Glassy cell carcinoma is a histologic subtype of cervical cancer with distinct pathologic features and it has an aggressive biologic course. It was first described by Glucksmann and Cherry in 1956 as a poorly differentiated adenoquamous carcinoma and commented on its poor prognosis, unresponsiveness to traditional modes of therapy, and often associated with pregnancy. The characteristic histologic features are defined as follows: 1) cells with a moderate amount of cytoplasm resembling ground glass, 2) a fairly distinct cell membrane that stains with eosin or PAS, 3) large nuclei with prominent nucleoli. We present two cases of glassy cell carcinoma of the cervix successfullyl treated by neoadjuvant chemotherapy and radical hyterectorny, with a brief review of literatures.
Cell Membrane ; Cervix Uteri* ; Coloring Agents ; Cytoplasm ; Drug Therapy* ; Eosine Yellowish-(YS) ; Female ; Glass ; Hysterectomy* ; Pregnancy ; Prognosis ; Prunus ; Uterine Cervical Neoplasms

Vasovagal syncope is elicited by the Bezold-Jarisch reflex, triggered by anxiety, emotional stress or pain. It is the result of reflexively increasing parasympathetic tone and decreasing sympathetic tone sensed by chemoreceptor in vagus nerve and mechanoreceptor of ventricle, which causes bradycardia, systemic vasodilatation and profound hypotension. Although it is a transient episode in many cases, it could give rise to cardiac arrest. Diabetic autonomic neuropathy can lead to significant change in blood pressure and pulse rate, bradycardia, hypotension, and even cardiac arrest by increasing the risk of hemodynamic instability under general or regional anesthesia. We have experienced a patient who had once cardiac arrest following after positional change and recovered in a few minutes. The patient was supposed to have diabetic autonomic neuropathy under the emotional stress and anxiety before spinal anesthesia was done. We believe that this is the result of combination between paradoxical Bezold-Jarisch reflex caused by overactivation of parasympathetic nerve system and autonomic nervous system instability precipitated by diabetic autonomic neuropathy.
Anesthesia, Conduction ; Anesthesia, Spinal* ; Anxiety ; Autonomic Nervous System ; Blood Pressure ; Bradycardia ; Death, Sudden, Cardiac* ; Diabetic Neuropathies ; Heart Arrest ; Heart Rate ; Hemodynamics ; Humans ; Hypotension ; Mechanoreceptors ; Reflex ; Stress, Psychological ; Syncope, Vasovagal ; Vagus Nerve ; Vasodilation

Endometrial carcinoma is the most common female genital organ malignancy in western countries and the incidence is increasing in Korea. Endometrial carcinoma frequently develops under the condition of excessive prolonged estrogenic stimulation in the absence of progesterone but the molecular mechanisms of carcinogenesis remain unknown. Recent advances in molecular biology have led to the concept that carcinoma arise from the accumulation of a series of gene alterations involving activation of proto-oncogenes and inactivation of tumor suppressor genes. The p53, one of tumor suppressor genes, is located on chromosome 17p. Alteration of p53 gene is observed in a wide variety of human cancer. Immunohistochemistry is considered as a simple and useful method to detect p53 overexpression in surgical pathologic specimens and close correlation of p53 expression with the presence of mutations in the gene has been demonstrated. In order to observe the expression of p53 protein, immunohistochemical studies were performed in 28 cases of endometrial carcinoma, 33 cases of endometrial hyperplasia, and 8 cases of disordered proliferative phase endometrium were used as a control group. The results were as follows: 1. The expression rate of p53 protein were 57.1% (16/28) in endometrial carcinoma and 12.1% (4/33) in endometrial hyperplasia but 8 cases of disordered proliferative phase endome-trium revealed negative reaction. 2. The expression rates of p53 protein were 47.4% (9/19) in early stage and 77.8% (7/9) in advanced stage of endometrial carcinoma. 3. According to histologic grade of endometrial carcinoma, the expression rates of p53 protein were 58.4% (10/7) in G1, 62.0% (5/8) in G2, and 33.3% (1/3) in G3. 4. The expression of p53 protein of simple hyperplasia were 12.5% (2/16) and that of complex hyperplasia were 11.8% (2/17). In conclusion, it could be suggested that p53 gene alteration might play a role in carcinogenesis of endometrium and mutation of p53 gene might be a relatively late event in tumor progression. Further study will be required to clarify the role of p53 in the carcinogenesis of the endometrium.
Carcinogenesis ; Endometrial Hyperplasia* ; Endometrial Neoplasms* ; Endometrium ; Estrogens ; Female ; Genes, p53 ; Genes, Tumor Suppressor ; Genitalia ; Humans ; Hyperplasia ; Immunohistochemistry ; Incidence ; Korea ; Molecular Biology ; Progesterone ; Proto-Oncogenes

