Gallbladder carcinoma is the most common primary hepatobiliary carcinoma and the fifth most common malignancy of the GI tract. The most common type of gallbladder carcinoma is adenocarcinoma. Squamous cell carcinoma of the gallbladder is rarer and is responsible for up to 12.7% of gallbladder tumors. A 78-year-old man was incidentally suspected of having a gallbladder mass on an abdominal CT scan and underwent laparoscopic cholecystectomy. Pathology results confirmed the mass as a squamous cell carcinoma. Here we report a case of keratinizing squamous cell carcinoma of the gallbladder and review the literature.
Adenocarcinoma ; Aged ; Carcinoma, Squamous Cell ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Gallbladder ; Gastrointestinal Tract ; Humans ; Keratins

No abstract available.
Brain Stem* ; Cysticercus* ; Granuloma*

Objective: This study aimed to review domestic and international literature on oral health interven-tions for pregnant women and provide basic data for the development of oral health intervention programs. Methods: We used domestic and international search databases, such as Medline, Embase, Re-search Information Sharing Service, Science On, Korea Citation Index, and DBpia. Among papers published between 2003 and 2023, 22 met the selection criteria by combining “pregnant women,” “oral hygiene,” and “oral health.” Results: Since 2007, foreign literature has steadily increased; however, domestic literature has decreased. Overseas research designs were mostly randomized control trials, whereas domestic designs were mostly non-equivalent control group pretest-posttest. The intervention methods in-cluded three preventive programs, five specialized oral care programs, and 14 oral health education programs. Conclusions In-depth research should be conducted to increase the understanding and interest of pregnant women. Systematic intervention programs that consider the effectiveness and sus-tainability of intervention methods should be developed, and policy support should be provided to strengthen the importance of oral health education by experts and institutional improvements.

Glioblastomas rarely occur in the posterior fossa. The authors present clinical and pathological findings in a 59-year-old female patient with a glioblastoma growing primarily in the cerebello-pontine angle. The patient presented with a 1-month history of diplopia. Neurological examination revealed right-sided trigeminal and abducens nerve paresis. Cerebral magnetic resonance imaging showed a well-enhancing mass at cerebello-pontine angle. Following near total removal via petrosal approach, the pathological examination revealed a glioblastoma. To the authors knowledge, this represents the first case of glioblastoma arising at cerebello-pontine angle, probably originating from the most proximal part of abducens nerve.
Abducens Nerve ; Diplopia ; Female ; Glioblastoma* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Examination ; Paresis

We report two cases of mucocele of the frontal sinus presenting with exophthalmos and diplopia. Total removal involved the transfrontal approach and neurological deficits were eliminated. Details of clinical manifestations are presented, and a review of the literature is included.
Diplopia ; Exophthalmos ; Frontal Sinus* ; Mucocele*

We report two cases of mucocele of the frontal sinus presenting with exophthalmos and diplopia. Total removal involved the transfrontal approach and neurological deficits were eliminated. Details of clinical manifestations are presented, and a review of the literature is included.
Diplopia ; Exophthalmos ; Frontal Sinus* ; Mucocele*

Background: Preoperative verification of fracture morphology is essential for determining the definitive fixation strategy in the management of a pilon fracture. This study aimed to determine the correlation between fibular injury patterns and fracture morphologies and introduce clinical implications. Methods: Computed tomography scans of 96 pilon fractures were retrospectively analyzed and divided into three types: intact fibula, simple fracture, and multifragment fracture. The principal fracture line and comminution zones were illustrated on a plafond template and diagrammatized on a 6 × 6 grid using PowerPoint software as fracture mapping. Correlations between fibular injury patterns and fracture morphologies, including comminution zones and principal fracture lines, were analyzed. Results: The thickest comminution zone was most often located in the anterolateral quadrant. According to fibular injury patterns, the comminution zone of the multifragment group was placed two grids more lateral than that of other groups. Lateral exits of the principal fracture line in the multifragment group were much more concentrated within the fibular incisura. Conclusions In pilon fractures, a more complex fibular fracture pattern was related to the valgus position. Moreover, the articular fracture pattern of pilon fractures differed according to coronal angulation and fibular fracture pattern. These differences should influence the operative approach and placement of the plate.

