Metastasis of Hepatocellular Carcinoma to Pituitary Adenoma: A Case Report

Metastasis to the pituitary gland is unusual, and metastasis to pituitary adenoma is extremely rare. We report here on a case of hepatocellular carcinoma metastasizing to a pituitary adenoma with MRI findings.

The Use of the Bethesda System for Reporting Thyroid Cytopathology in Korea: A Nationwide Multicenter Survey by the Korean Society of Endocrine Pathologists

BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has standardized the reporting of thyroid cytology specimens. The objective of the current study was to evaluate the nationwide usage of TBSRTC and assess the malignancy rates in each category of TBSRTC in Korea. METHODS: Questionnaire surveys were used for data collection on the fine needle aspiration (FNA) of thyroid nodules at 74 institutes in 2012. The incidences and follow-up malignancy rates of each category diagnosed from January to December, 2011, in each institute were also collected and analyzed. RESULTS: Sixty out of 74 institutes answering the surveys reported the results of thyroid FNA in accordance with TBSRTC. The average malignancy rates for resected cases in 15 institutes were as follows: nondiagnostic, 45.6%; benign, 16.5%; atypical of undetermined significance, 68.8%; suspicious for follicular neoplasm (SFN), 30.2%; suspicious for malignancy, 97.5%; malignancy, 99.7%. CONCLUSIONS: More than 80% of Korean institutes were using TBSRTC as of 2012. All malignancy rates other than the SFN and malignancy categories were higher than those reported by other countries. Therefore, the guidelines for treating patients with thyroid nodules in Korea should be revisited based on the malignancy rates reported in this study.

Nodular Fasciitis of the Chest in a Young Woman

Nodular fasciitis is a benign reactive proliferation that usually involves the deep fascia. Although it is relatively common in the adult population, it is often misdiagnosed as sarcoma due to its rapid growth and pathological features. It rarely presents as a chest wall tumor in young patients. Here, we report a case of nodular fasciitis involving the chest wall of an 18-year-old woman and its surgical management. This case underscores the need to consider nodular fasciitis in the differential diagnosis of chest wall tumors in young patients.

Colonic Mucormycosis Mimicking Ischemic Colitis in Kidney Transplant Recipient / 대한이식학회지

Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Mucormycosis of the gastrointestinal tract manifests with features similar to ischemic colitis. A 48-year-old man with end-stage renal disease due to diabetic nephropathy underwent deceased donor kidney transplantation. He complained of abdominal pain and distension on postoperative day 17. A computed tomography (CT) scan revealed symmetrical wall thickening of the ascending colon, which was consistent with ischemic colitis. However, a follow-up CT scan showed a localized wall-off colon perforation in the hepatic flexure and segmental mural gas in the ascending colon. Microscopic examination obtained from a surgical specimen demonstrated numerous fungal hyphae and spores in the mucosa and submucosa. A total colectomy was performed, but the patient died 36 days later due to multiple organ failure, despite antifungal agents. Clinicians should be informed about fungal infection, such as colonic mucormycosis mimicking ischemic colitis, in kidney transplant patients with diabetes mellitus, and treatment should be initiated at the earliest.

Concept Analysis of Volition for Health Behavior Practice in Patients with Chronic Disease

PURPOSE: The purpose of this study was to define and clarify the concept of volition for health behavior. METHODS: For this study the process of Walker & Avant’s concept analysis was used. Seventeen studies from electronic data basses met criteria for selection. RESULTS: Volition can be defined by the following attributes: 1) planning, 2) maintenance of self-efficacy, and 3) self regulation. The antecedents of volition consisted of: 1) risk awareness, 2) outcome expectation, 3) perceived self-efficacy, and 4) social support. The consequences occurring as a result of volition were: 1) prevention of disability and complications, 2) improvement of functional ability, and 3) enhencement of quailty of life. CONCLUSION: Definition and attributes of volition identified by this results can be applied to develop measurements and intervention programs for chronic patients health behavior.

The Impact of Psychosocial Health and Self-nurturance on Graduate Nurse Experience / 간호행정학회지

PURPOSE: The purpose of this study was to identify the effect of Psychosocial health and Self-nurturance on the experience of new graduate nurses. METHODS: A cross-sectional survey design was used. The participants in this study were 149 nurses who had less than 12 months of nursing experience and were working at one of 4 general hospitals. The data were collected by a self-administered questionnaire from Nov. 2012 to Oct. 2014. RESULTS: The total mean score for Psychosocial health was 3.07+/-0.60, Self-nurturance, 3.38+/-0.44, and graduate nurse experience, 2.59+/-0.27. The effect of Psychosocial health and Self-nurturance predicted 23% of variance in graduate nurse experience. CONCLUSION: These results indicate that Psychosocial health and Self-nurturance have a positive relationship to graduate nurse experience. Therefore, further studies including approaches that support Psychosocial health and Self-nurturance are recommended to help in the adaptation of newly graduated nurses to clinical settings.

