Metastases to the sinonasal tract are infrequent occurrences from primaries below the clavicles. The total number of reported cases to date is less than 100. There is, however, complete unanimity concerning the histologic type of metastatic neoplasm most often encountered. An interesting phenomenon, generally attributable only to breast and renal cell carcinoma, is the late recurrence of the malignant tumor, even 10 or more years after operation. A 61 year-old-male was admitted to ENT due to frequent epistaxis and right facial swelling. CT scan revealed a huge soft tissue density mass I right maxillary sinus with extension into nasopharynx and deviation of nasal septum. The histologic diagnosis was metastatic renal cell carcinoma. He had left nephrectomy because of renal cell carcinoma, 14 years ago. We report a case of metastatic renal cell carcinoma of maxillary sinus in view of rarity, and a brief review of the literature related to this type of tumor is presented.
Male ; Humans ; Neoplasm Metastasis

Merkel cell carcinoma is a relatively uncommon, cutaneous, neuroendocrine neoplasm that was first recognized by Toker in 1972. Occasionally it is found concurrent with squamous cell carcinoma or basal cell carcinoma and in them cases, the coexistence of them is suggesive of presenting the effect of a common carcinogenic influence on two distinct precursor cells. Now the authors report a case of Merkel cell carcinoma associated with squamous cell carcinoma arising in the overlying epidermis, and a brief review of literatures is introduced. The patient was a 75-year-old female, who had noticed a reddish brown, ulcerated mass on the right buttock. It had progressively enlarged to become lemon-size during last 4 months. The right buttock mass excised measured 10x8x3 cm and was gray white, solid, with an ill-defined marigin. Histologically the tumor was located in the dermis and was lacking in connection with the epidermis in which invasive squamous cell carcinoma developed. The neoplastic cells were arranged in a diffuse, lymphoma-like pattern or trabecular arrangement and their cytologic details were reminiscent of small cell carcinoma of the lung, On electron microscopy the cells displayed many neurosecretory granules averaging about 100nm in diameter, intermediate filaments and desmosomes. Immunohistochemically a ball-like immunostaining for keratin, resembling an inclusion body, was seen, but other markers, including neuron-specific enolase, vimentin, S-100 protein and leukocyte common antigen, were unrewarded.
Female ; Humans

PURPOSE: This study was conducted to study the attitude of Korean lawyers toward withdrawal of life sustaining treatment, and compare and analyze different types of their attitudes. METHODS: Research design of this project was Q methodology approach. The study population was 24 lawyers, aged from 32 to 69 years. Q sample to investigate the attitude of the lawyers toward withdrawal of life sustaining treatment included 34 statements obtained from literatures, TV debate, and depth interviews of 5 lawyers among the lawyers included. After listening to the purpose and method of the study, the 24 lawyers agreed to fill out a survey asking sociodemographic information, and the information was distributed in 9 scale Q-sample. RESULTS: The collected data were processed through QUANL PC program and sorted into 5 types as follows: The first type was 'Choosing to withdraw life sustaining treatment', the second 'Withholding life sustaining treatment' regardless of the cost, the third is neutral type that claims that humans have the right to decide the death and life, and demands the proper legalization to protect such rights, the fourth type agrees to withdrawal of life sustaining treatment, nevertheless, admits that one has a rigt to withhold one's own life treatment, categorized as self contradiction type. The fifth type believed that 'Life and death are providential' with the faith, therefore, such authority to decide life and death belongs to God, but not human beings. CONCLUSION: In conclusion, the lawyer's attitudes toward withdrawal of life sustaining treatment were grouped into five different types as follows: 'Choosing to withdraw life sustaining treatment', 'Withholding life sustaining treatment', 'Demanding legalization', 'Self contradiction type', and 'Life and death are providential'.
Aged ; Human Rights ; Humans ; Lawyers ; Nursing Methodology Research ; Q-Sort ; Research Design ; Withholding Treatment

Infection with Helicobacter pylori (H. pylori) leads to gastritis, but the majority of infected persons are asymptomatic, and it has been recently described that the ability of H. pylori to cause more severe disease is related to the presence of the cytotoxin-associated gene A (cagA). We investigated the prevalence of cagA-bearing strains in a group of H. pylori-positive gastritis, and compared the morphologic differences between cagA-positive and cagA-negative cases on H&E stained slides. Polymerase chain reaction (PCR) assays for detection of H. pylori and cagA of 62 gastric biopsy specimens were performed. All the slides were analyzed by the updated Sydney system. Forty eight (77.4%) were PCR positive for H. pylori and thirty four (54.8%) were positive for cagA. There were no significant differences in numbers of H. pylori, degree of infiltration of mononuclear cells and degree of atrophy between cagA-positive and cagA-negative groups. The rates of neutrophilic infiltration and intestinal metaplasia were significantly higher in cagA-positive group than in cagA-negative group. In conclusion, the detection of H. pylori by PCR method is more sensitive than that of microscopic examination and H. pylori strains possessing cagA are associated with an enhanced induction of severe gastritis.
Atrophy ; Biopsy ; Gastritis* ; Helicobacter pylori ; Helicobacter* ; Humans ; Metaplasia ; Neutrophils ; Polymerase Chain Reaction ; Prevalence

To analyze a wide variety of polymorphisms in patients with endometriosis is important since this disease has a strong genetic component. Until now, more than 30 Korean studies have been performed in order to elucidate the possible role of specific polymorphisms in the susceptibility to endometriosis. The most meaningful polymorphisms in Korean patients with endometriosis came from studies investigating GSTM1, AhRR, ER-alpha, VEGF, AHSG, and TNF-alpha. However, following studies should be made to confirm the consistency of the data to have some implications in the prediction of endometriosis. In this review, we also present the future direction of the association studies in complex trait disease such as endometriosis.
Endometriosis ; Female ; Humans ; Polymorphism, Genetic ; Porphyrins ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

