Myxofibrosarcomas (MFSs), which consist of multiple nodules with a variable cellular population in a myxoid matrix, are primarily located in subcutaneous tissue. Pleomorphic hyalinizing angiectatic tumors (PHATs) are rare soft-tissue tumors characterized by a proliferation of highly pleomorphic spindle or polygonal cells and abundant ectatic blood vessels in cellular or myxoid stroma. We present here an unusual case of a high-grade MFS with a PHAT-like appearance. A 67-year-old man presented with an asymptomatic subcutaneous mass in the right forearm. The tumor had myxoid, hypo-, and hypercellular areas with highly pleomorphic spindle or polygonal tumor cells that showed frequent mitoses and nuclear pseudoinclusions. Foci of punctuate necrosis and inflammatory infiltration were present throughout the tumor, and abundant ectatic, thick-walled vessels containing blood clots were noted. The tumor cells were immunohistochemically positive for vimentin but negative for CD34, S-100 protein, smooth muscle actin, desmin, and bcl-2.
Actins ; Aged ; Blood Vessels ; Desmin ; Forearm ; Humans ; Hyalin ; Mitosis ; Muscle, Smooth ; Necrosis ; S100 Proteins ; Sarcoma ; Subcutaneous Tissue ; Vimentin

BACKGROUND: It has been reported that hypercholesterolemia is associated with coronary heart disease and that alcohol intake has influence on the lipid metabolism. This study was conducted to evaluate the relations between alcohol intake and serum lipid level. METHODS: We reviewed 906 subjects who had visited for routine checkup at family practice of Hanil hospital and then excluded 130 subjects with DM, renal disease, thyroid disease, hepatic disease or drug administration which might have influence on serum lipids. From the remaining 776 subjects, we obtained the amount and the frequency of alcohol drinking during the previous 2 weeks and the duration of alcohol intake, using a formed questionnaire. The alcohol dependence score was recorded by the National Alcoholism Screening Test. The serum lipids such as total cholesterol, triglyceride, and HDL-cholesterol were tested by enzyme method and the obesity index was obtained by Broca's method. These data were analyzed by SAS/PC program RESULTS: The total number of subjects was 776. Of those, 67.7%(n=525) were male and 32.3%(n= 251) females. The mean age of subjects was 50.5 years(range 15 to 77 years). The distribution according to the obesity index was as follows ; underweight group 7.1%, normal-weight group 38.1%, overweight group 31.6%, obesity group 23.2%. The number of the drinkers was 382(49.2%) in males and 7 (0.9%) in females. The mean serum lipid level were compared and analyzed among the groups. The results were as follows ; the total cholesterol and triglyceride levels were higher in males and the HDL-cholesterol levels was higher in female. The total cholesterol and triglyceride levels increased with age and obesity index, the HDL-cholesterol level decreased with obesity index. In the relationship between alcohol intake and serum lipid levels in males, the geometric mean of triglyceride level was higher among all the variables of alcohol intake, and that of HDL-cholesterol level increased with the amount and the frequency of alcohol intake. The results of multiple regression analysis associated with age, obesity index, the amount and the frequency of alcohol intake in males were as follows ; the triglyceride level was positively associated with the amount of alcohol intake, and the HDL-cholesterol level was positively associated with the frequency of akohol intake. CONCLUSIONS: The effects of age, sex and the obesity index on the serum lipid level are remarkable, and in males, alcohol intake increases triglycaride and HDL-cholesterol levels. Further study is needed to find out about whether alcohol intake have influences on coronary heart disease according to serum lipid levels.
Alcohol Drinking ; Alcoholism ; Cholesterol ; Coronary Disease ; Family Practice ; Female ; Humans ; Hypercholesterolemia ; Lipid Metabolism ; Male ; Mass Screening ; Obesity ; Overweight ; Thinness ; Thyroid Diseases ; Triglycerides ; Surveys and Questionnaires

