The malignant mixed mullerian tumor (MMMT) is an uncommon tumor containing epithelial and mesenchymal components. MMMT of the ovary is rare, constituting less than 1% of all primary ovarian tumors. It is a particularly aggressive and rapidly progressive tumor, especially in advanced stages. This disease is usually advanced when diagnosed, because it is asymptomatic in early stage. The survival rate is very low in spite of surgery, chemotherapy and radiotherapy. The optimal treatment for this neoplasm is still controversial because of its rarity. We experienced one case of malignant mixed mullerian tumor of the ovary and report with a brief review of literature.
Drug Therapy ; Female ; Ovary* ; Radiotherapy ; Survival Rate

Arteriovenous malformation of the pelvic organ is a very rare cause of massive uterine bleeding. But, it is important to consider in the assessment of a patient with abnormal uterine bleeding because accurate diagnosis can allow appropriate treatment to be planned and avoid hysterectomy in women who wish to retain their reproductive capacity. This malformation may be congenital or acquired. In the past, the diagnosis is usually made retrospecively after hysterectomy, however, recently it may be made before management by ultrasound, doppler ultrasound, pelvic angiography, magnetic resonance imaging, etc. We have experienced two cases of arteriovenous malformation of the uterus, which is presented with a brief review of the literatures.
Arteriovenous Malformations* ; Diagnosis ; Female ; Humans ; Hysterectomy ; Magnetic Resonance Angiography ; Ultrasonography ; Uterine Hemorrhage ; Uterus

Mature cystic teratoma of the ovary is the most common ovarian germ cell tumor and almost benign, but malignant transformation occurs in less than 2% of benign mature teratoma. Of the malignancies arising in teratomas, squamous cell carcinoma is the most common (70-80%). The presentation in stage I disease dose not differ from that of benign cystic teratoma. In the early stage, the treatment is possible through surgical intervention alone. We experienced a case of squamous cell carcinoma of the ovary arising in mature cystic teratoma, which is presented with a brief review of literature.
Carcinoma, Squamous Cell* ; Female ; Neoplasms, Germ Cell and Embryonal ; Ovary* ; Teratoma*

OBJECTIVE: Acquisition of a proangiogenic environment is essential to the cervical cancer growth, invasion and metastasis, and the angiogenic phenotype in cervical cancer is strongly associated with clinical outcome. However, the regulation of the metastatic process in cervical cancer has not been well defined. Thrombospondin-1 (TSP-1) is a representative angiogenesis suppressor whose loss or reduced expression has been frequently observed in many types of human neoplasms. In this study, we examined whether expression of TSP-1 is associated with clinicopathological features, including microvessel density and evaluated its prognostic significance in patients with cervical cancer. METHODS: The expression and mutation status of TSP-1 was examined by quantitative RT- and genomic PCR and RT-PCR-SSCP analysis and microvessel density was performed using immunohistochemical staining in 7 normal cervix and 37 cervical cancers. RESULTS: All normal cervix tissues express easily detetable levels of TSP-1 transcript in range of 1.41-1.62 (mean 1.51 +/- 0.07). In contrast to normal tissue, mRNA expression of TSP-1 in primary cancer was detected in range of 0.51-1.69 (mean 1.03 +/- 0.36), and 35.1% (13 of 37) of carcinomas expressed abnormally low levels of TSP-1 (p<0.05). Moreover, abnormal reduction of TSP-1 expression was more frequently observed in IIa-IIb cancer (60%, 6 of 10) compared to Ib cancer (25.9%, 7 of 27) (p<0.05). None of carcinoma tissues we tested showed abnormal reduction of TSP-1 gene level and no evidences for sequence alterations leading to amino acid substitution were identified, indicating that allelic deletion or mutational alteration of TSP-1 might be a rare event in cervical carcinogenesis. Microvessel density was significantly higher in tumors showing decreased expression of TSP-1 (abnormal low group: 11.3 +/- 5.06, others: 6.64 +/- 7.15) (p<0.05). To detect the possible deletion of the gene and the presence of sequence alteration in TSP-1 transcripts, we performed quantitative genomic PCR and RT-PCR-SSCP analysis. However, none of carcinoma tissues we tested showed abnormal reduction of TSP-1 gene level and no evidence for sequence alterations leading to amino acid substitution were identified. CONCLUSION: Our study demonstrates that abnormal reduction of TSP-1 mRNA expression is frequent in cervical cancer and correlates with the malignant progression of cervical cancers. Our data also show that allelic deletion or mutational alteration of TSP-1 is rare in cervical cancers, suggesting that abnormal reduction of TSP-1 mRNA expression in cervical cancers might be caused by altered transcriptional down regulation of the gene, such as epigenetic gene silencing. The inverse correlation between TSP expression and microvessel density also indicates that decreased TSP-1 expression might be associated with an angiogenic phenotype in cervical cancer.
Amino Acid Substitution ; Carcinogenesis ; Cervix Uteri ; Down-Regulation ; Epigenomics ; Female ; Gene Silencing ; Humans ; Microvessels ; Neoplasm Metastasis ; Phenotype ; Polymerase Chain Reaction ; RNA, Messenger* ; Thrombospondin 1* ; Uterine Cervical Neoplasms*

