Primary malignant fibrous histocytoma (MFH) of pleura is very rare. Upon microscopic examination, the tumor was characterized by storiform pattern of growth and intense, diffuse immunostaining for alpha l-antichymotripsin. We report a case of primary malignant pleural fibers histiocytoma with extension to lung, which was managed by complete excision of pleural mass and lobectomy with thoracoplasty.
Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Lung ; Pleura* ; Thoracoplasty

BACKGROUND: Majority of patients with mitral valve disease and chronic atrial fibrillation can resume sinus rhythm with the maze procedure. The purpose of this study is to identify mid-term outcome and possibility of recurrent atrial fibrillation in the patients who underwent mitral valve operation and the maze procedure. MATERIAL AND METHOD: A retrospective study was undertaken on 11 consecutive patients(including 10 patients with rheumatic mitral valve disease) operated on for mitral valve disease and chronic atrial fibrillation. Maze II and its modified procedure were performed in 6 patients and maze III and its modified procedures in 5 patients. Postoperative left atrial contractility was compared between the patients that underwent mitral valve operation and maze procedure and the patients with mitral valve procedure and medication of anti-arrhythmic drugs. RESULT: Five(83.3%) of 6 patients with maze II procedure and all 5 patients(100%) with maze III procedure resumed sinus rhythm. In 1(20%) of 5 patients with sinus rhythm after maze II procedure and 2(40%) of 5 patients with sinus rhythm after maze III procedure, atrial fibrillation recurred 23, 2, and 13 months after the operations, respectively. None of three patients with the modified procedure had recurrence of atrial fibrillation. Of 3 patients with recurrent atrial fibrillation, 2 patients resumed sinus rhythm and 1 still had atrial fibrillation. After the maze procedures, only 4 (40%) of 10 patients with sinus rhythm presented left atrial contraction, and their mean velocity of mitral 'A' wave was lower than that of the patients who resumed sinus rhythm with only valve replacement and anti-arrhythmic drugs. CONCLUSION: Although the maj ority of patients with mitral valve disease and chronic atrial fibrillation can resume sinus rhythm with the maze procedure associated with mitral valve operation, atrial fibrillation may recur in mid-term. Also, the left atrial contractility may be very poor in patients who resumed sinus rhythm with maze procedure.
Atrial Fibrillation* ; Humans ; Mitral Valve ; Recurrence ; Retrospective Studies

PURPOSE: We performed a retrospective study to compare the accuracy between conventional CT staging and intraoperative staging for advanced gastric cancer. MATERIALS AND METHODS: Sixty patients with advanced gastric cancer were included in this study during the recent 2 year-period. All were pre- and posto- peratively diagnosed as advanced gastric cancer. CTwas performed with G E 9800 and Somatom DR3 under conventional technique in 50 and with others in 10 referred patients. The CT staging for T and N category with emphasis on incurable factor, if not resacted, were performed. And we compared the accuracy between conventional CT and intraoperative staging. The final histo-pathologic staging was used as a gold standard. RESULTS: Accuracy of CT and operation for T4(n=l7) factor is 76.9 % and 86.2 % respectively. Overestimation rate for T4 was 9.3 % by CT and 6.1% by operation, and underestimation rate for was 13.8 % and 7.7 % respectively. Accuracy of CT and operation for N (n=60) factor was 50 % and 60 % respectively. Overestimation rate for N factor was 18.3 % by CT and 18.3 % by operation, and underestimation rate for N factor was 31.7 % and 21.7 % respectively. Correct Tand IM staging was possible only in 33% by CT and 38% by intraoperative assessment. CONCLUSION: Conventional CT and intraoperative staging for incurable T/N factor in advanced gastric cancer have a potential limitations, especially for N factor. Therefore, more reliable modality or technique such as dynamic scanning by spiral CT, transabdominal or endoscopic ultrasonography should be preoperatively performed to complement infrequent errors in intraoperative staging. Furthermore, a histology-oriented surgical approach seems essential in selecting the most appropriate surgical procedure.
Complement System Proteins ; Endosonography ; Fibrinogen ; Humans ; Retrospective Studies ; Stomach Neoplasms* ; Tomography, Spiral Computed

No abstract available.
Bleomycin* ; Humans ; Sclerotherapy*

Cholangiolocellular carcinoma is a rare lesion, intermediate in type between hepatocellular and cholangio-cellular carcinoma. The radiologic findings of cholangiolocellular carcinomas have not been reported. We describe the ultrasound, CT, MR, and angiographic findings of a case of cholangiolocellular carcinoma not associated with liver cirrhosis.
Liver Cirrhosis ; Ultrasonography

