Soft tissue tumor is defined as a tumor occurring in voluntary muscles, fat, fibrous tissue, along with the vessels serving these tissue and peripheral nervous system. It is difficult to make a diagnosis by conventional microscopic observation because of their pleuripotentiality and similar growth characteristics. Although their morphological findings of tumors are similar to one another, their clinical courses, treatment and prognosis are different. So early, correct diagnosis and proper treatment are neccessary. The present study is aimed to evaluate a value of immunoperoxidase staining to make definite diagnosis of soft tissue tumors and its application to surgical pathology. The material consisted of 106 cases of fibrohistiocytic tumors and malignant soft tissue tumors which are morphologically similar to malignant fibrohistiocytic tumors for 5 years period lasting from 1980 to 1984 at the Department of Pathology, Yonsei University College of Medicine. After the classificationof fibrohistiocytic tumors by the Enzinger (1983), clinical finndings were reviewed and peroxidase antiperoxidase(PAP) method with alpha1-antichymotrypsin was done in 15 cases of all fibrohistiocytic tumors. Other soft tissue tumors which were difficult to differentiate from MFH by light microscopic observation were liposarcoma, rhabdomyosarcoma, fibrosarcoma and malignant schwannoma. These 21 cases of tumors including MFH were stained with PAP method for alpha1-antichymotrypsin, S-100 protein and myoglobin. Results obtained were as follows: 1) The cases on study consisted of 19 cases of malignant fibrous histiocytoma, 2 dermatofibrosarcoma protuberans, 45 fibrohistiocytic tumors and 11 other benign fibrohistiocytic tumors. 2) The male to female ratio was 1 : 1.8 in benign and intermediate group of fibrohistiocytic tumor, but 2.2 : 1 in malignant histiocytic tumor. 3) Most cases of benign fibrohistiocytic tumors were occurred in 4th and 5th decade of life. Intermediate and malignant fibrohistiocytic tumors were mostly found in late adult life and their mean age was 43.6 year. 4) The most common sites were trunk and both extrimities in benign fibrohistiocytic tumors(88.9%), but head, neck and lower extremities in MFH (78.9%). Two cases of dermatofibrosarcoma protuberans were occurred in turnk and upper extremity. 5) The PAP stain for alpha1-antichymotrypsin was done in 15 cases of 77 fibrohistiocytic tumors which included MFH, dermatofibrosarcoma protuberans, xanthoma, xanthofibroma, dermatofibroma showed variable degree of positivity to alpha1-antichymotrypsin. The positivity of alpha1-antichymotrypsin revealed no significant difference according to differentiation of the tumors, such as benign, intermediate and malignant. 6) The PAP stain for alpha1-antichymotrypsin revealed diffuse positivity in all cases of MFH and also in a case of malignant schwannoma, fibrosarcoma, liposarcoma and rhabdomyosarcoma, but myoglobin and S-100 protein were negative. In three cases of leiomyosarcoma, two of rhabdomyosarcoma and three of malignant schwannoma, alpha1-antichymotrypsin, S-100 protein and myoglobin were negative, although a few positive tumor cells were present, which may the considered as metatypci differentiation. Another possibility of this discordance was loss of antigenicity by improper procedure of paraffin embedding and poor differentiation of tumor cells. In summary, PAP method for specific tumor marker is important for proper diagnosis of soft tissue tumors, and application to surgical pathology.
Adult ; Male ; Female ; Humans ; Tumor Markers, Biological

Thanatophoric dysplasia is the most common lethal congenital chondrodysplasia with characteristic features of narrow thorax, short rib, severe platyspondyly, short bowed limbs and skull deformity, etc. It is not a hereditary disorder and there is usually no family history of dysplasia. We experienced a case of thanatophoric dysplasia at 38 weeks of gestation with antenatal sonographic and abdominal radiographic findings of small thorax, short bowed extremities with surrounding thickened soft tissues and marked platyspondyly. Soon atter delivery, the baby died and post-mortem radiographs showed the characteristic findings of thanatophoric dysplasia.
Congenital Abnormalities ; Extremities ; Humans ; Pregnancy ; Ribs ; Skull ; Thanatophoric Dysplasia* ; Thorax ; Ultrasonography

