Neurofibromatosis is a systemic hereditary disorder with varied manifestations in bone, soft tissue, the nervous system and skin. Cutaneous manifestations of neurofibromatosis are characterized by cafe-au-lait macules, multiple neurofibromas, Lisch nodules and intertriginous freckling. Some benign or malignant tumors such as juvenile xanthogranuloma, pheochromocytoma, and malignant melanoma can accompany neurofibromatosis. But, in the English literature, no case of eccrine spiradenoma associated with neurofibromatosis has been reported. Eccrine spiradenoma is a benign uncommon neoplasm of skin adnexa. It presents as a painful, slow-growing and solitary nodule on the head or upper trunk. Here, we report a rare case of eccrine spiradenoma in a patient with neurofibromatosis.
Head ; Humans ; Melanoma ; Nervous System ; Neurofibromatoses ; Neurofibromatosis 1 ; Pheochromocytoma ; Skin ; Xanthogranuloma, Juvenile

OBJECTIVE: In an effort to develop a more effective therapeutic strategy for ovarian cancer, we examined whether the restoration of the wild-type p53 gene can enhance the therapeutic effect of chemotherapy. METHODS: In this study, Ov-ca-2774 cells, which are known to have p53 point mutation and cisplatin-resistance, were selected and currently used chemotherapeutic agents including cisplatin, carboplatin, paclitaxel, etoposide, topotecan, and doxorubicin were added concurrently or sequentially with adenovirus-mediated p53 gene transfer (Ad5CMV-p53). RESULTS: Transfer of the wild-type p53 cDNA gene into Ov-ca-2774 cells showed 55% cell killing in vitro at a multiplicity of infection (MOI) of 40. Although the combination of carboplatin or paclitaxel followed by p53 gene transfer with an interval of 48 h manifested no enhanced cell killing compared with cells infected with Ad5CMV-p53 alone, the other combinations of chemotherapeutic agents and p53 gene transfer resulted in 15% to 37% further cell killing (P<0.05). Furthermore, p53 gene transfer followed by doxorubicin with an interval of 24 h and concurrent combination of etoposide with p53 gene transfer showed significant difference in cell killing in contrast to the other combination strategies in the respective chemotherapeutic agent exposure groups (P<0.05). CONCLUSION: Our data demonstrated that combination of p53 gene transfer and chemotherapeutic agents had higher cell killing than either of these two modality alone.
Carboplatin ; Cisplatin ; DNA, Complementary ; Doxorubicin ; Drug Therapy* ; Etoposide ; Genes, p53 ; Homicide ; Humans* ; Ovarian Neoplasms* ; Paclitaxel ; Point Mutation ; Topotecan

OBJECTIVE: To evaluate the compliance and satisfaction of rehabilitation recommendations for advanced cancer patients hospitalized in the palliative care unit. METHODS: Advanced cancer patients admitted to a hospice palliative care unit were recruited. Patients with advanced cancer and a life expectancy of less than 6 months, as assumed by the oncologist were included. Patients who were expected to die within 3 days were excluded. ECOG and Karnofsky performance scales, function ambulatory category, level of ambulation, and survival days were evaluated under the perspective of comprehensive rehabilitation. Problem-based rehabilitations were provided categorized as physical therapy at the gym, bedside physical therapy, physical modalities, medications and pain intervention. Investigation of compliance for each category was completed. Patient satisfaction was surveyed using a questionnaire. RESULTS: Forty-five patients were recruited and received evaluations for rehabilitation perspective. The subjects were reported to have gait-related difficulties (71.1%), pain (68.9%), poor medical conditions (68.9%), bladder or bowel problems (44.4%), dysphagias (11.1%), mental status issues (11.1%), edemas (11.1%), spasticity (2.2%), and pressure sores (2.2%). In the t-test, patients with good compliance for GymPT showed higher survival days (p < 0.05). In the satisfaction survey, patients with performance scales showed a greater satisfaction in Spearman's correlation analysis (p < 0.05). CONCLUSION: Advanced cancer patients admitted to the hospice palliative care unit have many rehabilitation needs. Patients with a longer survival time showed better compliance for GymPT. Patients with a better performance scale showed a higher satisfaction. Comprehensive rehabilitation may be needed to advanced cancer patients in the hospice palliative care unit.
Compliance ; Deglutition Disorders ; Edema ; Hospice Care ; Hospices ; Humans ; Life Expectancy ; Muscle Spasticity ; Palliative Care ; Patient Satisfaction ; Pressure Ulcer ; Rehabilitation ; Urinary Bladder ; Walking ; Weights and Measures

