Adenocarcionma of fetal type is in lung is a newly recognized malignant tumor sharing morphologic features with the epithelial component of the pulmonary blastoma devoid of sarcomatous component. We present a case of adenocarcinoma of fetal type in a 28-year-old female, consisting of numerous branching tubules or glands and morula-like epithelial complexes. Histologically, the tubules and glands were composed of glycogne-rich nonciliated epithelial cells showing in part argyrophilia. Some of tubular and morula-like epithelial cells revealed immunoreactivity for neuron-specific enolase. We report this case with a review of literatures with special references on the histogenisis. This report is the pathologically confirmed second case of the pulmonary adenocarcinoma of fetal type in Korea, following the report of Cho and Lee, 1990.
Female ; Humans ; Adenocarcinoma

The authors report a case of uterine tumor resembling ovarian sex-cord tumor in a 31-year-old woman with emphasis on immunohistochemistry. Histologically this case showed identical features to a well-recognized endometial stromal tumor except for focal epithelial-like differentiation that resembled sex-cord tumors of the ovary. The sex-cord like differentiation of tumor cells were manifested by trabeculae, plexiform cords, and gland-like pattern. We diagnosed this case, according to the features described by Clement and Scully(1976), as uterine tumor resembling ovarian sex-cord tumor, group I. Although the histogenesis of this tumor is unclarified, most authors believe that this tumor may be originated from multipotent mesenchymal cells of the uterus. On immunohistochemical stains, Desmin was uniformly reactive in epithelial-like cells and in focal areas of endometrial stromal sarcoma-like component. Vimentin was partly reactive in all tumor components, however EMA was non-reactive.
Female ; Humans

No abstract available.
Gaucher Disease* ; Humans ; Siblings*

Addisons disease is relatively rare than secondary adrenal insufficiency and result from progressive adrenocortical destruction. The common causes are idiopathic autoimmune atrophy and tuberculosis of adrenal glands. It is generally regarded as incurable in the sense that substitution therapy is required for the rest of the patients life. We report a case of tuberculous primary adrenal insufficiency which was confirmed by biopsy. This case was treated with antituberculous medication and showen to have improved adrenocortical function after six months.
Addison Disease* ; Adrenal Glands ; Adrenal Insufficiency ; Atrophy ; Biopsy ; Humans ; Tuberculosis

PURPOSE: Minimal incision distal metatarsal osteotomy (MIDMO) is known to be an effective surgical procedure for mild to moderate hallux valgus. However, the result of MIDMO on moderate to severe hallux valgus is controversial; therefore, we investigated the radiological and clinical results of MIDMO on moderate to severe hallux valgus. MATERIALS AND METHODS: We reviewed 51 feet (48 patients) with moderate to severe hallux valgus. The mean age was 67.0 years and the mean follow-up period was 32.2 months. Radiological data of hallux valgus angle, first intermetatarsal angle, and distal metatarsal articular angle on plain radiographs were analyzed. Recurrence, union, lateral translation of distal fragment and angulation were also analyzed. The clinical data were obtained using American Orthopaedic Foot and Ankle Society (AOFAS) score of preoperation and last follow-up. Receiver operating characteristic (ROC) curve was used to determine a cut-off value. RESULTS: The mean hallux valgus angle measured at preoperation was 37.7o and 15.9degrees at last follow-up. The mean first intermetatarsal angle of preoperation and last follow-up were 15.2degrees and 8.3degrees. The mean distal metatarsal articular angle changed from 12.6degrees at preoperation to 7.8degrees at last follow-up. Preoperative hallux valgus angle (p=0.0051) and distal metatarsal articular angle (p=0.0078) were statistically significant factors affecting postoperative AOFAS score. Cut-off value of each was 37degrees and 13degrees, respectively. Lateral translation of distal fragment in 5 recurrent cases was 23.0% compared to 45.3% of 46 non-recurrent cases. The result was statistically significant and the cut-off value was 38%. CONCLUSION: Sufficient lateral translation over 38% in MIDMO on moderate to severe hallux valgus patients with preoperative hallux valgus angle under 37degrees and distal metatarsal articular angle under 13degrees can lead to good clinical results without recurrence.
Ankle ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Humans ; Metatarsal Bones* ; Osteotomy* ; Recurrence ; ROC Curve

No abstract available.
Hypnotics and Sedatives ; Light

Full skin auto-grafts are required for reconstruction of skin burns and trauma scars. However, currently available clinical approaches such as sheet skin graft, mesh skin grafts, artificial skin graft, and in vivo skin expansion have limitations due to their potential danger for secondary damage and scar formation at the donor site, and discomfort during skin expansion. We developed an advanced bioreactor system and evaluated its function in skin expansion using porcine full skin. The reactor was designed as a pneumatic cylinder type, was programmed to adjust the pressure and the operating time. The system was composed of culture chamber unit, environmental control unit, and monitoring unit. Skins were expanded at 200 kPa pneumatic force and the expanded skins were analyzed by immunohistochemistry and histology. Furthermore we carried out auto-grafting experiment of the expanded skins in vivo using Yucatan pigs and skins were harvested and histologically analyzed after 8 weeks. The results showed that the bioreactor expanded skins to 160% in 4 hours. Histological analysis of the expanded skins revealed that epidermal cells and dermal fibroblasts were viable and remained integrity. The results of auto-grafting experiment indicated that fibrosis and scars were not detected in the grafted skins. This study demonstrates that the newly developed skin bioreactor enabled to obtain large sized full skin rapidly and successful grating.
Bioreactors* ; Burns ; Cicatrix ; Fibroblasts ; Fibrosis ; Humans ; Immunohistochemistry ; Skin* ; Skin, Artificial ; Swine ; Tissue Donors ; Transplants

