Plexiform schwannoma is a rare benign tumor arising from the peripheral nerve sheath and characterized by a multinodular and plexiform growth pattern. This tumor usually arises sporadically. In rare cases, plexiform schwannomas have been associated with neurofibromatosis type 2. Plexiform schwannoma should be differentiated from plexiform neurofibroma, because the latter is pathognomonic tumor of neurofibromatosis type 1 and has a potential of malignant transformation. We report a case of multiple plexiform schwannomas associated with bilateral acoustic neuromas and meningioma.
Meningioma ; Neurilemmoma* ; Neurofibroma, Plexiform ; Neurofibromatoses* ; Neurofibromatosis 1 ; Neurofibromatosis 2* ; Neuroma, Acoustic ; Peripheral Nerves

BACKGROUND: Antibiotics are used prophylactically in surgery to prevent postoperative infection. However, antibiotics administered in large doses can cause a bleeding diathesis as a result of platelet dysfunction. We wondered whether these antibiotics might impair platelet function by interfering with the initial step of platelet activation: the binding of agonists to their specific receptors on the platelet surface. METHODS: In 30 patients (male 18, women 12) undergoing primary elective knee arthroscopic surgery, the whole blood coagulation system was prospectively evaluated before, and 10 and 40 minutes after administration of 1 g of augmentin. All patients who had abnormal preoperative coagulation profiles or who received anticoagulant or antiplatelet, antibiotics therapy within 7 days prior to surgery were precluded. RESULTS: At 10 minutes after augmentin administration 25 of 30 patients had a significant impairment in all phases of whole blood coagulation as monitored by thromboelastography. In contrast, three of 30 patients had a significantly decreased coagulation time. Two of 30 patients had no significant changes of TEG variables. TEG variables were restored toward baseline in fourty minutes after augmentin administration. CONCLUSIONS: Augmentin can cause a significant but transient change in the viscoelastic properties of blood. Coagulation parameters of the TEG should be measured prior to augmentin administration to prevent and prospect a bleeding diathesis as a result of platelet dysfunction.
Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Arthroscopy ; Blood Coagulation ; Blood Platelets ; Disease Susceptibility ; Female ; Hemorrhage ; Humans ; Knee ; Platelet Activation ; Prospective Studies ; Thrombelastography*

BACKGROUND/AIMS: This study was aimed to examine if FB1 induced-hepatotoxicity involves apoptosis, and cholesteryl hemisuccinate (CS) pre-treatment would selectively interfere with FB1 induced-apoptosis of hepatocytes. METHODS: Sprague-Dawley rats were intravenousely injected with FB1 (1.25 mg/kg/day) for two days, and were sacrificed at 3, 6, 12, 24 and 48 hours after injection. Another experiment group was composed of rats with pretreatment of CS (100 mg/kg/day, i.p.) before FB1 injection. RESULTS: This study demonstrated that administration of hepatotoxic dose of FB1 to Sprague-Dawley rats resulted in liver injury leading to cell death by apoptosis. FB1-induced apoptosis was preceded by early elevation in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, and appearance of injured pre-apoptotic cells at 12 hours was followed by massive fragmentation and margination of heterochromatin at 24 hours. CS pre-treatment prior to FB1 injection ameliorated serum biochemistry and hepatic injury with apoptosis, demonstrated by histological, ultrastructural and TUNEL (terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling) methods. In addition, there was remarkable decrease in number of PCNA (proliferative cell nuclear antigen)-positive proliferating hepatocytes compared to that of FB1 treated group. CONCLUSION: This study suggests that apoptosis significantly contributes to FB1-induced hepatotoxicity in vivo, and pre-exposure of rat to CS prevents FB1-induced hepatic apoptosis and proliferation.
Alanine Transaminase ; Animals ; Apoptosis* ; Aspartate Aminotransferases ; Biochemistry ; Cell Death ; Cholesterol ; Hepatocytes* ; Heterochromatin ; In Situ Nick-End Labeling ; Liver* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley

Most cases of primary squamous cell carcinoma of the ovary are associated with mature teratoma or Brenner tumor, and a few cases are related to endometriosis of the ovary. But a few cases of ovarian primary squamous cell carcinoma have occurred without clear associated etiology. Although some of them are concurred with cervical carcinoma in situ, they have not shown clear associations with the ovarian primary squamous cell carcinoma. We report a case of primary squamous cell carcinoma of the ovary appearing in pure form. A left ovarian mass was detected in a 43-year-old woman. A total hysterectomy and bilateral adnexectomy with regional lymph node dissection were performed. Histologically, the tumor was predominantly composed of polygonal tumor cells with keratinization and intercellular bridge, dyskeratotic cells, necrotic cell debris, and inflammatory cells. Also, metastasis to paraaortic lymph node was detected.
Adult ; Brenner Tumor ; Carcinoma in Situ ; Carcinoma, Squamous Cell* ; Endometriosis ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Ovary* ; Teratoma

Concurrence of adenocarcinoma and neuroendocrine carcinoma in the gastrointestinal tract has rarely been observed. We report two cases of gastric collision tumors (adenocarcinoma and neuroendocrine carcinoma) that developed in a 64-year-old man and a 71-year-old man. In both cases, there was a single ulcerative lesion in the stomach. Histologically, the gastric lesions were composed of two discrete lesions: tubular adenocarcinoma at the edge of an ulcer and neuroendocrine carcinoma in the ulcer base. We will discuss collision and composite tumors.
Adenocarcinoma ; Aged ; Carcinoma, Neuroendocrine ; Gastrointestinal Tract ; Humans ; Middle Aged ; Stomach ; Ulcer

Pilomatrixoma is a benign tumor which usually occur as a solitary, firm nodule in the head and neck, and upper extremities of young people. This tumor is occasionally encountered during aspiration biopsy of subcutaneous masses, but only a small number of cases are correctly diagnosed prior to excision. We report five cases of pilomatrixoma. Four cases occurred in the neck and one case in the back. The characteristic fine needle aspiration cytologic features are shadow cells and basaloid cells in the background of inflammatory cells, including some multinucleated giant cells. The shadow cells were recognized in all five cases. These cells were pale, anucleated cells with relatively distinct cell borders. May-Gr nbald-Giemsa stain is useful for the identification of shadow cells. The recognition of shadow cells appears to be essential for accurate diagnosis of pilomatrixoma.
Biopsy, Fine-Needle* ; Biopsy, Needle ; Diagnosis ; Giant Cells ; Head ; Neck ; Pilomatrixoma* ; Upper Extremity

We presented several cases of the exophthalmos due to the orbital tumors, with the review of the literatures. We performed modified Kronlein operation and anterior orbitotomy, appropriately for each cases to improve the visual acuity and at least to correct cosmetically the proptosed eye. It will be better to do one's best in order to search a possible way to save the eye ball by which the ophthalmologist can remove the orbital tumor even if the patient lost his vision.
Exophthalmos* ; Humans ; Orbit ; Visual Acuity

BACKGROUND AND OBJECTIVES: The mastoid air cell system has been recognized as an important contributor to the function of middle ear ventilation. And, mastoid pneumatization is thought to be correlated with the petrous apex pneumatization. We attempted a comparative analysis of petrous apex pneumatization and the mastoid portion by using target imaging CT. MATERIALS AND MEDTHOD: Pneumatization of the petrous apex v as investigated in 100 subjects without middle ear disease by computer-assisted digital processing of CT images of' the hone. RESULTS: The rate of pneumatization of the petrous apex in all subjects was 22% (44/200 ears), and there was no difference in the degree of pneumatization between the left and the right ears or between sexes. In 44 ears that showed pneumatization of the petrous apex, a higher degree of pneumatization was found in larger mastoid cavities, suggesting a correlation between pneumatization of the petrous apex and the pneumatized air cells in other parts of the temporal bone. Pneumatization in all parts of the petrous apex was found in about 5% (2/44 ears), and pneumatization in some parts of the petrous apex eas about 95% (42/44 ears). In the latter cases, there was no difference in the degree of pneumatization between the lower portions of the CT slices and the higher ones. SUMMARY: These results indicate that the effects of pneumatization of the petrous apex must be taken into consideration in studies measuring the gas composition and volume of the middle ear, and in temporal bone peumatization which acts as a pressure buffer in middle ear diseases.
Ear ; Ear, Middle ; Mastoid ; Middle Ear Ventilation ; Temporal Bone

PURPOSE: Phenylacetate has potent antiproliferative effects in many malignant tumors. However, the exact mechanism as to how phenylacetate induces cell growth arrest remains unclear and very little is known about its effects on human osteosarcoma cells. In this study, we investigated whether phenylacetate is effective against two osteosarcoma cell lines (HOS and U-2 OS) in vitro. MATERIALS AND METHODS: The viability of phenylacetate- treated cell lines was assessed by trypan blue exclusion assay, and the cell cycle distribution was measured by flow cytometry. To measure cell apoptosis, poly (ADP- ribose) polymerase cleavage assay and flow cytometry were employed. The expressions of cell cycle-regulatory proteins and the apoptosis-related genes were evaluated by western blot analysis. RESULTS: Phenylacetate was found to inhibit the growth of osteosarcoma cells, induce cell cycle arrest in the G1 phase, and induce apoptosis. A significant decrease in Bcl-2 expression and a mild up-regulation of Bax were also observed in both phenylacetate-treated cell lines. Reduced phosphorylation of the pRb and the increased expression of p21Cip1 were observed subsequent to treatment with phenylacetate. CONCLUSION: These findings support the idea that pheny lacetate may be an effective chemotherapeutic agent to be employed in the future against osteosarcoma, because phenylacetate acts to inhibit the growth of osteosarcoma cells through cell cycle arrest and apoptosis.
Apoptosis* ; Blotting, Western ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Line ; Flow Cytometry ; G1 Phase ; Humans* ; Osteosarcoma* ; Phosphorylation ; Trypan Blue ; Up-Regulation

BACKGROUND: The use of troglitazone (a PPARgamma ligand) and COX-2 inhibitor have been intensively studied for inhibition of tumor growth in cancer treatment, but the anti-tumor effect with a combination of these agents for cancer has not yet been studied. The aim of this study was to determine if low concentrations of troglitazone with COX-2 inhibitor in combination would cause significant cytotoxicity in glioma cells. METHODS: The effects of co-treatment with troglitazone and COX-2 inhibitor on cell growth and apoptosis were assessed by use of trypan blue exclusion and a DNA fragmentation assay. A western blot was used to analyze the apoptotic signaling for the expression of bcl-2, bax, PARP and p21 proteins. RESULTS: A low dose of troglitazone (5micrometer) and COX-2 inhibitor (5micrometer) strongly enhanced the cell growth inhibition and apoptosis in glioma cells when compared to a low dose of each drug alone. Western blotting analysis showed a decreased expression of bcl-2 and PARP proteins. In contrast, the bax protein level was increased. CONCLUSIONS: The combination of troglitazone and COX-2 inhibitor in a low dose elicits synergistic cytotoxicity in glioma cells. Our study also demonstrates that down regulation of bcl-2, fragmentation of PARP protein and increased expression of bax protein were accompanied by co-treatment with troglitazone and the COX-2 inhibitor.
Apoptosis ; bcl-2-Associated X Protein ; Blotting, Western ; Cyclooxygenase 2 ; DNA Fragmentation ; Down-Regulation ; Glioma* ; PPAR gamma ; Trypan Blue