Sertoli-Leydig cell tumors of the ovary are rare, accounting for no more than 0.5% of all ovarian neoplasms. These tumors occur predominantly in women 10 to 30 years of age. Heterologous elements are found in over 20% of the moderately and poorly differentiated Sertoli- Leydig cell tumors. The most common element is gastrointestinal mucin-secreting epithelium, found in approximately 20% of all cases. Approximately 4% of Sertoli-Leydig cell tumors contain immature skeletal muscle and/or cartilaginous elements. The origin of these neoplasms is regarded as neometaplasia of the mesodermal neoplastic element. While the degree of differentiation of Sertoli-Leydig cell tumors is probably of greater importance in determining prognosis than the presence of heterologous components, recent evidence does point to an unfavorable effect on clinical outcome when heterologous mesenchymal components such as cartilage and striated muscle are present. We experienced two cases of ovarian heterologous Sertoli-Leydig cell tumors with gastrointestinal type epithelium and striated skeletal muscle in 20 and 21 year-old females, respectively. One case involved a patient who had complained of amenorrhea for 3 years while the other case involved a patient who had complained of left lower abdominal tenderness and amenorrhea for one and one half years. It was determined by ultrasonography of the pelvis that the two patients suffered from right and left ovarian masses. Both patients underwent adnexectomy. These tumors were large with partly solid and partly cystic areas. Based on light microscopic examination one case was classified as an intermediate Sertoli-Leydig cell tumor with heterologous gastrointestinal type epithelium, while the other case was classified as a poorly differentiated Sertoli-Leydig cell tumor with heterologous striated skeletal muscle.
Female ; Humans

OBJECTIVE: The goal of this study is to determine the efficacy of rapid karyotyping from fetal ascitic fluid. METHODS: In three cases of isolated fetal ascites diagnosed by prenatal ultrasonography, ultrasound guided fetal paracentesis and amniocentesis were performed and successfully obtained. Fetal karyotyping in each case at 29, 30 and 32 weeks gestation using modified lymphocyte culture method was conducted. RESULTS: The chromosomal analysis was successful within 72 hours and abnormalities were detected in two cases and revealed trisomy 21 in each case. Our study demonstrated that the majority distribution of white blood cells was lymphocytes which ranged from 2.1 * 10(6) cells/ml to 3.7 * 10(6) cells/ml and the cell density for culture was at least than 0.35 * 10(6) cells/ml. CONCLUSION: The use of ascitic fluid as a cell source to achieve rapid fetal karyotyping can be valuable when cordocenteis or amniocentesis would be technically more difficult, or when rapid result is required for planning of perinatal management at late second or third trimester gestational age.
Amniocentesis ; Ascites ; Ascitic Fluid* ; Cell Count ; Cytogenetics* ; Diagnosis* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotyping ; Leukocytes ; Lymphocytes ; Paracentesis ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography ; Ultrasonography, Prenatal

PURPOSE: To describe the sonographic features of angioleiomyoma arising from superficial soft tissue. MATERIALS AND METHODS: A retrospective study of the sonographic findings of 11 pathologically proven angioleiomyomas was performed. We evaluated the location, layer, size, shape, margin, echotexture, echogenicity, internal content, presence of calcification, and relationship to adjacent structures on gray scale sonography. We evaluated the presence, degree, and distribution pattern of vascularity within the mass on color Doppler sonography. RESULTS: All tumors were located in the subcutaneous layers of the extremities (5 in hand, 2 in elbow, 2 in knee, 1 in foot, 1 in calf). The sizes ranged from 8 to 30 mm, with an average size of 15.5 mm. All lesions were relatively homogeneous and hypoechoic, with well-defined margins and oval to round shape. There were no intratumoral calcifications or cystic portions in any of the masses. Vascularity was not detected in any patient (type 1), but was easily detected in 10 other patients. The degree of vascularity was mild (type 2) in 1 patient, moderate (type 3) in 4, and abundant (type 4) in 5. CONCLUSION: Although angioleiomyoma is an uncommon entity, our study suggests that it must be included in the differential diagnosis of well-defined, hypoechoic, vascular subcutaneous tumors in the extremities.
Angiomyoma ; Diagnosis, Differential ; Elbow ; Extremities ; Foot ; Hand ; Humans ; Knee ; Retrospective Studies

OBJECTIVES: The critical pathways provide high quality of medical services in a cost-effective manner. To investigate the decrease in length of hospital stay and increase of cost effectiveness by using critical pathways, we compared hospital stay, cost of treatment, and the patient's satisfaction before and after critical pathway use. METHODS: We made a critical pathway team, which consisted of obstetric staff members, a resident, two nurses, a pharmacist, two clerical staff members. We made critical pathways for the medical team and patients. A prospective evaluation of a critical pathway for cesarean section was used as a comparison for control patients. RESULTS: The data for 305 patients with a critical pathway were compared to those of 136 control patients. The mean hospital stay is shorter in critical pathway patients than control patients. The cost of treatment decreased and differences between DRG (Diagnosed Related Groups) and cost of treatment increased in critical pathway patients. CONCLUSIONS: Using critical pathways in cesarean section decreased the duration of hospital stay and increased cost effectivesess. The critical pathways were useful as a means to minimize cost while increasing patient satisfaction.
Cesarean Section* ; Cost-Benefit Analysis ; Critical Pathways* ; Diagnosis-Related Groups ; Female ; Humans ; Length of Stay ; Patient Satisfaction ; Pharmacists ; Pregnancy ; Prospective Studies

