A 70 years old female patient with thyroid cancer received palliative radiation therapy for neck swelling and hemoptysis. She had a cardiac pacemaker under her chest due to complete AV block since 8 years ago. We present clinical detail and review previously reported articles.
Aged ; Atrioventricular Block ; Female ; Hemoptysis ; Humans ; Neck ; Radiotherapy* ; Thorax ; Thyroid Neoplasms

Although tumor necrosis factor (TNF)-alpha antagonist is a successful treatment modality for various autoimmune diseases, including rheumatoid arthritis (RA), ankylosing spondylitis and psoriatic arthritis, many adverse effects have been reported. Cutaneous adverse reactions of TNF-alpha antagonist include skin rash, urticaria, lupus like rash, seborrheic dermatitis and different kinds of psoriasiform dermatitis. We report a case of psoriasiform dermatitis during TNF-alpha antagonist treatment in a 50-year-old woman with RA. The patient has been treated with adalimumab. After 2 months, she developed pruritic erythematous eruption and desquamative lesions on the head and limbs, which were defined as psoriasiform change by a skin biopsy. These skin lesions are successfully treated with combination therapy, including cessation of adalimumab, corticosteroid and phototherapy.
Antibodies, Monoclonal, Humanized ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Biopsy ; Dermatitis ; Dermatitis, Seborrheic ; Exanthema ; Extremities ; Female ; Head ; Humans ; Middle Aged ; Phototherapy ; Skin ; Tumor Necrosis Factor-alpha ; Urticaria ; Adalimumab

No abstract available.
Choledochal Cyst*

OBJECTIVE: Ovarian cancer is common a gynecologic malignancy and leading cause of death in women being diagnosed with advanced disease. This study was undertaken to investigate the roles of the proteins related to G1 cell cycle in ovarian carcinogenesis. METHODS: The expression of cyclin Dl, p16, RB and PCNA in DMBA (7, 12-dimethylbenzanthracene)-induced ovarian cancer of rats was analyzed by immuno-histochemistry and Western blot. RESULTS: 1. Twenty-nine tumors were induced in 32 ovaries from 16 rats (90.6%) in the experimental group. The average weight of tumor was 3.35+/-0.73 gm and the average size was 1.84+/-0.17 cm in greatest dimension. The histologic types were adenocarcinomas (n=20), squamous cell carcinomas (n=3), sarcoma (n=4) and combined types (n=3). 2. With respect to the cyclin D1 and PCNA labelling index, ovarian cancers showed significantly higher index than normal ovarian surface epithelium. There were no differences among the cancer types. In Western blot analysis, the expression of cyclin Dl in ovarian cancers was higher than that in normal ovarian surface epithelium. 3. With respect to the p16 and RB labelling index, ovarian cancers showed significantly lower index than normal ovarian surface epithelium. There were no differences among the cancer types. In Western blot analysis, the expression of cyclin Dl in ovarian cancers were lower than that in normal ovarian surface epithelium. 4. Positive correlation was shown among cyclin D1, PCNA. RB was negatively correlated with cyclin D1, PCNA. The p16 had no correlation with cyclin D1, PCNA. CONCLUSION: These results suggest that the deregulation of cyclin Dl, p16, RB and PCNA occur in DMBA induced rat ovarian carcinogenesis and result in tumor progression. Further studies are needed to investigate the role and function of cyclin Dl-p16-RB pathway in human ovarian cancer with this animal model.
9,10-Dimethyl-1,2-benzanthracene* ; Adenocarcinoma ; Animals ; Blotting, Western ; Carcinogenesis* ; Carcinoma, Squamous Cell ; Cause of Death ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Epithelium ; Female ; Humans ; Models, Animal ; Ovarian Neoplasms ; Ovary ; Proliferating Cell Nuclear Antigen* ; Rats* ; Sarcoma

Primary lymphoma of the central nervous system is a rare disease, occurring spontaneously and/or in conjunction with immunosuppressive state. Its incidence is increasing according to the increment of organ transplantation and AIDS. Recently we experienced a case of primary lymphoma occurred in central nervous system after renal transplantation in a 58-year-old women who had complained of persistent headache and left hemiparesis. CT scan of the brain showed two hyperdense mass lesions in right frontal and right basal ganglia areas. Immunohistochemical stain of the excised mass lesion revealed that tumor cells were derived from B cells. The patient was treated with discontinuance of immunosuppressive drug and irradiation, but expired due to pneumonia.
B-Lymphocytes* ; Basal Ganglia ; Brain ; Central Nervous System ; Female ; Headache ; Humans ; Immunosuppression ; Incidence ; Kidney Transplantation* ; Lymphoma ; Lymphoma, B-Cell* ; Middle Aged ; Nervous System* ; Organ Transplantation ; Paresis ; Pneumonia ; Rare Diseases ; Tomography, X-Ray Computed ; Transplants

BACKGROUND: This study was to verify the necessity of a control program developed to improve compliance, by conducting a research on the status of medication compliance in the elderly with chronic diseases in rural area and analyzing the related variables. METHODS: The organized questionnaire and pill-count were used to collect information on personal details, physical status, drugs taken in the elderly over 65 years old suffering from more than two chronic diseases in one rural area. RESULTS: The mean age of the subjects was 73.13+/-6.36 (65~93), and the number of the subjects in compliance group was 60 (77.9%) and the accuracy of self-report which was identified by pill-count was 0.86. Polypharmacy and visiting several clinics were the main factors that decided a low- degree of compliance, with OR of 5.92 (95% CI 1.11~31.44, P=0.037), and 4.25 (95% CI 1.03~17.53, P=0.045), respectively. CONCLUSION: Systematic efforts are necessary and plans must be established without delay to increase compliance in the elderly in the rural, expansively to manage chronic diseases in stay-at-home elders.
Aged ; Chronic Disease ; Compliance ; Humans ; Medication Adherence ; Polypharmacy ; Republic of Korea ; Stress, Psychological ; Surveys and Questionnaires

