Epithelial cadherin (E-cadherin) is a Ca2+ -dependent cell-cell adhesion molecule that connects cells via homotypic interactions. Its function is critical in the induction and maintenance of cell polarity and differentiation, and its loss is associated with an invasive and poorly differentiated phenotype in a wide range of tumors. Formalin-fixed, paraffin-embedded tissue sections from 36 cases of cervical intraepithelial neoplasia (CIN) and 14 cervical squamous cell carcinomas were investigated for the expression of E-cadherin immunohistochemically. While E-cadherin expression was usually restricted on the cell membrane of basal and parabasal cells in normal cervix, the presence of cytoplasmic E-cadherin was found to be associated with its grade in CIN lesions. Also, marked cytoplasmic staining was commonly revealed in poorly differentiated ones than well-differentiated squamous cell carcinomas. More intense reactivity of cytoplasmic E-cadherin was frequently seen in the foci of invasion than adjacent carcinoma in situ, and in its periphery than the center of tumor islands. In addition, DNA ploidy and S-phase fraction of squamous cell carcinomas were analyzed and compared with those of CIN lesion. We found that invasive squamous cell carcinomas more frequently disclosed DNA aneuploidy than CIN lesions, and there was correlation between cytoplasmic E-cadherin expression and DNA aneuploidy. Also, cytoplasmic E-cadherin-reactive cervical neoplasms had a higher rate of cell proliferation than that of membranous E-cadherin-reactive cases. These data suggest that the increased cytoplasmic E-cadherin expression may represent one of the abnormalities underlying the loss of polarity and invasiveness of cancer cells, and the abnormal E-cadherin expression combined with/without DNA ploidy or S-phase fraction may serve as a prognostic indicator.
Aneuploidy ; Cadherins* ; Carcinoma in Situ ; Carcinoma, Squamous Cell* ; Cell Membrane ; Cell Polarity ; Cell Proliferation ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Cytoplasm ; DNA* ; Female ; Islands ; Phenotype ; Ploidies* ; Uterine Cervical Neoplasms

PURPOSE: To evaluate the short-term therapeutic effectiveness of ovarian vein embolization using coils for pelvic congestion syndrome (PCS), a common cause of chronic pelvic pain, and to determine patient satisfaction. MATERIALS AND METHODS: Forty-four multiparous women aged 26-73 (mean, 39.9) years in whom chronic pelvic pain due to unknown causes had lasted for more than six months, and whose gynecologic findings and laboratory data suggested PCS, underwent transabdominal or transvaginal ultrasonography and selective ovarian venography. PSC was finally diagnosed in 21 of th 44, who underwent 22 ovarian vein embolizations (in one case, bilaterally). The simple pain rating system was used at admission, with a 'minimal' or 'moderate' grade representing discomfort in daily life, and 'severe' indicating the need for medication. Indications for coil embolization included dilatation of the ovarian vein to a diameter of more than 6 mm, reflux involving an incompetent valve, congestion of the pelvic venous plexus (involving the stasis of contrast media), and/or opacification of the ipsilateral internal iliac vein (or contralateral filling). Embolizations were undertaken using coils of optimal size and number, and the mean follow-up period was 217 (31-267) days. By means of a telephone questionnaire, the outcome was classified as a cure, pain reduction, or 'no change, or aggravation', and on the basis of whether or not they would opt for the same treatment, or recommend embolization to others, patient satisfaction was graded as 'substantial', 'moderate', or 'absent. RESULTS: Venous occlusion was confimed at postembolization venography in all 22 cases. Clinical treatment led to symptomatic relief in 76.2% of patients a cure in 33.3% (7/21), pain reduction in 42.9% (9/21) and no imchange, or aggravation, in 23.8% (5/21). Eighteen patients (85.8%) were very (9/21, 42.9%) or moderately (9/21, 42.9%) satisfied with coil embolization. In two, the coil migrated, and was successfully retrieved using a snare loop. CONCLUSION: In this study, ovarian vein embolization using coils for PCS appeared to be both safe and effective in controlling pain. If other causes of pelvic pain are absent, it is thought to be a valuable alternative to surgical procedures.
Dilatation ; Embolization, Therapeutic ; Estrogens, Conjugated (USP)* ; Female ; Follow-Up Studies ; Humans ; Iliac Vein ; Patient Satisfaction ; Pelvic Pain ; Phlebography ; Surveys and Questionnaires ; SNARE Proteins ; Telephone ; Ultrasonography ; Veins*