Purpose: To evaluate the risk factors for the development of osteonecrosis in civilian professional divers by an epidemiologic study and to determine the correlation between osteonecrosis in divers and coagulopathy by analysis of serologic markers that are related to thrombophilia and hypofibrinolysis. Materials and Methods: Forty-two divers, who collected pen shells (Atrina pinnata), and among whom 10 had osteonecrosis (group 1), were compared with 32 divers without osteonecrosis (group 2). Both groups were evaluated based on the number of years of diving experience, number of dives per year, mean number of dives per day, mean diving time and depth, and diving methods. We determined any statistically significant differences among these variables. We measured the levels of serologic markers that were related to hyperlipidemia, thrombophilia, and hypofibrinolysis from the divers and a control group of 20 physicians (group 3). The levels of the serologic markers were compared between groups 1 and 2 and between the divers and the control group, in order to determine the relationship between the serologic markers and the development of dysbaric osteonecrosis. Results: None of the variables demonstrated any statistically significant differences, except for the mean diving time, in which group 1 had a mean diving time of 124 minutes and group 2 had a mean diving time of 62.1 minutes (P<0.05). In the analysis of the serologic markers, there were no statistically significant differences between groups 1 and 2; however, in comparison with the group 3, the divers demonstrated significantly decreased activity levels of proteins C and S (Protein C: P<0.05; Protein S: P<0.05), and an increase in the levels of plasminogen activator inhibitor-1 (PAI-1) (P<0.05). Conclusion: The divers with osteonecrosis had a longer mean diving time than did those divers without osteonecrosis. In the serologic marker analysis, the divers with osteonecrosis demonstrated significantly decreased activity levels of Proteins C, S and a significant increase in the levels of PAI-1, compared with the control group.
Biomarkers* ; Diving ; Epidemiologic Studies* ; Epidemiology ; Hyperlipidemias ; Osteonecrosis* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein S ; Risk Factors ; Thrombophilia

OBJECTIVES: Recent studies have reported a correlation between obstructive sleep apnea syndrome (OSA) and depression. In attempt to verify the suggestion that eveningness is related to depression, we examined the effect of morningness-eveningness on their depressive mood in patinets with OSA. METHODS: The examination was based on the medical records and polysomnography reports of 211 OSA patients. Information was gathered from the patients who filled out the Horne and Ostberg questionnaire (HOQ), profile of mood states-Korean version (K-POMS), and Epworth sleepiness scale (ESS). We compared mean values of K-POMS total, subscales of K-POMS, ESS, and OSA severity variables among the 3 morningness-eveningness groups (morningness, eveningness, and neither groups). Partial correlation analysis was performed between variables and ANCOVA was performed among the 3 groups after adjustment with age and weight. RESULTS: There were significant negative correlations between HOQ and the followings : K-POMS total, POMS-T (tension-anxiety), POMS-D (depression-dejection), POMS-A (anger-hostility), POMS-F (fatigue-inertia), POMS-C (confusion-bewilderment), spontaneous arousal index, average O2 saturation. There were significant positive correlations between HOQ and the followings : POMS-V (vigor-activity), apnea-hypopnea index, respiratory arousal index, snore time. There were significant negative correlations between POMS-D and the followings : HOQ, POMS-V, stage 1 sleep (%), AHI, TAI (total arousal index), oxygen desaturation index, respiratory arousal index, neck circumference, average O2 desaturation, snore time (%). There were significant positive correlations between POMS-D and K-POMS total, POMS-T, POMS-A, POMS-F, POMS-C, sleep latency, stage 2 sleep (%), heart rate, spontaneous arousal index. There were significant differences in K-POMS total, POMS-T, POMS-D, POMS-F, POMS-C, spontaneous arousal index among the three HOQ groups in ANCOVA. CONCLUSION: The depressive correlates of OSA patients might be affected, not by excessive daytime sleepiness or OSA severity indexes, but by eveningness circadian characteristics. It would be important to take into account the morningness-eveningness tendency when we manage the depressive mood of OSA patients.
Animals ; Arousal ; Circadian Rhythm ; Depression ; Disorders of Excessive Somnolence ; Heart Rate ; Horns ; Humans ; Medical Records ; Neck ; Oxygen ; Polysomnography ; Surveys and Questionnaires ; Sleep Apnea, Obstructive

LPS and IFN-r induce nitric oxide synthase in macrophages and the resultant NO causes apoptotic cell death in the activated macrophages. NO production and apoptosis were inhibited by N-monomethyl L-arginine (NMMA), a competitive inhibitor of NO synthase. To study the role of BCL-X proteins, RAW 264.7 cells were transfected with the expression vectors with human bcl-Xl or bcl-Xs cDNAs, respectively. Stable transfectants were selected and confirmed by RT-PCR. NO production in response to LPS and IFN-r caused apoptosis in RAW 264.7 cells and vector transfected control cells within 24 hr. Both NO production and apoptosis were inhibited by N(G)-monomethyl L-arginine (NMMA). In contrast, bcl-Xs transfectant appeared slightly susceptible and bcl-X(L)< transfectant appeared slightly resistant, although NO production was similar to control cells. These results suggest that bcl-X proteins play roles in both positive and negative regulation of apoptosis induced by NO.
Apoptosis* ; Arginine ; bcl-X Protein* ; Cell Death ; DNA, Complementary ; Humans ; Macrophages* ; Nitric Oxide ; Nitric Oxide Synthase

