The incidence of carcinoma of the small intestine is very low in children, and it is also known that the prognosis of this tumor in children is very poor. A case of adenocarcinoma in a 13-year-old girl arising in the jejunum is herein reported. The girl underwent a curative resection and is free of recurrence or metastasis 12 months after operation. This particular case is reported here with a review of the literature.
Adenocarcinoma* ; Adolescent* ; Child ; Female* ; Humans ; Incidence ; Intestine, Small ; Jejunum ; Neoplasm Metastasis ; Prognosis ; Recurrence

Purpose: Recently, microRNA (miRNA) has been evaluated to provide a new diagnostic and therapeutic modality hepatocellular carcinoma (HCC) and other tumors. They are small non-coding RNA molecules that function as transcriptional and post-transcriptional regulators of gene expression by silencing target genes. The aim of this study was to evaluate the clinical significance of microRNA-18a, 221 (miR-18a, miR-221) expression in HCC formalin-fixed paraffin-embedded (FFPE) tissue. Methods: miR-18a and miR-221 expressions were assessed by reverse transcription and real-time quantitative reverse transcription polymerase chain reaction in 50 pairs of FFPE HCC and the adjacent noncancerous liver tissues. And we evaluated the expression level in HCC tissues as compared with their adjacent noncancerous counterparts. And the relationship between miR-18a, miR-221 level and clinicopathological data and survival rates were analyzed. Results: miR-221 and miR-18a were overexpressed in HCC tissue as compared with their adjacent noncancerous liver tissue (P<0.001). miR221 expression was found to be correlated with larger tumor size (P=0.048). miR-18a expression was correlated with modified Union for International Cancer Control stage (P=0.05). The overall survival (P=0.02) of HCC patients with high miR-221 expression was significantly poorer compared to those patients with low expression. Multivariate analyses demonstrated that miR-221 may be a poor prognostic factor of HCC patients. Conclusion High expression of miR-221 in FFPE tissues could provide significance for prognosis of HCC patients. Although, miR-18a expression was significantly upregulated in HCC tissues, they are not correlated with prognosis. Further large prospective studies are needed to determine their clinical significance.

Carotid body tumor is a rare lesion of the neuroendocrine system. It typically presents as a slow growing, painless neck mass found along the anterior border of the sternocleidomastoid muscle. We present clinicoradiologic findings of a bilateral carotid body tumor from a 35-year-old woman with a review of literatures. Magnetic resonance imaging showed a vascular mass at the carotid bifurcation, displacing the external and internal carotid arteries. After embolization of feeding vessels using polyvinyl alcohol and gelfoam, we excised the mass without severe bleeding and neurologic symptoms.
Adult ; Angiography ; Carotid Artery, Internal ; Carotid Body Tumor* ; Carotid Body* ; Female ; Gelatin Sponge, Absorbable ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Neck ; Neurologic Manifestations ; Neurosecretory Systems ; Polyvinyl Alcohol

Lymphangioma is a rare benign congenital tumor involving both the head and the neck and causing obstructing symptoms in the upper airways as well as aesthetic anomalies. About 90% of the cases occur within 2 years of age, except for a few cases, which occur in adulthood. The lesions can grow rapidly with infection, truma or bleeding, resulting in disfigurement as well as severe impairment of respiraton, swallowing and speech. The middle ear lymphangioma is very extreme. There have been no previously reported cases of middle ear lymphangioma in Korea. The treatment of choice for lymphangioma located in the middle ear is surgical excision. We present and discuss this rare case with a review of the literature.
Deglutition ; Ear, Middle* ; Head ; Hemorrhage ; Korea ; Lymphangioma* ; Neck

