True malignant mixed tumor (carcinosarcoma) of the salivary gland is an extremely rare tumor. By definition, it is a heterologous neoplasm that's composed of both malignant epithelial and mesenchymal components. We report here on a case of an 83 year old female patient with a parotid gland mass. Histologic examination showed a biphasic pattern of growth with both a poorly differentiated epithelial component and a sarcomatous spindle cell background. The immunohistochemical and ultrastructural findings support the diagnosis of a small cell neuroendocrine epithelial tumor and an undifferentiated malignant mesenchymal features. The histologic and ultrastructural features along with the immunohistochemical findings are presented. We also review the literature and we discuss the different opinions on the exact histogenesis of the true malignant mixed tumor of the salivary gland. To the best of our knowledge, this histological pattern has not been previously reported in the English medical literature.
Female ; Humans

PURPOSE: The human fetus is primarily dependent on the placenta for its nutrition. However, as the fetus matures, it swallows increasing amounts of amniotic fluid, which contributes to the growth of fetus. Accordingly fetuses with congenital obstruction of the gut at high level have a reduced capacity for intestinal absorption of amniotic fluid. We undertook a study to investigate the effect of congenital gut obstruction on fetal growth. METHOD: A retrospective review of the records of all patients presenting congenital gut obstruction over 6-year period (from 1992 to 1997) in Chung-ang Gil hospital was performed. Patients with a complete proximal obstruction were included in group A; patients with incomplete or lower obstruction were included in group B. RESULT: 1) The ratio of male to female was 1.5:1. The mean birth weight and gestational age were 2.89+/-0.60kg and 38.7+/-0.20weeks. The mean birth weight and gestational age in group A were 2.68+/-0.69kg and 37.8+/-0.25weeks. The mean birth weight and gesnal age in group B were 2.980.54kg and 39.1+0.17weeks. There was significant difference between group A and B (P<0.01). 2) Significant differences were found between group A and B in prematurity and growth retardation rate (P<0.01). No significant difference was found between group A and B in associated anomaly rate (P>0.05). 3) In group A, 3 (42.8%) of 7 patients with associated anomalies had IUGR, whereas 8 (40.0%) of 20 patients without associated anomalies had IUGR (P>0.05). The corresponding figures for group B were 23.0% and 14.8%, respectively (P>0.05). CONCLUSION: Congenital gut obstruction causes IUGR by reducing intestinal absorption of amniotic fluid and the effect of IUGR is more pronounced as the obstruction is proximal to jejunum rather than distal to it.
Amniotic Fluid ; Birth Weight ; Female ; Fetal Development* ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Humans ; Intestinal Absorption ; Jejunum ; Male ; Placenta ; Retrospective Studies ; Swallows

We experienced a case of eisenmenger syndrome treated by simple surgical intervention. Eisenmenger syndrome refers to patients with congenital heart defects who have a systemic level of pulmonary arterial pressure and high pulmonary vascular resistance, with right-to-left or bidirectional shunting. Because a progressive rise in pulmonary vascular resistance may be better tolerated with an intracardiac communication, surgical repair in such patients may shorthen their life. But, urgent surgical intervention should be undertaken to reverse process if the pulmonary vascular disease is of recent origin. Patients who respond to vasoilator therapy, such as oxygen, are subjected to surgery. We reported a case of PDA with eisenmenger syndrome whose pulmonary vascular resistance fall following vasodilator, 100% oxygen, and closure of defect during cardiac catheterization, preoperatively, and who may faborable after simple surgical repair.
Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Ductus Arteriosus, Patent* ; Eisenmenger Complex* ; Heart Defects, Congenital ; Humans ; Ligation* ; Oxygen ; Vascular Diseases ; Vascular Resistance

