We present the cytologic features of a case of solid and papillary neoplasm of the pancreas. Cytologically, the tumor was composed of a monotonous population of polygonal cells containing eccentrically located round nuclei with one or two distinct small nucleoli and a finely stippled chromatin pattern. The tumor cells were similar to those of the islet cell tumor and showed isolated loosely aggregated and solid sheets or large cell clumps. The large cell clumps revealed a branching papillary structure containing fibrovascular central core, which is characteristic histologic feature of solid and papillary neoplasm of the pancreas. This case was confirmed by tissue examination including histochemical, immunohistochemical and electron microscopical studies. Ultrastructurally, the tumor cells contained a few membrane-bound electron dense granules.
Adenoma, Islet Cell ; Chromatin ; Pancreas ; Urinary Tract*

There has been much interest in the involvement of wind-up in the hyperalgesia and allodynia of chronic pain syndrome. For investigating the hehaviorml parallels of this wind-up phenomenon, it was limed to evaluate the changes of neurotransmitters(aspartate. lutamate, and taurine) in central sensitization after formalin-induced peripheral nerve injurv in the rats. The experiment was divided into two subexperiments; One was the formalin test.;and the other was microdialysis for evaluation of neurotransmitters. In formalin test (n=7), 50 microliter of 5% formalin was injected suhcutaneously in the foot dorsum of the right hind limb with a 30 G neeclle. To cluantify the formilin response. the number of spontaneous t1inches was counted at 1-2 minutes and 5-6 minutes and at 5 minutes intervals during the period 10- 60 minutes after formalin injeclion. In microdialysis study. the experimental animals were divided randomly into two groups. In experimentl group (n=10). the microdialysis catheter was perfused with artificial cerehrospinal fluid by 3 microliter/min for one hour. Then. the two beseline dialysis samples were collected and 50 microliter of 5% formalin was injected .iuhcutaneously in thc plantar surface of the right hind paw with a 30 G needle. Three 10 minutes dialysate samples were collected after formalin injection. In control group(n=10), the normal saline instead of formalin was used. The results were as followed: In formalin test, there was a biphasic pattern of flinchine after formalin injection. The peak in phase I was shown at 2 minutes after formalin injection. The second peak was shown at 35 minutes alter formalin injection during phase II. In microdialysis study, thcre were statistically significant increascs of aspartate and lutamate concentrations, excitatory neuro transmitters, during the first 10 minutes after formalin injection. After lhen, all values of these neurotransmitters were rcturned to baseline values. The concentrations of taurine, an inhihitory neurotransmitter, was shown a tendency of an increase after formalin injection but, it was not statistically significant. From these results, it secms that the excitatory amino acid ncurotransmitter may partly play a role to triqer the central sensitization after peripheral nerve injury.
Animals ; Aspartic Acid ; Catheters ; Central Nervous System Sensitization* ; Chronic Pain ; Dialysis ; Dronabinol ; Excitatory Amino Acids ; Extremities ; Foot ; Formaldehyde ; Hyperalgesia ; Microdialysis ; Needles ; Neurotransmitter Agents* ; Pain Measurement ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; Taurine

Takayasu's arteritis is briefly as an inflammatory process of unknown etiology occuring dominantly in young female most commonly involving the great vessels arising from the aortic arch. The disease process results in stenosis and obliteration of involved vessels. Syncope in Takayasu's arteritis is known to result from decreased blood flow to brain because of stenosing blood vessels. We herein describe a case of paroxysmal atrioventricular block in a 40-year old man with Takayasu's arteritis. The patient presented with spontaneous recurrent syncope associated with paroxysmal AV block. Carotid sinus pressure repeatedly induced paroxysmal AV block and syncope. Carotid sinus pressure after pretreatment of atropine failed to induce AV block or syncope. Coronary angiogram was normal. We concluded that syncope in this patients was attributed to carotid hypersensitivity rather than decreased blood flow to the brain due to vessel stenosis.
Adult ; Aorta, Thoracic ; Atrioventricular Block* ; Atropine ; Blood Vessels ; Brain ; Carotid Sinus ; Constriction, Pathologic ; Female ; Humans ; Hypersensitivity ; Syncope ; Takayasu Arteritis*

No abstract available.
Craniocerebral Trauma* ; Follow-Up Studies* ; Head* ; Humans

OBJECTIVES: The aim of this study was to identify the relationship between serum gamma-glutamyltransferase (GGT) and bone mineral density (BMD) in postmenopausal women. METHODS: We evaluated 200 postmenopausal women who were visiting a health promotion center at a university hospital from January 2009 to December 2011. Their current medical diseases and medication history were collected through medical records. Basic physical examinations and laboratory tests were performed on all subjects. RESULTS: The levels of serum GGT within their normal range were positively correlated with waist circumference (P = 0.01), triglycerides (P <0.001), alkaline phosphatase (P = 0.009), and uric acid (P = 0.01). The serum GGT within their normal range were negatively associated with the femur neck BMD (P = 0.002). In adjusted analysis including age and body mass index, the BMD of the femur neck was more strongly associated with a high-normal serum GGT level among the postmenopausal women as compared with those with a low-normal serum GGT level (P = 0.02). CONCLUSIONS: Serum GGT within its normal range is negatively correlated with the BMD in the femur neck among postmenopausal women. It can be useful for selecting a group that is at high risk for the bone fracture regardless of the underlying mechanism.
Alkaline Phosphatase ; Body Mass Index ; Bone Density ; Female ; Femur Neck ; Fractures, Bone ; gamma-Glutamyltransferase ; Health Promotion ; Humans ; Medical Records ; Physical Examination ; Postmenopause ; Reference Values ; Triglycerides ; Uric Acid ; Waist Circumference

