Cushing's disease is an ACTH-producing pituitary corticotrope adenoma. This pituitary adenoma exhibits an unrestrained ACTH secretion resulting in hypercortisolemia. A 27-year-old female visited us with a 3-year history of diffuse hair loss on the scalp. Her past medical history included recently-developed hypertension and 10 years of increased weight gain and oligomenorrhea. Central obesity, hirsutism, acne, violet striae on the abdomen, lower and upper extremities, and christmas tree-shaped alopecia on the scalp were observed upon physical examination. The secretion of cortisol was not suppressed in both a low and high dose dexamethasone suppression test. A brain MRI detected a pituitary microadenoma in the sella turcica. Based on the clinical and laboratory findings, we diagnosed androgenetic alopecia associated with Cushing's disease. After surgical removal of the pituitary adenoma, the alopecia showed a remarkable improvement. We report a case of Cushing's disease found in a patient with androgenetic alopecia.
Abdomen ; Acne Vulgaris ; Adenoma ; Adrenocorticotropic Hormone ; Adult ; Alopecia* ; Brain ; Dexamethasone ; Female ; Hair ; Hirsutism ; Humans ; Hydrocortisone ; Hypertension ; Magnetic Resonance Imaging ; Obesity, Abdominal ; Oligomenorrhea ; Physical Examination ; Pituitary Neoplasms ; Scalp ; Sella Turcica ; Upper Extremity ; Viola ; Weight Gain

Microvenular hemangioma is an uncommon aquired vascular tumor, occurring in young to middle-aged adults of both genders. It usually presents as a small, solitary, purple-to-red papule, nodule or plaque on the extremities or trunk. Histologically, the tumor is composed of small branching venules with collapsed lumina and conspicuous pericytes infiltrating the full thickeness of the reticular dermis. Herein, we report a case of microvenular hemangioma, clinically mimicking Kaposi's sarcoma, on the toe of the right foot in a 44-year old male.
Adult ; Dermis ; Extremities ; Foot ; Hemangioma* ; Humans ; Male ; Pericytes ; Sarcoma, Kaposi* ; Toes ; Venules

No abstract available.
Cyclosporine* ; Fluorescence Polarization Immunoassay* ; Fluorescence Polarization* ; Fluorescence*

Castleman's disease, also known as angiofollicular lymphoid hyperplasia or giant lymph-node hyperplasia, is an unusual form of a lymphoproliferative disorder, and is divided clinically into a solitary and a multicentric form. The multicentric form of Castleman's disease is almost always of the plasma cell type. This can coexist with Kaposi's sarcoma in some cases. Kaposi's sarcoma is a multicentric, proliferative, vascular tumor involving cutaneous and visceral tissue. Iatrogenically-developed, immunosuppression-associated Kaposi's sarcoma is usually the result of immunosuppressive therapy. A 61-year-old man diagnosed as the plasma cell type of Castleman's disease, who had been treated with prednisolone for 2 years, was referred to the department of dermatology with numerous skin lesions consisting of confluent, violaceous-colored papules and plaques on his palm and soles. Histologic examination of the cutaneous lesions showed consistency with Kaposi's sarcoma. We report a rare case of Kaposi's sarcoma associated with multicentric Castleman's disease.
Dermatology ; Giant Lymph Node Hyperplasia* ; Herpesvirus 8, Human ; Humans ; Hyperplasia ; Lymphoproliferative Disorders ; Middle Aged ; Plasma Cells ; Prednisolone ; Sarcoma, Kaposi* ; Skin

