The author examined expression of tumor-related antigens, such as p53 tumor supressor protein, c-myc, TGF-alpha, and TGF-beta proteins in 75 cases of surgically resected epithelial ovarian tumors. Peroxidase immunohistochemistry was used to determine the frequency of expression, the relationship among expression of these antigens and histopathological spectrums, and clinical stage, and their potential prognostic significance. The results are summarized as follows. A positive correlation was found between expression of p53(P=0.02), c-myc(P=0.03), and TGF-alpha(P=0.001) and histological degrees of malignancy(benign, borderline, or malignant) in epithelial ovarian tumors. A significant correlation was found between expression of p53 and histological degrees of malignancy in serous ovarian tumors(P=0.003) and mucinous tumors (P=0.049). A significant correlation was also found between expression of c-myc and the histological grade of serous carcinomas(P=0.02). A correlation between expression of these antigenic proteins and clinical stage of epithelial ovarian tumors was not demonstrated. Expression of p53 and c-myc was closely correlated with expression of TGF-alpha irrespective of the histological degrees of malignancy and type of epithelial ovarian tumors(0.4 < or = K < or = 0.7). The results of this study support the ideas that expression of c-myc and TGF-alpha might be a useful prognostic indicator in human ovarian carcinomas, and expression of p53 could be another indicator of prognosis, as the expression of p53 is characteristic in that the expression is mostly seen in invasive ovarian carcinomas.
Humans

Epithelioid hemangioendothelioma of liver is a very rare tumor of vascular origin, the most peculiar feature of which is that it is composed of endothelial cells closely resembling epithelial cells. We present a primary epithelioid hemangioendothelioma of liver in a 40-year-old male. This tumor was composed of an ill-defined yellowish white, 7 x 4cm sized, firm, solid mass and small satellite nodules in the right lobe of liver. Microscopically, two types of tumor cells-dendritic and epithelioid-were identified. The neoplastic cells infiltrated into sinusoids and intrahepatic veins. The background of tumor showed marked sclerotic change and focal proliferation of bile ductules. Confirmation of the endothelial origin of these cells was provided by positive immunoperoxidase staining for factor VIII-related antigen, and by electron mi-croscopic demonstration of Weibel-Palade body. This is the first case of epithelioid heman- gioendothelioma of liver documented in Korea. We report this case in view of its scarcity and distinctive morphologic features that allow differentiation from sclerosing carcinoma and angiosarcoma.

Synovial sarcoma is one of the most common malignant soft tissue tumors in paraarticular regions. However, it is very rare to occur without any apparent relationship to synovial or articular structures. We report a case of synovial sarcoma manifested as a subcutaneous nodule in the upper lip. A 12-year-old boy complained of a palpable tender mass in the upper lip for several months. Under the impression of a benign soft tissue neoplasm, surgical excision was done. The mass, 1.5 cm in maximum diameter, was easily separated from surrounding tissues. Microscopically, this tumor showed a characteristic biphasic pattern of synovial sarcoma. On immunohistochemical and ultrastructural studies, the tumor cells showed evidence of epithelial differentiation. There was no evidence of joint-related, primary lesions or metastatic foci. This report describes a case of synovial sarcoma arising in very unusual location and size for histologically typical synovial sarcoma.
Neoplasm Metastasis

Diffusely infiltrating primary colorectal carcinoma is a rare disease. This type of carcinoma extensively spreads beneath the mucosal layer. Clinically, it resembles inflammatory colorectal disease and metastatic carcinoma and is difficult to diagnosis. Moreover, the prognosis is extremely poor. A 66-year-old man was admitted to our hospital because of lower abdominal pain. Barium enema showed circumferential long segment narrowing in the proximal sigmoid colon without definite mass or ulceration and abdominal CT demonstrated colonic wall thickening. So it was diagnosed as inflammatory condition by image study. Colonoscopic examination showed hypertrophied mucosa and luminal narrowing on the 40 cm from the anal verge, but the oral side couldn't be examined because of stenosis. Biopsy revealed poorly differentiated adenocarcinoma, and left hemicolectomy was done. The pathology showed diffusely infiltrating adenocarcinoma with metastasis in regional lymph node and mesentry involvement.
Abdominal Pain ; Adenocarcinoma ; Aged ; Barium ; Biopsy ; Colon* ; Colon, Sigmoid ; Colonic Neoplasms* ; Colorectal Neoplasms ; Constriction, Pathologic ; Diagnosis ; Enema ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Pathology ; Phenobarbital ; Prognosis ; Rare Diseases ; Tomography, X-Ray Computed ; Ulcer

