Colorectal cancer is rare in teenagers, especially without known risk factors. Colon cancer in young age is more likely to be diagnosed at advanced-stage, to present unfavorable tumor histology such as mucinous carcinoma, and poor outcome. We report a case of sporadic mucinous adenocarcinoma of the colon in a 19-year-old male patient without any risk factors. He complained of severe left abdominal pain that developed 1 month ago. He had a distended abdomen with severe tenderness on the left lower quadrant. A distal descending colon mass causing mechanical obstruction was observed on abdominal computed tomography. Emergency colonoscopy showed a large, fungating mass obstructing the lumen at 40 cm from the anal verge. Biopsy of the colonic mass suggested a mucinous adenocarcinoma. After decompression by colonic stent, the patient was transferred to the general surgery department for left hemicolectomy. The lesion was confirmed to be a mucinous adenocarcinoma (7.0x4.5 cm). For hereditary nonpolyposis colorectal cancer evaluation, immunohistochemical staining for MLH1 and MSH2 was normal. Reverse transcription polymerase chain reaction analysis did not detect microinstability in any of the markers tested. The patient had no familial history of cancer. Mucinous adenocarcinoma has high frequencies of poor differentiation, advanced tumor stage, loss of mismatch repair gene expression, and increased MUC2 expression. A mucinous histology is considerably more frequent in children and adolescent than in adults. Adequate invasive study is also necessary for young age patients.
Abdomen ; Abdominal Pain ; Adenocarcinoma, Mucinous ; Adolescent ; Adult ; Biopsy ; Child ; Colon ; Colon, Descending ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis ; Decompression ; DNA Mismatch Repair ; Emergencies ; Gene Expression ; Humans ; Male ; Mucins ; Polymerase Chain Reaction ; Reverse Transcription ; Risk Factors ; Stents ; Young Adult

No abstract available.

Esophageal hemangioma occurs in fewer than three percent of all benign esophageal neoplasm. To treat symptomatic esophageal hemangioma, surgical resection can be performed. A case of esophageal hemangioma was successfully treated by endoscopic mucosal resection (EMR). The patient was a 50-year-old man who presented with dysphagia and epigastric discomfort. An endoscopic ultrasonography examination revealed an esophageal submucosal mass confined to the submucosal layer, with no continuity with adjacent vessels without regional lymphadenopathy. For diagnosis and symptomatic relief, EMR was performed. The final diagnosis was benign esophageal cavernous hemangioma. No complications have been evident during a 3-year follow-up.
Deglutition Disorders ; Endosonography ; Esophageal Neoplasms ; Follow-Up Studies ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Lymphatic Diseases ; Middle Aged

Adrenal cyst is a rare disease and its incidence rate is about 0.06~0.18%. Many cases of adrenal cysts are diagnosed incidentally. Surgical excision is generally performed to rule out malignancy when an adrenal cyst is detected. However, a reviewing the overall cases revealed that only 7% of adrenal cysts were malignant or potentially malignant. Thus, it has been suggested to observe an asymptomatic simple benign cyst after aspiration. From this point of view, it is necessary to perform a functional hormonal test and fine needle aspiration cytology for investigating the nature of adrenal cysts. Adrenal cyst drainage can be performed when surgical resection is not indicated. Computed tomography or ultrasonography guided percutaneous aspiration and drainage has been performed, but linear endoscopic ultrasound has not yet been used for this purpose. We have performed endoscopic ultrasound guided fine needle aspiration of adrenal cysts for cytologic and hormonal examination and endoscopic ultrasound guided adrenal cyst drainage, and we report here on our experiences with this technique.
Biopsy, Fine-Needle ; Drainage ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Incidence ; Rare Diseases

