Ancient schwannoma is a variant of schwannoma characterized by slow progression, degenerative changes, and a higher incidence in older adults. There have been two prior reported cases of ancient schwannoma arising from the distal ulnar nerve at the wrist level, but neither were longstanding or very large. Herein, we report an ancient schwannoma found in the ulnar nerve of the distal forearm that was found to be clinically meaningful in size. A 61-year-old man presented with complaints of tingling sensation of the fourth and fifth fingers and bulging of the ulnar side of the wrist. The patient reported that the mass in his wrist had grown very slowly, starting about 10 years ago, and that he had started experiencing a tingling sensation in his fourth and fifth fingers about 3 years prior, which had become worse in the past year. Based on the results of the preoperative examination, a benign nerve sheath tumor was suspected. As it was thought that the possibility of malignancy was not high, we elected to perform a marginal excision. Pathological examination confirmed ancient schwannoma. At his most recent visit, 3 years after surgery, he reported no recurrence and that he felt better than before surgery, but some tingling sensations remained. As with small ancient schwannoma in the distal wrist, most cases of large ancient schwannoma can be treated without special complications based on an accurate preoperative diagnosis.

OBJECTIVE: Penumbra ACE68 reperfusion catheter is a new large bore aspiration catheter used for reperfusion of large vessel occlusion. The objective of this study was to investigate the efficacy of this catheter in comparison to that of previous Penumbra catheters in patients with acute ischemic stroke related to internal carotid artery (ICA) occlusion.METHODS: Data of all eligible patients who received endovascular treatment (EVT) for ICA occlusion using Penumbra aspiration catheters between January 2015 and December 2018 were retrospectively reviewed. After dividing into two groups according to use of penumbra ACE68, baseline characteristics of patients, successful recanalization rate, puncture to recanalization time, and switch to stent base technique rate were assessed. Successful recanalization was defined by a thrombolysis in cerebral infarction (TICI) score ≥2b and favorable functional outcome was defined according to modified Rankin scale (score, 0–2).RESULTS: ACE68 reperfusion catheter was used in 29 of 75 eligible patients (39%). The puncture to recanalization time was significantly shorter (26±18.2 minutes vs. 40±24.9 minutes, p=0.011) and the rate of switch to stent-based retrieval was significantly lower (3% vs. 20%, p=0.046) in ACE68 catheter group. Moreover, although not statistically significant, the successful recanalization rate was higher (83% vs. 76%, p=0.492) in ACE68 catheter group. Favorable functional outcome was observed in 48% of patients treated with ACE68 reperfusion catheter and in 30% of patients treated using other Penumbra systems (p=0.120). Baseline Alberta Stroke Program Early CT Scores ≥8 (odds ratio [OR], 9.74; 95% confidence interval [CI], 1.72–54.99; p=0.010) and successful recanalization (OR, 10.20; 95% CI, 1.13–92.46; p=0.039) were independent predictors of favorable outcome.CONCLUSION: EVT using ACE68 reperfusion catheter can be considered a first-line therapy in patients with acute ICA occlusion as it can achieve rapid recanalization and reduce the frequency of conversion to stent-retrieve therapy.
Alberta ; Brain Ischemia ; Carotid Artery, Internal ; Catheters ; Cerebral Infarction ; Humans ; Punctures ; Reperfusion ; Retrospective Studies ; Stents ; Stroke ; Thrombectomy

Small cell carcinoma (SCC) primarily arises in the lung. Cases of primary extrapulmonary small cell carcinoma are uncommon, and may develop in various different organs. In particular, small cell carcinoma of the urinary bladder is very rare in female nonsmokers, and its prognosis is poor. The main part of treatment in SCC is a chemotherapy, which is a critical factor in its prognosis. In the present report, we describe the case of an 82-year-old female non-smoker who underwent transurethral resection of bladder tumor (TURBT) without chemotherapy for small-cell carcinoma of the bladder, and experienced a relapse at a same area to the primary tumor site.
Aged* ; Aged, 80 and over ; Carcinoma, Small Cell* ; Drug Therapy ; Female* ; Humans ; Lung ; Prognosis ; Recurrence ; Urinary Bladder Neoplasms ; Urinary Bladder*

