Co-existing Brenner tumor and struma ovarii in the unilateral ovary is very rare. The present case, which is the first case in Korea, and to our knowledge only nine cases had been reported in other countries. We report a case of 42-year-old woman who had co-existing Brenner tumor and struma ovarii in the unilateral ovary with a brief review of the literature.
Adult ; Brenner Tumor ; Female ; Humans ; Korea ; Ovary ; Struma Ovarii

PURPOSE: The schwannoma is a tumor originating from Schwann cell proliferation. Schwannoma is a rare disease, making up only 1% of all the tumors that develop in the orbit. Schwannomas usually arise from the choroids or the ciliary body, and occurrence in the conjunctiva is especially rare. Few cases have been reported worldwide, and no cases have been reported in Korea thus far. We report our case along with a literature review. CASE SUMMARY: A 31-year-old male patient visited our department with a history of discomfort of in his right eye for the past 5 years caused by a bulbar conjunctival mass. On ophthalmologic examination, a 5x3x3 mm, elevated, yellowish mass with a smooth surface was observed on the bulbar conjunctiva adjacent to the superonasal limbus near the 2 o'clock area of the right eye. We performed excision and biopsy for diagnosis and treatment of the bulbar conjunctival mass and confirmed the pathologic report for the diagnosis of schwannoma.
Adult ; Biopsy ; Cell Proliferation ; Choroid ; Ciliary Body ; Conjunctiva ; Eye ; Humans ; Korea ; Male ; Neurilemmoma ; Orbit ; Rare Diseases

A 56-year-old male with a gastrointestinal stromal tumor (GIST) underwent surgical resection of the tumor. Nine months after surgery, imatinib therapy was initiated because of the discovery of metastatic tumors in the left adrenal gland and in a lymph node of the peritoneum. Seventeen months later, the patient achieved complete remission (CR) and imatinib therapy was continued. However, 48 months after initiation of imatinib therapy, computed tomography scans revealed a left adrenal gland metastasis and the patient underwent left adrenalectomy. Immunohistochemical staining indicated that the spindle-shaped cells of the resected tumor were positive for C-kit, thus confirming metastasis of the GIST. This is the first report from Korea of an adrenal gland metastasis from a GIST. Worldwide, only two such cases have been reported. Here, we describe the first case of a distant recurrence of a GIST in the left adrenal gland after CR had been achieved with the aid of surgical resection and imatinib therapy.
Adrenal Glands* ; Adrenalectomy ; Gastrointestinal Stromal Tumors* ; Humans ; Imatinib Mesylate ; Korea ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis* ; Peritoneum ; Recurrence

BACKGROUND: Liver fibrosis and cirrhosis are the ultimate histologic consequences of chronic liver damage. Efforts have been made to study the mechanisms of cirrhosis and to discover effective therapeutic strategies. However, to date, no animal model reproduces the disease in man. The purpose of this work is to establish a model of DMN-induced liver cirrhosis for treatment of liver cirrhosis, to understand the basic characteristics of DMN-induced liver cirrhosis, and to confirm the expression of HGF, its receptor c-Met, and TGF-beta1 in Sprague-Dawley rats. METHODS: Five-week-old male Sprague-Dawley rats (n=56) were used for this study. Liver cirrhosis was induced in the rats by using DMN (1 ml/kg body weight, i.p.) given 3 consecutive days a week for 6 weeks. Changes in the portal vein pressure were measured by a venous catheter during the duration of the DMN-treatment. The levels of serum albumin, bilirubin, and ammonia were determined in a clinical laboratory by routive methods. Pieces of the median lobe were cut and fixed in 10% buffered neutral formalin, embedded in paraffin, and stained by hematoxylin-eosin (H&E) & masson-trichrome (M&T). Changes in the extracellular matrix were measured by image analysis and hydroxyproline content. Immunohistochemical staining of alpa-smooth muscle actin was performed to confirm the activation ofhepatic stellate cells. Northern blot analyses were performed to confirm the expression of HGF and TGF-beta1 and western blotting was performed c-Met, HGF receptor. RESULTS: Pressures in the portal vein were significantly increased during the DMN-treatment time (p<0.05). Biochemical parameters were significantly correlated with the progression of liver cirrhosis. H&E staining of 4-week DMN-treated rats demonstrated fibrous tissue bridging between the periportal and the pericentral areas with gradual widening of fibrous bands. Both the extracellular matrix measured by image analysis of the M&T staining and the hydroxyproline content rose continuously throughout the 6 weeks of DMN treatment. alpa-smooth muscle actin was observed in the stellate cells of DMN-treated rats. The northern blot analyses showed that the expression of HGF mRNA decreased with the progression of DMN-induced liver cirrhosis but that of TGF-beta1 mRNA did not. The western blot analyses showed that the expression of the c-Met receptor protein increased continuously, but the expression of HGF mRNA a decreased. CONCLUSION:The model of cirrhosis induced by chronic, discontinuous treatment with a low dose of DMN in rats was simple and predictable and displayed many of the features of human cirrhosis. The decrease in the expression of HGF mRNA may be responsible for the reduced hepatocyte regeneration in liver cirrhosis. The expression of the c-Met protein was related with the decreased expression of HGF. The exact significance of TGF-beta1 was not determined in this study.
Actins ; Ammonia ; Animals ; Bilirubin ; Blotting, Northern ; Blotting, Western ; Body Weight ; Catheters ; Dimethylnitrosamine ; Extracellular Matrix ; Fibrosis ; Formaldehyde ; Hepatocyte Growth Factor* ; Hepatocytes* ; Humans ; Hydroxyproline ; Liver Cirrhosis* ; Liver* ; Male ; Models, Animal ; Paraffin ; Portal Vein ; Proto-Oncogene Proteins c-met ; Rats ; Rats, Sprague-Dawley* ; Regeneration ; RNA, Messenger ; Serum Albumin ; Transforming Growth Factor beta1 ; Transforming Growth Factors*

