No abstract available.
Pyelonephritis, Xanthogranulomatous* ; Wilms Tumor*

Patients with atypical or incomplete Kawasaki disease are at same risk for development of coronary artery complications as typical Kawasaki disease. In this communication we report six patients with unusual presentation of Kawasaki disease complicated by coronary artery aneurysms, in whom correct diagnosis were not made in time for proper treatment. One of these patients died from massive myocardial ischemia due to giant aneurysms along the entire coronary artery system. These patients had either less than enough number of diagnostic criteria at initial presentation or diagnostic signs which occurred over an extended period of time, resulting in difficulty in diagnosis during the acute phase. As a result, none of these patients received intravenous gamma globulin treatment. Thus strict adherence to currently accepted criteria for diagnosis of Kawasaki disease may lead to failure to recognize atypical form of this illness with potential sequelae of myocardial ischemia or sudden death. We would like to emphasize from this experience that clinicians must be aware of the wide variations in clinical presentation of Kawasaki disease and take an aggressive approach in making correct diagnosis by obtaining early cardiac evaluation in order to initiate prompt treatment with intravenous gamma globulin.
Aneurysm ; Coronary Aneurysm* ; Coronary Vessels ; Death, Sudden ; Diagnosis ; gamma-Globulins ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia

Neurilemmomas of the trachea are extremely rare. The most common site of them is the distal third of the trachea and the age of the patients at presentation varied from 6 to 78 years old. They usually have a freqeuntly very long natural history, causing symptoms only after they have attained a considerable size. We experienced a case of near-total obstruction of the trachea by an intraluminal sessile neurilemmoma. The patient was a 66-year-old man with 2-year history of progressive exertional dyspnea and had several episodes of pneumonitis associated with productive cough. Grossly, the tumor was a well-circumscribed mass. Microscopically, typical cellular Antoni A and myxoid Antoni B areas were revealed.
Aged ; Cough ; Dyspnea ; Humans ; Natural History ; Neurilemmoma* ; Pneumonia ; Trachea

Stomach of 34 year old man showed an early stage of the cancer with slight involvement of the superficial part of the inner muscle layer and accompanied with one metastatic lymph node. The cancer is that of medium differentiated adenocarcinoma. There is an heavy infiltration of lymphocytes mixed with histiocytic mononuclear cells and multinucleated giant cells. Some giant cells appear as Langhans' type suggesting phagocytic cells of their origin containing PAS positive materials in the cytoplasma. In other places, they appear as atrophic cancer nests suggesting that these tumor nests were arrested and undergone to regressive cellular process because of the over-whelming immunological pressure by the host.
Male ; Humans ; Neoplasm Metastasis ; Stomach Neoplasms

PURPOSE: To compare 23-gauge transconjunctival sutureless vitrectomy (TSV) and sutured vitrectomy in the aspect of intraocular pressure (IOP) changes and complications. METHODS: Through a retrospective chart review, 45 sutureless patients (48 eyes) and 48 sutured patients (52 eyes) who had undergone 23-gauge transconjunctival vitrectomy by one surgeon (J.H. Sohn) were compared. IOP was measured routinely pre-operativley, at 1 day, 1 week, and 1 month post-operatively. Postoperative IOP, hypotony (IOP<7 mmHg) rates and complications associated with hypotony were assessed respectively. In addition, the cases involving intraocular air or gas tamponade or cataract extraction were compared. RESULTS: One day after the surgery, 3 eyes of the sutureless group developed hypotony,which persisted in 2 eyes through postoperative 1 week. Two eyes of the sutureless group developed hypotony 1 week after the surgery. Most of the hypotony cases were transient, but choroidal detachment occurred in 2 cases, and retinal detachment occurred in 1 case. In contrast, none of the sutured group developed hypotony. Intraocular air or gas tamponade significantly raised IOP 1 day after the surgery. When the operation was combined with cataract extraction, IOP was reduced postoperative 1 week and 1 month. CONCLUSIONS: The well-known risk factor of 23-gauge sutureless vitrectomy is postoperative hypotony. The present study showed postoperative hypotony can result in retinal detachment as a complication in contrast to previous studies. The authors conclude that suturing the wound for the prevention of hypotony is better, especially in cases with high risk of hypotony or definite wound leakage.
Cataract Extraction ; Choroid ; Eye ; Humans ; Intraocular Pressure ; Retinal Detachment ; Retrospective Studies ; Risk Factors ; Vitrectomy

