Breast carcinoma has been infrequently reported in children. About 25 cases have been reported in world literatures since first description in 1913, by Bryan. We present a case of juvenile breast carcinoma in a 17 months old girl with brief review of literatures. Grossly, the submitted specimen is grayish white and measured by 1.3x1.0x0.8 cm in size. It is not encapsulated and its cut surfaces are homogeneous. Microscopic examination showed a neoplastic proliferation of duct cells forming mainly glandular spaces with focal papillary pattern, solid sheets or cribriform pattern. The glandular spaces were filled with collections of PAS-positive eosinophilic secretory materials. The individual cell varied from columnar to polygonal and showed moderate hyperchromatism and variation of nuclear size. Mitoses and necrosis are not found. Tumor cell invasion into the stroma was found.
Child ; Male ; Female ; Humans

No abstract available.
Holoprosencephaly*

The serous papillary cystadenoma of low malignant potential in the paratesticular tissue is a tumor characterized by its resemblance to ovarian serous papillary tumor of low malignant potential. Several possible origins have been proposed but it is thought to originate from the Mullerian-type epithelium just like ovarian serous tumor of low grade malignancy. Because of the rarity of this tumor, the natural history and treatment have not been established. Herein we report on a serous papillary cystadenoma arising in the paratesticular tissue of a 12 year old . To our knowledge, this is the first reported case in the Korean literature. The size of this cystic tumor in this patient was 0.9x0.9x0.8 cm and had a sponge-like cut surface. The papillary structure was lined by both ciliated and nonciliated secretory cells, the same cellular structure as the salpinx. Areas with just a few mitoses and stratification of epithelial cells were noted, but invasion into the paratesticular tissue was absent, suggesting borderline malignancy. He is doing well after 5 months follow up. Prognosis of this scrotal tumor is thought to be better than the ovarian tumor of similar histology due to a better possibility of early detection.

Although embryonal rhabdomyosarcoma has been frequently reported in genitourinary tract, head and neck, embryonal rhabdomyosarcoma of the biliary tree is an extremely rarte. It must be considered in differential diagnosis of jaundice in childhood. About 35 cases have been reported in world literatures, since first description on 1875, by Moxon and Wilks. We present a case of embryonal rhabdomyosarcoma of the biliary tree in a 25 months old boy with brief review of literatures. Since chief complaints of this case were jaundice and loss of appetite, the first clinical diagnosis was infectious hepatitis. On ultrasound examination, there is a space occupying lesion in right lobe of liver and it was diagnosed as hepatoma. Choledochoduodenostomy with biopsy was done. The operation revealed dilated common bile dut and both hepatic ducts which were filled with light brown jelly like materials and diagnosed as embryonal rhabdomyosarcoma on frozen and permanent senions. In gross and histologic characteristics, this tumor resembles embryonal rhabdomyosarcoma(sarcoma botryoides) in other locations. In spite of chemo-and radiotherapy after operation, the boy was died.
Child ; Male ; Female ; Humans ; Diagnosis, Differential ; Biopsy

No abstract available.

Segmentalization of spinal fixation enhances correction of the coronal plane deformity and allows preservation of normal sagittal contour offering rigid fixation. Purpose of this paper was to evaluate the efficacy and safety of segmental pedicle screw fixation in the treatment of idiopathic thoracic scoliosis. From 1987 to 1991, 78 idiopathic thoracic scoliosis patients were treated with CD instrumentation. Thirty-one were treated with hooks, 23 with pedicle screws inserted in hook pattern and 24 with segmental pedicle screws. In segmental screw group, the screws were inserted for every other on the convex side. After follow up of minimum 2 years(range:24 to 52 months), the results of coronal, sagittal and rotational correction were compared. Major curve correction was 55% with hooks, 66% with hook pattern screws and 72% with segmental screws, with loss of correction of 6%, 2% and 1% respectively. Compensatory curve correction was 57% with hooks, 67% with hook pattern screws and 70% with segmental screws. In patients with hypokyphosis, all groups showed significant improvement, with best restoration in segmental screws. Rotational correction of the apical vertebra was 19% with hooks, 26% with hook pattern screws and 59% with segmental screws. Thirteen(3%) screws were malpositioned but they did not cause neurologic impairment nor adversely affect the results of treatment. This study implies that the segmental pedicle screw fixation is safe and effective method of correcting the triplanar deformity of the thoracic idiopathic scoliolis.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Methods ; Pedicle Screws ; Scoliosis ; Spine

