This is a case report of virilizing adrenal cortical adenoma in 22 month old male patient who was diagnosed by clinical features, endocrinological studies, radiologic studies and pathologic findings. During surgery, a 40gm well-encapsulated tumor was removed from the right adrenal gland. Histologic examination revealed no capsulr invasion and a diagnosis of adrenocortical adenoma was made. He is in well condition without the clinical or laboratory evidence of recurrence at 2 years of follow up.
Adrenal Glands ; Adrenocortical Adenoma* ; Diagnosis ; Follow-Up Studies ; Humans ; Infant ; Male ; Recurrence

BACKGROUND: Metallothioneins(MTs) are ubiquitous low molecular weight cytosolic proteins with high contents of cystein that xhibit a selective binding affinity for zinc, copper and other group II heavy metal ions. In additi~on to the sequestration function and detoxification action, MTs probably participate in the cellirlar protection against. ionizing radiation and alkylating agent cytotoxicity and in cellular pn:liferation. OBJECT: The objective of this study was to evaIuate the expression of MTs and to clarify t.heir role in carcinogenesis and/or biological behaviour in the neoplasms of ectoderrnal origin. METHODS: We performed immunohistochemical studies on the surgical specimens of rnalignant rnelanoma and squamous cell carcinoma and basal cell carcinoma. The results were compared with the normal skin and mu osa and hair t,issues and raf't-on culture tissues of skin and mucosal keratinocytes. RESULTS: 1) MTs were strongly expressed in epidermal basal cells of the normal skin and raft-on cultured artificial skin They were also rnore weakly expressed in epithelial basal cells of the normal mucosa and raft on cultured artificial mucosa and in matrix cells of the normal hair. 2) In rnalignant melanoma, MTs were meaningfully expressed, i.e., a strong expression was seen in the lesions showing a rapid vertical growth phase with fatal out,comes, but a weak expression in the cases whose precursor lesions were thought as dysplastic nevi, compared to the negative finding of norrnal melanocyt,es. The strong expression in a case of congenit.al rnelanocyt.ic nevus is considered as the activation of nevoid melanocytes. 3) MTs were weakly expressed in squarnous cell carcinoma with a diffuse aattern within the tumor mass. St,rong expression of MTs was particularly apparent in the poorl. differentiated squamous cell carcinoma and at the growing border of well differentiated squamous cell carcinoma. 4) In basal cell carcinoma, MTs were rather weakly expressed in solid cireumscribed types with a diffuse pattern and in cystic type with a patchy pattern. However they were not expressed in the solid infiltrative type. CONCLUSION: From these resuilts, we concluded that MTs were ubiquitously present in possible stem cells of various epithelial tissues except melanocytes irrespective of normal or artificial skin and/or mucosa including norrnal hair tissues. In the neoplasms of ectodermal origin, MTs might be involved in the invasive growth of tumor cells in the malignant melanoma and squamous cell carcinoma. It was implied that the role of MTs in basal cell carcinoma might be related to early events of hasal cell carcinogeresis and its down regulating tendency could be possible in its infil trative stage.
Carcinogenesis ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Copper ; Cytosol ; Dysplastic Nevus Syndrome ; Ectoderm* ; Hair ; Ions ; Keratinocytes ; Melanocytes ; Melanoma ; Metallothionein* ; Molecular Weight ; Mucous Membrane ; Nevus ; Radiation, Ionizing ; Skin ; Skin, Artificial ; Stem Cells ; Zinc

The incidence of cervical pregnancy and the number of combined intrauterine pregnancy and ectopic pregnancy seems to be increasing. So the possibility of heterotopic pregnancy should always be considered by every gynecologist, especially those who treat infertility problem. We experience a case of a heterotopic pregnancy coexisting of an intrauterine pregnancy and a cervical pregnancy after in-vitro fertilization and embryo transfer, and was successfully managed by transcervical evacuation and resulted in a normal intrauterine pregnancy. Here we present the case with review of literatures.
Embryo Transfer ; Female ; Fertilization ; Fertilization in Vitro* ; Incidence ; Infertility ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Heterotopic*

PURPOSE: To evaluate abnormal neurosonographic (NSG) findings of thalami and basal ganglia in full term babies with hypoxic-ischemic encephalopathy and to correlate the findings with follow-up studies and prognosis. METHODS: We evaluated 13 full term babies with abnormal NSG findings of thalarni and basal ganglia. NSG was performed within 7 days after clinical abnormalities. Follow-up NSG was done in 11 cases; CT scan in 4 and MRI in 7. We classified NSG findings as diffuse, unilateral, and focal types according to increased echogenicity and evaluated prognosis based on follow-up studies and neurological sequelae. RESULTS: Nine cases of diffuse type had diffuse echogenic changes of bilateral thalami and basal ganglia, slit-like lateral ventricles suggesting cerebral edema, and increased parenchymal echogenicity. In diffuse type, follow-up studies showed more prominent echogencities and ventricular dilatations and cerebromalacia. One case of unilateral type caused by thromboembolism had unilateral echogenicity of right thalamus and basal ganglia with increased echogenicity of the ipsilateral cerebral hemisphere and compression of the lateral ventricle, suggesting cerebral infarction. Follow-up study showed unilateral cystic cerebromalacia. Three cases of focal type had a localized echogenic area in thalamus with lacunar infarction, which decreased in size during follow-up. Among nine cases of diffuse type, one died within 2 days, two were discharged against medical advice, and six had severe neurologic sequelae. One case of unilateral type had a moderate degree of neurologic sequelae. All 3 cases of focal type had normal development. CONCLUSION: Pattems of abnormal echogenicity in thalami and basal ganglia in fullterm infants with hypoxic-ischemic encephalopathy are correlated with the outcome and may be helpful for treatment planning.
Basal Ganglia* ; Brain ; Brain Edema ; Brain Ischemia* ; Cerebral Infarction ; Cerebrum ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant* ; Lateral Ventricles ; Magnetic Resonance Imaging ; Prognosis* ; Stroke, Lacunar ; Thalamus* ; Thromboembolism ; Tomography, X-Ray Computed