BACKGROUND: The occurrence of an outbreak of food-borne infectious disease requires a hospital to do extended role. There has been no report of an outbreak and an outbreak management of food-borne infectious diseases in a hospital. Therefore, this report of an outbreak and management of Shigellosis in the hospital would help others to manage further cases. METHODS: This was a descriptive study for an infection control program for food-borne infectious diseases in a hospital. RESULTS: There was a shigellosis outbreak at a university hospital in Seoul between December 3 and 30, 2001, Five hundred eighty four were affected, of which 81 cases were suspected and 86 cases were confirmed Shigella sonnei in fetal culture. The source of infection was identified as a lunch box or seaweed rolled rice that was contaminated and was supplied from the S-catering facility. The infection control team had developed the various strategies to control the outbreak and implemented them. The strategies included an epidemiology investigation, the removal of infection sources, medical treatment and isolation of patients, education and management of public relationship, environmental control, withdrawal of medical students' training, prevention and control of asymptomatic cases, intensive care unit strong financial support, analysis and management various data and the construction of cooperation and reporting system with the public health system CONCLUSION: This outbreak was controlled by effective team approach. The effective management of an outbreak of food-borne infectious diseases requires a systematic infection control, public relationship strategies for the reputation of the hospital, and the cooperation with a public health system.
Communicable Diseases ; Dysentery, Bacillary* ; Education ; Epidemiology ; Financial Support ; Humans ; Infection Control* ; Intensive Care Units ; Lunch ; Public Health ; Seaweed ; Seoul ; Shigella sonnei

BACKGROUND: Several studies have been conducted on the role of the p63 gene family in non-small cell lung carcinoma (NSCLC). Nevertheless, the role of these genes in the development and progression of NSCLC remains controversial. This study was designed to examine the expression and clinicopathologic significance of the p63 family in NSCLC. METHODS: Immunohistochemical staining was performed on 92 cases of NSCLC (47 squamous cell carcinomas [SqCCs] and 45 adenocarcinomas [ACs]) using tissue microarray blocks. The results were analyzed and correlated with clinicopathologic data. RESULTS: The expression of delta Np63 (Delta Np63) was elevated in SqCC (39/47), but not in AC (2/45; p<0.01). Both p63 and Delta Np63 had high expression in 39 SqCCs; p63 and Delta Np63 also had a similar geomorphologic distribution in most positive tumors. The expression of Delta Np63 was correlated with histologic type, gender, pT stage, p53 expression, and p63 expression. pT and pN stages were independent factors in survival (p<0.05, respectively). CONCLUSIONS: The major p63 isoform in NSCLC, Delta Np63, had a strong correlation with p53 and p63, and was exclusively expressed in SqCC. However, our findings suggest that Delta Np63 was not an independent prognostic factor for NSCLC.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Immunohistochemistry ; Lung

We report a case of Langerhans cell sarcoma presented as a solitary mass in the left supraclavicular area in a 31-year-old woman. Computed tomography revealed a relatively well-defined and lightly enhancing mass in the left supraclavicular area, measuring 5.5x4.5x3.2 cm. Excision was subsequently performed. Microscopically, the specimen consisted of an enlarged and partially effaced lymph node. Nests of different size composed of atypical tumor cells were located in the paracortex and the medulla of the lymph node. The tumor cells exhibited abundant eosinophilic or clear cytoplasm and displayed marked nuclear atypia and increased mitotic figures. Infiltration of many eosinophils was identified in the periphery and between the tumor cells. The tumor cells were reactive for CD1a and S100 protein. Ultrastructually, they were found to have Birbeck granules in the cytoplasm.
Adult ; Antigens, CD1 ; Cytoplasm ; Eosinophils ; Female ; Humans ; Langerhans Cell Sarcoma ; Lymph Nodes

Hamartoma is rare but the most common benign neoplasm in the lung. However endobronchial lipomatous hamartoma has been rarely reported. A 73-year-old male patient was admitted to our hospital due to hemoptysis 1 month prior to admission. On bronchoscopic examination, a large pedunculated endobronchial mass right upper lobar bronchus. The endobronchial mass was enucleated by bronchotomy that is no evidence of malignancy in frozen specimens. We report a case of endobronchial lipomartous hamartoma which was resected by bronchotomy.
Aged ; Bronchi ; Bronchial Neoplasms ; Hamartoma* ; Hemoptysis ; Humans ; Lung ; Male

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, classically was considered a exceedingly rare obstetrical phenomenon. But nowadays the natural incidence is increasing and especially in association with assisted reproductive technologies, such as use of variable methods for ovulation inductions, in-vitro fertilization and embryo transfer, and gamate intrafallopian transfer. In spite of the difficult early diagnosis, which is potentially dangerous to the mother and fetus, the maternal mortality, morbidity and fetal loss is low when the diagnosis is made in timely fashion and proper management is achieved. The presence of a intrauterine pregnancy dose not exclude the possibility of a extrauterine pregnancy, and in women associated with assisted reproductive technologies, the possibility of a heterotopic pregnancy should be considered. We report a case of a heterotopic pregnancy following ovulation induction and intrauterine insemination with brief review of literature.
Diagnosis ; Early Diagnosis ; Embryo Transfer ; Female ; Fertilization ; Fetus ; Humans ; Incidence ; Insemination ; Maternal Mortality ; Mothers ; Ovulation Induction* ; Ovulation* ; Pregnancy ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted

Malignant fibrous histiocytoma is an uncommon pleomorphic tumor of the soft tissues possibly arising from the histiocyte. A case of huge malignant fibrous histiocytoma weighing 10.2kg in the retroperitoneal space is reported with brief review of literatures.
Histiocytes ; Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Retroperitoneal Space

BACKGROUND: There are three basic types of fungal sinusitis: noninvasive, invasive, and allergic. Both noninvasive and invasive fungal sinusitis necessarily require surgery with or without antifungal treatment. This study was performed to evaluate the efficacy of treatment modalities and clinical characteristics between pathologically proven noninvasive and invasive fungal sinusitis. METHODS: 40 patients pathologically proven to have fungal sinusitis from July, 1990 to January, 2000 were enrolled in this study. This retrospective study was performed in Severance Hospital, Yong-Dong Severance Hostpital and Ah-Joo University Hospital. The efficacy of treatment modalities and prognosis between pathologically proven noninvasive group (group A) and invasive group (group B) were evaluated. RESULTS: Of the total 40 patients, 13 were male and 27 were female, and the mean age was 51.6+/-14.2 years. 32 patients belonged to noninvasive group and 8 patients belonged to invasive group. Of the total 40 patients, 20 (50%) patients had underlying diseases, such as 8 cases of Diabetes Mellitus, 3 cases of hematologic malignancy, 2 cases of solid cancer, 1 case of steroid overuse, and the others 6 cases. In group A, only 12 patients (37.5%) had underlying diseases, however, all 8 patients (100%) in group B had underlying diseases. All 32 patients of group A went chronic course but in group B, all 8 patients appeard to be acute in course. The pathogens were classified to 36 cases of Aspergillus spp. (69.2%), 3 cases of Rhizopus spp. (5.8%), and 1 case of Candida spp. (1.9%). As for the treatment modalities, in group A, 30 cases had surgery only and 2 cases performed surgery and antifungal treatment. Both showed 100% of treatment efficacy. In group B, 5 cases were treated with antifungal therapy only and 2 cases performed surgery and antifungal treatment. The former showed 20% and the latter, 33% of treatment efficacy. Noninvasive fungal sinusitis revealed good results even in surgery only therapy, but invasive fungal sinusitis tended to reveal better results in both surgery and antifungal treatment. CONCLUSION: The pathologic type of fungal sinusitis is now thought to be very important for the choice of treatment modalities and efficacy of treatment. Also the type of pathogens, immunologic state of patients, and early diagnosis of fungal sinusitis attribute to the treatment efficacy of fungal sinusitis.
Aspergillus ; Candida ; Diabetes Mellitus ; Early Diagnosis ; Female ; Hematologic Neoplasms ; Humans ; Male ; Prognosis ; Retrospective Studies ; Rhizopus ; Sinusitis* ; Treatment Outcome

BACKGROUND: It is clear that the biologic characteristics of gastric cancer are different on the basis of mucin phenotypes. However, there are unabated controversies on the exact biologic differences of mucin expression in gastric cancer. METHODS: We analyzed various protein expressions and microsatellite instability (MSI) status based on mucin expression in 130 differentiated early gastric adenocarcinoma cases. Furthermore, we evaluated the genomic alternation in 10 selected differentiated early gastric adenocarcinoma cases using array based comparative genomic hybridization (aCGH). RESULTS: Intestinal mucin predominant subtype showed significantly elevated p53 protein and caudal-related homeobox 2 expression, and delocalization of beta catenin expressions compared to the gastric mucin predominant subtype. On MSI status, the gastric mucin predominant subtype more frequently showed unstable status than the intestinal mucin predominant subtype. CGH study showed more frequent chromosomal gain and loss in the intestinal mucin predominant subtype than the gastric mucin predominant subtype, albeit without statistical significance. Interestingly, there were significant differences in chromosomal alternation between four mucin phenotypes. CONCLUSIONS: Study results suggest possible different points of biologic behaviors in early differentiated gastric adenocarcinomas by mucin expression type.
Adenocarcinoma ; beta Catenin ; Comparative Genomic Hybridization ; Gastric Mucins ; Genes, Homeobox ; Microsatellite Instability ; Mucins ; Phenotype ; Population Characteristics ; Stomach Neoplasms ; Succinimides ; Tumor Suppressor Protein p53