Endometrial carcinoma is the most common female genital organ malignancy in western countries and the incidence is increasing in Korea. Endometrial carcinoma frequently develops under the condition of excessive prolonged estrogenic stimulation in the absence of progesterone but the molecular mechanisms of carcinogenesis remain unknown. Recent advances in molecular biology have led to the concept that carcinoma arise from the accumulation of a series of gene alterations involving activation of proto-oncogenes and inactivation of tumor suppressor genes. The p53, one of tumor suppressor genes, is located on chromosome 17p. Alteration of p53 gene is observed in a wide variety of human cancer. Immunohistochemistry is considered as a simple and useful method to detect p53 overexpression in surgical pathologic specimens and close correlation of p53 expression with the presence of mutations in the gene has been demonstrated. In order to observe the expression of p53 protein, immunohistochemical studies were performed in 28 cases of endometrial carcinoma, 33 cases of endometrial hyperplasia, and 8 cases of disordered proliferative phase endometrium were used as a control group. The results were as follows: 1. The expression rate of p53 protein were 57.1% (16/28) in endometrial carcinoma and 12.1% (4/33) in endometrial hyperplasia but 8 cases of disordered proliferative phase endome-trium revealed negative reaction. 2. The expression rates of p53 protein were 47.4% (9/19) in early stage and 77.8% (7/9) in advanced stage of endometrial carcinoma. 3. According to histologic grade of endometrial carcinoma, the expression rates of p53 protein were 58.4% (10/7) in G1, 62.0% (5/8) in G2, and 33.3% (1/3) in G3. 4. The expression of p53 protein of simple hyperplasia were 12.5% (2/16) and that of complex hyperplasia were 11.8% (2/17). In conclusion, it could be suggested that p53 gene alteration might play a role in carcinogenesis of endometrium and mutation of p53 gene might be a relatively late event in tumor progression. Further study will be required to clarify the role of p53 in the carcinogenesis of the endometrium.
Carcinogenesis ; Endometrial Hyperplasia* ; Endometrial Neoplasms* ; Endometrium ; Estrogens ; Female ; Genes, p53 ; Genes, Tumor Suppressor ; Genitalia ; Humans ; Hyperplasia ; Immunohistochemistry ; Incidence ; Korea ; Molecular Biology ; Progesterone ; Proto-Oncogenes

OBJECTIVES: It is widely accepted that estrogen has favorable effects on cardiovascular diseases, especially in the postmenopausal women. Endothelin-1(ET-I), released from the vascular endothelium, is a 21-amino acid peptide with strong vasoconstrictor activity. However, the effect of estrogen on the vasoconstriction to ET-1 has not been extensively studied. METHODS: To investigate the effect of estrogen (175beta-estradiol) on the vascular contraction to ET-1, porcine coronary artery(PCA) rings were suspended in organ chambers(37 degrees C, 95% O2/5% CO2) for measurement of isometric tension change. Endothelium was removed mechanically if necessary. In acute experiments, vascular rings were preincubated for 15minutes with 3different concentrations of 170beta-estradiol(10(-6), 10(-5), 10(-4)M) and concentration-contraction curves to cumulative doses of ET-1 were constructed. In the experiments after a longer exposure to 17beta-estradiol, the vessels with endothelium were exposed in the 5% CO2 incubator to 3different concentrations of 17beta-estradiol(10(-9), 10(-8), 10(-7)M) for 44-50 hours, and then concentrationcontraction curves to ET-1 were obtained. RESULTS: Incubation for 15minutes with 170beta-estradiol(10(-4)M) inhibited ET-1-induced contraction in the vessels with endothelium(area under the curve and maximal contraction, p<0.05 compared with control). This effect persisted regardless of the sex and the presence or absence of the endotheliurn. Incubation of the vessels far a longer time with 170beta-estradiol(44-50 hours) resulted in the inhibition of maximal contraction to ET-1(p<0.05) by a lower concentration of 175beta-estradiol(10(-7)M) than in acute experiments in male PCA rings, but an enhanced contraction to ET-1(area under the curve; p<0.05) by 10M of 175beta-estradiol was observed in female PCA rings. CONCLUSION: Short-time incubation with 17Pbeta-estradiol has an inhibitory effect on the contraction to ET-1 in PCA rings. This effect is independent of the presence of the endothelium and the sex of the pigs. A longer incubation with 17beta-estradiol results in a similar inhibitory effect on male(but not female) PCA rings, suggesting that a sex-related difference may exist concerning the effect of 17beta-estradiol on ET-1-induced contraction.
Cardiovascular Diseases ; Coronary Vessels* ; Endothelin-1* ; Endothelins ; Endothelium ; Endothelium, Vascular ; Estrogens ; Female ; Humans ; Incubators ; Male ; Passive Cutaneous Anaphylaxis ; Swine ; Vasoconstriction

