Pseudoangiomatous stromal hyperplasia (PASH) of the breast occurs in premenopausal women and is characterized by anastomosing channels lined by spindle cells. It has been suggested to be of hormonal origin. This unusual condition may also be mistaken for a vascular tumor. We analyzed eight cases of PASH of the breast in Samsung Cheil Hospital from 1992 through 1998. All patients were premenopausal and had painless breast lump. Clinical diagnoses were fibroadenomas. Grossly, the masses were well circumscribed, nonhemorrhagic and measure 2.2 to 5 cm. Histologically, they consisted of complex interanastomosing channels lined by slender spindle cells, which resembled low grade angiosarcoma. Cells that line the interanastomosing channels showed no immunoreactivity for Factor VIII and electron microscopic findings consistent with fibroblast. All patients were treated with surgical excision and none of them had recurrence for 1 to 69 months (mean: 19 months) postoperatively. Pathologic diagnosis of PASH may be difficult unless the pathologists are aware of the presence of a mass lesion and appreciate the characteristic stromal changes. PASH should be included in the differential diagnosis of a circumscribed mass, especially in the premenopausal women.
Breast* ; Diagnosis ; Diagnosis, Differential ; Factor VIII ; Female ; Fibroadenoma ; Fibroblasts ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Recurrence

PURPOSE: Adriarnycin induced cardiomyopathy is irreversible and may procede to clinical congestive heart failure. Recently, it has been suggested that adriamycin may exert cardiomyopathy due to inhibition of transport across mitochondrial membranes rnediated by the carnitine palmitoyltransferase system(CPT I). The effect of adriamycin on fatty acid metabolisrn according to cumulative dose was not clarified. The purpose of this study was to ascertain the acute effect of adriamycin on lipid and fatty acid metabolism accoring to cumulative dose. METHODS: Sprague-Dawley rats were divided into two groups. The first group was control. The second group was given intraperitoneal injection with adriamycin(5mg/kg) twice a week for 2 weeks. Serum lipid (total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol) and fatty acid levels were analyzed on the first day, 8th day, and 11th day after injection of adriamycin. RESULTS: Total cholesterol, triglyceride, and LDL cholesterol were significantly higher in adriamycin group compared to the control group. HDL cholesterol was similar in both groups. Total cholesterol and LDL choleterol level significantly increased over the adriamycin dose. Total fatty acid levels were significantly higher after injection of adriamycin. Long chain fatty acids such as palmitic acid, linoleic acicl and oleic acid levels were significantly elevated in the adriamycin group. CONCLUSION: Serum lipid and fatty acid levels increased significantly after injection of adriamycin.
Animals ; Cardiomyopathies* ; Carnitine O-Palmitoyltransferase ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Doxorubicin* ; Fatty Acids ; Heart Failure ; Injections, Intraperitoneal ; Metabolism* ; Mitochondrial Membranes ; Oleic Acid ; Palmitic Acid ; Rats* ; Rats, Sprague-Dawley ; Triglycerides

PURPOSE: The aim of this study was to assess and compare the efficacies of proton pump inhibitor-based triple therapy and bismuth-based quadruple therapy as first-line treatments for Helicobacter pylori eradication in Korean children. METHODS: We retrospectively reviewed the data of children who had been diagnosed with H. pylori infection at the Seoul National University Bundang Hospital from March 2004 to August 2012. The patients were randomly assigned to receive either triple therapy consisting of omeprazole, amoxicillin, and clarithromycin for 2 weeks (OAC group) or quadruple therapy comprising omeprazole, amoxicillin, metronidazole, and bismuth salts for 1 week (OAMB group). The patients were evaluated for eradication of H. pylori infection at 4 weeks after the completion of the treatment. RESULTS: Of the 129 children enrolled in this study, 118 (91.5%) were included in the final analysis. The eradication rates in OAC and OAMB groups were 67.7% (42/62) and 83.9% (47/56), respectively, which were significantly different between the 2 treatment groups (p=0.041). The eradication rates in the OAMB group during the periods 2004-2006, 2007-2009, and 2010-2012 were superior to those in the OAC group. CONCLUSION: This study indicated that the 1-week bismuth-based quadruple therapy, compared with the standard 2-week triple therapy, was significantly more successful in eradicating H. pylori infection in Korean children.
Amoxicillin ; Bismuth ; Child ; Clarithromycin ; Disease Eradication ; Helicobacter ; Helicobacter pylori ; Humans ; Metronidazole ; Omeprazole ; Proton Pumps ; Protons ; Retrospective Studies ; Salts

