No abstract available.
Lymphatic Diseases*

To investigate the immunohistochemical expression of mutated p53 protein and bcl-2 protein in the cutaneous melanocytic lesion, 15 cases of compound nevus, 10 cases of congenital melanocytic nevus, 15 cases of primary malignant melanoma(4 cases less than 1.5 mm thick and 11 cases more than 1.5 mm thick), and 10 cases of metastatic malignant melanoma(7 cases in lymph node and 3 cases in soft tissue) were examined. All cases of compound nevi and of congenital melanocytic nevi showed no immunoreactivity for p53 protein. p53 protein overexpression was observed in 75%(3/4) wth primary malignant melanoma less than 1.5 mm thick, 81%(9/11) with primary malignant melanoma more than 1.5 mm thick, and 100%(10/10) with metastatic malignant melanoma. The difference in p53 protein overexpression was statistically significant between benign nevi and malignant melanoma(p<0.01). Bcl-2 protein expression was observed in 73%(11/15) with compound nevus, 70%(7/10) with congenital melanocytic nevus, 75% (3/4) in primary malignant melanoma less than 1.5 mm thick, 54%(6/11) with primary malignant melanoma more than 1.5 mm thick, and 40%(4/10) with metastatic malignant melanoma. These findings suggested that mutation of p53 gene may be an important mechanism in the development of malignant melanoma. Although bcl-2 protein was expressed in cutaneous melanocytic lesion, no correlation was found between p53 protein and bcl-2 protein expression in malignant melanoma.
Genes, p53 ; Lymph Nodes ; Melanoma ; Nevus ; Nevus, Pigmented ; Skin*

To investigate the immunohistochemical expression of mutated p53 protein and bcl-2 protein in the cutaneous melanocytic lesion, 15 cases of compound nevus, 10 cases of congenital melanocytic nevus, 15 cases of primary malignant melanoma(4 cases less than 1.5 mm thick and 11 cases more than 1.5 mm thick), and 10 cases of metastatic malignant melanoma(7 cases in lymph node and 3 cases in soft tissue) were examined. All cases of compound nevi and of congenital melanocytic nevi showed no immunoreactivity for p53 protein. p53 protein overexpression was observed in 75%(3/4) wth primary malignant melanoma less than 1.5 mm thick, 81%(9/11) with primary malignant melanoma more than 1.5 mm thick, and 100%(10/10) with metastatic malignant melanoma. The difference in p53 protein overexpression was statistically significant between benign nevi and malignant melanoma(p<0.01). Bcl-2 protein expression was observed in 73%(11/15) with compound nevus, 70%(7/10) with congenital melanocytic nevus, 75% (3/4) in primary malignant melanoma less than 1.5 mm thick, 54%(6/11) with primary malignant melanoma more than 1.5 mm thick, and 40%(4/10) with metastatic malignant melanoma. These findings suggested that mutation of p53 gene may be an important mechanism in the development of malignant melanoma. Although bcl-2 protein was expressed in cutaneous melanocytic lesion, no correlation was found between p53 protein and bcl-2 protein expression in malignant melanoma.
Genes, p53 ; Lymph Nodes ; Melanoma ; Nevus ; Nevus, Pigmented ; Skin*

Primary angiosarcoma of the female reproductive system is extremely rare, and its management is not well understood. We experienced a very rare case of angiosarcoma arising in the uterus of a 37-year-old woman who presented abdominal distension. At laparotomy, the uterus was observed to be enlarged and deformed by multilobulated hemorrhagic mass. Tumor deposits were present on both ovaries and the omentum. The operation consisted of total abdominal hysterectomy with salpingo-oophorectomy, and omentectomy. Microscopic examination showed that the tumor consisted mostly of solid sheets of pleomorphic and spindle cells forming irregular, communicating cleft-like spaces. Well-formed vascular channels lined by atypical endothelial cells were seen in differentiated areas. Some vessels were partially lined by normal endothelial cells and partially by neoplastic endothelial cells. Papillary architecture composed of epithelioid tumor cells was noted in a focal area. The tumor cells were immunoreactive for factor VIII-related antigen, Ulex europaeus agglutinin-1, CD31 and CD34. Weibel-Palade bodies were not seen in the tumor cells. She received adjuvant chemotherapy, but died 13 months after the diagnosis.
Adult ; Chemotherapy, Adjuvant ; Diagnosis ; Endothelial Cells ; Female ; Hemangiosarcoma* ; Humans ; Hysterectomy ; Laparotomy ; Omentum ; Ovary ; Ulex ; Uterus* ; von Willebrand Factor ; Weibel-Palade Bodies

BACKGROUND: The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center. METHODS: Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status. RESULTS: Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients' B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum. CONCLUSIONS: Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.
Basal Ganglia ; Brain* ; Cerebellum ; Cerebral Cortex ; Emergencies ; Hand ; Humans ; Hypoxia-Ischemia, Brain ; Intensive Care Units ; Magnetic Resonance Imaging* ; Neuroimaging ; Out-of-Hospital Cardiac Arrest* ; Putamen ; Retrospective Studies ; Survivors

