PURPOSE: We evaluated the expressions of hTERT, Ki-67 and p53 in patients who underwent a curative resection for hepatic colorectal metastasis to see if there was any relationship of these immunohistochemical analyses with the disease free survival. METHODS: Patients who underwent a curative resection for hepatic colorectal metastasis, between 1995 and 2003, were analyzed. For each patient, the clinical prognostic score was derived from the patient's sex, age, tumor size and lymph node status, and serum CEA level. Tumor specimens were analyzed for Ki-67, hTERT and p53 using standard immunohistochemical techniques. RESULTS: The study included 23 patients: 9 and 12 survived without disease for less and more than 12 months, respectively. Ki-67, hTERT (labeling indexes greater than or equal to 50%) and p53 positivities (labeling indexes greater than or equal to 10%) were observed in 5, 17 and 11 patients, respectively. CONCLUSION: In patients undergoing resection of hepatic colorectal metastasis, the expressions of Ki-67, hTERT and p53 did not correlate with the disease free survival.
Colorectal Neoplasms ; Disease-Free Survival ; Hepatectomy ; Humans ; Humans* ; Liver* ; Lymph Nodes ; Neoplasm Metastasis* ; Telomerase*

BACKGROUND: Osteogenesis imperfecta (OI) is a congenital disorder of type I collagen, with variable phenotypes, due to increased bone fragility and low bone mass. Previous pharmacological treatments for OI have been attempted with calcitonin and growth hormone but with little beneficial effects. Recently, Glorieux reported the beneficial effects of bisphosphonates in OI. METHODS: In this study, the effects of pamidronate treatment were evaluated in 9 patients with OI. All patients received intravenous pamidronate infusions, which was dose adjusted according to the patients' age. The outcome measures included the biochemical bone markers; serum alkaline phosphatase, urine deoxy-pyridinoline, urine Ca/Cr ratio, and bone mineral density (BMD). RESULTS: Serum alkaline phosphatase, urine deoxypyridinoline, and urine Ca/Cr ratio were slightly decreased after 1 year of therapy, although these changes were not statistically significant. The BMDs of the lumbar spine and proximal femur were significantly increased after 1-year of pamidronate treatment. No fractures were reported during the 1 year treatment periods. CONCLUSION: Pamidronate treatment had an effect on the BMD in osteogenesis imperfecta, probably due to decreasing bone resorption
Alkaline Phosphatase ; Bone Density ; Bone Resorption ; Calcitonin ; Collagen Type I ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Diphosphonates ; Femur ; Growth Hormone ; Humans ; Osteogenesis Imperfecta* ; Osteogenesis* ; Outcome Assessment (Health Care) ; Phenotype ; Spine

Eosinophilic gastroenteritis is a rare clinicopathologic entity of an unknown etiology with a variety of digestive symptoms. The clinical features depend on the site of eosinophilic infiltration and affected layer of intestinal wall. Diagnostic criteria include demonstration of eosinophilic infiltration of the affected bowel wall, lack of evidence extra-intestinal disease, and exclusion of various disorders that could mimic similar conditions. We experienced a 54-year-old man with 6 months history of severe intermittent abdominal colic associated with malnutrition and weight loss. Abdominal computed tomography showed mass like lesion at terminal ileum, which caused partial small bowel obstruction. So, we carried out laparotomy, and then segmental resection and ileo-ascending colostomy were done because of small bowel obstrucion. We diagnosed the case as transmural type of eosinophilic gastroenteritis. We report this case with a brief review of the literatures.
Colic ; Colostomy ; Eosinophils* ; Gastroenteritis* ; Humans ; Ileum ; Laparotomy ; Malnutrition ; Middle Aged ; Weight Loss

