No abstract available.
Risk Factors*

A primary adenosquamous carcinoma of the liver is a rare subtype of a cholangiocarcinoma. Adenosquamous carcinoma is known to have an aggressive biologic behavior and is associated with a poor prognosis. Recently, we experienced a case of a primary adenosquamous carcinoma of the liver. A 69-year-old man was subjected to a right hemicolectomy five months ago due to an ascending colon cancer. At a periodic check-up, abdominal ultrasonography and magnetic resonance imaging showed a ~1.1 cm-sized hepatic mass which was highly suspicious of being a hepatic metastasis from the ascending colon cancer. A hepatic segmentectomy was performed. The tumor was microscopically composed of an adenocarcinoma and a squamous cell carcinoma, and it was different from the previous colon cancer as determined by immunohistochemistry. Three months after the hepatic segmentectomy, multiple hepatic metastasis was found and the patient has been treated as an outpatient with capecitabine.
Adenocarcinoma* ; Aged ; Carcinoma, Adenosquamous* ; Carcinoma, Squamous Cell ; Cholangiocarcinoma ; Colon* ; Colon, Ascending ; Colonic Neoplasms ; Humans ; Immunohistochemistry ; Liver* ; Magnetic Resonance Imaging ; Mastectomy, Segmental ; Neoplasm Metastasis ; Outpatients ; Prognosis ; Ultrasonography ; Capecitabine

PURPOSE: Improved survival of patients with childhood acute lymphoblastic leukemia (ALL) has drawn attention to the potential for late consequences of previous treatments among survivors, including metabolic syndrome. In this study, we evaluated changes in 3 parameters, namely, random blood glucose, body mass index (BMI), and Z score for BMI (Z-BMI), in children with ALL during chemotherapy and after completion of treatment. METHODS: Patients newly diagnosed with ALL from January, 2005 to December, 2008 at Saint Mary's Hospital, The Catholic University of Korea, who completed treatment with chemotherapy only were included (n=107). Random glucose, BMI, and Z-BMI were recorded at 5 intervals: at diagnosis, before maintenance treatment, at completion of maintenance treatment, and 6 and 12 months after completion of maintenance treatment. Similar analyses were conducted on 2 subcohorts based on ALL risk groups. RESULTS: For random glucose, a paired comparison showed significantly lower levels at 12 months post-treatment compared to those at initial diagnosis (P<0.001) and before maintenance (P<0.001). The Z-BMI score was significantly higher before maintenance than at diagnosis (P<0.001), but decreased significantly at the end of treatment (P<0.001) and remained low at 6 months (P<0.001) and 12 months (P<0.001) post-treatment. Similar results were obtained upon analysis of risk group-based subcohorts. CONCLUSION: For a cohort of ALL patients treated without allogeneic transplantation or cranial irradiation, decrease in random glucose and Z-BMI after completion of chemotherapy does not indicate future glucose intolerance or obesity.
Blood Glucose ; Body Mass Index ; Child ; Cohort Studies ; Cranial Irradiation ; Glucose ; Glucose Intolerance ; Humans ; Korea ; Matched-Pair Analysis ; Obesity ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Saints ; Survivors ; Transplantation, Homologous

PURPOSE:Preconditioning due to activation of AMPK might reduce ischemia-reperfusion (I/R) injury in the kidney, based on the key role of AMPK in preserving ATP. To evaluate this possibility, the effect of preconditioning with 5-aminoimidazole-4-carboxamide ribonucleoside (AICAR), AMPK activator, before sustained ischemia was investigated. METHODS:Adult male Sprague-Dawley rats weighing approximately 220-250 g were used. To induce renal ischemia, a laparotomy was performed under ketamine and xylazine hydrochloride, and the blood supply to both kidneys was interrupted by placement of vessel clamps at the level of the renal pedicles. Reflow was initiated by removing the clamps. The following experimental groups were defined 1. Acute renal ischemia 0 sec, 10 min, 15 min, 2. AICAR treatment, 3. Sham group (S), 4. Ischemia/ Reperfusion group (I/R), 5. AICAR+I/R group (A+I/R), 6. AraA (Adenine-9-b-D-arabinofuranoside, an AMPK) inhibitor+AICAR+I/R group (AraA+A+I/R) RESULTS:There was only faint AMPK phosphorylation in the sham group. After 10 minutes of ischemia, or AICAR preconditioning however, Thr172 phosphorylation of AMPK was increased (p<0.05). The serum levels of BUN and creatinine were significantly decreased in AICAR preconditioning group (A+I/R). (128.0+/-7.33 mg/dL, 4.18+/-0.27 mg/dL vs. 90.2+/-11.13 mg/dL, 2.58+/-0.7 mg/dL, p<0.05), but these effects were attenuated by AMPK inhibitor, AraA (AraA+A+I/R group). In quantitative analysis of tubular injury, tubular injury score in AICAR preconditioning group significantly decreased (p<0.05). CONCLUSION:The AMPK activator AICAR has a protective effect against renal I/R injury.
Adenosine Triphosphate ; Aminoimidazole Carboxamide ; AMP-Activated Protein Kinases ; Creatinine ; Glycosaminoglycans ; Humans ; Ischemia ; Ketamine ; Kidney ; Laparotomy ; Male ; Phosphorylation ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury ; Ribonucleotides ; Salicylamides ; Xylazine

