No abstract available.

No abstract available.
Carcinoma, Hepatocellular* ; Child* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans

No abstract available.
Escherichia ; Hemolytic-Uremic Syndrome

A 69-year-old female patient presented with a huge liver mass at another hospital. Computed tomography (CT) revealed a huge, well-demarcated, low-attenuated mass in the right lobe of the liver and multiple nodules in both lungs. The liver mass invaded the colon at the hepatic flexure and infiltrated into the retroperitoneum. Spiral CT revealed a huge tumor thrombus in the right ventricle (RV). The enhancement pattern of the right ventricular mass was identical to that of the liver mass. After ultrasonography-guided needle biopsy of the liver mass, the patient was diagnosed with intrahepatic sarcomatoid cholangiocarcinoma. Although we recommended debulking open-heart surgery for the prevention of sudden death caused by massive pulmonary embolism, the patient and her family opted against surgery due to high operation-related mortality and old age. The patient later died of massive pulmonary embolism at another hospital a few weeks later.
Aged ; Biopsy, Needle ; Cholangiocarcinoma ; Colon ; Death, Sudden ; Female ; Heart Ventricles ; Humans ; Liver ; Lung ; Pulmonary Embolism ; Thrombosis ; Tomography, Spiral Computed

No abstract available.
Delivery of Health Care* ; Irritable Bowel Syndrome* ; Korea ; National Health Programs*

Acral metastasis to the finger is a very rare phenomenon. We report herein a case of cutaneous acrometastasis to the right 5th finger tip in a 36-year-old woman with metastatic breast cancer. The patient underwent a right modified radical mastectomy for T3N3 invasive ductal carcinoma and received adjuvant chemotherapy and radiotherapy. After 2 years, she developed metastasis to the brain, bones, and lungs. She was found to have a growing tender mass on the tip of right 5th finger. A well-demarcated, soft tissue mass was identified on sonography. Under the clinical impression of a possible benign process, the nodule was surgically removed. The pathologic finding was consistent with metastatic breast cancer. Immunohistochemical staining for estrogen receptor, progesterone receptor, and HER2 were all negative, as in the primary tumor. Radiation was given to the finger tip and systemic chemotherapy with capecitabine was tried for systemic metastatic disease.
Adult ; Brain ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Chemotherapy, Adjuvant ; Deoxycytidine ; Estrogens ; Female ; Fingers ; Fluorouracil ; Humans ; Lung ; Mastectomy, Modified Radical ; Neoplasm Metastasis ; Receptors, Progesterone ; Capecitabine

Non-Hodgkin's lymphoma arising in lung comprises 0.5% of primary lung tumor and 3% of extranodal lymphoma. The most common radiographic abnormalities of pulmonary lymphoma include pulmonary nodule and consolidation but hilar lymphadenopathy is rarely observed. Recently we experienced primary pulmonary T-cell lymphoma presenting with bilateral hilar lymphadenopathies and diffuse pulmonary infiltration. A 39-year-old man was admitted to the hospital because of fever, cough, and severe dyspnea. Chest PA obtained on admission revealed bilateral hilar lymphadenopathies and diffuse bilateral pulmonary infiltration. The diagnosis of sarcoidosis was strongly suggested and empirical treatment with corticosteroids resulted in dramatic clinical and radiological improvement for a short time. Eventually, CT-guided lung biopsy was performed and the specimen disclosed primary pulmonary Non-Hodgkin's lymphoma of T-cell origin, diffuse small lymphocytic with focal plasmacytoid differentiation.
Adrenal Cortex Hormones ; Adult ; Biopsy ; Cough ; Diagnosis ; Dyspnea ; Fever ; Humans ; Lung* ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell* ; Sarcoidosis ; T-Lymphocytes* ; Thorax