Neuralgic amyotrophy is an uncommon disorder characterized by acute onset of severe shoulder and upper arm pain followed by marked upper arm weakness. It is easily confused with other neck and upper extremity abnormalities, such as cervical spondylosis and cervical radiculopathy. The diagnosis is based on histroy, clinical findings, electromyography and excluding other disease. Early diagnosis and adequate treatment is important to avoid unnecessary tests and surgery, and prevent complications, especially adhesive capsulitis of the shoulder. 20-year old female patient presented with a history of severe pain involing left shoulder and upper extremity. 1 month after onset of pain suddenly, she noted weakness of left shouler muscles, especially abduction and flexion. At first visit in our clinic, she felt persistant pain for 4 months in the left shoulder, upper extremity and mild pain in the left lower extremity. She diagnosed with neuralgic amyotrophy with complex regional pain syndrome. Her pain managed with epidural block, sympathetic ganglion block, brachial plexus block, stellate ganglion block, intravenous regional block, intravenous local anesthetic infusion, oral analgesics, and exercise therapy. 5 months after the onset of pain, weakness of her shoulder muscles were fully recovered and 9 weaks after caring in our clinic, she had tolerable pain in her extremities and discharged.
Analgesics ; Arm ; Brachial Plexus ; Brachial Plexus Neuritis* ; Bursitis ; Diagnosis ; Early Diagnosis ; Electromyography ; Exercise Therapy ; Extremities ; Female ; Ganglia, Sympathetic ; Humans ; Lower Extremity ; Muscles ; Neck ; Radiculopathy ; Shoulder ; Spondylosis ; Stellate Ganglion ; Upper Extremity ; Young Adult

Pseudomyxoma peritonei is a poorly understood condition characterized by gelatinous, mucinous implants, and often massive gelatinous ascites. It is commonly associated with mucinous tumors of the ovary or appendix, and a frequently relapsing and protracted disease. But, there are much confusion about its etiology, clinical manifestation, treatment, and prognosis. We experienced a case of pseudomyxoma peritonei originating from the borderline and microinvasive mucinous tumor of the ovary. So we report this case with a brief review of literatures.
Appendix ; Female ; Gelatin ; Mucins ; Ovary ; Prognosis ; Pseudomyxoma Peritonei*