No abstract available.
Breast Neoplasms* ; Breast*

A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.
Actins ; Aneuploidy ; Coloring Agents ; Common Bile Duct ; Dendritic Cells, Follicular ; Herpesvirus 4, Human ; Immunohistochemistry ; Keratins ; Liver ; Lung ; Lymph Nodes ; Maxillary Sinus ; Membranes ; Muramidase ; Muscle, Smooth ; Myofibroblasts* ; Prognosis ; Recurrence ; S100 Proteins ; Thigh ; Urinary Bladder ; Vimentin

Objective: To evaluate circularity as a quantitative shape factor of small renal tumor on computed tomography (CT) in differentiating fat-poor angiomyolipoma (AML) from renal cell carcinoma (RCC). Materials and Methods: In 257 consecutive patients, 257 pathologically confirmed renal tumors (either AML or RCC less than 4 cm), which did not include visible fat on unenhanced CT, were retrospectively evaluated. A radiologist drew the tumor margin to measure the perimeter and area in all the contrast-enhanced axial CT images. In each image, a quantitative shape factor, circularity, was calculated using the following equation: 4 x π x (area ÷ perimeter 2 ). The median circularity (circularity index) was adopted as a representative value in each tumor. The circularity index was compared between fat-poor AML and RCC, and the receiver operating characteristic (ROC) curve analysis was performed. Univariable and multivariable binary logistic regression analysis was performed to determine the independent predictor of fat-poor AML. Results: Of the 257 tumors, 26 were AMLs and 231 were RCCs (184 clear cell RCCs, 25 papillary RCCs, and 22 chromophobe RCCs). The mean circularity index of AML was significantly lower than that of RCC (0.86 ± 0.04 vs. 0.93 ± 0.02, p < 0.001).The mean circularity index was not different between the subtypes of RCCs (0.93 ± 0.02, 0.92 ± 0.02, and 0.92 ± 0.02 for clear cell, papillary, and chromophobe RCCs, respectively, p = 0.210). The area under the ROC curve of circularity index was 0.924 for differentiating fat-poor AML from RCC. The sensitivity and specificity were 88.5% and 90.9%, respectively (cut-off, 0.90). Lower circularity index (≤ 0.9) was an independent predictor (odds ratio, 41.0; p < 0.001) for predicting fat-poor AML on multivariable logistic regression analysis. Conclusion Circularity is a useful quantitative shape factor of small renal tumor for differentiating fat-poor AML from RCC.

Objective: To evaluate circularity as a quantitative shape factor of small renal tumor on computed tomography (CT) in differentiating fat-poor angiomyolipoma (AML) from renal cell carcinoma (RCC). Materials and Methods: In 257 consecutive patients, 257 pathologically confirmed renal tumors (either AML or RCC less than 4 cm), which did not include visible fat on unenhanced CT, were retrospectively evaluated. A radiologist drew the tumor margin to measure the perimeter and area in all the contrast-enhanced axial CT images. In each image, a quantitative shape factor, circularity, was calculated using the following equation: 4 x π x (area ÷ perimeter 2 ). The median circularity (circularity index) was adopted as a representative value in each tumor. The circularity index was compared between fat-poor AML and RCC, and the receiver operating characteristic (ROC) curve analysis was performed. Univariable and multivariable binary logistic regression analysis was performed to determine the independent predictor of fat-poor AML. Results: Of the 257 tumors, 26 were AMLs and 231 were RCCs (184 clear cell RCCs, 25 papillary RCCs, and 22 chromophobe RCCs). The mean circularity index of AML was significantly lower than that of RCC (0.86 ± 0.04 vs. 0.93 ± 0.02, p < 0.001).The mean circularity index was not different between the subtypes of RCCs (0.93 ± 0.02, 0.92 ± 0.02, and 0.92 ± 0.02 for clear cell, papillary, and chromophobe RCCs, respectively, p = 0.210). The area under the ROC curve of circularity index was 0.924 for differentiating fat-poor AML from RCC. The sensitivity and specificity were 88.5% and 90.9%, respectively (cut-off, 0.90). Lower circularity index (≤ 0.9) was an independent predictor (odds ratio, 41.0; p < 0.001) for predicting fat-poor AML on multivariable logistic regression analysis. Conclusion Circularity is a useful quantitative shape factor of small renal tumor for differentiating fat-poor AML from RCC.