No abstract available.
Hand

PURPOSE: In order to elucidate the tumor angiogenesis and to evaluate the usefulness of some cytokines as parameters of tumor progression and metastasis, we investigated the expression of Factor VIII related antigen (Factor VIII R-Ag) and measured the plasma levels of interleukins-1alpha (IL-1alpha), 1beta (IL-1beta), and 6 (IL-6) during rat liver tumorigenesis. METHODS: Sprague-Dawley rats were given diethylnitrosamine (DEN) by water, and sequentially sacrificed. For evaluation we performed light microscopy, immunohistochemical study using avidin-biotin complex, and ELISA. RESULTS: During the carcinogenesis, the staining of Factor VIII R-Ag was negative in normal livers, focal in hyperplastic nodules, scattered in hepatocellular adenomas and diffusely positive in hepatocellular carcinomas. The serum level of IL-1 GGGalpha peaked at 9 weeks, that of IL-1beta steadily increased to peak at 12 weeks, and that of IL-6 continuously increased after DEN administration. In addition, the serum concentration of IL-6 was markedly elevated in hepatocellular carcinomas metastasized to the lung. CONCLUSION: From the above results it could be suggested that sinusoidal phenotypic acquisition of Factor VIII R-Ag is linked to the development of hepatocellular carcinomas and that serum levels of IL-1beta and IL-6 are related to the multistep development of hepatocellular carcinoma. Furthermore, excess production of IL-6 may be a useful parameter to predict metastatic potentials.
Adenoma, Liver Cell ; Animals ; Carcinogenesis* ; Carcinoma, Hepatocellular ; Cytokines ; Diethylnitrosamine* ; Enzyme-Linked Immunosorbent Assay ; Factor VIII* ; Interleukin-1 ; Interleukin-6* ; Liver* ; Lung ; Microscopy ; Neoplasm Metastasis ; Plasma ; Rats* ; Rats, Sprague-Dawley ; von Willebrand Factor* ; Water

PURPOSE: The aim of this study was to analyse expression of COX-2, VEGF, CD34 and MMP-9 in colonic adenocarcinoma, and correlate this expression with clinicopathologic parameters. METHODS: Tumor sections of 66 consecutive patients undergoing potentially curative surgery for an adenocarcinoma of the colon were immunohistochemically stained using antihuman-COX-2, VEGF, CD34 and MMP-9 antibodies. For the evaluation of COX-2, VEGF and MMP-2 expression, those cases showing the respective antigen expression in more than 10% of the tumor cells were considered to be positive. Microvessel density (MVD) by CD34 expression was evaluated as the number of vessels per high-power field(X200). The mean value for the three fields were recorded as the MVD for each tumor. RESULTS: Although COX-2 expression was not correlated with any clinicopathologic factors, it showed the increased expression according to T-stage, lymph node metastasis and clinical staging. Microvessel density with CD34 expression was correlated with lymph node metastasis and clinical staging. MMP-9 expression was correlated with clinical stage. Microvessel density was correlated with COX-2, VEGF and MMP-9 expression. CONCLUSION: This results indicate that angiogenesis is a complex process that involves multiple factors including COX-2, VEGF, CD34 & MMP-9, and suggest that microvessel density with COX-2 and MMP-9 expression are related to tumor progression and metastasis of colonic adenocarcinoma.
Adenocarcinoma* ; Antibodies ; Colon* ; Humans ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

BACKGROUND: Airway pressure increases during one-lung ventilation compared to two-lung ventilation. We measured the peak inspiratory airway pressure and the actual exhaled volume during one-lung and two-lung ventilation. And then we evaluated the loss of the exhaled volume according to the increase of peak insphatory airway pressure. METHODS: Left-sided double lumen endobronchial tube (male 37 Fr., female 35 Fr.) was inserted in 62 patients and then proper position of double lumen tube was confirmed with the fiberoptic bronchoscopy. After setting the tidal volume (10 ml/kg), respiratory rate 12/min, inspiratory: expiratory ratio (1: 2) and oxygen 2 1/min, we measured exhaled volume and peak inspiratory airway pressure during two-lung and one-lung ventilation in the supine and lateral decubitus position. RESULTS: The increase of the peak inspiratory airway pressure was ranged from 33.7% to 52.1% and exhaled volume decreased 9.5% to 14.8% in one-lung ventilation compared to two-lung ventilation. CONCLUSIONS: The decrease of actual tidal volume according to the increase of peak inspiratory airway pressure during one-lung ventilation would result in carbon dioxide retention. Therefore we should readjust ventilatory setting during one-lung ventilation.
Bronchoscopy ; Carbon Dioxide ; Female ; Humans ; One-Lung Ventilation* ; Oxygen ; Respiratory Rate ; Tidal Volume ; Ventilation