Cystic hypersecretory carcinoma of the breast is a rare variant of ductal carcinoma of breast, first described in 1984 by Rosen and Scott. Histologically, it is characterized by the formation of dilated ducts and cysts containing an eosinophilic secretory product resembling thyroid colloid. Cytologic findings show a few clusters of atypical ductal epithelial cells in amorphous proteinaceous material with cracking artifact. Differential diagnosis include mucinous carcinoma and benign mucocele-like tumor. We present two cases of fine needle aspiration cytology of cystic hypersecretory intraductal carcinoma of the breast with a review of the literature.
Adenocarcinoma, Mucinous ; Artifacts ; Biopsy, Fine-Needle* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating* ; Colloids ; Diagnosis, Differential ; Eosinophils ; Epithelial Cells ; Thyroid Gland

Phospholipase C (PLC) plays a role in ligand-mediated signal transduction for cellular activity such as proliferation and differentiation. A recent observation that PLC- gamma1 is highly expressed in some kinds of human cancer tissue supports the view that PLC-gamma1 may be involved in proliferation and carcinogenesis. PLC-gamma2 is known to be involved in B cell differentiation and maturation. However, there have been few studies about the expressions of PLC-gamma1 and gamma2 in human lymphoid malignancy. In the present study, we examined the contents of PLC-gamma1 and gamma2 in 10 cases of B cell, 10 cases of T cell non-Hodgkin's lymphoma and 5 cases of Hodgkin's lymphoma to find out whether these enzymes play any role in the carcinogenesis by immunohistochemistry and immunoprecipitation. Immunoprecipitation analysis revealed that in contrast to increased expression of PLC-gamma2 only in B cell lymphoma, a considerably higher level of PLC-gamma1 was detected in both B and T cell lymphoma. Immunohistochemical finding confirmed this observation. PLC-gamma1 and PLC-gamma2 were expressed in the cytoplasm of most tumor cells. PLC-gamma2 was also expressed in mature B cells, while PLC-gamma1 was not expressed in reactive non-tumor cells. These results suggest that PLC-gamma1 mediated signal transduction implicates a significant role in the carcinogenesis of all types of lymphoid tissue, and PLC-gamma2 may play a role in the carcinogenesis of B cell lymphoma as well as B cell differentiation.
B-Lymphocytes ; Carcinogenesis ; Cell Differentiation ; Cytoplasm ; Hodgkin Disease* ; Humans ; Immunohistochemistry ; Immunoprecipitation ; Lymphoid Tissue ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Phospholipases* ; Signal Transduction ; Type C Phospholipases

Recently, in Korea, imported malarial infections are increased and occasionally domestic infections are reported. But the malarial infected pregnant women are seldom cases and we have experienced second trimester infected one. She had no traveling and transfusion history. She delivered a healthy baby at term by repeated cesarean section and her baby had no evidence of congenital malarial infection. We treated her with hydroxychloroquine at antepartum and primaquine at postpartum. We present this case with a brief review of literatures.
Cesarean Section ; Female ; Humans ; Hydroxychloroquine ; Korea ; Malaria ; Postpartum Period ; Pregnancy Trimester, Second ; Pregnancy* ; Pregnant Women ; Primaquine

We present a case of thoracic splenosis in a 42-yr-old man with a medical history of abdominal surgery for a penetration injury with an iron bar of the left abdomen and back. He had been in good condition, but a chest radiograph taken during a regular checkup showed a multinodular left pleura-based mass. Computed tomography (CT) showed that the mass was well-enhanced and homogeneous, indicating a sclerosing hemangioma. Following its removal by video-assisted thoracoscopic surgery, the mass appeared similar to a hemangioma, with marked adhesion to the left side diaphragmatic pleura and lung parenchyma. Frozen section showed that the lesion was a solid mass consisted with abundant lymphoid cells, suggesting a low grade lymphoma. On permanent section, however, the mass was found to be composed of white pulp, red pulp, a thick capsule and trabeculae and was diagnosed as ectopic splenic tissue, or thoracic splenosis. Review of the patient's history and chest CT at admission revealed that the patient had undergone a splenectomy for the penetration injury 20 yr previously.
Abdominal Injuries/complications ; Adult ; Diagnosis, Differential ; Humans ; Male ; Medical Records ; Spleen/injuries/surgery ; Splenectomy ; Splenosis/*diagnosis/etiology/radiography ; Thoracic Diseases/*diagnosis/etiology/radiography ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed

PURPOSE: Many studies on the time course of inducible nitric oxide synthase (iNOS) gene expression have been performed in the LPS (Lipopolysaccharide)-induced endotoxemic model, but there have been few experimental approaches to continuous peritonitis-induced sepsis model. We conducted this study to establish basic data for future sepsis-related research by investigating the time course of iNOS gene expression and the relationship with the production of inflammatory mediators in the early sepsis model induced by cecal ligation and puncture (CLP). METHODS: Male Sprague-Dawley rats were operated on by sing the CLP method to induce of peritonitis; and then, they were sacrificed and samples of blood and lung tissues were obtained at various times (1,2,3,6,9 and 12 h after CLP). We observed the expression of iNOS mRNA from lung tissues and measured the synthesis of nitric oxide, IL-1beta , and TNF-alpha from the blood. RESULTS: iNOS mRNA began to be expressed at 3 h and was maintained untill 12 h after CLP. The nitric oxide concentration was increased significantly at 6 h, reached its peak level at 9 h, and maintained a plateau untill 12 h after CLP. TNF-alpha began to be detected at 3 h, increased gradually, and decreased steeply from 9 h after CLP. IL-1beta showed its peak level at 6 h after CLP, and tended to decrease without significance. CONCLUSION: We observed that the iNOS gene was expressed later in peritonitis-induced sepsis than in LPSinduced sepsis. Nitric oxide and key inflammatory mediators were also expressed later in peritonitis-induced sepsis than in LPS-induced sepsis.
Animals ; Gene Expression ; Humans ; Inflammation Mediators ; Ligation ; Lung ; Male ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Peritonitis ; Punctures ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Sepsis ; Tumor Necrosis Factor-alpha

