Vaginal Brenner tumor is extremely rare. Only five cases have been reported in the English literature to date. Here we report a vaginal Brenner tumor in a 76-year old postmenopausal woman, who presented with a 2.5cm-sized sessile vaginal polyp. Microscopically, it showed characteristic features of Brenner tumor consisting of three components; transitional islands, glands, and dense fibrous stroma. The epithelial tumor cells were positive for GATA-3, p63 and ER, but negative for PAX8. The origin of Brenner tumors in the vagina is unclear, but previous reports suggested of Müllerian origin. However, our case revealed that vaginal Walthard nests could be possible precursor lesions based on their immunohistochemical staining results.

OBJECTIVES: The aim of this study is to verify the status and the clinical significance of BRAF and NRAS mutations in patients of one of the university hospitals in Korea. METHODS: Polymerase chain reaction (PCR) amplification and direct sequencing were performed for the analysis of melanoma samples (n=22) for the detection of mutations in exon 15 of the BRAF gene, and exons 2 and 3 of the NRAS gene in genomic DNA. Mutations of the BRAF gene were correlated with the clinicopathologic features of patients and the BRAF mutation status was compared in 18 paired primary and metastatic tumors. RESULTS: Incidence of somatic mutations within the BRAF and NRAS genes was 27.3% (6/22) and 0% (0/22), respectively. Age, gender, Breslow thickness, and ulceration did not show correlation with BRAF mutations. Among 18 patients with metastasis, BRAF mutation was detected in 22.2% of cases (4/18), and all four cases with BRAF mutations were identified in metastatic lymph node tissues. BRAF mutations were only found in lymph node metastases, which was statistically significant (28.6% vs 0%, P<0.01). CONCLUSION: The incidence of BRAF mutation is as low as in other Asian reports and the NRAS mutation was not found in patients of our institute.
Asian Continental Ancestry Group ; DNA ; Exons ; Hospitals, University ; Humans ; Incidence ; Korea ; Lymph Nodes ; Melanoma* ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Prevalence* ; Ulcer

The incidence of renal cell neoplasms has been increased in worldwide as well as in Korea. Even though the World Health Organization (WHO) Classification of renal tumors (2004) is currently used, new entities require to be added in the updated classification because of recent modification with our understanding of the molecular biology and different clinical behavior of new renal tumors. In this review, recently described tumors and candidate entities will be discussed. It is of importance to know these new entities for the proper diagnosis, treatment, and their prognosis.
Carcinoma, Renal Cell ; Classification ; Diagnosis ; Incidence ; Korea ; Molecular Biology ; Prognosis ; World Health Organization

Purpose: The purpose of this longitudinal study was to identify the relationship between the readiness for hospital discharge and self-care changes in an early stage of liver transplantation after discharge. Methods: Data of 75 liver transplant recipients within one year of surgery from a transplantation center from May 2019 to May 2020 were collected for this study. Their readiness for discharge was measured before discharge. Self-care after liver transplantation was evaluated at one week, one month, and three months of discharge at outpatient visits. Linear mixed model was used to evaluate the statistical relationship. Results: The readiness for hospital discharge was significantly higher when the caregiver was a spouse (p = .027), with fewer post-transplantation days (p = .027), absence of acute rejection (p = .004), or high self-efficacy (p < .001). As a result of the linear mixed model analysis, the higher the discharge readiness score, the higher the self-care score (β = 0.29, p < .001). However, after three months, their self-care had decreased regardless of their level of readiness for hospital discharge compared to one week after discharge. Conclusion Improving the readiness before discharge is essential to enhance self-care. Also, active intervention at 3 months of discharge should be performed to check and promote their long-term self-care.

Ectopic liver is a rare entity that has been previously identified during abdominal exploration for other surgery and this has usually been described in the vicinity of the liver such as on the gallbladder, hepatic ligaments, diaphragm, thoracic cavity, adrenal glands, pancreas, omentum, spleen, esophagus and umbilical cord. Most cases of ectopic liver reported in the literature were located in the gallbladder. We report here on a case of ectopic liver related to the gallbladder, and this was encountered during an elective laparoscopic cholecystectomy.

Intraluminal duodenal diverticulum (IDD) is a rare congenital abnormality, consisting of a sac-like mucosal lesion in the duodenum. Cases of IDD can present with gastrointestinal bleeding, duodenal obstruction, or pancreatitis. Here, we report a rare case of a 25-year-old female presenting with IDD complicated by duodeno-duodenal intussusception and recurrent pancreatitis. The diagnosis was based on findings from radiologic examinations (CT and MRI), upper gastrointestinal series (barium swallow), and gastroduodenofiberscopy. Laparoscopic excision of the presumed duodenal duplication was performed. The subsequent histopathologic evaluation of the excised sac revealed normal mucosa on both sides, but the absence of a proper muscle layer confirmed the diagnosis of IDD. Radiologic detection of a saccular structure in the second portion of the duodenum can indicate IDD with duodeno-duodenal intussusception as the lead point

