Hairy polyps are a rare malformations of bigerminal origin that comprise of both ectodermal and mesodermal elements. Meningothelial elements are an extremely rare pathologic finding in hairy polyps. Here we report a case of a hairy polyp with a meningothelial element, which originated from the hard palate. A 1-year-old boy was evaluated for an intraoral mass accompanied by multiple congenital anomalies. A small polypoid mass was noted at the midline of the hard palate. The lesion had central fibroconnective tissue with an unusual stromal component showing reticulated anastomosing pseudovascular patterns. Immunohistochemical staining of the cells lining the pseudovascular spaces and the interstitial cells revealed vimentin and epithelial membrane antigen positivity.

Carcinosarcoma of the stomach is a rarely occurring malignant biphasic tumor that consists of both carcinomatous and sarcomatous components simultaneously in a single tumor. The common carcinoma component is tubular or papillary adenocarcinoma and the mesenchymal sarcomatous components are variable and these include leiomyosarcoma, rhabdomyosarcoma, osteosarcoma and chondrosarcoma. However, neuroendocrine carcinomatous differentiation in the carcinomatous component is extremely rare. We present here a rare gastric carcinosarcoma that demonstrated neuroendocrine carcinomatous and leiomyosarcomatous differentiation in a 47-year-old man.
Adenocarcinoma, Papillary ; Carcinosarcoma ; Chondrosarcoma ; Humans ; Leiomyosarcoma ; Middle Aged ; Muscle, Smooth ; Neurosecretory Systems ; Osteosarcoma ; Rhabdomyosarcoma ; Stomach

Cystic lymphangioma is also known as cystic hygroma, and this is a congenital malformation of the lymphatic system. Most lymphangiomas are present at birth and they are diagnosed by the age of 2. They are mostly located in the neck or axillary region. The breast as a site of origin is an extremely unusual location, and especially in adults. We report here on a case of cystic lymphangioma in a 36-year-old woman. Physical examination revealed a tender cystic mass in the upper outer quadrant of the right breast. Ultrasonography revealed an irregular hypoechoic mass lesion that was associated with irregular duct dilatation and several enlarged axillary lymph nodes. After the operation, the mass was revealed to be a cystic lymphangioma. Although it is very rare, cystic lymphangioma should be considered in the differential diagnosis of a breast mass in adults.
Adult ; Male ; Female ; Humans ; Diagnosis, Differential

OBJECTIVE: To induce a mouse model of scleroderma with repeated bleomycin injections for research into human scleroderma at our research laboratory. METHODS: The protocol of Yamamoto et al. was replicated to establish the bleomycin-induced mouse model of scleroderma. RESULTS: A mouse model of scleroderma was induced by repeated subcutaneous injections of bleomycin. The dermal thickness increased with homogeneous and thickened collagen bundles. Semiquantitative measurements of dermal fibrosis were prominent in bleomycin-treated mice. CONCLUSION: A mouse model of scleroderma was induced with repeated injections of bleomycin at our laboratory.
Animals ; Bleomycin ; Collagen ; Fibrosis ; Humans ; Injections, Subcutaneous ; Mice ; Models, Animal

PURPOSE: During hemodialysis, various methods are used to evaluate adequate water removal; however, few of them are currently clinically applicable. To evaluate the differences of body fluid changes, we have compared changes of ICW (intracellular water) and ECW (extracellular water) before and after hemodialysis in diabetic and non-diabetic patients with MF-BIA. Also various factors influencing in this transcellular body fluid shift were evaluated. METHODS: TBW (total body water), ICW, ECW were measured before and after hemodialysis by using MF-BIA in 85 stable maintenance hemodialysis patients in a university hospital. Among these patients, 30 patients (mean age 55.6+/-12.4 year-old, average dialysis duration 26 months) were diabetic, while 55 patients (mean age 47.1+/-13.0 year-old, average dialysis duration 69 months) were non-diabetic. RESULTS: ECW/TBW in diabetic and non-diabetic patients were 0.338+/-0.02, 0.334+/-0.02, respectively. There was no significant difference between two groups. There were also no significant differences in the sex, age, duration of dialysis, BMI, hemoglobin, total protein, osmolarity of ICW loss/TBW removal. But there was a significant positive correlation between the increase in ultrafiltration volume (UFV:%) and ICW loss in diabetic patients (R=0.51, p=0.019); however, such correlation was not observed in non-diabetic patients. CONCLUSION: We found that ICW of diabetic patients moved to extracellular spaces even before achieving appropriate dry body weight or less amount of fluid was removed compared to non-diabetic patients. This finding might imply diabetic ESRD patient has relatively low cellular membrane integrity and oncotic pressure maintenance ability to physical transmembrane pressure.
Body Fluids ; Body Weight ; Diabetes Mellitus ; Dialysis ; Electric Impedance ; Extracellular Space ; Hemoglobins ; Humans ; Kidney Failure, Chronic ; Maintenance ; Membranes ; Osmolar Concentration ; Renal Dialysis ; Ultrafiltration

