PURPOSE: We evaluated the correlation between the carcinogenesis of gallbladder and the expression of lysozyme, p53, c-erbB2 and CEA in gallbladder lesions. MATERIALS AND METHODS: Thirty cases of gallbladder lesions (containing 17 cases of GB carcinoma) were examined. We analyzed the clinicopathologic findings of the early (stage I & II) and advanced carcinoma (stage III, IV & V) and those of carcinoma with or without metaplasia in the tumor. We performed p53, c-erbB2 and CEA immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. We also performed lysozyme immunohistochemical staining and compared its finding with metaplastic and non-metaplastic lesions. RESULTS: There are two distinct genetic pathways in gallbladder cacinogenesis and metaplastic carcinoma was more frequent than non-metaplastic carcinoma. Metaplasia of gallbladder did not reveal any difference of the clinicopathologic findings and depth of invasion (Nevin stage). Lysozyme expression was found in all metaplastic lesions but non-expression did not indicate non-metaplastic lesions. p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively. The correlation of p53 and c-erbB2 expressions was found but which did not indicate that the co-expression was needed in the carcinogenesis. CEA immunohistochemical staining may be helpful in the differential diagnosis of benign lesions and precancerous and cancerous lesions of the gallbladder. CONCLUSION: These results suggest that p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively.
Carcinogenesis ; Diagnosis, Differential ; Gallbladder* ; Metaplasia* ; Mucous Membrane ; Muramidase

No abstract available.
Aged* ; Femur Neck* ; Femur* ; Humans

Intrsneural ganglion cysts of the peroneal nerve are rare. The precise etiology and pathological changes remain obscure. We have experienced recently a case of intraneural ganglion cyst developed in the sheath of the peroneal nerve. A 28 year old male had suffered from lump producing pain over the posterolateral aspect of the upper portion of the fibula, weakness of dorsiflexion of the ankle and of extension of the toes and diminution of sensation on the dorsum of the foot. He underwent excision of the ganglion and the prognosis for recovery of function is good.
Ankle ; Fibula ; Foot ; Ganglion Cysts ; Humans ; Male ; Peroneal Nerve ; Prognosis ; Recovery of Function ; Sensation ; Toes

BACKGROUND: These days, narrowband-UVB (NB-UVB) phototherapy is used worldwide for treating psoriasis. Some evidence allegedly suggests that, in contrast to broadband UVB therapy, near- erythemogenic doses are not required as starting doses for NB-UVB phototherapy to decrease the risk of burning. However, a recent study has proved that the near-erythemogenic dose to start NB-UVB phothotherapy was preferable to the far-erythemogenic dose method. OBJECTIVE: We compared the therapeutic effects between 70% MED (MED70%) and 50% MED (MED50%) methods in NB-UVB phototherapy of psoriasis. In addition, to elucidate the action mechanism of NB-UVB in psoriasis treatment, we also investigated the immunosuppresive effects of Langerhans cells, macrophages and chemokine/chemokine receptors. METHOD: We compared the near-erythemogenic NB-UVB protocol (initial 70% MED+delta10% increase at each visit, twice per week) with the far-erythemogenic protocol (initial 50% MED+delta10% increase at each visit, twice per week). We performed skin biopsies after 4 times of 1 MED, once of 4 MED and once of 1 MED, along with corresponding controls from the lesional and non-lesional sites. Immunohistochemistry was also performed with anti-CD1a, anti-CD11b, anti-MCP-1 and anti-CCR2 antibodies. RESULTS: The results of immunohistochemcial experiments were as follows; 1. NB-UVB irradiation decreased the number of CD1a+ Langerhans cells in the epidermis, but increased CD11b+ macrophages in the dermis. CD11b+ macrophages were increased more in the dermis in single high-dose irradiation than repeated small dose irradiations of equivalent total doses. 2. MCP-1 was expressed only in the entire epidermis of the psoriatic lesion, and was especially high in proliferating keratinocytes of basal and suprabasal layers. It was also expressed in the papillary dermis to a lesser extent. CCR2, a receptor for MCP-1, was also found to be expressed in a similar pattern to MCP-1. Single high-dose irradiation reduced MCP-1 and CCR2 to a moderate degree, especially in the basal layer, more than the repeated low-dose irradiation of an equivalent total dose. CONCLUSION: The near erythemogenic NB-UVB protocol (MED70%) showed an earlier resolution of the psoriatic lesions and a lower recurrent rate than the far-erythemogenic NB-UVB protocol. Higher NB-UVB reduced the number of CD1a+ Langerhans cells in the epidermis, and increased CD11b+ monocytes/macrophages in the dermis. A higher dose of NB-UVB downregulated CCR-2 and MCP-1 expression. The expression patterns of epidermal and dermal APCs and chemokines in this study indicate that NB-UVB in psoriasis treatment has immunosuppressive properties. For better NB-UVB protocols in psoriasis treatment, higher starting doses and incremental doses may be desirable.
Antibodies ; Biopsy ; Burns ; Chemokines* ; Dendritic Cells* ; Dermis ; Epidermis ; Immunohistochemistry ; Keratinocytes ; Langerhans Cells ; Macrophages ; Phototherapy* ; Psoriasis* ; Skin

