Bilateral nonfunctioning-carcinoma of adrenal cortex is extremely rare and its prognosis is poor. We report a 43-year-old man hospitalized with complaints of both flank pain and generalized weakness. There were no endocrinoloeical abnormalities except for a slightly increase in serum norepinephrine. Ultrasonoeraphy. computerized tomography and MRI revealed bilateral huge adrenal masses with no metastasis evidence. Under the impression of bilateral nonfunctioning adrenocortical carcinoma. inevitable partial resection of right adrenal mass. adjuvant chemotherapy (o. p'-DDD) end radiotherapy were performed.
Adrenal Cortex ; Adrenocortical Carcinoma* ; Adult ; Chemotherapy, Adjuvant ; Flank Pain ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Norepinephrine ; Prognosis ; Radiotherapy

No abstract available.
Brain Edema* ; Brain* ; Microvessels* ; Vascular Endothelial Growth Factor A*

A case of primary gastric carcinoma with patterns resembling those of hepatocellular carcinoma(HCC) is reproted. This patient who represented high serum alpha-fetoprotein(AFP) underwent a subtotal gastrectomy for stomach cancer and lobectomy of liver metastasis. The hepatoid component of the tumor was characterized by solid nests of large polygonal cells arranged in cords and trabeculae, with central nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm; single-nuclear giant cells were frequently noted. These tumor cells of stomach stained positive immunohistochemically for AFP, ACT(alpha-1-antitrypsin), AACT(alpha-1-antichy-motrypsin). Thus, this hepatoid gastric adenocarcinoma tumor cells demonstrated both morphologic and immunohistochemical features of partial differentiation to the HCC. Careful histologic examination in conjunction with the immunohistochemical demonstration of AFP can provide a useful contribution to the diagnosis of this rare histological type of gastric carcinoma And the presence of metastatic hepatoid adenocarcinoma from the stomach should be considered in a patient with hepatic tumor mimicking HCC. Because of frequent venous and lymphatic invasion, as well as liver metastasis, prognosis appears to be poor. The authors reviewed 45 cases of hepatoid adenocarcinoma of stomach reported in the literature, also.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Neoplasm Metastasis ; Stomach Neoplasms

Tissue welding is a potentially expectable surgical application in the field of medical laser technology. We investigated to establish the technology of laser welding and its efficacy with auxiliary stent and solder in the anastomosis of urological tubular organs including ureter and urethra of rabbits and vas of human using CO2, laser(Shaplan 1100 System). The objects consist of four groups including control group of the conventional microsuture anastomosis and three experimental groups that included group I of laser welding only, group II of laser welding with stent and group III of laser welding with solder. The overall success rate in control group was 90.7 % and in experimental groups were lower with 58.3% and 73.3% in group I and II , respectively, but higher with 95.5% group III. According to each tubular organ in experimental groups, the overall success rates in ureter, urethra and vas were 83.3%, 75.0% and 76.9% respectively, so that the thinner in the wall thickness of tubular organ revealed the higher success rate. Also, time of procedures was significantly shorter in laser groups than control group. Histological findings of laser welding showed the only localized adventitial reactions with intact subserosal layer. In conclusion, laser welding in the urological tubular organ anastomosis with auxiliary solder is not only a more simple and fast technique but also has higher success rate than conventional microsuture anastomosis.
Humans ; Rabbits ; Stents ; Ureter ; Urethra ; Welding*

No abstract available.
Brain Edema* ; Brain* ; Meningioma* ; Vascular Endothelial Growth Factor A*

Strongylodiasis is universal in distribution but is most abundant in countries with a tropical climate. Although infestation by Strongyloides stercoralis is usually limited to the intestines, dessemination of this helminth in debilitated host can be lead to death with various clinical disorders. characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram negative or opportunistic fungal sepsis, coma and death. Cell-mediated immunity contributing significantly to the control of helminthic infections, may be suppressed by carcinoma, immunosuppressive chemotherapy and use of corticosteroids. Diagnosis of Strongyloidiasis is achieved by an examination of samples of feces, duodenal aspirates and sputum of patients for Strongyloides stercoralis. Treatment of strongyloidiasis is twofold : correction of the immunosuppressive state by withdrawal of immunosuppressive drug, if possible, and vigorous treatment with thiabendazole. Testing for strongyloidiasis is especially recommanded before treating a patients should be monitored for infection by Strongyloides stercoralis and other opportunistic infection. We are reporting a case patient with Strongyloides stercoralis hyperinfection and pulmonary tuberculosis who had been. used corticosteroid for persisting polyarthritis.
Adrenal Cortex Hormones ; Arthritis ; Coma ; Diagnosis ; Diarrhea ; Drug Therapy ; Feces ; Helminths ; Humans ; Immunity, Cellular ; Intestines ; Opportunistic Infections ; Sepsis ; Sputum ; Strongyloides stercoralis* ; Strongyloides* ; Strongyloidiasis ; Thiabendazole ; Tropical Climate ; Tuberculosis, Pulmonary

