Primary cutaneous leiomyosarcoma is a rare neoplasm. The tumor presents as a nondescript subcutaneous mass, and may be painful or tender. The diagnosis depends on the histopathologic findings. We report a case of primary cutaneous leiomyosarcoma developed in a 57-year-old male. Five and half years ago, the patient noticed a rice grain sized nodule on the right deltoid area. Five years ago, the lesion was excised at a local medical office. From 2 years ago, the tumor recurred on the excision site as a well defined painful erythematous hard tumor, measuring 3.5*3cm. Biopsy specimen showed densely packed, interlacing bundles of smooth muscle cells which have numerous anaplastic nuclei, atypical giant cells with bizarre nuclei and 10 mitotic figures per 10 high power fields.
Biopsy ; Edible Grain ; Diagnosis ; Giant Cells ; Humans ; Leiomyosarcoma* ; Male ; Middle Aged ; Myocytes, Smooth Muscle

A 3-year-old-male had the appearance of red urine at birth and developed recurrent bullae in sun-exposed area of the skin, erythrodontia, alopecia, splenomegaly and hemolytic anemia, We observed coral red fluorescence of the teeth and urine under Wood's light and detected excessive excretion of the uroporphyrin in the urine and coproporphyrin in the stool wlth inreased porphyrin in the blood. Fluorescence of erythrocyte was demonstrated by:fluoreacence microscopy. Histologic findings showed subepidermal bulla with PAS-positive hyaline deposits around the blood vessels and revealed IgG deposits in the wall of blood vessels and dermo-epidermal junction by direct immunofluorescence.
Alopecia ; Anemia, Hemolytic ; Anthozoa ; Blood Vessels ; Erythrocytes ; Fluorescence ; Fluorescent Antibody Technique, Direct ; Hyalin ; Immunoglobulin G ; Microscopy ; Parturition ; Porphyria, Erythropoietic* ; Porphyrias ; Skin ; Splenomegaly ; Tooth

PURPOSE: To determine the activity and the toxicity associated with a low dose regimen of leucovorin (LV) plus 5-fluorouracil (5-FU) combined with oxaliplatin every two weeks (modified FOLFOX 4) as a salvage therapy for advanced gastric cancer patients. MATERIALS AND METHODS: Between December 2003 and December 2004, 33 patients were enrolled in this study. The patients were treated with oxaliplatin 85 mg/m2 as a 2-hour infusion on the first day plus LV 20 mg/m2 over 10 minutes. Subsequently, the patients were given a 5-FU bolus 400 mg/m2 followed by a 22-hour continuous infusion of 600 mg/m2 on days 1~2. The treatment was repeated at 2 week intervals. RESULTS: The median age of the patients was 50 years (range: 31~74), 82% (27/33) had the Eastern Cooperative Oncology Group performance status was 0 and 1. Of the 30 patients who could be evaluated for their tumor response, 8 achieved a partial response, with an overall response rate of 26.7% (95% confidence interval (CI): 20.5~32.7%). Fifteen patients (50%) showed stable disease and 7 patients (23.3%) progressed during the course of treatment. The median time from the start of chemotherapy to progression was 3.5 months (95% CI: 2.6~4.4 months) and the median overall survival time was 7.9 months (95% CI: 5.9~9.9 months). The major grade 3/4 hematological toxicity encountered included neutropenia (45.4%) and thrombocytopenia (3.0%). Neutropenic fever occurred during only 2 of the 178 cycles. The most common non-hematological toxicity encountered was grade 1/2 nausea/vomiting, which occurred in 18.2% of patients, diarrhea in 12.1% and neuropathy in 15.2%. There were no treatment related deaths. CONCLUSIONS: The modified FOLFOX 4 regimen appears to be a safe and effective salvage therapy for advanced gastric cancer patients.
Diarrhea ; Drug Therapy ; Fever ; Fluorouracil* ; Humans ; Leucovorin* ; Neutropenia ; Salvage Therapy* ; Stomach Neoplasms* ; Thrombocytopenia

Fusarium species are representative of the emerging group of filamentous molds, which cause respiratory and disseminated infections in immunocompromised patients. To date, only five cases of respiratory or disseminated skin infections due to Fusarium spp. have been described in Korea. Here we describe a fungemia case of Fusarium oxysporum in a 3-year old boy who was neutropenics following chemotheray for leukemia. Fever, painful macules on both extremities and phlebitis on the site of venous blood sampling developed on the day 35 of admission. All four blood cultures obtained on hospital days 37, 38, 40 and 42 yielded the same F. oxysporum. The infection was cured with a high dose (1.5 mg/kg) of amphotericin B. This case shows that Fusarium is among a few filamentous fungi that cause clinically detectable fungemias in immuncompromised hosts.
Amphotericin B ; Child, Preschool ; Extremities ; Fever ; Fungemia ; Fungi ; Fusarium* ; Humans ; Immunocompromised Host ; Korea ; Leukemia ; Male ; Neutropenia ; Phlebitis ; Skin