No abstract available.
Lung Neoplasms* ; Lung*

BACKGROUND: Acute liver failure either after liver resection or as part of underlying liver disease is still associated with high mortality. Various treatments have been tried to improve liver function during acute liver failure, including metabolic and nutritional support, hemodialysis, hemoperfusion, plasmapheresis, and hepatocyte and liver transplantation. Hepatocyte transplantation in various forms has attracted attention recently. We investigated whether allogeneic isolated hepatocytes transplanted in the spleen would prolong survival, facilitate liver regeneration, and improve biochemical parameters in rats with acute liver failure induced by a 90% hepatectomy. METHODS: Allogeneic male Sprague-Dawley rats were used. Group I rats (n=26) received an intrasplenic injection of 2 107 hepatocytes in 0.3 ml of Dulbecco's modified Eagle's medium (DMEM), and 1 days later acute liver failure was induced. Group II acute-liver-failure rats (n=24) received an intrasplenic injection of DMEM. The survival time was determined for 22 rats in Group I and for 20 rats in Group II. The remaining 8 (4/each group) acute liver failure rats were used to assess the liver function and regeneration. RESULTS: The survival was longer and the number of long-term survivors was greater for Group I rats than for the Group II controls. At 24 hour after the hepatectomy, Group I rats had lower ammonia, lower total bilirubin, lower activities of liver enzymes, and higher glucose levels than did Group II rats. In Group I, there was significant increase in the ratio of the weight of the remnant liver lobes to the body weight. CONCLUSION: Compared with the Control group intrasplenic hepatocyte transplantation in acute liver failure rats acts as a bridge to support experimental rats in going from acute or fulminant liver failureto liver regeneration or compensation, prolongs survival in rats with acute liver failure induced by a 90% hepatectomy, and improves the biochemical parameters, except for the albumin levels and prothrombin time. Transplantation of hepatocytes may be beneficial in supporting a liver which has been acutely devastated by a 90% hepatectomy.
Ammonia ; Animals ; Bilirubin ; Body Weight ; Compensation and Redress ; Glucose ; Hemoperfusion ; Hepatectomy* ; Hepatocytes* ; Humans ; Liver ; Liver Diseases ; Liver Failure, Acute* ; Liver Regeneration ; Liver Transplantation ; Male ; Mortality ; Nutritional Support ; Plasmapheresis ; Prothrombin Time ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Renal Dialysis ; Spleen ; Survivors

PURPOSE: The management of cuffed endotracheal (ET) tubes is routine practice for emergency physicians. Although various cuff inflation techniques are used, there is no standard technique identified in the literature as the method for cuff inflation or intracuffed pressure (ICP). A loss of resistance (LOR) syringe has been used for years and this is located in the epidural space. The purpose of this study was to measure the actual ICP obtained by a new estimation technique. METHODS: Using a manikin simulation model, we assessed how physicians inflated the cuff in 5.5, 6.5, 7.5 mm inner diameter ET tubes. We measured the inflated air volumes and the ICPs obtained by the conventional technique (A group), by the commercial 10-ml syringe + passive release technique (B group), and by a LOR syringe + PRT (C group). Subsequently, a manometer was used to measure the actual ICP (normal: 16 to 40 cmH2O). RESULTS: We sampled 90 participants. They were classified into three groups: those who underwent the conventional inflation technique (A group, n=30), those who underwent the commercial syringe technique (B group, n=30) and those who underwent the Perifix(R) LOR syringe technique (C group, n=30). In the control group, the mean recorded ICPs were 78.2+/-30.7 cmH2O (A group) and 56.1+/-16.0 cmH2O (B group). The initial cuff pressures were greater than 40 cmH2O in 25 (83.3%) cases. For the experimental group, the mean recorded ICP was 19.1+/-1.8 cmH2O. With respect to the rate of optimal cuff inflation, the LOR syringe technique was significantly higher than the conventional method or the PRT + 10-ml syringe method (100% vs. 16.7 and 23.3%, respectively, p<0.001). CONCLUSION: Using conventional syringe technique, most cuff pressures exceeded a safe pressure and they required correction. Ultimately, PRT using the Perifix(R) LOR syringe is a useful alternative cuff inflation method when direct intracuff pressure measurement is not available.
Emergencies ; Epidural Space ; Inflation, Economic ; Intubation ; Manikins ; Statistics as Topic ; Syringes ; Trachea

