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Purpose: Neuropilin-2 is expressed by venous and lymphatic endothelial cells and can bind the lymphangiogenesis-associated ligand vascular endothelial growth factor (VEGF)-C and D. Recently, neuropilin-2 was shown to play a role in lymph node metastasis and cancer promotion. The aim of this study was to determine the clinical relevance of neuropilin-2 expression in colorectal carcinomas. Methods: Immunohistochemical analysis of neuropilin-2 expression of 350 colorectal cancer samples was evaluated using tissue microarray. The relationship between neuropilin-2 expression and other clinicopathological variables were analyzed in colorectal carcinomas. To clarify the role of neuropilin-2 in colorectal cancer lymphangiogenesis, its expression was examined with VEGF-C, VEGF-D, and VEGF receptor 3 expression of the colorectal carcinomas. Results: Neuropilin-2 was detected in 176 of 350 colorectal carcinomas (50.3%). Overexpression of neuropilin-2 was correlated with lymph node metastasis (P=0.041) and VEGF-D expression (P=0.020), but was not correlated with TNM (tumor, node, metastasis) stage, other lymphangiogenic factor expression and survival colorectal cancer patients. Conclusion: Neuropilin-2 expression was correlated with lymph node metastasis and VEGF-D expression in colorectal carcinomas. Our results suggest a possible role of neuropilin-2 in lymphangiogenesis and cancer progression in colorectal carcinomas.

Internal biliary fistula (IBF) is occurred spontaneously due to the biliary disease in most cases. Bilioenteric, biliobiliary, bronchobiliary, and vasculobiliary type of IBF have been reported in the literature. We herein describe our experience with an incidental cholecystojejunal fistula, a very rare type of bilioenteric fistula in laparoscopic cholecystectomy. A 61-year-old woman with several years' history of intermittent right upper abdominal pain was admitted to Soonchunhyang University Cheonan Hospital. Abdominal CT scan showed the pneumobilia in gallbladder with common bile duct dilatation. Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy were done. On operative findings, there was a cholecystojejunal fistula. We performed laparoscopic cholecystectomy and fistulectomy with jejunal partial resection. To our knowledge, this is the first report on incidental cholecystojejunal fistula uncombined with any other disease and was treated with laparoscopic procedure.

Acute appendicitis is a common occurrence in childhood. It is very rare in newborns, so it misses the appropriate diagnosis time. Peritonitis due to perforation of acute appendicitis is the cause of death. We report the case of periappendiceal abscess of female premature baby on the age of 23 weeks and 3 days. The baby has abdominal distension and irritability, and she did not respond to antibiotics and conservative treatment. No abnormal findings were found on simple plain radiography and ultrasonography on the abdomen. The clinical manifestations did not improve in spite of conservative care - antibiotics, nasogastric decompression. So diagnostic laparotomy was done. On operation, panperitonitis was found which may be caused by periappendiceal abscess. After ileocecectomy the patient was recovered and gained weight to 2,050 gram. Appendicitis should be considered in the differential diagnosis for a neonate with abdominal distension and bilious vomiting and needs strong clinical suspicion.

Cystic lymphangiomas of the adrenal gland are rare. A 79-year-old female presented in the emergency room with epigastric discomfort, and an immovable mass was palpated in her abdomen upon physical examination. Imaging studies revealed a large cystic lesion in the pancreatic tail. The radiologic impression ruled out the possibility of a mucinous cystic neoplasm, or a pseudocyst in the pancreas. The operative findings demonstrated that the cystic mass originated in the left adrenal gland. A laparoscopic excision of the cystic mass was performed, and immunohistochemistry confirmed that this mass was a lymphangioma of the adrenal gland. Several prior reports have suggested that lymphangioma can mimic renal or splenic cysts. However, lymphangioma cases mimicking pancreatic cysts are very rare.

Purpose: Astrocyte elevated gene-1 (AEG-1) plays important roles in tumorigenesis such as proliferation, invasion, metastasis, angiogenesis, and chemoresistance. We examined the expression of AEG-1 in patients with hepatocellular carcinoma (HCC). Methods: Eighty-five samples were collected from patients with HCC who underwent surgery and were histopathologically confirmed to have HCC. Two independent pathologists, experienced in evaluating immunohistochemistry and blinded to the clinical outcomes of the patients, reviewed all samples. They determined AEG-1 expression semiquantitatively by assessing the percentage of positively stained immunoreactive cells and staining intensity. Clinicopathological data were analyzed in association with prognosis. Results: The association was estimated by univariate and multivariate analyses with Cox regression. Tumor size (hazard ratio [HR], 2.285; 95% confidence interval [CI], 1.175?4.447; P = 0.015), microvascular invasion (HR, 6.754; 95% CI, 1.631?27.965; P = 0.008), and AEG-1 expression (HR, 4.756; 95% CI, 1.697?13.329; P = 0.003) were independent prognostic factors for overall survival. Those for disease-free survival rate were tumor size (HR, 2.245; 95% CI, 1.282?3.933; P = 0.005) and AEG-1 expression (HR, 1.916; 95% CI, 1.035?3.545; P = 0.038). The cumulative 5-year survival and recurrence rates were 89.2% and 50.0% in the low-expressing group and 24.5% and 82.4% in the high-expressing group, respectively. Conclusion: The results suggest that AEG-1 overexpression could serve as a valuable prognostic marker in patients with HCC.

The article described the experiences of elderly couples caring for each other using ethnographic methodology. Ten couples were interviewed in depth. The presence of a support system was found to be the primary requirement of elderly couples. Three taxonomies comprised the support system: (a) desire for respect in care, (b) desire for reliance, and (c) expectation. The close linkage and interaction of desire for care, desire for reliance, and expectations were confirmed. The findings suggested establishing a holistic support network for these elders.