Nonpancreatic pseudocyst is a rare lesion, with a specific fat-fluid level in the cyst. It is found among all age groups. The condition has been previously reported in foreign but not in domestic journals; we now describe one such case.
Humans

PURPOSE: The purpose of this study was to test the hypothesis that neoadjuvant chemotherapy (NACT) does not increase morbidity in patients undergoing radical hysterectomy with lymphadenectomy for locally advanced cervical cancer. MATERIALS AND METGODS: A retrospective study was undertaken of 140 patients with locally advanced cervical cancer (FIGO stage Ia to IIb) who underwent radical hysterectomy with lymphadenectomy by the same surgeon at the same hospital. Among the 140 patients, 39 received NACT followed by radical hysterectomy with pelvic lymphadenectomy (NACT group). This group received three cycles consisting of cisplatin 100 mg/m2/day on day 1 and 5-fluorouracil 1000 mg/m2/day from day 1 to 5. The NACT group was compared, in terms of intraoperative morbidity and postoperative morbidity, with the other 101 patients who underwent radical hysterectomy with lymphadenectomy but without chemotherapy (surgery-only group). RESULTS: There were no significant differences in mean age, body weight or height between the two groups. The only significant difference was that the NACT patients had higher stages of cancer. The incidence of intraoperative morbidity did not differ between the NACT and surgery only patients. We considered the operation duration, amount of blood loss and need for transfusion as indicators of intraoperative morbidity. We could not find any significant differences in the duration of suprapubic catheterization, days of hemovac drainage, amount of drained hemovac fluid, days of hospitalization or postoperative febrile morbidity between the NACT and surgery-only groups. Patients in the surgery-only group had more postoperative complications (ureteral obstruction, intestinal obstruction, lymphocyst, lymphedema, and death) than the NACT group, although not to a statistically significant degree (P>0.05). CONCLUSION: In this retrospective review, there was no evidence that NACT increased intraoperative or postoperative morbidity in patients with locally advanced cervical cancer. As this was a retrospective study, other prospective, randomized studies are needed to confirm these results.
Body Weight ; Catheterization ; Catheters ; Cisplatin ; Drainage ; Drug Therapy* ; Fluorouracil ; Hospitalization ; Humans ; Hysterectomy ; Incidence ; Intestinal Obstruction ; Lymph Node Excision ; Lymphedema ; Postoperative Complications ; Retrospective Studies ; Uterine Cervical Neoplasms

BACKGROUND: Following several decades of decline, the incidence of tuberculosis has recently begun to increase in many countries and the control of this disease has been impeded by the emergence of multi-drug resistant tuberculosis (MDR-TB). The development of rapid diagnostic methods and effective new drugs are needed to control MDR-TB. One of the new drugs for MDR-TB is rifabutin (RBU) which has been known to be effective in some patients with MDR-TB. A few reports showed that some types of mutaitions of the rpoB gene, which were known to be present in 96-98% of rifampicin-resistant M. tuberculosis, were associated with the rifampicin-resistant but RBU-susceptible phenotype. This study was performed to investigate the correlation between RBU susceptibility and the patterns of rpoB gene mutations in Korean MDR-TB. METHODS: Sixty-five clinical isolates of multi-drug resistant Mycobacterium tuberculosis, gathered from patients two visited the Asan Medical Center from July 1997 to June 1999, were investigated. Clinical responses to rifabutin-containing regimen were evaluated. An RBU susceptibility test and sequencing analysis of rpoB gene were performed, and the result were analyzed to confirm which mutations correlated with RBU-susceptible MDR-TB. RESULTS: Fifty-three of 56 (95%) clinical isolates of MDR-TB had 60 mutations of the rpoB gene. The most frequent mutations were found at codon 531 (43%), and two mutations were combined in seven clinical isolates. Five of 53 (10%) clinical isolates showed the RBU-susceptible phenotype, and in them the characteristic patterns of point mutations were found at codon 509, 516, and 526. CONCLUSION: The frequency and pattern of mutations of the rpoB gene of Korean MDR-Tb isolates were similar to those in western countries, where the prevalence of tuberculosis is low, but some show RBU-susceptible phenotypes. RBU-susceptible MDR-TB isolates showed the characteristic pattern of mutations of the rpoB gene which could be used to rapidly diagnose RBU susceptibility.
Chungcheongnam-do ; Codon ; Humans ; Incidence ; Mycobacterium tuberculosis* ; Mycobacterium* ; Phenotype ; Point Mutation ; Prevalence ; Rifabutin* ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