BACKGROUND: Infiltration of eosinophils in the nasal mucosa is a consistent feature of nasal allergic inflammation. Various cytokines, especially interleukin-5(IL-5), were identified to play important roles in the infiltration and activation of eosinophils in nasal mucosa. Our previous study found that among 4 kinds of sophoricosides extracted from Sophora japonica, named sophi, orobol, genistin, and genistein, 3 compounds except genistein known as protein tyrosine kinase(PTK) inhibitor had anti-inflammatory and anti-IL-5 effects, and sophi was the most potent. OBJECTIVE: The goal of this study was to investigate the antagonism of sophi on the nasal eosinophilia in ovalbumin(OA)-sensitized murine nasal allergy model. METHODS: Male BALB/c mice sensitized intraperitoneally and then topically with OA were treated with sophi(10 or 30mg/kg) or anti-mouse IL-5 monoclonal antibody(anti-IL-5 mAb, 1mg/Kg) intravenously 1 hour before challenge. The effect of sophi on the infiltration of eosinophils into the nasal mucosa, peripheral blood eosinophilia, nasal symptom, and OA-specific IgE antibody production were evaluated. Results: Administration of sophi(10, 30mg/kg) significantly inhibited the nasal eosinophil infiltration and nasal symptom compared to that of anti-IL-5 mAb. But eosinophil count inthe peripheral blood and the titer of OA-specific IgE were not affected by sophi. CONCLUSION: Sophi inhibited not only the tissue eosinophilia but also the acute nasal allergic symptom. These findings suggest that sophi has anti-eosinophilic cytokine activity and also plays blockade of early allergic reaction. Taken together, sophi may be a candidate for new anti-allergic medicine.
Animals ; Antibody Formation ; Cytokines ; Eosinophilia ; Eosinophils* ; Genistein ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Inflammation ; Interleukin-5 ; Male ; Mice ; Nasal Mucosa ; Sophora ; Tyrosine

An 84-year-old woman presented with obstructive jaundice due to unresectable gallbladder cancer with a left renal cell carcinoma. Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTBD) were unsuccessful because of tumor obstruction of the duodenal bulb, right hepatic duct and distal common bile duct. Endoscopic ultrasound (EUS)-guided biliary drainage with a transgastric approach was performed. A guide-wire was passed through the biliary obstruction and was successfully advanced into the duodenum via the ampulla. The procedure was completed in an antegrade fashion. The obstructed biliary system was successfully decompressed by the insertion of a biliary covered metal stent through the malignant stricture. There were no complications related to the use of this procedure.
Aged, 80 and over ; Biliary Tract ; Carcinoma, Renal Cell ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Constriction, Pathologic ; Drainage ; Duodenum ; Female ; Gallbladder Neoplasms ; Hepatic Duct, Common ; Humans ; Jaundice ; Jaundice, Obstructive ; Stents

PURPOSE: p63 is a recently described as p53 homologue. Despite their structural homologies, they have different activities. p63 is a specific myoepithelial cell marker in normal breast tissue and it is expressed in a minority of breast cancers. The aim of this study was to evaluate the prognostic significance of the p63 expression in breast cancer. METHODS: The expression of p63 in breast cancer was determined by performing immunohistochemistry on 350 patients who underwent mastectomy at the Department of Surgery at Korea University Medical Center between January 1992 and September 2004. A retrospective analysis was conducted using the medical records. A tissue microarray was constructed, and immunohistochemical analysis for p63 was performed according to the usual methods. RESULTS: Among 350 patients, 40 (11.4%) showed a p63 expression. There was a significant correlation between p63 and the histologic grade. There were significant correlations of p63 with p53 and HER2/neu, respectively. In the basal type of breast cancer, the p63 expression was significantly higher than in the luminal type of breast cancer. The 5 year disease free survival rates were 69% in the patients with a p63 expression and 76% in the patients without a p63 expression, but there was no statistical difference. CONCLUSION: The present results indicate that a p63 expression is associated with a high grade tumor, a p53 expression and a HER2/neu expression in breast cancer, which are the known poor prognostic factors of breast cancer. Immunohistochemical subtyping shows that the p63 expression is a useful predictor for the basal type of breast cancer. In addition, this study suggests that the p63 expression in the basal type of breast cancer is associated with a poor prognosis.
Academic Medical Centers ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Korea ; Mastectomy ; Medical Records ; Phenobarbital ; Prognosis ; Retrospective Studies