BACKGROUND: The recent advances in flow cytometric technology and the development of monoclonal antibodies have led to the important insights into the cell lineage and maturation stage of leukemia. The increased use of immunophenotyping in acute leukemia revealed the unusual anigen expression and biclonal or biphenotypic acute mixed lineage leukemia (AMLL). However, the data on their frequency and prognostic significance are still conflicting. METHODS: The immunophenotyping of leukemic cells (HLA-DR, CD10, CD19, CD20, CD22, CD3, CD5, CD7, CD13, CD33, CD61, TdT, cytoplasmic Ig, surface Ig) was performed by flow cytometry in 115 cases of acute leukemia between January 1994 and August 1996. Double-color immunofluorescent staining was performed in the cases expressing unusual antigens. RESULTS: 51 cases (44.3%) of 115 acute leukemias showed unusual antigens expression. These included 27 cases (38.6%) of 70 AML, 13 cases (43.3%) of 30 B-lineage ALL, 4 cases (50%) of 8 T-LL and 7 AMLL cases (6.1%) of 115 acute leukemias. CD7 (28.6%) and CD19 (11.4%) are expressed in AML, and CD13 (36.7%) and CD33 (26.7%) are expressed in ALL. Among 7 cases of AMLL, we could obtain the clinical data of 5 cases. The 4 cases of 5 AMLL failed to respond to induction chemotherapy or died before or during induction chemotherapy, and only one case showed partial remission. CONCLUSION: The unusual antigen expressions of acute leukemic cells are frequently observed, and the identification of relatively rare AMLL is very important, because AMLL showed poor response to the chemotherapy.
Antibodies, Monoclonal ; Cell Lineage ; Cytoplasm ; Drug Therapy ; Flow Cytometry ; Immunophenotyping ; Induction Chemotherapy ; Leukemia*

PURPOSE: We evaluated health-related quality of life (HRQOL) in long-term survivors of indolent and aggressive non-Hodgkin lymphoma (NHL). MATERIALS AND METHODS: TheHRQOLwas assessed by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) at diagnosis in NHL patients between 2008 and 2011, and follow-up evaluation was conducted from June 2014 to February 2015 using EORTC QLQ-C30 and the quality of life in cancer survivors (QOL-CS) questionnaire. We used linear mixed models to compare changes in HRQOL between indolent and aggressive NHL over time. RESULTS: The HRQOL of long-term survivors with aggressive NHL improved to the similar level of indolent NHL during the follow-up survey. However, survivors of NHL were found to fear the probability of relapse and second malignancy, and the degree of fear was not different between survivors with aggressive stage I/II or III/IV NHL (p > 0.05). Furthermore, a half of survivors reported impaired sense of psychosocial well-being regardless of aggressiveness and stage during follow-up survey. More than 65% of survivors thought they did not receive sufficient support from others, and patients who had financial difficulties at diagnosis were more frequently associated with suffering from insufficient support. Impaired physical and cognitive functioning at diagnosis was significantly associated with lack of life purpose in long-term survivors. CONCLUSION: The HRQOL of aggressive NHL survivors improved to a similar level to that of indolent NHL. However, the majority of survivors still had fear of relapse, and psychosocial well-being remained unmet needs.
Cohort Studies* ; Diagnosis ; Follow-Up Studies ; Humans ; Lymphoma, Non-Hodgkin* ; Neoplasms, Second Primary ; Prospective Studies* ; Quality of Life* ; Recurrence ; Survivors*

Background and Objectives: The standard surgical procedure for primary hyperparathyroidism is the bilateral exploration. However, the unilateral exploration and direct focused parathyroidectomy have been performed to reduce surgical morbidity. The purpose of this study was to report the surgical outcomes and efficacy of the bilateral exploration, unilateral exploration, and direct focused approaches for primary hyperparathyroidism.Subjects and Method We retrospectively analyzed the surgical outcomes of 87 patients with primary hyperparathyroidism from January 2007 to December 2017. We compared the operative time, complication and recurrence rate between the three operative methods. Results: The most common histopathology was parathyroid adenoma, which was found in 73 cases (83.9%), followed by hyperplasia. In terms of complications, there were two cases of transient vocal cord palsy, one case of hematoma, one case of hypocalcemia and one case of hungry bone syndrome. Recurrence occurred in two (2.3%) out of 87 cases. There was no significant difference in the recurrence rate between the three surgical approaches. Conclusion The success rate of surgery for primary hyperparathyroidism is high. Direct focused parathyroidectomy may be a good option for parathyroid adenoma if the localization tests localize the lesion. The bilateral exploration is effective for parathyroid hyperplasia.