STUDY DESIGN: Retroprospective study. OBJECTIVES: To evaluate the efficacy of biphasic calcium phosphate and local autobone mixed graft in cases of spinal stenosis and spondylolisthesis in posterolateral fusion by examining radiologic union rates and clinical outcomes. SUMMARY OF LITERATURE REVIEW: It can be a practical alternative to the use of tricalcium phosphate in hydroxyapatite as a graft aid since using hydroxyapatite mixture in lumbar spine fusion has been reported to lead to a high rate of bone union. MATERIALS AND METHODS: From July 2011 to February 2013, we followed up 107 patients who had lumbar posterolateral fusion using biphasic calcium phosphate composed of HA/TCP (60:40) and local autobone mixed graft. Of these patients, 64 had spinal stenosis and 43 had spondylolisthesis. The bone fusion rate was determined using Lenke's criteria and clinical outcomes were evaluated using Kim's method. RESULTS: In spinal stenosis, bone union was presented in 53 patients (of 64; 82.8%) and in spondylolisthesis, 35 patients (of 43; 81.4%). In spinal stenosis, the clinical outcomes resulted in 20 excellent, 34 good, 9 fair and 1 poor. (84.4%, excellent or good) In spondylolisthesis, the clinical outcomes resulted in 10 excellent, 25 good, 7 fair and 1 poor. (81.4%, excellent or good). CONCLUSION: Posterolateral fusion using biphasic calcium phosphate and local autobone mixed graft showed high rates of bone union and acceptable clinical outcomes, and is considered a satisfactory bone graft aid.
Calcium* ; Durapatite ; Humans ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Transplants*

BACKGROUND: Using long-term (more than 30 years) data from a single center, this retrospective study evaluated changes of independent risk factors affecting renal allograft survival by transplant era. METHODS: Of 3,000 cases of kidney transplantation, 2,708 (90.3%), including their follow-up observations, were reviewed. Transplant era was classified according to immunosuppressive regimens as either early group (transplant serial No. 1~1,500) or recent group (transplant serial No. 1,501~3,000). RESULTS: There was a significant difference observed in pre-transplant clinical manifestations between the early and recent groups. The number of elderly recipients and donors, number of deceased donors, and cases related to pre-transplant diabetes, pre-emptive transplantation, and retransplantation were differed relative to transplant era. The short- and long-term graft survival rate of the recent group improved significantly, and the effect of human leukocyte antigen mismatching and living donor type disappeared in the recent group. Moreover, pre-emptive transplantation and retransplantation were effective only in the recent group. However, non-immunological factors such as elderly recipients and donors, and immunologic factors such as episodes of acute rejection and types of immunosuppressive regimen were persistent independent risk factors affecting graft survival rate. CONCLUSIONS: According to the retrospective survival analysis of a large number of recipients in a single center, risk factors for kidney transplant patients differed by transplant era. However, the independent risk factors associated with elderly recipients and donors (non-immunologic), and episodes of acute rejection, and types of immunosuppressive regimen (immunologic) persisted regardless of transplant era.
Aged ; Follow-Up Studies ; Graft Survival ; Humans ; Immunologic Factors ; Kidney ; Kidney Transplantation ; Leukocytes ; Living Donors ; Rejection (Psychology) ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplantation, Homologous ; Transplants

STUDY DESIGN: A retrospective study. OBJECTIVES: We examined union rates and clinical outcomes to evaluate the efficacy of using autologous bone marrow along with a local autobone and biphasic calcium phosphate mixed graft with posterolateral fusion in spinal stenosis and spondylolisthesis. SUMMARY OF LITERATURE REVIEW: In lumbar posterolateral fusion, union rates of biphasic calcium phosphate and local autobone mixed graft are low compared to union rates of autogenous iliac bone graft. MATERIALS AND METHODS: Among the patients who had lumbar posterolateral fusion with autologous bone marrow along with local autobone and biphasic calcium phosphate mixed graft between February 2013 and January 2014, we analyzed 40 patients who were available for at least one year of follow-up. There were 22 cases with spinal stenosis and 18 cases with spondylolisthesis. Bone fusion was determined along with the fusion rates based on Lenke's criteria (citation). All patients were evaluated postoperatively at one year, using 3D CT. and the clinical outcomes were assessed using Kim's method (citation). RESULTS: In spinal stenosis, bone union was observed in 19 cases out of 22 (86.4%), and in case of spondylolisthesis, bone union was observed in 16 cases out of 18 (88.9%). In spinal stenosis, the clinical outcomes were: 2 excellent, 16 good, 3 fair, and 1 poor; in other words 18 cases (81.8%) displayed good or excellent outcomes. In spondylolisthesis, 2 excellent, 12 good, 4 fair and 0 poor; in other words, 14 cases (77.8%) showed good or superior outcomes. CONCLUSIONS: Posterolateral fusion using autologous bone marrow along with a local autobone and biphasic calcium phosphate mixed graft showed similar bone fusion rates to using autogenous iliac bone graft. Therefore, this method could serve as an alternative to using autogenous iliac bone graft in posterior lumbar fusion.
Bone Marrow* ; Calcium* ; Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis ; Transplants*