No abstract available.
Chin* ; Hemangioma*

p27Kip1 has been recognized as a negative regulator of cell cycle. Reduced level of p27 expression is associated with development and aggressiveness of several human tumors. To investigate the role of p27Kip1 on progression of colorectal adenocarcinoma, we studied 40 cases of human colorectal adenocarcinomas for expression of p27Kip1 protein using an immunohistochemical method, and compared these results with known prognostic parameters of colorectal adenocarcinoma. Among 40 cases of colorectal adenocarcinomas, p27Kip1 expression was detected in the nuclei of tumor cells in 14 cases (35%). The expression rate of p27Kip1 protein was significantly lower in the cases with lymph node metastasis (25.8%) than in those without lymph node metastasis (66.6%) (p<0.05). But it did not correlate with other parameters such as tumor size, histologic grade, vascular invasion, and Ki-67 labeling index. The results suggest that reduced expression of p27Kip1 protein plays a role in biologically aggressive behavior of colorectal adenocarcinoma.
Adenocarcinoma* ; Cell Cycle ; Cyclin-Dependent Kinase Inhibitor p27* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

Amyloid goiter is a rare disease entity that is defined as a symptomatic mass or clinically detectable thyroid enlargement because of amyloid deposition. We present a case of amyloid goiter diagnosed in the fine needle aspiration cytology(FNAC) in a 73-year-old Korean woman presented with nephrotic syndrome and thyroid enlargement. The thyroid function was in normal range. Thyroid scan showed a nodule, 4x2 cm in the right lobe with underlying diffuse goiter. Aspirates revealed benign looking follicular cells and scattered eosinophilic material. The sections of the cell block showed nodular deposit of eosinophilic hyalinized material in the interfollicular area. It showed apple-green birefringence under polarization with Congo red stain. The renal biopsy also exhibited deposition of eosinophilic materials in the glomeruli and interstitial vascular wall, which were confirmed as amyloidosis. This material was morphologically distinct from the colloid.
Aged ; Amyloid* ; Amyloidosis ; Biopsy ; Biopsy, Fine-Needle* ; Birefringence ; Colloids ; Congo Red ; Eosinophils ; Female ; Goiter* ; Humans ; Hyalin ; Nephrotic Syndrome ; Plaque, Amyloid ; Rare Diseases ; Reference Values ; Thyroid Gland

Synovitis is the inflammation of the synovial membrane with unknown etiology which occurs in association with auto-immune inflammatory arthritis, mainly in rheumatoid arthritis. Synovitis manifesting as rapidly progressing monoarticular or pauciarticualr symptoms could make early diagnosis difficult, thus it could be misdiagnosed as other forms of arthritic diseases. We experienced a rare case of knee joint synovitis which initially manifested as mimicking a septic arthritis. A 58-year-old-male patient underwent renovascular embolization due to retroperitoneal hemorrhage which was developed after renal biopsy. Suddenly, the patient's left knee joint became swollen rapidly with redness and tenderness. Moreover, his right knee also became inflamed. Surgical irrigation and intravenous antibiotics had never worked on his knee joint inflammation, however administration of intermediate dose of steroid could decrease inflammatory signs dramatically. Synovitis in a large joint could be mistaken as a septic arthritis, delaying the right diagnosis. Thus, we report this case with literature review.
Anti-Bacterial Agents ; Arthritis ; Arthritis, Infectious* ; Arthritis, Rheumatoid ; Biopsy ; Diagnosis ; Early Diagnosis ; Hemorrhage ; Humans ; Inflammation ; Joints ; Knee Joint ; Knee* ; Synovial Membrane ; Synovitis*

Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.
Bradycardia ; Cardiomyopathies* ; Coronary Angiography ; Coronary Artery Disease ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Failure ; Hormone Replacement Therapy* ; Humans ; Hypopituitarism ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; Takotsubo Cardiomyopathy ; Thyroxine

OBJECTIVE: To estimate the cardiovascular (CV) and gastrointestinal (GI) risks of etoricoxib in the treatment of osteoarthritis (OA) compared to a placebo and other non-steroidal anti-inflammatory drugs (NSAIDs). METHODS: A systematic review of randomized, controlled trials (RCTs) of etoricoxib were performed. Bayesian network meta-analysis was used over a duration of 12 weeks. The incidence of CV and GI events for a duration ≥26 weeks were also tabulated and presented using descriptive statistics. RESULTS: From this search, 10 studies were identified. Of these, 6 and 5 RCTs that measured the CV and GI events at 12 weeks were included in meta-analysis. They showed that etoricoxib did not increase the CV events compared to the placebo or NSAIDs during the 12 week period (odds ratio [OR]=0.59 compared to celecoxib, OR=0.89 with ibuprofen, OR=0.70 with placebo, and OR=2.16 with naproxen). The risk of GI events was comparable to that of most comparators, with the exception of naproxen, which had a significantly lower risk of GI events (OR=0.18) during the 12 week period. For a duration ≥26 weeks, the incidence of CV and GI events with etoricoxib increased with increasing duration. CONCLUSION: Etoricoxib is an alternative short-term treatment option for OA, showing comparable CV and GI complications to other NSAIDs. Nevertheless, further studies will be needed to elucidate the long-term safety of etoricoxib in the treatment of OA.
Anti-Inflammatory Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Celecoxib ; Ibuprofen ; Incidence ; Naproxen ; Osteoarthritis*

