No abstract available.
Sertoli-Leydig Cell Tumor*

Carcinoid tumors of the appendix are common incidental findings, but appendiceal tumors with histologic features of both carcinoids and adenocarcinomas are rare, and their biologic behavior and histogenesis are still unclear. We report a case of goblet cell carcinoid of the appendix in a 54-year-old male, who exhibited pain in the right lower abdomen. Microscopically, the tumor contained smooth-bordered, widely separated nests composed of tumor cells with abundant mucin. The principal tumor cell type had a close resemblance to the normal goblet cell. Histochemically, the tumor cells revealed positive reaction for PAS and alcian blue stain. Immunohistochemically, the tumor showed strong reactivity for carcinoembryonic antigen, chromogranin and, neuron specific enolase but none for cytokeratin and epithelial membrane antigen.
Adenocarcinoma

Complex regional pain syndrome (CRPS) is often a devastating neuropathic condition that has been recognized with increasing frequency in the lower extremities. Patients with CRPS may worsen to such a degree that the individual may never return to a satisfactory and productive life. Spinal cord stimulation (SCS) is one of the most minimally invasive and effective treatments for intractable pain such as CRPS. The most important factor for successful stimulation of the spinal cord is proper lead position that stimulation and pain regions match completely. A 39-year-old male patient, suffering from CRPS type II in his lower extremity, visited our pain clinic. It was a difficult case that the electrode for spinal cord stimulation was positioned at the proper site due to the adhesion of the epidural space by frequent epidural blocks and procedures. We report the efficacy of a steerable epidural catheter for adhesiolysis on the setting the electrode to the proper site in the epidural space.
Adult ; Catheters ; Causalgia ; Electrodes ; Epidural Space ; Humans ; Lower Extremity ; Male ; Pain Clinics ; Pain, Intractable ; Spinal Cord ; Spinal Cord Stimulation ; Stress, Psychological

OBJECTIVE: This study was designed to compare the vaginal hysterectomy and abdominal hysterectomy for a non-prolapsed, benign uterus in women without vaginal delivery. METHODS: A retrospective study in Hallym-university hospital analysed 182 total hysterectomies in women without vaginal delivery performed from January 2000 to December 2001. Vaginal route was used for 98 (53.8%) patients and 84 (46.2%) had laparotomies. RESULTS: The mean uterine weight was 217 g in vaginal route, 270 g in abdominal route. Mean operation time was 70 minutes in vaginal route, 125 minutes in abdominal route. There was one serious re-operation due to hemorrhge in each group and other complication was not much different at each gruops. The hospital stay was 6.2 days in vaginal route and 8.4 days in abdominal route. CONCLUSION: Vaginal hysterectomy for a non-prolapsed uterus is indicated for women without vaginal delivery and is feasible to performance. Vaginal hyterectomy is less morbidity, shorter hospitalization and faster convalescence. So training in vaginal surgury should allow safe performance of the procedure at most center.
Convalescence ; Female ; Hospitalization ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal* ; Laparotomy ; Length of Stay ; Retrospective Studies ; Uterine Diseases* ; Uterus

BACKGROUND: It was known that conventional stress-redistribution imaging was not adequate for detection of severely ischemic but viable myocardium. Albeit the gold criteria of viable myocardium is the presence of metabolism which can be detected by PET, reinjection technique was reported to be able to identify most, if not all, of viable myocardium. Because reinjection imaging is performed immediately after redistribution imaging, an additional redistribution could be happened if we follow the patient longer. To prove the guess authors performed an additional delayed imaging 24 hours after reinjection of 201T1. METHODS: Subject patients were 20 ischemic heart disease patients who showed irreversible perfusion defect(s) on standard pharmacologic(dipyridamole) stress-redistribution images. Immediately after the redistribution images were obtained, 37 MBq thallium was injected at rest, and images were reacquired at 10 minutes and 24 hours after reinjection. Four sets of images(stress, redistribution, reinjection and delayed images) were then analyzed qualitatively and quantitatively. Left ventricle was arbitrarily divided into 9 segments(apex, proximal and distal portions of anterior, septal, inferior and lateral walls). RESULTS: These were 45 irreversible perfusion defects in 20 subject patients, of which 21(46.7%) showed improved thallium uptake after reinjection. Among these 21 segments 2 demonstrated further improvement of uptake on 24-hour delayed images, of the 24 regions determined to have persistent defects after reinjection. 10(41.7%) showed improved uptake on delayed images. CONCLUSIONS: In addition to reinjection imaging, 24-hour delayed imaging after reinjection was also helpful to identify severely ischemic but viable myocardium.
Dipyridamole* ; Heart Ventricles ; Humans ; Metabolism ; Myocardial Ischemia ; Myocardium* ; Perfusion ; Thallium ; Tomography, Emission-Computed, Single-Photon*