Uterine choriocarcinoma metastatic to kidney and brain is rare. We experienced a 55-year-old woman with complaints of right flank pain and gross hematuria. On admission urine HCG was positive and serum HCG was elevated to 42,250 mIU/ml. Intravenous pyelography revealed delayed visualization of the right kidney. Ultrasonography and computed tomography of the abdomen showed the irregular, multiloculated, mixed density lesion in the posterolateral parenchyme and a subcapsular hematoma of the right kidney. Three days after admission, the patient suffered a seizure. Computed tomography of brain revealed the mass which was the same density as the right kidney in the midbrain and medial occipital lobe of cerebrum. Cerebrospinal HCG was also elevated Under the impression or choriocarcinoma metastatic to kidney and brain, chemotheraphy (EMA- CO : etoposide, methotrexate, actinomycin D, cyclophosphamide and oncovin) was started.
Abdomen ; Brain* ; Cerebrum ; Choriocarcinoma* ; Cyclophosphamide ; Dactinomycin ; Etoposide ; Female ; Flank Pain ; Hematoma ; Hematuria ; Humans ; Kidney* ; Mesencephalon ; Methotrexate ; Middle Aged ; Occipital Lobe ; Pregnancy ; Seizures ; Ultrasonography ; Urography

PURPOSE: Some authors noted unilateral testicular torsion often leading to a damage in the contralateral testis. But it is not known whether this is the result of an intrinsic abnormality in the remaining testis or testicular injury associated with the ischemic event. Recently some authors noted an increase in germ cell apoptosis in the contralateral testis and suggested the involvement of nitric oxide (NO) in the apoptosis of germ cells. We aimed at the NO involvement in testicular torsion in this study, in which we measured inducible nitric oxide synthase (iNOS) expressions and found pathological changes in the torsed and detorsed testes of the rats. MATERIALS AND METHODS: Adult, male, Sprague-Dawley rats were divided into two groups: I) unilateral left testicular torsion persisting for 1, 4, 8 hours. II) torsion for 4 or 8 hours followed by detorsion. Testes were fixed in scrotal wall with a suture. Testes were fixed in formalin solution and prepared in paraffin blocks and slide mounted. All histologic examinations were done by a single observer. The expression of iNOS gene in the testis was determined by reverse transcriptase-polymerase chain reaction and relative iNOS mRNA levels were assessed with normalization to beta-actin mRNA levels. RESULTS: Histologically, the degeneration and inflammation were found in 4 hours after torsion and the necrosis was found in 8 hours after torsion. In contralateral testis, normal findings were noted in 4 hours and 8 hours after torsion. iNOS gene expression was found in the normal control testis. In the torsed testis, iNOS gene expression significantly increased in 1 hour after torsion, then decreased to the control level. In contralateral testis, iNOS gene expression was also increased in 1 hour to 8 hours after torsion. After detorsion, iNOS gene expression significantly decreased in detorsed testis, but constantly increased in contralateral testis. CONCLUSIONS: In rats, iNOS gene expression and histological changes were observed in torsed and detorsed testes. These results support the hypothesis that NO by iNOS protein may play a role in contralateral testicular damage, such as ischemic-reperfusion injury.
Actins ; Adult ; Animals ; Apoptosis ; Formaldehyde ; Gene Expression ; Germ Cells ; Humans ; Inflammation ; Male ; Necrosis ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Paraffin ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Spermatic Cord Torsion ; Sutures ; Testis*

BACKGROUND: Follicular dendritic cells (FDCs) play key roles during T cell-dependent humoral immune responses by allowing antigen-specific B cells to survive, proliferate, and differentiate within the FDC networks of secondary follicles, i.e., germinal centers (GC). METHODS: A novel monoclonal antibody, 3C8, was generated by immunizing with an FDC line HK, in order to understand the molecular signals involved in the FDC-B cell interactions in the microenvironment of the GC. RESULTS: The 3C8 antibody did not bind to mononuclear cells, including T cells, B cells, and monocytes. Murine L929 and human skin fibroblasts exhibited no or little reactivity to 3C8. However, 3C8 specifically recognized HK cells by flowcytometry. Furthermore, the antigen recognized by 3C8 was restricted to the GC of the human tonsil. Dendritic networks of the GC were intensely stained by 3C8, but cells out side the GC were not. CONCLUSION: Our result s suggest that the antigen 3C8 may play some unique role on FDCs during the GC reactions.
B-Lymphocytes ; Cell Communication ; Dendritic Cells, Follicular* ; Fibroblasts ; Germinal Center ; Humans ; Immunity, Humoral ; Monocytes ; Palatine Tonsil ; Skin ; T-Lymphocytes

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