Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

BACKGROUND: Suction auto epidermal graft for the treatment of stable vitiligo has become popular clinically. In general, depigmented epidermis is removed by liquid nitrogen freezing for preparation of the recipient site. There have been some problems with the nitrogen freezing method, uneven repigmentation, appearance of Koebner's phenomenon on normal colored skin around the graft site, scar formation on recipients sites. In our view these resulted in unwanted damage to the dermis and epidermal and skin appendageal melanocytes of normal skin by freezing. OBJECTIVE: To introduce a method to remove the depigmented epidermis of recipient site with minimal unwanted damage to melanocytes and dermal tissue. METHODS: Using Ellman surgitron, irradiation equipment of 3.8MHz frequency the depigmented epidermis was removed with a blade electrode under rated electric power around 10 watts depending on the thickness of the epidermis. Operating mode was fully filtered current for minimal charring and destruction of tissue through pure micro-smooth cutting. RESULTS: In the case of removal of the epidermis with Ellman surgitron, oozing and inflammation decreased markedly compared with those applied with liquid nitrogen. And it was confirmed histopathologically that there was no significant unwanted destruction of healthy tissue. Moreover, the electrode of Ellman surgitron is designed to be apt to trace the margin of depigmented lesion. And Ellman surgitron features a continuously linear intensity setting for precise, predictable control to minimize tissue destruction and charring. So we were able to remove the epidermis of the shallow lesion looking like a pseudopod and of the thinnest part of the body like eyelid also. And we grafted normal epidermis successfully on the depigmented lesion. CONCLUSION: The removal of depigmented epidermis by radio-frequency gave satisfactory results in the suction auto epidermal graft by overcoming the defects shown as depigmented epidermis which were removed by liquid nitrogen freezing. And this method made patients comfortable because of less pain, a one day operation procedure and good results.
Cicatrix ; Dermis ; Electrodes ; Epidermis* ; Eyelids ; Freezing ; Humans ; Inflammation ; Melanocytes ; Nitrogen ; Skin ; Suction* ; Transplants* ; Trout ; Vitiligo

OBJECTIVE: To estimate the long-term skeletal responses to hormone replacement therapy(HRT) with or without active vitamin D(VD) by using short-term changes of bone markers in postmenopausal women (PMW). METHODS: Biochemical markers of bone formation(osteocalcin,OC) and (&) resorption(deoxypyridinoline, Dpd ) at 3 months & lumbar bone mineral density(BMD) at 1 year were measured in 64 natural PMW taking HRT(n=41) & HRT with calcitriol 0.25 microgram/day(n=23). The correlation of percent changes of bone markers after 3 months of Tx with those in lumbar BMD after 1 year was evaluated. RESULTS: 1. serum-OC & urine-Dpd showed decrease of 20.9% & 30.1% at 3months respectively & BMD increase of 3.8% after 1 year of Tx. 2. Among 58 PMW with decreased u-Dpd change, 49 (84.5%) revealed increase in BMD, while 40 (81.6%) among 49 PMW with decreased serum-OC change showed increased BMD. 3. Bone gainers showed significant decrease in changes of serum-OC(18.1% vs 9.2% p<0.05) & urine-Dpd(32.6% vs 20.4%, p<0.05) compared with those of bone losers. 4. No correlations of change of serum-OC (r=-0.174 p>0.05) & urine-Dpd (r=-0.091 p>0.05) at 3month with BMD changes at 1year were seen in total PMW, but urine-Dpd changes in HRT without active VD group revealed significantly inverse correlation(r=-0.376 p<0.05). CONCLUSION: Short-term changes of bone markers did not precisely predict the long-term changes of BMD in total PMW except urine- Dpd in HRT without active VD.
Biomarkers ; Bone Density* ; Calcitriol ; Estrogen Replacement Therapy* ; Female ; Humans ; Osteocalcin ; Vitamin D* ; Vitamins*

BACKGROUND: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. METHODS: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. RESULTS: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. CONCLUSIONS: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.
Arm ; Arthroplasty ; Arthroscopy ; Asian Continental Ancestry Group ; Body Mass Index ; Female ; Follow-Up Studies ; Hematologic Tests ; Humans ; Humerus ; Incidence* ; Liver ; Male ; Pilot Projects* ; Pulmonary Embolism ; Shoulder* ; Thrombosis ; Ultrasonography ; Veins ; Venous Thromboembolism* ; Venous Thrombosis

For some cyanotic children with deficient pulmonary blood flow, the Blalock-Taussig shunt is a life-saving or temporizing form of palhation. Extensive experience has been gathered, and mortality and morbidity as well as the incidence of shunt stenosis and thrombosis have significantly decreased. However, even nowadays, the most frequently encountered complication excluding mortality in early postoperative course is occlusion of the shunt. We experienced a case of Blalock-Taussig shunt occlusion with thrombus. We diagnosed him as ventricular septal defect with pulmonary atresia by echocardiography and performed a right classic Blalock-Taussig shunt at 7th day of age, Oxygen saturation was gradually decreased since the 6th day postoperative. He was diagnosed as thrombosis of shunt at 12th day postoperative by cardiac angiography, and then was treated with a local low-dose urokinase infusion(1,000U/kg/hr) through Cobra catheter(Cook. In. Co.). After 21 hours, thrombolysis of shunts was comfirmed. We stopped the urokinase and medicated low-dose aspirin(5mg/kg/day). After the eighth day, shunt flow by echocardiography was patent.
Angiography ; Child ; Constriction, Pathologic ; Echocardiography ; Elapidae ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Infant, Newborn* ; Mortality ; Oxygen ; Pulmonary Atresia ; Thrombosis* ; Urokinase-Type Plasminogen Activator*

