Peritoneal origin serous papillary carcinoma is an uncommon primary malignancy occurring in the abdominal or pelvic peritoneum lining. It is characterized by peritoneal carcinomatosis with massive ascites, uninvolved or minimally involved ovary, and is histologically indistinguishable from ovarian serous tumors. Better recognition of this phenomenon in recent years has contributed to an increasing diagnostic frequency. We describe a rare case of peritoneal origin serous papillary carcinoma with unusual clinical presentations involving a solitary primary tumor originating from the peritoneal lining of the sigmoid colonal mesentery, without pelvic lymph node involvement or distant metastasis. Because of the location and morphological similarity, it was misdiagnosed as an ovarian malignancy. We aim to assist in the diagnosis of this disease with the following case report, thereby improving the management of patients with this condition.
Ascites ; Carcinoma ; Carcinoma, Papillary* ; Colon, Sigmoid ; Diagnosis ; Female ; Humans ; Lymph Nodes ; Mesentery ; Neoplasm Metastasis ; Ovarian Neoplasms* ; Ovary ; Peritoneum

The Fas (TNF receptor superfamily, member 6) (FAS)/FAS ligand (FASLG) interaction plays a central role in the regulation of programmed cell death. FAS and FASLG polymorphisms in promoter regions affect transcriptional activities. To investigate whether FAS and FASLG polymorphisms are associated with the development and clinical phenotypes of stroke, 2 promoter single nucleotide polymorphisms (SNPs) in FAS (rs1800682, -670C/T) and FASLG (rs763110, -844C/T) were selected and genotyped by direct sequencing in 220 stroke patients [107 ischemic stroke (IS), 77 intracerebral hemorrhage (ICH), and 36 subarachnoid hemorrhage (SAH)] and 369 control subjects. For the analysis of clinical symptoms, all stroke patients were divided into 3 clinical phenotypes according to the respective results of the National Institutes of Health Stroke Survey (NIHSS) and the Modified Barthel Index (MBI) and the presence or absence of complex regional pain syndrome (CRPS). The SNPStats, SNPAnalyzer, and Helixtree programs were used to analyze the genetic data. Multiple logistic regression models (codominant, dominant, and recessive) were used to estimate odds ratios (ORs), 95% confidence intervals (CIs), and p-values. The promoter SNP rs1800682 was associated with stroke in the codominant (OR=0.48, 95% CI=0.25-0.94, p=0.04) and dominant models (OR=0.51, 95% CI=0.30-0.87, p=0.011). However, a FASLG SNP (rs763110) was not in Hardy-Weinberg equilibrium (p<0.05). In the analysis of stroke types, rs1800682 was associated with IS in the codominant (OR=0.30, 95% CI=0.12-0.74, p=0.025), dominant (OR=0.44, 95% CI=0.23-0.88, p=0.018), and recessive models (OR=0.45, 95% CI=0.21-0.99, p=0.042). The genotype frequencies of rs1800682 were different between ICH and controls in the dominant model (OR=0.49, 95% CI=0.26-0.94, p=0.031) but not between SAH and controls. In the analysis of clinical symptoms, however, rs1800682 was not related to the 3 clinical phenotypes (NIHSS, MBI, and CRPS). These results suggest that a promoter SNP (rs1800682, -670C/T) in FAS may be associated with the development of stroke in the Korean population.
Cell Death ; Cerebral Hemorrhage ; Genotype ; Humans ; Logistic Models ; National Institutes of Health (U.S.) ; Odds Ratio ; Phenotype ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Stroke ; Subarachnoid Hemorrhage