BACKGROUND: The purpose of this study was to investigate the association between diabetes and depressive symptoms among Korean women. METHODS: We performed an analysis of data for 6,572 women aged 30 or over obtained from the Fifth Korean National Health and Nutrition Examination Survey conducted in 2010 to 2011. We examined the presence of depressive symptoms and the treatment of depression according to diabetes status. RESULTS: The presence of depressive symptoms was observed in 22.6% of subjects with diabetes. In the multiple logistic regression model, diabetes was associated with an increased risk of depressive symptoms (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.20 to 1.21) but the treatment of depression among diabetics was less common (OR, 0.54; 95% CI, 0.54 to 0.55). Uncontrolled diabetes (glycosylated hemoglobin > or = 7%) was associated with an increased risk of depressive symptoms (OR, 1.71; 95% CI, 1.69 to 1.73) among diabetics. CONCLUSION: Physicians should manage individuals with diabetes in consideration of the presence of depressive symptoms, especially in those with uncontrolled diabetes.
Depression* ; Diabetes Mellitus ; Female ; Humans ; Logistic Models ; Nutrition Surveys*

PABAP (Palindrome Analysis by BLAST Program) is an analysis system that identifies palindromic sequences from a large genome sequence up to several megabases long. It uses NCBI BLAST as a searching engine, and data processing such as alignment filtration and detection of inverted repeats which satisfy user- defined parameters is performed by manipulating data after populating into a MySQL database. PABAP outperforms publicly available palindrome search program in that it can detect large palindrome with internal spacer at a faster speed from bacterial genomes. It is a standalone application and is freely available for noncommercial users. AVAILABILITY: This application was implemented with free software (Perl, Apache, MySQL, and NCBI BLAST) and is freely available to noncommercial users upon request. Analysis of user data can be carried out directly at http://chimp.kribb.re.kr/~javamint/palindrome.
APACHE ; Filtration ; Genome* ; Genome, Bacterial

We describe an unusual case of extragastrointestinal stromal tumor (EGIST) presenting as a scrotal mass. A 71-year-old man presented with a gradually enlarging scrotal mass with a 20-year duration. Physical examination revealed a huge (as large as volleyball), round, nontender mass occupying the whole scrotum, which was resected completely. Clinical and radiological findings did not comply with any other primary site disease. Under histological examination, the tumor showed a spindle cell pattern with low cellularity, absence of necrotic and mitotic features. immunohistochemical analysis revealed the tumor reactive for CD117 and CD34, while negative for smooth muscle actin, desmin and S-100 protein. To our knowledge, this is the first reported case of an EGIST involving the scrotum.
Aged ; Antigens, CD34 ; analysis ; Gastrointestinal Stromal Tumors ; diagnosis ; Humans ; Immunohistochemistry ; Male ; Proto-Oncogene Proteins c-kit ; analysis ; Scrotum ; pathology ; Sex Cord-Gonadal Stromal Tumors ; chemistry ; pathology

