A case of primary gastric carcinoma with patterns resembling those of hepatocellular carcinoma(HCC) is reproted. This patient who represented high serum alpha-fetoprotein(AFP) underwent a subtotal gastrectomy for stomach cancer and lobectomy of liver metastasis. The hepatoid component of the tumor was characterized by solid nests of large polygonal cells arranged in cords and trabeculae, with central nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm; single-nuclear giant cells were frequently noted. These tumor cells of stomach stained positive immunohistochemically for AFP, ACT(alpha-1-antitrypsin), AACT(alpha-1-antichy-motrypsin). Thus, this hepatoid gastric adenocarcinoma tumor cells demonstrated both morphologic and immunohistochemical features of partial differentiation to the HCC. Careful histologic examination in conjunction with the immunohistochemical demonstration of AFP can provide a useful contribution to the diagnosis of this rare histological type of gastric carcinoma And the presence of metastatic hepatoid adenocarcinoma from the stomach should be considered in a patient with hepatic tumor mimicking HCC. Because of frequent venous and lymphatic invasion, as well as liver metastasis, prognosis appears to be poor. The authors reviewed 45 cases of hepatoid adenocarcinoma of stomach reported in the literature, also.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Neoplasm Metastasis ; Stomach Neoplasms

No abstract available.
Brain Edema* ; Brain* ; Meningioma* ; Vascular Endothelial Growth Factor A*

Massive ovarian deema is a tate conditian. It is a benign enlargement of the ovary caused by accumulation of fluid, which is thought to result from intermittent partial toraion of the ovarian pedicle. Histologically, the ovaries were characterized by diffuse edema of medulla and inner cortex. Two cases of massive ovanan edema are reported with brief review of the literatures.
Edema* ; Female ; Ovary

No abstract available.
Brain Edema* ; Brain* ; Microvessels* ; Vascular Endothelial Growth Factor A*

Localized fibrous mesothelioma of the liver is very rare benign tumor. It usually manifest large palpable hepatic mass in right upper quadrant area, and the prognosis is excellent by surgical resection. Contrast enhanced CT scan shows well defined hyperattenuating mass and celiac anglogram shows hypervascular mass. Recently we experienced 1 case of localized fibrous mesothelioma of the liver, and we report CT and anglographic findings of this tumor.
Liver* ; Prognosis ; Solitary Fibrous Tumor, Pleural* ; Tomography, X-Ray Computed

PURPOSE: Some authors noted unilateral testicular torsion often leading to a damage in the contralateral testis. But it is not known whether this is the result of an intrinsic abnormality in the remaining testis or testicular injury associated with the ischemic event. Recently some authors noted an increase in germ cell apoptosis in the contralateral testis and suggested the involvement of nitric oxide (NO) in the apoptosis of germ cells. We aimed at the NO involvement in testicular torsion in this study, in which we measured inducible nitric oxide synthase (iNOS) expressions and found pathological changes in the torsed and detorsed testes of the rats. MATERIALS AND METHODS: Adult, male, Sprague-Dawley rats were divided into two groups: I) unilateral left testicular torsion persisting for 1, 4, 8 hours. II) torsion for 4 or 8 hours followed by detorsion. Testes were fixed in scrotal wall with a suture. Testes were fixed in formalin solution and prepared in paraffin blocks and slide mounted. All histologic examinations were done by a single observer. The expression of iNOS gene in the testis was determined by reverse transcriptase-polymerase chain reaction and relative iNOS mRNA levels were assessed with normalization to beta-actin mRNA levels. RESULTS: Histologically, the degeneration and inflammation were found in 4 hours after torsion and the necrosis was found in 8 hours after torsion. In contralateral testis, normal findings were noted in 4 hours and 8 hours after torsion. iNOS gene expression was found in the normal control testis. In the torsed testis, iNOS gene expression significantly increased in 1 hour after torsion, then decreased to the control level. In contralateral testis, iNOS gene expression was also increased in 1 hour to 8 hours after torsion. After detorsion, iNOS gene expression significantly decreased in detorsed testis, but constantly increased in contralateral testis. CONCLUSIONS: In rats, iNOS gene expression and histological changes were observed in torsed and detorsed testes. These results support the hypothesis that NO by iNOS protein may play a role in contralateral testicular damage, such as ischemic-reperfusion injury.
Actins ; Adult ; Animals ; Apoptosis ; Formaldehyde ; Gene Expression ; Germ Cells ; Humans ; Inflammation ; Male ; Necrosis ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Paraffin ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Spermatic Cord Torsion ; Sutures ; Testis*