The intracranial hematoma following cerebral aneurysmal rupture makes patient's clinical status and outcome worse by pressure effect on the brain structure. It's incidence has varied with authors between 5-30% of patients with ruptured cerebral aneurysms. Several authors emphasized the importance of early operation to obtain better results by early removal of hematoma and reducing intracranial pressure. The authors retrospectively evaluated seventy-six patients with intracranial hematomas in 370 patients with ruptured aneurysms from Jan. 1987 to Dec. 1992. The incidence of hematoma resulting from ruptured aneurysm was 20.5%. The most frequent site of aneurysm which was accompanied by intracranial hematoma was the middle cerebral artery, and the next was the anterior cerebral artery. The amount of hematoma and/or evidence of midline shift were the important factors in predicting the clinical outcome. The most favorable outcome was found in cases with intracerebral hematoma only, and the worst was in cases with intracerebral hematoma associated with intraventricular hemorrhage. Fifty out of 76 patients with intracranial hematomas were operated on. Their outcomes were more favorable than in the patients who were not operated on. Aggressive surgical intervention was especially effective in patients with poor Hunt & Hess grades(IV or V) .
Aneurysm ; Aneurysm, Ruptured* ; Anterior Cerebral Artery ; Brain ; Hematoma* ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm ; Intracranial Pressure ; Middle Cerebral Artery ; Retrospective Studies ; Rupture

Retroperitoneal fibrosis (RPF) is a rare, progressive disease characterized by chronic non specific inflammation of the retroperitoneum. Although the pathogenesis of idiopathic retroperitoneal fibrosis (IRF) remains unclear, IRF has been reported in association with autoimmune disorders. However, few cases of IRF associated with rheumatoid arthritis (RA) have been reported. We experienced a rare case of IRF in a patient with RA and chronic B viral hepatitis. A 39-year-old Korean man with RA and hepatitis B was referred to our hospital due to left hydronephrosis. An abdominal computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a diffuse infiltrating retroperitoneal mass around the abdominal aorta and left ureter. The patient underwent intraureteral stent insertion and was treated with corticosteroid. Three months later, the follow up abdominal CT showed that the retroperitoneal mass had decreased in size. Herein, we report the first case of coexistent IRF, RA, and chronic B viral hepatitis with a literature review.
Adult ; Aorta, Abdominal ; Arthritis, Rheumatoid* ; Follow-Up Studies ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Hydronephrosis ; Inflammation ; Magnetic Resonance Imaging ; Retroperitoneal Fibrosis* ; Stents ; Tomography, X-Ray Computed ; Ureter

Verruca plana is a subtype of warts, which are one of the most common dermatological diseases. A 37-year-old man presented with multiple asymptomatic skin-colored, 1∼2-mm, flat-topped papules on both arms, neck, and face. The patient had ulcerative colitis, which had been treated with immunosuppressants for 15 years. After skin biopsy, verruca plana was confirmed. The patient was treated with 5% imiquimod cream for 6 months. However, only mild improvement was observed. Acitretin was then added to the treatment regimen. After 44 weeks of treatment, acitretin was stopped. Dramatic and rapid clinical improvement was achieved after 3 weeks of treatment, and no sign of recurrence after treatment cessation has been reported for 60 weeks. Consequently, the combination of oral acitretin and topical 5% imiquimod cream should be recommended for the effective and safe treatment of recalcitrant verruca plana in immunosuppressed patients.
Acitretin* ; Adult ; Arm ; Biopsy ; Colitis, Ulcerative ; Humans ; Immunosuppressive Agents ; Neck ; Recurrence ; Skin ; Warts* ; Withholding Treatment

Background: s/Aims: This study was performed to reveal the usefulness of the trabecular bone score (TBS) in assessing bone strength in patients with ankylosing spondylitis (AS) in comparison with dual-energy X-ray absorptiometry (DXA) methods. Methods: A total of 215 AS patients (75.8% male) were enrolled from a single university hospital in Korea. Demographic and clinical information were assessed. Patients completed X-rays of the cervical and lumbar spine (L-spine), and spinal ankyloses were quantified using the modified Stoke AS Spine Score (mSASSS). Hip, anteroposterior and lateral L-spine bone mineral density (BMD) and TBS were assessed by DXA methods. Clinical characteristics and bone strength measurement results were compared between male and female AS patients. The accuracy of each bone strength evaluation method in predicting Fracture Risk Assessment Tool (FRAX) scores indicating moderate or higher fracture risk was compared by receiver operating characteristic curves in patients aged ≥ 40 years. Correlations between each bone strength measurement method and mSASSS were examined. Results: Male patients showed higher mSASSS and less prevalent peripheral joint involvement compared to female patients (p < 0.05). TBS, hip BMD, and L-spine lateral BMD showed comparably high areas under the curve (AUCs) for predicting FRAX-major osteoporotic fractures (MOF) ≥ 10% (AUC ranged 0.72 to 0.76). TBS negatively correlated with mSASSS in both male and female patients (p < 0.01). Conclusions TBS could predict the risk of MOF and is not influenced by spinal osteoproliferation in AS patients, even in those with advanced spinal changes.