PURPOSE: We investigated the prognostic factors for distant metastasis (DM) in patients with locally advanced oropharyngeal cancer (OPC) treated with surgery and adjuvant radiotherapy with or without concurrent chemotherapy. MATERIALS AND METHODS: Eighty-five patients treated between January 1995 and August 2014 were evaluated retrospectively. Data regarding the pathological tumour and nodal status, human papillomavirus (HPV) status, treatment characteristics, and pretreatment maximum standardized uptake value (SUVmax) of 18-fluoro-2-deoxyglucose positron emission tomography–computed tomography scan (¹⁸F-FDG PET-CT) were evaluated, and their influence on DM and survival outcomes were analyzed. RESULTS: Median follow-up period was 48.0 months. Recurrence was observed in 20 patients, including locoregional recurrence and DM. DM was observed in 13 patients. A multivariate analysis confirmed that the presence of lymphovascular invasion (p=0.031), lower neck lymph node (LN) involvement (p=0.006), SUVmax ≥ 9.7 (p=0.014), and tumour size ≥ 3 cm (p=0.037) significantly affected DM. HPV status was not associated with DM. Perineural invasion (p=0.048), lower neck LNinvolvement (p=0.008), SUVmax ≥ 9.7 (p=0.019), and tumour size ≥ 3 cm (p=0.033) were also significant factors for the DM-free survival rate. CONCLUSION: Lower neck LN involvement, high SUVmax in pretreatment ¹⁸F-FDG PET-CT, and large tumour size were predictive factors for DM in patients of OPC.
Drug Therapy* ; Electrons ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neck ; Neoplasm Metastasis* ; Oropharyngeal Neoplasms* ; Radiotherapy* ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate

BACKGROUND: Peroxisome proliferator activated receptor-gamma (PPAR-gamma) is a nuclear receptor that regulate adipocyte differentiation and modulate intracellular insulin-signaling events. As such, PPARgamma is a candidate gene for several human disorders including obesity and type 2 diabetes mellitus. The objective of our study was to examine the relationship between genetic variation of PPARgamma2 and diabetes and obesity in Korean subjects. METHODS: We studied 99 subjects with type 2 diabetes mellitus, 128 obesity patients and 97 controls. Screening for mutation at codon 12 and 115 of PPARgamma2 were carried out by PCR-RFLP analyses. Statistical significance was evaluated by Chi-square test. RESULTS: The allele frequency of the Pro12Ala PPARgamma2 variant were 0.05 in controls, 0.06 in type 2 diabetes group, and 0.07 in obesity group (p=0.47). Pro115Gln variant were only proline homozygote in all groups. Genotype frequencies were also similar and conformed to expectations of the Hardy-Weinberg rule. The presence of PPARgamma2 gene variant was no associated with concentrations of total cholesterol, triglyceride, HDL-cholesterol, and also with fasting glucose. CONCLUSION: We concluded that the Pro12Ala and Pro115Gln PPARgamma2 missense mutation may not be associated with type 2 diabetes mellitus and obesity in Korean patients.
Adipocytes ; Cholesterol ; Codon ; Diabetes Mellitus, Type 2* ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Gene Frequency ; Genetic Variation ; Genotype ; Glucose ; Homozygote ; Humans ; Liver Cirrhosis ; Mass Screening ; Mutation, Missense ; Obesity* ; Peroxisomes ; PPAR gamma* ; Proline ; Triglycerides

PURPOSE: Adjuvant chemotherapy is routinely recommended for locally advanced colorectal cancer (CRC). There are very few data for the optimal starting date of adjuvant chemotherapy after the surgery. This study aimed to evaluate the effectiveness of earlier adoption of adjuvant chemotherapy after curative surgery for stage III CRC. METHODS: In this study, 159 patients with stage III CRC, who had undergone a curative resection, were enrolled retrospectively. Patients were categorized into 3 groups representing different timings to initiate the chemotherapy; less than 2 weeks (group 1), 3 to 4 weeks (group 2), and more than 5 weeks (group 3). The overall survival rate (OS) and the relapse-free survival rate (RFS) were analyzed to evaluate the effectiveness of adjuvant chemotherapy. RESULTS: The 5-year OSs of the patients were 73.7% in group 1, 67.0% in group 2, and 55.2% in group 3. The 5-year RFSs of the patients were 48.8% in group 1, 64.7% in group 2, and 57.1% in group 3. There were no significant differences in either the OS or the RFS (P = 0.200, P = 0.405). CONCLUSION: Starting chemotherapy earlier than 6 weeks after surgery does not show any significant difference. Thus, although adjuvant chemotherapy should preferably begin within 6 weeks, the starting date should not necessarily be hastened, and the patient's general condition should be taken into consideration.
Chemotherapy, Adjuvant ; Colorectal Neoplasms ; Humans ; Prognosis ; Retrospective Studies ; Survival Rate