No abstract available.
Colon, Descending* ; Leiomyosarcoma*

PURPOSE: To evaluate the effectiveness of a dexamethasone intravitreal implant (Ozurdex(R)) in the treatment of diabetic macular edema refractory to combined treatment of bevacizumab and triamcinolone. METHODS: We reviewed 9 eyes of 9 patients with diabetic macular edema treated with dexamethasone intravitreal implant. The patients were included in the study if presenting with refractory diabetic macular edema of more than 3 months despite combined treatment of intravitreal bevacizumab injection with posterior subtenon triamcinolone injection or intravitreal triamcinolone injection. We assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) using optical coherence tomography at initial visit and 1, 3 and 4 months. RESULTS: The mean follow-up was 6.7 +/- 2.2 months. The baseline mean BCVA was 0.81 +/- 0.47 logarithm of the minimum angle of resolution (log MAR), which improved to 0.61 +/- 0.37 log MAR (p = 0.017), 0.57 +/- 0.38 log MAR (p = 0.011) and 0.62 +/- 0.36 log MAR (p = 0.027) at 1 month, 3 months and 4 months, respectively. The baseline mean CMT was 558.0 +/- 110.32 microm and decreased to 325 +/- 64.21 microm (p = 0.008) and 300.22 +/- 59.46 microm (p = 0.008) at 1 month and 3 months, respectively, then increased to 468.44 +/- 150.85 microm (p = 0.058) at 4 months after injection. CONCLUSIONS: Dexamethasone intravitreal implant showed short-term efficacy in the treatment of diabetic macular edema refractory to combined treatment of bevacizumab and triamcinolone and produced significant improvements in BCVA and CMT until 3 months after injection. The CMT then increased, but BCVA was sustained until the fourth month.
Dexamethasone* ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macular Edema* ; Tomography, Optical Coherence ; Triamcinolone ; Visual Acuity ; Bevacizumab

A 12-year-old boy developed cholestatic hepatitis with Steven-Johnson syndrome following the use of amoxicillin. The skin lesion and general condition were improved over 2 weeks, but jaundice was gradually aggrevated. We performed liver biopsy, on 30th hospital day, which showed cholestatic hepatitis. The patient improved gradually and liver function was normalized 5 months later.
Amoxicillin ; Biopsy ; Child ; Hepatitis* ; Humans ; Jaundice ; Liver ; Male ; Skin

This research was performed to investigate whether or not the psychobiology of posttraumatic stress disorder is related to dopamine systems. Plasma homovanillic acid levels were measured in 16 male patients with posttraumatic stress disorder and in 16 nonpsychiatric normal males. Posttraumatic stress disorder was diagnosed using the DSM-IV. Plasma homovanillic acid levels were significantly higher in patients with posttraumatic stress disorder than in normal control subjects(p<0.05). The findings of this study suggest that hyperactivity of dopamine systems may be related to the psychobiology of posttraumatic stress disorder.
Diagnostic and Statistical Manual of Mental Disorders ; Dopamine ; Homovanillic Acid* ; Humans ; Male ; Plasma* ; Stress Disorders, Post-Traumatic*

BACKGROUND: Pregnancy in human and rodents is associated with dramatic matemal metabolic changes. Insulin-like growth factors (IGFs) are mitogenic peptides that are essential for fetal and maternal tissue growth during pregnancy. They circulate complexed primarily with a serum IGF-binding protein (IGFBP-3) which regulates the availability of the IGFs to their specific target tissues. METHODS: To examine the changes of IGFs and IGFB-3 during pregnancy, we measured serum total IGF-I, free IGF-I, IGF-II and IGFBP-3 by using specific radioimmunoassay, immunoradio-metric assay, western ligand blot and western immunoblot. Blood samples were obtained from 88 pregnant women between 6-40 weeks gestation. RESULTS: While serum IGF-I levels increased up to 50% in late pregnancy, serum IGF-II levels remained unchanged. However, serum free IGF-I levels were significantly higher during pregnancy than in nonpregnancy. Western ligand blot analysis revealed that IGFBP-3 in pregnancy serum was significantly decreased at 6 weeks of gestation, continued decreased level until term, and returned to a nonpregnant level by postpartum 10 day. Serum IGFBP-3 profiles in Western immunoblot analysis revealed that 30 kDa fragments of IGFBP-3 were detectable in pregnancy serum but not in nonpregnancy serum. In contrast, serum IGFBP-3 levels using radioimmunoassay was significantly increased in late pregnancy. CONCLUSIONS: 1) serum IGF-I was significantly elevated in late pregnancy 2) serum IGF-II was not significantly changed 3) free IGF-I significantly elevated throughout gestation 4) intact IGFBP-3 was markedly reduced after 6 weeks of gestation.
Blotting, Western ; Female ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Peptides ; Postpartum Period ; Pregnancy* ; Pregnant Women ; Radioimmunoassay ; Rodentia ; Somatomedins