Tuberculosis mainly develops in the lung, but may also rarely invade other parts of the abdominal region. Abdominal tuberculosis is associated with pulmonary tuberculosis in approximately 15% of cases, and abdominal tuberculosis primarily develops in the terminal ileum and lymphatic gland. Moreover, hepatic tuberculosis is uncommon and is usually accompanied with active pulmonary or miliary tuberculosis. Hence, the development of primary hepatic tuberculoma as a single liver mass is very unusual. In the present report, we describe the case of a 63-year-old man with a solitary hepatic tuberculoma; the 6.4 cm mass was incidentally detected during abdominal computed tomography in the asymptomatic patient, and the diagnosis was confirmed by liver biopsy through ultrasonography-guided fine-needle aspiration.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Humans ; Ileum ; Liver ; Lung ; Middle Aged ; Tuberculoma* ; Tuberculosis ; Tuberculosis, Hepatic ; Tuberculosis, Miliary ; Tuberculosis, Pulmonary

This is a case report of a 50-year-old female who presented to our clinic with headache and left temporal pulsatile mass. Aneurysm was revealed incidentally on a computed tomography angiography of her head. Open surgical resection with aneurysmal trapping was performed under local anesthesia. Histological examination demonstrated a true aneurysm of the superficial temporal artery. There was loss of normal elastin in the internal elastin layer. This case report describes the rare entity along with a review of the literature.
Anesthesia, Local ; Aneurysm ; Angiography ; Elastin ; Female ; Head ; Headache ; Humans ; Middle Aged ; Temporal Arteries

Serous cystadenomas of the pancreas account for approximately a third of pancreatic cystic neoplasms. Their coexistence with a second tumor is extremely rare. We now report a case of a serous microcystic adenoma combined with an intraductal papillary mucinous tumor of the pancreas in a 69-year-old man. Abdominal computed tomography scans demonstrated an incidental cystic mass in the body with cystic dilatation of the duct in the head of the pancreas. Central pancreatectomy with pancreatico-jejunostomy, and cyst excision of the pancreatic head were performed. Histologic examination demonstrated a serous microcystic cystadenoma in the body coexisting with an intraductal papillary mucinous adenoma in the head of the pancreas. This case study highlights the importance of careful intra-operative and pathologic examination for synchronous pancreatic tumors.
Adenoma ; Aged ; Cystadenoma ; Cystadenoma, Serous ; Dilatation ; Head ; Humans ; Mucins ; Pancreas ; Pancreatectomy ; Pancreatic Cyst

BACKGROUND: Molecular tools for tissue profiling generally require collection of fresh frozen tissues (FFT) as sources of high-quality DNA and RNA. Nowadays, researchers carry out large-scale, multi-center studies and they request inter-institutional minimal intrinsic bias, some fundamental similarities, and the same standardized and validated procedures. METHODS: This study reports standardized quality control procedure for fresh frozen tissue of the National Biobank of Korea. RESULTS: The main procedures for quality control for FFT are as follows: records related to sample collection such as labeling of samples, transport temperature, lag time from excision of tissue to freezing, and sample size were reviewed for all fresh frozen samples. The stability of RNA and DNA in fresh frozen tissue was evaluated for 3% of collected samples and purity was assessed (ratio of the absorbance at 260 and 280 nm) as was integrity (agarose gel electrophoresis). Stained hematoxylin and eosin sections were reviewed by a pathologist to confirm the diagnosis and to assess how representative the frozen sample was. CONCLUSIONS: We introduced that the quality-control criteria for fresh frozen tissue of the NBK. We expect that this study contributes to standardization of collection, storage, and quality control of fresh frozen tissue.
Bias (Epidemiology) ; DNA ; Eosine Yellowish-(YS) ; Freezing ; Hematoxylin ; Korea ; Quality Control ; RNA ; Sample Size