To determine the content of thyroglobulin in oxyphilic cells of the thyroid, which have been considered as non-thyroglobulin producing cells, the degree of stainability of the various oxyphilic cells for thyroglobulin was compared with that of non-oxyphilic follicular cells in either same or different lesion. A total of 13 oxyphilic lesions, including three follicular adenomas containing oxyphilic cell nodules, four pure oxyphilic cell adenomas, and six Hashimoto's thyroiditis were compared with 16 of non-oxyphilic lesions such as, seven follicular adenomas, four chronic lymphocytic thyroiditis, and five Graves' disease. Many oxyphilic cells stained positively for thyroglobulin regardless of their morphologic variation, but less intensely than the usual follicular cells in follicular adenomas, chronic lymphocytic thyroiditis, and Graves' disease. The stainability of oxyphilic cells for thyroglogulin did not show any significant correlation with morphologic features, whereas in follicular adenomas, the non-oxyphilic follicular cells forming microfollicles stained less strongly for thyroglobulin than the same cells lining large mature follicles in a reproducible way. With above findings, we concluded that oxyphilic cells maintain the functional activity in terms of thyroglobulin synthesis, although the content of the thyroglobulin is less than that of non-oxyphilic colloid forming follicular cells.
Adenoma/*metabolism/pathology ; Graves Disease/*metabolism/pathology ; Humans ; Staining and Labeling ; Thyroglobulin/*biosynthesis ; Thyroid Neoplasms/pathology ; Thyroiditis, Autoimmune/*metabolism/pathology

To evaluate exercise capacity, treadmill test and exercise pulmonary function test with cycle ergometer were preformed in 52 patients(pts) (M/F : 18/34, mean age : 43+/-11 yrs) with mitral stenosis before and 5~10 days after percutaneous mitral balloon valvuloplasty(PMV). Twenty four pts had atrial fibrillation. The results are as follow : 1) The mitral valve area increased from 0.9+/-0.2 to 1.8+/-0.3cm2(P<0.001). 2) The duration of exercise time on treadmill test(modified Bruce protocol) increased from 7.7+/-3.3min to 11.1+/-2.6min(P<0.001), but peak heart rate(HR) and maximum double product(MDP) did not change significantly. After exclusion of the patients with atrial fibrillation, peak HR and MDP increased from 157+/-24beats/min and 22350+/-8220mmHg beat to 165+/-19beats/min and 26290+/-5770mmHg beat respectively(P<0.05). 3) Diffusion capacity and diffusing capacity/alveolar volume at rest decreased from 95+/-25% and 112+/-24% to 87+/-22% and 100+/-18% respectively(p<0.001). 4) FVC, FEV1, FEV1/FVC, FEF25~75% and maximum voluntary ventilation increased from 77+/-12%, 79+/-16%, 104+/-10%, 69+/-25%, and 68+/-14%, to 80+/-11%, 84+/-14%. 106+/-9%, 78+/-25%, and 74+/-12%, respectively(P<0.05). But total lung capacity, residual volume and functional residual capacity did not change significantly. 5) Maximum oxygen consumption, anaerobic threshold, oxygen pulse and maximum work load during exercise increased form 53+/-14%, 34+/-8%, 6.2+/-2.1ml/min and 48+/-18 watts to 61+/-13%, 39+/-7%, 7.3+/-2.0ml/min and 58+/-20 watts respectively(P<0.0005). We conclude that oxygen transport and exercise capacity improve within 10days after PMV and the improvement results from not only hemodynamic improvement but also improvement of static pulmonary function.
Anaerobic Threshold ; Atrial Fibrillation ; Balloon Valvuloplasty* ; Diffusion ; Exercise Test ; Functional Residual Capacity ; Heart ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Oxygen Consumption* ; Oxygen* ; Residual Volume ; Respiratory Function Tests ; Total Lung Capacity ; Ventilation

