Cases of acute myocardial infarction (AMI) that occur during pregnancy or postpartum are rarely reported. Ergot derivatives are known to induce the spasmodic contraction of coronary arteries. Administration of ergot derivatives can cause AMI, even in normal healthy people. In several reported cases, ergot derivatives triggered severe AMI during the postpartum period. Here, we report the case of a forty-year-old woman who was successfully impregnated by artificial fertilization and died after treatment with ergot derivatives. The autopsy revealed AMI with severe coronary atherosclerosis. This is the first case that reports aggravation of pre-existent severe coronary atherosclerosis after postpartum infusion of ergot derivtives.
Pregnancy ; *Postpartum Period ; Myocardial Infarction/*chemically induced/diagnosis/pathology ; Maternal Age ; Humans ; Female ; Ergot Alkaloids/*adverse effects ; Coronary Arteriosclerosis/chemically induced/diagnosis/pathology ; Adult

Inflammatory myofibroblastic tumor, also known as inflammatory fibrosarcoma, has been frequently diagnosed as inflammatory pseudotumor. Although there are six cases reported as inflammatory pseudotumors or inflammatory myofibroblastic tumors in the lung, no cases of pulmonary inflammatory myofibroblastic tumor with features of inflammatory fibrosarcoma have been reported in Korea. We experienced a case of inflammatory myofibroblastic tumor (inflammatory fibrosarcoma)characterized by high cellularity, severe nuclear pleomorphism, necrosis, or increased mitoticcounts. A 31-year-old male patient with a solitary pulmonary nodule on the routine chest x-rayreceived a right lower lobectomy. The tumor was an ovoid solid mass with multifocal necrosis, showing diffuse irregular proliferation of spindle cells with high cellularity and focal nuclear pleomorphism, admixed with dense lymphoplasmacytic cells. Although spindle cells are focally immunoreactivefor smooth muscle actin, the ultrastructural examination failed to demonstrate smooth muscledifferentiation. In cases of inflammatory myofibroblastic tumor (inflammatory fibrosarcoma), a completeexcision and close follow-up without radical surgery, radiation, or chemotherapy are needed.
Actins ; Adult ; Drug Therapy ; Fibrosarcoma ; Follow-Up Studies ; Granuloma, Plasma Cell ; Humans ; Korea ; Lung* ; Male ; Muscle, Smooth ; Myofibroblasts* ; Necrosis ; Solitary Pulmonary Nodule ; Thorax

Endometrial carcinomas arising in a bicornuate uterus are rare, only five case of which have been previously reported. We present a case of endometrial cancer arising in a bicornuate uterus, occurring in a 65-year-old woman. Unlike previously reported cases, our case showed mixed endometrial adenocarcinoma and undifferentiated carcinoma in one horn and focal adenocarcinoma in the other. Adequate tissue sampling of both horns is necessary for accurate diagnosis of malignancy in patients with a bicornuate uterus. Physicians should be aware of the possibility of this abnormality in cases when endometrial cancer is suspected but histology fails to confirm.
Adenocarcinoma ; Aged ; Animals ; Carcinoma ; Diagnosis ; Endometrial Neoplasms* ; Female ; Horns ; Humans ; Uterus*

A 48-year-old divorced woman was found dead, lying in her room. A scarf was wound two times around her neck, which was tightened like a tourniquet. Self- strangulation by ligature is very rare and such cases emphasize the need for an accurate medicolegal evaluation of the circumstances, a thorough postmortem examination, and methodical inspection of the scene, particularly when postmortem decomposition is present. This case showed decomposition and was initially treated by the police as endogenous cardiac death. However the detailed examination of the scene photograph and of the deceased person, along with the investigation of the circumstances leading to the death, produced the verdict of suicide in this case. As we know, distinction between murder and suicide may be impossible by an examination of the body alone, and therefore the authors emphasize that close collaboration between the investigative and medicolegal fields is essential in order to gain a full understanding of this unusual case.
Autopsy ; Cooperative Behavior ; Death ; Deception ; Divorce ; Female ; Homicide ; Humans ; Ligation ; Middle Aged ; Neck ; Police ; Suicide ; Tourniquets ; Wounds and Injuries

