; Duodenum ; Fallopian Tubes ; Female ; Gallbladder ; Gastric Outlet Obstruction ; Hemorrhage ; Humans ; Intestinal Obstruction* ; Intussusception ; Jejunum* ; Meckel Diverticulum ; Mediastinum ; Muscle, Smooth ; Pancreas ; Stomach ; Sutures ; Umbilicus ; Weight Loss