No abstract available.
Aged* ; Femur* ; Humans

The occurrence of squamous metaplasia(morule) in colorectal mucosa and adenocarcinoma, althrough rare, has been well documented. In contrast, very little mention has been given to mature squamous cells seen in colorectal polyps or adenomas. A 42-year-old woman presented with a 2-month history of diarrhea and melena. Proctosigmoidoscopy revealed a 4 cm-sized polypoid tumor 20 cm above the anal verge. Colonoscopic biopsy showed tubular adenoma, and a segmental resection of sigmoid colon was done. Microscopically, the tumor was c classical tubular adenoma containing multiple solid nests of squamous cells scattered only in the neoplasm; the squamous nests were generally small, and some showed direct continuity with adenomatous glands. The squamous cells were keratinizing and had regular nuclei with no mitotic activity. The importance of this phenomenon lies in its pathologic recognition, and the findings suggest that awareness of this rare occurrence in colorectal polyps should avert such overdiagnosis, and consequently prevents unnecessary radical surgery.
Female ; Humans ; Adenoma ; Biopsy

BACKGROUND: Recent findings in molecular pathology suggest that genetic translocation and/or overexpression of oncoproteins is important in salivary gland tumorigenesis and diagnosis. We investigated PLAG1, SOX10, and Myb protein expression in various salivary gland neoplasm tissues. METHODS: A total of 113 cases of surgically resected salivary gland neoplasms at the National Cancer Center from January 2007 to March 2017 were identified. Immunohistochemical staining of PLAG1, SOX10, and Myb in tissue samples was performed using tissue microarrays. RESULTS: Among the 113 cases, 82 (72.6%) were benign and 31 (27.4%) were malignant. PLAG1 showed nuclear staining and normal parotid gland was not stained. Among 48 cases of pleomorphic adenoma, 29 (60.4%) were positive for PLAG1. All other benign and malignant salivary gland neoplasms were PLAG1-negative. SOX10 showed nuclear staining. In normal salivary gland tissues SOX10 was expressed in cells of acinus and intercalated ducts. In benign tumors, SOX10 expression was observed in all pleomorphic adenoma (48/48), and basal cell adenoma (3/3), but not in other benign tumors. SOX10 positivity was observed in nine of 31 (29.0%) malignant tumors. Myb showed nuclear staining but was not detected in normal parotid glands. Four of 31 (12.9%) malignant tumors showed Myb positivity: three adenoid cystic carcinomas (AdCC) and one myoepithelial carcinoma with focal AdCC-like histology. CONCLUSIONS: PLAG1 expression is specific to pleomorphic adenoma. SOX10 expression is helpful to rule out excretory duct origin tumor, but its diagnostic value is relatively low. Myb is useful for diagnosing AdCC when histology is unclear in the surgical specimen.
Adenoma ; Adenoma, Pleomorphic ; Antibody-Dependent Cell Cytotoxicity ; Carcinogenesis ; Carcinoma, Adenoid Cystic ; Diagnosis ; Immunohistochemistry ; Oncogene Proteins ; Oncogene Proteins v-myb ; Parotid Gland ; Pathology, Molecular ; Salivary Gland Neoplasms ; Salivary Glands ; SOX Transcription Factors ; Translocation, Genetic

Apoptotic cell death induced by p53 occurs at a late G1 cell cycle checkpoint termed the restriction(R)point, and it has been proposed that p53-induced apoptosis causes upregulation of CD95. However, as cells with defective in CD95 signaling pathway are still sensitive to p53-induced apoptosis, CD95 cannot be the sole factor resulting in apoptosis. In addition, unlike p53-induced apoptosis, the relationship between CD95-mediated apoptosis and the cell cycle is not clearly understood. It would there-fore be worth investigating whether CD95-mediated cell death is pertinent with p53-induced apoptosis in view of cell cycle related molecules. In this report, biochemical analysis showed that etoposide-induced apoptosis caused the induction and the nuclear translocation of effector molecules involved in G1 cell cycle checkpoint. However, there was no such translocation in the case of CD95-mediated death. Thus, although both types of apoptosis involved caspase activation, the cell cycle related proteins responded differently. This argues against the idea that p53-induced apoptosis occurs through the induction of CD95/CD95L expression.
Active Transport, Cell Nucleus ; Antigens, CD95/*metabolism ; *Apoptosis ; Cell Cycle ; Cell Nucleus/metabolism ; Coculture ; Dose-Response Relationship, Drug ; Down-Regulation ; Etoposide/pharmacology ; Flow Cytometry ; Human ; Immunoblotting ; Jurkat Cells ; Nucleic Acid Synthesis Inhibitors/pharmacology ; Protein Binding ; Protein Transport ; Protein p53/*metabolism ; Signal Transduction ; Up-Regulation