OBJECTIVE: Human papillomavirus (HPV) has been identified more than 100 HPV subtypes. The distributions of subtypes are different according to nations and regions. We analysed subtype of infection with HPV among women who live in Pusan and surburbs of Pusan. We accessed the clinical usefulness of HPV DNA chip test as a supplementary method of Pap smear in the evaluation of cervical lesion. METHOD: This study was undertaken from January 2002 to January 2005 and the samples were collected from the patients who had abnormal Pap smear. We analysed subtypes of 143 positive cases with HPV DNA chip (Biomedlab) test and estimated pathologic reports of 115 patients except 28 patients who had not biopsy. We investigated pathologic results of 54 of 115 patients who had atypical squamous cells / low grade squamous intraepithelial lesion (ASC/LSIL) in Pap smear and examined high risk HPV in 54 pathologic results. RESULTS: The prevalence of HPV subtypes was 42 cases of HPV-16, 20 cases of HPV- 58, 16 cases of HPV-52, 10 cases of HPV-35, 9 cases of HPV-56, 7 cases of HPV-51, 6 cases of HPV-18 in descending order of incidence in high risk HPV group and 3 cases of HPV-6, 3 cases of HPV-42, 2 cases of HPV-34, 2 cases of HPV-43 in descending order of incidence in low risk HPV group. The results of HPV DNA chip test and 115 pathologic reports were estimated by comparative study. A pure infection with low risk HPV group was detected in low grade lesion. Infection with high risk HPV group was also detected in low grade lesion but was mainly detected in high grade lesion. The pathologic results of 54 patients who had ASC / LSIL in Pap smear were 13 patients had above high grade lesion include 2 cases of invasive carcinoma so false negative rate of Pap smear in the detection of high grade lesion was 24%. CONCLUSION: HPV subtypes were detected HPV 16, 58, 52, 35, 56, 51, 18 types in descending order of incidence and prevalence. Mass study and integrated data from larger population and various regions in many hospitals will be needed. And the supplementary use of HPV DNA chip test may provide clinical usefulness because it can reduce the false negative rate of Pap smear and improve the positive predictive value in the detection of high grade cervical lesion and it enables to decrease the incidence of cervical cancer.
Biopsy ; Busan ; Cervix Uteri* ; DNA* ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Human papillomavirus 6 ; Humans ; Incidence ; Oligonucleotide Array Sequence Analysis* ; Prevalence ; Uterine Cervical Neoplasms

Endometrial stromal sarcoma (ESS) is a relatively rare form of uterine sarcoma. Endometrial stromal sarcoma (ESS) of the myometrium compose just 0.2% of uterine malignant tumors. Low-grade stromal sarcoma has extended beyond the uterus in 40% of cases at the time of diagnosis, but the extra-uterine spread is confined to the pelvis in two thirds of the cases. A few cases of extra-uterine endometrial stromal sarcoma have been reported in literature concerning the ovary and pelvis. We have experienced a Post-total hysterectomy with bilateral salpingooophorectomy retroperitoneal endometrial stromal sarcoma, so we report this case with a brief review of literature.
Animals ; Diagnosis ; Female ; Hysterectomy* ; Mice ; Myometrium ; Ovary ; Pelvis ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Uterus

I experienced a case of a congenital intramural cyst of the uterine fundus. It was composed of a single layer of non-ciliated low cuboidal epithelium without associated with endometrial stroma and was found to be derived from the mesonephric duct. This case is presented with a brief review of the literature.
Epithelium ; Uterus* ; Wolffian Ducts

OBJECTIVE: This study was to determine if placental histologic acute inflammation is related to maternal and fetal serum cytokine levels in preterm labor. METHODS: In 2003-2004, 32 consecutive patients at 20-36 weeks with progressive labor and tocolytic failure were recruited. Maternal serum sampled during the labor, and fetal serum of umbilical vein were assayed by ELISA for levels of soluble interleukin-1beta and interleukin-6. Acute placental inflammation was scored by two groups blinded to clinical data, and the average scores analyzed for relationships to serum cytokine levels. RESULTS: Fetal level of interleukin-1beta was higher with grade 3-4 acute amnionitis than with grade 0-2 (p=0.022 and p=0.023). Fetal levels of both cytokine were higher in grade 3-4 umbilical vasculitis (interleukin-1beta p=0.008 and interleukin-6 p=0.03). In contrast, maternal serum interleukin levels were not associated with presence or severity of histologic evidence of acute placental inflammation. CONCLUSION: We conclude that fetal serum, but not maternal serum interleukin levels, was correlated with histologic evidence of acute placental inflammation. This result may be used to detect acute placental inflammation as an indirect indicator.
Amnion ; Chorioamnionitis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Inflammation* ; Interleukin-1beta* ; Interleukin-6* ; Interleukins ; Obstetric Labor, Premature ; Pregnancy ; Umbilical Veins ; Vasculitis