PURPOSE: The effect of PTK inhibitors (herbimycin A and genistein) on the induction of radiation-induce d apoptosis in Ph-positive K562 leukemia cell line was investigated. MATERIALS AND METHODS: K562 cells in exponential growth phase were irradiated with a linear accelerator at room temperature. For 6 MV X-ray irradiation and drug treatment, cultures were initiated at 2x10' cells/mL. The cells were irradiated with 10 Gy. Stock solutions of herbimycin A and genistein were prepared in dimethyl sulphoxide (DMSO). After incubation at 37C for 0-48 h, the extent of apoptosis was determined using agarose gel electrophoresis and TUNEL assay. The progression of cells throughth the cel l cycle after irradiation and drug treatment was also determined with flow cytometry. Western blot analysis was used to monitor bcl-2, bcl-X and bax protein levels. RESULTS: Treatment with 10 Gy X-irradiation did not result in the induction of apoptosis. The HMA alone (500 nM) also failed to induce apoptosis. By contrast, incubation of K562 cells with HMA after irradiation resulted in a substantial induction of nuclear condensation and fragmentation by agarose gel electro-phoresis and TUNEL assay. Genistein failed to enhance the ability of X-irradiation to induce DN A fragmentation. Enhancement of apoptosis by H MA was not attributable to downregulation of the bcl-2 or bcl-X anti-apoptotic proteins. When the cells were irradiated and maintained with HMA, the percentage cf cells in G2/M phase decreased to 30-40% at 48 h. On the other hand, cells exposed to 10 Gy X-irradiation alone or maintained with genistein did not show marked cell cycle redistribution. CONCLUSION: We have shown that nanomolar concentrations of the PTK inhibitor HMA synergize with X-irradiation in inducing the apoptosis in Ph (+) K562 leukemia cell line. While, genistein, a PTK inhibitor which is not selective for p2 10""'' failed to enhance the radiation induced apoptosis in K562 cells. It is unlikely that the ability of HMA to enhance apoptosis in K562 cells is attributable to bcl-2 family. It is plausible that the relationship between cell cycle delays and cell death is essential for drug development based on molecular targeting designed to modify radiation-induced apoptosis.
Apoptosis Regulatory Proteins ; Apoptosis* ; bcl-2-Associated X Protein ; Blotting, Western ; Cell Cycle ; Cell Death ; Cell Line ; Dimethyl Sulfoxide ; Down-Regulation ; Electrophoresis, Agar Gel ; Flow Cytometry ; Genistein ; Hand ; Humans ; Hydrogen-Ion Concentration ; In Situ Nick-End Labeling ; K562 Cells* ; Leukemia ; Particle Accelerators ; Sepharose

PURPOSE: To assess the efficacy of ancillary CT findings other than the obstructive lesion per se for the differential diagnosis of extrahepatic biliary obstruction. MATERIALS AND METHODS:CT findings of 49 patients with extrahepatic bile duct obstruction(22 benign and 27 malignant lesions) were assessed with emphasis on the patterns of ductal dilatation, contrast enhancement, and diffuse thickening of the extrahepatic ductal wall. Degree of central and peripheral intrahepratic ductal dilatation was graded by comparing with the adjacent portal radicles and hepatic parenchymal thickeness. RESULTS: Diffuse circumferential thickening and contrast enhancement of the extrahepatic ductal wall were more frequent in benign cases, but only thickening was statistically significant(p < 0.01). Peripheral intrahepatic ducts were more severely dilated by malignant causes(p < 0.01). With the same degrees of extrahepatic and central ductal dilatations, peripheral intrahepatic ducts were more severely dilated in malignant than in benign cases. CONCLUSION: These results may help to interpret the CT findings of extrahepatic biliary obstruction, particularly when the cause of biliary obstruction is uncertain.
Bile Ducts, Extrahepatic ; Diagnosis, Differential ; Dilatation* ; Humans