BACKGROUNDS/OBJECTOVES: Family has an impact on dietary intake of children as a proximal food environment and family structures are changing and becoming more diverse. This study was performed to identify the association between family structure and food group intake of children aged 3-18 years in Korea. SUBJECTS/METHODS: A total of 3,217 children with complete data on variables for household information, dietary intake and sampling weights were obtained from 2010-2011 Korea National Health and Nutrition Examination Survey. Children's family structure was classified into 3 groups (Living with both parents, Living with one parent and Living without parents). To evaluate children's food group intake, scores of individual food groups ('Grains', 'Meat, Fish, Eggs and Beans', 'Vegetables', 'Fruits' and 'Milk and Dairy products') was calculated from percent adherence to the recommended servings of the Korean Food Guidance System (KFGS). 'Food group mean score' was obtained by calculating the average of five food group scores. RESULTS: After adjusting for age, sex, number of family members, and household income, children living with both parents had higher scores in 'Fruits' (P < 0.01), 'Milk and Dairy products' (P < 0.05), and mean score of individual food group score (P < 0.001) compared to children living with one parent. Individual food group scores and mean scores of individual food group scores were associated with different socio-demographic factors in study children. Family structure was associated with 'Fruits,' 'Milk and Dairy products' score and mean scores of food group scores. CONCLUSIONS: These results suggested that different approach might be required to solve nutrition problem in children depending on their family structure and other socio-demographic factors.
Child* ; Eggs ; Family Characteristics ; Humans ; Korea ; Nutrition Surveys ; Ovum ; Parents ; Weights and Measures

We Describe a case of ovarian serous cystadenoma having Sertoli-Leydig cell tumor, well differentiated, in the cystic septum. Well differentiated Sertoli-Leydig cell tumor coexisting with other tumor, including serous tumor, has not yet been described. In all cases of Sertoli-Leydig cell tumor with heterologous components or other tumors, the androblastomatous components are intermediately or poorly differentiated. The present case revealed a well differentiated Sertoli-Leydig cell tumor arising in a septum of serous cystadenoma, as a circumscribed nodule. With these findings, we discuss the possibility of this Sertoli-Leydig cell tumor, considered a mural nodule, which is well established in cystic common epithelial tumors of the ovary.
Adult ; Case Report ; Cystadenoma/*pathology ; Female ; Human ; Leydig Cells/pathology ; Male ; Ovarian Neoplasms/*pathology ; Sertoli Cells/pathology ; Sertoli-Leydig Cell Tumor/*pathology ; Support, Non-U.S. Gov't

Although it is commonly appreciated that there is an inordinately large number of anormalies associated with the excretory ducts of the liver, comparatively little attention has been paid to the position of the orfice of the common bile duct into the duodenum. But, obiviously the site of entrance of the common bile duct into the duodenum becomes of great importance to the endoscopist, radiologist, and surgeon in diseases of the extra-hepatic biliary tract diag-nostically and therapeutically. We report 'a case of anomalous termination of the common bile duct into the duodenal bulb with the gall bladder empyema.
Biliary Tract ; Cholecystitis* ; Common Bile Duct* ; Duodenum ; Liver

Gastritis cystica profunda is an uncommon benign mass that usually occurs on the gastric side of the site of a gastroenterostomy, but has also been known to develop in which has not been operated on. We report the case of stomach a 51-years-old man with pathologically proven gastritis cystica profunda. This patient had not undergone gastric surgery and CT showed a well-defined, 3 cm sized, cystic mass at the gastric antrum.
Gastritis* ; Gastroenterostomy ; Humans ; Pyloric Antrum ; Stomach

Adenocarcinoma of the ciliary epithelium is a rare tumor, usually occuring in elderly patients who have a history of severe ocular trauma or chronic inflammation. We report an adenocarcinoma of the nonpigmented ciliary epithelium found within the phthisical globe of a 36-year-old female whose eye had been loss of vision since infancy. The mass, measured 4.0 x 4.0 cm, was relatively limited by sclera but had invasion to posterior portion. Histologically, the tumor was a compact mass which consisted of tubular and papillary structures with foci of the pleomorphic area. Strands of cells and individual cells were invested with thick basement membrane that have positivity for periodic acid-Schiff stain. Immunohistochemical staining showed strong reactivity for cytokeratin and epithelial membrane antigen, and focal for neuron-specific enolase and S-100 protein.
Adenocarcinoma ; Adenocarcinoma, Papillary* ; Adult ; Aged ; Basement Membrane ; Epithelium* ; Female ; Humans ; Inflammation ; Keratins ; Mucin-1 ; Phosphopyruvate Hydratase ; S100 Proteins ; Sclera

BACKGROUND AND OBJECTIVES: This study was performed to elucidate the relationship between body mass index (BMI) and snoring time (ST) in patients with obstructive sleep apnea (OSA) using a portable sleep monitoring device. SUBJECTS AND METHOD: From May 2011 to December 2015, 492 patients whose apnea-hypopnea index (AHI) was more than 5 were enrolled. Subjects were classified into 3 groups on the basis of the AHI (mild=5≤AHI<15; moderate=15≤AHI<30; severe=30≤AHI). Using the multiple linear regression analysis, the relationship between ST and other variables (BMI, arousal index, O2 desaturation events, age and AHI) were measured in each group. RESULTS: There was significant association between ST and BMI, especially in the severe group (p=0.005). CONCLUSION: In the severe group, reducing BMI is important to improve ST.
Arousal ; Body Mass Index* ; Humans ; Linear Models ; Methods ; Polysomnography ; Sleep Apnea, Obstructive* ; Snoring*