The authors experienced a case of traumatic infarction of cerebellum and brain stem. The victim was 48-year-old woman and died after violence including head trauma. On admission, being unconscious, clinical diagnosis was cerebellar infarction of unknown cause. Autopsy showed severe subscalp hemorrhage and avulsion, cerebral edema, infarction of cerebellum and brain stem, and we also noted cervical spine fracture(C4) and Rt. vertebral artery occlusion by thrombus and dissection. There was no signs of trauma on the surface of the neck. We will describe the autopsy findings and clinical course of death.
Autopsy ; Brain Edema ; Brain Stem ; Cerebellum ; Craniocerebral Trauma ; Diagnosis ; Female ; Hemorrhage ; Humans ; Infarction* ; Middle Aged ; Neck ; Spine* ; Thrombosis ; Vertebral Artery* ; Violence

BACKGROUND :Although clinicopathologic differences have been described between Epstein-Barr virus (EBV)-positive and negative gastric adenocarcinomas, the pathogenetic basis for these differences remains unclear. In this study, efforts were made to confirm that expression of EBV-latent membrane protein (LMP1) and immunohistochemical characteristics of EBVpositive gastric adenocarcinomas. METHODS: We investigated genomic deletion, and RNA & protein expression of the EBV-LMP1, as well as immunohistochemical protein expression of transforming growth factor (TGF)-beta1, TGF-bata RII, p21, p16, E2F1, thymidylate synthase, and NF-kappaB in relation to EBV positive gastric adenocarcinoma. RESULTS: A total of 38 Epstein-Barr Virus Encoded RNA-positive and 80 negative gastric carcinomas were examined. A 30 bp DNA deletion in the EBV-LMP1 gene, initiating at codon 342, was detected in 94.4% of EBVpositive cases. By RT-PCR and western blotting, EBV-LMP1 mRNA and protein expressions were absent in all cases, re-gardless of DNA deletion. No significant differences in TGF-bata1, TGF-betaRII, p21, NF-kappaB, E2F1, or thymidylate synthase expression were identified. However, the decreased expression of p16 was found in 84.2% of EBV-positive carcinomas, relative to only 57.5% of EBV-negative tumors (p=0.024). CONCLUSION: EBV-LMP1 DNA deletion, mRNA and protein losses are highly prevalent in EBV-positive gastric adenocarcinoma among Korean patients, along with decreased p16 expression.
Adenocarcinoma* ; Blotting, Western ; Codon ; DNA ; Herpesvirus 4, Human* ; Humans ; Membrane Proteins* ; Membranes* ; NF-kappa B* ; RNA ; RNA, Messenger ; Stomach Neoplasms ; Thymidylate Synthase* ; Transforming Growth Factors*

PURPOSE: ROS1 is an oncogene, expressed primarily in glioblastomas of the brain that has been hypothesized to mediate the effects of early stage tumor progression. In addition, it was reported that ROS1 expression was observed in diverse cancer tissue or cell lines and ROS1 is associated with the development of several tumors. However, ROS1 expression has not been studied in breast cancer to date. Therefore, we investigated ROS1 expression at the protein and gene level to compare expression patterns and to verify the association with prognostic factors in invasive ductal carcinoma (IDC) of the breast. MATERIALS AND METHODS: Tissue samples from 203 patients were used. Forty-six cases were available for fresh tissue. We performed immunohistochemical staining and real-time polymerase chain reaction (PCR). RESULTS: ROS1 expression was significantly lower in proportion to higher histologic grade, higher mitotic counts, lower estrogen receptor expression, and a higher Ki-67 proliferation index, although ROS1 expression was not significantly associated with the survival rate. The result of real-time PCR revealed similar trends, however not statistically significant. CONCLUSION: Higher ROS1 expression may be associated with favorable prognostic factors of IDC and its expression in IDC is related to the proliferation of tumor cells.
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/*metabolism/pathology ; Carcinoma, Ductal, Breast/*metabolism/pathology ; Cell Proliferation ; Female ; Humans ; Immunohistochemistry ; Middle Aged ; Neoplasm Grading ; Prognosis ; Protein-Tyrosine Kinases/genetics/*metabolism ; Proto-Oncogene Proteins/genetics/*metabolism ; Survival Analysis

