Carcinosarcomas of the female genital tract have generally been regarded as a type of sarcoma. Recent studies, however, suggest the tumor may be more closely related to carcinoma and may represent metaplastic carcinoma in histogenesis. We analyzed clinicopathologic and immunohistochemical features of 10 carcinosarcomas to evaluate the relative importance of the carcinomatous and sarcomatous components in metastasis and recurrence. The primary tumor originated in the uterine body in seven cases, the uterine cervix in two and the ovary in one. Patient,s ages ranged from 54 to 71 years (mean, 64). The most common symptom of the uterine mass was vaginal bleeding. The median survival time was 21 months following diagnosis in five cases. Surgico-pathologic FIGO stages of five patients who received an operation were stage III and IV, but clinical FIGO stage of three patients (60%) among them were I. Lymphovascular invasions were identified in seven areas; five vascular invasion lesions showed the carcinomatous component alone, one the sarcomatous component alone, and remained one admixture of both components. Metastatic and recurrent lesions to the paraaortic lymph node, ovary, pelvic wall, or vaginal vault showed characteristically carcinomatous component only. Immunohistochemically, positive reactions for cytokeratin and epithelial membrane antigen were noted in the sarcomatous component of five cases. Vimentin positivity was detected in carcinomatous component of three cases. We conclude that the dominant element in carcinosarcomas of the female genital tract is the carcinomatous component. The survival rate of carcinosarcoma is extremely poor. The surgico-pathologic stage is better indicator of survival than the clinical stage. Immunohistochemical findings suggest that carcinosarcoma may represent a metaplastic carcinoma in histogenesis.
Carcinosarcoma* ; Cervix Uteri ; Diagnosis ; Female* ; Humans ; Keratins ; Lymph Nodes ; Mucin-1 ; Neoplasm Metastasis ; Ovary ; Recurrence ; Sarcoma ; Survival Rate ; Uterine Hemorrhage ; Vimentin

OBJECTIVES: This study was performed to survey worker's demands for worksite medical care and agency's intention for offering worksite medical care in Group Health Service Agency. METHODS: One study subjects were employers, workers and office personnels in 167 factories. They were asked for medical care utilization behavior and worksite medical care demand. 121 employers(72.5%), 145 office personnels(86.8%) and 816 workers(60.5%) answered the questionnaire. The other subjects were doctors, nurses and administrators in 66 Group Health Service Agencies nationwide. They were asked for intention of offering worksite medical care in Group Health Service Agency through the mail survey. 31 doctors(47.0%), 38 nurses(57.6%) and 34 administrators answered the questionnaire. RESULTS: 87 percentage of doctors and 94 percentage of nurses had experiences of being requested to prescribe and laboratory examination. All nurses, 94 percentage of administrators and 76 percentage of doctors thought that it was necessary to give medical treatment at worksite. Also in worksite 85 percentage of employers, 86 percentage of office personnels and 81 percentage of workers answered that they accepted the worksite medical care when it would be given. CONCLUSIONS: Worksite medical care should be permitted because almost of all workers and employers requested worksite medical care, and doctors and nurses in Group Health Service Agency were willing to give worksite medical care and there was necessity to prevent occupational cerebrovascular disease.
Administrative Personnel ; Health Services* ; Humans ; Intention* ; Postal Service ; Questionnaires ; Workplace*

