Neoplasms showing both carcinomatous and sarcomatous features are well established, and have been reported in practically every organ where carcinoma can occur. But the difference in terminology and difficulties in histopathologic interpretation have hampered adequate understanding of these neoplasms. We report a case of carcinosarcoma in the recurrent form of serous cystadenocarcinoma of the ovary. The patient was a 64-year-old female who underwent total hysterectomy and bilateral salpingoophorectomy three years ago, due to perforated papillary serous cysta denocarcinoma of the right ovary. Recurrent pelvic masses contained both carcinomatous and sarcomatous components. Morphological transition between carcinomatous and sarcomatous components, and epithelial characteristics in the sarcomatous component by immunohistochemistry were recognized. We postulate the histopathogenetic mechanism based on the phenotypic conversion of carcinoma into sarcoma in the carcinosarcoma.
Carcinosarcoma* ; Cystadenocarcinoma, Serous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Middle Aged ; Ovary* ; Sarcoma

A case of an ovarian mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma is reported. The patient was a 46-year-old female with a right ovarian cystic mass and underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient died of the disease in five months. Macroscopically, the right ovarian cyst wall contained numerous well-demarcated mural nodules. Histologically, the cysts were mucinous cystadenocarcinoma, and the nodules were composed of sarcoma-like spindle and polygonal cells with atypia and numerous mitoses. Spindle cells in the mural nodule showed epithelial characteristics by electron microscopy and immunohistochemistry. This case supports an epithelial origin of the mural nodule of anaplastic carcinoma in ovarian mucinous tumors.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Microscopy, Electron ; Middle Aged ; Mitosis ; Mucins* ; Ovarian Cysts ; Ovary

No abstract available.
Granuloma, Pyogenic* ; Port-Wine Stain*

A study of the volume and linear measurements of the breast to determine new nipple positions for 142 subjects was undertaken. Volume determination was done by using the Grossman-Roudner device. The size and shape of the female breast may differ significantly, and such size and linear measurements have to be measured accurately prior to breast aesthetic surgery. Statistical analysis of these results are closely related to physical constitution(height, weight, chest circumference). There have been increasing changes in linear measurement and decreasing changes in breast volume during the last 10 years, The results were as follows: 1) the mean distance from the midclavicular point to the nipple was 19.5cm, the distance from the sternal notch to the nipple was 19.4cm, the distance between nipples was 18.6cm, and the areolar diameter was 3.3cm, 2) the regression equation for the midclavicular point to the nipple was 7.236+ 0.00077x height(cm)+ 0.233 x weight(kg), for the sternal notch to the nipple was 8.845-0.0039 x height(cm)+ 0.214x weight(kg), for the distance between nipples was 11.192 - 0.0033xheight(cm)+ 0.151x weight(kg), and for the areolar diameter was 4.031+0.02xheight(cm)-0.048 x weight(kg),3) the mean value of breast volume of the left side was 209.6cc, and that of the right side was 211.8cc, 4) the regression equation for the mean breast volume was -137.673 + 6.668 x weight(kg), which was equal to -528.414 + 9.115x chest circumference under the axilla(cm) and -468.420 + 8.298 x chest circumference across the nipple (cm). In conclusion, these data could be useful for numerous aspects of breast surgery, including augmentation mammoplasty, mastopexy, reduction mammoplasty, and correction of asymmetrical breasts as the standard for Korean females, if we know the body constituents (weight, chest circumference) before surgery.
Breast* ; Female* ; Humans ; Mammaplasty ; Nipples ; Thorax

Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

BACKGROUND: The purpose of this study was to evaluate the applicability of the Korean version of Fall Efficacy scale(FES) and Activities-specific Balance Confidence Scale(ABC) to Korean older adult through an examination of instrument`s internal consistency and validity METHOD: A sample of 90 Korean older adults who lived in a community completed a survey instrument which included Korean version of FES and ABC. Because of comparable data derived from each scale, fear of falling and quality of life, activity daily living were included. Concurrent validity, criterion validity and correlational validity were tested. Reliability was tested by internal consistency, test-retest method. RESULTS: Cronbach`s alpha was 0.9043 in FES, and 0.99623 in ABC. Test-retest correlations in all scales were higher than 7.0. Statistically significant association was found between fear of falling and both scales. Correlation coefficient between Quality of life(SF-8) and ABC was -0.142(p=0.049). Both FES and ABC are correlated significantly each other. CONCLUSION: The Korean version of FES and ABC appears to be a reliable and valid method for meas- uring fear of falling. These instruments may be useful in assessing the independent contribution of fear of falling. ABC scale may be more useful to detect loss of balance confidence in more highly functioning seniors.
Adult ; Humans ; Quality of Life ; Reproducibility of Results* ; Weights and Measures