For some cyanotic children with deficient pulmonary blood flow, the Blalock-Taussig shunt is a life-saving or temporizing form of palhation. Extensive experience has been gathered, and mortality and morbidity as well as the incidence of shunt stenosis and thrombosis have significantly decreased. However, even nowadays, the most frequently encountered complication excluding mortality in early postoperative course is occlusion of the shunt. We experienced a case of Blalock-Taussig shunt occlusion with thrombus. We diagnosed him as ventricular septal defect with pulmonary atresia by echocardiography and performed a right classic Blalock-Taussig shunt at 7th day of age, Oxygen saturation was gradually decreased since the 6th day postoperative. He was diagnosed as thrombosis of shunt at 12th day postoperative by cardiac angiography, and then was treated with a local low-dose urokinase infusion(1,000U/kg/hr) through Cobra catheter(Cook. In. Co.). After 21 hours, thrombolysis of shunts was comfirmed. We stopped the urokinase and medicated low-dose aspirin(5mg/kg/day). After the eighth day, shunt flow by echocardiography was patent.
Angiography ; Child ; Constriction, Pathologic ; Echocardiography ; Elapidae ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Infant, Newborn* ; Mortality ; Oxygen ; Pulmonary Atresia ; Thrombosis* ; Urokinase-Type Plasminogen Activator*

The E-cadherin, alpha-catenin, and beta-catenin expressions were immunohistochemically investigated in paraffin-embedded materials of 80 cases of colorectal adenocarcinomas. The staining similar to normal colorectal mucosa with preserved strong membranous staining pattern was considered normal or preserved expression. The X2 test was used to analyse the statistical correlation of cadherin/catenin expression with clinicopathologic parameters and the Breslow test for the correlation with survival length. Normal colorectal mucosa showed strong membranous expression of cadherin/catenin complex. The reduced E-cadherin, alpha-catenin, and beta-catenin expression were found in 53/80 (66.3%), 46/80 (57.5%), and 44/80 (55.5%) cases of colorectal cancers examined, respectively. There were significant correlations between E- cadherin and alpha -catenin (p=0.035), and between alpha-catenin and beta-catenin (p=0.013). The reduced E-cadherin expression was associated with histologic dedifferentiation, tumor depth, lymph node metastasis, clinical stage (p<0.05), poor clinical outcome in stage II (p=0.016) and the reduced alpha-catenin expression with lymph node metastasis and clinical stage (p<0.05). Reduced expression of two or more proteins was correlated with lymph node matastasis, histologic dedifferentiation, clinical stage, and survival (p<0.05). The present study demonstrates a significant down-regulation of E-cadherin and alpha-catenin expression in colorectal cancer is associated with tumor invasiveness, histologic dedifferentiation, lymph node metastasis, and clinical stage. These results suggest that E-cadherin and alpha-catenin may be useful markers of invasiveness, lymph node metastatic potential, and clinical stage and of value as prognostic markers in the earlier stage. Further studies are needed to confirm the prognostic value of these cadherin/catenin complex.
Adenocarcinoma* ; alpha Catenin* ; beta Catenin* ; Cadherins* ; Colorectal Neoplasms ; Down-Regulation ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis

Posterior epidural migration of a sequestrated intervertebral lumbar disc is rare with only five cases ever reported in the literature so far. The objective of this paper is to report our experience of such a extremely rare case with a review the literature

Endometriosis is defined as the presence of endometrial tissue(gland and stroma) outside the uterus. The incidence of scar endometriosis is quite rare, and must differentiate with cellulitis and abscess. We have experienced one case of perineal endometriosis and one case of abdominal wall endometriosis at the site of postoperative wound scar. The possible pathogenesis of endometriosis and treatment were discussed.
Abdominal Wall ; Abscess ; Cellulitis ; Cicatrix* ; Endometriosis* ; Female ; Incidence ; Uterus ; Wounds and Injuries

PURPOSE: MDM-2 is an oncoprotein that inhibits p53 tumor-suppressor protein. These abnor malities have a role in tumorigenesis through inactivation of p53 function. To determine the clini copathological and prognostic value of MDM2 abnormalities in gastric adendegrees Carcinoma, MDM-2& p53 protein expression were analysed in surgically resected materials of gastric adendegrees Carcinoma. MATERIALS AND METHODS: Fifty cases which had got follow-up after surgical resection were immunohistdegrees Chemically studied with p53 and MDM-2 antibodies. We defined variable clinico pathologic factors for expression of p53 and MDM-2 protein and analysed their relationships. RESULTS: Immunohistdegrees Chemical stain revealed expression of MDM-2 protein as a 52.0% (26/50) and p53 protein 20.0% (10/50), respectively. But their expressions were not assdegrees Ciated with clinicopathological factors such as T-factor, N-factor, stage, histology and differentiation. Overall, p53-negative patients seemed to have a better prognosis regardless of MDM-2 protein status (P= 0.057). MDM-2 protein status was considered to have no play as a prognostic factor. CONCLUSION: In the gastric adendegrees Carcinoma, p53 protein expression seemed to have a inverse relationship with clinical outcomes but MDM-2 protein expression, which was observed more frequently than those of p53, seemed not to be prognostic indicator.
Antibodies ; Carcinogenesis ; Follow-Up Studies ; Humans ; Prognosis ; Proto-Oncogene Proteins c-mdm2 ; Stomach Neoplasms