We have previously demonstrated that phytoestrogens isolated from safflower seeds significantly attenuated bone loss in ovariectomized rats, and directly stimulated proliferation and differentiation of cultured osteoblastic cells. In an attempt to elucidate underlying cellular mechanisms, in the present study we investigated effects of 17beta-estradiol (E2) and phytoestrogens such as matairesinol and acacetin, a type of lignan and flavonoid, respectively, on activation of mitogen activated protein (MAP) kinases, extracellular signal-regulated kinase 1 (ERK1) and ERK2, in cultured osteoblastic ROS 17/2.8 cells. Western blot analysis with anti-MAP kinase antibody showed that a wide range concentrations (10(-14) to 10(-6) M) of E2 as well as both phytoestrogens induced rapid and transient activation of ERK1/2 through phosphorylation within minutes. Maximum activation of MAP kinases by E2 and phytoestrogens were observed at 10 and 15 min, respectively. E2-induced phosphorylation of ERK1/2 returned to the control level at 30 min, whereas phytoestrogen-induced phosphorylation was maintained at high level until 30 min. PD-98059, a highly selective inhibitor of MAP kinase, prevented phosphorylation of ERK1/2 in the cells treated either with E2 or phytoestrogens. To examine a possible involvement of estrogen receptor in the activation process of MAP kinase, Western blot analysis was performed in the presence and absence of the estrogen receptor antagonists, ICI 182,780 and tamoxifen. These antagonists blocked MAP kinase phosphorylation induced not only by E2, but also by the phytoestrogens. To the best our knowledge, this study is the first to demonstrate that phytoestrogens such as flavonoid and lignan extracted from safflower seeds produce a rapid activation of MAP kinase, at least partially via membrane estrogen receptor of the cultured osteoblastic cells.
Animals ; Blotting, Western ; Carthamus tinctorius ; Estrogens* ; Extracellular Signal-Regulated MAP Kinases ; Membranes* ; Osteoblasts* ; Phosphorylation* ; Phosphotransferases* ; Phytoestrogens ; Rats ; Tamoxifen

Angiography is a useful diagnostic tool in cases with massive gastrointestinal bleeding such as angiodysplasia and varicosis when endoscopy is not available. Angiodysplasia and varicosis have distinguishable characteristic features on angiography, such as the presence of a nidus, visible late-draining veins, and the typical vascular tuft. We recently treated a rare case of congenital angiodysplasia without the characteristic angiodysplasia features on angiography. Instead, the patient presented with a very rare case of idiopathic jejunal varicosis. A 42-year-old woman visited the emergency room with the chief complaint of melena for three days and a hemoglobin level of 5.9 g/dL. An abdominal CT angiogram showed varicosis at the jejunal mesentery. Angiography of the superior and inferior mesenteric arteries showed tortuous and dilated jejunal and ileal branches during the venous phase, suggesting a vascular malformation such as varicosis of the jejunum. Surgical exploration with intraoperative endoscopy revealed diffuse engorged veins and a 1.0-cm-diameter superficial ulcer covered with a blood clot that was 70 cm from the ligament of Treitz. A 100-cm segment of jejunum was resected. Histological examination revealed that the lesion was angiodysplasia, not varicosis. The final diagnosis was congenital angiodysplasia.
Adult ; Angiodysplasia ; Angiography ; Emergencies ; Endoscopy ; Female ; Hemoglobins ; Hemorrhage ; Humans ; Jejunum ; Ligaments ; Melena ; Mesenteric Artery, Inferior ; Mesentery ; Ulcer ; Vascular Malformations ; Veins

Microscopic polyangiitis is a systemic small-vessel vasculitis that is primarily associated with necrotizing glomerulonephritis and pulmonary capillaritis. Lung involvement is characterized by a diffuse alveolar hemorrhage. However, rarely central nervous system involvement has been reported to be occurred with the microscopic polyangiitis. Relapse of microscopic polyangiitis are reported to be more frequent than those of polyarteritis nodosa, often after a reduction or discontinuation of the therapy. We would like to report two patients with microscopic polyangiitis. One presented with clinical manifestations of both lung and central nervous system involvements and the other was a case of recurrence during steroid tapering following the steroid pulse therapy.
Antibodies, Antineutrophil Cytoplasmic ; Central Nervous System ; Glomerulonephritis ; Hemorrhage ; Humans ; Lung ; Microscopic Polyangiitis* ; Polyarteritis Nodosa ; Recurrence ; Vasculitis ; Vasculitis, Central Nervous System

Signet ring cell carcinoma of lung is an unique variant of mucin producing adenocarcinoma which is characterized by abundant intracellular mucin accumulation. Only a few cases of primary signet ring cell carcinoma of lung have been reported in the world wide literature. And we have, recently experienced one case of primary signet ring cell carcinoma of lung. A 55 years old man was evaluated for paralysis of lower extremities and was found to have lung cancer in the left upper and lower lobe with pleural, multiple spinal, bone and liver metastases. Signet ring tumor cells were revealed by cytologic examination of pleural fluids. And there were no evidence of signet ring cell carcinoma of other organs. Primary signet ring cell carcinoma of lung seems to have an aggressive behavior and therapeutic modalities could be different from those for signet ring cell carcinomas from other organs. Therefore it is important to separate primary signet ring cell adenocarcinoma of lung from metastatic tumors.
Adenocarcinoma ; Carcinoma, Signet Ring Cell* ; Humans ; Liver ; Lower Extremity ; Lung Neoplasms ; Lung* ; Middle Aged ; Mucins ; Neoplasm Metastasis* ; Paralysis