BACKGROUND: An aggressive skin cancer on the nose, tends to have poorly defined clinical margins, and has a higher recurrence rate. A small tumor on the nose is usually easily treated by any of the standard methods. However, removal and reconstruction with preserved cosmesis is more laborous in a basal cell carcinoma larger than 10 mm in diameter. This is because the nose has complex contoures, unique skin color and texture, and the limited availability of mobile adjacent skin. When available Mohs micrographic surgery is the preferred treatment for these large tumors. OBJECTIVE: Our purpose was to investigate the preferred reconstruction method(especially, local flap reconstruction) by the cosmetic unit of the nose after Mohs micrographic surgery. METHODS: From March 1991 to February 1997, twenty-one patients were diagnosed with basal cell carcinoma on the nose at our department. All the tumors were removed with Mohs micrographic surgery, and then the defects were reconstructed with a primary closure, skin graft, and local flap.
Carcinoma, Basal Cell* ; Humans ; Mohs Surgery* ; Nose* ; Recurrence ; Skin ; Skin Neoplasms ; Transplants

Radiation induced pemphigus, as an example of induced pemphigus, is a rare disease which occurs in patients receiving radiotherapy. A 56-year-old male patient with nasopharyngeal cancer received 3 cycles of chemotherapy and radiotherapy on the neck and anterior chest areas. One month after completion of radio-therapy, eroded and crusted areas developed within the irradiation site. In spite of systemic antibiotic treatment, the skin lesions persisted and spread further to the trunk and upper extremities with new crops of bullae. He was treated with a high dose of prednisolone and the skin lesions cleared. We discuss the suggestive pathogenesis of radiation-induced pemphigus with the comparative results of immunoblotting in various variants of pemphigus.
Cytochrome P-450 CYP1A1 ; Drug Therapy ; Humans ; Immunoblotting ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; Neck ; Pemphigus* ; Prednisolone ; Radiotherapy ; Rare Diseases ; Skin ; Thorax ; Upper Extremity

Dendritic cells (DC) are highly efficient antigen-presenting cells that initiate the primary immune response. Several laboratories have developed culture systems for human DC from peripheral blood monocytes. Most of these studies have used fetal calf serum (FCS) containing culture conditions that are inappropriate for human application. GM-CSF and IL-4 were used to make immature DC. The monocyte-conditioned medium (MCM) was used to induce the final maturation of DC. Using the previously described methods, the quality of MCM has unpredictable variations. Therefore using a defined cocktail of growth factors for the generation of mature DC would be advantageous for experimental as well as clinical purposes. In this study, it is suggested that combinations of both GM-CSF/IL-4 or GM-CSF/IL-13 could be used as the first-step culture to produce immature DC, and that cytokine cocktail (GM-CSF, IL-4, IL-1beta, TNF-alpha, IL-6, PGE2) was as efficient as MCM for the second step-culture to produce fully maturated DC. Here, we have generated an easily reproducible culture system for DC that allows for the generation of large amounts of immature and mature DC, and we also now have established the method in a FCS-free system that is suitable for clinical use.
Cell Division/drug effects ; Culture Media/pharmacology ; Cytokines/pharmacology ; Cytological Techniques* ; Dendritic Cells/cytology* ; Human ; Monocytes/cytology*

Duodenal leiomyosarcoma is a rare condition with a poor prognosis. Early diagnosis of duodenal leiomyosarcoma is challenging because it presents with nonspecific symptoms and endoscopic biopsies usually do not enable a definitive diagnosis. Duodenal leiomyosarcomas are diagnosed on the basis of the histopathological identification of a mesenchymal lesion composed of malignant tumor cells that on immunohistochemical examination is positive for smooth muscle actin and desmin. We report the case of a 38-year-old man who presented with gastrointestinal bleeding and obstruction who was diagnosed with duodenal leiomyosarcoma after surgical resection.
Actins ; Adult ; Biopsy ; Desmin ; Diagnosis ; Duodenal Obstruction ; Early Diagnosis ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Leiomyosarcoma ; Muscle, Smooth ; Prognosis

No abstract available.
Female ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy Trimester, Second*

OBJECTIVE: The purpose of this study was to assess the usefulness of sonohysterography in the detection of abnormalities of the uterine cavity in infertile patients, compared with other diagnostic methods, such as transvaginal sonography, hysterosalpingography and hysteroscopy. METHODS: Three intrauterine pathologies including intrauterine synechiae, endometrial polyp and submucosal myoma, that could be possible causes of infertility were diagnosed. RESULTS: Transvaginal ultrasonography and hysterosalpingography were able to detect 41.7% and 83.3% of uterine pathologies respectively comparing with sonohysterography to detect all of the uterine pathologies. CONCLUSION: Our results show that sonohysterography is easy, inexpensive, well-tolerated and non-invasive technique with high sensitivity in the detection of uterine pathologies. Therefore the use of sonohysterography for the diagnosis of intrauterine pathologies in infertile patients is highly recommended.
Diagnosis ; Female ; Gynatresia ; Humans ; Hysterosalpingography ; Hysteroscopy ; Infertility ; Myoma ; Pathology ; Polyps ; Ultrasonography