An eccrine squamous syringometaplasia (ESS) is defined as a mature squamous metaplasia of the eccrine ducts. The clinical and pathological features of an ESS are presented. Syringometaplasia is a rare lesion, mostly occuring in the extremities, and as far as we know, no report on the ESS has been published in Korean literature. We experienced a case of an ESS occured in a 15 year-old male, who had a tender erythematous plaque in the right knee. The histologic examination revealed some scattered nests of metaplastic squamous epithelium in the deep dermis, associated with acute nonspecific panniculitis. The importance of the ESS is that it histologically simulates the well differentiated squamous cell carcinoma. The histopathologic findings were discussed and a brief review of the literature was made.
Adolescent ; Carcinoma, Squamous Cell ; Dermis ; Epithelium ; Extremities ; Humans ; Knee ; Male ; Metaplasia ; Panniculitis

The occurrence of Non-Hodgkin's lymphoma (NHL) during pregnancy is rare. The optimal management of NHL during pregnancy requires special considerations. Because of their rapid progression, women with aggressive NHL should receive standard chemotherapy despite the potential risk to the developing fetus. We experienced a case of 30-year-old pregnant woman diagnosed as a diffuse large B cell NHL at 28 weeks of gestation, who was taken 4 cycles of CHOP combination chemotherapy and delivered a male baby weighing 2660g at 39 weeks of gestation. Following delivery, she received additional 3 cycles of chemotherapy with 4500cGy of radiotherapy on the neck. While she has been in complete remission of NHL over 6 years, her baby have developed mild developmental retardation.
Adult ; Child* ; Drug Therapy ; Drug Therapy, Combination ; Female ; Fetus ; Follow-Up Studies* ; Humans ; Lymphoma, Non-Hodgkin* ; Male ; Mothers* ; Neck ; Pregnancy* ; Pregnant Women ; Radiotherapy

Background: Desflurane, a fluorinated methyl-ethyl ether, has some advantageous properties including low blood solubility, stability in soda lime, and resistance to biodegradation. Desflurane in vivo has demonstrated myocardial depressant property. The purpose of this study was to test the direct effects of desflurane on myocardial contractile function and coronary flow in the isolated heart. Methods: Twelve isolated rat hearts were continuously perfused with modified Krebs solution containing 6, 9 and 12 vol% of desflurane for 10 min at each concentration. Systolic left ventricular pressure and rate of change of ventricular pressure (dp/dt) were measured. Heart rate and coronary flow were also measured. To differentiate direct vasodilatory effect of desflurane from an indirect metabolic effect due to autoregulation of coronary flow, oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated. Results: Heart rate (control 266+/-22 beats/min) decreased to 250+/-23 beats/min at 6 vol%, 236+/-26 beats/min at 9 vol% and 223+/-22 beats/min at 12 vol% of desflurane. Systolic left ventricular pressure and dp/dt decreased in a concentration-dependent manner. In spite of decrement of myocardial oxygen consumption, coronary flow (control 12.0+/-1.2 ml/min) increased to 12.8+/-1.6 ml/min at 6 vol%, 12.9+/-1.6 ml/min at 9 vol% and 13.7+/-1.4 ml/min at 12 vol% of desflurane. Oxygen delivery increased proportionally with coronary flow. Percent oxygen extraction decreased in a concentration-dependent manner. Conclusion: These results suggest that desflurane has a direct myocardial depressing and coronary vasodilating effect in a concentration-dependent manner.
Animals ; Ether ; Heart Rate ; Heart* ; Homeostasis ; Oxygen ; Oxygen Consumption ; Rats* ; Solubility ; Ventricular Pressure

