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

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.

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

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

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

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

BACKGROUND: Changes in airway mucosal osmolarity are an underlying mechanism of bronchoconstrictive responses to exercise and hypertonic saline (HS). The purpose of this study was to examine whether an osmotic challenge test using HS can predict exercise-induced bronchospasm (EIB) in asthma patients. METHODS: Thirty-six young male asthmatic patients underwent bronchial challenge tests based on 4.5% HS, exercise (> 24h later), and methacholine (MCh) at the Chonnam National University Hospital. The relationships between responses to HS and exercise, and between MCh and exercise were evaluated. RESULTS: The maximal fall in forced expiratory volume in one second following exercise was significantly higher in the HS-responders (n=19) than in the HS-nonresponders (n=17, 35.9+/-4.1% vs. 17.9+/-2.7%, p< 0.001), and there was a significant correlation between the severity of EIB and HS-airway hyperresponsiveness (AHR). When compared with the MCh-AHR test in terms of predicting EIB, the HS-AHR test showed higher specificity (71.4% vs. 42.9%), but a lower sensitivity (58.6% vs. 89.7%) and negative predictive value (29.4% vs. 50.0%). At the moderate AHR cutoff value, the MCh-AHR test had a specificity that was comparable with and predictive values that were higher than those of the HS-AHR test. CONCLUSIONS: The HS-AHR test was more specific than the MCh-AHR test, but was less sensitive and had a poorer negative predictive value, which in combination preclude the use of the HS-AHR test as a screening tool for EIB. The MCh-AHR test had a cutoff value for moderate AHR that may be more useful for predicting EIB in asthmatic patients.
Saline Solution, Hypertonic/*diagnostic use ; Predictive Value of Tests ; Methacholine Chloride/diagnostic use ; Male ; Humans ; Bronchoconstrictor Agents/diagnostic use ; Bronchial Provocation Tests/*methods ; Bronchial Hyperreactivity/*diagnosis ; Asthma, Exercise-Induced/*diagnosis ; Adult ; Adolescent

PURPOSE: It is important to differentiate non-diabetic renal diseases (NDRD) from diabetic nephropathy (DN) in type 2 diabetes. Our study was reviewing the clinical data and treatment strategies from diabetic patients performed renal biopsy to determine the clinical indicators suggestive of NDRD METHODS: We reviewed the medical records of type 2 patients who underwent renal biopsy from Jan. 1995 to Dec. 2007. RESULTS: Seventy four patients were included. Mean age was 52.0+/-12.5 years and 41 (55%) patients were male suddenly developed. Nephrotic syndrome [34 cases (46%)] was the leading reason for renal biopsy. There were 37 cases (50%) with a pathologic diagnosis of DN, 31 (42%) with NDRD, and 6 (8%) with concurrent DN and NDRD. IgA nephropathy (35%) was the most common lesion found in patients with NDRD. Thirty one patients (84%) with DN and 26 (84%) with NDRD had follow-up periods of more than 6 months. Of 26 patients with NDRD, 12 were treated with immune suppressants and 6 achieved complete remission. Thirteen patients with DN and one with NDRD developed end-stage renal disease. Patients with NDRD tended to show shorter duration of diabetes, lower systolic blood pressure (SBP) and lower serum triglyceride, and had significantly lower incidence of diabetic retinopathy (DR). In the univariate regression analysis, diabetes duration, SBP, triglyceride and DR showed statistically significance. And SBP and DR were identified as independent correlating factors by multivariate regression analysis. CONCLUSION: In this study, the absence of retinopathy could predict the presence NDRD among NIDDM patients presenting with renal disease. And additional disease-specific therapies may be helpful for the patients with NDRD.
Biopsy ; Blood Pressure ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Diabetic Retinopathy ; Follow-Up Studies ; Glomerulonephritis, IGA ; Humans ; Incidence ; Kidney Failure, Chronic ; Male ; Medical Records ; Nephrotic Syndrome

We experienced a 59 year-old female diabetic CAPD patient with severe peritonitis due to perforated acute cholecystitis. Because of heart failure due to old myocardial infarction and cerebral infarction she had been treated with CAPD for 5 years in bed-ridden state. Initial presentation was dark brown colored peritoneal dialysate effluent (changed greenish bile color later) and septic shock. We diagnosed perforated acute cholecystitis by computerized tomography three days after improvement of sepsis. She was received laparoscopic cholecystectomy and continuous venovenous hemodiafiltration for two weeks and returned to peritoneal dialysis without complication. Secondary CAPD peritonitis with cholecystitis or bowel disease should be carefully considered in patients with specific dialysate color, which could be cured with laparoscopic surgery, and then patients can be returned to CAPD again without complication.
Bile ; Cerebral Infarction ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute ; Female ; Heart Failure ; Hemodiafiltration ; Humans ; Laparoscopy ; Myocardial Infarction ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Sepsis ; Shock, Septic