Malignant transformation of benign cystic teratomas of the ovary is rare, with an incidence rate of 1-3%. The most common malignancy associated with benign cystic teratoma of the ovary is squamous cell carcinoma, which represents 90% of malignant transformations, followed by adenocarcinoma and carcinoid. Primary malignant neuroectodermal tumor in a mature cystic teratoma is extremely rare and microscopically can be subclassified as differentiated, primitive, and anaplatic. We experienced a case of primitive neuroectodermal tumor (PNET) associated with mature cystic teratoma of the ovary in a 11-year-old girl. Grossly, the ovary was a unilocular cyst which contained sebum material and disclosed several large, yellow to gray-tan polypoid excresences attached to the inner cystic wall. Except a large, fish-flesh, soft mass, the other polypoid masses were covered with sebum and contained small pieces of cartilage and tooth, and microscopically represented as mature teratoma. The large, fish-flesh, soft mass disclosed sheets and lobules of closely packed small cells with thin fibrovascular septa, which frequently replacing and encroaching the mature cystic teratoma. The small tumor cells were uniform and made up of round to oval nuclei with coarse chromatin and prominent nucleoli, very similar to those of PNET of the central nervous system.
Incidence ; Cysts ; Adenocarcinoma

p53 gene alterations in the ovarian cancers are regarded as early events in the whole process of carcinogenesis. This study is intended to compare p53 protein expression rate in the ovarian surface epithelial tumors according to histologic types, degree of malignancy and differentiation. 134 cases of ovarian epithelial tumors including 26 cases of serous cystadenoma, 7 cases of serous borderline malignancy, 15 cases of serous cystadenocarcinoma, 40 cases of mucinous cystadenoma, 21 cases of mucinous borderline malignancy, 20 cases of mucinous cystadenocarcinoma, 4 cases of endometrioid carcinoma, and 1 case of clear cell carcinoma were studied. Immunohistochemistry using monoclonal p53 antibody(DO-7) was applied to the routine formalin-fixed paraffin embedded tissue. The results were as follows; 1. No immunohistochemical positivity of p53 protein was found in all 66 cases of benign serous and mucinous tumors studied. 2. There was no significant difference of p53 protein expression between serous and mucinous malignant tumors. 3. The expression rate of p53 protein exhibited a statistically significant difference between borderline(42%) and malignant(74%) ovarian surface epithelial tumors (p<0.05). 4. The expression rate of p53 protein of poorly differentiated carcinomas(100%) was higher than those of moderately (88%) and well differentiated carcinomas(60%), but there was no statistical significance. In summary, p53 protein expression might be a good indicator of malignant transformation of the ovarian surface epithelial tumors.
Ovarian Neoplasms ; Genes, p53

Heterotopic pregnancy occurs when an intrauterine pregnancy co-exists with an ectopic pregnancy. It is a potentially fatal condition, rarely occuring in natural conception cycle. But its incidence is increased since the rise in PID, pelvic surgery, IUD, and advent of assisted reproductive technology involving use of superovulatory drugs and/or in vitro-fertilization. We present a case of intrauterine twin pregnancy and right tubal pregnancy following treatment with in vitro-fertilization. The right tubal pregnancy was diagnosed after rupturing at 6th gestational weeks, and resected via laparoscopy. And healthy twin babies were delivered without complication at 38th gestational week. So we report this case with a brief review of the literatures.
Female ; Fertilization ; Humans ; Incidence ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Pregnancy, Twin ; Reproductive Techniques, Assisted

PURPOSE: Many reconstruction procedures have been developed in order to resolve patient complaints after a total gastrectomy. However, until now, there has been no general agreement with regard to the ideal reconstruction to perform after a total gastrectomy. Moreover, there have been few reports of the long-term effects of different reconstruction procedures. In this study, we compared the long-term nutritional status and quality of life for patients that received either a Roux-en-Y esophagojejunostomy (R-Y), jejunal interposition (JI), jejunal pouch interposition (JPI), or double tract reconstruction (DT), to determine the optimum reconstruction procedure after a total gastrectomy. MATERIALS AND METHODS: The study consisted of 41 patients younger than 80 years who had undergone a total gastrectomy with curative resection and who had no evidence of recurrence at our hospital between August 2000 and January 2004. The patients were classified into the following four groups, according to the type of reconstruction; simple Roux-en-Y (R-Y group, n=15), jejunal interposition (JI; group, n=8), j Jejunal pouch interposition (JPI group, n=8), double tract interposition (DT group, n=10). The nutritional status was assessed by measuring body weight, serum albumin level, serum hemoglobin level, and the level of serum total protein, and the PNI (Prognostic nutritional index). Quality of life was assessed by GSRS. In addition, endoscopy was performed to confirm the presence of reflux esophagitis. RESULTS: The laboratory findings showed no significant differences between the four groups except for a lower total protein and album level in the DT group after 3 years postoperatively (P=0.006, P=0.033). The percentage of body weight at 1 year, and 3 years postoperatively in the JI group (P=0.013, P=0.011) were significantly less than other groups (P=0.011, P=0.000). The frequency of postoperative symptoms and reflux esophagitis and eating capacity showed no significant differences between the four groups. The GSRS score in the JIP group was significantly better than for the other groups at 1 year, and 3 years postoperatively (P=0.028, P=0.003). CONCLUSION: We believe that the jejunal pouch interposition is the most useful of the four procedures for improving postoperative quality of life.
Body Weight ; Eating ; Endoscopy ; Esophagitis, Peptic ; Gastrectomy* ; Humans ; Nutritional Status* ; Quality of Life* ; Recurrence ; Serum Albumin