A 73-year-old man visited our hospital because of pain with swelling and redness on the right foot dorsum. He was diagnosed with liver cirrhosis and nodular hepatic cellular carcinoma. Lower extremity CT scan and MRI showed abscess formation in the right foot dorsum. Gram-negative cocci were recovered from the culture of drained pus at the site and identified as Neisseria skkuensis by 16S rRNA gene sequencing. Here, we report the first case of cellulitis due to N. skkuensis and provide a literature review.
Abscess ; Aged ; Cellulitis* ; Foot ; Genes, rRNA ; Humans ; Liver Cirrhosis ; Lower Extremity ; Magnetic Resonance Imaging ; Neisseria* ; RNA, Ribosomal, 16S ; Sequence Analysis ; Suppuration ; Tomography, X-Ray Computed

BACKGROUND/AIMS: To evaluate the expression of cellular inhibitor of apoptosis protein 2 (cIAP2) during gastric carcinogenesis after Helicobacter pylori (HP) infection and after HP eradication. METHODS: We divided non-cancer patients into four groups according to the status of HP infection and atrophic gastritis (AG)/intestinal metaplasia (IM). We compared cIAP2 mRNA expression among these four groups and patients with HP-positive early gastric cancer (EGC) by using real-time polymerase chain reaction (PCR). We evaluated the expression of cIAP2 messenger RNA (mRNA)/protein by using real-time PCR/immunohistochemistry and the degree of apoptosis with a terminal deoxynucleotidyl transferase-mediated nick end labeling assay before and 12 months after endoscopic submucosal dissection (ESD) in HP-positive EGC patients, regardless of whether they had undergone eradication therapy. RESULTS: The expression of cIAP2 mRNA was significantly higher in the groups with HP(+), AG/IM(+), and HP-positive EGC than in the control, HP(+), and AG/IM(−) groups (p<0.005). In the HP eradication group, the expression of cIAP2 mRNA/protein significantly decreased (p=0.006) and apoptosis increased at the 12-month follow-up after ESD. In the HP noneradication group, the aforementioned changes were not found during the same follow-up period. CONCLUSIONS: The expression of cIAP2 increased during gastric carcinogenesis after HP infection; HP eradication in the patients who had undergone ESD for EGC reversed overexpression of cIAP2 and suppressed cell apoptosis.
Apoptosis ; Carcinogenesis* ; Follow-Up Studies ; Gastritis, Atrophic ; Helicobacter pylori* ; Helicobacter* ; Humans ; Inhibitor of Apoptosis Proteins* ; Metaplasia ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Stomach Neoplasms

BACKGROUND: Recently, myeloproliferative leukemia (MPL) W515 mutations have been reported to be molecular markers for myeloproliferative neoplasms (MPNs). We studied the association between MPL W515 mutations and the clinico-hematological features of patients with MPNs. METHODS: Our study included 154 consecutive patients diagnosed with MPNs (31 had polycythemia vera [PV]; 106, essential thrombocythemia [ET]; and 17, primary myelofibrosis [PMF]). MPL W515 mutations were detected by real-time PCR and direct sequencing methods. RESULTS: The MPL W515L mutation was found in 4 patients and the MPL W515A mutation was detected in 1 patient. These 5 patients were diagnosed with JAK2 V617F-negative ET, and they accounted for 12.5% of patients with JAK2 V617F-negative ET. The patients with MPL W515-positive ET showed significantly lower hemoglobin levels and WBC counts than did patients with MPL W515-negative ET or JAK2 V617F-positive ET. CONCLUSIONS: MPL W515 mutation is a useful diagnostic marker for JAK2 V617F-negative MPNs and it is associated with specific hematologic characteristics such as lower hemoglobin levels and WBC counts.
Humans ; Janus Kinase 2 ; Leukemia ; Polycythemia Vera ; Primary Myelofibrosis ; Real-Time Polymerase Chain Reaction ; Thrombocythemia, Essential

Pulmonary embolism is not a frequent cause of morbidity and mortality in patients with or without malignancies. Pulmonary embolism should be ruled out when sudden tachypnea and pulmonary hypertension develop in leukemic children, and chest radiograph shows no or minimal abnormalities. A 14-year-old girl with acute lymphoblastic leukemia was admitted due to neutropenic fever and dyspnea. Chest computed tomography and ventilation/perfusion scan showed pulmonary embolism, and embolectomy revealed aspergillosis. Invasive aspergillosis is the major opportunistic fungal pathogen in neutropenic patient and an important cause of death. The critical elements of successful management of invasive aspergillosis complicating neutropenia and pulmonary embolism are early diagnosis, initiation of aggressive doses of amphotericin B, reversal of immune suppression and feasible surgical resection of the lesions. To the best of our knowledge, this is the first report of pulmonary embolism caused by Aspergillus in an immunocompromised setting in Korea and we present a case report with a brief review.
Adolescent ; Amphotericin B ; Aspergillosis ; Aspergillus* ; Cause of Death ; Child* ; Dyspnea ; Early Diagnosis ; Embolectomy ; Female ; Fever ; Humans ; Hypertension, Pulmonary ; Korea ; Mortality ; Neutropenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pulmonary Embolism* ; Radiography, Thoracic ; Tachypnea ; Thorax