Purpose: To investigate the clinical characteristics of infectious keratitis in Gwang-ju, Jeonnam Province, Korea. Methods: We retrospectively reviewed the medical records of 260 eyes of 260 patients diagnosed with infectious keratitis at the Chosun University Hospital from January 2015 to February 2020. Results: The mean age of disease onset was 58.9 years; 132 (50.8%) of all patients were male and 128 (49.2%) female. The culture positivity rate was 24.6%. Gram-negative bacteria were cultured from 38 eyes (59%), Gram-positive bacteria from 21 (33%), and fungi from five (8%). The most commonly isolated microorganism was Stenotrophomonas (xanthomonas) maltophilia (a Gram-negative rod; 17 cases [26.6%]). Prior use of topical antibiotics was significantly more prevalent in the culture-negative than -positive group. In the latter group, the initial visual acuity was poor (p = 0.015) and the frequency of epithelial defects ≥5 mm2 in area was higher than in the culture-negative group (p = 0.001). Trauma caused by vegetable matter (44 eyes, 16.9%) was the most common predisposing factor. The risk factors for a poor visual outcome were such trauma (p = 0.013), previous ocular surgery (p = 0.006), an epithelial defect area greater than 5 mm2 (p < 0.001), and a follow-up period <10 months (p = 0.005). Conclusions The Gwangju Jeollanam-do community is more rural than urban, contains a large older population, and features few hospitals. Staphylococcus epidermidis and Pseudomonas aeruginosa are considered to be the most frequent causes of infectious keratitis in Korea. However, in our study Stenotrophomonas maltophilia was the organism most frequently cultured.

OBJECTIVES: Magnetic resonance imaging (MRI)-guided high intensity focused ultrasound surgery (MRgFUS) is a newly emerging non-invasive technique for the treatment of uterine fibroids. The purpose of this study is to review the clinical impact of MRgFUS. METHODS: This study examined 157 patients. The high intensity focused ultrasound (HIFU) utilized in this study was Philips Achieva 1.5 Tesla MR (Philips Healthcare, Best, the Netherlands) and Sonalleve HIFU system. The patients were followed in post-operative Month 1, Month 3, and Month 6 to investigate any change. Then, these were further classified according to the use of uterine stimulant (oxytocin) in parallel, Funaki Type of uterine fibroid, HIFU intensity, and non-perfused volume (NPV) ratio. RESULTS: When the uterine stimulant was utilized, the HIFU intensity was measured at significantly lower levels, compared with the group not using uterine stimulant, and treatment duration was significantly. The NPV ratio was found significantly higher in the group using uterine stimulant. Concerning the correlation between Funaki Type of uterine fibroid and average sonication power, it was found that the closer to Type I, the lower the sonication power, the shorter the treatment duration, and the higher the NPV ratio significantly. CONCLUSIONS: In this study, it was found that the lower the Funaki Types of uterine fibroids, and the higher the NPV ratio immediately after the operation, the larger the uterine fibroid volume decrease and SSS change were. Also, if uterine stimulant was used in parallel in treatment, treatment duration and HIFU intensity could become shorter and lower.
Delivery of Health Care ; High-Intensity Focused Ultrasound Ablation ; Humans ; Leiomyoma* ; Magnetic Resonance Imaging ; Myoma ; Oxytocin ; Sonication ; Ultrasonography*

Biliary cystadenomas are very rare cystic neoplasms usually arising from the intrahepatic bile ducts. The majority of patients are middle-aged women who present with abdominal discomfort and/or a palpable mass. The diagnosis was performed using several methods such as abdominal ultrasonography, computed tomography, percutaneous cholangiography or endoscopic retrograde cholangiopancreatography, and showed multiloculated cystic tumors with multiple internal septation. But confirmatory diagnosis was done by surgical pathology. Because the prognosis is comparatively better than after complete resection and the cystadenoma is warranted to avoid malignant change, early detection and surgical resection must be needed. We have experienced two cases, 30 and 50 year old females, which presented with nonspecific abdominal pain and dyspepsia. They were diagnosed as having intrahepatic biliary cystadenoma histopathologically which was confirmed after surgical resection. We report two cases of intrahepatic biliary cystadenoma with a review of literature.
Abdominal Pain ; Bile Ducts, Intrahepatic ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cystadenoma* ; Diagnosis ; Dyspepsia ; Female ; Humans ; Liver ; Middle Aged ; Pathology, Surgical ; Prognosis ; Ultrasonography