Metabolomics has been used as a powerful tool for the analysis and quality assessment of the natural product (NP)-derived medicines. It is increasingly being used in the quality control and standardization of NP-derived medicines because they are composed of hundreds of natural compounds. The most common techniques that are used in metabolomics consist of NMR, GC-MS, and LC-MS in combination with multivariate statistical analyses including principal components analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). Currently, the quality control of the NP-derived medicines is usually conducted using HPLC and is specified by one or two indicators. To create a superior quality control framework and avoid adulterated drugs, it is necessary to be able to determine and establish standards based on multiple ingredients using metabolic profiling and fingerprinting. Therefore, the application of various analytical tools in the quality control of NP-derived medicines forms the major part of this review. Veregen® (Medigene AG, Planegg/Martinsried, Germany), which is the first botanical prescription drug approved by US Food and Drug Administration, is reviewed as an example that will hopefully provide future directions and perspectives on metabolomics technologies available for the quality control of NP-derived medicines.
Chromatography, High Pressure Liquid ; Dermatoglyphics ; Metabolomics* ; Prescriptions ; Quality Control* ; United States Food and Drug Administration

A hand-arm vibration syndrome, local vibration illness, occurs in some workers who use hand held vibration tools. It consists of white fingers, diffusely distributed finger neuropathy, pain in the hand and arm, and a small excess risk of osteoarthritis. This study is aimed to identify effective methods to confirm local vibration illness among various health exams, which are mentioned in worker's special health exam regulation. In addition, this study is aimed to quantitatively assess the daily vibration exposure level as a major determinant of vibration illness. The subjects, 46 vibration workers, were selected according to the results of the first special health exam about vibration hazards at shipbuilding industry in 1997. They all had experiences of work related blanching of fingers. Fifteen controls, who had no vibration exposure at all, were also recruited to compare their test results with the results of vibration workers. We adopted 1 subjective and 6 objective tests to evaluate the effectiveness and feasibility for confirming local vibration illness. These tests were history taking of subjective symptoms according to the Stockholm classification, checking blood pressure of finger, checking grasp power, checking finger skin temperature, nail-bed pressing test, vibration perceptional threshold test, and skin prick test for pain perception. Among these, checking skin temperature, nail-bed pressing test, and vibration perception test included cold water provocations. We also estimated some vibration exposure levels of hand held vibration tools by using previously published data from one automobile company. In conclusion, history taking of subjective symptoms according to the Stockholm classification, nail-bed pressing test, and vibration perceptional threshold test were discovered to be effective to diagnose local vibration illness. Furthermore, vibration perceptional threshold on right fingers showed a dose-response relationship to daily vibration exposure levels. The parameter beta was 0.0005(+/-0.0002), and statistically significant by REM (random effects model).
Arm ; Automobiles ; Blood Pressure ; Classification ; Fingers ; Hand ; Hand Strength ; Hand-Arm Vibration Syndrome ; Osteoarthritis ; Pain Perception ; Skin ; Skin Temperature ; Vibration* ; Water

PURPOSE: There are compelling evidences that house dust mites are important in the pathogenesis of atopic dermatitis. Recently, detection of house dust mite allergens from clothing, skin, and dust from human hair has been reported. To evaluate the importance of house dust mite exposure in the clinical severity of atopic dermatitis. METHODS: We measured house dust mite allergens (Der f1 from Dermatophagoides farinae and Der p1 from D. pteronyssinus) in scalp dander from 27 children with atopic dermatitis and 41 children with asthma only by enzyme-linked immunosorbent assay and examined correlation between house dust mite allergen concentrations in scalp dander and clinical severity of atopic dermatitis in children. RESULTS: Der f1 was detectable in scalp dander samples of 32 patients (47%) from overall 68 patient and Der p1 was detectable in 33 patients (49%). House dust mite allergens (Der f1 or Der p1) were detectable in scalp dander samples of 46 patients (70%) from overall 68 patient. There was no significant differences in house dust mite allergen levels between atopic dermatitis patients and patients with asthma only. There was a tendency of inverse correlation between frequency of scalp washing and concentration of Der f1 in scalp dander extract (r=-0.24, P=0.052). There was a significant correlation between severity grade of atopic dermatitis and concentration of Der f1 in scalp dander (r=0.39, P<0.05) in 27 children with atopic dermatitis. However, there was no significant correlation between severity grade of atopic dermatitis and concentration of Der p1 in scalp dander (r=-0.05, P>0.05). CONCLUSION: There was a significant correlation between house dust mite allergen concentrations in scalp dander and clinical severity in children with atopic dermatitis. And these results suggest that exposure to house dust mite allergen is important in the pathogenesis of atopic dermatitis.
Allergens ; Asthma ; Child* ; Clothing ; Dander* ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Hair ; Humans ; Pyroglyphidae* ; Scalp* ; Skin

