The serous papillary cystadenoma of low malignant potential in the paratesticular tissue is a tumor characterized by its resemblance to ovarian serous papillary tumor of low malignant potential. Several possible origins have been proposed but it is thought to originate from the Mullerian-type epithelium just like ovarian serous tumor of low grade malignancy. Because of the rarity of this tumor, the natural history and treatment have not been established. Herein we report on a serous papillary cystadenoma arising in the paratesticular tissue of a 12 year old . To our knowledge, this is the first reported case in the Korean literature. The size of this cystic tumor in this patient was 0.9x0.9x0.8 cm and had a sponge-like cut surface. The papillary structure was lined by both ciliated and nonciliated secretory cells, the same cellular structure as the salpinx. Areas with just a few mitoses and stratification of epithelial cells were noted, but invasion into the paratesticular tissue was absent, suggesting borderline malignancy. He is doing well after 5 months follow up. Prognosis of this scrotal tumor is thought to be better than the ovarian tumor of similar histology due to a better possibility of early detection.

A case of calcifying synovial sarcoma, occuring in the deep muscle fascia of the left thigh is reported. The presence of extensive calcification in synovial sarcoma is a favorable sign for prognosis. The patient was a 31-year-old female. The tumor mass had been present for 3 years, accompanying local tenderness. X-ray revealed a soft tissue tumor with central calcification, which was located between the adductor magnus and brevis of the left thigh. The tumor size was 7 x 5.5 cm. There was no connection with the knee joint or the femur. Grossly, the tumor was a relatively well circumscribed hard tumor with massive calcification. Microscopically, the tumor was composed of predominantly spindle cells with accompanying hyalinization, numerous spherical concretions and ossification. The epithelial component was not clearly noted. Mitotic figures were rarely noted in the densely cellular area. Immunohistochemical staining for EMA, S-100, vimentin, and carcinoembryonic antigen was negative while vimentin and cytokeratin were weakly and focally positive. EM study revealed multiple desmosome-like calcification intercellular junctions with a slit-like lumen and an incomplete basal lamina, which suggest that tumor show these cells were undergoing epithelia] differentiation. Above evidence suggest that this tumor is a synovial sarcoma associated with a large area of calcification, a so called calcifying synovial sarcoma. No recurrence was noted in one and half years of follow up.
Female ; Humans

This report concerns a rare malignant smooth muscle neoplasm of the skin and the subcutaneous tissue, which was examined immunohistochemically and ultrastructurally. It occured in a 48-year-old female patient who had suffered from painful nodules on the left shoulder. The nodules were removed and diagnosed as a benign fibrohistiocytic tumor. One year after local excision, multiple nodules were detected by physical examination at the previous operation site. Grossly, thirteen well-defined small nodules had spread in the dermis and the subcutaneous tissue, of which nine were located from lower dermis to the subcutaneous tissue and four were in the subcutaneous tissue. Histologically, each nodule consisted mainly of epithelioid tumor cells having eosinophilic or clear plump cytoplasm and round to oval nuclei with small nucleoli, and some peripheral spindle tumor cells. The tumor cells were negative for PAS reaction with and without diastase digestion or alcian blue. Immunohistochemically, tumor cells were positive for smooth muscle actin and vimentin. Ultrastructurally, the tumor cells showed actin filaments and dense bodies in cytoplasm. This case was diagnosed as an epithelioid leiomyosarcoma of the skin and the subcutaneous tissue with local metastasis one year after local excision.
Actin Cytoskeleton ; Actins ; Alcian Blue ; Amylases ; Cytoplasm ; Dermis ; Digestion ; Eosinophils ; Female ; Humans ; Leiomyosarcoma* ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Periodic Acid-Schiff Reaction ; Physical Examination ; Shoulder ; Skin* ; Subcutaneous Tissue ; Vimentin

Forty cases of infiltrating duct carcinoma of the breast were examined immunohistochemically for expression of TGF-beta and angiogenesis in order to analyze significant correlation with prognostic parameters including tumor size, axillary lymph node metastasis, clinical stage, histologic grade, estrogen receptor and progesterone receptor status. The TGF-beta expression was observed in tumors center and advancing edges of tumors. To determine microvessel density for angiogenesis, we stained endothelial cells for Factor VIII related antigen and counted microvessel within tumor. The results were as follows: 1) The strong immunohistochemical expression of TGF-beta and higher counts of microvessels were observed in advancing edges of tumors (p<0.05). 2) The TGF-beta expression in the advancing edges of tumors was closely related to clinical stage and presence of axillary lymph node metastasis (p<0.05). 3) The mean microvessel counts were significantly higher in tumors from patients with axillary lymph node metastasis and increased with increasing clinical stage (p<0.05). 4) The TGF-beta expression was not related to histologic grade, estrogen receptor and progesterone receptor status(p>0.05). Therefore, the results suggested that the TGF-beta expression and angiogenesis in infiltrating duct carcinoma of the breast may play an important part in prognostic factors, closely related to the lymph node metastasis and clinical stage.
Neoplasm Metastasis

To elucidate the developmental sequence of the eccrine sweat gland, a morphologic and a morphometric observation were done using developing human embryos and fetuses. Five embryos and sixty four fetuses from the 9th to the 38th week of the gestational age were studied. The skin was sampled in eight different areas, i.e., scalp, forehead, face, chest, abdomen, back, palm and sole. Routine histological sections were made for histological evaluation and morphometric analysis. The results obtained were as follows : The primordia of the eccrine sweat glands appeared first as regular undulation of the basal cells in the palm and the sole in the 13th week of getation. Subsequently, elongation and coiling of the cell cords were noted from the 16th to the 18th weeks. Intraductal lumen formation was first noted in the 20th week. Secretory segment of the eccrine sweat glands were noted from the distal part of the coiling intradermal sweat duct in the 22nd week of the gestational age. The eccrine sweat glands became fully developed by the 28th week of gestation and this included the clear cell, the dark cell and the myoepithelial cell. In the morphometric analysis, the number of eccrine epithelial buddings were decreased with aging and the highest were in the palm and the sole. The diameter of the eccrine sweat duct showed no significant change by gestational age or in the different sites observed. Straight and coiled eccrine sweat ducts or glands were lengthened into the deep reticular dermis and upper portion of the subcutaneous adipose tissue with an increase of the gestational age. The above results suggest that developmental stage and the number of eccrine glands of the skin in the fetal stage is different from other areas of the body, especially in the palm and the sole.
Abdomen ; Aging ; Dermis ; Eccrine Glands ; Embryonic Structures ; Fetus ; Forehead ; Gestational Age ; Humans ; Pregnancy ; Scalp ; Skin ; Subcutaneous Fat ; Sweat Glands* ; Sweat* ; Thorax

To elucidate the developmental sequence of the eccrine sweat gland, a morphologic and a morphometric observation were done using developing human embryos and fetuses. Five embryos and sixty four fetuses from the 9th to the 38th week of the gestational age were studied. The skin was sampled in eight different areas, i.e., scalp, forehead, face, chest, abdomen, back, palm and sole. Routine histological sections were made for histological evaluation and morphometric analysis. The results obtained were as follows : The primordia of the eccrine sweat glands appeared first as regular undulation of the basal cells in the palm and the sole in the 13th week of getation. Subsequently, elongation and coiling of the cell cords were noted from the 16th to the 18th weeks. Intraductal lumen formation was first noted in the 20th week. Secretory segment of the eccrine sweat glands were noted from the distal part of the coiling intradermal sweat duct in the 22nd week of the gestational age. The eccrine sweat glands became fully developed by the 28th week of gestation and this included the clear cell, the dark cell and the myoepithelial cell. In the morphometric analysis, the number of eccrine epithelial buddings were decreased with aging and the highest were in the palm and the sole. The diameter of the eccrine sweat duct showed no significant change by gestational age or in the different sites observed. Straight and coiled eccrine sweat ducts or glands were lengthened into the deep reticular dermis and upper portion of the subcutaneous adipose tissue with an increase of the gestational age. The above results suggest that developmental stage and the number of eccrine glands of the skin in the fetal stage is different from other areas of the body, especially in the palm and the sole.
Abdomen ; Aging ; Dermis ; Eccrine Glands ; Embryonic Structures ; Fetus ; Forehead ; Gestational Age ; Humans ; Pregnancy ; Scalp ; Skin ; Subcutaneous Fat ; Sweat Glands* ; Sweat* ; Thorax