Histologic, immunohistochemical and ultrastructural studies were performed on 6 cases of undifferentiated thyroid carcinoma to study the histogenesis of the undifferentiated thyroid carcinoma, to determine the most useful markers for diagnosing these tumors and to investigate the nature of osteoclast-like giant cells rarely observed in these tumors. For the immuno-histochemical study, a panel of antibodies to epithelial (cocktailed keratin, low molecular weight keratin, CEA), mesenchymal(vimentin, desmin, actin, FVIIIRAg) endocrine(calcitonin, chromogranin), lymphocytic(LCA), histiocytic(alpha-l-ACT, alpha-1-AT, lysozyme, CD68), and Schwann cell(S-100 protein) markers were used. The following results were obtained; 1) Well differentiated carcinoma was associated with 2 cases of spindle cell type and 1 case of giant cell type of undifferentiated thyroid carcinoma and a transitional zone between the well differentiated and undifferentiated lesions was observed. 2) All of the examined cases expressed keratin, and 3 tumors expressed CEA. 3) All the mesenchymal markers, LCA, S-100 protein, calcitonin, and chromogranin were not expressed. Vimentin was coexpressed with keratin in 4 cases. 4) Osteoclast-like giant cells were observed in 1 case of spindle cell type. They expressed CD68 but not keratin. 5) Ultrastructural study revealed the desmosomes between the tumor cells and non-neoplastic, follicular, thyroid epithelial cells. The above results indicate that undifferentiated thyroid carcinoma originates from follicular epithelial cell, keratin is the most useful marker for diagnosis of this tumor, and the osteoclast-like giant cells are histiocytic in nature and reactive, rather than neoplastic.

No abstract available.

For the estimation of the proliferative activity, related to the biologic behaviour, malignant potential, and prognosis, of human thyroid tumors, PCNA(proliferating cell nuclear antigen) immunohistochemical staining was performed on paraffin-embedded sections of 9 normal thyroid tissues, 9 adenomatous goiters, 9 follicular adenomas, 4 Hurthle cell tumors, 12 papillary carcinomas, 4 follicular carcinomas, and 3 anaplastic carcinomas. The results were as follows: 1) The PCNA labeling indices in adenomatous goiter, follicular adenoma, and Hurthle cell tumor were 1.1, 1.5, and 2.4, respectively. They were significantly higher than the labeling index in normal thyroid. 2) The PCNA labeling indices in papillary carcinoma and follicular carcinoma were 3.5 and 4.4, respectively. They were significantly higher than the labeling indices in adenomatous goiter and follicular adenoma, but there was no significant difference between papillary and follicular carcinoma. 3) The PCNA labeling index in anaplastic carcinoma, 14.1, was significantly higher than those in benign and other malignant tumors. According to the results, the PCNA labeling index was well correlated with the malignant potential of a tumor. So the PCNA immunohistochemical staining is thought to be a useful method for the evaluation of the malignant potential and prognosis of a tumor.
Humans

PURPOSE: Combination chemotherapy with cisplatin and etoposide have been considered as one of the chemotherpy regimen for non small cell lung cacer(NSCLC) with the response rate of 20~40%. Ifosfamide is one of the most active agent against NSCLC. And so, we initiated a phase II trial for advanced NSCLC to determine the effect of PIE(cisplatin, ifosfamide, etoposide) regimen. MATERIALS AND METHODS: 36 patients with inoperable non-small cell lung cancer who had no prior systemic chemotherapy were treated with combined ifosfamide (1,800 mg/m2 plus mesna 1,100 mg/m2 by intravenous continuous infusion daily for 3 days) with cisplatin (20 mg/m2 intravenous for 3 days) and etoposide (80 mg/m2 intravenous for 3 days). We evaluated the response rate, survival and toxicities of these patients. RESULTS: The objective response rate was 28%(CR; 2/36, 6%, PR; 8/36, 22%). Among 10 responders, 7 patients were in good ECOG performance status(0~1). The mean survival of all these patients were 43 weeks(8~141 weeks); the responding patients survived longer than the non-responders(median survival; 59 weeks vs 28 weeks, p<0.05). The toxicities of this regimen were acceptable without treatment related toxic death. CONCLUSION: We concluded that PIE regimen is effective in the treatment of advanced non-small cell lung cancer with acceptable toxicities and long-term follow up is warranted.
Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Follow-Up Studies ; Humans ; Ifosfamide* ; Lung ; Mesna ; Small Cell Lung Carcinoma* ; Survival Rate

The objective of this study was to establish the effect of high dose steroid therapy in traumatic optic neuropathy with Heidelberg Retina Flowmeter(HRF) to detect the changes of optic nerve head bleed flow. HRF permits the noninvasive assessment of the blood velocity, volume and flow(flux) in a sample volume of the nerve head. Such measurements were performed in two groups of experimental traumatic optic neuropathy rabbits. We experimentally damaged the optic nerves of ten white rabbits with a Hartman mosquito. The first group(n=5) was intravenously infected with 0.25mg/kg dexamethasone every six hours for a 48 hour period. The second group(n-5) was used as controls. Both groups were tested before operation, 1 week, 1 month, and 2 months later Experimental optic nerve damage created a significant decrease in optic nerve head blood flow 50.51%(p=0.001), with blood volume decreased by 46.02%(p=0.001) and blood velocity reduced by 43.12%(p=0.002) compared to the baseline value. After 2 months of high dose corticosteroid therapy, optic nerve head blood flow was increased by 76.90% (p=0.012), blood volume 77.53%(p=0.012)and blood velocity 47.21%(p=0.012) as compared to control group. The high dose corticosteroid therapy improved the optic nerve head blood flow as demonstrated in traumatic optic neuropathy. HRF may be used to assess the therapeutic responses in traumatic optic neuropathy under variable conditions.
Blood Volume ; Culicidae ; Dexamethasone ; Head ; Optic Disk* ; Optic Nerve Injuries* ; Optic Nerve* ; Rabbits ; Retina