A 45-year-old male with alleged asymptomatic hepatic hemangioma of 4 years duration had right upper-quadrant pain and was referred to a tertiary hospital. Computed tomography and magnetic resonance imaging scans revealed a hypervascular mass of about 7 cm containing intratumoral multilobulated cysts. A preoperative liver biopsy was performed, but this failed to provide a definitive diagnosis. The patient underwent a partial hepatectomy of segments IV and VIII. The histologic findings revealed multifocal proliferation of flattened or cuboidal epithelioid cells and a highly vascular edematous stroma. Immunohistochemistry findings demonstrated that the epithelioid tumor cells were positive for cytokeratin (AE1/AE3), vimentin, calretinin, and cytokeratin 5/6, and were focally positive for CD10, and negative for WT1 and CD34, all of which support their mesothelial origin. Immunohistochemistry for a mesothelial marker should be performed for determining the presence of an adenomatoid tumor when benign epithelioid cells are seen.
Adenomatoid Tumor/*diagnosis/pathology/surgery ; Calcium-Binding Protein, Vitamin D-Dependent/metabolism ; Hemangioma/*diagnosis/pathology/surgery ; Hepatectomy ; Humans ; Keratins/metabolism ; Liver Neoplasms/*diagnosis/pathology/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neprilysin/metabolism ; Tomography, X-Ray Computed ; Vimentin/metabolism

BACKGROUND: Letrozole is an oral non-steroidal inhibitor of the aromatase enzyme, which has proven to be a useful drug against breast cancer. METHODS: This single-dose, randomized 2 x 2 crossover study was conducted in healthy male volunteers. Participants of each sequence group (each 13 volunteers for sequence group) received, in randomized sequence, a single oral 2.5-mg dose of generic letrozole (test) or branded letrozole (reference). Each treatment period was separated by a 5-week washout period. Blood samples were collected for up to 312 hours after drug administration, and drug concentrations were determined using validated LC/MS-MS. Pharmacokinetic properties were obtained using noncompartmental analysis. Drug tolerability was assessed throughout the study, using measurements of vital signs, physical examination, clinical chemistry testing, EKG, and interviews. RESULTS: A total of 26 subjects completed the study. The geometric mean ratios (90% CI) of Cmax and AUClast were 0.92 (0.85 - 0.99) and 1.01 (0.97 - 1.04), respectively. No serious AEs were reported, and there were no clinically significant differences between test and reference groups. CONCLUSION: The findings from this study suggest bioequivalence between two formulations of letrozole in healthy male volunteers. The safety profile of two formulations had similar characteristics.
Aromatase ; Breast ; Clinical Chemistry Tests ; Cross-Over Studies ; Electrocardiography ; Humans ; Male ; Nitriles ; Physical Examination ; Therapeutic Equivalency ; Triazoles ; Vital Signs

We review the effect of methylphenidate, focusing on Osmotic-controlled Release Oral delivery System (OROS) methylphenidate, on cardiovascular system, appetite and growth, sleep, tic, epilepsy, psychiatric and rare adverse events. Although OROS methylphenidate has side effects including increased heart rate or blood pressure, decreased appetite, delayed sleep onset, emergence or aggravation of tics, withdrawal or changes in mood, these effects appeared to be minimal in impact or difficult to distinguish from risk to untreated population and tended to be improved by dose adjustment or drug discontinuation. However, in subjects with underlying cardiac problems, uncontrolled epilepsy, previous psychotic episode, clinicians should pay attention and balance the risk and benefit.
Appetite ; Blood Pressure ; Cardiovascular System ; Epilepsy ; Heart Rate ; Methylphenidate ; Tics

