Estrogen and progesterone receptors exist in the epithelial and stromal cells of the endometrium. Proliferative disorders of the endometrium may be associated with autocrine and paracrine actions of estrogen and progesterone in epithelial and stromal cells. This study was performed to evaluate the differences estrogen and progesterone receptor(ER/PR) expression in the epithelial and stromal cells of endometrial hyperplasias and adenocarcinomas using immunohistochemical methods. Immunohistochemical analysis of proliferating cell nuclear antigen(PCNA) was done to evaluate a possible correlation between PCNA and hormone receptor expression. Evaluation was based on samples from 31 simple hyperplasias, 30 complex hyperplasias, and 32 adenocarcinomas. The immunohistochemical expression of ER, PR and PCNA in epithelial and stromal cells were examined according to a scoring system based on the percentage of positive cells and the staining intensity. The results were as follows; 1) The expression of ER and PR in epithelial cells showed a graded, significant decreases in simple hyperplasia, complex hyperplasia and endometrial carcinoma, in that order(ER: P=0.008, PR: P= 0.026). 2) PR expression in the stromal cells showed a significant decrease between hyperplasia and adenocarcinoma(P=0.003). The difference in ER expression was not significant. 3) In stromal cells, the decrease in PR expression was more prominent than the decrease in ER expression when complex hyperplasia was compared to simple hyperplasia. 4) The PCNA expression in simple and complex hyperplasia and adenocarcinoma was not higher than the expression of PCNA in nomal proliferative endometrium. There was no significant difference in PCNA expression between simple and complex hyperplasia and adenocarcinoma(P=0.073). 5) A negative correlation between PCNA and ER/PR expression was not demonstrated in simple and complex hyperplasia, or in adenocarcinoma. Endometrial hyperplasia and adenocarcinoma are probably related to a paracrine action of estrogen and progesterone in epithelial and stromal cells. A progressive loss of PR expression in stromal cells may induce abnormal proliferation of endometrium due to a disrupted hormonal balance.
Adenocarcinoma

In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and "O"ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994. Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and "O"ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.
Adenoma ; Biopsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Laser Therapy ; Ligation ; Male ; Polyps ; Recurrence ; SNARE Proteins ; Stomach Neoplasms ; Upper Gastrointestinal Tract*

No abstract available.
Leukemia, Hairy Cell*

The market for hearing technology is evolving—with the emergence of hearables, it now extends beyond hearing aids and includes any ear-level devices with wireless connectivity (i.e., wireless earbuds). However, will this evolving marketplace bring forth opportunities or challenges to individuals’ hearing health care and the profession of audiology and otolaryngology? The debate has been ongoing. This study explores the wide spectrum of hearables available in the market and discusses the necessity of high-quality clinical evidence prior to the implementation of over-the-counter devices into clinical practice.

BACKGROUND: MMP-2 and MMP-9 are involved in the degradation of extracellular matrix, and MMP-2 and MMP-9 expressions in breast carcinomas have been reported as a poor prognostic factor. The aim of this study is to evaluate the prognostic value and the regulatory factors of MMP-2 and MMP-9 expressions in 73 cases of infiltrating ductal carcinomas, NOS type. METHODS: Immunohistochemistry for MMP-1, -2, -3, -9 and TIMP-1, -2 were performed and evaluation for patient? age, size, histologic grade, lymph node metastasis and tumor markers such as ER, PR, p53, c-erbB-2, cathepsin D, MIB-1, and microvessel density was done. RESULTS: The expression rates of MMP-1, MMP-2, MMP-3, MMP-9, TIMP-1 and TIMP-2 were 74.0%, 76.7%, 1.4%, 87.7%, 24.7% and 75.3%, respectively. MMP-2 expression rate was higher in the tumors of low and intermediate grade and PR positive tumors (p<0.05), and MMP-9 expression showed an increasing tendency in ER positive tumor (p=0.0676). Positive relationships between MMP-2 and MMP-1 expressions, and MMP-9 and TIMP-2 expressions were recognized (p<0.05). Conclusion : The prognostic significance of MMP-2 and MMP-9 expressions is still unclear, and MMP-2 and MMP-9 expressions seemed to be positively related with MMP-1 and TIMP-2 expression, respectively.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cathepsin D ; Extracellular Matrix ; Humans ; Immunohistochemistry ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2 ; Biomarkers, Tumor