In this study, the effects of a mixture consisting of vitamin E, vitamin C, pycnogenol and evening primrose oil (mixture LGNC-5) on ultraviolet light (UV) induced pigmentation and wrinkle reductions of normal healthy volunteers were studied. In a double-blind placebo-controlled study, each of 54 subjects took daily either 4 capsules of the mixture LGNC-5 (Group ABC; 282.5 mg/capsule) or placebo (Group Ganada). We irradiated 2.5 MED UV on the upper arms and measured the whitening effect by colorimeter-based L value. The level of wrinkle reduction was determined by image analysis using skin replica around the crow' feet, and the level of serum vitamin E was determined at baseline and 12 weeks. After 12-week oral administration, the treated group showed a significant reduction in skin pigmentation and wrinkles compared with the placebo group (p = 0.011 and p = 0.000005 , respectively). Also, the level of serum vitamin E was significantly increased in the treated group after 12-week oral adminstration of the mixture compared with that in the placebo group (p = 0.0001). In conclusion, 12-week oral administration of LGNC-5 as a dietary supplement could be effective to reduce both UV induced pigmentation and skin wrinkle without side effects.
Administration, Oral ; Arm ; Ascorbic Acid ; Capsules ; Dietary Supplements ; Flavonoids ; Foot ; gamma-Linolenic Acid ; Humans ; Linoleic Acids ; Oenothera biennis ; Pigmentation ; Plant Oils ; Skin ; Skin Pigmentation ; Ultraviolet Rays ; Vitamin E ; Vitamins

BACKGROUND: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the human liver. However, the molecular changes and mechanisms that regulate the development and progression of HCC remain unclear. Beta-catenin is known as a multi-functional protein that acts as a regulator of the cadherin-mediated cell-cell adhesion system and also in the Wingless/Wnt signal transduction pathway. The aim of this study was to investigate the expression of beta-catenin and its possible role in HCC. METHODS: We investigated the expression of beta-catenin, Ki-67, TP53, alpha-smooth muscle actin and CD34 by performing immunohistochemical staining for 61 specimens of HCC and their adjacent non-tumorous tissue. We also examined the relationship between the nuclear expression of beta-catenin and the clinicopathologic parameters. RESULTS: The altered expression of beta-catenin was not detected in the nontumorous liver tissue. The nuclear expression of beta-catenin was observed in approximately 16% (10/61) of the HCC specimens. Double immunohistochemical staining for beta-catenin and E-cadherin showed a close relationship between nuclear translocation of beta-catenin and the loss of the membranous E-cadherin expression. Significant correlation was found between the nuclear translocation of beta-catenin and the tumor size, tumor necrosis and the presence of microvessel invasion and intrahepatic metastasis (p<0.05). CONCLUSIONS: This data indicates that nuclear translocation of beta-catenin could play a role in the growth and progression of HCC.
Humans ; Carcinoma, Hepatocellular ; Neoplasm Metastasis

Lipoma is a common benign neoplasm, but lipoma arising from the pleura is rare. Most pleural lipomas are asymptomatic and are discovered incidentally on chest radiographs. Here we report an unusual case of a pedunculated subpleural lipoma with incomplete torsion in a 29-year-old woman who presented with flank pain. On chest radiography, there was a well-defined, ellipsoidal, homogeneous, radioopaque mass in the left lower lobe. An intrathoracic tumor was suspected, and video-assisted thoracic surgery was performed to establish the final diagnosis. The resected tumor was a 10 X 5 cm sized pedunculated pleural mass. The cut surface showed a yellow, well-circumscribed mass with areas of hemorrhage. Histologically, the tumor was composed of mature adipose tissue with fibrous septae composed of fibroblasts. The outer surface of the tumor was covered by mesothelial cells. Some areas were hypercellular, and occasional mitoses were found, but neither lipoblasts nor atypical mitoses were identified.
Adipose Tissue ; Adult ; Benzeneacetamides ; Female ; Fibroblasts ; Flank Pain ; Hemorrhage ; Humans ; Lipoma ; Mitosis ; Piperidones ; Pleura ; Thoracic Surgery, Video-Assisted ; Thorax