PURPOSE: The Rho family of GTPases are involved in actin cytoskeleton organization and are associated with carcinogenesis and progression of human cancers. The clinicopathological significance of RhoA is not yet well known in the case of colorectal cancer. To investigate the expression of RhoA protein in colorectal carcinoma and to evaluate the relationship between RhoA protein expression and invasion and metastasis of colorectal cancer, we examined the expression of RhoA protein by using Western blotting and immunohistochemistry. METHODS: The protein levels of RhoA in colorectal carcinomas of surgical specimens were analyzed in 71 consecutive patients with colorectal cancers by using immunohistochemistry and Western blotting. The relationships between the protein levels of RhoA in tumor tissues and the clinicopathological features of the patients were also assessed. RESULTS: RhoA was highly expressed in 48 colorectal carcinomas (67.6%). There was a significant association between RhoA expression and lymph nodal status. The expression of RhoA protein was related to lymph-node metastasis (P=0.032) and advanced TNM tumor staging (P=0.020). RhoA expression had a significant prognostic value for overall survival. Kaplan-Meier plots of survival in patients with high RhoA showed that high RhoA expression was associated with a shorter overall survival. However, no association was found between RhoA and other pathologic or clinical variables, including age, gender, degree of differentiation, and presence of perineural spread. CONCLUSIONS: The RhoA protein may be related to malignant transformation and development of colorectal caricinomas and may play an important role in the invasion and the metastasis of colorectal carcinomas.
Actin Cytoskeleton ; Blotting, Western ; Colorectal Neoplasms ; GTP Phosphohydrolases ; Humans ; Immunohistochemistry ; Neoplasm Metastasis ; Neoplasm Staging ; rhoA GTP-Binding Protein

PURPOSE: Acute promyelocytic leukemia (APL or AML, M3) represents an unique model for cancer research in terms of biological and clinical features. Since 1988, it has been widely confirmed that all-trans retinoic acid (ATRA) can induce complete clinical remission in over 85% of APL patients by a differentiation process, with PML-RARalpha protein possibly being the direct target of ATRA. However, ATRA treatment has two clinical limitations, namely, retinoic acid syndrome and retinoic resistance. Recently, it has been shown that arsenic trioxide used in some traditional Chinese remedy is very effective in retinoic resistant APL treatment. We tried to observe arsenic effect on cell lines and APL patient cells. MEHTODS: We investigated arsenic trioxide-induced apoptosis on APL, HL60, K562, KPH1 cell lines through MTT assay, DNA fragmentation assay and morphologic features. RESULTS: In MTT assay, cell survival rate decreased as the concentration of arsenic trioxide increased. In DNA fragmentation assay with HL60 cell line, DNA fragmentation was more frequent in high concentrations of arsenic trioxide than in low concentrations. During arsenic trioxide treatment, the morphologic change in bone marrow cells of APL patient, included nuclear differentiation and dark cytoplasmic granule during arsenic trioxide treatment. Serum arsenic reached peak level at 4hr after injection. We experienced a case of a 9-year-old male with APL who had relapsed after cessation of retinoic acid treatment. The patient successfully achieved remission following arsenic trioxide treatment without bone marrow depression and exacerbating bleeding diathesis. CONCLUSION: Arsenic trioxide can be used effectively to treat APL patients by inducing apoptosis and partial differentiation in tumor cells. The precise cellular and molecular mechanisms of its therapeutic effects remain to be determined.
Apoptosis ; Arsenic* ; Asian Continental Ancestry Group ; Bone Marrow ; Bone Marrow Cells ; Cell Line ; Cell Survival ; Child ; Cytoplasmic Granules ; Depression ; Disease Susceptibility ; DNA Fragmentation ; Hemorrhage ; HL-60 Cells ; Humans ; Leukemia, Promyelocytic, Acute* ; Male ; Tretinoin

The perineal defect in female genitalia results from multiple etiologies, including obstetric injury, sexual assaults, and perineal trauma. Untreated defects may lead to significant physical, functional, and esthetic complaints. Numerous reconstruction methods are used for a perineal defect, but various complications, such as fecal impaction, fecal incontinence, and wound disruption, are introduced. We report a case of a 40-yr-old woman with a cloaca-like perineal defect, who was treated with reconstructive surgery of the perineal defect and recovered with a good anatomical and functional outcome.
Fecal Impaction ; Fecal Incontinence ; Female ; Genitalia, Female ; Humans