PURPOSE: Heptaplatin (SKI-2053 R) is a new platinum analogue, with a better toxicity profile than cisplatin, and has antitumor activity even in cisplatin resistant cell lines. 5-fluoruracil (5-FU) has shown synergy with platinum compounds. This phase II trial was designed to determine the efficacy and toxicities of heptaplatin/ 5-FU (5-fluorouracil) for treating stomach cancer. MATERIALS AND METHODS: Thirty-two patients with advanced, measurable gastric adenocarcinomas were enrolled in this trial. The treatment consisted of heptaplatin, 400 mg/m2/day (1 hour IV infusion), on day 1 and 5-FU, 800 mg/m2/day (12 hours IV infusion), on days 1 to 5. The cycles were repeated every 3 weeks. RESULTS: Of the 26 evaluable patients, 9 had partial responses and 1a complete response (overall response rate, 38%; 95% confidence interval, 19~57%). The median response duration was 23 weeks (range: 4~60 weeks). The median time to progression was 26 weeks (range: 3~68 weeks). The grades III-IV toxicities were mostly hematological toxicities: leucopenia was observed in 11 patients (35%) and thrombocytopenia 4 (13%). No definite neuropathy was observed. Grade I-II nephropathy was also noted: grade I high BUN/creatinine levels occurred in 5 patients (16%), grade II proteinuria 2 (6%), grade I proteinuria 5 (16%). Neutropenic fever developed in 5 patients (16%) and 1 died of pneumonia in a neutropenic state. CONCLUSION: This study suggests that the regimen of Heptaplatin/5-FU should be effective and have a favorable toxicity profile for the patients suffering with advanced stomach cancer.
Adenocarcinoma ; Cell Line ; Cisplatin ; Drug Therapy ; Fever ; Fluorouracil ; Humans ; Leucovorin* ; Platinum ; Platinum Compounds ; Pneumonia ; Proteinuria ; Stomach Neoplasms* ; Stomach* ; Thrombocytopenia

Thymidine phosphorylase (TP) has shown to be up-regulated in several cancers and to play a role in angiogenesis and invasion. Most studies regarding TP have focused on cancer cells. Recently, evidences suggest that TP in cancer-infiltrating inflammatory cells (CIICs) also affect the cancer cell behavior. To evaluate the significance of TP expression of CIICs in gastric cancer, we assessed TP expression of cancer cells and CIICs separately using immunohistochemical assay on 116 paraffin-embedded tissue samples from stomach cancer patients and investigated their clinical significance. When subjects were divided into 4 groups according to the TP expression: cancer/matrix (+/+), C/M (+/-), C/M (-/+), and C/M (-/-), intratumoral microvessel density scores were higher in the C/M (+/-) group than in the C/M (-/-) group (p=0.02). For lymph node metastasis and survival, there were no significant differences among the 4 groups. However, there were significant differences in survival (p=0.035) and LN metastasis (p=0.023) between the two groups divided by TP expression of CIICs alone irrespective of TP expression of cancer cells. Taken together, this study suggested the TP expression in CIICs could affect lymph node metastasis and patients' survival in gastric cancer.
Adult ; Aged ; Female ; Humans ; Immunohistochemistry ; Inflammation/*enzymology/pathology ; Kaplan-Meiers Estimate ; Lymphatic Metastasis ; Lymphocytes, Tumor-Infiltrating/*enzymology/pathology ; Male ; Microcirculation/pathology ; Middle Aged ; Neovascularization, Pathologic ; Prognosis ; Stomach Neoplasms/blood supply/*enzymology/mortality/pathology ; Thymidine Phosphorylase/*metabolism

BACKGROUND: Chemotherapy with 5-fluorouracil (5-FU) has been one of the mainstay in breast cancer treatment. The effects of high dose 5-FU on cell cycle regulation were studied in breast caner cells. METHODS: A breast cancer cell line MCF-7 was used. Protein expressions of G1/S cyclins, p21(Waf1/Cip1), cdk2, E2F1 and retinoblastoma were tested by western blot analysis. Immunoprecipitation and immune complex kinase assay were done for the assessment of E2F1/RB interacton and the activity of cdk2 respectively. RESULTS: p21(Waf1/Cip1) expression was barely detectable in control cells. With addition of 5-FU level of p21(Waf1/Cip1) were induced and cyclin D3 level was decreased as cell growth decreases. In accordance with increased expression of p21(Waf1/Cip1), cyclin E-associated cdk2 kinase activity was reduced. Retinoblastoma protein (RB) became dephosphorylated and E2F-1 binding activity with RB was increased. CONCLUSION: In this situation of high concentration of 5-FU breast cancer cells tend to be G1/S cell cycle arrested. Overexpression of p21(Waf1/Cip1) and dephosphorylation of RB may mediate the effectss of 5-FU by inhibiting E2F-1 activity, which contributes to G1/S cell cycle arrest. These results could be an indicating landmark for further study of high dose chemotherapy with 5-FU.
Antigen-Antibody Complex ; Blotting, Western ; Breast Neoplasms* ; Breast* ; Cell Cycle Checkpoints ; Cell Cycle* ; Cell Line* ; Cyclin D3 ; Cyclins ; Drug Therapy ; Fluorouracil* ; Immunoprecipitation ; Phosphotransferases ; Retinoblastoma ; Retinoblastoma Protein