Mesoblastic nephroma is a neoplasm of the kidney which is characterized by interlacing bundles of spindle mesenchymal cells. It is usually diagnosed during the first six months of life and is mostly benign. Incidence in adults is exceedingly rare. In most cases, only total excision is required without postoperative adjuvant therapy, and the rare cases of local recurrence have usually been related to incomplete removal. However, mesoblastic nephroma may behave aggressively, in contrast to a congenital mesoblastic nephroma. Several cases of metastatic mesoblastic nephroma have been previously described. We report herein a case of a 42-year-old woman with mesoblastic nephroma which recurred as a large metastatic lung mass seven years after the nephrectomy. The patient presented with chest wall discomfort for four days. Seven years previously, total nephrectomy had been performed because of a right renal tumor which had been diagnosed as a mesoblastic nephroma. There had been no evidence of recurrence for five years, after which she discontinued follow-up. On readmission two years later, chest X-ray and CT scan revealed a large lung mass in the left upper lobe. It was completely excised and the pathologic examination was identical with that of the original renal tumor. Synovial sarcoma was excluded because the fusion transcripts of the SYT-SSX fusion gene associated with the t(X;18) translocation were negative. The final diagnosis was a lung metastasis of mesoblastic nephroma and the patient remained free of disease for 7 months postoperatively.
Adult ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kidney ; Lung* ; Neoplasm Metastasis* ; Nephrectomy ; Nephroma, Mesoblastic* ; Recurrence ; Sarcoma, Synovial ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Eosinophilic esophagitis (EE) is a chronic inflammatory disorder characterized by abnormal dense eosinophilic infiltration of esophageal mucosa and results in dysphasia and food impaction. EE is being increasingly recognized in adults. The prevalence is largely unknown. This study was performed to evaluate the detection rate of EE diagnosed based on pathologic criteria and to define the clinical characteristics of EE in Korea. METHODS: We reviewed biopsy specimen of the 1,609 patients who underwent esophageal biopsy from January 2006 till August 2008. The presence of more than 20 eosinophils per high power field in biopsy specimens was considered cases of EE. Clinical information and endoscopic findings were obtained. RESULTS: 7 (0.4%) patients were diagnosed as EE based on pathologic criteria retrospectively. Clinical symptoms were epigastric pain (43%), regurgitation (29%), dyspepsia (14%), and no symptom (14%). Endoscopic findings were whitish exudates or granules (57%), esophageal polyp (29%), and hyperemic change (14%). Two patients received treatment. One patient with bronchial asthma improved after treatment with inhaled corticosteroid, and one patient improved after 8 week proton pump inhibitor therapy. CONCLUSIONS: Eosinophilic esophagitis was found in 0.4% of the total esophageal biopsied cases. Our results suggest that Korean patients with eosinophilic esophagitis showed symptoms mimicking gastroesophageal reflux disease and atypical endoscopic findings. Therefore, regardless of the gross appearance of the mucosa, meticulous diagnostic approaches are needed for patients with swallowing difficulty and lack of response to proton pump inhibitor.
Adult ; Aged ; Biopsy ; Dyspepsia/etiology ; Eosinophilia/epidemiology/*pathology ; Esophagitis/epidemiology/*pathology ; Female ; Humans ; Incidence ; Incidental Findings ; Male ; Middle Aged ; Regurgitation, Gastric/etiology ; Retrospective Studies

BACKGROUND: It was previously thought that persons with genetic predispositions to vitiligo develop the condition after exposure to various precipitating environmental factors. However, in many cases, the aggravating factors of vitiligo have not been clearly identified. OBJECTIVE: To identify the aggravating factors of vitiligo in the working environment and daily life. METHODS: A total of 489 vitiligo patients were recruited from 10 institutions in South Korea; patients were provided with a questionnaire about environmental factors and behavior patterns in the workplace and in daily life, and their association with vitiligo. RESULTS: Ninety-five of the 470 enrolled patients (20.2%) answered that environmental risk factors in daily life and in the workplace affected the development of vitiligo. The most frequently attributed causes were trauma and burn (13.6%), followed by sunlight (12.8%), stress (12.8%), cleaning products/disinfectant/chemicals (4.9%), and hair dye (2.1%). CONCLUSION: Vitiligo of the hand and foot was associated with frequent exposure to aggravating materials and overexposure to sunlight, along with frequent trauma of these areas, all of which could be considered important risk factors of vitiligo. The development of vitiligo could potentially be controlled through the early detection of aggravating factors.
Burns ; Foot ; Genetic Predisposition to Disease ; Hair ; Hand ; Humans ; Korea ; Occupations* ; Risk Factors ; Sunlight ; Vitiligo* ; Surveys and Questionnaires