Fractures of the acetabulum are relatively uncommon. But if fractures of the acetubulum are not accurately evaluated, classified, and reduced anatomically, major sequalae and complications are frequently developed. Because of complicated anatomy, difficulty with surgical exposure, severe comminution, and major associated injuries, the treatment of displaced acetabular fractures between conservative and operative methods is still controversial. We reviewed thirty five cases of displaced acetabular fracture treated operaively from January 1984 to December 1991. The prevalent age was the fourth decade. There was twenty seven cases of associated injuries, twenty two dislocations of the hip. According to the Letournel's classification, the most common fracture type was posterior wall and both column type. The fracture was fixed internally with only screws in thirteen cases and with plate and screws in twenty two cases. Among thirty five patients, five patients were lost in the follow up and another five patients had followed up lesser than one year. The mean duration of follow-up afrer the operation was three years (range, one to eight years). Among twenty five patients who had followed up more than one year, the satisfactory results were achieved in nineteen patients (76%) and the poor results were achieved in three patients (8%). The complications were post-traumatic arthritis, avascular necrosis of femoral head, osteomyelitis in iliac bone, skin necrosis, and heterotopic ossification.
Acetabulum ; Arthritis ; Classification ; Dislocations ; Follow-Up Studies ; Head ; Hip ; Humans ; Necrosis ; Ossification, Heterotopic ; Osteomyelitis ; Skin

Intraosseous lipoma is a very rare primary tumor of the bone. We report four cases of intraosseous lipoma. The patient ranged in age from 34 to 59-year-old (median age: 35 year-old). There were three men and one woman. All of four cases presented with pain. The involved bones were calcaneus in two cases, tibia in one case and ilium in one case, respectively. In all cases plain x-ray film revealed well-defined lytic lesion. Their size ranged 2 to 4.5 cm (mean size: 3.5 cm). Histologic examination showed mature adipose tissue. Three cases showed secondary changes such as atrophic bone, fat necrosis, fibrosis, dystrophic calcification, and reactive ischemic bone formation. The clinicopathologic and roentgenographic correlation are necessary in establishing correct diagnosis of this tumor.
Adipose Tissue ; Calcaneus ; Diagnosis ; Fat Necrosis ; Female ; Fibrosis ; Humans ; Ilium ; Lipoma* ; Male ; Middle Aged ; Osteogenesis ; Tibia ; X-Ray Film

Carcinoma Showing Thymus-Like Differentiation (CASTLE) is a rare tumor, which occurs in the thyroid gland and surrounding soft tissue, or soft tissue of the neck. It is thought to originate from ectopic thymus or branchial pouch remnants. We report a case of CASTLE of the thyroid gland in a 42-year-old woman. Grossly, a nodular, partly well demarcated, grayish yellow, 3.0 2.0 cm sized, solid mass was found in the right thyroid gland. Microscopically, the tumor was divided into lobules of variable size and shape, nests and cords with thin and thick fibrous septa which were infiltrated by lymphocytes and plasma cells. The tumor cells were large, polygonal and had vesicular nuclei with prominent nucleoli and eosinophilic cytoplasm. Some cells, especially in the central portion of the nests had abundant eosinophilic cytoplasm and showed squamoid feature.
Adult ; Cytoplasm ; Eosinophils ; Female ; Humans ; Lymphocytes ; Neck ; Plasma Cells ; Thymus Gland ; Thyroid Gland*

Adenosquamous carcinoma of stomach is a mixed glandular-epidermoid tumor where both components are neoplastic. Its incidence is extremely rare. The five theories on the origin of squamous components are 1) island of ectopic squamous epithelium in the gastric mucosa, 2) squamous metaplasia of gastric epithelium, 3) squamous differentiation in a preexisting adenocarcinoma, 4) endothelial cell differentiated toward squamous elements, and 5) totipotential undifferentiated cells of the gastric mucosa. We experienced three cases of adenosquamous carcinoma. Case 1 was a 71-year-old female patient; an ulcerative lesion was present in the pylorus, measuring 5 cm in diameter. Case 2 was a 57-year-old male patient; an ulcerative lesion is present in the pylorus, measuring 6 cm in diameter. Case 3 was a 58-year-old female patient; an ulcerative lesion was present in the body and fundus, measuring 10 cm in diameter. Microscopic examination revealed a mixed malignant squamous and adenomatous component.
Adenocarcinoma ; Aged ; Carcinoma, Adenosquamous* ; Endothelial Cells ; Epithelium ; Female ; Gastric Mucosa ; Humans ; Incidence ; Male ; Metaplasia ; Middle Aged ; Pylorus ; Stomach* ; Ulcer

We experienced a case of adenocarcinoma arising in sacrococcygeal teratoma. The patient was a 52-year-old woman. She was admitted due to one month of sacral pain. She had a sacral mass since birth. On physical examination, anal fistula was present at the perianal area and pus drainage was noted. MR image showed multiple variable-sized cysts with inhomogeneous density. Resected specimen, mesuring 12.5 7.0 cm in diameter, showed multiple variable-sized cystic lesions admixed with grayish solid portion. The cysts contained mucoid material. The microscopic examination showed mature teratoma composed of cysts lined by pseudostratified ciliated columnar epithelium, intestinal mucosa, mature cartilage, bone, and fat tissue. A moderately differentiated adenocarcinoma developed from the cystic area in the mass.
Adenocarcinoma* ; Adult ; Cartilage ; Drainage ; Female ; Humans ; Intestinal Mucosa ; Middle Aged ; Mucous Membrane ; Parturition ; Physical Examination ; Rectal Fistula ; Suppuration ; Teratoma*