BACKGROUND: The anaphase promoting complex (APC) promotes the degradation of mitotic cyclins as well as other substrates involved in sister chromatid adhesion. This study was carried out to examine the relationship between the APC expression and the clinicopathological variables, in an attempt to determine the role of the APC in the proliferation of lung cancer and to evaluate the possibility of an aberrant APC function in surgically resected squamous cell carcinomas and adenocarcinomas of the lung. METHODS: Immunohistochemical staining was performed for APC, Ki-67, cyclin B1, Cdc2, MMP-2 and VEGF in 55 cases of squamous cell carcinoma and 34 cases of adenocarcinoma of the lung, using the avidin-biotin-peroxidase method. RESULTS: The immunohistochemical stains for APC revealed a positive reaction in 49 cases (55.1%). The APC expression level was higher in the cyclin B1-positive group (p= 0.01), the Cdc2-positive group (p=0.001), the MMP-2-positive group (p=0.03), the group with lymph node metastasis (61.4% vs 48.9%), and the group with stage II/III cancer (60.7%) compared with those with stage I (42.9%). CONCLUSIONS: The APC may have an aberrant function, such as a change in its role in controlling the cell cycle, and might be associated with the invasiveness and proliferation of tumor cells.
Adenocarcinoma* ; Anaphase* ; Anaphase-Promoting Complex-Cyclosome* ; Carcinoma, Squamous Cell* ; Cell Cycle ; Chromatids ; Coloring Agents ; Cyclin B1 ; Cyclins ; Humans ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Siblings ; Vascular Endothelial Growth Factor A

Multicystic dysplastic kidney (MCDK) is a relatively common developmental anomaly in infants and children and has a good prognosis. In contrast, a malignant rhabdoid tumor of the kidney (MRTK) is one of the most lethal neoplasms of early life. However, the presentation of such a lethal tumor combined with multicystic dysplasia has not been reported to date. In this report, we describe a case of MRTK in a 5-yr-old girl who also had multicystic dysplasia. She was previously diagnosed with MCDK at birth due to a huge palpable mass on the right side of the abdomen. The right kidney was extensively replaced by numerous grossly dilated, variable-sized cysts. Microscopically, the tumor cells show a diffusely infiltrative growth pattern, which revealed large non-cohesive, round-to-polygonal tumor cells with vesicular nuclei. Some tumor cells had eccentric nuclei and large, round, eosinophilic cytoplasmic inclusions. There were metanephrons present, with the central ureteric bud and peripheral branches surrounded by condensing mesenchyma, immature glomeruli, and metaplastic cartilage in the adjacent parenchyma. To our knowledge, this is the first combined case of the two aforementioned diseases and this case may, in fact, suggest a new disease entity.
Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms/*complications/*diagnosis ; Multicystic Dysplastic Kidney/*complications/*diagnosis ; Prognosis ; Rhabdoid Tumor/*complications/*diagnosis

The etiology of several motility disorders, including persistent megacolon after definitive surgery for Hirschsprung's disease, meconium ileus which is not associated with cystic fibrosis and idiopathic megacolon, is still unclear. Interstitial cells of Cajal (ICC) are thought to modulate gut motility as gastrointestinal pace maker cells. The aim of this study was to evaluate the role of ICC in the bowel walls of the patients (n=15) who had variable motility disorders. The ICC were identified by immunohistochemical staining using an anti-C-Kit antibody and the results were compared with control specimens (n=2). The control group (G1) showed evenly distributed ICC in their bowel walls. The second group (G2, n=5) who had normal bowel movements after Duhamel procedures and the third group (G3, n=4) who had persistent megacolon after Duhamel procedures showed absent or scarcely distributed ICC in their aganglionic bowels. The ICC were identified by immunohistochemical staining using an anti-C-Kit antibody and the results were compared with control specimens (n=2). The control group (G1) showed evenly distributed ICC in their bowel walls. The second group (G2, n=5) who had normal bowel movements after Duhamel procedures and the third group (G3, n=4) who had persistent megacolon after Duhamel procedures showed absent or scarcely distributed ICC in their aganglionic bowels. Whereas ICC were evenly distributed in the ganglionic bowels of G2, they were not seen or scarecely distributed in the ganglionic bowels of G3. Two patients (G4) who suffered from idiopathic megacolon showed absence or decrease of ICC in spite of presence of ganglion cells in their colons. Four neonates (G5) who underwent ileostomy because of meconium obstruction showed absent or markedly decreased ICC in the colon at the time of ileostomy and the distribution of ICC was changed to a normal pattern at the time of ileostomy closure between 39-104 days of age and their bowelmotility were restored after that. The results suggest that lack of ICC caused reduce motility in the ganglionic colons and it may be responsible for the development of various motility disorders. Delayed maturity of ICC may also play a role in the meconium obstruction of neinates.
Colon ; Cystic Fibrosis ; Ganglion Cysts ; Hirschsprung Disease* ; Humans ; Ileostomy ; Ileus ; Infant, Newborn ; Interstitial Cells of Cajal* ; Meconium ; Megacolon*