PURPOSE: This study assessed the association between the ratio of leukotriene E4 (LTE4) to fractional exhaled nitric oxide (FENO) in the response of children with exercise-induced bronchoconstriction (EIB) enrolled in a therapeutic trial with montelukast or inhaled corticosteroid (fluticasone propionate [FP]). METHODS: Children aged 6 to 18 years with EIB were randomized in a 4-week, placebo-controlled, double-blinded trial with montelukast or FP. Before and after treatment, treadmill exercise challenges were performed. The LTE4 levels in the induced sputum and urine and the FENO levels were measured in subjects before and 30 minutes after the exercise challenges. The same tests were conducted after treatment. RESULTS: A total of 24 patients completed the study: 12 in the montelukast group and 12 in FP group. Both study groups displayed a similar postexercise maximum decrease in forced expiratory volume in one second (FEV1) before treatment as well as after treatment. However, there were significant differences in the magnitude of change between the two (Delta; -18.38+/-14.53% vs. -4.67+/-8.12% for the montelukast and FP groups, respectively; P=0.021). The Delta logarithmic sputum baseline and postexercise LTE4/FENO ratio were significantly lower in the montelukast group than in the FP group (baseline; -0.09+/-0.21 vs. -0.024+/-0.03, P=0.045; postexercise, -0.61+/-0.33 vs. -0.11+/-0.28, P=0.023). CONCLUSIONS: These data indicate that the efficacy of montelukast for preventing a maximum decrease in FEV1 after exercise is significantly higher than that of FP, and the high LTE4/FENO ratio is associated with a greater response to montelukast than to FP for EIB therapy. These results suggest that LTE4 may play an important role in EIB.
Acetates ; Aged ; Bronchoconstriction ; Child ; Diethylpropion ; Forced Expiratory Volume ; Humans ; Leukotriene E4 ; Nitric Oxide ; Quinolines ; Sputum

BACKGROUND: Pain on injection of rocuronium is a common clinical problem. We compared the efficacy of lidocaine, ketorolac, and the 2 in combination as pretreatment for the prevention of rocuronium-induced withdrawal movement. METHODS: For this prospective, randomized, placebo-controlled, double-blind study a total of 140 patients were randomly allocated to one of 4 treatment groups to receive intravenously placebo (saline), lidocaine (20 mg), ketorolac (10 mg), or both (n = 35 for each group), with venous occlusion. The tourniquet was released after 2 min and anesthesia was performed using 5 mg/kg thiopental sodium followed by 0.6 mg/kg rocuronium. The withdrawal response was graded on a 4-point scale in a double-blind manner. RESULTS: The overall incidence of withdrawal movements after rocuronium was 34.3% with lidocaine (P = 0.001), 40% with ketorolac (P = 0.004), and 8.6% with both (P < 0.001), compared with 74.3% with placebo. There was a significantly lower incidence of withdrawal movements in patients receiving the lidocaine/ketorolac combination than in those receiving lidocaine or ketorolac alone (P = 0.009 and 0.002, respectively). The incidence of moderate to severe withdrawal movements was 14.3% with lidocaine, 17.2% with ketorolac, and 2.9% with lidocaine/ketorolac combination, as compared to 45.7% with the placebo. There was no significant difference in withdrawal movement between the lidocaine group and the ketorolac group. CONCLUSIONS: Ketorolac pretreatment had an effect comparable to that of lidocaine in attenuating rocuronium-induced withdrawal movements and the lidocaine/ketorolac combination pretreatment, compared with lidocaine or ketorolac alone, effectively reduced withdrawal movements during rocuronium injection.
Androstanols ; Anesthesia ; Double-Blind Method ; Humans ; Incidence ; Ketorolac ; Lidocaine ; Prospective Studies ; Thiopental ; Tourniquets

The materials used in rhinoplasty can be divided into autogenous and alloplastic one. The advantages of autogenous materials such as bone, cartilage, dermofat are no postoperative rejection and good adaptation. They are also economical. But they are often limited in harvesting which entails additional morbidity. Many synthetic materials have been introduced in rhinoplasty. Silicone is popular material for augumentation, but that has disadvantage, such as infection, protrusion, foreign body reaction and showing. Porous high density polyethylene implant (Medpor(R)) present an alternative to autogenous material as they allow of fibrovascular ingrowth, leading to stability of the implant and decreased rates of infection. We reviewed the data from 10 consecutive patients with foreign body injection on the nose who were operated in Dong-A University Hospital from May 2001 to July 2003. Our application is that the necessity of enough rigidity to provide structural support and enough volume to provide augumentation. Patient follow-up ranged from 1 month to 2 years. We can achieve 7 good satisfaction patients and 3 fair satisfaction patients. No complications were reported, such as infection, secondary deformity and exposure of implants. Medpor(R) is useful in corrective rhinoplasty, especially in the cases with foreign body injection, because it can provide structural support and augumentation with enough rigidity.
Cartilage ; Coinfection ; Congenital Abnormalities ; Follow-Up Studies ; Foreign Bodies* ; Foreign-Body Reaction ; Humans ; Nose ; Polyethylene* ; Rhinoplasty* ; Silicones