OBJECTIVE: To evaluate whether the histopathological differentiation and the expression of vascular endothelial growth factor (VEGF) of hepatocellular carcinoma (HCC) do show correlation with the apparent diffusion coefficient (ADC) value on diffusion-weighted imaging (DWI). MATERIALS AND METHODS: Twenty-seven HCCs from 27 patients who had undergone preoperative liver MRI (1.5T) and surgical resection were retrospectively reviewed. DWI was obtained with a single-shot, echo-planar imaging sequence in the axial plane (b values: 0 and 1,000 sec/mm2). On DWIs, the ADC value of the HCCs was measured by one radiologist, who was kept 'blinded' to the histological findings. Histopathologically, the differentiation was classified into well (n = 9), moderate (n = 9) and poor (n = 9). The expression of VEGF was semiquantitatively graded as grade 0 (n = 8), grade 1 (n = 9) and grade 2 (n = 10). We analyzed whether the histopathological differentiation and the expression of VEGF of the HCC showed correlation with the ADC value on DWI. RESULTS: The mean ADC value of the poorly-differentiated HCCs (0.9 +/- 0.13x10(-3) mm2/s) was lower than those of the well-differentiated HCCs (1.2 +/- 0.22x10(-3) mm2/s) (p = 0.031) and moderately-differentiated HCCs (1.1 +/- 0.01x10(-3) mm2/s) (p = 0.013). There was a significant correlation between the differentiation and the ADC value of the HCCs (r = -0.51, p = 0.012). The mean ADC of the HCCs with a VEGF expression grade of 0, 1 and 2 was 1.1 +/- 0.17, 1.1 +/- 0.21 and 1.1 +/- 0.18x10(-3) mm2/s, respectively. The VEGF expression did not show correlation with the ADC value of the HCCs (r = 0.07, p = 0.74). CONCLUSION: The histopathological differentiation of HCC shows inverse correlation with the ADC value. Therefore, DWI with ADC measurement may be a valuable tool for noninvasively predicting the differentiation of HCC.
Adult ; Aged ; Carcinoma, Hepatocellular/metabolism/*pathology ; Cell Differentiation ; Contrast Media/diagnostic use ; Diffusion Magnetic Resonance Imaging/*methods ; Echo-Planar Imaging/methods ; Female ; Gadolinium DTPA/diagnostic use ; Humans ; Image Enhancement/methods ; Liver/metabolism/pathology ; Liver Neoplasms/metabolism/*pathology ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index ; Vascular Endothelial Growth Factor A/*metabolism

PURPOSE: The incidence of multiple primary malignant tumor has ranged from 0.7% to 11% in the medical literature. Various organs in the digestive system are the sites of multiple primary cancer (MPC). MPC may be synchronous or metachronous depending on the interval between their diagnosis. To the best of our knowledge, there are only rare reports of resected cases of synchronous primary carcinomas that developed in the GB and duodenum. METHODS: We present here a patient who underwent an operation for synchronous primary carcinomas of the GB and duodenum. A 51-year-old female was admitted for postprandial abdominal discomfort. CT scan and MRI of the abdomen showed a 3 x 2 cm sized heterogenously enhancing mass in the GB and a 3.7 x 2.7 cm sized hetrogenously enhancing mass in the 2nd portion of the duodeum. The laboratory findings, including the tumor markers, were non-specific. An elective operation was done under the impression of combined GB cancer and cancer in the 2nd portion of the deuodenum. On the operative findings, there was a 3 x 2.5 cm sized mass in the GB and a 5 x 4 cm sized duodenal mass with near complete luminal obstruction 3 cm distal from the pyloric ring. Radical cholecystectomy with wedge resection of the liver bed and Whipple's operation was performed. RESULTS: On microscopic examination, the GB mass was well differentiated adenocarcinoma and the duodenal mass was moderately differentiated adenocarcinoma, and one lymph node (a lymph node along the common hepatic artery) among the 18 dissected lymph nodes was invaded by tumor cells. The microscopic findings showed that the GB mass and duodenal mass were synchronous primary carcinomas. The patient recovered uneventfully and is alive and doing well without evidence of recurrence at 21-months of follow up evaluation. CONCLUSIONS: We report here on a case of combined curative resection for synchronous primary carcinomas of the gallbladder and duodenum.
Abdomen ; Adenocarcinoma ; Cholecystectomy ; Diagnosis ; Digestive System ; Duodenum* ; Female ; Follow-Up Studies ; Gallbladder* ; Humans ; Incidence ; Liver ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Phenobarbital ; Recurrence ; Tomography, X-Ray Computed ; Biomarkers, Tumor

Patients with acromegaly have high incidence of benign or malignant neoplasia than general population. Around fifteen percent of the deaths reported in acromegaly are attributable to malignancy of cancer. On the whole, mortality in acromegaly has been shown to be correlated with the degree of growth hormone (GH) control. Especially, the levels of insulin like growth factor-1 (IGF-1) may be higher in neoplasm, but there is no clear evidence to prove that tumor development is triggered by IGF-1 in acromegaly. Henceforth, we report a case of acromegaly associated with lung and gastric cancer in a 58-year-old man, suggesting the possible carcinogenic role of IGF-1.
Acromegaly* ; Growth Hormone ; Humans ; Incidence ; Insulin ; Insulin-Like Growth Factor I ; Lung Neoplasms ; Lung* ; Middle Aged ; Mortality ; Stomach Neoplasms*