BACKGROUND/AIMS: Balloon expulsion test (BET) is regarded as a screening tool of dyssynergic defecation (DD). However, some patients with normal BET results may be treated effectively by biofeedback training. This study aims to validate BET as a single screening test. METHODS: Two hundred and thirty-two patients who were diagnosed with functional constipation or irritable bowel syndrome with constipation who underwent anorectal manometry (ARM) and BET at Seoul National University Hospital were enrolled. We evaluated the validity of BET based on ARM and electromyography (EMG) during biofeedback training. RESULTS: If BET ≤ 1 minute was defined as normal, sensitivity and negative predictive value (NPV) of BET in predicting paradoxical contraction based on ARM findings were 71.4% and 13.9%. If BET ≤ 3 minutes was defined as normal, sensitivity and NPV were 35.2% and 6.6%. Specificity and positive predictive value (PPV) of BET ≤ 3 minutes criteria were 84.8% and 93.3%. Same analysis was conducted in 107 patients who underwent EMG during biofeedback training. With 1-minute criteria, sensitivity and NPV of BET were 70.3% and 14.3%. With 3 minutes criteria, sensitivity and NPV of BET was 38.6% and 8.8%. Specificity and positive predictive values were both 100.0%. CONCLUSIONS: Based on either ARM or EMG during biofeedback training, sensitivity was at most 71.4% and NPV was less than 15.0% irrespective of whether BET was within 1minute or within 3 minutes. BET seems to have a limitation as both a screening test for dyssynergic defecation and a simple assessment to rule out the necessity of biofeedback training.
Arm ; Biofeedback, Psychology ; Constipation ; Defecation* ; Electromyography ; Humans ; Irritable Bowel Syndrome ; Manometry ; Mass Screening* ; Sensitivity and Specificity ; Seoul

PURPOSE: In the metastatic process, interactions between circulating tumor cells (CTCs) and the extracellular matrix or surrounding cells are required. beta1-Integrin may mediate these interactions. The aim of this study was to investigate whether beta1-integrin is associated with the detection of CTCs in colorectal cancer. METHODS: We enrolled 30 patients with colorectal cancer (experimental group) and 30 patients with benign diseases (control group). Blood samples were obtained from each group, carcinoembryonic antigen (CEA) mRNA for CTCs marker and beta1-integrin mRNA levels were estimated by using reverse transcription-polymerase chain reaction, and the results were compared between the two groups. In the experimental group, preoperative results were compared with postoperative results for each marker. In addition, we analyzed the correlation between the expressions of beta1-integrin and CEA. RESULTS: CEA mRNA was detected more frequently in colorectal cancer patients than in control patients (P = 0.008). CEA mRNA was significantly reduced after surgery in the colorectal cancer patients (P = 0.032). beta1-Integrin mRNA was detected more in colorectal cancer patients than in the patients with benign diseases (P < 0.001). In colorectal cancer patients, expression of beta1-integrin mRNA was detected more for advanced-stage cancer than for early-stage cancer (P = 0.033) and was significantly decreased after surgery (P < 0.001). In addition, expression of beta1-integrin mRNA was significantly associated with that of CEA mRNA in colorectal cancer patients (P = 0.001). CONCLUSION: In conclusion, beta1-integrin is a potential factor for forming a prognosis following surgical resection in colorectal cancer patients. beta1-Integrin may be a candidate for use as a marker for early detection of micrometastatic tumor cells and for monitoring the therapeutic response in colorectal cancer patients.
Carcinoembryonic Antigen ; Case-Control Studies* ; Colorectal Neoplasms* ; Extracellular Matrix ; Humans ; Neoplastic Cells, Circulating ; Prognosis ; RNA, Messenger

OBJECTIVES: In the metastatic process, interactions between circulating tumor cells (CTCs) and the extracellular matrix or surrounding cells are required. β1-integrin may mediate these interactions. The aim of this study was to investigate whether β1-integrin is associated with the detection of CTCs in colorectal cancer. METHODS: We enrolled 30 patients with colorectal cancer (experimental group) and 30 patients with benign diseases (control group). Blood samples were obtained from each group, carcinoembryonic antigen (CEA) mRNA for CTCs marker and β1-integrin mRNA levels were estimated by using reverse transcription-polymerase chain reaction, and the results were compared between the two groups. RESULTS: CEA mRNA was detected more frequently in colorectal cancer patients than in control patients (P=0.008). CEA mRNA was significantly reduced after surgery in the colorectal cancer patients (P=0.032). β1-integrin mRNA was detected more in colorectal cancer patients than in the patients with benign diseases (P<0.001). In colorectal cancer patients, expression of β1-integrin mRNA was detected more for advanced-stage cancer than for early-stage cancer (P=0.033) and was significantly decreased after surgery (P<0.001). In addition, expression of β1-integrin mRNA was significantly associated with that of CEA mRNA in colorectal cancer patients (P=0.001). CONCLUSION: In conclusion, β1-integrin is a potential prognostic factor following surgical resection in colorectal cancer patients. β1-integrin may be a candidate for use as a marker for early detection of micrometastatic tumor cells and for monitoring the therapeutic response in colorectal cancer patients.
Carcinoembryonic Antigen ; Case-Control Studies* ; Colorectal Neoplasms* ; Extracellular Matrix ; Humans ; Integrins ; Neoplastic Cells, Circulating ; RNA, Messenger