BACKGROUND: The reproducibility in grading a cervical intraepithelial neoplasia (CIN) are not perfect. The aim of this study was to assess the value of the immunohistochemical expression of p63 and the other biomarkers for grading a CIN (dysplasia and in situ carcinoma), and diagnosing invasive carcinomas. METHODS: Sixty six cervical specimens were immunostained with the monoclonal antibodies against p63, Ki-67, p27Kip1, and p53 to determine the localization. RESULTS: The p63 positive cells are well linked with squamous cell maturation and the degree of dysplasia. In mild dysplasia, the p63 positive cells were localized to the basal and parabasal cells, which gradually extended into the middle and upper layers in moderate and severe dysplasia. p63 expression was strong in immature squamous epithelium and invasive squamous cells, but was constantly absent in an adenocarcinoma. The Ki-67 positive cells were scattered from the parabasal cells to the superficial cells in accordance with the degree of dysplasia. p27Kip1 expression was noted in the intermediate cells in the normal cervix. In CIN, the p27Kip1 positive nuclei tended to extend to the basal cells, but it showed no diagnostic consistency in an invasive carcinoma. p53 expression was also variable. CONCLUSION: p63 is a useful diagnostic adjunct for grading CIN as well as for detecting microinvasion and squamous differentiation in invasive carcinoma. However, immunohistochemical expressions for the p27Kip1 and p53 have no correlation with the grade of CIN and squamous cell carcinoma.
Adenocarcinoma ; Antibodies, Monoclonal ; Biomarkers ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Epithelium ; Female ; Uterine Cervical Neoplasms

MHS is a myopathic disorder transmitted by a dominant autosomal gene. The seriousness of the problem is underscored by the fact that the mortality rate, until recently, has ranked the highest among the complications of modern anesthesia. During halothane anesthesia we experienced a case of MHS with high temperature and rigidity after succinylcholine, observed change of serum electrolytes, and noted CPK and myoglobin in the urine. The patient was managed with surface cooling, bicarbonate, diurectics, mechanical ventilator and corticosteroids. The patient survived without any sequelae and was discharged after 10 days.
Adrenal Cortex Hormones ; Anesthesia ; Electrolytes ; Halothane ; Humans ; Malignant Hyperthermia* ; Mortality ; Myoglobin ; Succinylcholine ; Ventilators, Mechanical

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

Primary non-Hodgkin's lymphoma of the extrahepatic bile duct presenting as obstructive jaundice is extremely rare. A 60-year-old man was admitted due to suddenly developed jaundice. Computerized tomography and endoscopic retrograde cholangiopancreatography showed a tumor at the proximal common hepatic duct. These clinical and radiologic findings resembled those of Klatskin tumor. The resection of the common hepatic duct tumor, lymph node dissection, and Roux-en-Y hepaticojejunostomy were carried out. There was no regional lymph node metastasis and no residual tumor at the resection margins. Histology and immunohistochemistry of the resected specimen confirmed a diffuse large B-cell malignant lymphoma involving the common hepatic duct. The patient is scheduled to receive adjuvant chemotherapy. In summary, primary non-Hodgkin's lymphoma of the extrahepatic bile duct, despite its rarity, should be considered in the differential diagnosis of causes for obstructive jaundice. An accurate histopathologic diagnosis and surgical resection combined with chemotherapy may be the approach to offer a chance for cure.
Antigens, CD20/metabolism ; Bile Duct Neoplasms/*diagnosis/pathology/surgery ; Cholangiopancreatography, Magnetic Resonance ; Diagnosis, Differential ; Humans ; Klatskin's Tumor/diagnosis ; Lymphoma, Large B-Cell, Diffuse/*diagnosis/pathology/surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed

Budd-Chiari syndrome (BCS) is a heterogenous group of disorders characterized by obstruction of hepatic venous outflow. Severe liver cirrhosis and limited cardiac reserve in patients with BCS makes them less tolerant to liver transplantation. We experienced two cases of massive bleeding during living donor liver transplantation in patients with BCS. Blood products and fluids were rapidly infused with a rapid infusion system, final infusion volume in these two patients were 177 L and 193 L, and the use of Cell Savers allowed for the patient's blood products to be saved. The patients were managed successfully and recovered uneventfully with advanced monitoring, including monitoring of their jugular venous oxygen saturation and continuous cardiac output. Therefore, rapid infusion systems and Cell Savers, along with advanced monitoring, are necessary in the event of massive bleeding during liver transplantation.
Budd-Chiari Syndrome* ; Cardiac Output ; Hemorrhage* ; Humans ; Liver Cirrhosis ; Liver Transplantation* ; Liver* ; Living Donors ; Oxygen

BACKGROUND/AIMS: Because of rarity, role of chemotherapy of bladder adenocarcinoma are still unidentified. Therefore, we performed a retrospective analysis of the clinical features and chemotherapy outcomes of bladder adenocarcinoma. METHODS: Eligible patients for this retrospective analysis were initially diagnosed with bladder adenocarcinoma and presented with a clinically no other primary site of origin. The collected data included age, gender, performance status, stage, hemoglobin, albumin, initial date of diagnosis, treatment modality utilized, response to treatment, presence of relapse, last status of patient, and last date of follow-up. RESULTS: We retrospectively reviewed 29 patients, who were treated with chemotherapy for bladder adenocarcinoma at 10 Korean medical institutions from 2004 to 2014. The median age of patients was 58 years (range, 17 to 78) and 51.7% of the patients were female. Urachal adenocarcinoma was identified in 15 patients. Of 27 symptomatic patients, 22 experienced gross hematuria. Twelve patients were treated with 5-f luorouracil based chemotherapy, five were gemcitabine based, three were taxane and others. Thirteen of them achieved complete response (10.3%) or partial response (34.5%). Median progression-free survival (PFS) and overall survival (OS) for all patients were 10.6 months (95% confidence interval [CI], 9.5 to 11.6) and 24.5 months (95% CI, 1.2 to 47.8), respectively. The cases of urachal adenocarcinoma exhibited worse tendency in PFS and OS (p = 0.024 and p = 0.046, respectively). CONCLUSIONS: Even though bladder adenocarcinoma had been observed moderate effectiveness to chemotherapy, bladder adenocarcinoma is a highly aggressive form of bladder cancer. PFS and OS were short especially in urachal carcinoma.
Adenocarcinoma* ; Diagnosis ; Disease-Free Survival ; Drug Therapy* ; Female ; Follow-Up Studies ; Gynecology* ; Hematuria ; Humans ; Recurrence ; Retrospective Studies* ; Urinary Bladder Neoplasms ; Urinary Bladder*