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

BACKGROUND: Elevation of intubating laryngeal mask airway (ILMA) handle increase the efficacy of the seal by pressing the cuff more firmly into the periglottic tissues and many clinicians apply an upward force to ILMA handle during blind intubation. In this study, we compared the first intubation success rate through ILMA during intubation with or without handle elevation. METHODS: With informed consent, fifty adult patients of ASA physical status I or II were selected. After insertion of ILMA size 4, optimal ventilation was established by slightly rotating the device in the sagittal plane, using the metal handle, until the least resistance to bag ventilation is achieved. Ventilation grade and fiberoptic bronchoscopic view were evaluated at the proper position. Intubation using ILMA was limited to first attempt regardless of successful tracheal intubation. After intubated tube was removed, ILMA was slightly elevated away from the posterior pharyngeal wall using the metal handle, and ventilation grade with fiberoptic bronchoscopic view were evaluated, then intubation was proceeded. Success rates of both methods on the first attempt were calculated. RESULTS: Ventilation grade and fiberoptic bronchoscopic view had no significant differences under the intubation using ILMA with or without handle elevation. Success rates of intubation on the first attempt with and without handle elevation were 78% and 82%. Therefore both methods had no significant differences. CONCLUSIONS: Blind tracheal intubation using ILMA with handle elevation is not necessary to get higher intubation success rates on the first attempt. Finding proper ventilation position and technical experience are required for successful blind tracheal intubation using ILMA.
Adult ; Humans ; Informed Consent ; Intubation* ; Laryngeal Masks* ; Ventilation

BACKGROUND: Sevoflurane anesthesia is associated with emergence agitation in children. In this study, we compared the emergence and recovery profiles of children who received sevoflurane with fentanyl or alfentanil for inguinal herniorrhaphy. METHODS: Forty-five children receiving sevoflurane anesthesia for inguinal herniorraphy were assigned to three groups. Saline 0.1 ml/kg (group S), alfentanil 10microgram//kg (group A) or fentanyl 1microgram//kg (group F) was administered intravenously at the beginning of fascia closure. Duration of operation and anesthesia and emergence time were evaluated at the operating room. Agitation score, a degree of pain, the time of stay in PACU (postanesthetic care unit) and postoperative side effects were evaluated by a blinded observer at the PACU. RESULTS: The emergence time was prolonged in the group F compared to the other groups. The time of stay in PACU was prolonged in the group F compared to the group S. Group A and F had lower agitation score and pain score in comparison with that of the group S at the 0, 5, 10, 15 min in the PACU. Agitation score was also significantly lower in the group F compared to the group A at 30 min. CONCLUSIONS: We suggest that intravenous administration of alfentanil 10microgram//kg or fentanyl 1microgram//kg at the closure of fascia could effectively reduce the agitation score. Alfentanil also does not delay from emergence and the time of stay in the PACU.
Administration, Intravenous ; Alfentanil* ; Anesthesia* ; Child* ; Dihydroergotamine* ; Fascia ; Fentanyl ; Herniorrhaphy ; Humans ; Operating Rooms

A congenital intrahepatic portosystemic shunt is a rare anomaly; but, the number of diagnosed cases has increased with advanced imaging tools. Symptomatic portosystemic shunts, especially those that include hyperammonemia, should be treated; and various endovascular treatment methods other than surgery have been reported. Hepatic masses with either an intra- or extrahepatic shunt also have been reported, and the mass is another reason for treatment. Authors report a case of a congenital intrahepatic portosystemic shunt with a hepatic mass that was successfully treated using a percutaneous endovascular approach with vascular plugs. By the time the first short-term follow-up was conducted, the hepatic mass had disappeared.
Child ; Diagnosis, Differential ; Hepatic Encephalopathy/*congenital/diagnosis/therapy ; Humans ; Liver Neoplasms/*congenital/diagnosis/therapy ; Male ; Portal Vein/*abnormalities ; *Septal Occluder Device ; Tomography, X-Ray Computed ; Ultrasonography, Doppler, Color ; Ultrasonography, Interventional