In this report, we descrbed a case of multiple brain abscesses associated with diffuse congenital pulmonary arteriovenous malformations (PAVM). Although the cases of brain abscesses associated with congenital PAVM are very rare, the brain abscess could be an initial clinical manifestation in asymptomatic PAVM as in the case presented in this report. PAVM may contribute to the development of a brain abscess by allowing easy bacterial access to systemic circulation through the right-to-left pulmonary vascular shunt, bypassing the filtering effect of the pulmonary capillaries. Hence, this association should be considered in cases with brain abscesses of undetermined etiologic factors.
Arteriovenous Malformations/*complications/radiography ; Brain Abscess/*etiology/radiography ; Capillaries ; Child ; Humans ; Male ; *Pulmonary Circulation ; Tomography, X-Ray Computed

Cytokines and growth factors are important regulatory proteins controlling the growth and differentiation of normal and malignant glial cells. In this study, we investigated the expression and origin of tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta 1 (TGF-beta 1) in the subacute brain injury after a single high-dose irradiation using 60 Sprague-Dawley rats. The right cerebral hemispheres of rats were exposed to a single 10 Gy dose of gamma rays using Ir-192. The radiation effect was assessed at 1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks after irradiation, and the results were compared with those in sham operation group. Histological changes characteristic of radiation injury were correlated with the duration after the single dose irradiation. The loss of cortical thickness also increased with the lapse of time after irradiation. The TNF-alpha expression in the irradiated cerebral hemispheres was significantly increased compared with that in the sham operation group. TGF-beta 1 expression was also increased in the irradiated hemispheres. Immunohistochemical study revealed that TGF-beta 1 was expressed predominantly by infiltrating macrophages and astrocytes around the necrotic areas. These findings indicate that TNF-alpha and TGF-beta 1 may play prominent roles in the radiation injuries after a single high-dose irradiation.
Animals ; Brain/immunology/pathology/*radiation effects ; Dose-Response Relationship, Radiation ; Immunohistochemistry/methods ; Rats ; Rats, Sprague-Dawley ; Time Factors ; Transforming Growth Factor beta/*biosynthesis ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha/*biosynthesis

PURPOSE: To evaluate the treatment outcomes of the three-dimensional conformal radiotherapy (3D-CRT), in conjunction with induction chemotherapy, for the treatment of stage III non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Between November 1998 and March 2003, 22 patients with histologically proven, clinical stage III NSCLC, treated with induction chemotherapy, followed by 3D-CRT, were retrospectively analyzed. There were 21 males (96%) and 1 female (4%), with a median age of 68.5 (range, 42~79). The clinical cancer stages were IIIA and IIIB in 41 and 59%, respectively. The histologies were squamous cell carcinoma, adenocarcinoma and others in 73, 18 and 9%, respectively. Twenty patients (91%) received induction chemotherapy before radiation therapy. The majority of the chemotherapy regimen consisted of cisplatin and gemcitabine. Radiation was delivered with conventional anteroposterior/ posteroanterior fields for 36 Gy, and then 3D-CRT was performed. The total radiation dose was 70.2 Gy. The median follow-up period was 17 months (range, 4~59 months). RESULTS: The median overall survival was 19 months. The two and four-year overall survival rates were 37.9 and 30.3%, respectively. The median progression-free survival was 21 months. The two and four-year progression-free survival rates were 42.1 and 21%, respectively. The prognostic factors for overall survival by a univariate analysis were age, histology and T stage (p<0.05). Acute radiation toxicities, as evaluated by the RTOG toxicity criteria, included two cases of grade 3 lung toxicity and one case of grade 2 esophagus toxicity. CONCLUSIONS: The radiation dose could be increased without a significant increment in the acute toxicities when using 3D-CRT. It also seems to be a safe, well- tolerated and effective treatment modality for stage III NSCLC.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Cisplatin ; Disease-Free Survival ; Drug Therapy ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Lung ; Male ; Radiotherapy, Conformal* ; Retrospective Studies ; Survival Rate