We review the effect of methylphenidate, focusing on Osmotic-controlled Release Oral delivery System (OROS) methylphenidate, on cardiovascular system, appetite and growth, sleep, tic, epilepsy, psychiatric and rare adverse events. Although OROS methylphenidate has side effects including increased heart rate or blood pressure, decreased appetite, delayed sleep onset, emergence or aggravation of tics, withdrawal or changes in mood, these effects appeared to be minimal in impact or difficult to distinguish from risk to untreated population and tended to be improved by dose adjustment or drug discontinuation. However, in subjects with underlying cardiac problems, uncontrolled epilepsy, previous psychotic episode, clinicians should pay attention and balance the risk and benefit.
Appetite ; Blood Pressure ; Cardiovascular System ; Epilepsy ; Heart Rate ; Methylphenidate ; Tics

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). MATERIAL AND METHODS: Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. RESULTS: Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides beta-lactams. CONCLUSION: Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.
Anti-Bacterial Agents ; Arthritis, Infectious ; Bacteremia ; beta-Lactams ; Colon ; Demography ; Ear ; Epidemiology ; Humans ; Insurance, Health ; Korea* ; Medical Records ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Risk Factors ; Skin ; Soft Tissue Infections

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). MATERIAL AND METHODS: Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. RESULTS: Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides beta-lactams. CONCLUSION: Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.
Anti-Bacterial Agents ; Arthritis, Infectious ; Bacteremia ; beta-Lactams ; Colon ; Demography ; Ear ; Epidemiology ; Humans ; Insurance, Health ; Korea* ; Medical Records ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Risk Factors ; Skin ; Soft Tissue Infections

PURPOSE: Disturbance in normal cell cycles by cell cycle control factors is an important process of cancer carcinogenesis. The aims of this dissertation were identify the influence of cyclin B1 and D1 on the growth and expression of gastric cancer and their effects on the prognosis. METHOD: The subjects were 128 patients selected from those who underwent gastric surgery for their gastric cancer between January 1995 and December 1998. Immunohistochemical staining was conducted for cyclin B1 and D1 using paraffin embedded tissues, followed by analysis of their protein expressions, possible prognostic factors and survival rate. RESULTS: Cyclin B1 expression was founded in 48 of the 128 patients (37.5%), and that of cyclin D1 in 96 (75%). Both cyclin B1 and D1 showed no statistical significance with T-stage, location of tumors or histologic types. However, for the case of any significance with lymph node metastasis, the higher the N-stage, the greater was the expression of cyclin B1 (P=0.014). For the case of any significance with life term, the Kaplan-Meier method showed the greater the expression of cyclin B1, the shorter the life term (P=0.042). CONCLUSION: An association was indicated between cyclin B1 and lymph node metastasis in gastric cancer, but has no relation with the T-stage, histologic type or location of tumors. Cyclin D1 shows no association with lymph node metastasis, T-stage, histologic type or location of tumors. However, cyclin B1 showed a significant association with the survival rate.
Carcinogenesis ; Cell Cycle ; Cell Cycle Checkpoints ; Cyclin B1* ; Cyclin D1 ; Cyclins* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Stomach Neoplasms* ; Survival Rate*

BACKGROUNDS: Peripheral blood stem cells (PBSC) are increasingly used because of ease of collection and rapid kinetics of recovery relative to bone marrow transplantation (BMT). Here we summarize laboratory and clinical experiences of 671 PBSC harvests performed at a single institution. METHODS: PBSC harvests were performed mainly with Fenwal CS3000 plus blood cell separator. 126 cancer patients and 12 allogeneic BMT donors (54 children, 84 adults) were enrolled in this study. Total WBC and mononuclear cells (MNC) were analyzed in peripheral blood before procedure, and total WBC, MNC and CD34+ cell count on PBSC product. Correlation between dose of CD34+ cells and hematologic recovery was evaluated by Wilcoxon rank sum test and Pearson correlation analysis. RESLUTS: A mean of 4.8 leukapheresis was performed and 9,155 mL blood was processed. A mean volume of PBSC product was 66 mL and MNC purity of that was 84%. An average of 3.0 +/- 3.3x108 WBC/kg, 2.4 +/- 2.6x108 MNC/kg, and 2.7 +/- 5.4x106 CD34+ cells/kg was collected in each procedure. A goal of 1x108/kg MNCs was reached in 98.4% (127/129) of the patients and more than 1x106/kg CD34+ cells were collected in 91.8% (90/98). Various complications of PBSC harvests were observed but the incidence of serious adverse reaction was low. Median times to an absolute neutrophil count over 500/uL were 11 (7-34) and 11 (8-29) days respectively, in adult and children, and those to a sustained platelet count over 50,000/uL were 18.5 (9-118) and 36 (16-85) days, respectively. CONCLUSION: We analyzed yield, adverse reaction and hematologic recovery of PBSC harvests and this can serve basic data for the PBSC procedure.
Adult ; Blood Cells ; Bone Marrow Transplantation ; Cell Count ; Child ; Humans ; Incidence ; Kinetics ; Leukapheresis ; Neutrophils ; Platelet Count ; Stem Cells* ; Tissue Donors