Glassy cell carcinoma is an unusual neoplasm of the uterine cervix with highly aggressive clinical behavior. On cervico-vaginal smear examination, the tumor has well confused of atypical repair cell of the endocervix. Recently, we have experienced two cases of glassy cell carcinoma of the uterine cervix, diagnosed on cervico-vaginal smears and confirmed on following histologic sections. The cervico-vaginal smears revealed abundant clusters with well defined boarders. The cell clusters were composed of large tumor cells. The tumor cells had distinct granular cytoplasm and eosinophilic macronucleoli. Characteristic cytologic features of this tumor were discussed in view of differential diagnosis.
Adenocarcinoma ; Breast ; Cervix Uteri ; Cytoplasm ; Diagnosis, Differential ; Eosinophils ; Female ; Hydronephrosis*

A ‘collision’ tumor refers to the existence of two different neoplasms within the same tumor. Sometimes, the term ‘biphasic tumor’ is also used. However, a ‘collision’ tumor is defined as the occurrence of two neoplasms within proximity of each other yet maintaining distinctly defined, separate boundaries. In contrast, a ‘biphasic’ tumor demonstrates two or more phenotypically distinct neoplastic cell populations merging within the same space. Here, we report a case of collision tumor associated with sarcomatoid eccrine porocarcinoma and basal cell carcinoma arising in a 57-year-old male patient.
Carcinoma, Basal Cell* ; Eccrine Porocarcinoma* ; Humans ; Male ; Middle Aged

Congenital long QT syndrome (LQTS) is an inherited disease characterized by prolonged QT intervals and polymorphic ventricular tachycardia. The clinical manifestations vary from sudden cardiac death by ventricular arrhythmia to asymptom throughout life. In 1957, Jervell and Lange-Nielsen reported a syndrome of congen-ital sensory deafness associated with a prolonged QT interval in four children. The affected children had multiple syncopal episodes, and three died suddenly. The mode of inheritance is autosomal recessive. Affected persons are susceptible to recurrent syncope, and they have a high incidence of sudden death and short life expectancy. We report a case and review the literature on long QT syndrome diagnosed in a 30-year-old female with a history of convulsion and loss of consciousness during delivery.
Adult ; Arrhythmias, Cardiac ; Child ; Deafness* ; Death, Sudden ; Death, Sudden, Cardiac ; Female ; Humans ; Incidence ; Jervell-Lange Nielsen Syndrome ; Life Expectancy ; Long QT Syndrome* ; Seizures ; Syncope* ; Tachycardia, Ventricular ; Unconsciousness ; Wills

OBJECTIVES: Apathy Evaluation Scale (AES) is one of the most frequently used scales to evaluate apathy. The purpose of this study was to evaluate the reliability and validity of the Korean version of the AES (K-AES) and to apply the K-AES in examining the characteristics of apathy in the Korean patients with schizophrenia. METHODS: 129 healthy people and 29 patients with schizophrenia have been evaluated using the K-AES, Physical Anhedonia Scale (PAS), Social Anhedonia Scale (SAS), and the Beck's Depression Inventory (BDI). Split-half reliability and internal consistency were evaluated and factor analysis and correlation analysis was conducted. Between-group comparison was conducted using independent sample t-tests. RESULTS: K-AES showed good reliability and validity. Factor analysis confirmed 3 factors, which represented interest and drive, initiative, self-awareness and self-assessment. Patients with schizophrenia showed significantly higher K-AES and BDI scores than the healthy group. K-AES scores in patients with schizophrenia were significantly correlated with the PAS score, but did not correlate with SAS and BDI scores. CONCLUSION: This study demonstrates the reliability and validity of the K-AES. Our findings also suggest that the K-AES may be a reliable instrument in assessing apathy as a negative symptom in patients with schizophrenia.
Anhedonia ; Apathy* ; Depression ; Factor Analysis, Statistical ; Humans ; Reproducibility of Results* ; Schizophrenia* ; Self-Assessment ; Weights and Measures