Background and Objectives: O-cyclic phytosphingosine-1-phosphate (cP1P) is a synthetic chemical and has a structure like sphingosine-1-phosphate (S1P). S1P is known to promote cell migration, invasion, proliferation, and anti-apoptosis through hippocampal signals. However, S1P mediated cellular-, molecular mechanism is still remained in the lung.Acute lung injury (ALI) and its severe form acute respiratory distress syndrome (ARDS) are characterized by excessive immune response, increased vascular permeability, alveolar-peritoneal barrier collapse, and edema. In this study, we determined whether cP1P primed human dermal derived mesenchymal stem cells (hdMSCs) ameliorate lung injury and its therapeutic pathway in ALI mice. Methods: and Results: cP1P treatment significantly stimulated MSC migration and invasion ability. In cytokine array, secretion of vascular-related factors was increased in cP1P primed hdMSCs (hdMSCcP1P ), and cP1P treatment induced inhibition of Lats while increased phosphorylation of Yap. We next determined whether hdMSCcP1P reduce inflammatory response in LPS exposed mice. hdMSCcP1P further decreased infiltration of macrophage and neutrophil, and release of TNF-α, IL-1β, and IL-6 were reduced rather than naïve hdMSC treatment. In addition, phosphorylation of STAT1 and expression of iNOS were significantly decreased in the lungs of MSCcP1P treated mice. Conclusions Taken together, these data suggest that cP1P treatment enhances hdMSC migration in regulation of Hippo signaling and MSCcP1P provide a therapeutic potential for ALI/ARDS treatment.

We describe herein a rare case of a laryngeal myxoma presenting as a nodule. Laryngeal myxomas involving the neck region, especially the laryngeal area, are quite rare. A 36-year-old male patient presented with a 2 month history of hoarseness. On laryngoscopic examination, there was a myxoid homogeneous transparent mass on the right vocal cord. On microscopic examination, the lesion was hypocellular and myxoid. The lesion showed stellate or spindle cells which were evenly dispersed in the poorly vascularized myxoid stroma. Although the incidence is extremely rare, a laryngeal myxoma should be considered in the differential diagnosis of laryngeal masses.
Male ; Humans ; Diagnosis, Differential ; Incidence

A coronary arteriovenous (AV) fistula consists of a communication between a coronary artery and a cardiac chamber, a great artery or the vena cava. It is the most common anomaly that can affect coronary perfusion. Yet bilateral involvement of a coronary fistula, constitutes an uncommon subgroup of coronary AV fistulas. We herein report on a case of bilateral coronary AV fistula that was coexistent with variant angina originating from the distal right ventricular branch of the right coronary artery and the distal septal branch of the left anterior descending artery, and the latter drained into the right ventricle.
Angina Pectoris, Variant/*etiology/radiography ; Coronary Vessel Anomalies/*complications/*diagnosis ; Female ; Heart Ventricles/*abnormalities ; Humans ; Middle Aged ; Vascular Fistula/complications/*congenital/*diagnosis

Obesity hypoventilation syndrome (OHS) is characterized by severe obesity, excessive daytime sleepiness, hypoxemia and hypercapnea. Because OHS mimics pulmonary hypertension or cor pulmonale, clinicians should recognize and treat this syndrome appropriately. A 58-year-old female visited the emergency room because of dyspnea. She was obese and had kyphoscoliosis. The patient also experienced snoring, recurrent choking during sleep and daytime hypersomnolence which worsened after gaining weight in the recent year. The arterial blood gas analysis showed she experienced hypoxemia and hypercapnea not only during nighttime but also daytime. We suspected OHS and the patient underwent polysomnography to confirm whether obstructive sleep apnea was present. During the polysomnography test, sleep obstructive apnea was observed and apnea-hypopnea index was 9.2/hr. The patient was treated with bilevel positive airway pressure therapy (BiPAP). After BiPAP for 4 days, hypoxemia and hypercapnia were resolved and she is currently well without BiPAP. We report a case successfully treated with clinical improvement by presuming OHS early in a patient who had typical OHS symptoms, even while having other conditions which could cause hypoventilation.
Airway Obstruction ; Anoxia ; Apnea ; Blood Gas Analysis ; Disorders of Excessive Somnolence ; Dyspnea ; Emergency Service, Hospital ; Female ; Humans ; Hypercapnia ; Hypertension, Pulmonary ; Hypoventilation ; Middle Aged ; Obesity Hypoventilation Syndrome* ; Obesity, Morbid ; Polysomnography ; Pulmonary Heart Disease ; Sleep Apnea, Obstructive ; Snoring

PURPOSE:Cardiovascular disease is the predominant cause of death in patients with end stage renal disease. Approximately 33.7% of overall mortality is due to cardiovascular disease, and about 27% of these cardiovascular deaths are attributed to acute myocardial infarction (AMI). Despite the significance of AMI, there are little data on the clinical characteristics of AMI in dialysis patients. METHODS:Thirty-two dialysis patients admitted for AMI from January 2004 to December 2007 were retrospectively analyzed. One hundred twenty-three AMI patients were included as a control. The clinical and laboratory findings of AMI were compared between dialysis patients and non-dialysis patients. RESULTS:The frequency of typical chest pain was significantly lower in dialysis patients than in non- dialysis patients (18.8% vs. 62.6%, p<0.001), and typical ECG findings of STEMI were significantly less noted (28.1% vs. 82.9%, p<0.001). Increases in CPK, CK-MB, and troponin T levels were significantly lower in dialysis patients than in non-dialysis patients ( p<0.001). In contrast, dialysis patients revealed more multi-vessel diseases on coronary angiography and more left ventricular hypertrophy and were associated with higher mortality during admission than non-dialysis patients. CONCLUSION:Although dialysis patients with AMI had less typical chest pain and typical ECG findings, and had lower increases in cardiac enzyme levels, they revealed more severe coronary vessel diseases than non-dialysis patients. Therefore, efforts for early and accurate diagnosis of AMI are needed in dialysis patients with nonspecific complaints of AMI.
Cardiovascular Diseases ; Cause of Death ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Dialysis ; Electrocardiography ; Glycosaminoglycans ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Myocardial Infarction ; Retrospective Studies ; Troponin T