Malignant schwannoma is rare tumor which is derived from schwan cells or nerve sheath cells, and it is frequently associated with Von Rechlinghausen's disease. We experienced one case of malignant schwannoma on the right chest wall without Von Rechlinghausen's disease. Patient was 64-year-old man who presented painless palpable mass on the right lower chest wall for about 2 months. On chest computed tomography, the mass which was 6 X 6 cm in size and had central necrosis, involved 11th rib with destruction, invaded the diaphragm and displaced the kidney anteriorlly. He underwent en-bloc resection of the tumor and discharged without any problem after 20 days.
Diaphragm ; Humans ; Kidney ; Middle Aged ; Necrosis ; Neurilemmoma* ; Ribs ; Thoracic Wall* ; Thorax*

Ten cases with esophageal foreign body were treated surgically from July 1980 to October 1995 at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The mean age was 45.3 years, with a range from 25 to 71. Out of ten cases, 6 were female and four were male. Common symptoms were dysphagia, fever, foreign body sensation and neck pain. Three cases of foreign bodies were of fish bones, two of bubble package of drugs, one case of a beer bottle cap, one of a piece glass, one of a bathtub plug, one of chicken and one of a bean. The diagnosis was established by esophagography using a water soluble contrast material and esophagoscopy. Among of ten cases, two had esophageal stricture due to the ingestion of lye at a young age. One case had experienced psychological problems. All foreign bodies were removed by surgical procedures. Five cases were treated by cervical esophagostomy, one case by right thoracotomy, one case by retrograde bougienation through gastrostomy and two cases by cervical incision and drainage for cervical abscess. Three cases developed post operative esophageal leaks which healed spontaneously and transient hoarseness developed in one case. One case developed traumatic pneumothorax and subcutaneous emphysema which was treated by closed thoracostomy. There were no operative deaths.
Abscess ; Beer ; Chickens ; Chungcheongnam-do ; Deglutition Disorders ; Diagnosis ; Drainage ; Eating ; Esophageal Stenosis ; Esophagoscopy ; Esophagostomy ; Esophagus ; Female ; Fever ; Foreign Bodies* ; Gastrostomy ; Glass ; Hoarseness ; Humans ; Lye ; Male ; Neck Pain ; Pneumothorax ; Sensation ; Subcutaneous Emphysema ; Thoracostomy ; Thoracotomy

PURPOSE: The purpose of this study was to evaluate the clinicopathological features and immunohistochemical features of gastrointestinal stromal tumor (GIST), and specifically the expressions of platelet derived growth factor receptor A (PDGFRA), protein kinase C theta (PKC theta), discovered on GIST-1 (DOG-1), p16 and p27. MATERIALS AND METHODS: Total 118 patients who underwent surgical resection for GIST at our institution between Jan 1997 and Dec 2007 were retrospectively studied. Immunohistochemical staining for c-kit, PDGFRA, PKC-theta, DOG-1, p16 and p27 was performed on a tissue microarray of the 118 GIST. The clinicopathologic parameters, the disease-free survival (DFS) and the overall survival rate were analyzed along with immunohistochemistry. RESULTS: The immunohistochemical stains for c-kit, CD34, PKC-theta, PDGFRA, DOG-1, p16 and p27 were positive in 89.8%, 72.0%, 56.8%, 94.9%, 90.7%, 69.5% and 44.1% of the tumor samples, respectively. The immunohistochemical expression of c-kit was strongly correlated with PKC-theta (p=0.000), DOG-1 (p=0.000) and CD34 (p=0.002). The DFS rate was significantly decreased for the patients with peritoneal GIST, high risk GIST, > or =10 cm-sized GIST, > or =10 mitoses/50 high power fields (HPFs) and p16 positivity (p=0.001, p=0.004, p=0.001, p=0.003 and p=0.028). GISTs > or =10 cm, epithelioid tumor cell type, and c-kit, and DOG-1 negativity were significantly associated with shorter period of overall survival (p=0.048, p=0.006, p=0.000 and p=0.000). CONCLUSION: The expression of p16 and no expression of c-kit and DOG-1 in GISTs, as well as peritoneal tumor site, high risk group, large tumor size, epithelioid tumor cell type and numerous mitoses, may be potentially prognostic factors for predicting worse outcome for patients who suffer from GIST.
Coloring Agents ; Disease-Free Survival ; Gastrointestinal Stromal Tumors ; Humans ; Immunohistochemistry ; Mitosis ; Prognosis ; Protein Kinase C ; Receptors, Platelet-Derived Growth Factor ; Retrospective Studies ; Survival Rate

No abstract available.

Transposition of the island pedicle flap is a versatile method of mobilizing tissue from a relatively distant reservoir and moving it across intervening tissue. Advantages are the similar color and texture to those of the affected area, the minimal donor scar, the increased viability with local blood supply, and the potential to camouflage scars into natural skin lines or cosmetic units. In a 73-year-old woman, the lesion of a basal cell carcinoma on her left nasal ala was removed by Mohs micrographic surgery and the resultant defect was reconstructed by transposition of the island pedicle flap. In our case, there were no significant complications and the final result was satisfactory in both functional and cosmetic aspects. Through our experience, we can confirm that transposition of the island pedicle flap is another alternative for the reconstruction of nasal alar defects.
Aged ; Carcinoma, Basal Cell ; Cicatrix ; Female ; Humans ; Mohs Surgery ; Skin ; Tissue Donors

