We experienced a case of adenocarcinoma arising in sacrococcygeal teratoma. The patient was a 52-year-old woman. She was admitted due to one month of sacral pain. She had a sacral mass since birth. On physical examination, anal fistula was present at the perianal area and pus drainage was noted. MR image showed multiple variable-sized cysts with inhomogeneous density. Resected specimen, mesuring 12.5 7.0 cm in diameter, showed multiple variable-sized cystic lesions admixed with grayish solid portion. The cysts contained mucoid material. The microscopic examination showed mature teratoma composed of cysts lined by pseudostratified ciliated columnar epithelium, intestinal mucosa, mature cartilage, bone, and fat tissue. A moderately differentiated adenocarcinoma developed from the cystic area in the mass.
Adenocarcinoma* ; Adult ; Cartilage ; Drainage ; Female ; Humans ; Intestinal Mucosa ; Middle Aged ; Mucous Membrane ; Parturition ; Physical Examination ; Rectal Fistula ; Suppuration ; Teratoma*

No abstract available.
Germ Cells* ; Neoplasms, Germ Cell and Embryonal* ; Prognosis*

Background: Cutaneous metastasis (CM) is the spread of cancer cells from a primary site to the skin and is rarely the first sign of silent cancer. We investigated the clinicopathological characteristics of CM from internal malignancies in Korean patients treated at our institution over 20 years. Methods: The clinicopathological findings of 112 patients (62 females, 50 males) with CM diagnosed at Yeungnam University Hospital between 2000 and 2020 were retrospectively reviewed. Results: Mean patient age was 58.6 years (range, 26 to 87 years), and the most common primary cancer site was breast (74.2%) in women and lung (36.0%) in men. Ninety-six patients (85.7%) presented with CM after primary tumor diagnosis. CM from the lung or biliary tract usually occurred within 2 years of primary tumor diagnosis, whereas metastases from the breast and kidney occurred several years later. The chest, abdomen, and scalp were common sites of CM. Breast cancer usually metastasized to chest skin, while gastrointestinal tract cancers commonly metastasized to the abdomen. The scalp was a common location for CM from various tumors. The most common dermatologic presentations were nodules and masses. Immunohistochemical studies helped identify underlying malignancies when primary tumors were unknown. Conclusions The relative frequency of CM parallels the overall incidence of primary malignant tumors, and CMs usually occur at anatomic sites close to the primary tumor. CM can be diagnosed based on clinical, radiological, and histological features; however, immunohistochemical study is required in some cases.

Background: Cutaneous metastasis (CM) is the spread of cancer cells from a primary site to the skin and is rarely the first sign of silent cancer. We investigated the clinicopathological characteristics of CM from internal malignancies in Korean patients treated at our institution over 20 years. Methods: The clinicopathological findings of 112 patients (62 females, 50 males) with CM diagnosed at Yeungnam University Hospital between 2000 and 2020 were retrospectively reviewed. Results: Mean patient age was 58.6 years (range, 26 to 87 years), and the most common primary cancer site was breast (74.2%) in women and lung (36.0%) in men. Ninety-six patients (85.7%) presented with CM after primary tumor diagnosis. CM from the lung or biliary tract usually occurred within 2 years of primary tumor diagnosis, whereas metastases from the breast and kidney occurred several years later. The chest, abdomen, and scalp were common sites of CM. Breast cancer usually metastasized to chest skin, while gastrointestinal tract cancers commonly metastasized to the abdomen. The scalp was a common location for CM from various tumors. The most common dermatologic presentations were nodules and masses. Immunohistochemical studies helped identify underlying malignancies when primary tumors were unknown. Conclusions The relative frequency of CM parallels the overall incidence of primary malignant tumors, and CMs usually occur at anatomic sites close to the primary tumor. CM can be diagnosed based on clinical, radiological, and histological features; however, immunohistochemical study is required in some cases.

Purpose: Eosinophil-derived neurotoxin (EDN) is not the only a marker for eosinophil activation, but also acts as an alarm protein.Very few studies have examined the potential role of eosinophils in the development of bronchopulmonary dysplasia (BPD). This study aims to address the roles of eosinophil and EDN in the early phase of BPD development. Methods: Patients were preterm neonates with respiratory distress syndrome (RDS) born at 36 weeks of gestation or less. Blood and urine samples were collected to measure total eosinophil count in the blood, serum eosinophil cationic protein (ECP), serum EDN, and urinary EDN during the first week of life. Results: Fifty-two preterms were recruited, of whom 43 infants were analyzed. Comparisons were made between the RDS (n = 16) and non-RDS groups (n = 27) and between the BPD (n = 6) and non-BPD groups (n = 26). There were no differences between RDS and non-RDS group in total eosinophil count, serum ECP, serum EDN, or urinary EDN, except when compared by gestational age, birth weight and prenatal dexamethasone use. Urinary EDN was increased significantly in the BPD group compared to the non-BPD group. Conclusion We demonstrated the roles of eosinophil and EDN in the development of BPD and suggest that urinary EDN may be utilized as a noninvasive factor predicting the development of BPD.