Although dermatophytes are still the main etiologic agents of onychomycosis, some species of nondermatophytic molds and yeasts are also capable of invading the nails. Scopulariopsis (S.) brevicaulis is a nondermatophytic mold which is saprophytic fungus in soil. We report four cases of toenail onychomycosis caused by S. brevicaulis in a 42-year-old male, a 46-year-old male, a 37-year-old male, and a 64-year-old male. Three patients presented with a typical distal subungual onychomycosis and one case was proximal subungual onychomycosis. Direct microscopic examination of scrapings on the potassium hydroxide preparation revealed fungal elements in all cases. Cultures from toenail lesions of the all patients on Sabouraud dextrose agar showed a typical brown colony with powdery surface of S. brevicaulis. Numerous branched conidiophores with chains of lemon-shaped conidia with rough walled were observed in slide culture and scanning electron microscopy (SEM). We confirmed S. brevicaulis by colony, light microscopic morphology and SEM.
Adult ; Agar ; Arthrodermataceae ; Fungi ; Glucose ; Humans ; Male ; Microscopy, Electron, Scanning ; Middle Aged ; Nails* ; Onychomycosis* ; Potassium ; Scopulariopsis* ; Soil ; Spores, Fungal ; Yeasts

Microsporum (M.) gypseum is geophilic and abundant in soil throughout the world. The source of human infection has been traced to soil or animals. But tinea corporis caused by M. gypseum is rare. We report 4 cases of tinea corporis caused by M. gypseum in a 38 year-old female, a 7 year-old girl, a 2 year-old boy, and a 18 year-old female. The lesions were manifested by localized pruritic fine scaly erythematous annular patches on the shin, forearm, neck, and antecubital fossa. Direct microscopic examination of scales on the potassium hydroxide preparation showed hyphae and spores in 3 cases. But cultures from the skin lesion of all patients on Sabouraud dextrose agar showed typical colonies of M. gypseum. The patients were treated with topical ketoconazole application and/or oral antifungal agents.
Adolescent ; Adult ; Agar ; Animals ; Antifungal Agents ; Child ; Child, Preschool ; Female ; Forearm ; Glucose ; Humans ; Hyphae ; Ketoconazole ; Male ; Microsporum* ; Neck ; Potassium ; Skin ; Soil ; Spores ; Tinea* ; Weights and Measures

Although metastasis from cutaneous malignant melanoma to the small intestine is not uncommon, primary small bowel melanoma (SBM) is extremely rare. This case report describes a rare case of primary SBM, diagnosed by single-balloon enteroscopy. A 74-year-old man presented with recurrent melena. Upper endoscopy and colonoscopy were unremarkable. Abdominal computed tomography (CT) revealed an ileal mass with ileo-ileal intussusception. Subsequent single-balloon enteroscopy identified an ileal tumor, which was histologically diagnosed as melanoma. Extensive clinical examination did not reveal any primary cutaneous lesions. To the best of our knowledge, this is the first case of primary SBM in South Korea.
Aged ; Colonoscopy ; Endoscopy ; Humans ; Intestine, Small ; Intussusception ; Korea ; Melanoma* ; Melena ; Neoplasm Metastasis

Idiopathic hypereosinophilic syndrome(HES) is a multisystem disease characterized by unexplained prolonged eosinophilia and evidence of specific organ damage, including skin. Cutaneous involvement occurs in more than 50 percent of patients but cutaneous nodule as the only manifestation of HES is rare. We report a case of hypereosinophilic syndrome in a 39-year-old male, who showed a solitary tender coin-sized erythematous nodule on his right lower abdomen for 2.5 months without evidence of systemic involvement.
Abdomen ; Adult ; Eosinophilia ; Humans ; Hypereosinophilic Syndrome* ; Male ; Skin

Pemphigus foliaceus is characterized by superficial blisters with acantholysis in the upper portion of the epidermis. Pemphigus foliaceus in pregnancy is rare. We report a case of pemphigus foliaceus in a 26-year-old pregnant woman who showed erythematous bullae, erosions and crusts on the whole body for 2 months. She was diagnosed by clinical and histopathological findings, direct immunofluorescent test and immunoblotting analysis. She was treated with prednisolone for 28 days and skin lesions were markedly improved.
Acantholysis ; Adult ; Blister ; Epidermis ; Female ; Humans ; Immunoblotting ; Pemphigus* ; Prednisolone ; Pregnancy* ; Pregnant Women ; Skin

Congenital smooth muscle hamartoma usually presents as a well-circumscribed, hypertrichotic, hyperpigmented or skin colored patch or plaque on the trunk or an extremity at birth. Histologically, numerous thick, long, well defined bundles of smooth muscle fibers are scattered throughout the dermis in various directions. We report a case of congenital smooth muscle hamartoma in an 8-month-old female infant who showed hypertrichotic, skin colored plaque on the lumbosacral area since at birth. The pseudo-Darier sign was positive. Histopathologic findings were numerous, well-defined bundles of smooth muscle fibers in the dermis (H and E, Masson-trichrome stain).
Dermis ; Extremities ; Female ; Hamartoma* ; Humans ; Infant ; Muscle, Smooth* ; Parturition ; Skin