BACKGROUND/AIMS: Pancreatic acini of streptozotocin (STZ)-induced diabetic rats release amylase less than normal acini on cholecystokinin (CCK) stimulation. Pancreatic enzyme secretion has been closely related to the intracellular calcium concentration ([Ca2+]i) of the acinar cell. In the present study, sequential changes of the intracellular calcium signal which probably underlie the altered enzyme secretion in response to CCK-8 were investigated using pancreatic acini from diabetic rats. METHODS: Diabetic rats were prepared by single intravenous injection of STZ (70 mg/kg). Stimulating experiments with CCK-8 were performed 7 days later. Pancreatic acini were isolated by collagenase digestion. Amylase release and [Ca2+]i were measured by colorimethod and calcium imaging, respectively. The geometry of intracellular calcium signal was analyzed. RESULTS: Normal acini exhibited concentration-dependent [Ca2+]i increase and regular oscillatory calcium signal on CCK-8 stimulation. Amylase release was also concentration-dependent. However, diabetic acini showed significantly less [Ca2+]i increase, prolonged time to peak [Ca2+]i, decreased calcium spikes number, and decreased amylase release compared with normal acini. The decreased [Ca2+]i in diabetic acini was restored significantly by insulin treatment. CONCLUSIONS: Relatively decreased amylase release in diabetic pancreatic acini in response to CCK, appears to be associated with altered calcium signal due to insulin deficiency.
Amylases/*secretion ; Animals ; Calcium Signaling/*drug effects ; Diabetes Mellitus, Experimental/*physiopathology ; Pancreas/cytology/metabolism/*secretion ; Rats ; Rats, Sprague-Dawley ; Sincalide/*pharmacology

PURPOSE: To evaluate the significance of distal radioulnar joint injury which may affect the postoperative radiologic and clinical results of AO classification, type C distal radius fractures. MATERIALS AND METHODS: From October 2000 to October 2005, 58 patients of AO classification, type C distal radius fracture, who had been treated with operative methods were studied. They are thirty-six men and twenty-two women. The average follow up period was 14 months. The patients were divided into five groups. In the first group (13 cases), there was no distal radioulnar joint injuries. In the second group (20 cases), there were ulnar styloid fractures. In the third group (11 cases), there were separation of distal radioulnar joint. In the fourth group (9 cases), there were ulnar styloid fractures with separation of distal radioulnar joint. In the fifth group (5 cases), there were displacement of ulna in sagittal plane. We measured the radial length, radial inclination and volar tilt in plain radiograph in each group and analyzed the results through Scheck's methods. To analyzed the clinical results, we used the Demerit Point System by Sarmiento. RESULTS: There was no significant differences in radiologic and clinical results among the five groups. CONCLUSION: According to compairing the radiologic results of each group which was suspicious of distal radioulnar joint injuries, in the intraarticular comminuted fractures of distal radius, the distal radioulnar joint injuries did not affect the results of treatment when anatomical reduction of distal radius was achieved.
Classification ; Female ; Follow-Up Studies ; Fractures, Comminuted ; Humans ; Intra-Articular Fractures* ; Joints* ; Male ; Radius Fractures ; Radius* ; Ulna

BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is the most accurate modality in diagnosis of choledocholithiasis. However, it carries some complications. Endoscopic ultrasonography (EUS) is less invasive than ERCP and used for the diagnosis of choledocholithiasis. Recent studies showed that a usefulness of EUS for the diagnosis of small choledocholithiasis without common bile duct (CBD) dilatation. For such a reason, ERCP is being replaced by EUS in the diagnosis of bile duct stones. The aim of this study was to investigate the accuracy of EUS for the diagnosis of choledocholithiasis without CBD dilatation. METHODS: A total of 66 patients with suspected choledocholithiasis without CBD dilatation were enrolled. EUS were performed in all cases within 48 hours after computed tomography (CT) or ultrasonography (US). Final diagnosis was obtained by ERCP or clinical course (minimum 6 months follow-up). We analyzed the accuracy of US, CT, and EUS, respectively. RESULTS: CT and US were performed in 51 and 15 cases, respectively. CBD stones were detected in 23 (35%) patients by ERCP. EUS showed 100% sensitivity, 95% specificity, 92% positive predictive value, and 100% negative predictive value for identifying CBD stones. CT or US showed 26%, 93%, 67%, and 70%, respectively. There were no EUS-related complications. CONCLUSIONS: EUS was more effective than CT or US and as accurate as ERCP for the diagnosis of small choledocholithiasis without CBD dilatation. Thus, EUS may help to avoid unnecessary diagnostic ERCP and its complication.
Adult ; Aged ; Aged, 80 and over ; Choledocholithiasis/pathology/*ultrasonography ; Common Bile Duct Diseases/diagnosis ; Diagnosis, Differential ; Dilatation, Pathologic/diagnosis ; *Endosonography ; Female ; Gallstones/ultrasonography ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Tomography, X-Ray Computed