OBJECTIVE: We investigated plantar nerve injuries associated with calcaneal fracture and severity of disability. METHOD: From July, 2001 to June, 2002, twelve patients who had calcaneal fractures with persistent foot pain and paresthesia were included in our study. We examined electromyography for medial and lateral plantar nerve, inferior calcaneal nerve, also evaluated types of calcaneal fracture and severity of pain and disability with nerve injury. RESULTS: The intraarticular types were 13 cases, extraarticular type was 1 case and communited types were 2 cases. In the electromyographic findings, the 9 cases were diagnosed asneuropathy. In a cases with neuropathy, 8 persons complained over moderate degree of pain and all persons complained over moderate degree of walking disability. However one of three persons without neuropathy complained over moderate degree of walking disability. So disability tended to be more severe in cases with neuropathy. CONCLUSION: We think that neuropathy associated with calcaneal fracture is a cause of aggravation of pain and walking disability, and electromyography for nerves of foot will be needed in the calcaneal fracture.
Electromyography ; Foot ; Humans ; Paresthesia ; Walking

OBJECTIVE: To evaluate the correlation of electrodiagnostic severity, severity of symptom, and clinical severity in carpal tunnel syndrome (CTS). METHOD: The sixty eight patients with documented CTS in outpatient clinic from January, 2000 to June, 2001 were included (9 male, 59 female, averaged age 50.0+/-8.8 years). We evaluated the severity of symptom, functional status of ADL with the Levine' questionnaire, and clinical severity with 3 kinds of examination (thenar atrophy, sensory change, and Phalen's test). The electrodiagnostic severity was classified according to Stevens' classification and compared with the severity of symptom, functional status, and clinical severity. RESULTS: The electrodiagnostic severity was classified into three degrees. Five patients (7.4%) were classified into mild degree, 32 patients (47.1%) moderate degree, 31 patients (45.6%) severe degree. The average of severity of symptom scores were 28.4+/-8.5, 31.8+/-7.4, and 31.8+/-9.1 respectively, and there was no significant difference (p>0.05) between the groups. Functional status scales were 14.2+/-6.7, 15.6+/-5.4 and 18.9+/-7.0 respectively and no significant difference (p=0.07) but there was a tendency that the severer was electrodiagnostic severity, the more decreased functional status scale. The clinical severity showed a significant correlation with the electrodiagnostic severity (p<0.05). CONCLUSION: The electrodiagnostic severity has a significant correlation with the clinical severity, but not with the severity of symptom, the functional status in CTS.
Activities of Daily Living ; Ambulatory Care Facilities ; Atrophy ; Carpal Tunnel Syndrome* ; Classification ; Female ; Humans ; Male ; Surveys and Questionnaires ; Weights and Measures

This study was performed in order to evaluate the usefulness of the crush cytologic features and differential diagnosis between meningiomas and schwannomas in the central nervous system. Deeply seated and unusually located meningiomas and schwannomas with equivocal or erroneous frozen section diagnosis can be correctly diagnosed cytologically in crush preparations. Twenty-four meningiomas and nine schwannomas were studied by frozen section and crush preparation technique. These tumors displayed distinctive cytologic features. In meningiomas, the tumor tissue fragments were easy to crush, and the tumor cells were arranged in small clusters, flat sheets, papilla-like, whorling pattern or singly. Individual tumor cells displayed round or oval nuclei with finely granular chromatin pattern and inconspicuous small nucleoli. Occasionally psammoma bodies, nuclear pseudoinclusion or nuclear grooves were found. In schwannomas, tissue fragments were hard in consistency and difficult to crush. The crushed tissue presented as thick, irregular fragments with sharp borders. The cells showed ill-defined cytoplasm and round, oval, cigar-shaped or curved nuclei. It is important to emphasize that the smear pattern under low-power view and cytologic features are helpful in discriminating between these two tumors.
Central Nervous System* ; Chromatin ; Cytoplasm ; Diagnosis ; Diagnosis, Differential* ; Frozen Sections ; Meningioma* ; Neurilemmoma*