BACKGROUND: Cytokeratins were subdivided into 20 different cytokeratins. It is known that cytokeratin 19 is particularly abundant in carcinoma of the lung. METHOD: A sandwich enzyme-linked immunosorbent assay called CYFRA 21-1, combining two monoclonal antibodies directed specifically aganist cytokeratin 19 was done by ES-300(Boehringer Mannheim, Germany). We investigated the diagnostic value of the new tumor marker CYFRA 21-1 in lung cancer in comparison to carcinoembryonic antigen(CEA) and neuron specific enolase(NSE) in the pilot study on 39 serum samples from lung cancer (17 squamous cell cancer, 11 adenocarcinoma, 11 small cell carcinoma) and 51 benign lung diseases and 41 normal healthy persons. RESULTS: Postulating a specificity 95% versus benign lung disease and healthy group, the diagnostic sensitivity of CYFRA 21-1 in lung cnacer independent of histologic type was 43.6% whereas CEA was 48.7% and NSE was 30.8%. The diagnostic sensitivity is increased to 69.2% by combining CYFRA 21-1 with CEA. Classifying the lung carcinomas following their histologic type, squamous cell carcinomas proved to possess the highest CYFRA 21-1 sensitivity(CYFRA 21-1 47.1%, CEA 23.5%, NSE 11.8%) and the combination with CEA 52.9% could not markedly increase the number of true-positive test results. In adenocarcinoma, CEA possessed the highest sensitivity (81.8%) whereas CYFRA 21-1 was 45.5% and NSE was 9.1%. In small cell carcinoma of lung, NSE possessed the highest sensitivity(81.8%) whereas CYFRA 21-1 was 36.4% and CEA was 54.5%. CONCLUSION: This study indicates that CYFRA 21-1 has a potential as a new marker for squamous cell lung cancer. If histologic type is unknown at the time of primary diagnosis. the combined determination of CYFRA 21-1 and CEA showed the best discrimination between benign and malignant lung disease.
Adenocarcinoma ; Antibodies, Monoclonal ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Discrimination (Psychology) ; Enzyme-Linked Immunosorbent Assay ; Humans ; Keratin-19 ; Keratins ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Neoplasms, Squamous Cell ; Neurons ; Pilot Projects ; Sensitivity and Specificity

OBJECTIVE: The purpose of this study was to analyze the clinical study for patients with cervical cancer who had undergone radical hysterectomy. METHOD: The subjects of this study were one hundred and sixty two patients with cervical cancer who had undergone radical hysterectomy at Eulji Medical College Hospital, Taejon, Korea, from January 1983 to December 1992. We reviewed the medical record retrospectively and analyzed the data. RESULT: The distribution of patients by age was found in the order of 50 decade and 60 decade, 40 decade. Those by the clinical stages were as follows: Stage Ia, 12 cases(7.4%); Stage Ib, 84 cases(51.9%); Stage IIa, 39 cases(24.1%); Stage IIb 27 cases(16.7%). The results of histopathologic type were distributed as follows: squamous cell carcinoma was 91.9%, adenocarcinoma was 4.9% and adenosquamous cell carcinoma was 3.1%. The histologic subtypes of squamous cell carcinoma(149 cases) were as follows: Large cell non-keratinizing type was 75.9%, large cell keratinizing type was 14.8% and small cell type was 1.2%. The frequancy of lymph node metastasis was 22.9% in stage I and 31.8% in stage II. The overall incidence of lymph node metastasis was 26.4%. The frequency of external radiation therapy done after radical hysterectomy was 63.5% in stage I and 75.8% in stage II. The 5-year survival rate was as follows: The Ia was 100%; Stage Ib, 95.2%(4cases); Stage IIa, 87.2%(5cases); Stage IIb, 77.8%(6cases). The incidence of recurrence was 7.4% and recurrent sites were vaginal stump , rectum and pelvic wall. CONCLUSION: The highest incidence of cervix cancer in age distribution was 50 decade(30.9%) and 60 decade(30.9%). The most common clinical stage was Ib(51.9%) and most frequent pathologic type was squamous cell carcinoma(91.9%). The overall incidence of lymph node metastasis was 26.4% and The most common site of recurrence was vaginal stump. The 5-year survival rate was 100% in the stage Ia, 95.2% in the stage Ib, 87.2% in the stage IIa, 77.8% in the stage IIb.
Adenocarcinoma ; Age Distribution ; Carcinoma, Squamous Cell ; Daejeon ; Humans ; Hysterectomy* ; Incidence ; Korea ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

Migration of an intrauterine device into the bladder, together with secondary stone formation is an extremely rare complication. We have recently encountered the migration of a Lippes loop into the urinary bladder and an associated secondary stone formation. We report our findings together with a review of the literature.
Intrauterine Devices ; Urinary Bladder Calculi* ; Urinary Bladder*

OBJECTIVE: To determine whether oxidants are formed as part of the cisplatin-induced apoptotic process, intracellular markers of oxidative stress were examined. METHODS: Apoptotic death of HeLa cells by cisplatin was confirmed by flow cytometry. RESULTS: The pre-treatment with glutathione (GSH) significantly attenuated cisplatin-induced apoptosis through the reduction of reactive oxygen species (ROS) accumulation and diminished caspases-3 and 9 protease activity. Furthermore, z-VAD-fmk, an inhibitor of pan-caspase, effectively inhibited the activation of caspases and prevented apoptosis by cisplatin, although cisplatin-induced ROS generation was not attenuated. CONCLUSION: These data indicate that ROS may play a role as an upstream mediator of caspases. Taken together, our results suggest that oxidative stress mediates cisplatin-induced apoptosis in HeLa cells.
Apoptosis* ; Caspases ; Cisplatin ; Flow Cytometry ; Glutathione ; HeLa Cells* ; Humans ; Oxidants ; Oxidative Stress* ; Reactive Oxygen Species

