Solid pseudopapillary tumor with hepatic metastasis / 대한외과학회지

Solid pseudopapillary tumor of the pancreas is a rare tumor that affects young females with low malignant potential and good prognosis with more than 90% survival at 5 years. Metastasis is very rare. We report the case of a 74-year-old female who had pancreatic solid-pseudopapillary tumor and synchronous hepatic metastasis.

Carotid-axillary Bypass for Subclavian Atery Occlusion with Gaining Access through the Axillary Fossa: Report of One Case

Some representative operative techniques have been introduced for treating subclavian artery stenosis or occlusion: carotid-subclavian bypass, carotid-subclavian interposition and axillo-axillary bypass. But the cases of carotid-axillary bypass are rare and moreover, carotid-axillary bypass with gaining access through the axillary fossa are rare in the medical literature. A 77-year-old man who had left upper arm claudication that was aggravated when he performed some hand movements like buttoning-up or undoing buttons visited our hospital. The upper extremity computed tomography angiography showed a 4-centemeter-long occlusion of the left subclavian artery, which began at the point passed by the bulb of the vertebral artery. We performed carotid-axillary bypass between the left axillary artery at the axillary fossa and the left common carotid artery at the left neck at the anterior aspect of the sternocleidomastoid muscle. This operation could be a feasible alternative modality for a patient with occlusion of a long distal segment of the subclavian artery.

Acute Appendicitis Caused by Colonoscopy

A 48-year-old woman who was without any abnormal past medical history underwent colonoscopy as a screening procedure for colorectal disease. The procedure was uneventful and there was no sign of inflammation around the appendicular orifice or the luminal surface of the cecum. The patient did not complain of pain or significant discomfort throughout the procedure. She then developed pain in the right lower quadrant of the abdomen that evening and this persisted for four days. She visited the outpatient department and underwent abdominal ultrasonography, which showed a swollen appendix with a collection of pericecal fluid. Surgical exploration and appendectomy were performed; the final diagnosis was acute suppurative appendicitis. Colonoscopists should be aware of this rare complication and consider it when making the differential diagnosis of post-colonoscopy abdominal pain.

The Expression of NIS and Pendrin in Thyroid Cancer Tissues with Real Time RT-PCR / 대한내분비외과학회지

PURPOSE: It has not been clearly investigated how iodine can be trapped from the extracellular space into thyroid follicular cells, the defective iodide-trapping mechanism appears to be an early and constant feature during oncogenic transformation of thyroid cells. In recent studies, NIS and pendrin are associated with the trapping process. Thus, in order to reveal this uncertain relationship, each of the quantitative expressions of NIS and pendrin in various thyroid tissues were evaluated by real time RT-PCR. METHODS: This study included 63 patients who had undergone thyroidectomy in Uijongbu St. Mary's hospital from Jan. 2000 to Jan. 2003. 13 cases of normal thyroid, 17 cases of hypofunctioning thyroid adenomas, and 33 cases of thyroid cancer were examined. The thyroid cancer group was further divided into high and low risk group according to the AMES score, and the NIS and pendrin levels were compared between the two groups. Real time RT-PCR was conducted with the extracted RNAs, using GAPDH as the control. RESULTS: As for pendrin, its expression was decreased by 7% in the thyroid adenoma group compared with that of normal thyroid, while there was a 59% decrease in thyroid cancer cases. NIS expression was decreased by 20% in the thyroid adenoma group, and a 40% decrease was found in thyroid cancer group. Due to the impediment of pendrin in both high and low risk group of thyroid cancer, there was a 19% decrease in the high risk group compared with the low risk group. As for the impediment of NIS in the high risk group, an increase of 30% was found. However, no statistical significance was shown (P=0.344 vs P=0.688). CONCLUSION: According to this study, it can be inferred that the decrease in the expressions of NIS and pendrin are related to tumorigenesis of thyroid cancer. Also, further research is needed to reveal the cause of genetic transformation, as well as the value of utilization of NIS and pendrin as tumor markers.