PURPOSE: A pancreaticoduodenectomy is the procedure of choice for managing a periampullary malignancy. This is a complex procedure accompanied with some morbidity. In order to improve postoperative clinical results, we tried to apply a binding pancreaticojejunostomy and Endo GIA stapler during pancreaticoduodenectomy. According to the clinical outcomes, compare this trial with a conventional procedure. METHODS: We evaluated retrospectively clinical results of 30 patients who had received pancreaticoduodenectomy from Jan. 2003 to Dec. 2004 in the Pusan National University Hospital. These cases were divided into two groups; Group I comprised of 16 patients receiving this procedure and Group II comprised of 14 patients receiving conventional procedure. RESULTS: There were some differences in the mean operation time and the amount of blood loss between two groups, but significant difference only in an aspect of blood loss (P=0.042). Postoperative complications were as these: Group I, pancreatic fistula was in 12.5%, intraabdominal bleeding in 6.2%, wound infection in 12.5%; Group II, pancreatic fistula was in 35.7%, intraabdominal bleeding in 21.4%, wound infection & intraabdominal abscess in 7.1%. In Group I, there was a lower morbidity rate than in Group II, but there was a significant difference in the development of a pancrea-tic fistula as a pancreatic parenchymal texture (P=0.021). CONCLUSION: Although there was a small number of cases, it appears that a pancreaticoduodenectomy with the application of a binding pancreaticojejunostomy and Endo GIA stapler can produce good results, also need to get more clinical results.
Abscess ; Busan ; Fistula ; Hemorrhage ; Humans ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Pancreaticojejunostomy* ; Postoperative Complications ; Retrospective Studies ; Wound Infection

Anti-GQ1 antibody is found in patients with Miller-Fisher syndrome (MFS), atypical MFS, and Bickerstaff's brainstem encephalitis (BBE). These conditions are various manifestations of post-infectious autoimmune disorders, and anti-GQ1b antibodies play a core pathogenic role. So they are referred as the 'anti-GQ1b antibody syndrome'. We report two cases of recurrent anti-GQ1b antibody syndrome.
Antibodies ; Brain Stem ; Encephalitis ; Humans ; Miller Fisher Syndrome ; Recurrence

The aim of this case study was to report the clinical outcome of immediate provisionalization using one-piece narrow diameter (3.0mm) implants in missing maxillary lateral or mandibular incisors. The present study included 36 patients who were treated with 62 one-piece narrow diameter implants. After implant placement, immediate provisional restorations were delivered. All implants showed favorable osseointegration and after progressive loading from 3 months to 9 months (average of 5 months), final restorations were completed without failure in all cases. A survival rate of 100 % (62 of 62) was observed up to 23 months of observation (average of 12.6 months).
Humans ; Incisor ; Osseointegration ; Survival Rate

Background: Bevacizumab-induced proteinuria is known to occur when vascular endothelial cell receptors are blocked, which leads to decreased protein filtration. Although several studies have analyzed the correlation between therapeutic effect of bevacizumab and proteinuria, no conclusion has been established. Methods: In this retrospective study, colorectal cancer patients who received bevacizumab and urinary protein check from January 2015 to December 2016, were included. The incidence of proteinuria and the grade according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 were evaluated after bevacizumab administration. The primary objective was to correlate proteinuria with overall response rate (ORR) and time to progression (TTP). Primary lesion, metastasized organs, surgery or radiation therapy, chemotherapy were investigated for analysis of risk factors for proteinuria development. Results: A total of 149 patients included in the analysis. Proteinuria occurred 19.5% (n=29) in the study patients; 20 in grade 1, 7 in grade 2, and 2 in grade 3. ORR was 55.2% in the proteinuria group and 51.7% in the non-proteinuria group. There was no difference between two groups (p=0.89). The TTP through the survival curve was similar in both groups (10 months, p=0.97). The risk of proteinuria was high in patients who had liver metastasis (p=0.02) and no surgery (p=0.01). Conclusions These result indicates that bevacizumab-induced proteinuria expression was not correlated with the therapeutic effect on patients with colorectal cancer. Further analysis is required to find out the correlation between proteinuria and therapeutic effects. The risk of proteinuria was increased from patients who had liver metastasis, and no surgery.