PURPOSE: Placenta growth factor (PlGF) is a member of the vascular endothelial growth factor (VEGF) family. PlGF is implicated in several pathologic processes, including the growth and spread of cancer and tumor angiogenesis. The aim of this study was to evaluate the expression and the clinical implications of PlGF in colorectal cancer. METHODS: In order to ascertain the clinical significance of PlGF expression in colorectal cancer, the researcher analyzed the expression pattern of PlGF by using an immunohistochemical method and attempted to establish if a relationship existed between PlGF expression and microvessel density (MVD), and subsequently between PlGF expression and the predicted prognosis. A total of 83 patients with colorectal cancer were included for immunohistochemical staining. Clinicopathological characteristics were defined according to the tumor-node-metastasis (TNM) criteria of the Union for International Cancer Control. Clinicopathologic factors, such as age, sex, histological types of tumors, tumor cell grade, TNM stage, lymphovascular invasion, and lymph-node metastasis, were reviewed. RESULTS: In this study, the PlGF protein expression level was significantly correlated with MVD, patient survival, and clinicopathological factors such as lymph-node metastasis, TNM staging, lymphatic invasion and vascular invasion. CONCLUSION: PlGF may be an important angiogenic factor in human colorectal cancer, and in this study, PlGF expression level was significantly correlated with positive lymph-node metastases, tumor stage, and patient survival. These findings suggest that PlGF expression correlates with disease progression and may be used as a prognostic marker for colorectal cancer.
Angiogenesis Inducing Agents ; Colorectal Neoplasms ; Disease Progression ; Humans ; Microvessels ; Neoplasm Metastasis ; Neoplasm Staging ; Pathologic Processes ; Placenta ; Pregnancy Proteins ; Prognosis ; Vascular Endothelial Growth Factor A

BACKGROUND: The treatment of intrahepatic stones is difficult because of frequent recurrence and residual stones. There are several suggested methods of treatment which include surgical bile-uct exploration with or without biliary drainage, an endoscopic procedure, transhepatic cholangiolithotomy, and hepatic resection. METHODS: We reviewed the therapeutic results in 96 patients who had hepatolithiasis and received surgery at Soon Chun Hyang University Chunan Hospital during the 10 years from June 1987 to June 1997. We divided them into 2 groups: one was the group of patients receiving a hepatic resection with or without a drainage procedure (resection group), and the other was the group of patients receiving only a T-ube choledochostomy or drainage procedure (nonresection group). RESULTS: The male-to-female ratio was 1:1.74, and the most prevalent age group was the 5th decade (31.3%). The most common symptoms were epigastric pain (61%) and RUQ pain (60%), and the locations of stones were the right intrahepatic duct in 10 cases (10.4%), the left intrahepatic duct in 47 cases (49%), and both intrahepatic duct in 39 cases (40.6%). Operative methods were a resection in 29 cases and a nonresection in 67 cases. The incidence of residual stones were 31.0% in the hepatic resection group and 68.6% in the nonresection group. The postoperative complication rate was 20.6% in hepatic resection group and 38.8% in the nonresection group, and the follow-p study showed the good results (Good & Fair) for 92.5% of the hepatic resection group and 66.7% of the nonresection group. CONCLUSION: The hepatic resection with or without drainage is an adequate treatment for hepatolithiasis. It can eradicate localized intrahepatic calculi, irreversible biliary stricture, an atrophied segment, and, possibly, an associated cholangiocarcinoma, with good results in clinical evaluation.
Calculi ; Cholangiocarcinoma ; Choledochostomy ; Chungcheongnam-do ; Constriction, Pathologic ; Drainage ; Humans ; Incidence ; Postoperative Complications ; Recurrence

PURPOSE: Currently, single port laparoscopic cholecystectomy (SLC) is gradually being expanded. However, its operative time and complications are reportedly variable according to the surgeon's expertise and experience. In order to overcome these problems, we introduced surgical methods using a 2 mm sized auxiliary device (NELIS, Korea) in cholecystectomy. METHODS: Between March 2010 and October 2010, laparoscopic cholecystectomy was performed in 53 patients for non-inflammatory gallbladder stones or gallbladder polyps based on the computed tomography findings. Fourteen of 53 consecutive patients underwent SLC and others underwent CLC. The patient's clinical characteristics and operative results were evaluated retrospectively. RESULTS: Comparison of clinical characteristics between SLC and CLC groups indicated that the SLC group included younger patients (p=0.008), however other characteristics (sex, mean body index, and previous abdominal operation history) were not significantly different. Operative outcomesparameters including the intensity of postoperative pain, rate of wound complication, and postoperative hospital stay did not differ significantly between the 2 groups. Operative time of the SLC group was longer than that of the CLC group (p=0.002). However, the operative time was decreased according to the increasing SLC cases. By 3 months, patients in the SLC group reported significantly better cosmesis (p=0.036). CONCLUSION: SLC with an auxiliary device (2 mm, Hold port, NELIS) is technically feasible and might be an alternative method for obtaining a critical view of safety and cosmetic results.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Gallbladder ; Humans ; Length of Stay ; Operative Time ; Pain, Postoperative ; Polyps ; Retrospective Studies ; Wounds and Injuries