OBJECTIVES: We examined the effects of diabetes mellitus (DM) case management program developed by National Health Insurance Corporation in Korea. METHODS: One trained nurse performed the case management for 30 DM patients recruited through the reimbursement information of National Health Insurance in a rural community. The case manager had four home visits and two telephone calls for 12 weeks. We evaluated the effectiveness of the program in terms of self-efficacy, self-care behaviors and glyco-metabolic control. RESULTS: The self-efficacy score was significantly increased from 70.0 of pre-intervention to 80.5 of post-intervention (p<0.001). The self-care score was also significantly increased from 2.86 to 3.60 (p<0.001). The scores of its components such as nutritional care, self-test of sugar level, foot care, oral care, and aerobic exercise were significantly improved (p<0.001). However, the improvement of score in medication management was statistically marginal (p=0.071). The fasting blood sugar level and HbA1c level was significantly decreased from 128.6 mg/dl to 114.5 mg/dl (p<0.001) and from 6.78 % to 6.54 % (p<0.001) respectively. CONCLUSIONS: The case management program was effective to improve the self-efficacy and self-care behaviors, and to control blood sugar level in DM patients.
Blood Glucose ; Case Management ; Diabetes Mellitus ; Exercise ; Fasting ; Foot ; House Calls ; Humans ; National Health Programs ; Rural Population ; Self Care ; Telephone

The purpose of this study was to identify the degree of self-care activities of stroke patients, the family burden, and the educational needs of primary caregivers. A descriptive survey research was conducted in 97 stroke patients and their respective primary caregivers. Data were collected the using 26th to by interviews a structure questionnare from July August 5th, 1999. NIH stroke status was 12.15+/-8.40, the degree of self-care activities of stroke patients was 26.85+/-9.39. The score of objective burden of primary caregivers was 31.24+/-4.81 and subjective burden was 24.30+/-6.99. The score of the educational needs was 89.78+/-9.99. We present several imformations about clients from these scores as follows: The patients were convalescent and their depentant level of self-care was middle range: The objective burden was higher than the subjective burden: And the educational needs of family caregivers were very high. The Elain Mattis Educational Wants of Family Caregivers of Disabled Adults Questionnaire was used to assess the educational needs of primary caregivers of stroke patients. The results of this research are offered to help nurses understand the feelings of uncertainty about the new and unexpected role that family caregivers face and to help nurses meet the needs of families preparing to care stroke survivors at home.
Adult ; Caregivers* ; Humans ; Surveys and Questionnaires ; Self Care* ; Stroke* ; Survivors ; Uncertainty

The cystic mesothelioma is a very rare tumor which has a clinically and histologically benign nature. Here in reported is the case of a cystic mesothelioma presented as a palpable mass of the inguinal area in a 28-year-old male. Ultrasound showed a cystic tumor at the inguinal canal, and the other physical and laboratory examinations were within normal limits. Grossly, the tumor consisted of cysts containing clear serous fluid and focally solid areas. Microscopically, the tumor was encapsulated with fibrocollagenous wall, and the tumor cells were cuboidal or polygonal epithelial cells with single or multiple layers and had clear cytoplasm. Some areas showed thyroid follicle-like structures. The content of follicle-like structures showed eosinophilia in the H&E section, but positive in mucin stain. Neither cytologic atypia nor mitoses were present. Immunohistochemical staining revealed positive reaction for keratins of low molecular weight, while negative for the thyroglobulin and CEA. These findings suggested mesothelial in origin. We concluded that this tumor was primary rather than metastatic, because he had no evidence of a tumor in gastrointestinal, genitourinary tracts and scrotum.
Adult ; Cytoplasm ; Eosinophilia ; Epithelial Cells ; Humans ; Inguinal Canal ; Male ; Mesothelioma, Cystic* ; Mitosis ; Molecular Weight ; Mucins ; Scrotum ; Thyroglobulin ; Thyroid Gland ; Ultrasonography

No abstract available.
Tuberculosis, Laryngeal*