BACKGROUNG AND OBJECTIVES: Diet is the basic and principal therapeutic modality for hyperlipidemia. However, diet therapy alone showed variable responses in lowering lipid levels in different studies. This research is to prove the effect of diet and Apo E polymorphism on the variation of serum lipid profile in Korean males. MATERIALS AND METHODS: To evaluate the gene-diet interation, serum total cholesterol (Chol), triglycerides (TG), HDL-cholesterol and LDL-cholesterol (HDLc, LDLc), lipoprotein (a) (Lp (a)), and fasting blood glucose (FBS) were measured with Apo E genotyping in vegeterians (group A, n=154) and in healthy Korean male adults (group B, n=150) of similar mean age (50.1 vs. 49.3). RESULTS: Lipid profiles showed significantly lower levels in group A compared to group B (Chol 168.3+/-30.5 mg/dL vs. 181.3+/-33.4 mg/dL, p<0.001;TG 131.0+/-62.9 mg/dL vs. 149.4+/-76.7 mg/dL, p=0.023;HDLc 56.0+/-11.0 mg/dL vs. 56.9+/-11.5 mg/dL, p=0.509;LDLc 92.5+/-28.1 mg/dL vs 100.6+/-29.9 mg/dL, p=0.016;Lp (a) 22.1+/-14.6 mg/dL vs. 26.9+/-13.8 mg/dL, p=0.004;FBS 85.1+/-14.1 mg/dL vs. 102.7+/-16.6 mg/dL, p<0.001). The Apo E genotyping showed Epsilon3/3, 64.1%; Epsilon3/4, 20.7%;Epsilon2/3, 11.8%;Epsilon2/2, 1.3%;Epsilon4/4, 0.6% in the combined groups. The distribution was similar in both groups. Chol and LDLc were significantly (p<0.05) higher in Epsilon3/4 allele group compared to other allele groups among non-vegetarians. On the other hand, Chol and LDLc were significantly (p<0.01) lower in vegetarians compared to non-vegetarians only in Epsilon3/4 allele group. CONCLUSION: Vegetarian diet significantly lowered Chol, TG, LDLc, Lp (a) and FBS levels. Significant lipid lowering effect of vegetarian diet was noted in Apo E allele Epsilon3/4 group which had significantly higher Chol and LDLc levels without diet intervention. These data suggest that the influence of diet on serum lipid profiles differ according to apo E genotypes.
Adult ; Alleles ; Apolipoproteins E ; Blood Glucose ; Cholesterol ; Diet Therapy ; Diet* ; Diet, Vegetarian ; Fasting ; Genotype ; Hand ; Humans ; Hyperlipidemias ; Lipoprotein(a) ; Male* ; Triglycerides

Pseudoxanthoma elasticum (PXE) is an uncommon heritable disorder of elastin characterized by cutaneous, ocular and vascular abnormalities. Typical skin lesion shows yellowish papules and redundant skin folds on the neck, axilla and groin due to degeneration and calcification of elastic fibers in deep dermis. As in all heritable disorders of connective tissue, no curative therapy is presently know. Redundant and unsightly skin folds about the neck can be improved by surgery, but irregular papular lesion on skin does not improved by surgery. A-44-year-old female who had a skin lesion and angioid streak was treated as follows: Skin folds on the neck were excised successfully without any significant problem such as intraoperative bleeding, wound dehiscence or hypertrophic scar formation. To evaluate whether we could smooth the irregular skin surface due to multiple papules, laserbrasion with a SLT contack Nd:YAG laser system was performed experimentally on a limited area which was located on the right supracla-vicular area about 2 x 3cm in size. An acceptable aesthetic appearance was achieved with surgical excision 12 months after the operation. Biopsy of the laserbrasion site revealed disappearance of the calcium deposit. This study emphasizes the possibility of using laserbrasion in solving troblesome skin lesion of the PXE.
Angioid Streaks ; Axilla ; Biopsy ; Calcium ; Cicatrix, Hypertrophic ; Connective Tissue ; Dermis ; Elastic Tissue ; Elastin ; Female ; Groin ; Hemorrhage ; Humans ; Neck* ; Pseudoxanthoma Elasticum ; Skin ; Wounds and Injuries

A 21-year-old female is presented with semicircular lipoatrophy, which had developed since birth with annular depressed strophic lesion of the left thigh. Biopsy specimen from the depressed area of left thigh showed no abnormal pathologic findings. But X-ray and CT scan of the lower extremity revealed remarkably reduced fat layer of the left thigh, compared to the right side.
Biopsy ; Female ; Humans ; Lower Extremity ; Parturition ; Thigh ; Tomography, X-Ray Computed ; Young Adult