BACKGROUND: This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules (18microgram once daily) with a ipratropium metered dose inhaler (2 puffs of 20microgram q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). METHOD: After the initial screening assessment and a two-week run-in period, patients received either tiotropium 18microgram once daily or ipratropium 40microgram four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. RESULT: In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted FEV1 of 42 (12)% were analyzed. The trough FEV1 response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. CONCLUSION: This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.
Adult* ; Albuterol ; Bronchodilator Agents ; Capsules ; Forced Expiratory Volume ; Humans ; Inhalation ; Ipratropium* ; Lung ; Mass Screening ; Metered Dose Inhalers ; Outcome Assessment (Health Care) ; Peak Expiratory Flow Rate ; Pulmonary Disease, Chronic Obstructive* ; Surveys and Questionnaires ; Vital Capacity ; Tiotropium Bromide

A-57-year-old male patient suddenly developed cramping pain in the left lower abdomen with a slight abdominal distension. He had undergone a laparoscopic nephrectomy for transitional cell carcinoma 7 days earlier. An abdominal CT scan revealed a dilated small bowel loop and an internal hernia was suspected. Surgery revealed a herniation of the jejunal loop through defects in the retroperitoneum, which was successfully reduced. We report a case of an internal hernia following a laparoscopic nephrectomy. To the best of our knowledge, this is the only reported case of an internal hernia as a complication of laparoscopic nephrectomy.
Abdomen ; Carcinoma, Transitional Cell ; Hernia* ; Humans ; Laparoscopy ; Male ; Muscle Cramp ; Nephrectomy* ; Tomography, X-Ray Computed

BACKGROUND: It has been known that Ginseng extract causes the hypotensive action while it rather produces the hypertensive action. Some studies have suggested that Ginseng extract causes a biphasic response on blood pressure, namely, transient fall followed by prolonged elevation. It has been also shown that administration of Korean Red Ginseng powder has no effect on blood pressure in normotensive and hypertensive rats. The present study was designed to examine the effect of total Ginseng saponin on contractile responses of vasoconstrictors in the rat aorta and to establish the mechanism of its action. METHODS: The ring segment of aorta was mounted in a muscle bath filled with oxygenated Krebs solution for the measurement of isometric tension. After the equilibration period, under the presence of total Ginseng saponin, isometric tension induced by some vasoconstrictors were observed and compared to the control responses. The data were expressed as % of the control tension. RESULTS: Phenylephrine (an adrenergic alpha1-receptor agonist) and high potassium (a membrane depolarizing agent) caused greatly contractile responses in the rat aorta, respectively. However, in the presence of total ginseng saponin (600 g/ml), the contractile responses of phenylephrine (10(-6) and 10(-5) M) and high potassium (3.5 x 10(-2) and 5.6 x 10(-2) M) were markedly potentiated whereas prostglandin F2alpha(5 x 10(-6) M)-induced contractile responses was not affected. The contractile responses induced by phenylephrine (10(-5) M) and high potassium (3.5 x 10(-2) M) even under the presence of total ginseng saponin (600 g/ml) were greatly inhibited by the pretreatment of nicardipine (10(-6) M), a calcium channel blocker. CONCLUSION: Taken together, these experimental results suggest that total ginseng saponin can enhance the contractile responses evoked by stimulation of adrenergic alpha1-receptor and the membrane depolarization in the isolated rat aortic strips, which seems to be associated to calcium influx.
Animals ; Aorta* ; Baths ; Blood Pressure ; Calcium ; Calcium Channels ; Membranes ; Nicardipine ; Oxygen ; Panax* ; Phenylephrine ; Potassium ; Rats* ; Saponins* ; Vasoconstriction ; Vasoconstrictor Agents*

No abstract available.
Humans ; Neoplasm Metastasis*

No abstract available.
Child* ; Fracture Fixation, Intramedullary* ; Humans

Acrodynia is caused by chronic mercury poisoning and/or mercury, hypersensitivity occuring in infants and children only. Ingestion or inhalation of mercury contained in some house paints, calomel ingestion, the use of mercury ointments and other mercurial preparations can be the causes of acrodynia. We herein report a 3-year-old boy with typical acrodynia after expoaure to house paints and lacquer for 2 months. His hands and feet were erythematous and edematous vesiculo-bullous lesion with acral dark bluish discoloration. Mercury levels of blood and urine were significantly incresed by 61. 2ug/dl and 264ug/L (normal; below 30ug/dl and 100ug/L).
Acrodynia* ; Child ; Child, Preschool ; Eating ; Foot ; Hand ; Humans ; Hypersensitivity ; Infant ; Inhalation ; Lacquer ; Male ; Mercury Poisoning ; Ointments ; Paint

Eccrine poroma, first described in 1956 by Pinkus, is a fairy common benign skin appendage tumor arising from the poral epitheliurr of the eccrine sweat gland in most regions of the body surface, hairy or nonhairy. generally in persons past the age of 40. The tumor is almost always single, but cases of eccrine poromatosis have been described and is a firm, sometimes lobulated nodule which may be sessile or slight pedunculated. There is often a vascular appearance, and the clinical appearance may suggest pyogenic granuloma. Microscopically, the tumor mass extends from the epidermis downward into the dermis as broad, anastomosing bands. Tumor cells are small, uniform, cuboidal appearance containing round, deeply basophilic nucleus and are connected by intercellular bridges. PAS stain-positive glycogen which diisappears with diastase are irregularly scattered in the tumor cells. A caee of unusual variant of eccrine poroma is reported. 25-year-old male patient has a finger tip sized crusting pedunculated lesion for approximated 12 months on the right postauricular area. The diagnosis was confirmed by clinical and histopathological findings as eccrine poroma and surgical excision was done.
Adult ; Amylases ; Basophils ; Dermis ; Diagnosis ; Epidermis ; Fingers ; Glycogen ; Granuloma, Pyogenic ; Humans ; Male ; Poroma* ; Skin ; Sweat Glands