Digital Papillary Carcinoma

No abstract available.

Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis

BACKGROUND: The incidence of early colorectal epithelial neoplasm (ECEN) is increasing, and its pathologic diagnosis is important for patient care. We investigated the incidence of ECEN and the current status of its pathologic diagnosis. METHODS: We collected datasheets from 25 institutes in Korea for the incidence of colorectal adenoma with high grade dysplasia (HGD) and low grade dysplasia in years 2005, 2007, and 2009; and early colorectal carcinoma in the year 2009. We also surveyed the diagnostic terminology of ECEN currently used by the participating pathologists. RESULTS: The average percentage of diagnoses of adenoma HGD was 7.0%, 5.0%, and 3.4% in years 2005, 2007, and 2009, respectively. The range of incidence rates of adenoma HGD across the participating institutes has gradually narrowed over the years 2005 to 2009. The incidence rate of early colorectal carcinoma in the year 2009 was 21.2%. The participants did not share a single criterion or terminology for the diagnosis of adenoma HGD. The majority accepted the diagnostic terms that distinguished noninvasive, mucosal confined, and submucosal invasive carcinoma. CONCLUSIONS: Further research requirements suggested are a diagnostic consensus for the histopathologic diagnosis of ECEN; and standardization of diagnostic terminology critical for determining the disease code.

A Case of Localized Tenosynovial Giant Cell Tumor in the Infrapatellar Fat Pad of the Knee

Localized giant cell tumor of the tendon sheath (GCTTS) usually occurs in extensor an tendon sheath of the fingers and toes. It has rarely been observed in the fat pad of the knee joint. We treated a case of a 2.5x3x4 cm mass arising from the infrapatellar fat pad, which presented with extension limitation and knee pain due to lateral femorotibial joint impingement. The tumor was successfully treated using arthroscopic excision with a motorized shaver. Histologic findings were diagnosed as localized GCTTS. Herein we report this case with a literature review.

A Case of Lambda-expressing Pulmonary MALT Lymphoma with Dual Clonal Rearrangements of Kappa and Lambda Immunoglobulin Light Chain Gene / 대한진단검사의학회지

A 70-yr-old woman was hospitalized with a history of dry cough. Bronchial endoscopy and transbronchial lung biopsy were performed. However, the findings of histopathology and immunohistochemistry were not sufficient to decide whether the lesion was benign or malignant, because of the presence of crush artifacts in the biopsy specimens. We performed B-cell clonality studies using BIOMED-2 multiplex PCR (InVivoScribe Technologies, USA) to detect clonal rearrangements in the immunoglobulin gene. The results of multiplex PCR showed clonal rearrangements of both kappa and lambda immunoglobulin light chain genes. The findings of immunochemistry revealed that the lesion expressed lambda light chain, but not kappa light chain. Based on the clinical, pathologic, and molecular findings, this case was diagnosed as pulmonary MALT lymphoma. We report the first case in Korea of lambda-expressing MALT lymphoma that is shown to have dual clonal rearrangements of kappa and lambda immunoglobulin light chain gene by multiplex PCR.

Significance of the Expression of Cathepsins B, H, & L in Colonic Epithelial Neoplasms

BACKGROUND: Cathepsin is associated with tumorigenesis, tumor invasion and metastasis through its ability to induce degradation of extracellular matrix components. METHODS: To investigate the correlation between cathepsin expression and tumor progression, invasion depth or nodal metastasis, immunohistochemical staining for cathepsins B, H and L were done on 20 hyperplastic polyps, 48 adenomas, and 67 adenocarcinomas of the colon. Evaluation of the expression of cathepsins B, H and L was based on the percentage of neoplastic cells that stained positive for any given cathepsin. RESULTS: Cathepsin B expression was significantly higher in adenocarcinomas than adenomas (29.33 vs 5.48%), but was not associated with the degree of differentiation, depth of invasion and nodal status of the tumors. Expression of cathepsins H and L was absent or low in both adenomas and adenocarcinomas. CONCLUSIONS: We suggest that cathepsin B is involved in progression of a subset of colonic adenomas, while cathepsins H and L are not.