Recently developed new classifications (Holland, Van Nuys, modified Lagios) of ductal carcinoma in situ (DCIS) linked to outcome have emphasized the importance of nuclear morphology rather than architecture. We have evaluated these three classifications in ductal carcinomas composed of in situ and invasive carcinomas. The reproducibility of three classifications was assessed (n=49), and the histological grade of the DCIS was compared with the histologic differentiation (modified Bloom & Richardson method) and nuclear grade (modified Black method) of the coexisting invasive ductal carcinoma (n=45). According to Holland classification, the DCIS component was poorly differentiated in 51.0%, intermediately differentiated in 40.8%, and well differentiated in 8.2%. Using the Van Nuys classification, the DCIS component was group 3 (high grade with or without necrosis) in 44.9%, group 2 (non-high grade with necrosis) in 28.6%, and group 1 (non-high grade without necrosis) in 26.5%. According to the modified Lagios classification, the DCIS component was high-grade in 42.8%, intermediate-grade in 32.7%, and low-grade in 24.5%. The histologic grades of the three classifications revealed significant correlations between Holland and Van Nuys classification (p<0.0001) and between Holland and modified Lagios classification (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. The reproducibility of classification of the DCIS was 71.4% in the Holland, 61.2% in the Van Nuys, and 55.1% in the modified Lagios classifications. The grade of the DCIS showed significant correlation with the grade of coexisting invasive ductal carcinoma (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. In conclusion, DCIS grade, determined by the Holland, Van Nuys or modified Lagios classifications, is closely correlated with the histologic grade of the invasive ductal component in tumors composed of in situ and invasive ductal carcinoma, and may be a useful factor to estimate clinical behavior of DCIS. In our experience the Holland classification is recommended for DCIS classification due to its high reproducibility.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Classification* ; Netherlands

No abstract available.
Bone Marrow* ; Necrosis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

The term malignant mesenchymoma has been applied to those tumors of the soft tissue of mesenchymal origin which are composed of tumor cells differentiating into two or more unrelated malignant forms in addition to the fibrosarcomatous element. Recently authors experienced a case of malignant mesenchymoma in the right axillary area. Microscopically the sarcoma revealed multiple pattern of differentiation, including liposarcoma, malignant schwannoma, fibrosarcoma, malignant fibrous histiocytoma and rhabdomyoblastoma. The presence of rhabdomyblastic cells were proved by immunochemical study utilizing desmin. This patient was treated with surgical excision and radiation.

PURPOSE: To determine clinically useful biochemical markers reflecting disease activity and/or gastrointestinal (GI) tract involvement in Henoch-Schonlein purpura (HSP). METHODS: A total of 185 children with HSP and 130 controls were included. Laboratory data indicating inflammation, standard coagulation, and activated coagulation were analyzed for the HSP patients, including measurements of the hemoglobin level, white blood cell (WBC) count, absolute neutrophil count (ANC), platelet count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, prothrombin time, activated partial thromboplastin time, and fibrinogen, D-dimer, and fibrin degradation product (FDP) levels. The clinical scores of the skin, joints, abdomen, and kidneys were assessed during the acute and convalescence phases of HSP. RESULTS: The WBC count, ANC, ESR, and CRP, fibrinogen, D-dimer, and FDP levels were significantly higher in the acute phase compared with the convalescent phase of HSP (p<0.05). The total clinical scores were more strongly correlated with the D-dimer (r=0.371, p<0.001) and FDP (r=0.369, p<0.001) levels than with inflammatory markers, such as the WBC count (r=0.241, p=0.001), ANC (r=0.261, p<0.001), and CRP (r=0.260, p<0.001) levels. The patients with GI symptoms had significantly higher ANC (median [interquartile range], 7,138.0 [4,446.4-9,470.0] vs. 5,534.1 [3,263.0-8,153.5], p<0.05) and CRP (0.49 [0.15-1.38] vs. 0.23 [0.01-0.67], p<0.05), D-dimer (2.63 [1.20-4.09] vs. 1.75 [0.62-3.39]), and FDP (7.10 [0.01-13.65] vs. 0.10 [0.01-7.90], p<0.05) levels than those without GI symptoms. CONCLUSION: D-dimer and FDPs are more strongly associated with disease activity and more consistently reflect GI involvement than inflammatory markers during the acute phase of HSP.
Abdomen ; Biomarkers* ; Blood Coagulation ; Blood Sedimentation ; C-Reactive Protein ; Child* ; Convalescence ; Fibrin ; Fibrin Fibrinogen Degradation Products ; Fibrinogen ; Humans ; Inflammation ; Joints ; Kidney ; Leukocytes ; Neutrophils ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Purpura ; Purpura, Schoenlein-Henoch* ; Skin