PURPOSE: The phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) pathway has a central role in regulation of cell proliferation, differentiation, motility and survival. This pathway has recently generated great interest because its elements are, potentially, novel targets for the treatment of various malignancies, including breast cancer. METHODS: Using tissue microarray sections of breast carcinoma, we performed immunohistochemical studies using antibodies against the phosphorylated forms of Akt (p-Akt) and mTOR (p-mTOR) in 530 invasive breast carcinomas and 30 ductal carcinomas in situ (DCIS). We investigated possible associations between expression of these proteins and clinicopathologic characteristics and disease outcomes. RESULTS: In 530 invasive carcinomas, weak and strong expression of p-Akt was observed in 180 (34.0%) and 288 (54.3%) cases, respectively. The expression of p-Akt was associated with expression of estrogen receptors (ER) (p=0.045), progesterone receptors (PR) (p=0.003), lymph node metastasis (p<0.001) and cancer stage (p=0.027). Weak and strong expression of p-mTOR was found in 136 (25.7%) and 207 (39.1%) cases, respectively. The mTOR pathway was more frequently activated in DCIS than in invasive breast carcinoma (p=0.001). p-mTOR expression was associated with expression of ER (p=0.040), PR (p=0.009), tumor size (p<0.001), and stage (p=0.002). In a univariate analysis, strong expression of p-Akt was associated with longer disease-free survival (DFS). In a multivariate analysis, neither p-Akt nor p-mTOR was associated with DFS. CONCLUSION: The PI3K/Akt/mTOR pathway is active in DCIS as well as in invasive carcinoma of the breast. Our study also suggests that the PI3K/Akt/mTOR pathway is influenced by ER rather than erbB-2, and that this pathway may contribute more to cancer pathogenesis in ER-positive tumors.
Antibodies ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Cell Proliferation ; Disease-Free Survival ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Phosphatidylinositol 3-Kinase ; Proteins ; Receptors, Estrogen ; Receptors, Progesterone ; Sirolimus ; TOR Serine-Threonine Kinases

Orientia tsutsugamushi, a causative agent of scrub typhus, is an obligate intracellular parasite. The mechanisms by which O. tsutsugamushi invade host cells are unknown. Given the importance of surface-exposed proteins in the pathogenesis of microbial pathogens, outer membrane proteins (OMP) of O. tsutsugamushi were extracted with detergents and their cellular binding was studied. Outer membrane fraction of O. tsutsugamushi was enriched by a sodium-lauryl sarcosinate (Sarkosyl) treatment of total membranes. Outer membrane proteins were extracted by the treatment with sodium dodecyl sulfate (SDS) and Sarkosyl. The resulting soluble fractions were examined for their cellular binding by the immunofluorescence microscopy. A fifty six kilodalton protein was found to bind to fixed ECV304 cells only when the outer membrane preparation was not treated by DTT or heat. These results suggest that the conformation the 56-kDa OMP is important for the attachment to the host cell surfaces.
Detergents ; Hot Temperature ; Membrane Proteins* ; Membranes* ; Microscopy, Fluorescence ; Orientia tsutsugamushi* ; Parasites ; Scrub Typhus ; Sodium Dodecyl Sulfate

Microtubule network provides many intracellular microbes with an efficient way to move within host cells. Orientia tsutsugamushi move from the cell periphery to the microtubule organizing center (MTOC) by dynein-dependent mechanism. In this study, we investigated the role of microtubule on the growth of O. tsutsugamushi. The treatment of infected cells with taxol as well as daunomycin enhanced the bacterial growth in contrast to colchicine. Immunofluorescent (IF) staining of taxol-treated cells exhibited that O. tsutsugamushi clustered tightly near the nucleus with thick bundles of microtubules, whereas dispersed in the cytoplasm in colchicine-treated cells. These results suggest that microtubule network facilitate the growth of O. tsutsugamushi.
Colchicine ; Cytoplasm ; Daunorubicin ; Microtubule-Organizing Center ; Microtubules ; Orientia tsutsugamushi* ; Paclitaxel

PURPOSE: We analyzed the oncologic characteristics and outcome of patients with inflammatory myofibroblastic tumor of extremities. MATERIALS AND METHODS: Among the soft tissue tumor patients who were treated between 1999 and 2012, 5 patients who were pathologically confirmed as the inflammatory myofibroblastic tumor of extremities were analyzed retrospectively. RESULTS: There were 1 man and 4 women with mean age of 44 years (37-55 years). The average follow up was 34.6 months (8-87 months). All patients underwent surgical treatment. Only 1 patient had wide resection margin and remaining 4 had marginal (3) or intralesional (1) resection margin. All of 4 patients without wide resection margin developed local recurrence at 10.3 months (8-19 months). Malignant transformation to fibrosarcoma was occurred in 2 patients who developed local recurrence, and 1 patient developed multiple metastases to lung, liver and lymph nodes and expired at 37 months. Three of 5 patients had tumor location abutted to or invasion to major arteries and 1 patient had tumor invading sciatic nerve. CONCLUSION: It is observed that inflammatory myofibroblastic tumor of extremities is usually located near the major neurovascular structure. Wide resection should be considered as the initial surgical treatment because this tumor showed a high local recurrence rate and possibility of malignant transformation.
Arteries ; Extremities ; Female ; Fibrosarcoma ; Follow-Up Studies ; Humans ; Liver ; Lung ; Lymph Nodes ; Myofibroblasts ; Neoplasm Metastasis ; Recurrence