Extrarenal Wilms' tumor is a very exceptional tumor which is defined as Wilms' tumor found anywhere other than in the kidneys. Until now less than 60 cases have been reported in the English literature. The tumor can be located in the retroperitoneum, inguinal canal, uterus, cervix, testes, skin and even in the thorax. The diagnosis is almost always made after surgical intervention. Distant metastasis of this tumor has only been reported in the case of a 6-year-old girl who developed Wilms' tumor in the inguinal canal with lung involvement. In this paper we report a case of extrarenal Wilms' tumor in retroperitoneum with distant metastasis to lungs, ribs and pelvic bone in a 6- year old male. The tumor was successfully removed without tumor cell spillage. The patient was diagnosed as favorable histologic group, in which the tumor consists of epithelial, blastemal and mesenchymal components without teratomatous elements. He received combination chemotherapy according to NWTS-IV guidelines and radiation to involved lungs, and has been alive and well for the last 6 months without severe complication or relapse.
Cervix Uteri ; Child ; Diagnosis ; Drug Therapy, Combination ; Female ; Humans ; Inguinal Canal ; Kidney ; Lung* ; Male ; Neoplasm Metastasis* ; Pelvic Bones ; Recurrence ; Ribs ; Skin ; Testis ; Thorax ; Uterus ; Wilms Tumor*

Enteric fistulae result from gastrointestinal perforations in which communication is established between the site of perforation and another hollow viscus, potential space, or skin surface. Certain types of enteric fistulae are difficult to demonstrate by conventional radiographic methods, and CT is unique in its ability to demonstrate the extent and nature of extraluminal changes. The purpose of this study is to illustrate the CT findings of enteric fistulae occurring in a variety of abdominal and pelvic organs.
Fistula* ; Skin

OBJECTIVE: To compare the diagnostic accuracy of ultrasonographic endometrial thickness with that of hysteroscopy, it is to establish the most appropriate method for the diagnosis of endometrial cancer and other endometrial diseases in postmenopausal women with abnormal uterine bleeding (AUB). METHODS: This retrospective study was conducted in 105 consecutive postmenopausal patients with AUB, who underwent ultrasonographic evaluation of endometrial thickness, hysteroscopy and endometrial biopsy. Evaluation of sensitivity and specificity was performed. RESULTS: Histologic findings for <4 mm level revealed that atrophy was present in 30 (71.4%) and in 1 case (2.4%) endometrial cancer was found; for > or =4 mm values polyps and myomas were present in 31 (49.2%) and there were 3 (4.8%) in endometrial cancer. Sensitivity and specificity for trans-vaginal ultrasound, with a cut-off value > or =4 mm, was 75% and 40.6%. CONCLUSIONS: Generally speaking, obstetrics & gynecologists know that endometrial aspiration biopsy is the routine method in postmenopausal women with AUB. However transvaginal ultrasound remains the first line diagnostic procedure in postmenopausal women without AUB. In case of endometrial thickness less than 4 mm, it is likely to miss the early stage endometrial cancer but trans-vaginal ultrasound remains the first line diagnostic procedure in postmenopausal women, because it is not invasive and has high sensitivity for detecting endometrial cancer and other endometrial disease; According to our experience, hysteroscopy with biopsy is mandatory in all postmenopausal women with AUB.
Atrophy ; Biopsy ; Biopsy, Needle ; Diagnosis ; Endometrial Neoplasms ; Female ; Hemorrhage* ; Humans ; Hysteroscopy* ; Myoma ; Obstetrics ; Polyps ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography ; Uterine Diseases ; Uterine Hemorrhage

We observed the gastric varices in l89 variceal patients with liver cirrhosis and in 129 patients with UGI bleeding by endoscopy. Gastric varices was found in 27 cases(14.2%) amoag 189 variceal cases. There was variceal bleeding in 74 cases(57.4%) beieg the toy cause of UGI: bleeding among l29 cases with UGI bleeding and 6(4.7%) had endoscopically proved gastric Variceal bleeding. Cardiac and fundic varices were observed in l8 and 12 cases, respectively end 12 cases of cardiac varices were mainly observed on the lesser curvature side. The incidence of isolated gastric varices being 30 % amoag gastric varices was far less than that of esophagogastric varices. There was no significant relations between the severity of liver cirrhosis and the kinds of varices These results suggest that gastric varices are not infrequent cause of UGI bleeding cases. Therefore all must have attention in gastric intestinal fiberscopic examination in portal hypertensive patients.
Endoscopy ; Esophageal and Gastric Varices* ; Hemorrhage ; Humans ; Incidence ; Liver Cirrhosis ; Play and Playthings ; Varicose Veins