BACKGROUND/AIMS: Performance of polyethylene glycol solution (PEG) is often unsatisfactory as bowel preparation agent for colonoscopy. In order to provide equivalent efficacy with better patient tolerance, sodium phosphate tablet (SPT) has been developed. This study was carried out to compare the efficacy and compliance of two bowel preparation methods: PEG with ascorbic acid (PEGA) vs. SPT preparation. METHODS: A multicenter, randomized controlled trial was performed. Primary efficacy variable was overall quality of colon cleansing assessed by Boston bowel preparation scale (BBPS) during colonoscopy. Patient's satisfaction and adverse events were evaluated by means of symptom questionnaire completed by each patient immediately before colonoscopy. RESULTS: A total of 189 patients were randomly assigned to undergo pre-colonoscopic bowel preparation with either SPT (n=96) or PEGA (n=93). Overall BBPS score was 8.3+/-1.12 in the SPT group and 8.4+/-0.96 in the PEGA group (p=0.441). Among the 189 patients, 90 had polyps (47.6%) and 50 had adenomas (26.5%). The polyp/adenoma detection rate was 54.2% (n=52)/27.1% (n=26) for SPT group and 40.9% (n=38)/25.8% (n=24) for PEGA group (p=0.079 and 0.790, respectively). More number of patients were unable to take the prescribed dose of PEGA compared with the SPT regimen (8.6% vs. 2.0%, p=0.045). Overall satisfaction score was 7.9+/-1.63 in the SPT group and 7.4+/-1.53 in the PEGA group (p=0.022). CONCLUSIONS: Degree of colon preparation, polyp/adenoma detection rate and adverse effect were similar between SPT group and PEGA group. Patient compliance and satisfaction were greater in the SPT group.
Abdominal Pain/etiology ; Adenoma/pathology ; Adult ; Ascorbic Acid/*therapeutic use ; Cathartics/adverse effects/*therapeutic use ; Colonic Polyps/pathology ; *Colonoscopy ; Female ; Humans ; Male ; Middle Aged ; Nausea/etiology ; Patient Satisfaction ; Phosphates/*therapeutic use ; Polyethylene Glycols/*therapeutic use ; Surveys and Questionnaires

BACKGROUND/AIMS: Colorectal adenomas that are > or =10 mm have villous histology or high-grade dysplasia, or that are associated with > or =3 adenomas are considered high-risk for metachronous advanced neoplasia. We evaluated the cumulative incidence of metachronous advanced neoplasia according to the total number of high-risk findings detected on baseline colonoscopy. METHODS: This was a retrospective cohort study performed in 862 patients who underwent removal of colorectal adenomas between 2005 and 2009. At least one surveillance colonoscopy had been conducted at Konkuk University Medical Center, Seoul, Korea. RESULTS: The cumulative incidence of metachronous advanced neoplasia in patients with 0, 1, 2, and 3-4 high-risk findings at 1 year were 0.7%, 1.3%, 2.8%, and 8.0%; at 3 years, those were 5.9%, 11.9%, 15.5%, and 24.7%; and at 5 years, those were 8.5%, 18.7%, 26.3%, and 37.2%, respectively. In a multivariate model, the risk of metachronous advanced neoplasia was significantly higher for the multiple high-risk findings group when compared with the 0 high-risk findings group (1 high-risk (+): hazard ratio, 1.86 [95% confidence interval, 1.00-3.44]; 2 high-risk (+): 1.84 [0.88-3.84]; and 3-4 high-risk (+): 3.29 [1.54-7.01]; ptrend=0.020). CONCLUSIONS: The presence of overlapping multiple high-risk findings was associated with an increased risk of advanced neoplasia during surveillance.
Adenoma/epidemiology/*etiology/pathology ; Aged ; Colonic Polyps/complications/surgery ; *Colonoscopy ; Colorectal Neoplasms/epidemiology/*etiology/pathology ; Early Detection of Cancer/methods ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasms, Second Primary/epidemiology/*etiology/pathology ; Population Surveillance/methods ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Time Factors ; Tumor Burden

OBJECTIVETo study the clinicopathologic characteristics of parathyroid carcinoma (PTC).

METHODSEleven cases of PTC encountered during the period from 1994 to 2012 were enrolled into the study. Forty cases of parathyroid adenoma (PA) were also retrieved for comparison. The clinical manifestations, laboratory results and pathologic features were analyzed, with literature review.