OBJECTIVE: This study was performed to evaluate the expression of MAGE gene and human papillomavirus (HPV) 16, 18 type in patients with cervical neoplasia using in exfoliated cervical cells. METHODS: The expression of common MAGE gene (MAGE 1 to 6) in cervical scraps was studied by reverse-transcription polymerase chain reaction (RT-PCR) in 12 normal control patient and 48 patients with abnormal cytologic results. In all 60 patients, colposcopic directed biopsy and HPV test by polymerase chain reaction (PCR) was done. RESULTS: The pathologic results of 60 patients was 12 cervicitis, 37 cervical intraepithelial neoplasia (14 LSIL, 23 HSIL), and 11 invasive squamous cell carcinomas. No expression of common MAGE gene was detected in 12 cervical scraps of cervicitis. The common MAGE gene of LSIL, HSIL and invasive squamous cell carcinomas was expressed in two (14.3%), seventeen (73.9%), ten (90.9%) respectively. HPV type 16 or 18 was detected in 1 cervicitis, 5 LSIL, 20 HSIL and 10 invasive squamous cell carcinoma. In 51 patients (85%), the HPV test result and the common MAGE gene expression showed coincident results. CONCLUSION: This result suggests common MAGE gene might be potential tumor marker in cervical neoplasia and adjuvant test of the Papanicolaou smear.
Biopsy ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Gene Expression ; Human papillomavirus 16* ; Humans* ; Papanicolaou Test ; Polymerase Chain Reaction ; Uterine Cervicitis

Disseminated peritoneal leiomyomatosis is rare condition characterized by multiple subperitoneal nodules of benign smooth muscle proliferations. It is associated with high level of estrogen such as pregnancy, oral contraceptives or estrogen producing ovarian tumor, and occasionally associated with operation history of myomectomy or hysterectomy. Clinical course of disseminated peritoneal leiomyomatosis is usually benign, but malignant changes also rarely have been reported. We experienced a case of disseminated peritoneal leiomyomatosis who has history of laparoscopic myomectomy 10 years ago. The patient was a 35-year-old woman, and her chief complaint was palpable masses in lower abdomen. She underwent laparoscopic surgery which revealed numerous solid masses on the surface of peritoneum, descending colon, rectosigmoid colon, uterus, round ligament, and broad ligament. We present it with a brief review of literature.
Abdomen ; Adult ; Broad Ligament ; Colon ; Colon, Descending ; Contraceptives, Oral ; Estrogens ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Leiomyomatosis ; Muscle, Smooth ; Peritoneum ; Pregnancy ; Round Ligament of Uterus ; Uterus

OBJECTIVE: The aim of this study was to compare survival outcomes and toxicities between concurrent radiotherapy with cisplatin plus 5-fluorouracil and that with cisplatin plus paclitaxel in patients with locally advanced cervical carcinoma. METHODS: We retrospectively reviewed data from 93 locally advanced cervical carcinoma patients (stage IB to IVA) who had been treated by concurrent radiotherapy with cisplatin plus 5-fluorouracil (CF, n=45) vs. cisplatin plus paclitaxel (CP, n=48) as primary therapy. Toxicities and survival outcomes were compared. RESULTS: In the CP group, there were higher frequencies of severe (grade 3 or 4) leukopenia (79.2%, as compared to 11.1% in the CF group), severe neutropenia (77.1%, as compared to 8.9% in the CF group) and severe peripheral neuropathy (12.5%, as compared to 2.2% in the CF group). In the CF group, there were higher frequencies of severe nausea (33.3%, as compared to 14.6% in the CP group) and severe hyponatremia (11.1%, as compared to 0% in the CP group). Five-year DFS of the CF and CP groups was 67.4% and 79.1%, respectively (p=NS). Five year OS of the CF and CP groups was 79.6% and 80.9%, respectively (p=NS). CONCLUSION: Concurrent radiotherapy with cisplatin plus paclitaxel showed increased leukopenia, neutropenia and peripheral neuropathy, but less gastrointestinal toxicity (nausea) than that with cisplatin plus 5-fluorouracil. Survival outcome between these two groups was not statistically different in this study. Large prospective randomized controlled studies will be needed to confirm this result.
Chemoradiotherapy ; Cisplatin ; Fluorouracil ; Humans ; Hyponatremia ; Leukopenia ; Nausea ; Neutropenia ; Paclitaxel ; Peripheral Nervous System Diseases ; Retrospective Studies ; Uterine Cervical Neoplasms