A 56-year-old male with a gastrointestinal stromal tumor (GIST) underwent surgical resection of the tumor. Nine months after surgery, imatinib therapy was initiated because of the discovery of metastatic tumors in the left adrenal gland and in a lymph node of the peritoneum. Seventeen months later, the patient achieved complete remission (CR) and imatinib therapy was continued. However, 48 months after initiation of imatinib therapy, computed tomography scans revealed a left adrenal gland metastasis and the patient underwent left adrenalectomy. Immunohistochemical staining indicated that the spindle-shaped cells of the resected tumor were positive for C-kit, thus confirming metastasis of the GIST. This is the first report from Korea of an adrenal gland metastasis from a GIST. Worldwide, only two such cases have been reported. Here, we describe the first case of a distant recurrence of a GIST in the left adrenal gland after CR had been achieved with the aid of surgical resection and imatinib therapy.
Adrenal Glands* ; Adrenalectomy ; Gastrointestinal Stromal Tumors* ; Humans ; Imatinib Mesylate ; Korea ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis* ; Peritoneum ; Recurrence

We report a dislocation of the thumb carpometacarpal joint associated with an oblique fracture of the trapezium. This case was treated with open reduction and internal fixation using two Kirschner wires for the trapezial fracture and repair of the ruptured dorsal capsular ligament and additional Kirschner wire fixation for the carpometacarpal joint stability. At the 12 months follow-up examination, there was no pain or chronic instability. There was no evidence of post-traumatic arthritic changes.
Bone Wires ; Carpometacarpal Joints ; Dislocations ; Follow-Up Studies ; Ligaments ; Thumb

Hemangiopericytoma is uncommon vascular neoplasm that arises from pericytes arround the capillary walls. It was first described as a distinct vascular neoplasm by Stout and Murray in 1942 The anatomic distribution is widespread throughout the body, with approximately one third occur in the head and neck. No sex predilection has been found. Although middle age appears to be the most prevalent time of onset, this neoplasm has been found in all age groups. The differentiation between benign and malignant hemangiopericytoma can be difficult. Although the majority of these tumors are benign, there are malignant variants that can metastasize. Metastasis of seemingly benign tumors may appear year of decade later, so long term close follow-up is needed The treatment of choice is complete surgical excision of the tumor. Despite their vascular origin, these tumors are relatively radioresistant. Radiation therapy is reserved for inoperable metastases or treatment of postoperative surgical fields. Here we present a case of hemangiopericytoma occuring on the Lt. buccal mucosa.
Capillaries ; Follow-Up Studies ; Head ; Hemangiopericytoma* ; Humans ; Middle Aged ; Mouth Mucosa* ; Neck ; Neoplasm Metastasis ; Pericytes ; Vascular Neoplasms

Constipation is a prevalent, often chronic, gastrointestinal motility disorder. Bisacodyl, a stimulant laxative, is widely used to treat constipation in adults and children. This drug is usually safe, but it has some side effects including diarrhea, abdominal pain, colitis, and proctitis. There have been reports that rectal administration of bisacodyl could cause injury to the rectal mucosa by mechanical and chemical mechanisms. However, there has been no report of severe proctitis with rectal ulcers in patients taking oral bisacodyl. In this report, we describe the case of an 80-year-old woman with severe rectal ulcers and proctitis after taking oral bisacodyl for several days, and review the literature.
Abdominal Pain ; Administration, Rectal ; Adult ; Aged, 80 and over ; Bisacodyl* ; Child ; Colitis ; Constipation ; Diarrhea ; Female ; Gastrointestinal Motility ; Humans ; Mucous Membrane ; Proctitis* ; Rectum ; Ulcer*