RESULTSThe main clinical manifestations of PTC included neck mass (11/11), hypercalcemia (11/11) and hyperparathyroidism (11/11). Most patients also had osteoporosis (10/11). In contrast, PA often manifested as hypercalcemia (40/40) and hyperparathyroidism (40/40). Histologic examination of PTC showed that the tumor cells contained clear to eosinophilic cytoplasm and separated by dense bands of fibrosis. The tumor mass was surrounded by thick fibrous capsule. Foci of capsular invasion and vascular permeation were identified at the tumor periphery in all cases. Cellular atypia was not conspicuous but mitotic figures and coagulative necrosis were easily identified. On the other hand, PA were composed of tumor cells with clear to eosinophilic cytoplasm, forming glands, trabeculae or nests. Most of them (35/40) had intact fibrous capsule. Mitotic figures were rarely encountered and tumor necrosis was absent. Immunohistochemical study showed that the tumor cells in PTC were positive for CK19 (11/11), chromogranin A (9/11), synaptophysin (7/11) and parathyroid hormone (11/11). They were negative for thyroglobulin, TTF-1 and calcitonin. The Ki-67 index was less than 10% (range = 2% to 9%). In contrast, the tumor cells in PA were positive (40/40) for CK19, chromogranin A, synaptophysin and parathyroid hormone. They were negative for thyroglobulin, TTF-1 and calcitonin. The Ki-67 index was less than 3%. Follow up-data were available in 9 cases of PTC (duration of follow up = 11 months to 224 months) and 7 of the patients were still alive. Follow up of all PA cases showed no evidence of recurrence.

CONCLUSIONSPTC is a rare malignant endocrine tumor presenting as neck mass. Histologic features suggestive of malignant behavior include presence of coagulative tumor necrosis and capsular/vascular invasion. It needs to be distinguished from other entities such as parathyroid adenoma, papillary thyroid carcinoma and medullary thyroid carcinoma.

Adenoma ; metabolism ; pathology ; Adult ; Carcinoma ; metabolism ; pathology ; Carcinoma, Neuroendocrine ; Carcinoma, Papillary ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Hypercalcemia ; etiology ; Hyperparathyroidism ; etiology ; Immunohistochemistry ; Keratin-19 ; metabolism ; Male ; Middle Aged ; Osteoporosis ; etiology ; Parathyroid Hormone ; metabolism ; Parathyroid Neoplasms ; complications ; metabolism ; pathology ; surgery ; Synaptophysin ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology

It is rare that large mixed tumors of salivary gland located in the nose and uvula. The patient who had mixed tumors of salivary gland at nose found exophytic growth tumor for half a year. The other patient who had mixed tumors of salivary gland at uvula felt swallowing foreign body sensation for one year, and dysphagia for one month. After surgical resection, the symptoms disappear.
Adenoma, Pleomorphic ; complications ; pathology ; Deglutition ; Deglutition Disorders ; etiology ; Humans ; Nose Neoplasms ; pathology ; Palatal Neoplasms ; pathology ; Salivary Gland Neoplasms ; complications ; pathology ; Uvula ; pathology

Here, we report an extremely rare case of acquired nasolacrimal duct obstruction caused by oncocytic carcinoma. A 64-year-old man presented to the hospital complaining of epiphora and left-side nasal obstruction. Ophthalmic and otolaryngology examination revealed a left lacrimal duct obstruction caused by a mass in the left nasal cavity and lacrimal drainage system. The mass was removed and confirmed as an oncocytic carcinoma. Nine months after surgery, without adjuvant radiotherapy, a left orbital mass was observed and the patient underwent reoperation. The mass proved to be recurrent oncocytic carcinoma. The patient underwent adjuvant radiotherapy to eradicate any residual tumor and the patient remains tumor-free one year post-radiotherapy.
Adenoma, Oxyphilic/*complications/pathology/surgery ; Humans ; Lacrimal Duct Obstruction/*etiology/pathology/surgery ; Male ; Middle Aged ; Nasolacrimal Duct/*pathology/surgery ; Neoplasm Recurrence, Local/complications/pathology/surgery ; Nose Neoplasms/*complications/pathology/surgery ; Reoperation

Here, we report an extremely rare case of acquired nasolacrimal duct obstruction caused by oncocytic carcinoma. A 64-year-old man presented to the hospital complaining of epiphora and left-side nasal obstruction. Ophthalmic and otolaryngology examination revealed a left lacrimal duct obstruction caused by a mass in the left nasal cavity and lacrimal drainage system. The mass was removed and confirmed as an oncocytic carcinoma. Nine months after surgery, without adjuvant radiotherapy, a left orbital mass was observed and the patient underwent reoperation. The mass proved to be recurrent oncocytic carcinoma. The patient underwent adjuvant radiotherapy to eradicate any residual tumor and the patient remains tumor-free one year post-radiotherapy.
Adenoma, Oxyphilic/*complications/pathology/surgery ; Humans ; Lacrimal Duct Obstruction/*etiology/pathology/surgery ; Male ; Middle Aged ; Nasolacrimal Duct/*pathology/surgery ; Neoplasm Recurrence, Local/complications/pathology/surgery ; Nose Neoplasms/*complications/pathology/surgery ; Reoperation

Tumours consisting of a glandular component, either an adenoma or adenocarcinoma, and a carcinoid component are uncommon. These tumours can be differentiated into collision, composite or amphicrine tumours. Most cases reported in the literature were mixed adenocarcinoma-carcinoid tumours. To date, only four cases of mixed adenoma carcinoid tumours have been reported in the literature. This case report describes a unique case of collision adenoma-carcinoid tumour in the colon complicated by carcinoid syndrome in a 45-year-old woman who presented with a one-month history of diarrhoea and weight loss. She developed recurrence of the carcinoid component of the tumour four months after endoscopic resection. We conclude that carcinoid syndrome can occur in an adenoma-carcinoid tumour; however, the prognosis of this condition is uncertain.
Adenoma ; pathology ; Carcinoid Tumor ; pathology ; Colonic Neoplasms ; pathology ; Colonoscopy ; Diarrhea ; etiology ; Female ; Humans ; Malignant Carcinoid Syndrome ; pathology ; Middle Aged ; Weight Loss

OBJECTIVEThe aim of this study was to investigate the relationship of the mutations of leptin receptor gene exon 4, exon 6, exon9, and exon20 with the tumorigenesis of breast cancer.