Inflammatory pseudotumor of the bladder is an unusual benign lesion arising from the bladder submucosa. This benign lesion must be differentiated histologically from several malignant lesions of the bladder. Complete surgical excision, either by transurethral resection or partial cystectomy, appears to be curative. We report a case and describe the clinical presentation, and radiographic and histological findings.
Cystectomy ; Granuloma, Plasma Cell* ; Urinary Bladder*

PURPOSE: In order to elicit efficient and effective operation of the Korean Emergency Medical Service System, we observed patients brought in by way of the Emergency Center by 119 ambulances and analyzed the appropriateness of the transport and the level of emergency care provided. METHODS: For the month of August 2002, patients who visited a university hospital emergency unit in Seoul were separated and evaluated according to the study protocols. The appropriateness of the 119 transport was based on a patient questionnaire and an evaluation of medical records and was categorized as follows; 1) need for emergency care or urgency/emergency transport by 119 ambulance, 2) need for emergency care or urgency/emergency transport by non 119 ambulance, 3) no need for emergency care or subemergency/nonemergency transport by 119 ambulance, 4) no needs for emergency care or subemergency/ nonemergency transport by non 119 ambulance. Of these, category 1 is viewed as the appropriate level of transport to the hospital emergency unit by 119 rescuers whereas category 3 is considered inappropriate transportation by 119 rescuers. The analysis of the appropriateness of the level of emergency care was based on sorting patients into 5 service categories; 1) emergency care required - appropriate operation, 2) emergency care required - no operation, 3)emergency care required - inappropriate operation, 4) no emergency care required - operation, 5) no emergency care required - no operation. Within these, categories 1 and 5 are considered appropriate and categories 2, 3 and 4 as inappropriate. RESULTS: Over the course of the study, 1,376 out of 1,451 patients transported to the hospital emergency unit qualified to be included under study protocols. Among them, the proportion of patients who needed emergency care or urgency/emergency transport was 22.8% (314 patients), and the proportion of those who received appropriate transport by the 119 emergency team was 62.6% (196 patients). Among the 282 patients who were transported by 119 emergency teams, in 195 patients (69.1%), emergency care was indicated while only 81 of the 195 patients (41.5%) received operations with an emergency or critical level of care. Of these 81, 47 patients (58.0%) received the appropriate operation. Therefore, the overall appropriateness of emergency care was 45.0% (127 patients), including emergency care required - appropriate operation (47 patients) and no emergency care required - no operation (80 patients). CONCLUSION: From this study, the appropriateness of transport by 119 rescuers is 62.6% but if subemergency cases are included, the appropriateness of transport increases to 95.2%. However, the appropriateness of care is only 45.0%, implying a need for continuing training for 119 emergency medical technicians and further organization of the medical control system.
Ambulances ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Emergency Service, Hospital ; Humans ; Medical Records ; Surveys and Questionnaires ; Seoul ; Transportation

PURPOSE: The total number of times a paper is cited, also known as the impact factor (IF) of a medical journal, is widely implied in evaluating the quality of a research paper. We evaluated the citation index data as an IF of Korean J Pediatr in Korean Medical Citation Index (KoMCI) and JCI of Web of Science. METHODS: We calculated the IF of Korean J Pediatr at KoMCI supervised by Korean Association of Medical Journal Editors. And we estimated the IF of Korean J Pediatr by the JCI of Web of Science although it was never officially reported. RESULTS: The IF of Korean J Pediatr on KoMCI has increased from 0.100 in the year 2000, to 0.205 in 2008, and 0.326 in 2009. Although the IF of Korean J Pediatr was 0.006 in 2005, 0.018 in 2006, 0.028 in 2008, 0.066 in 2009, and 0.018 in 2010 according to the JCI of Web of Science, the number of citations are steadily increasing. CONCLUSION: Understanding and realizing the current status will be a stepping stone for further improvement. The next objective of the Korean J Pediatr is to become registered in the SCI or SCIE. Increasing the IF according to the JCI of Web of Science is crucial in order to achieve this goal.
Pediatrics

Primary thyroid lymphoma is defined as a lymphoma involving either the thyroid gland alone or both the thyroid gland and neck lymph nodes, without contiguous spread or distant metastases from other areas of involvement at the time of diagnosis. Despite its rarity, prompt recognition of primary thyroid lymphoma is essential due to its distinct management, which differs significantly from the treatment approaches for other neoplasms of the thyroid gland. Herein, we report a 64 years old female patient who complained of hoarseness, and was diagnosed as thyroid lymphoma with unilateral vocal fold paralysis. After chemotherapy, vocal fold paralysis was relieved and the patient’s hoarseness improved.

BACKGROUND AND OBJECTIVES: Interleukin-21 receptor (IL-21R) gene polymorphism is related with the development of systemic vasculitis. In this study, we investigated the polymorphisms of IL-21R gene in patients with Kawasaki disease (KD). SUBJECTS AND METHODS: We genotyped the promoter region of IL-21R gene (-2500 bp to +1 bp) in 100 patients with KD and 100 healthy controls. All study subjects were Korean. We designed five pairs of primers and performed polymerase chain reaction (PCR) and direct sequencing. We analyzed whole promoter sequences of 200 individuals with comparison to reference sequences of IL-21R gene (NG_012222.1/NC_000016.9). RESULTS: We found five single nucleotide polymorphisms (SNPs) of which minor allele frequency (MAF) >0.01 in the promoter region of IL-21R gene. Those are -1681 G>T (chromosome site 27411802), -379 G>A (27413104), -332 G>C (27413151, rs2214537), -237 A>T (27413246), and -53 G>A (27413430). There is no significant difference in MAF of each SNP between patients with KD and healthy controls except -237 A>T. Twenty five patients with KD had more than 1 SNP in contrast to only seven healthy controls had. The patients with KD have significantly more IL-21R gene polymorphisms than controls (odds ratio: 3.0, 95% confidence interval: 1.6-5.6, p=0.0005). There was no significant correlation between IL-21R gene polymorphisms and the serum level of IL-21. The serum level of total IgE was not significantly correlated with the presence of IL-21R gene polymorphisms. CONCLUSION: Our data suggest that the genetic susceptibility profile for KD may include IL-21R gene.
Gene Frequency ; Genetic Predisposition to Disease ; Humans ; Immunoglobulin E ; Interleukins ; Mucocutaneous Lymph Node Syndrome ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Receptors, Interleukin-21 ; Systemic Vasculitis