BACKGROUND: Liver transplantation (LT) is a complicated procedure with a high incidence of postoperative acute kidney injury (AKI). Previous studies indicate that even transient or mild post-LT AKI can result in critical conditions, including prolonged stays in hospitals and intensive care units and increased morbidity and mortality. The aim of this study was to investigate the association between body mass index (BMI) and occurrence of AKI in LT recipients. METHODS: Medical data from 203 patients who received LT surgery from January 2010 to August 2016 in a single university hospital setting were retrospectively collected and analyzed. Patients were classified as either underweight (BMI <20 kg/m²) or normal weight (20 ≤ BMI < 30 kg/m²). Demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Propensity analyses and logistic regression were performed to evaluate the association between BMI and post-LT AKI. RESULTS: There was no significant difference in occurrence of post-LT AKI between underweight and normal weight patients. The underweight patient group had significantly longer hospital stay compared with the normal weight patient group (P = 0.023). CONCLUSIONS: BMI classification was neither a positive nor negative predictor of postoperative AKI occurrence. However, patients with lower BMI had significantly longer hospital stay compared with their counterparts. Although our study was limited by its retrospective design, our observations suggest that lower BMI might play a role in post-LT AKI.
Acute Kidney Injury* ; Body Mass Index* ; Classification ; Humans ; Incidence ; Intensive Care Units ; Length of Stay ; Liver Transplantation* ; Liver* ; Logistic Models ; Mortality ; Retrospective Studies* ; Thinness

OBJECTIVE: The aim of the study was to review the clinical and radiological findings of those non-functioning adenomas(NFAs) with positive immnoreactivity for anterior pituitary hormones. METHODS: Sixty patients with pituitary adenoma were treated at the author's institution between January 2000 and July 2005. All consecutive patients were underwent transsphenoidal surgery by same operator. In addition to the routine histopathological examination, surgical specimen was examined by immunohistochemical staining against adenohypophyseal cells. And clinical analysis was performed by retrospective review of medical records, neuroimaging examinations and immunohistochemical technique. We classified these pituitary adenomas into functioning adenomas (group F), immunopositive NFAs (group S, so-called silent adenoma) and immuno-negative NFAs (group N), and compared clinical and radiological differences between group F, N, and S. RESULTS: Of the 60 cases, group F was 25, group S was 25, and group N was 10. Among the group S, 5 cases showed reactivity against PRL, 1 against GH, 1 against both PRL and GH, 1 against TSH and GH, 2 against ACTH, 11 against FSH and 4 against both LH and FSH. Radiologically, invasiveness was noted in 8 in group S, compared to 3 in group N and 1 in group F (p=0.02). Intratumoral bleeding was noted in 7 of group S, 2 of group N and 2 of group F (p>0.05). CONCLUSION: Silent adenomas were thought to behave more aggressive than other subgroups of pituitary adenomas. And so we suggest the immunohistochemical study against adenohypophyseal cells may be helpful for evaluating clinical course of pituitary adenoma, expecially for, NFAs.
Adenoma* ; Adrenocorticotropic Hormone ; Hemorrhage ; Humans ; Immunohistochemistry ; Medical Records ; Neuroimaging ; Pituitary Gland* ; Pituitary Hormones, Anterior ; Pituitary Neoplasms ; Retrospective Studies

BACKGROUND/AIMS: Cancer-induced bone pain (CIBP) is one of the most common pains in patients with advanced neoplasms. Because of treatment-associated side effects, more than half of cancer patients are reported to have inadequate and undermanaged pain control. New mechanism-based therapies must be developed to reduce cancer pain. Quetiapine is a commonly used atypical antipsychotic drug. We report a study of the potential analgesic effects of quetiapine in a mouse model of CIBP and examine the mechanism of bone pain by analyzing the expression of various nociceptors. METHODS: Fifteen male C3H/HeN mice were arbitrarily divided into five groups: control and, CIBP with no treatment, quetiapine treatment, opioid treatment, and melatonin treatment. The mice were tested for mechanical hyperalgesia by determining the nociceptive hind paw withdrawal pressure threshold. Tissues from tibia were removed and subjected to quantitative and qualitative evaluations of transient receptor potential vanilloid 1 (TRPV1), TRPV4, acid-sensing ion channel 1 (ASIC1), ASIC2, and ASIC3 expression. RESULTS: Paw withdrawal pressure threshold was improved in the quetiapine treatment group compared with the CIBP group. Expression of TRPV1, TRPV4, ASIC1, ASIC2, and ASIC3 in the CIBP with quetiapine treatment group was significantly lower than that in the CIBP group. CONCLUSIONS: Our results suggest an analgesic effect of quetiapine in the CIBP animal model and implicate TRPV and ASICs as potential targets for cancer pain management.
Animals ; Evaluation Studies as Topic ; Humans ; Hyperalgesia ; Ion Channels ; Male ; Melatonin ; Mice* ; Models, Animal ; Nociceptors ; Pain Management ; Quetiapine Fumarate* ; Tibia