Two cases of unusual giant carcinoma of the pancreas are presented. Each presented with a large tumor mass with or without cystic change, either in the head or tail portion of the pancreas. A pleomorphic gaint cell carcinoma variant (case 1) differed from an epulis type (case 2) with nuclear atypism of giant cells, but widespread metastasis in both cases reflected the accountability of spindle cell element as an important parameter for the determination of their biological behavior.
Neoplasm Metastasis

A case of hepatocellular carcinoma (HCC) complicating with secondary biliary cirrhosis due to intrahepatic bile duct growth of the tumor is presented. The patient was 34 years-old male who had been suffered from right upper quadrant pain with intermittent fluctuating jaundice for 4 months. Left lobectomy specimen contained a single, 4 cm sized, relatively well circumscribed and partly protruding nodular HCC in the medial seqment of left lobe. It compressed the left hepatic duct, and the intra and extra-hepatic ducts were completely plugged with tumor casts (extending to the common bile duct at the operating table). Remaining hepatic parenclyma was the seat of advanced secondary biliary cirrhosis in which were abundance of HBsAg-containing hepatocytes possibily representing a HBsAg carrier status. Biliary cirrhosis in HCC is an extremely rare manifestation, reflecting the delayed adequate clinical procedure by unusual pattern of obstructive jaundice. In such a case presenting as persisting and fluctuating obstructive jaundice in HCC, an intrabile duct tumor growth should be suspected.
Male ; Humans ; Carcinoma, Hepatocellular

Neurofibromatosis(NF) is a disorder characterized by its relative commonness, variability, and heterogeneity. It is usually expressed as a generalized form, but is rarely localized in a limited part of the body as a segmental form. In 1981, Riccardi classified NF into 8 types and a segmental form (type V) was defined by limitation of cafe-au-lait spots and/or neurofibroma on a given unilateral segment of the body. Recently we came across two cases of typical segmental neurofibromatosis. The First case was a 53-year-old woman with localized neurofibromatosis on the right T8,9 dermatome. The Second case was a 34-year-old man with localized neurofibromatosis on the right T5,6 dermatome. There were no cafe-au-lait spots, axillary frecklings, Lisch nodules or a family history in both cases. We report these rare cases with a literature review.
Adult ; Cafe-au-Lait Spots ; Female ; Humans ; Middle Aged ; Neurofibroma ; Neurofibromatoses* ; Population Characteristics

The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T on seizure duration. The results were follows ' 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine 0.0093mg kg(-1), pentothal 2.76mg kg(-1) or propofol 1.42mg kg(-1). 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal(35.7 sec)(p<0.001). This suggest the possibility that additional treatment may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.
Atropine ; Bipolar Disorder ; Delusions ; Depressive Disorder, Major ; Dihydroergotamine ; Electroconvulsive Therapy ; Humans ; Inpatients ; Propofol* ; Schizophrenia ; Seizures* ; Thiopental*

PURPOSE: The purpose of this study was to compare the accuracy of the implant master cast according to the type (pick-up, transfer) and the length (long, short) of the impression copings. MATERIALS AND METHODS: The metal master cast was fabricated with three internal connection type implant analogs (Osstem GS III analog), embedded parallel and with 10degrees of mesial angulation to the center analog. Four types of impression coping were prepared with different combinations of types (transfer, pick-up) and lengths (long, short) of the coping. The impressions were made using vinyl polysiloxane (one step, heavy + light body) with an individual tray, and 10 impressions were made for each group. Eventually, 40 experimental casts were produced. Then, the difference in the distance between the master cast and the experimental cast were measured, and the error rate was determined. The analysis of variance was performed using the SPSS (v 12.0) program (alpha = .05), and the statistical significance was set at P < .05. RESULTS: The ANOVA showed that the pick-up type impression coping exhibited a significantly lower error rate than the transfer type. However, no significant difference was observed with respect to the length of the impression coping. Additionally, no significant difference was observed between the parallel and mesial angulated groups. CONCLUSION: Within the limitations of this study, the pick-up type impression coping exhibited a more accurate implant master cast than the transfer type in parallel group. The accuracy of the implant master cast did not differ for different lengths of impression coping of at least 11 mm. Additionally, the accuracy of the implant cast was not different for the parallel and 10degrees mesial angulated groups.
Light ; Polyvinyls ; Siloxanes

No abstract available.
Osteomalacia* ; Primary Myelofibrosis* ; Vitamin D Deficiency*

No abstract available.