The Differential Expressions of the Epithelial-Mesenchymal Transition Regulator, Slug and the Cell Adhesion Molecule, E-cadherin in Colorectal Adenocarcinoma

BACKGROUND: Slug is a member of the Snail family of transcription factors, and it plays a crucial role in the regulation of the epithelial-mesenchymal transition by suppression of several epithelial proteins and adhesion molecules, including E-cadherin. METHODS: The aim of the present study was to examine the significance between the expression of Slug in colorectal adenocarcinoma (CRA) specimens and the clinicopathological parameters of CRA, as determined by immunohistochemical analysis, and to determine the correlation between the Slug and E-cadherin expressions in non-neoplastic colorectal mucosa (n=45), primary CRA (n= 109) and metastatic CRA (n=17). A semiquantitative scoring system was applied based on the intensity and extent of the positive immunohistochemical staining. RESULTS: The expressions of Slug and E-cadherin were associated with the depth of tumor invasion (pT) (p=0.019, p=0.001, respectively), and these expressions showed a significant inverse correlation (p<0.001) each other. CONCLUSIONS: Our results demonstrated a positive role for Slug in the development of CRA, and Slug is a mediator of tumor invasion in CRA. In addition, an up-regulated Slug expression is significantly correlated with the loss of an E-cadherin expression, which suggests that Slug may play some role in the epithelial-mesenchymal transition (EMT) by down-regulating the E-cadherin expression.

Papillary carcinoma arising in a struma ovarii of the complex teratoma / 대한산부인과학회지

Benign or malignant tumors that arise in a benign cystic teratoma are rare. Malignant transformation in mature cystic teratoma of ovary is reported to occur in 1~3%. Several types of malignancy can occur from any of three germ-cell layers, but the most common malignancy is a squamous cell carcinoma derived from ectoderm. We experienced a papillary carcinoma arising in a struma ovarii of the complex teratoma. 74-year-old female presented with an abdominal discomfort. A pelvic ultrasonograph and computed tomography detected a 7 x 6 cm-sized and well-circumscribed cystic mass at the anterior to the uterus. The inner part of the mass was filled with cystic fluid showing low-density, however, solid portion including fat and soft tissue accompanied by calcification was identified in more than half of the entire tumor volume. The patient underwent a bilateral salpingo-oophorectomy. On histopathologic examination, the lesion was consistent with papillary carcinoma with squamoid features arising in a struma ovarii of the mature cystic teratoma. We herein report a case of the very rare papillary carcinoma arising in a struma ovarii of the complex teratoma and review the available literature.

Adenocarcinoma with Yolk Sac Tumor of the Stomach: Case Report with Review of the Literature and an Immunohistochemical Study

Gastric yolk sac tumors are extremely rare with only a few cases reported in the literature. Here, we present the case of a 50-year-old man with an adenocarcinoma and a yolk sac tumor of the stomach, without metastasis to the lymph nodes. The tumor was an early gastric carcinoma confined to the submucosa. Twelve months post-operation the patient was alive with no complications. The yolk sac tumor showed positive labeling for alpha-fetoprotein (AFP), alpha1-antitrypsin (alpha1-AT), cytokeratin (CK) and carcinoembryonic antigen (CEA), but was negative for human chorionic gonadotrophin (hCG), placental alkaline phosphatase (PLAP), epithelial membrane antigen (EMA) and p53. The adenocarcinoma was positive for alpha1-AT, CK, EMA, and CEA, but was negative for AFP, hCG, PLAP, and p53. These findings suggest that the yolk sac tumor and the adenocarcinoma components are closely related and may represent distinct phenotypes that arise from a common mucosal epithelial cell.

Frequency of Mutation of Codon 249, Overexpression of p53, and Hepatitis B Virus DNA Positivity in Hepatocellular Carcinoma / 대한임상미생물학회지

BACKGROUND: In hepatocellular carcinoma (HCC), the frequency of p53 mutation and the association with hepatitis B virus (HBV) infection varies with geographic locations and risk factors. The aim of this study was to determine the frequency of codon 249 mutation of p53, p53 overexpression, and HBV DNA positivity and to observe the relationship between them in Korean HCC. METHODS: We analyzed overexpression of p53 in hepatoma tissue from 17 HCC patients by immunohistochemistry (IHC), specific mutations at the third base position of codon 249 by PCR-restriction fragment length polymorphism (PCR-RFLP) method, and presence of HBV by nested PCR. RESULTS: Although a point mutation at codon 250 was seen in one (5.8%) of 17 patients, no codon 249 mutations were found in the patient cohort. The p53 protein was overexpressed in 4 (23.5%) of 17 HCCs. PCR for HBV DNA from HCCs showed a positivity rate of 82.4% (14 of 17 specimens). CONCLUSION: In HCC of this study, HBV infection was not associated with either 249 mutation or overexpression of p53, and overexpression of p53 protein seemed to be related to other than this mutation.