BACKGROUND: Terminally ill cancer patients suffer from refractory symptoms, and the last option of treatment is to consider sedatives. However, due to concerns that sedation may shorten survival time, some people prefer not to take sedatives. The purpose of this study was to investigate the effects of sedative administration on survival time among terminally ill cancer patients.METHODS: Two hundreds and thirty-seven patients who were hospitalized to the hospice care unit of public hospitals in Seoul from January, 2015 to March, 2016 were analyzed retrospectively. The univariate and multivariate Cox's proportional hazard regression model was used to determine independent factors related to survival time.RESULTS: The usage of sedation was necessary because the incidence of insomnia was 61.4% in the lorazepam only group, and the incidence of delirium was highest in the haloperidol group and the haloperidol with lorazepam group. Interestingly, multivariate analysis showed that male (HR, 1.766; P < 0.001), decreased consciousness (HR, 1.803; P=0.003), anorexia (HR, 1.506; P=0.012), resting dyspnea (HR, 1.757; P < 0.001), elevated serum bilirubin (HR, 1.657; P=0.001), and the haloperidol with lorazepam group (HR, 0.535, P < 0.001) were each significantly associated with survival time. Furthermore, patients in the haloperidol with lorazepam group survived longer than patients with no such medications.CONCLUSION: There is no evidence that treatment with sedative medication shortens the survival time of patients with terminally ill cancer with refractory symptoms.
Anorexia ; Bilirubin ; Consciousness ; Delirium ; Dyspnea ; Haloperidol ; Hospice Care ; Hospices ; Hospitals, Public ; Humans ; Hypnotics and Sedatives ; Incidence ; Lorazepam ; Male ; Multivariate Analysis ; Palliative Care ; Retrospective Studies ; Seoul ; Sleep Initiation and Maintenance Disorders ; Terminally Ill

Primary Hyperparathyroidism is the metabolism abnormality of calcium, phosphate, and bone due to the high synthesis of parathyroid hormone, a rare endocrine disease in children. It scarcely occurs in children so that till now it was reported only 4 cases in Korea, especially with abdominal symptoms. We report this case of primary hyperparathyroidism with brief review of literatures.
Abdominal Pain ; Calcium ; Child ; Endocrine System Diseases ; Humans ; Hyperparathyroidism, Primary ; Korea ; Parathyroid Hormone ; Parathyroid Neoplasms

Desmoid tumors are uncommon benign neoplasm of the fibroblasts. They occur rarely in the general population, but they are comparatively common in patients with familial polyposis coli with or without other elements of Gardner's syndrome. Herein, we report a 16-year-old woman with Gardner's syndrome complicated by desmoid tumors on the right subscapular area.
Adenomatous Polyposis Coli ; Adolescent ; Female ; Fibroblasts ; Fibromatosis, Aggressive ; Gardner Syndrome ; Humans

OBJECTIVES: After LEEP conization of cervical precancerous lesions, cytologic follow-up and colposcopy is frequently unsatisfactory. This study was performed to investigate the relationship between the presence of human papillomavirus (HPV) and abnormal follow-up results. METHODS: Between March 1995 and Feburary 1999, 98 patients treated by LEEP for cervical dysplasia and CIS were included. All patient had initially done HPV testing by Hybrid Capture System (Digene Co., U.S.A.). Patients were followed up with PAP, colposcopy and HPV test. RESULTS: After mean follow-up 10.9-month follow-up, 9 patients (9.2%) had the abnormal cytology (>ASCUS). After treatment, there were 2 abnormal cytologic follow-up cases (13.3%) in the groups of koilocytosis and CIN I in initial tissue pathology, 7 abnormal follow-up cases (8.4%) in groups of CIN II/III and CIS. There was no significant difference between the recurrence rates of these two group (P=0.27). The presence of high-risk HPV DNA after LEEP was done in 26 cases. Of the HPV-positive follow-up cases, 4 patients (50%) had abnormal cytologic results. But none had abnormal cytology in HPV-negative patients. CONCLUSION: Participants with positive follow-up HPV test have a higher recurrence rate than those with negative HPV test. Our study suggests the value of supplementary HPV DNA testing during follow-up of patients treated for cervical precancerous lesions.
Colposcopy ; Conization ; DNA ; Follow-Up Studies* ; Human Papillomavirus DNA Tests ; Humans ; Pathology ; Recurrence

It has been known that glassy cell carcinoma (GCC) of uterine cervix is rare and rapidly progressive, and has a poor prognosis. Here we describe a case of GCC in which photodynamic therapy (PDT) was performed prior to radical hysterectomy. The patient, a 42 year-old woman at the stage of FIGO Ib2 underwent interstitial PDT (Photogem, 2 mg/kg; light, p=100 mV, W=100 J/cm2, 15 min/each 4 direction). The cervical lesion displayed inflammation and necrosis at 48 h following PDT. At 2 weeks post PDT, inflammatory reaction was disappeared and the tumor volume was decreased. No side effects of PDT were also observed. Subsequently, the patient underwent radical hysterectomy and pelvic lymph node resection. This case suggests that PDT prior to radical surgery might be an effective way to reduce tumor size without any side effects. More cycles of PDT might be beneficial for treating GCC of the uterine cervix.
Adult ; Cervix Uteri* ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Inflammation ; Lymph Nodes ; Necrosis ; Photochemotherapy* ; Prognosis ; Tumor Burden

