Osteochondroma is one of the most common benign tumor. But, intraarticular occurrence is very rare. This tumor have been thought not a true neoplasm hut a developmental malformation or harnartoma. The authors experienced a case of intaarticular osteochondroma arising from inferior pole of pateUa, projecting into the infrapatellar fat pad. The tumor was excised surgically, and symptoms were relieved.
Adipose Tissue ; Knee ; Osteochondroma* ; Patella*

BACKGROUND: Resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), such as gefitinib, is a limited factor in the treatment of non-small-cell lung cancer (NSCLC) patients. Therefore, ongoing studies are trying to identify EGFR-TKIs-resistant mechanisms and to discover novel therapeutic strategies and targets for NSCLC treatment.METHODS: In the present study, the possibility of overcoming intrinsic gefitinib-resistance was examined by regulating the expression of AXL. A natural product-derived antitumor agent, yuanhuadine (YD) was employed to modulate the expression of AXL in the cells.RESULTS: Treatment with YD effectively downregulated AXL expression in AXL-overexpressed gefitinib-resistant H1299 cells. The combination of gefitinib and YD exhibited a synergistic grwoth-inhibitory activity in H1299 cells by downregulation of AXL expression.CONCLUSIONS: Based on these findings, AXL was found to be a promising therapeutic target to overcome the intrinsic resistance to gefitinib in NSCLC. Furthermore, YD is able to effectively regulate the expression of AXL and thus it may be applicable as a potential lead compound for the treatment of gefitinib-resistant NSCLC.
Carcinoma, Non-Small-Cell Lung ; Down-Regulation ; Drug Resistance ; Humans ; Lung Neoplasms ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor

The tissues of gluteal region including skin and underlying gluteus maximus muscle are used for reconstructions of head and neck deformities caused by trauma and lumbosacral defects caused by bed sores, and for reconstruction of breast. Moreover, gluteus maximus flaps were used for reconstruction of anal -and vaginal -sphincter dysfunctions after radical resection for treatment of cancer in anorectal or vaginal region. Because the knowledge on the precise course and branching patterns of the arteries supplying the gluteus maximus muscle enables the prediction of the safety of surgery, the perforating branches supplying skin and subcutaneous tissues which exited from the gluteus maximus muscle, the positions of the superior and inferior gluteal arteries exited from pelvic cavity under the gluteus maximus muscle, and the course of these arteries under surface of the muscle were investigated. Total ninety -one dissected gluteus maximus from 47 Korean cadavers (44 bilateral specimens and 3 unilateral specimens) were observed. The perforating branches exited from the gluteus maximus were divided into upper and lower parts. The superior gluteal artery supplied upper two fifth of gluteal region and the inferior gluteal artery supplied the rest of gluteal region. The positions of superior and inferior gluteal arteries exited from pelvic cavity were in 1 cm medial to upper one third point on connecting line from posterior superior iliac spine to greater trochanter of femur, and middle point on connecting line from posterior superior iliac spine to ischial spine, respectively. The courses of the superior and the inferior gluteal arteries were classified into four types by distribution patterns. The most common incidence (46.5%) was observed in the typical type (Type I) that the superior and inferior gluteal artery supplied the upper or lower part of gluteus maximus muscle, respectively. The incidence of type II that some branches of inferior gluteal artery run up to the area supplied by superior gluteal artery was 16.3%. In contrast to type II, the incidence of type III that some branches of superior gluteal artery run down to the area supplied by inferior gluteal artery was 18.6%. The incidence of Type IV that only superior gluteal artery supplied the muscle was 18.6%.
Arteries* ; Breast ; Buttocks ; Cadaver ; Congenital Abnormalities ; Femur ; Head ; Incidence ; Myocutaneous Flap* ; Neck ; Pressure Ulcer ; Skin ; Spine ; Subcutaneous Tissue

Antigens, CD20 ; metabolism ; Breast Neoplasms ; diagnosis ; diagnostic imaging ; metabolism ; Female ; Humans ; Immunohistochemistry ; Lymphoma ; diagnosis ; diagnostic imaging ; metabolism ; Middle Aged ; Positron-Emission Tomography ; Radiography ; Ultrasonography

Anti–glomerular basement membrane (GBM) nephritis is characterized by circulating anti-GBM antibodies and crescentic glomerulonephritis (GN) with deposition of IgG along the GBM. In a limited number of cases, glomerular immune complexes have been identified in anti-GBM nephritis. A 38-year-old female presented azotemia, hematuria, and proteinuria without any pulmonary symptoms. A renal biopsy showed crescentic GN with linear IgG deposition along the GBM and mesangial IgA deposition. The patient was diagnosed as concurrent anti-GBM nephritis and IgA nephropathy. Therapies with pulse methylprednisolone and cyclophosphamide administration were effective. Concurrent cases of both anti-GBM nephritis and IgA nephropathy are rare among cases of anti-GBM diseases with deposition of immune complexes. This rare case of concurrent anti-GBM nephritis and IgA nephropathy with literature review is noteworthy.
Adult ; Anti-Glomerular Basement Membrane Disease ; Antibodies ; Antigen-Antibody Complex ; Azotemia ; Basement Membrane ; Biopsy ; Cyclophosphamide ; Female ; Glomerulonephritis ; Glomerulonephritis, IGA ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Methylprednisolone ; Nephritis ; Proteinuria