METHODSGenomic DNA was extracted from breast cancer tissues of 155 patients, benign lesions of 56 patients and normal tissues and blood samples from 100 health control subjects. The leptin receptor genes were assayed with polymerase chain reaction (PCR) amplification and direct sequence analysis.

RESULTSNucleotide substitutions no mutations were found at exon 4, and nucleotide substitutions occurred at codon 1029 in exon 9, no significant difference among the three groups (P = 0.574). The nucleotide substitutions at codon 668 in exon 6 resulted in Gln223Arg polymorphisms. The occurring frequencies of GG, GA, AA in breast cancer, breast benign lesions tissues and health tissues control group were 70.9% and 17.4%, 12.3%; 80.4%, 14.3% and 5.4%; and 81.0%, 16.0%, and 3.0%, respectively. Alleles of G and A in the three groups were 79.1% and 20.8%, 87.5% and 12.5%, and 89.0% and 11.0%, respectively. Compared the Gln223Arg genotype with the three allele groups, there were significant differences (χ(2) = 16.11, P < 0.005 and χ(2) = 11.41, P < 0.01), respectively. The nucleotide substitutions at codon 3057 in exon 20 resulted in Pro1019Pro polymorphisms. The occurrence frequencies of GG, GA, AA in the breast cancer, benign disease and health control groups were 11.6%, 30.3% and 56.1%; 32.1%, 44.0% and 28.5%; and 32.0%, 45.0% And 23.0%, respectively. Alleles of G and A in the three groups were 26.8% and 73.2%, 51.8% and 48.2%, and 54.5% and 45.5%, respectively. There are significant differences among the three groups (χ(2) = 6.56, P < 0.03 and χ(2) = 5.45, P < 0.05), respectively. Nucleotide substitutions occurred at relatively high frequencies at exon 6 and exon 20 in obese and overweight breast cancer patients compared with those in normal weight breast cancer patients, there were significant differences (P < 0.05 and P < 0.01).

CONCLUSIONSOur findings show that there is no relationship between the variations of leptin receptor gene exon 9 and tumorigenesis of breast cancer. The variation rate of leptin receptor gene exon 6 and exon 20 are significantly increased in the obese and overweight breast cancer patients.

Adenoma ; genetics ; Adult ; Aged ; Breast ; pathology ; Breast Neoplasms ; etiology ; genetics ; Carcinoma ; etiology ; genetics ; Exons ; Female ; Gene Frequency ; Humans ; Hyperplasia ; genetics ; Middle Aged ; Obesity ; genetics ; Point Mutation ; Receptors, Leptin ; genetics

Adenoma ; complications ; pathology ; Adult ; Antipsychotic Agents ; adverse effects ; therapeutic use ; Aripiprazole ; Benzodiazepines ; adverse effects ; therapeutic use ; Bromocriptine ; adverse effects ; therapeutic use ; Dopamine Antagonists ; adverse effects ; therapeutic use ; Female ; Hormone Antagonists ; adverse effects ; therapeutic use ; Humans ; Hyperprolactinemia ; complications ; etiology ; Piperazines ; adverse effects ; therapeutic use ; Pituitary Neoplasms ; complications ; pathology ; Quinolones ; adverse effects ; therapeutic use ; Risperidone ; adverse effects ; therapeutic use ; Schizophrenia ; drug therapy ; etiology ; pathology ; Serotonin Antagonists ; adverse effects ; therapeutic use ; Trifluoperazine ; adverse effects ; therapeutic use

Functioning adrenocortical oncocytomas are extremely rare and most reported patients are 40-60 yr of age. To our knowledge, only 2 cases of functioning adrenocortical oncocytomas have been reported in childhood. We report a case of functioning adrenocortical oncocytoma in a 14-yr-old female child presenting with virilization. She presented with deepening of the voice and excessive hair growth, and elevation of plasma testosterone and dehydroepiandrosterone sulfate. She had an adrenalectomy. The completely resected tumor composed predominantly of oncocytes without atypical mitosis and necrosis. A discussion of this case and a review of the literature on this entity are presented.
Adenoma, Oxyphilic/*complications/metabolism/pathology/surgery ; Adolescent ; Adrenal Cortex Neoplasms/*complications/metabolism/pathology/surgery ; Adrenalectomy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Virilism/*etiology/pathology/surgery