Malignant transformation of mature cystic teratoma of the ovary can develop with an incidence of 1-2%. Squamous cell carcinoma is the most common malignant tumor arising in benign cystic teratoma. The authors have recently experienced a case of combined microcystic adnexal carcinoma and squamous cell carcinoma arising in a benign cystic teratoma of the ovary in a 72-year-old Korean woman. The right ovarian cystic mass had been ruptured and firmly adhered with salpinx and omental fat tissue on operation. Thickened cystic wall with yellowish white solid infiltrative lesion was noted grossly, and two different malignant tumors of microcystic adnexal carcinoma exhibiting both eccrine and hair follicular differentiation and squamous cell carcinoma were observed microscopically. PAS and CEA positivities suggested eccrine differentiation in areas of microcystic adnexal carcinoma.
Aged ; Carcinoma, Skin Appendage/*pathology ; Carcinoma, Squamous Cell/*pathology ; Case Report ; Female ; Human ; Neoplasms, Multiple Primary/*pathology ; Ovarian Neoplasms/*pathology ; Skin Diseases/*pathology ; Skin Neoplasms/*pathology ; Teratoma/*pathology

Fine needle aspiration cytologic findings in 14 cases of gynecomastia are described. General cytomorphologic features resemble those of fibrocystic disease in women than those of fibroadenoma. Among the cytologic parameters, three-dimensional structure of epithelial cell clusters, presence of micronucleoli and irregularities of nuclear size and shape are suggestive of epithelial proliferative activity. In addition, 4 cases are proliferative breast disease without atypia and 10 cases are nonproliferative breast disease depending on cytologic criteria grading system.
Biopsy, Fine-Needle* ; Breast Diseases ; Epithelial Cells ; Female ; Fibroadenoma ; Gynecomastia* ; Humans ; Male

Background and Objectives: Cochlear implants (CIs) are well known to improve audibility and speech recognition in individuals with hearing loss, but some individuals still struggle with many aspects in communication, such as prosody. This study explores how prosodic elements are perceived by those with normal hearing (NH) and CIs. Subjects and Methods: Thirteen individuals with NH and thirteen CI users participated in this study and completed speech perception, speech prosody perception, speech prosody production, pitch difference discrimination, and melodic contour perception testing. Results: NH listeners performed significantly better than CI users on speech perception, speech prosody perception (except for words with neutral meaning and a negative prosody change and when words were repeated twice), pitch difference discrimination, and melodic contour perception testing. No statistical significance was observed for speech prosody production for both groups. Conclusions Compared to NH listeners, CI users had limited ability to recognize prosodic elements. The study findings highlight the necessity of an assessment tool and signal processing algorithm for CIs, specifically targeting prosodic elements in clinical settings.

Purpose: The purpose of this study is three-fold: 1) to evaluate factors influencing hearing aid (HA) satisfaction; 2) to provide a profile of HA satisfaction in daily life; and 3) to examine the reasons why people gave up using HAs. Materials and Methods: Data for 1148 respondents were statistically analyzed and reported. Results: In the study, age (β=-0.03, p<0.01), level of education (β=1.21, p<0.01), HA purchase price (β=1.50, p<0.01), bilateral amplification (β=1.23, p<0.01), wearing time (β=0.28, p<0.01), and HA fitting and fine tuning on a regular basis (β=1.71, p<0.01) significantly influenced HA satisfaction. In addition, the authors observed that the most satisfactory factors were clarity of sound (53.5%), people’s trust in their HA (61.7%), and listening from a quiet environment (72.8%) in the domains of sound quality, HA features, and listening environments, respectively. Finally, with multiple choices being possible, 65% of the 40 respondents who no longer used HAs answered that their HAs ended up in a drawer since the background noise was annoying and distracting. Conclusion This study is significant in that it is a large-scale multi-center research to comprehensively examine the factors influencing HA satisfaction in South Korea. This data will provide helpful information that could lead to the successful rehabilitation of hearing loss with HAs.

James Paget issued the first report that nipple symptoms were related to breast carcinoma; however, the histogenesis of mammary Paget cells is still controversial. Toker presented evidence for epidermotropic migration of Paget cells. An other main theory hypothesizes that the Paget cell originates in the intraepidermis and is to be considered an independent in situ carcinoma, possibly as a multicentric breast cancer. The authors examined fifteen cases of Paget's disease in the breast for the immunohistochemical epithelial membrane antigen, glandular low-molecular-weight cytokeratin, epidermal high- molecular-weight cytokeratin, and carcinoembryonic antigen in order to determine the origin of the histogenesis of the Paget cell. All specimens revealed Paget cells strongly reactive with the epithelial membrane antigen. Thirteen out of the fifteen cases showed a strong reaction with the glandular cytokeratin. Four out of the fifteen cases showed a moderate reaction with the carcinoembryonic antigen. All specimens showed a negative reaction with the epidermal cytokeratin. With the above results, the authors conclud that mammary Paget cells may originate from the underlying breast tissue and suggest a radical mastectomy for Paget's disease with the underlying invasive cancer and conservative surgery for the disease with intraductal cancer in the breast.
Breast ; Breast Neoplasms ; Carcinoembryonic Antigen ; Keratins ; Mastectomy, Radical ; Mucin-1 ; Nipples