OBJECTIVE: The purpose of this study is to evaluate the effect of Vitamin-C vaginal tablets on vaginal pH and vaginitis symptoms of pregnant women. METHODS: Ninety pregnant women who visited the antenatal clinic were included in this study after giving their informed consent. The treatment regimen of the vitamin-C vaginal tablets (250 mg, Vagi-C(R), Taurus Pharma GmbH, Germany) was one tablet given once a day for 6 consecutive days. Vaginal pH was measured the day before and the day after the Vit-C vaginal treatment. Ninety women of initial, ten failed to follow-up (participate). After routine screening using microscopic analysis of the vaginal smears, 31 of the 80 participating women fell into one of 3 pathologic groups (15 monilial infection, 10 bacterial vaginosis, 6 trichomonial infection) and leaving 49 pathogen-free pregnant women. 10 of the pathogen-free pregnant women were excluded during the study because they did not complete the treatment period due to vaginal irritation such as itching or burning sensations. The diagnosis of each vaginal infection was made by specific pathologic findings. RESULT: Mean vaginal pH values for the pathology group decreased significantly from 4.9 to 4.2. Pathologic findings of each infection were also improved without specific treatment. Bacterial vaginosis disappeared in 80.0% (8/10) of patients. The specific pathogens of the remained two vaginitis types were not detected in 33.3% (5/15) of monilial infection and 33.3% (2/6) trichomonial infection 1 week after discontinuation of Vitamin-C vaginal tablets. Although it is not significant, mean vaginal pH values decreased from 4.4 to 4.2 in the pathogen-free pregnant women. CONCLUSION: Vitamin-C, when vaginally applied, is effective in lowering vaginal pH and in the treatment of vaginitis in pregnant women.
Burns ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hydrogen-Ion Concentration ; Informed Consent ; Mass Screening ; Pathology ; Pregnancy* ; Pregnant Women* ; Pruritus ; Sensation ; Vaginal Creams, Foams, and Jellies* ; Vaginal Smears ; Vaginitis* ; Vaginosis, Bacterial

PURPOSE: Both column and T-shaped acetabular fractures are frequently presented with difficulty in reduction. Incomplete reduction may cause traumatic arthritis in the hip joint, resulting in inferior clinical outcomes. The purpose of this study is to introduce our wiring technique and to report the clinical and radiological outcomes of such technique. MATERIALS AND METHODS: Eight patients who underwent our proposed technique for having acetabular fracture with displaced quadrilateral plate between March 2013 and December 2014 were enrolled. All patients were followed-up more than 1 year. The wire passer was set up from an anterolateral aspect of the iliac crest to the greater sciatic notch, between the abductor muscle and the periosteum. The quadrilateral plate of acetabular fracture was reduced with wiring. Internal fixation was added to the pelvic brim. An analysis of the clinical and radiological outcomes was performed. RESULTS: Reduction was performed within the 3 mm intra-articular step-off in all patients. The mean duration of union was 11.8 weeks (9-15 weeks). Five patients (62.5%) showed excellent results, and radiologically, three patients (37.5%) showed good results, and seven patients (87.5%) showed better than good results. CONCLUSION: The cerclage wiring fixation technique using a large cerclage passer instrument can be a useful and safe reduction method in some cases of acetabular fractures.
Acetabulum ; Arthritis ; Constriction* ; Hip Joint ; Humans ; Methods ; Periosteum

Osteoclasts are cells of hemopoietic origin that play an critical role in bone resorption and responsible for bone diseases, including osteoporosis, periodontal disease, and rheumatoid arthritis. In this study, we examined the effect of AG490, a Jak2-specific inhibitor on osteoclast differentiation. AG490 significantly inhibited receptor activator of NF-kappaB ligand (RANKL)-mediated osteoclast differentiation in a dose-dependent manner. RANKL stimulated the phosphorylation of p38, ERK, and JNK and promoted I-kappaB degradation. However, AG490 suppressed the phosphorylation of p38 induced by RANKL treatment. AG490 suppressed the mRNA expression of TRAP, c-Fos, NFATc1, and OSCAR in bone marrow-derived macrophages (BMMs) treated with RANKL. Also, AG490 significantly inhibited the protein expression of c-Fos and NFATc1 in response to RANKL. These results suggest that AG490 inhibited osteoclast differentiation by suppressing the expression of c-Fos and NFATc1.
Arthritis, Rheumatoid ; Bone Diseases ; Bone Resorption ; Macrophages ; Osteoclasts ; Osteoporosis ; Periodontal Diseases ; Phosphorylation ; Receptor Activator of Nuclear Factor-kappa B ; RNA, Messenger ; Tyrphostins