OBJECTIVE: To evaluate the efficacy of color Doppler ultrasound in diagnosis and management of placenta previa with accreta. METHODS: Hospital records were reviewed all cases of placenta previa from December 1999 to June 2002, and seventy-four patients with placenta previa underwent color Doppler ultrasound in their second and third trimester. Four diagnostic criteria of placenta accreta were diffuse lacunar flow pattern, exhibiting diffusely dilated vascular channels throughout the whole placenta: focal lacunar flow pattern showing irregular sonolucent vascular lakes, regionally or focally within the intraparenchymal placental area: absence of subplacental vascular signals in the areas lacking the peripheral subplacental hypoechoic zone: interphase hypervascularity with abnormal blood vessels linking the placenta to the bladder. RESULTS: Twenty-four of the seventy-four patients diagnosed placenta previa with accreta according to the above criteria and thirteen of these have proven to placenta accreta histopathologically. In ten cases hysterectomy were done under the group of suspicious placenta accreta. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 83%, 56% and 100%. CONCLUSION: The color Doppler ultrasound was effective method for the diagnosis of placenta previa with accreta, so proper diagnosis will be helpful to management of placenta previa with accreta patients.
Blood Vessels ; Diagnosis* ; Female ; Hospital Records ; Humans ; Hysterectomy ; Interphase ; Lakes ; Placenta Accreta ; Placenta Previa* ; Placenta* ; Pregnancy ; Pregnancy Trimester, Third ; Sensitivity and Specificity ; Ultrasonography* ; Urinary Bladder

PURPOSE: A tracheostomy is an important, life-saving procedure to maintain a patent airway. Our aim was to evaluate the effects and safety of tracheostomies done by emergency physicians. METHODS: This was a retrospective study conducted in the emergency intensive care unit (ICU) of a regional emergency medical center. We enrolled consecutive patients who had a tracheostomy in the emergency ICU between November 2004 and September 2008. We collected data on demographic characteristics, diagnosis at admission, the indication for a tracheostomy, time from intubation to tracheostomy, weaning success, time from tracheostomy to weaning, hospital stay, survival discharge, and complications. We divided the patients into two groups: the EM group included patients who had a tracheostomy done by an emergency physician; the OL group had it done by an otolaryngologists. We then made between-groups comparisons. RESULTS: One hundred forty six patients were enrolled in this study. Of the 146 patients, 94 were included in the EM group and 52 in the OL group. There was no significant difference in the demographic characteristics except age, diagnosis at admission, indication of tracheostomy, time from intubation to tracheostomy, weaning success, time from tracheostomy to weaning, hospital stay, and survival discharge between the two groups. There was no significant difference in demographic characteristics? or in the incidence of complications between the two groups. CONCLUSION: Tracheostomy done by emergency physicians are as effective and safe as ones done by otolaryngologists.
Emergencies ; Emergency Medicine ; Humans ; Incidence ; Intensive Care Units ; Intubation ; Length of Stay ; Otolaryngology ; Postoperative Complications ; Retrospective Studies ; Tracheostomy ; Treatment Outcome ; Weaning

No abstract available.
Female ; Fertilization* ; Humans ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, Twin*

No abstract available.
Hodgkin Disease*

BACKGROUND: Simvastatin belongs to the statin family, whose members have immunomodulatory activities. Ezetimibe have synergetic effects when co-administered with simvastatin. In several case reports, alopecia totalis and alopecia universalis were successfully treated with simvastatin/ezetimibe, suggesting that this combination could be a new efficient therapy for recalcitrant alopecia areata (AA). OBJECTIVE: To verify the efficacy of the simvastatin/ezetimibe combination therapy for recalcitrant AA and investigate the relationship between various treatment responses and prognostic factors. METHODS: This prospective open study was performed in patients with recalcitrant AA with the bald surface exceeding 75%. All patients took simvastatin (40 mg) and ezetimibe (10 mg) daily. The extent of hair regrowth expressed as percentage of the bald area was used to evaluate the effectiveness of the therapy. RESULTS: Of 14 enrolled patients, 4 patients (28.6%) were judged as responders showing regrowth of 30% to 80% after 3 months of treatment. The mean age of onset in non-responders was significantly lower than in responders. The total score of prognostic factors, calculated as a sum of factors related to poor prognosis, was much lower in responders than in non-responders. CONCLUSION: The remission rate in this study was unsatisfactory. However, since the recruited patients had not responded to any other treatments for AA, simvastatin/ezetimibe can still be considered as an alternative treatment for recalcitrant AA. The total scores of the prognostic factors were statistically different between responders and non-responders. These results can be used to predict the outcome of treatment with simvastatin/ezetimibe and anticipate prognosis.
Age of Onset ; Alopecia Areata* ; Alopecia* ; Ezetimibe ; Hair ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Prognosis ; Prospective Studies* ; Simvastatin