We report two cases of hyalinizing trabecular carcinoma (HTC) of the thyroid gland. These two patients were euthyroid women aged 36 and 65 years of age. The tumors were encapsulated and measured 0.8 and 4.0 cm in diameter, respectively. Histologically, the tumors were composed of a compact proliferation of cells in a lobular and trabecular pattern with an intervening hyalinized, fibrotic vascular stroma. Occasionally the cells were arrayed in microfollicles. Multiple and serial sections showed cords of tumor cells invading into the capsule in both cases and vascular invasion in one case. These findings suggested that HTCs are a malignant counterpart of hyalinizing trabecular adenoma, similar to conventional follicular tumor. Positive immunostaining of tumor cells for thyroglobulin and negative staining for high molecular weight cytokeratin, cytokeratin 19, neuron specific enolase, chromogranin, and synaptophysin allowed distinction from medullary carcinoma. Even though HTCs are an heterogeneous group of tumors, the present two cases are probably variants of follicular carcinoma rather than papillary carcinoma.
Adenoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Female ; Humans ; Hyalin* ; Keratin-19 ; Keratins ; Molecular Weight ; Negative Staining ; Phosphopyruvate Hydratase ; Synaptophysin ; Thyroglobulin ; Thyroid Gland*

Dural shunts are vascular communications in which blood flows through small meningeal branches of the carotid arteries to enter the venous circulation near the cavernous sinus. The clinical characteristics of 13 eyes[12 patients] with dural cavernous sinus fistula are described. Of these patients, 84.6%[11 eyes]were women with dilated conjunctival and episcler-al vessels, exophthalmos, retinal hemorrhage and venous engorgement, elevation of intraocular pressure, swelling of lid and orbital area, limited eye movement and diplopia, and bruit, in order of frequency. Decreased vision had occurred in only 1 eye, due to central retinal vein obstruction during follow-up periods after embolization. CT or MRI scan showed the enlargement of the extraocular muscle and superior ophthalmic vein. Two eyes had resolved spontaneously. Ten eyes of dural cavernous sinus fistula had the resolution of clinical symptoms after carotid angiography with embolization. The complications after embolization had occurred in one eye with transient sensory deficit of face.
Angiography ; Carotid Arteries ; Cavernous Sinus* ; Diplopia ; Exophthalmos ; Eye Movements ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Hyperemia ; Intraocular Pressure ; Magnetic Resonance Imaging ; Orbit ; Retinal Hemorrhage ; Retinal Vein ; Veins

No abstract available.
Focal Nodular Hyperplasia*

Human papillomavirus (HPV) 16/18 is a causative agent of uterine cervical carcinoma. HPV 16/18 can alter cell cycle regulation through apoptosis. Bcl-2 is an important regulatory gene of apoptosis. A study was done to evaluate the relation between HPV 16/18 and bcl-2 and apoptosis in 21 cases of carcinoma in-situ (CIS), 5 cases of microinvasive carcinoma and 23 cases of invasive squamous cell carcinoma. HPV 16/18 was detected by hybrid capture system (HCS), bcl-2 protein by immunohistochemical method and apoptosis by using the hematoxylin-eosin stained slide. The results were as follows: Expression of the bcl-2 protein was 43% (9/21) in CIS and 26% (6/23) in invasive carcinoma. Expression of the bcl-2 protein was 42% (5/12) in CIS with HPV 16/18 infection, 44% in CIS without HPV 16/18 infection, 20% (2/10) in invasive carcinoma with HPV 16/18 infection and 31% (4/13) in invasive carcinoma without HPV 16/18 infection. Mean apoptotic index (mAI) was 3.36 in CIS, 5.23 in microinvasive and 6.25 in invasive carcinoma. mAI was 3.66 in CIS with HPV 16/18 infection, 2.86 in CIS without HPV 16/18 infection, 6.18 in invasive carcinoma with HPV 16/18 infection and 6.30 in invasive carcinoma without HPV 16/18 infection. Based on these results, we conclude that there are no correlation between HPV infection and bcl-2, and between HPV infection and apoptosis in invasive and in situ carcinoma of the uterine cervix, and apoptosis is increased according to tumor progression.
Apoptosis* ; Carcinoma, Squamous Cell* ; Cell Cycle ; Cervix Uteri* ; Female ; Genes, Regulator ; Humans