BACKGROUND/AIMS: Malignant cells exhibit increased glycolytic metabolism, and in many cases increased glucose transporter gene expression. We studied the expression of the glucose transporters in hepatocellular carcinoma(HCC) and intrahepatic cholangiocarcinoma(CC). also, examined the usefulness of Glut-1 glucose transporter in the discrimination of HCC from CC. METHODS AND RESULTS: 23 HCC, 15 CC and 8 normal liver tissues were investigated immunohistochemically with Glut-1 glucose transporter. Immunostaning was regarded as positive when more than 5% of cells were stained. Among 38 liver tumor cases, Glut-1 was stained in 15(40%). in 2(9%) of 23 HCC and in 13(87%) of 15 CC were positive.(P=0.001) In HCC, underlying cirrhosis, 18(78%) were negative.(P=0.04) Other prognostic factors: histologic type, lymph node metastasis, distant metastasis did not show any significant correlation. CONCLUSION: Differential diagnosis between HCC and CC could be made by Glut-1 glucose transporter expression
Carcinoma, Hepatocellular* ; Cholangiocarcinoma* ; Diagnosis, Differential ; Discrimination (Psychology) ; Fibrosis ; Gene Expression ; Glucose Transport Proteins, Facilitative* ; Glucose* ; Liver ; Lymph Nodes ; Metabolism ; Neoplasm Metastasis

No abstract available.
Coronary Vessels* ; Dilatation* ; Edema* ; Meningitis, Aseptic* ; Mucocutaneous Lymph Node Syndrome*

Among several factors which have been evaluated for prognostic significance in patients with some types of solid tumors, tumor angiogenesis is reportedly correlated with metastasis, relapse, and prognosis of the tumor. Many studies have suggested that tumor growth is angiogenesis-dependent and that besides an increase in the delivery of nutrients to the tumor cells, this neovascularization also increases the opportunity for tumor cells to enter the circulation, which would imply the importance of tumor angiogenesis to the metastatic potential of tumors. The aim of this study was to investigate the correlation between the degree of angiogenesis and the malignancy potential in gastric carcinomas to determine whether angiogenesis of tumors has prognostic significance. Tumor angiogenesis at the invasive margins of 103 paraffin sections of gastric carcinomas was assessed by a immunohistochemical study by using a monoclonal antibody against the factor-VIII-related antigen and was compared with conventional clinicopathologic factors. In addition, the rate and the mode of recurrence were analyzed according to the degree of angiogenesis. Vessels were immunostained with anti-factor VIII polyclonal antibody, and areas with the most discrete microvessels were counted in a 200xfield, which were defined as angiogenesis score. The angiogenesis score from patients with lymph-node metastasis was significantly higher than that from patients without (P=0.0015). Furthermore, the recurrence rate was significantly greater in the group with higher than the mean angiogenesis score (P=0.004), and according to the pattern of recurrence, angiogenesis of tumors with hematogenous metastasis tended to be greater than that with other types of recurrence (P=0.0002). This retrospective study demonstrates that angiogenesis expressed as an angiogenesis score may be a good prognostic indicator and may be useful as a predictor of recurrence in patients with gastric carcinomas. If these findings are confirmed in larger prospective studies, it might be possible to add the angiogenesis score to the prognostic factors used to identify patients at higher risk for recurrence and to guide in decision for more aggressive adjuvant therapy after surgery.
Humans ; Microvessels ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms

No abstract available.
Enterovirus ; Meningitis, Aseptic* ; Seoul*

BACKGROUND: Malignant cells exhibit increased glycolytic metabolism, and in many cases increased glucose transporter gene expression. The authors hypothesized that GLUT1 glucose transporter expression is increased in gallbladder carcinoma, and the degree of expression might have prognostic significance. METHODS: To evaluate a possible prognostic factor, we studied the expression of GLUT1 glucose transporter by an immunohistochemical method in 56 gallbladder carcinomas from patients and we compared these results with established prognostic factors. RESULTS: Of the 56 cases, 34 (60.7%) were positive for GLUT1. The expression of GLUT1 was not associated with patient age, sex and histologic type. Whereas the expression of GLUT1 was significantly correlated with depth of tumor invasion and lymph node and distant metastases. CONCLUSIONS: GLUT1 glucose transporter expression is strongly associated with poor prognostic factors of the gallbladder carcinoma and the assessment of the extent of GLUT1 immunostaining identifies patient with poorer prognosis.
Gallbladder* ; Gene Expression ; Glucose Transport Proteins, Facilitative* ; Glucose* ; Humans ; Lymph Nodes ; Metabolism ; Neoplasm Metastasis ; Prognosis