PURPOSE: The zygomatic arch is a key element which composes the facial contour. In many cases of zygomatic arch fracture, it is difficult to fix rigidly the fractured segments. If reduced bone segments were not fixed rigidly, they are proven to be displaced by mastication or unintentional external forces. So, unfixed zygomatic arch fracture after reduction may require a external device of prevention of collapse. We introduce a new protector which stabilizing the fractured segments to prevent for collapse of the reduced zygomatic arch fracture. METHODS: After reduction of zygomatic arch with blind approach(Gillies', Dingman or Keen's approach), bone segments was pulled with percutaneous traction suture in medial aspect of zygomatic arch. Then, the suture was fixed with Aqua splint(R), externally. And intraoperative and postoperative X-ray was done. The splint was removed on 14 days after the operation. RESULTS: 5 patients were treated with this method. 4 patients of total patients had no collapse in zygomatic arch. There was minimal collapse in one patient. Postoperative complications such as facial nerve injury, mouth opening difficulty, contour deformity, infection, scar were not observed. CONCLUSION: In comparison with other techniques, this technique has several advantages which are simple and easy method, short operation time, no scar, less soft tissue injury, and facilitated removal of splint. Therefore, Aqua splint(R) would be a good alternative to prevent for collapse in unstable zygomatic arch fractures
Cicatrix ; Congenital Abnormalities ; Facial Nerve Injuries ; Humans ; Mastication ; Mouth ; Postoperative Complications ; Soft Tissue Injuries ; Splints ; Sutures ; Traction ; Zygoma*

No abstract available.
Transplants

PURPOSE: We investigated epidermal growth factor receptor(EGFR) expression in prostate cancer(PCa) and their potential role as predicting factor on biochemical recurrence(BCR). MATERIALS AND METHODS: Between February 2005 and February 2007, EGFR expression were prospectively evaluated in a consecutive series of 88 PCa patients with the following characteristics: 66 patients treated with retropubic radical prostatectomy(RRP); 22 patients treated with neoadjuvant hormonal therapy followed by RRP. The relationship between EGFR expression and several clinicopathologic parameters were evaluated. The probability of BCR-free survival was determined using the Kaplan-Meier method. RESULTS: EGFR expression, was evaluated by immunohistochemistry, was found in 31 of 88(35.2%) patients. 8 of 31 EGFR-positive patients(25.8%) had BCR, whereas only 5 of 57 EGFR-negative patients(8.8%) had BCR (p=0.031) during a median follow-up of 21 months. Among several variables, high serum prostate-specific antigen values(>or=20), extraprostatic extension, seminal vesicle invasion, and EGFR expression were the significant predictors of BCR on univariate analysis. But, multivariate analysis showed that no variable was significant predictor of BCR. EGFR-negative patients had a significantly longer mean BCR-free survival time than EGFR-positive patients(p=0.027). CONCLUSIONS: EGFR expression could be an potential predicting factor on BCR following RRP.