Bromate salt is very toxic oxidant. The clinical manifestations of bromate intoxications are vomiting, diarrhea, depression of central nervous system, oliguric or non-oliguric renal failure, hemolytic anemia and deafness. Most of the toxic manifestations are reversible with the exception of renal failure and deafness. Since bromate is a small hydrophilic molecule, its removal by dialysis, especially hemodialysis, can reasonably be expected. Since the serious complications such as deafness, acute renal failure usually occur concurrently within 4-16 hours after ingestion, dialysis should therefore be considered in every patient presenting within a few hours of a significant amount of bromate. Recently, we encountered a 40-year-old female, past hairdresser, who was admitted to Asan Kangnung Hospital due to frequent diarrhea, vomiting and anuria after ingestion of sodium bromate. The patient required regular hemodialysis therapy and has not any evidence of complication such as hearing loss, blindness and irreversible renal failure. The clinician must assess the potential for preventing irreversible ototoxicity and nephrotoxicity and weigh the importance of early intervention against the possible risks of aggressive treatment in bromate intoxication.
Acute Kidney Injury* ; Adult ; Anemia, Hemolytic ; Anuria ; Blindness ; Central Nervous System ; Chungcheongnam-do ; Deafness ; Depression ; Dialysis ; Diarrhea ; Early Intervention (Education) ; Eating ; Female ; Hearing Loss ; Humans ; Renal Dialysis ; Renal Insufficiency ; Sodium ; Vomiting

PURPOSE: The purpose of this study was to evaluate the radiologic and clinical outcomes after intramedullary nailing with Poller screw insertion at initial stage in infraisthmal femur shaft fractures. MATERIALS AND METHODS: Seven consecutive patients (7 femurs) treated with antegrade intramedullary nailing with Poller screw insertion for the infraisthmal femur shaft fracture were reviewed retrospectively. There were 4 male and 3 female patients. Mean age was 46.1 years (20-72 years). Operative time including Poller screw insertion, time for union, malalignment, and range of motion were evaluated. RESULTS: All 7 cases had primarily healed successfully. Mean time for radiologic union was 19.1 weeks (16-24 weeks) postoperatively. One case had 5 degree valgus malalignment. One case of 15 mm shortening was reported and he required shoe lift orthosis. All cases had a full range of motion in hip and knee joint. CONCLUSION: Antegrade intramedullary nailing with Poller screw insertion is useful in the initial treatment of infraisthmal femur shaft fracture, because it could provide additional stability. An additional 20 minutes were required but a Poller screw should be considered according to the anatomic location of a femur shaft fracture.
Female ; Femur* ; Fracture Fixation ; Fracture Fixation, Intramedullary ; Hip ; Humans ; Knee Joint ; Male ; Operative Time ; Orthotic Devices ; Range of Motion, Articular ; Retrospective Studies ; Shoes

PURPOSE: Hematopoietic stem cells from umbilical cord blood are one of the useful resources for stem cell transplantation in the various adult and childhood diseases. Immunologic complications of transplantation, e.g., graft-vs-host disease, occur much less with transplantation of cord blood stem cells. Cord blood-derived dendritic cells (CB-DCs) are known to be different from adult peripheral blood-derived dendritic cells (PB-DCs) in immunologic characteristics. These phenomena might be related to the characteristics of hematopoietic cells in cord blood. Therefore, we analysed characteristics of dendritic cells, which are well-known immune-provoking cells, derived from cord blood precursors. METHODS: Dendritic cells were differentiated from plastic-adherent cord blood monocytes in the presence of GM-CSF and IL-4. Immunophenotype was analysed by flow cytometry and expression of IDO (indoleamine 2, 3-dioxygenase), an enzyme expressed in immune-regulating or tolerogenic DCs, IL-12, IL-10 and IL-6 was measured by RT-PCR along in vitro differentiation. Changes in expression of cytokines and IDO after antibody engagement were also analysed. RESULTS: CB-DCs were very similar to PB-DCs in immunophenotype and expression of cytokines. But CB-DCs expressed IDO transcripts much earlier than PB-DCs during differentiation from precursors. Engagement of CB-DCs with DU-1 mAb induced upregulation of IDO and downregulation of IL-6. CONCLUSION: Although immunophenotype and cytokine expression pattern of CB-DCs were quite similar to those of PB-DCs, CB-DCs expressed IDO earlier than PB-DCs. This might be related to the phenomena that CB-DCs are less immunogenic or, sometimes, tolerance-inducing.
Adult ; Cytokines ; Dendritic Cells* ; Down-Regulation ; Fetal Blood ; Flow Cytometry ; Graft vs Host Disease ; Granulocyte-Macrophage Colony-Stimulating Factor ; Hematopoietic Stem Cells ; Humans ; Interleukin-10 ; Interleukin-12 ; Interleukin-4 ; Interleukin-6 ; Monocytes ; Stem Cell Transplantation ; Stem Cells ; Up-Regulation