Gastric neurofibroma is rare and its exact incidence is unknown. We experienced a case of solitary gastric neurofibroma. A 49-year-old woman was admitted because of hematemesis and melena. Neither cafe-au-lait spots in skin nor superficial tumor were found. Gastrofibroscopic examination and UGI series showed a 3 * 4 cm sized luminal protruding mass with adjacent bridging mucosal fold and cental ulceration on the anterior wall of lower body. Mass excision was performed. Grossly, the mass was 4.5 * 3.0 * 2.0 cm sized, well circumscribed submucosal tumor with homogenous cut surface, Microscopically, each of the tumor cells had oval shaped nucleus and spindle shaped cytoplasm. Nuclear atypism and frequent mitosis were not observed. We report a rare case of solitary gastric neurofibroma with review of the literatures.
Cafe-au-Lait Spots ; Cytoplasm ; Female ; Hematemesis* ; Humans ; Incidence ; Melena* ; Middle Aged ; Mitosis ; Neurofibroma* ; Phenobarbital ; Skin ; Stomach ; Ulcer

We present an adult female patient who developed irreversible paraplegia and areflexia four days post intrathecal chemotherapy with methotrexate, cytosine arabinoside and hydrocortisone. On magnetic resonance imaging (MRI) of the lumbar spine, diffuse gadolinium enhancement of the anterior spinal nerve roots (ventral roots) was detected. Methylprednisolone was intravenously administered at a daily dose of 30mg/kg for three days. Despite this treatment, flaccid weakness in the lower extremities and urinary retention persisted. Following consolidation chemotherapy, no improvement in neurologic status was noted. Six months later, a follow-up MRI revealed severe atrophy of the thoracic spinal cord.
Adult ; Antineoplastic Agents/administration & dosage/*adverse effects/*therapeutic use ; Female ; Humans ; Magnetic Resonance Imaging ; Paraplegia/*chemically induced/*pathology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy

PURPOSE: Most of studies dealing with abfractions are limited to the buccal surfaces of the teeth. In this study, we analyzed the cause for abfraction by investigating the incidence of palatal side abfractions in maxillary posterior teeth. MATERIALS AND METHODS: We investigated a total of 3193 maxillary posterior teeth by an intraoral examination, model observation, and observation of virtual model fabricated using model scanning. We recorded the results and classified them depending on the type of teeth, age, gender, and side of arches. We also performed Chi-square test to evaluate the statistical significance among the groups (α = 0.05). RESULTS: The incidence of palatal side abfraction of the maxillary molars (10.8%) was higher than the premolars (6.8%), and among them, the incidence of the 1st molars (39.1%) were the highest. The incidence of palatal side abfraction increased with age and was statistically significant (P < 0.05). There was no statistical significance in the difference by gender (P > 0.05); in the case of arches, left arch showed higher incidence and it was statistically significant (P < 0.05). CONCLUSION Palatal side abfraction in maxillary posterior teeth was frequently observed in the maxillary 1st molars, and the incidence increased with age. This result suggests that the main reason for abfraction is due to occlusal force.

PURPOSE: Aims to analyze the occlusal wear patterns in maxillary posterior teeth with palatal side abfractions and study the association between occlusal force and abfractions. MATERIALS AND METHODS: This study was conducted in a total of 308 teeth from 148 patients with palatal side abfractions in maxillary posterior teeth. The occlusal wears in maxillary premolars and molars with palatal side abfractions were classified and recorded. The classification was done by type of teeth, age, and gender, and in order to evaluate the statistical significance between groups, chi-square test was conducted (α = 0.05). RESULTS: Palatal side abfractions in maxillary posterior teeth were observed at the highest frequency in the 1st molars, and in all teeth with palatal side abfractions, more than one occlusal wear was observed. In classification by type of teeth, by age, and by gender, the occlusal wears in teeth with palatal side abfractions were observed at high frequency in cuspal inclined plane, central fossa, and marginal ridge, and there was a statistical significance (P < 0.05). CONCLUSION: Palatal side abfractions were observed at the highest frequency in maxillary 1st molars, and in all maxillary posterior teeth where palatal side abfractions were found, the occlusal wears were observed. And the occlusal wears were observed at high frequency in cuspal inclined plane, central fossa and marginal ridge. Such results show that abfraction is associated with occlusal force.
Bicuspid ; Bite Force ; Classification ; Humans ; Molar ; Tooth Attrition ; Tooth Fractures ; Tooth

Myoepitheliomas are well-established to occur in the salivary glands, but they have also been described in the breast, upper aerodigestive tract, skin, and soft tissues. We report here on a unique case of primary myoepithelioma that occurred in the right testis of a 28-year-old man. The tumor was entirely confined to the testis and it was clearly separated from the epididymis. Histopathology revealed mixed architectural patterns in which the reticular areas merged into the chondromyxoid stroma. The tumor cells, which were focally immunoreactive to pancytokeratin and S-100 protein, were round to ovoid and spindly arranged in cords, strands, and fascicles. They showed mild nuclear pleomorphism, sparse mitotic figures and a low Ki-67 proliferative index. There was no ductal differentiation in the tumor. To the best of our knowledge, there has been only one case report of a primary testicular myoepithelioma in the English medical literature.
Adult ; Breast ; Epididymis ; Humans ; Male ; Myoepithelioma ; S100 Proteins ; Salivary Glands ; Skin ; Testis