Clinicopathological Significance of Maspin Expression in Breast Cancer

Maspin is a unique serine proteinase inhibitor that has tumor suppressor activity. It has been reported that maspin is expressed in normal human mammary epithelial cells and it is down-regulated during the progression of cancer. However, to date, there is very limited data on the clinical significance of maspin expression in human breast cancer. In this study, maspin expression was assessed immunohistochemically from 80 invasive ductal carcinoma (IDC) specimens of the breast. Also, maspin expression was compared with the clinicopathological factors (age, grade, tumor size and lymph node status), the expression of estrogen receptor (ER), progesterone receptor (PR) and p53, DNA ploidy and the overall survival in an attempt to assess its prognostic value. The maspin expression was positive in 25 IDC cases (31.3%). The maspin expression in IDC was significantly correlated with a higher histologic grade, a larger tumor size, a positive p53 status and shorter survival. There was an inverse association with maspin expression and the PR status. These findings suggest that maspin expression is not down-regulated with the progression of cancer and maspin expression may be associated with a poor prognosis. The immunohistochemical detection of maspin in breast cancers may be helpful for predicting an aggressive phenotype.

Effect on Cell Growth, c-myc mRNA Expression and Telomerase Activity by Transforming Growth Factor-beta1 in Malignant Lymphoma and Leukemia Cell Line / 대한혈액학회지

BACKGROUND: Transforming growth factor-beta1 (TGF-beta1) is known to be a potent growth inhibitor of many cell types, including most epithelial cells. However, the mechanism of TGF-beta1 action on cell growth in lymphomas and leukemia still remains to be elucidated. c-myc is a central regulator of cell proliferation and apoptosis, and telomerase is believed to play an important role in carcinogenesis. The aim of the study was to determine the effects of cell growth, c-myc gene expression and telomerase activity due to TGF-beta1 and examine its mechanism of action in lymphomas and leukemia. METHODS: The cell growths of Jiyoye (Burkitt lymphoma), H9 (T cell lymphoma), and CCRF-CEM (acute lymphocytic leukemia, T cell) cell lines due to TGF-beta1 were measured using the MTT assay. RT-PCR was also performed to monitor the expression of the c-myc gene in these cells with the telomerase activity measured using a TRAP assay. RESULTS: There was significant inhibition of cell growth in TGF-beta1 (5ng/mL) treated Jiyoye cells. When treated with TGF-beta1, the Jiyoye cells exhibited marked decreases in the levels of c-myc RNA and telomerase activity. However, TGF-beta1 treated H9 and CCRF-CEM cells showed no cell growth inhibition or reductions in the levels of c-myc mRNA and telomerase activity. The effect of TGF-beta1 on cell growth was noted to closely correlate with c-myc mRNA expression and telomerase activity. CONCLUSION: These results suggest that TGF-beta1 may inhibit cell growth in Jiyoye cells by a mechanism involving down-regulation of the c-myc gene, which in turn, reduces the telomerase activity.

Expression of Osteopontin, ZO-1 and E-cadherin in Adenoma and Adenocarcinoma of the Colon

Background : The expressions of osteopontin (OPN), zonula occludens-1 (ZO-1) and E-cadherin, known as cell adhesion-associated substances, were examined in adenoma and adenocarcinoma of the colon. The relationship of their expressions with clinicopathologic factors was examined to investigate the roles of these proteins in the development, invasion or metas- tasis of colon adenocarcinoma. Methods : The expressions of OPN, ZO-1, and E-cadherin were examined in 54 cases of adenoma and 67 cases of adenocarcinoma of the colon by immunohistochemical staining. Results : The expression of OPN in colon adenocarcinoma correlated with staging (p=0.012) and distant metastasis (p=0.021). The expression of ZO-1 was closely related with tumor cell differentiation (p<0.001), and the reduced expression of E-cadherin was associated with tumor cell differentiation (p=0.05) and lymph node metastasis (p<0.001). Co-expression of ZO-1 and E-cadherin was significantly associated with tumor cell differentiation, and the expressions of ZO-1 and E-cadherin were reduced or lost in all cases (5 cases) of poorly differentiated adenocarcinoma. Conclusions : Our data suggest that OPN is involved in the process of invasion and metastasis of colon adenocarcinoma, and ZO-1- and E-cadherin-mediated cell adhesion may play an important role in the differentiation of colon adenocarcinoma.