Chloroma (granulocytic sarcoma) indicates an extramedullary leukemic cell collection. It often develops in the course of, or as a presenting sign of leukemia. Cardiac chloroma is uncommon and rarely detected as a mass. We report the first case of cardiac chloroma in a patient with acute lymphocytic leukemia in Korea. A 73-year-old man was admitted because of exertional dyspnea, orthopnea and generalized weakness. Thrombocytopenia and immature leukocytes were detected in the peripheral blood. An X-ray film of the chest showed mild cardiome-galy and bilateral pleural effusion. Transthoracic and transesophageal echocardiography showed a low echogenic mass at the lateral wall of the right ventricle. The size of the mass was about 6x4 cm. MRI of the chest showed right ventricular mass with slightly increased inhomogeneous signal intensity. Bone marrow aspiration and biopsy confirmed that he had a L3 FAB subtype of acute lymphocytic leukemia. Induction chemotherapy with vincristine, prednisolone, daunorubicin resulted in hematologic complete remission. At 6 weeks after the induction chemotherapy, transesophageal echocardiography demonstrated disappearance of the right ventricular mass which suggested that it was a cardiac chloroma complicating acute lymphocytic leukemia.
Aged ; Biopsy ; Bone Marrow ; Daunorubicin ; Dyspnea ; Echocardiography, Transesophageal ; Heart Ventricles ; Humans ; Induction Chemotherapy ; Korea ; Leukemia ; Leukocytes ; Magnetic Resonance Imaging ; Pleural Effusion ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prednisolone ; Sarcoma, Myeloid* ; Thorax ; Thrombocytopenia ; Vincristine ; X-Ray Film

BACKGROUND AND OBJECTIVES: The octapeptide hormone of the renin-angiotensin system, angiotensin ii, regulates a wide variety of physiological responses including salt and water balance, blood pressure, and vascular tone. Contradictory results have been reported regarding the effects of angiotensin ii on vascular smooth mu-scle cell (VSMC) proliferation. The aim of the present study was to investigate the direct effect of angiotensin ii on the growth of VSMC. MATERIALS AND METHOD: Rat aortic smooth muscle cells were obtained by the combined collagenase and elastase methods. Cells between the 4th and 8th passages were used for the experiments. Cultures were treated daily for 3 days with either angiotensin ii alone or angiotensin ii with equimolar concentrations of saralasin. Incorporated radioactivity of [3H]thymidine and [14C]phenylalanine was measured by liquid scintillation spectrometry. RESULTS: Angiotensin ii increased [14C]phenyalanine incor-poration about 20-30%, and saralasin completely blocked the stimulation by angiotensin ii. However, there was no significant increase in [3H]thymidine incorporation by angiotensin ii stimulation in this study. CONCLUSION: These results suggest that angiotensin ii alone induces cellular hypertrophy but has no detectable mitogenic activity in cultured rat aortic VSMC.
Angiotensin II* ; Angiotensins* ; Animals ; Blood Pressure ; Collagenases ; Hypertrophy ; Muscle, Smooth, Vascular* ; Myocytes, Smooth Muscle ; Pancreatic Elastase ; Radioactivity ; Rats ; Renin-Angiotensin System ; Saralasin ; Spectrum Analysis