PURPOSE: Cancer of the uterine cervix remains the leading cause of cancer death in Korean women. Conventional examinations still have limitations with regards to sensitivity and specificity in diagnosis and to monitoring of the disease. Thus, an additional specific tumor marker is needed for early detection of recunence of uterine cervical carcinoma and for estimation of prognosis. MATERIALS AND METHODS: Monoclonal antibodies against human cervical carcinoma were generated using hybridoma technology. These tnurine monoclonal antibodies were produced by fusion of spleen cells obtained from mice immunized with CUMC-6, a human cell line of squamous cell carcinoma derived from uterine cervix, and P3-X63-Ag8 mouse myeloma cells. RESULTS: We obtained 415 hybridomas secreting specific monoclonal antibodies to cervical carcinoma antigen continuously. Among them, one hybridoma designated CCS that was highly reactive with cervical carcinoma was selected and examined on. the staining pattern and the reactivity with antigenic detenninants of cervical carcinoma. Immunohistochemical staining revealed that CCS monoclonal antibody reacted with all of the seven cervical carcinoma tissues, but also reacted with one of the ten (10%) normal cervical tissues. Westem blot analysis showed that CC5 monoclonal antibody detected single 19.5-kDa protein band in cervical cancer patient's sera. The detection rate was 88% (7/8). However, the antibody did not show any reactivity to 15 sera of normal healthy women tested. Sodium dodecyl sulfate polyacrylamide gel electrophoretic (SDS-PAGE) analysis of CCS monoclonal antibody immunoprecipitates of extracts of L-[S] methionine-labeled human cer vical carcinoma cells showed a major band in apparent molecular weight of 51,000 daltons. The isotype and subclass of CC5 monoclonal antibody was IgG2b in hemagglutination assay. CONCLUSIONS: We have developed a new monoclonal antibody, CC5, against squamous cell carcinoma of the human uterine cervix. Further investigation is needed to establish this monoclonal antibody as an immunodiagnostic devise for cervical cancer.
Animals ; Antibodies, Monoclonal ; Carcinoma, Squamous Cell ; Cell Line ; Cervix Uteri ; Diagnosis ; Female ; Hemagglutination ; Humans ; Hybridomas ; Immunoglobulin G ; Mice ; Molecular Weight ; Prognosis ; Sensitivity and Specificity ; Sodium Dodecyl Sulfate ; Spleen ; Uterine Cervical Neoplasms

Telomerase, a ribonucleoprotein reverse transcriptase that extends telomeres of eukaryotic chromosomes is repressed in normal somatic cells but is activated during development and neoplasia. The regulation mechanism of telomerase activity in cancer cells is not clearly known. In this report, a possible affect of PKC on telomerase activity was examined using HeLa and CUMC-6 cervical cancer cell lines. Exposure of cells to PKC inhibitor, bisindolylmaleimide I and Go6976, and high levels of PKC activator, 12-O-tetradecanoyl phorbol 13-acetate (TPA) resulted in the inhibition of PKC activity in both cells. Telomerase activities were also inhibited by bisindolyl-maleimide I and Go6976, respectively, in a time-dependent manner. As PKC activity changes in TPA-treated cervical cancer cells, telomerase activities were increased at low dose of TPA and decreased at high dose. The expression levels of human telomerase subunits, human telomerase RNA (hTR) were not influenced by PKC modulating drugs. In contrast, the expression of full-length human telomerase reverse transcriptase (hTERT) was decreased after exposure to bisindolylmaleimide I and Go6976 in a time-dependent manner. hTERT expression was not affected by low dose of TPA. In contrast, high dose of TPA inhibited hTERT expression level. But the expression patterns of beta-deletion transcript of hTERT after 72 h of treatment with PKC inhibitors or high dose of TPA exposure were not discernable as compared with those of full-length hTERT transcripts to PKC modulating drugs. These results suggest that PKC-modulating drugs altered telomerase activities by affecting full-length hTERT expression profile in human cervical cancers.
Alternative Splicing ; Carbazoles/pharmacology ; Catalytic Domain ; Cervix Neoplasms/*enzymology ; Enzyme Inhibitors/metabolism ; Female ; Hela Cells ; Human ; Indoles/pharmacology ; Maleimides/pharmacology ; Protein Kinase C/antagonists & inhibitors/*metabolism ; RNA, Messenger/metabolism ; Support, Non-U.S. Gov't ; Telomerase/antagonists & inhibitors/genetics/*metabolism ; Tetradecanoylphorbol Acetate/pharmacology ; Tumor Cells, Cultured