Perception and Preference of Elementary Schoolchildren on Rice Foods in Changwon and Gimhae City

This study was based on the information provided by 1,180 elementary school children (630 boys and 550 girls) of 5th or 6th grade in Changwon and Gimhae of Gyeongnam province. They were asked about perception and preference for rice foods by questionnaires. The purpose of this survey was to find the way of encouraging rice intake and preference which is currently getting lower because of increasing simple westernized eating habits, and to provide basic information needed for inheriting and improving our traditional rice-based dietary culture. The results are summarized as follows. Most of subjects (91.2%) thought that steamed rice is better than bread for own health. The reason why they chose to eat steamed rice was 'because it is good for health' (61.2%), and 'because it is staple food item that we eat everyday' (26.4%). Seventy one percent of girls and 52.7% of boys gave the answer 'because it is good for health' as the reason for eating steamed rice. The reasons for the importance of the rice-based dietary culture were 'because of its superior nutritional value' (40.8%), and 'because it is our traditional eating culturec (28.6%). While significantly more girls (42.9%) answered as 'because of its superior nutritional value', more boys (39.0%) answered as 'because it is our traditional dietary culture'. More boys (59.0%) preferred noodles than girls' (54.7%), and fruits were preferred more by girls than boys as substitution foods for steamed rice showing significant difference (p<0.01). They wanted rice product developed in the forms such as Ssalamyun (29.8%), Ssalmandoo (24.1%), rice noodles (20.6%), and rice bread (15.6%). The preference score on rice products of subjects was one dish meals (4.27) and drinks (4.26), snacks (3.72), convenience foods (3.61), and steamed rice (3.44) in order. Preferred food showing points over 4 were Ssalbap (plain steamed rice) (4.29) in steamed rice type food, Kimchi bokeumbap (4.56), Bokeumbap (4.55), Bibimbop (4.45), Omelet rice (4.44), Kimbap (4.42), Ddukkuk (4.33), Curried rice (4.33), Jajangbap (4.28), and Ddukmandookuk (4.24) in one dish meal type food, Samgak Kimbap (4.26) in convenience type food, Songpyun (4.48), Injulmi (4.18), Teokbokki (4.71), Ddukkochiguyi (4.46), and rice cookies (4.24) in snack type food, and Shikhye (4.61) and Misugaru (4.28) in drink type food. Based on these results, it may be said that elementary school children think the rice-based diet is good for health and this dietary culture should be inherited and developed not only in a traditional aspect but also in a nutritional aspect. Therefore, more studies are needed to develop various forms of rice food products and cooking recipes.

A Study on Elementary Schoolchildren's Knowledge, One's Value and Consumption Pattern for Rice Foods in Changwon and Gimhae City

The informations concerning knowledge, value and consumption pattern for rice foods of elementary schoolchildren (630 boys and 550 girls in 5th or 6th grade) were investigated in Changwon and Gimhae of Gyeongnam province. They were asked based on knowledge, one's value and intake frequence of rice foods by questionnaries. Menus for 3 days including 2 weekdays and 1 weekend day were taken from 136 students (77 boys and 59 girls) in two Elementary Schools in Changwon and Gimhae to know intake reality of rice product. The purpose of this survey was to find the way of encouraging rice intake and preference which now seemed to be low because of simplified, westernized eating habits, and to provide basic information needed for inheriting and improving our traditional cooked rice centered eating culture. The results are summarized as follows. The knowledge of rice was positively correlated to the one's value (r=0.365, p<0.001) and the preference (r=0.132, p<0.001), the one's value was positively correlated to preference (r=0.409, p<0.001). The score of knowledge for rice was 12.8 points out of 20, the girls get points(13.12) significantly higher than the boys (12.53) (p<0.01). One's value about rice foods was 37.35 points out of 50 what is relatively high. They have eaten cooked rice type food for 2.24 times per day. Both boys and girls in Changwon and Gimhae area were having cooked rice type food significantly more during weekdays compared to weekends (p7lt;0.001) by 3 days food record. According the results, we can see the possibility that schoolchildren can be encouraged to eat more rice foods by nutritional education to go with the development of various programs.