OBJECTIVES: The aim of the study was to assess the intake of dietary cholesterol and its major food sources in the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 20,671 nationally representative sample who had 24-hour recall data from the KNHANES VI (2013–2015) was included in this study. Mean cholesterol intake and the prevalence of subjects with cholesterol intake over the Intake Goal of the Dietary Reference Intakes (DRIs) for Koreans were analyzed. Intakes of cholesterol by food groups or each food were calculated to find out the major food sources for cholesterol intake in Koreans. RESULTS: The mean dietary cholesterol intake was 261.3 mg, which was higher in men (303.5 mg) compared to women (219.1 mg). Dietary cholesterol intake and the prevalence of subjects with cholesterol intake over the Intake Goal of DRIs were the highest in the 19-29 year old group. The eggs was the first major food group source for cholesterol intake in all age groups. Major food sources for cholesterol intake among Korean were egg, chicken, pork, squid and beef, which contributed 66.9% to total cholesterol intake. CONCLUSIONS: Although the mean dietary cholesterol intake was under 300 mg, the prevalence of subjects with cholesterol intake over the Intake Goal of DRIs was about 30% in adults. Because both the mean intake and the prevalence of subjects with cholesterol intake over the Intake Goal of DRIs were higher in young adult groups, the dietary cholesterol intake was expected to be increased.
Adult ; Chickens ; Cholesterol ; Cholesterol, Dietary* ; Decapodiformes ; Eggs ; Female ; Humans ; Korea* ; Male ; Nutrition Surveys* ; Ovum ; Prevalence ; Recommended Dietary Allowances ; Red Meat ; Young Adult

A 50-year-old peri-menopausal woman presented with hard palpable mass on her lower abdomen and anemia from heavy menstrual bleeding. Ultrasonography showed a 13x12 cm sized hypoechoic solid mass in pelvis and a 2.5x2 cm hypoechoic cystic mass in uterine endometrium. Abdomino-pelvic computed tomography revealed a hypodense pelvic mass without enhancement, suggesting a leiomyoma of intraligamentary type or sex cord tumor of right ovary with submucosal myoma of uterus. Laparoscopy revealed a large Sertoli-Leydig cell tumor of right ovary with a very rare entity of intra-endometrial uterine leiomyoma accompanied by adenomyosis. The final diagnosis of ovarian sex-cord tumor (Sertoli-Leydig cell), stage Ia with intra-endometrial leiomyoma with adenomyosis, was made. Considering the large size of the tumor and poorly differentiated nature, 6 cycles of chemotherapy with Taxol and Carboplatin regimen were administered. There is neither evidence of major complications nor recurrence during 20 months' follow-up.
Adenomyosis/*diagnosis/drug therapy ; Carboplatin/therapeutic use ; Female ; Humans ; Laparoscopy ; Leiomyoma/*diagnosis/drug therapy ; Male ; Menorrhagia ; Middle Aged ; Neoplasm Recurrence, Local ; Paclitaxel/therapeutic use ; Sertoli-Leydig Cell Tumor/*diagnosis/drug therapy ; Treatment Outcome ; Uterine Neoplasms/*diagnosis/drug therapy

Purpose: The study aimed to investigate the role of Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) in predicting incidental prostate cancer (PCa) or urothelial carcinoma (UCa) extension in urinary bladder (UB) cancer patients. Materials and Methods: A total of 72 UB cancer patients who underwent radical cystoprostatectomy and 3 Tesla multiparametric MRI before surgery were enrolled. PI-RADS v2 ratings were assigned by two independent radiologists. All prostate specimens were examined by a single pathologist. We compared the multiparametric MRI findings rated using PI-RADS v2 with the pathologic data. Results: Of the 72 UB cancer patients, 29 had incidental PCa (40.3%) and 20 showed UCa extension (27.8%), with an overlap for 3 patients. With a score of 4 as the cut-off value for predicting incidental PCa, the diagnostic accuracy was 65.3%, specificity was 90.7%, and positive predictive value (PPV) was 66.7%. The diagnostic accuracy for incidental UCa extension was 47.2%, specificity was 92.3%, and PPV was 83.3%. Conclusion Despite the low diagnostic accuracy, the PPV and specificity were relatively high. Therefore, PI-RADS v2 scores of 1, 2, or 3 may help exclude the probability of incidental PCa or UCa extension.

A 31-year-old Korean male presented with altered consciousness and severe headache. Brain MRI delineated focal leptomeningeal enhancement without any intracerebral lesions. Diagnosis was made based on a brain biopsy showing anaplastic large cell lymphoma (ALCL), immunohistochemical stains revealing positivity for anaplastic lymphoma kinase (ALK) and an absence of involvement in any other organs; specifically, the primary central nervous system ALK+ALCL. Complete remission was achieved following 5 cycles of systemic chemotherapy with a high dose of Methotrexate and a simultaneous 7 cycles of intrathecal triple chemotherapy. Diagnosis of primary leptomeningeal ALK+ALCL is challenging given its rarity and non-specific symptoms along with non-pathognomonic radiologic findings. We present the first case of primary leptomeningeal ALK-positive ALCL where the clinical course, pathologic characteristics and treatment modality are described as well as a review of literature.
Adult ; Antineoplastic Agents/therapeutic use ; Biopsy ; Brain/metabolism/pathology ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Lymphoma, Large-Cell, Anaplastic/*diagnosis/drug therapy/pathology ; Male ; Meningeal Neoplasms/*diagnosis/drug therapy/pathology ; Receptor Protein-Tyrosine Kinases/*metabolism