Salmonella infection is an acute systemic disease that can lead to diffuse organ involvement with septicemia and cause clinically a variety of complications. But acute acalculous cholecystitis and acute hepatitis with jaundice due to Salmonella typhi occurred rarely. A 42 years old female was admitted with fever, chilling sensation and abdominal pain. On admission, the blood, stool, bile acid and bone marrow cultures were positive for Salmonella typhi. The patient had subsequently developed acute acalculous cholecystitis and acute hepatitis with jaundice. Her symptoms and signs resolved after cholecystostomy, parenteral antibiotic (ciprofloxacin) and supportive treatment. We report a case of acute acalculous cholecystitis and acute hepatitis with jaundice in a 42-ear-ld female, whose conditions were recovered completely after cholecystostomy and administration of ciprofloxacin, with reviewing the literatures.
Abdominal Pain ; Acalculous Cholecystitis* ; Adult ; Bile ; Bone Marrow ; Cholecystostomy ; Ciprofloxacin ; Female ; Fever ; Hepatitis* ; Humans ; Jaundice ; Salmonella Infections ; Salmonella typhi* ; Salmonella* ; Sensation ; Sepsis

BACKGROUND: To evaluate exudative pleural fluid, thoracentesis for microbiological and cytological examination and pleural biopsy by using a Cope needle are traditionally performed. Even after these studies, about 20% of patients remain undiagnosed. We evaluated the diagnostic accuracy and complications of 2-mm minithoracoscopy instead of blind biopsy in patients with undiagnosed exudative pleural effusion. METHOD: Fifteen patients with exudative pleural effusion underwent thoracoscopy between April 2002 and August 2003. The indication was undiagnosed pleural effusions after having performed sputum and pleural fluid examinations both microbiologically and cytologically. RESULT: The median age of the patients was 56 years (range 21-77). Pleural effusions were lymphocyte-dominant in 11 patients (73.3%) and neutrophil-dominant in 3 (20.0%). The remaining patient (6.7%) had pleural-fluid eosinophilia. Minithoracoscopic biopsy revealed accurate diagnosis in 14 patients (93.3%), consisting of tuberculous pleurisy in 8 (66.7%), malignant effusions in 4 (33.3%), and parapneumonic effusions in 2 (13.3%). One was diagnosed as having paragonimiasis from thoracoscopic findings and clinical considerations. There was no procedure-associated mortality. There were six cases of new onset fever (40%) and one of pneumothorax (6.7 %). CONCLUSION: Two-millimeter minithoracoscopy, which is less invasive than conventional thoracoscopy, was an accurate and safe method for undiagnosed exudative pleural effusion.
Biopsy* ; Diagnosis ; Eosinophilia ; Fever ; Humans ; Mortality ; Needles ; Paragonimiasis ; Pleural Effusion* ; Pneumothorax ; Sputum ; Thoracoscopy ; Tuberculosis, Pleural

BACKGROUND/AIMS: Balloon dilatation is a useful alternative to surgery in patients with benign pyloric stenosis. However, little data are available on the long-term outcome of the procedure. This report was attempted to determine the safety and efficacy of endoscopic balloon dilatation for 14 patients with gastric outlet obstruction caused by duodenal ulcer. METHODS: Review of medical records or telephone interview was performed retrospectively. RESULTS: Follow-up was conducted for median 18.5 months (3-48 months). Gastric outlet strictures had a median diameter 6 mm (range, 2-9 mm). Five (35.7%) patients had active ulcer. 12 mm to 18 mm balloons were inflated a median of 1 times (range, 1-4 times) for a median of 4 minutes (range, 1-11 minutes). Thirty-two procedure (1.5/patient) were performed; 9 patients (64.3%) had one treatment and 5 patients (35.7%) had multiple treatment. Immediate symptomatic relief was achieved in 13 patients (92.8%) and 7 patients (50%) achieved sustained symptomatic relief. Dilatation failed only in 2 patients (14.3%) ultimately and both recovered by palliative bypass surgery. No complication was noted during treatment. CONCLUSIONS: Endoscopic balloon dilatation is safe and effective for most patients with gastric outlet obstruction induced by duodenal ulcer. And due to limitation of retrospective aspect of this report, further prospective, randomized studies must be performed.
Constriction, Pathologic* ; Dilatation* ; Duodenal Ulcer ; Follow-Up Studies ; Gastric Outlet Obstruction ; Humans ; Interviews as Topic ; Medical Records ; Pyloric Stenosis ; Retrospective Studies ; Ulcer