BACKGROUND: Acute myelod leukemia (AML) is a hematologic malignant disease characterized by uncontrolled proliferation of myeloid cells in marrow and arrest in their maturation. It accounts for 70~80% of chromosomal abnormalities and t (8;21) has been found in 40% of AML-M2. Because cytogenetic studies can help classifying the disease, providing the clues of disease progression and monitoring remission after chemotherapy, we have performed cytogenetic studies to identify the incidence of t (8;21) and other chromosomal abnormalities and to assure their prognostic significance in patients with AML-M2. METHODS: From August 1998 to July 2000, 38 patients with AML-M2 were treated with ara-C and idarubicin in order to induce complete remission. We evaluated chromosomal abnormalities by high resolution banding technique. We divided patients into 3 groups. Patients having normal and intermediate risk karyotype belonged to group A, t (8;21) to group B and, unfavorable and undetermined prognostic karyotype to group C. RESULTS: The incidence of chromosomal abnormalities was 71% (27/38), and the proportion of A, B, and C group were 40%, 30% and 30%, respectively. The median follow up duration of evaluable patients was 381 (55~1,295) days. The complete remission (CR) rate accounted for 79% (30/38). The CR rate in A, B and C group were 88% (14/16), 91% (10/ 11) and 55% (6/11), respectively (P=0.06). The median remission duration had not been reached yet. The median remission duration of group A and B had not been reached yet, but that of group C was 337 days (P=0.60). The overall median survival duration was 567 days, and the median survival duration of group B had not been reached yet, otherwise those that of group A and C were 432 days and 364 days, respectively (P=0.02). CONCLUSION: The incidence of chromosomal abnormalities was observed 71% in patients with AML-M2. The patients with t (8;21) showed higher complete remission rate and tendency to have longer remission duration and survival duration.
Bone Marrow ; Chromosome Aberrations* ; Cytarabine ; Cytogenetics ; Disease Progression ; Drug Therapy ; Follow-Up Studies ; Humans ; Idarubicin ; Incidence ; Karyotype ; Leukemia ; Leukemia, Myeloid, Acute* ; Myeloid Cells

BACKGROUND: Although several molecular typing methods have been used to investigate C. albicans infections, there remains no "gold standard" method by which relatedness of C. albicans strains is determined. In this study, two DNA fingerprinting methods were compared for genotyping of clinical strains of C. albicans isolated from candidemic patients. MATERIALS AND METHODS: Twenty-nine strains of C. albicans isolated from various clinical specimens (14 from blood, 7 from catheter, 4 from respiratory tract secretion, and 4 from urine) of 14 candidemic patients were analyzed. Primer 1245 and 1246 were employed for IR PCR and Southern blot hybridization method was used for C2 fingerprinting, with Ca3 and C1 as primers, after the fragmentation of DNA with EcoR1 RESULTS: IR PCR method separated 29 isolates into 9 (1245 primer), 7 (1246 primer) and 14 (combination of two primers) types, whereas C1 fingerprinting identified 16 different types. By combining the IR PCR and C1 fingerprinting methods, total of 16 different genotypes were identified among 29 isolates from 14 patients, which is the same result obtained by the C1 fingerprinting only. Using both methods, blood and non-blood isolates from each patient produced identical genotypes for 10 patients and different genotypes for 1 patient. In three patients, isolates from blood and other site of each patient showed identical patterns by IR PCR fingerprinting, but appeared different (n=1) or similar (n=2) by C1 fingerprinting. Overall, for 87% (13/15) of patients, isolates collected from catheter (6 of 7 patients), urine (4 of 4 patients), or respiratory (3 of 4 patients) were identical or similar to the corresponding blood isolates. CONCLUSION: Our study shows that C1 fingerprinting method is more discriminatory than IR PCR for the molecular typing of C. albicans isolates. For the majority of patients, blood and other site isolates had identical or similar genotypes.
Blotting, Southern ; Candida albicans* ; Candida* ; Candidemia ; Catheters ; Dermatoglyphics ; DNA Fingerprinting* ; DNA* ; Genotype ; Humans ; Molecular Typing ; Polymerase Chain Reaction* ; Respiratory System

BACKGROUND: Although several molecular typing methods have been used to investigate C. albicans infections, there remains no "gold standard" method by which relatedness of C. albicans strains is determined. In this study, two DNA fingerprinting methods were compared for genotyping of clinical strains of C. albicans isolated from candidemic patients. MATERIALS AND METHODS: Twenty-nine strains of C. albicans isolated from various clinical specimens (14 from blood, 7 from catheter, 4 from respiratory tract secretion, and 4 from urine) of 14 candidemic patients were analyzed. Primer 1245 and 1246 were employed for IR PCR and Southern blot hybridization method was used for C2 fingerprinting, with Ca3 and C1 as primers, after the fragmentation of DNA with EcoR1 RESULTS: IR PCR method separated 29 isolates into 9 (1245 primer), 7 (1246 primer) and 14 (combination of two primers) types, whereas C1 fingerprinting identified 16 different types. By combining the IR PCR and C1 fingerprinting methods, total of 16 different genotypes were identified among 29 isolates from 14 patients, which is the same result obtained by the C1 fingerprinting only. Using both methods, blood and non-blood isolates from each patient produced identical genotypes for 10 patients and different genotypes for 1 patient. In three patients, isolates from blood and other site of each patient showed identical patterns by IR PCR fingerprinting, but appeared different (n=1) or similar (n=2) by C1 fingerprinting. Overall, for 87% (13/15) of patients, isolates collected from catheter (6 of 7 patients), urine (4 of 4 patients), or respiratory (3 of 4 patients) were identical or similar to the corresponding blood isolates. CONCLUSION: Our study shows that C1 fingerprinting method is more discriminatory than IR PCR for the molecular typing of C. albicans isolates. For the majority of patients, blood and other site isolates had identical or similar genotypes.
Blotting, Southern ; Candida albicans* ; Candida* ; Candidemia ; Catheters ; Dermatoglyphics ; DNA Fingerprinting* ; DNA* ; Genotype ; Humans ; Molecular Typing ; Polymerase Chain Reaction* ; Respiratory System