Eosinophilic cholangiopathy is a rare disease characterized by dense transmural eosinophilic infiltration of the gallbladder and bile duct. It's clinical and laboratory manifestations are not different from those of other causes of cholangiopathy, and the diagnosis is usually made based on pathologic findings after cholecystectomy. Moreover, the occurrence of eosinophilic cystitis accompanied by cholangiopathy is extremely rare. We report a rare case of hypereosinophilic syndrome manifested as eosinophilic cholangiopathy accompanied with eosinophilic cystitis, for the first time in Korea, in a 49-year-old woman who presented with persistent right upper quadrant pain. After performing imaging study to validate the diagnosis of acute acalculous cholecystitis and cholangitis, an urgent cholecystectomy was performed. Pathologic examination of the excised gallbladder was consistent with eosinophilic cholecystitis. The patient underwent bladder biopsy because there was persistant irritative voiding symptoms combined with constant mild peripheral eosinophilia even after cholecystectomy, and the pathologic findings revealed eosinophilic cystitis. Symptoms and peripheral eosinophilia were improved after steroid therapy for an indicated period.
Acalculous Cholecystitis ; Bile Ducts ; Biopsy ; Cholangitis ; Cholecystectomy ; Cholecystitis ; Cystitis* ; Diagnosis ; Eosinophilia ; Eosinophils* ; Female ; Gallbladder ; Humans ; Hypereosinophilic Syndrome* ; Korea ; Middle Aged ; Rare Diseases ; Urinary Bladder

PURPOSE: Gastrointestinal stromal tumors (GISTs) are the most common form of mesenchymal tumor of the gastrointestinal tract. Recently, tyrosine kinase inhibitors have improved the treatment of GISTs, and their diagnosis facilitated by immunohistochemical markers. The aim of this paper was to study the clinicopathological features of GISTs of the stomach and determine the accuracy of a new grading system and the prognostic factors. METHODS: Patients with mesenchymal tumors of the stomach, operated on between 1982 and 2004, were identified using medical and pathological files. Immunohistochemical staining for KIT (CD117), CD34, smooth muscle actin (SMA), desmin and s-100 protein were performed, and the diagnoses reviewed. Cases were classified into either the very low, low, intermediate or high risk groups according to National Institutes of Health (NIH) consensus symposium. RESULTS: 78 mesenchymal tumors were reanalyzed, and with the supportive use of immunohistochemical markers, 71 (91%) of the gastrointestinal mesenchymal tumors were shown to be GISTs. The tumors often coexpressed KIT and CD34 (90%) and were variably positive for SMA (18%), s-100 protein (11%) and desmin (23%). With a median follow-up of 73.9 months (range 1~228 months), a recurrence occurred in 10 (14%) patients. Analyses demonstrated that the mitotic index (P<0.001) and tumor size (P<0.001) were significant prognostic factors for survival. The new grading system showed a significant difference between the risk groups and the survival rates (P<0.001). CONCLUSION: Immunohistochemical staining is needed to distinguish GISTs from other mesenchymal tumors. The tumor size and mitotic count are significant prognostic factors for GISTs. The new grading system (2001 NIH) for classifying the 4 risk groups of GISTs, according to the tumor size and the mitotic count, is useful in the evaluation of the tumor behavior.
Actins ; Consensus ; Desmin ; Diagnosis* ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Mitotic Index ; Muscle, Smooth ; National Institutes of Health (U.S.) ; Prognosis* ; Protein-Tyrosine Kinases ; Recurrence ; S100 Proteins ; Stomach* ; Survival Rate