OBJECT: The purpose of this study was to determine the prevalence of fungal infection and ulcer on the feet of diabetic patients and the existence of correlation between ulcer and fungal infection. METHODS: A total of 21, 693 outpatients diagnosed as diabetes mellitus at the department of endocrinology of 32 hospitals were examined. The diabetic patients with foot problems were consulted to the department of dermatology. Physical examination and KOH preparation were performed. RESULTS: 13, 271 patients had certain kinds of foot problem, accounting for 61.2% of 21, 693 diabetics examined. Of these, fungal foot disease were found in 10, 403 that constituted 78.4% (48.0% of the entire diabetic population). Tinea pedis was the diagnosis in 6, 496 (29.9%), onychomycosis in 7, 783 (35.9%), and coexistence was in 3, 883 (17.9%). Foot deformity was in 1, 346 (6.2% of diabetics; 10.1% of foot disease), non-palpable pulse in 1, 051 (4.8% ; 7.9%), and foot ulcer was in 425 (2.0% ; 3.2%), following in a descending order of frequency. Odds ratios for diabetic foot ulcer were 2.5 in patients with the foot deformity, 1.6 with fungal foot disease and 2.2 with non-palpable pulse. Conversely, Odds ratios for fungal foot disease were 2.5 with foot deformity, and 1.6 with foot ulcer. A total of 5, 486 patients paid a visit to the department of dermatology. Of these, 4, 519 patients were diagnosed with fungal infection through physical examination and KOH smear by dermatologists. The population comprised of 2, 272 males and 2, 247 females, showing similar prevalence between sexes. However, age did have positive correlation regarding prevalence of fungal foot disease. The number of diabetic patients with toenail problems was 3, 847 patients (70%) and onychomycosis was proven mycologically in 3, 276. Onychomycosis of distal subungal type was the most common clinical finding, most frequently involving the great toenails. Abnormal skin findings of the foot were seen in 3, 885(70.8%) and tinea pedis was found in 3, 209 (58.5%), most commonly involving the soles. CONCLUSION: This study showed that fungal infection might be regarded as a risk factor of foot ulcer. Treatment of fungal infection in diabetic patients might prevent diabetic foot disease such as ulcer and reduce the disability, morbidity and mortality in diabetic patients.
Dermatology ; Diabetes Mellitus ; Diabetic Foot ; Diagnosis ; Endocrinology ; Female ; Foot Deformities ; Foot Diseases ; Foot Ulcer ; Foot* ; Humans ; Male ; Mortality ; Nails ; Odds Ratio ; Onychomycosis ; Outpatients ; Physical Examination ; Prevalence* ; Risk Factors ; Skin ; Tinea Pedis ; Ulcer*

Extrapelvic endometriosis is a fairly rare phenomenon. The majority of extrapelvic endometriosis involves scar tissue following obstetric/gynecologic procedures. Cesarean section scar endometriosis may be more common than reflected in the literature and has a distinct presentation and treatment. One patient with history of cesarean section presented with a painful, enlarging mass involving the cesarean section scar. The pain was cyclic and strongest just prior to menstruation. This patient was treated with surgical excision and specimens had endometriosis confirmed by histopathology. This case was reported with a brief review of the concerned literatures.
Cesarean Section* ; Cicatrix* ; Endometriosis* ; Female ; Humans ; Menstruation ; Pregnancy ; Subcutaneous Tissue*

Extrapelvic endometriosis is a fairly rare phenomenon. The majority of extrapelvic endometriosis involves scar tissue following obstetric/gynecologic procedures. Cesarean section scar endometriosis may be more common than reflected in the literature and has a distinct presentation and treatment. One patient with history of cesarean section presented with a painful, enlarging mass involving the cesarean section scar. The pain was cyclic and strongest just prior to menstruation. This patient was treated with surgical excision and specimens had endometriosis confirmed by histopathology. This case was reported with a brief review of the concerned literatures.
Cesarean Section* ; Cicatrix* ; Endometriosis* ; Female ; Humans ; Menstruation ; Pregnancy ; Subcutaneous Tissue*

The prevalence of Behcet's disease is the highest in the East Asian and the Medi-terranean countries. Behcet's disease is also distributed in the Asian countries, but the nationwide survey has not been performed in Korea yet. The Korean Study Group for Behcet's Disease, founded in 1999, conducted a multicenter, retrospective survey on epidemiologic and clinical features of the patients with Behcet's disease from 20 hospitals around the nation from 1997 to 1999. Of 3,497 patients, 1,527 were classified into complete or incomplete type of Behcet's disease according to the revised Shimizu's classification. The sex ratio was 1:1.75 with the female predominance. Geographical distribution showed the highest frequency in Seoul (38.5%). Clinically, 98.8% had oral ulcers, 83.2% had genital ulcers, 84.3% had skin lesions and 50.9% had ocular lesions. As for the minor clinical manifestations, articular symptoms were the most frequent. The pathergy test showed positive in 15.4% of patients and revealed a higher positive rate in males (20.2%) than in females (12.7%). In conclusion, we performed the first multicenter study on Behcet's disease in Korea and revealed the female predominance, higher frequency of ocular lesions, and lower positivity of pathergy test in the patients.
Adolescence ; Adult ; Aged ; Behcet's Syndrome/complications/*epidemiology ; Child ; Child, Preschool ; Female ; Human ; Infant ; Korea/epidemiology ; Male ; Middle Age ; Prevalence ; Retrospective Studies ; Sex Distribution