Breast metastases from extra-mammary malignancies are unusual. In particular, the characteristics of breast metastasis from gastric cancer are rarely reported and there is no common specific finding among the reported cases. Breast metastases from extra-mammary malignancies are often misdiagnosed as benign lesions due to the absence of characteristic finding in imaging studies; however, they also resemble inflammatory breast cancer clinically sometimes. Therefore, differential diagnosis between the primary breast cancer and the metastatic disease is considered difficult. In order to hasten the diagnosis, to avoid unnecessary mastectomy, and to determine appropriate options of treatment, it is important that physicians understand the clinicopathological and radiologic features of breast metastases and consider its possibility in patients with a history of extra-mammary malignancies. Herein, we report a case of breast metastases from gastric cancer.

An aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. The standard treatment of an aortoesophageal fistula is surgical, because conservative management results in very high mortality. Nevertheless, the mortality related to the surgical treatment ranges from 30 to 60%. Recently, endovascular stent grafting has become an alternative to open surgery in selected patients. We report an aortoesophageal fistula treated with endovascular stent grafting in an 84-year-old female with hematemesis and abdominal pain. Endoscopy showed a 5-cm pulsating esophageal mass with central ulceration and bleeding. Computed tomography (CT) of the abdomen revealed a descending thoracic aortic pseudoaneurysm. Being at high risk in open thoracic surgery, she underwent endovascular stenting. We suggest that endovascular stent grafting is an alternative treatment of aortoesophageal fistula, instead of open surgery, in selected patients.
Abdomen ; Abdominal Pain ; Aged, 80 and over ; Aneurysm, False ; Endoscopy ; Female ; Fistula ; Hematemesis ; Hemorrhage ; Humans ; Stents ; Thoracic Surgery ; Transplants ; Ulcer

Gastrocolic fistula is a fistulous communication between the stomach and the colon. It is a passage between the gastric epithelium and the colonic epithelium. This uncommon complication is caused by benign and malignant diseases of the stomach or the colon. Its clinical manifestations include weight loss, diarrhea and fecal vomiting; occasionally, anemia, poor oral intake, fatigue and dizziness; and very rarely, gastrointestinal bleeding. In this paper, an unusual case of gastrocolic fistula accompanied by hematochezia, which was revealed to have been caused by colon cancer invasion, is described.
Anemia ; Colon ; Colonic Neoplasms ; Diarrhea ; Epithelium ; Fatigue ; Fistula ; Gastrointestinal Hemorrhage ; Hemorrhage ; Intestinal Fistula ; Stomach ; Weight Loss

An esophageal foreign body has clinical significance because it may cause serious complications such as esophageal perforation, mediastinitis and/or aorto-esophageal fistula. A prompt attempt to remove an esophageal foreign body via flexible endoscopy should be made when the shape of the foreign body is especially sharp and long as it can easily lead to esophageal perforation. We report here on a case of endoscopic removal of an impacted esophageal foreign body, a fishhook, that hade been present in the esophagus for two months, and there were no serious complications from the procedure.
Endoscopy ; Epoxy Compounds ; Esophageal Perforation ; Esophagus ; Fistula ; Foreign Bodies ; Hydroxybenzoate Ethers ; Mediastinitis

OBJECTIVES: The extracapsular spread (ECS) of metastatic lymph nodes is associated with aggressive tumor behavior, and is regarded as a major risk factor for local recurrence in patients with head and neck squamous cell carcinoma. However, the significance of ECS of metastatic lymph nodes has not been well established in well-differentiated thyroid carcinoma. The purpose of this study was to examine this question. METHODS: A retrospective review was performed of 335 patients with papillary thyroid carcinoma who underwent total thyroidectomy with lymph node dissection from April 2001 to December 2009. We analyzed various clinical characteristics, pathologic factors, and the size, number, and ECS of foci in metastatic lymph nodes. RESULTS: On pathologic review, 201 of the patients (56.6%) had lymph node metastasis. This was significantly related to age and tumor size. ECS was noted in 64 of these 201 patients (31.8%), and was significantly related to male gender, tumor size, presence of extrathyroidal extension, metastatic lymph node size, and focus size. Recurrence occurred in 13 patients (3.9%), and the presence of ECS was significantly related to recurrence. CONCLUSION: ECS of metastatic lymph nodes is an important prognostic factor for loco-regional recurrence in papillary thyroid carcinoma.
Carcinoma, Squamous Cell ; Head ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Male ; Neck ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy