Cystadenoma of the liver is a rare neoplasm. Although many cystadenomas are asymptomatic, symptoms can include abdominal pain, postprandial epigastric discomfort, and nausea. Dramatic changes in hepatic imaging techniques have been helpful for diagnosing cystic lesions of the liver, such as simple cyst, hydatid cyst, cystadenoma, cystadenocarcinoma, and metastatic neuroendocrine tumors. However, it remains difficult to differentiate cystadenoma from cystadenocarcinoma for multiseptated cystic hepatic lesions with papillary projection on computed tomography (CT) and magnetic resonance imaging (MRI). Here we report the case of a 47-year-old woman with several months of postprandial discomfort and abdominal fullness. CT and MRI revealed multiseptated cystic lesions with papillary excrescences. A left hemihepatectomy was performed. Histology showed a benign mucinous cystic tumor with ovarian-like stroma.
Abdominal Pain ; Cystadenocarcinoma ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Papillary ; Echinococcosis ; Female ; Humans ; Liver ; Magnetic Resonance Imaging ; Middle Aged ; Mucins ; Nausea ; Neuroendocrine Tumors

No abstract available.
Purpura, Schoenlein-Henoch* ; Scarlet Fever*

PURPOSE: To evaluate types of gray matter heterotopias, associated brain anomalies, and its correlation with the patterns of seizure. MATERIALS AND METHODS: We evaluated retrospectively 19 patients(male :female=10:9, mean age 21 years) with gray matter heterotopias on brain MRI. Using 1.0T superconducting MR unit, spin echo TI-, proton-density- and T2-weighted images in axial, coronal and sagittal planes were obtained. RESULTS: Types of gray matter heterotopias were single subependymal in four patients, multiple subependymal in one, focal subcortical in eight, diffuse subcortical in two, mixed multiple subependymal and focal subcortical in four. Associated anomalies were seen in 11 patients:other neuronal migration anomalies in eight patients, corpus callosum agenesis in two, and combined holoprosencephaly and Dandy-Walker malformation in one. Fifteen patients had seizure. The patterns of seizure were not correlated with the types of heterotopias. CONCLUSION: In addition to subependymal, focal subcortical, and diffuse subcortical types, gray matter heterotopias included mixed variant of of multiple subependymal and subcortical type. Schizencephaly was the most common form of accompanying anomalies, and patterns of seizure were not correlated with types of gray matter heterotopias, even though main clinical menifestation was seizure.
Agenesis of Corpus Callosum ; Brain ; Dandy-Walker Syndrome ; Holoprosencephaly ; Humans ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Neurons ; Retrospective Studies ; Seizures

In view of the potential of replicase protein as a diagnostic reagent for human caliciviruses (HuCVs), we have cloned and over-expressed this gene from the Snow Mountain-like Korean strains in Escherichia coli as a fusion protein with glutathione S-transferase (GST, and described the preliminary antigenic characterization of the recombinant products. Each 470bp fragment corresponding to highly conserved region of RNA-dependent RNA polymerase was generated by RT-PCR from stools of two diarrheal children, cloned in pMOSBlue T-vector, and subcloned between the EcoRI and SalI restriction sites of pGEX-47-3, a GST gene fusion vector, yielding pGCVpol. This construct expressed a Snow Mountain-like HuCV replicate under the control of the IPTG-inducible pac promoter. An extract prepared by sonication of the E. coli cell inclusion bodies bearing pGCVpol products was purified and analyzed by SDS-PAGE. After Coomassie blue staining, it was shown that the recombinant replicase migrated on the gels with an approximate molecular mass of 46.5 kDa, that was subsequently cleaved into a 26 kDa GST fragment and a 20.5 kDa replicase protein upon digestion with thrombin protease. The replicase was recognized on immunoblotting with the sera from symptomatic children with the HuCV-associated diarrhea but not by asymptomatic sera from adults. The results presented the first biological activity of individually expressed HuCV replicase subunit and provided important reagents for diagnosis of HuCV infection.
Adult ; Child ; Clone Cells ; Diagnosis ; Diarrhea ; Digestion ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; Gels ; Gene Fusion ; Glutathione Transferase ; Humans ; Immunoblotting ; Inclusion Bodies ; Indicators and Reagents ; RNA Replicase ; Snow* ; Sonication ; Staphylococcal Protein A ; Thrombin

OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Abortion, Habitual ; Abortion, Spontaneous* ; Female ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma* ; Polymerase Chain Reaction ; Pregnancy ; Risk Factors ; Tandem Repeat Sequences ; Thymidylate Synthase*

No abstract available.
Fetal Death* ; Gastroschisis*

No abstract available.
Adult* ; Growth Hormone* ; Humans

BACKGROUNDS/AIMS: Prognostic factors for colorectal cancer with hepatic metastasis are not well-established. We investigated the factors that predicted survival following surgical resection of hepatic metastases in patients with colorectal cancer. METHODS: Fifty-three patients underwent resection of hepatic metastases of colorectal cancer between January 2000 and December 2005, with follow-up periods that ranged from 3 to 119 months. In this retrospective study, the effects of sex, age, type of hepatic resection, T stage and N stage of the primary cancer, number and size of metastatic hepatic tumors, synchronicity or metachronicity of the liver metastases, surgical resection margins, and preoperative carcinoembryonic antigen (CEA) levels on 1-year and 3-year survival were analyzed using the Kaplan-Meier method and the log rank test. RESULTS: Median survival was 39.9 months and the 3-year survival rate was 62.2%. Twenty patients died during the follow-up period of 3 to 119 months (mean, 48.8+/-34.24). In univariate analysis, only the surgical margin of the hepatic metastasis resection correlated significantly with 3-year survival. Sex, age, T stage and N stage of the primary cancer, synchronicity or metachronicity of the metastases, number and size of hepatic metastases, type of hepatic resection and preoperative CEA levels did not predict long-term outcome. CONCLUSIONS: Hepatic resection provides a safe and effective treatment in patients with hepatic metastasis from colorectal cancer. In this study, only the surgical resection margin of the hepatic metastasis of colorectal cancer significantly predicted survival.
Carcinoembryonic Antigen ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Liver ; Neoplasm Metastasis ; Retrospective Studies ; Survival Rate

No abstract available.
Syringomyelia*

PURPOSE: Authors analyzed the MR findings of swollen extremities to evaluate the MR features of lymphedema and phlebedema. MATERIALS AND METHODS: We reviewed MR imagings of 17 cases of swollen extremities, including 12 lymphedemas and 5 phlebedemas. We obtained axial TI-, T2-, and Gd-DTPA enhanced T1WIs using 1.0T superconducting magnet and measured cross-sectional areas of subcutaneous and subfascial tissues of a slice with grossly largest cross-sectional area using perimeter. We also analyzed changes in the signal intensities of the subcutaneous and subfascial tissues on T2WI, presence of enhancement on Gd-DTPA enhanced T1WI, and presence of skin thickening. RESULTS: Both subcutaneous and subfascial tissues of swollen extremities were increased in the cross-sectional areas than those of contralateral normal side. The subcutaneous compartment in lymphedema was statistically significantly increased in cross-sectional area than subfascial compartment in lymphedema(p<0.005) and subcutaneous tissue in phlebedema(p<0.05). Increased signal intensities and characteristic "honeycomb appearance" of subcutaneous tissue in the lymphedema were specific findings on T2WI. CONCLUSION: MR imaging was useful and noninvasive method in the diagnosis of swollen extremities. There were increased cross-sectional area of subcutaneous compartment with "honeycomb appearance" in lymphedema and increased signal intensities of both subcutaneous and subfascial compartment in phlebedema on the T2WI.
Diagnosis ; Extremities* ; Gadolinium DTPA ; Lymphedema* ; Magnetic Resonance Imaging ; Skin ; Subcutaneous Tissue