Xanthoma disseminatum (XD) is a rare, potentially progressive non-Langerhans cell histiocytosis, which preferentially affects males in their childhood or young adulthood. It is characterized by the insidious onset of small, yellowish-red to brown papules and nodules that are discrete and disseminated. They characteristically involve the eyelids and flexural areas of the axillary and inguinal folds, and the antecubital and popliteal fossae. Systemic disease frequently occurs, the most common manifestation being diabetes insipidus (DI), which occurs in about 40% of cases and is due to deposition of xanthoma cells in the hypothalamic-pituitary axis. We present a case of XD with DI, which was treated with the combination therapy of CO2 laser vaporization, cyclophosphamide, electrocauterization and synthetic anti-diuretic hormone.
Axis, Cervical Vertebra ; Cyclophosphamide ; Diabetes Insipidus ; Eyelids ; Histiocytosis ; Histiocytosis, Non-Langerhans-Cell ; Humans ; Lasers, Gas ; Male ; Volatilization ; Xanthomatosis

OBJECTIVE: Adult appendicitis (AA) with equivocal computed tomography (CT) findings remains a diagnostic challenge for physicians. Herein we evaluated the diagnostic performance of several clinical scoring systems in adult patients with suspected appendicitis and equivocal CT findings. METHODS: We retrospectively evaluated 189 adult patients with equivocal CT findings. Alvarado, Eskelinen, appendicitis inflammatory response, Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA), and adult appendicitis score (AAS) scores were evaluated, receiver operating characteristic analysis was conducted, and the optimal, low, and high cut-off values were determined for patient classification into three groups: low, intermediate, or high. RESULTS: In total, 61 patients were included in the appendicitis group and 128 in the non-appendicitis group. There were no significant differences between the area under the curve of the clinical scoring systems in the final diagnosis of AA for equivocal appendicitis on CT (Alvarado, 0.698; Eskelinen, 0.710; appendicitis inflammatory response, 0.668; RIPASA, 0.653; AAS, 0.726). A RIPASA score greater than 7.5 had a high positive predictive value (90.9) and an AAS score less than or equal to 5 had a high negative predictive value (91.7) in the diagnosis of AA. CONCLUSION: The accuracy of clinical scoring systems in the diagnosis of AA with equivocal CT findings was moderate. Therefore, a high RIPASA score may assist in the diagnosis of AA in patients with equivocal CT findings, and a low AAS score may be used as a criterion for patient discharge. Most patients presented with intermediate scores. The patients with equivocal CT findings may be considered as a third diagnostic category of AA.
Adult* ; Appendicitis* ; Classification ; Clinical Decision-Making ; Diagnosis ; Diagnostic Tests, Routine ; Humans ; Multidetector Computed Tomography ; Patient Discharge ; Retrospective Studies ; ROC Curve ; Skates (Fish)

BACKGROUND: The aim of this study was to compare the BD Phoenix (Beckton Dickinson Diagnostic Systems, USA) extended-spectrum beta-lactamase (ESBL) test with the Clinical and Laboratory Standards Institute (CLSI) ESBL phenotypic confirmatory test by disk diffusion (CLSI ESBL test) in Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis. METHODS: We tested 224 clinical isolates of E. coli, K. pneumoniae, K. oxytoca and P. mirabilis during May 2006 to March 2007. These isolates were examined by the Phoenix and the CLSI ESBL tests simultaneously. For the isolates showing discordant results between the two tests, boronic acid disk test was performed to differentiate AmpC beta-lactamase and ESBL. RESULTS: Among the 224 clinical isolates, 75 and 79 isolates were positive for ESBL by CLSI ESBL test and Phoenix test, respectively. Having detected 4 more isolates as ESBL-producers, Phoenix test showed a 98.2% agreement with a 100% sensitivity and 97.3% specificity compared with CLSI ESBL test. Among the four false positive isolates, three were AmpC-positive but ESBL-negative. CONCLUSIONS: The BD Phoenix ESBL test was sensitive and specific, and can be used as a rapid and reliable method to detect ESBL production in E. coli, Klebsiella species, and P. mirabilis.
Automation ; Bacterial Proteins/classification/*metabolism ; Disk Diffusion Antimicrobial Tests ; Escherichia coli/drug effects/*enzymology/isolation & purification ; Humans ; Klebsiella/*enzymology ; Klebsiella oxytoca/drug effects/enzymology/isolation & purification ; Klebsiella pneumoniae/drug effects/enzymology/isolation & purification ; *Microbial Sensitivity Tests ; Proteus mirabilis/drug effects/*enzymology/isolation & purification ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; beta-Lactamases/classification/*metabolism