Sclerosing hemangioma of the lung is uncommon benign neoplasm of uncertain histogenesis, although their radiological appearance is relatively distinct and well-defined. Recently, we experienced 2 cases of sclerosing hemangiomas of the lungs in 61 and 39 years old women. The light microscopic findings of the tissues are similar to the features reported by Liebow and Hubbell(1956). The basic cellular response is thought to be type II pneumonocytes because of findings of multilamellar-like bodies within stromal cells with electron microscopy in case I in addition to other characteristics generally found in epithelial cells.
Female ; Humans ; Hemangioma

Purpose: We report a case of orbital apex syndrome caused by co-infection of Actinomyces and Aspergillus invasive fungal sinusitis.Case summary: An 87-year-old female visited our clinic for decreased visual acuity which began 2 weeks prior to her visit. She had a history of angina and uncontrolled diabetes. Her best-corrected visual acuity (BCVA) of the left eye was 0.2, the intraocular pressure was in the normal range, and mild ptosis with impaired abduction was noted. Gadolinium-enhanced brain magnetic resonance imaging showed left maxillary sinusitis and an enhanced lesion invading the pterygopalatine fossa. Functional endoscopic sinus surgery was performed by an otorhinolaryngologist. Pathology revealed co-infection with Aspergillus and Actinomyces. Her left BCVA was negative light perception despite surgery and impaired abduction progressed to total ophthalmoplegia. Conclusions We report a case of orbital apex syndrome caused by invasive fungal sinusitis with a rare co-infection of Actinomyces and Aspergillus.

OBJECTIVE: To compare perioperative outcome of robot-assisted radical hysterectomy with abdominal radical hysterectomy for early-stage cervical cancer and endometrial cancer and to evaluate the feasibility of robotic-assisted radical hysterectomy. METHODS: We reviewed medical record of 37 patients who had radical hysterectomy at Hallym university for cervical cancer stage Ia1 to IIa and endometrial cancer stage Ia to Ib. Abdominal radical hysterectomy was carried out in 27 (Abdominal group) patients and robot-assisted radical hysterectomy carried out in 10 patients (Robotic group). We compared patient's characteristics between two groups. Perioperative characteristics compared included cancer stage, operative time, number of nodes, estimated blood loss, length of hospital stay and complications. RESULTS: There were no differences in age, parity, history of medical disease, body mass index between two groups (p>0.05). Robotic operative times were significantly longer than for abdominal (480.0+/-117.8 vs. 286.9+/-65.6 min, p<0.0001). Blood loss (660.0+/-245.9 vs. 1,137.0+/-608.4 mL. p<0.0001) and length of hospital stay (7.2 versus 17.1 days, p<0.0001) were significantly lower for the robotic group. Lymph node yield in the robotic group was equivalent to that for the abdominal group (30.1+/-8.7 vs. 35.4+/-16.9, p=0.356). No major operative complications occurred with both groups. CONCLUSION: Robot-assisted radical hysterectomy appears safe and feasible in early-stage cervical and endometrial cancer.
Body Mass Index ; Endometrial Neoplasms ; Female ; Humans ; Hysterectomy ; Length of Stay ; Lymph Nodes ; Medical Records ; Operative Time ; Parity ; Uterine Cervical Neoplasms