PURPOSE: Expression levels of tumor necrosis factor (TNF)-alpha expression on the mucosa of the small intestine is increased in patients with villous atrophy in food protein-induced enterocolitis syndrome (FPIES). TNF-alpha has been reported to induce apoptotic cell death in the epithelial cells. We studied the TNF family and TNF-receptor family apoptosis on the duodenal mucosa to investigate their roles in the pathogenesis of FPIES. METHODS: Fifteen infants diagnosed as having FPIES using standard oral challenge test and 5 controls were included. Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining was performed to identify the apoptotic cell death bodies. Immunohistochemical staining of TNF-alpha, Fas ligand (FasL) for TNF family and TNF-related apoptosis-including ligand (TRAIL) receptor 1 (DR4), TRAIL receptor 2 (DR5), and Fas for TNF-receptor family were performed to determine the apoptotic mechanisms. RESULTS: TUNEL+ was significantly more highly expressed in the duodenal mucosa of FPIES patients than in controls (P=0.043). TNF-alpha (P=0.0001) and DR4 (P=0.003) were significantly more highly expressed in FPIES patients than in controls. Expression levels of FasL, Fas, and DR5 were low in both groups and were not significantly different between the 2 groups. CONCLUSION: These results suggest that FPIES pathogenesis is induced by apoptosis, and that TNF-alpha expression and DR4 pathway may have an important role in apoptosis.
Apoptosis ; Atrophy ; Cell Death ; Enterocolitis ; Epithelial Cells ; Fas Ligand Protein ; Humans ; Infant ; Intestine, Small ; Mucous Membrane ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; Tumor Necrosis Factor-alpha ; Up-Regulation

Cowden's syndrome is a harmatomatous polyposis syndrome with characteristic mucocutaneous lesions and among the spectra of clinical disorders that has been attributed to germline mutations in the PTEN gene. Although Cowden's syndrome has rarely been reported, immunologic studies have revealed that patients with this syndrome have humoral and/or cellular immune abnormalities. We recently identified a 21-year-old woman with Cowden's syndrome who was diagnosed with candida esophagitis without a history of diabetes, carcinoma, or steroid therapy. We report the immunologic status of this patient and the relationship with candida esophagitis on the basis of a literature review.
Candida ; Esophagitis ; Female ; Germ-Line Mutation ; Hamartoma Syndrome, Multiple ; Humans ; Young Adult

Churg-Strauss syndrome (CSS) is a disorder characterized by pulmonary and systemic small- vessel vasculitis, extravascular eosinophilic infiltration and hypereosinophilia; it is rarely diagnosed in the pediatric age group. We experienced a case of CSS in a male infant who had repeated symptoms of asthma with hypereosinophilia and transitory non-fixed pulmonary infiltrates on chest radiographs. He also had rectal bleeding in early infancy and multiple erosions with extravascular eosinophilic infiltrations in the sigmoid colon. We report a rare case of CSS in a 14-month-old infant and review the medical literature.
Asthma ; Churg-Strauss Syndrome* ; Colon, Sigmoid ; Eosinophils ; Hemorrhage ; Humans ; Infant ; Male ; Radiography, Thoracic ; Vasculitis

Duplication cysts are rare congenital malformations, that may be detected anywhere along the alimentary tract, and they may communicate with the intestinal tract. Cystic duplication of the cecum is especially rare. About 80% of these cases are detected in the first 2 years of life as a result of an acute intestinal obstruction, which manifests as vomiting, recurrent abdominal pain, recurrent gastrointestinal bleeding and constipation. We report a case of intestinal obstruction secondary to a duplication cyst of the cecum in a neonate. The patient underwent surgery and was diagnosed subsequently, and is presently healthy.
Abdominal Pain ; Cecum ; Constipation ; Hemorrhage ; Humans ; Infant, Newborn ; Intestinal Obstruction ; Vomiting

Cyclosporine nephropathy was induced by intraperitoneal injection of cyclosporine 25 mg/kg in Sprague-Dawley rats daily for 1, 4, 8, and 12 weeks to clarify the relationship between cyclosporine nephropathy and the expression of TGF-beta1 with extracellular matrix deposition. On light microscopic examination, the kidneys in the 12 week cyclosporine-treated rats showed focal or striped fibrosis, vacuolization of tubular cells, and injury of endothelial cells. Immunohistochemically, TGF-beta1 protein was strongly expressed in the cyclosporine-treated rat kidneys, especially in the glomerular endothelial cells, interstitial endothelial cells, tubular epithelial cells, and parietal cells in the Bowman's capsule of the glomerulus as well as the periglomerular arterioles. The amount of TGF-beta1 expression was correlated with the morphological change in the cyclosporine-treated rats. Extracellular matrix, such as fibronectin and collagen IV, was also expressed in the endothelial cells of the glomerulus and the interstitium. It can be concluded, therefore that TGF-beta1 protein is probably involved in the early stage of fibrogenesis in cyclosporine nephropathy. It can be postulated that cyclosporine nephropathy results from the accumulation of extracellular matrix associated with the increase of TGF-beta1 transcription. Therefore, these results could be used in reducing fibrosis in cyclosporine nephropathy.
Animals ; Arterioles ; Bowman Capsule ; Collagen ; Cyclosporine ; Endothelial Cells ; Epithelial Cells ; Extracellular Matrix ; Fibronectins ; Fibrosis ; Injections, Intraperitoneal ; Kidney ; Rabeprazole ; Rats* ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1