Brugada syndrome is an arrhythmogenic disease that is manifested by specific patterns of right bundle branch block with ST elevation in right precordial (V1-V3) ECG leads causing ventricular fibrillation, leads to a sudden death without organic heart problems. It is an incomplete penetrating autosomal dominant disease that is due to mutation in SCN5A gene, coding for Na+ channel of cardiac muscles. This syndrome is more common and may be endemic in southeast Asia. Although it is a highly risky disease, it's preventive treatment for arrhythmia has not been established yet. We experienced a case of 28 year old man who had wedge resection of lung because of spontaneous pneumothorax under general anesthesia and who was suspected Brugada syndrome based on specific ECG patterns and a family history of his father's sudden death after syncope.
Adult ; Anesthesia, General ; Arrhythmias, Cardiac ; Asia, Southeastern ; Brugada Syndrome* ; Bundle-Branch Block ; Clinical Coding ; Death, Sudden ; Electrocardiography ; Heart ; Heart Arrest ; Humans ; Lung ; Myocardium ; Pneumothorax ; Syncope ; Ventricular Fibrillation

PURPOSE: Purpose was to explore associations between sleep duration and metabolic syndrome (MS) risks, and to determine factors associated with self-rated health (SRH) of adults with MS compared to other adults. METHODS: This is a secondary data analysis based on the Fifth Korea National Health and Nutrition Examination Survey KNHANES V (N=12662). Study instruments included sleep duration, MS risk factors, SRH and health-related quality of life (HRQoL). RESULTS: Mean age of participants was 43.68+/-12.26 years. Fifty-eight percent were women, and 18.3% were identified as having MS. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and SRH were significantly different according to sleep duration (p<.05) among all participants. In the non MS group, male gender, younger age (19~30 and 41~50 age brackets) upper income level, sufficient sleep duration, and high density lipoprotein (HDL) were positively associated with SRH, whereas, lower education levels (< or = middle school), glucose level, and waist circumference were negatively associated with SRH (p<.05). In the MS group, lower income, lower education levels (< or = middle school), glucose level, and waist circumference were negatively associated with SRH, whereas, having an occupation was positively associated with SRH (p<.05). CONCLUSION: Results suggest that tailored approaches are required for prevention and control of MS and sleep duration of each individual should be considered rather than applying standardized guidelines. However, as sleep quality was not included in the analysis, further investigations regarding influence of sleep quality on MS and SRH and controlling for other lifestyle and health behavior factors are required.
Adult ; Blood Glucose/analysis ; Blood Pressure/physiology ; Cholesterol, HDL/blood ; Female ; *Health Status ; Humans ; Male ; Metabolic Syndrome X/*physiopathology ; Middle Aged ; Odds Ratio ; Quality of Life ; Risk Factors ; Self Report ; *Sleep ; Young Adult

Dislocation of fixed bearing posterior stabilized total knee arthroplasty is very rare. There are several causes of postoperative dislocation such as malposition of the prosthesis, preoperative valgus deformity, a defect of the extensor mechanism and overwidening of the flexion gap. All of the three posterior dislocations of total knee arthroplasty occurred for the same design, which was the fixed bearing posterior stabilized type (TC-PLUS(R), Plus Orthopedics, Rotkreuz, Switzerland). The dislocations happened during full flexion with muscle relaxation and they could be manually reduced with the patient being given muscle relaxant. Each case showed two episodes of dislocation and there was no more dislocation in each case after quadriceps strengthening and walking exercise. In conclusion, this model requires modification of the design, including remodeling of the polyethylene spacer by heightening of the post.
Arthroplasty ; Congenital Abnormalities ; Dislocations ; Humans ; Knee ; Knee Prosthesis ; Muscle Relaxation ; Muscles ; Orthopedics ; Polyethylene ; Prostheses and Implants ; Ursidae ; Walking

Epiphrenic diverticulum(traction type) is such a rare disease. The case of this disease which is due to mediastinal tumor, not because of inflammatory adhesion or of motor disorder is especially hard to find. The patient was a 50-year-old male and admitted with the intermittent postprandial chest discomfort. The chest CT and esophagography showed epiphrenic diverticulum(traction type). The tumor was located at the left anterolateral of thoracic spine, adhered to the right wall of esophagus. We performed the diverticulectomy and extirpation of mediastinal tumor under left posterolateral thoracotomy. The tumor and the esophagus were well seperated without invasion to the esophagus. In the pathology of resected tissues, solitary neurofibroma was diagnosed. There was no complication or recurrence after surgical resection.
Age Factors ; Diverticulum* ; Epidemiology ; Esophagus ; Hepacivirus ; Hepatitis B virus ; Humans ; Male ; Middle Aged ; Neurofibroma ; Pathology ; Rare Diseases ; Recurrence ; Spine ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed

Brain abscess following ischemic stroke is a very rare and dangerous condition that can have catastrophic results, and thus requires urgent and comprehensive evaluation. We report a case of a patient with brain abscess that developed at the lesion site of a previous cerebral infarction. The disruption of the blood-brain barrier in the infarcted lesion might facilitate abscess formation, making it a preferred target for infectious agents.
Abscess ; Blood-Brain Barrier ; Brain ; Brain Abscess ; Brain Infarction ; Cerebral Infarction ; Humans ; Stroke