PURPOSE: To evaluate a scoring system based on ultrasonographic findings as a means of distinguishing between benign and malignant solid breast masses. MATERIALS AND METHODS: Histopathologically confirmed benign (n=102) and malignant (n=73) breast masses which ultrasonographic findings of histopathologic masses were reviewed for shape, border, internal echo, boundary echo, posterior echo, lateral echo, and ratio of transverse to anteroposterior diameter. There were statistically significant (p < 0.001 ; chi-square test) differences in each feature for benign and malignant lesions. The findings suggesting benignancy, equivocality, and malignancy of the masses were scored as 0, 1, and 2 respectively. The scores for all features were summed for each lesion. An ROC curve was obtained. RESULTS: When the score was 6, five benign and seven malignant cases were found. Scores of 0 and 1 indicated benign masses and a score above 11, malignancy. The turning point was a score of 6, so a score above 7 suggests malignancy. CONCLUSION: A ultrasonographic scoring system can be used to characterise breast masses. A score of a mass above 7 suggests probable malignancy and a score below 5 suggests benignancy.
Breast* ; ROC Curve ; Ultrasonography*

PURPOSE: To describe the MR findings for the three phases of eosinophilic granuloma, as defined by Mirra 'sconventional radiographic criteria. MATERIALS AND METHODS: Eighteen lesions in 14 patients with proveneosinophilic granuloma were retrospectively analyzed. Among this total, three vertebral lesions were excluded,and the remaining is were classified as early, middle, or late phase on the basis of Mirra's radiographiccriteria. For each phase, we compared MR findings with regard to signal intensity, homogeneity, contrastenhancement, perilesional marrow edema, and soft tissue change. For the three vertebral lesions excluded becausethe application of radiographic criteria was difficult, MR findings for paravertebral soft tissue reaction anddegree of cord compression were compared. RESULTS: Of the fifteen cases classified, eight were early phase, fivewere mid phase, and two were late phase. During each phase, all lesions except one, as seen on T1-weightedimages(T1W1), showed iso-signal intensity. On T2WI, all lesions showed high signal intensity. Contrast studydemonstrated marked contrast enhancement. Thus, no remarkable differences were found in the signal intensitydegree of contrast enhancement of each phase. With regard to heterogeneity, this was demonstrated in most earlyphase lesions, reflecting necrosis and hemorrhage of those lesions. Soft tissue swelling was more severe duringthe early phase than the mid or late phase, but marrow edema was similar in each of the three phase. One of threepatients with vertebra plana showed para-vertebral soft tissue swelling and cord compression, but this was notseen in the two other cases. CONCLUSION: For evalvating the extent of eosinophilic granuloma and its relationshipwith surrounding structures, MRI was superior to conventional radiography. During the early phase of the disease,lesions showed greater inhomogeneity and more aggressive soft tissue reaction than during the mid and late phase.The use of MRI for the evalvation of eosinophilic granuloma can help decide a therapeutic plan of action andfollow up evaluation.
Bone Marrow ; Edema ; Eosinophilic Granuloma* ; Eosinophils* ; Granuloma ; Hemorrhage ; Histiocytosis ; Humans ; Magnetic Resonance Imaging ; Necrosis ; Population Characteristics ; Radiography ; Retrospective Studies ; Spine

No abstract available.
Breast* ; Carcinoma, Ductal*

We herein describe a 70-year-old woman who presented with respiratory failure due to extensive lung adenocarcinoma. Despite advanced disease, care in the intensive care unit with ventilator support was performed because she was a newly diagnosed patient and was considered to have the potential to recover after cancer treatment. Because prompt control of the cancer was needed to treat the respiratory failure, empirical treatment with an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor was initiated before confirmation of EGFR-mutant adenocarcinoma, and the patient was successfully treated. Later, EGFR-mutant adenocarcinoma was confirmed.
Adenocarcinoma* ; Aged ; Female ; Humans ; Intensive Care Units ; Lung* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilators, Mechanical ; Erlotinib Hydrochloride

Even when DNA sequencing of purified DNA template failed under the optimal condition, it can be generally contributed to high GC content. GC-rich region of template causes a secondary structure to produce shorter readable sequence. To solve this problem, the sequencing reaction was modified by using dimethyl sulfoxide (DMSO). It was found that 5% (v/v) of DMSO in the reaction mixture recovers sequencing signal intensity with reduced frequency of ambiguous bases. When DMSO was added to sequencing reaction of DNA template with normal GC content, it did not show any adverse effect. Sequencing accuracy and unambiguous base frequency were significantly improved at concentration of 2% to 5% (v/v) DMSO in GC-rich DNA template. DMSO has been empirically introduced to enhance the efficiency of PCR in GC-rich templates. However, the underlying mechanism of improved cycle sequencing by DMSO is unknown. Thus, cycle sequencing reaction was remodified with other additives such as N-methyl imidazole, N-methyl2-pyrrolidone, N-methyl-2-pyridone and glycerol, possessing the similar chemical properties as DMSO. Most of methyl nitrogen ring-containing chemicals did not improve sequencing accuracy, whereas only glycerol mimicked the positive effect of DMSO by the same extent. In the present study, we suggest that the treatment of DMSO improve cycle sequencing by the alteration of structural conformation of GC-rich DNA template.
Base Composition ; DNA/chemistry* ; Dimethyl Sulfoxide/pharmacology* ; Plasmids/genetics ; Polymerase Chain Reaction/methods* ; Sequence Analysis, DNA* ; Solvents/pharmacology ; Solvents/chemistry ; Templates