Extramedullary plasmacytoma (EMP) is a plasma cell tumor located outside of the bone marrow. It most often occurs in the upper respiratory tract (85%), as well as the head and neck, and very rarely occurs in the retroperitoneum. Here we report the case of a 57-year-old woman with retroperitoneal EMP.
Bone Marrow ; Female ; Head ; Humans ; Middle Aged ; Multiple Myeloma ; Neck ; Plasmacytoma* ; Respiratory System ; Retroperitoneal Fibrosis ; Retroperitoneal Space

BACKGROUND/AIMS: Hepatocytes on the hepatic lobule mipate from portal zone to centrilobular mea as the DNA synthesis within it. And also, the xenobiotic reactions reveal characteristic differences associated with zone specific metabolism in the liver acinus. In this study, the zonal distribution of ethylnitrosourea (ENU)-induced hepatic precancerous lesion was stereologically investigated. METHODS: Nine B6C3F1 mices were given I.p. injection of ENU (60 ug/pn body weight) when the pups were 15 days old prior to sacrifices at 8 weeks of life. All the 150 consecutive sections, 3 p m in thickness, were stained with hematoxylin and eosin and identified the basophilic precancerous lesions with 80-165 p m diameter in equatorial plane by the Zeiss microprojector. And then the distances from the center of selected foci to terminal hepatic vein or portal vein branches were estimated under the microscopic fields. As a control group, the same estimations were performed from the random points by the appointments of random digit table. RESULTS: Mean distance between ENU-induced 52 hepatocellular foci and the nearest terminal hepytic vein was 181.15+112.39 p m (Mean+ SD), but that of randomly selected 104 points was 291.73+157.98pm (Mean+5D) (Students t-test, p<0.0005). Substantially, 52.7% of ENU-induced 52 hepatocellular foci were within 300 p m from the terminal hepatic vein, but randomly selected 104 points were only 50.9% (Shapiro Wilk W test, w=0.819857, p=0.048038). Mean distance from ENU-induced 52 foci to portal vein was 398.85+149.98pm (Mean+SD), but that from the randomly selected 104 points was 315.87+145.79 pm (Mean+SD)(Students t-test, p<0.0005). CONCLUSION: Stereologically, ENU-induced mice liver cell foci distribute non-randomly to Zone III, centrilobular zone of mouse hepatic acini where promote invasion toward terminal hepatic veins.
Animals ; Appointments and Schedules ; Basophils ; Cholestasis ; DNA ; Eosine Yellowish-(YS) ; Ethylnitrosourea ; Fluconazole ; Hematoxylin ; Hepatic Veins ; Hepatocytes ; Liver ; Metabolism ; Mice* ; Portal Vein ; Veins

PURPOSE: Pralidoxime(2-PAM) is the mainstay of organophosphate intoxication management as an antidote. We investigated the usefulness of high-dose pralidoxime therapy. METHODS: From January 2000 to July 2003, 86 patients presented with organophosphate insecticide intoxication to the emergency medical center of Chonnam National University Hospital. They were randomized into two groups: Group I was given continuous IV infusion of pralidoxime in dose of 500 mg/hr after an initial bolus dose of 2 g and Group II was given continuous IV infusion of pralidoxime in dose of 1000 mg/hr after an initial bolus dose of 2 g. Both groups were given same therapeutic interventions, including the duration of atropine administration. The plasma cholinesterase activites were monitored at admission and at 24 hr and 48 hr after infusion of pralidoxime. The effectiveness of the two treatment modalities were gauged by comparing the durations of mechanical ventilation and intensive care unit (ICU) stay. RESULTS: The mean durations of mechanical ventilation were 9.82+/-6.45 days in group I and 6.51+/-4.50 days in group II. The mean durations of ICU stay were 12.82+/- 7.69 days in group I and 9.15+/-5.38 days in group II. group I showed that longer durations of mechanical ventilation (p=0.03) and ICU stay( p<0.001). The plasma cholinesterase reactivation rate were higher in group II than in group I. CONCLUSION: The results suggest that continuous high-dose pralidoxime therapy may be helpful in the treatment of organophosphate intoxication.
Atropine ; Cholinesterases ; Emergencies ; Humans ; Intensive Care Units ; Jeollanam-do ; Plasma ; Respiration, Artificial

BACKGROUND/AIMS: Epidermal growth factors (EGF) is known to activate mitogen activated protein kinase (MAP kinase) in hepatocytes by the route of both Raf-dependent and Raf-indefendent pathways. And this is likely to play important role in normal liver cell growth and regeneration. EGF is also reported as a potent mitogen and one of the angiogenic factors. To elucidate the dynamic changes of the serum concentration of epidermal growth factor in chronic liver disease and its correlation with role of EGF and mechanism of tumor development, this study is intended to employ an ELISA in 38 biopsy-proven cases. METHODS: Sera taken out of 5 patients with chronic persistent hepatitis. 4 patients with chronic active hepatitis, 19 patients with liver cirrhosis, 10 patients with hepato-cellular carcinoma that pathological diagnosis was proven later were tested for EGF employing Quantikine ELISA Kits (R & D Systems Inc. Minneapolis, MN). The statistical analysis was evaluated by student's t-test. RESULTS: EGF concentration was 253.33+ 69.5pg/ml(Mean+ SE) in hepatocellular carcinoma, 246.60+ 91.19pg/ml(Mean+ SE) in chronic active hepatitis, 222.71+ 115.97pg/ml (Mean+ SE) in chronic persistent hepatitis, 141.15+ 23.12pg/ml(Mean+ SE) in liver cirrhosis in orders. Serum EGF concentration in hepatocellular carcinoma was significantly higher than that in liver cirrhosis(p value=0.021695). However, comparing to the remaining other groups, no significant difference was found. CONCLUSION: These results support that the reconstruction of the capillary networks in liver cirrhosis resplts in down-regulation of the EGF in comparison to chronic hepatitis. But it is suggested that revaluation of EGF stimulates MAP kinase activity eventually playing in tumorigenesis of the liver with neoangiogenesis.
Angiogenesis Inducing Agents ; Capillaries ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Diagnosis ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Epidermal Growth Factor* ; Fibrosis* ; Hepatitis, Chronic* ; Hepatocytes ; Humans ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Regeneration ; Phosphotransferases ; Protein Kinases ; Regeneration

PURPOSE: Critically ill patients frequently require rapid measurements of serum potassium. Analyses of serum samples take some time, but the results of blood gas analyses are often available more promptly. This study aims to determine the correlation between potassium concentrations measured by blood gas analyzer and automated chemical analyzer with a view to identifying whether the plasma potassium level can be used as an alternative to the serum values in the clinical management of selected patients in the Emergency Department (ED). METHODS: This prospective study of patients who were deemed by their treating doctor to require a blood gas analysis and chemistry analysis compared the potassium concentrations obtained from plasma and serum taken simultaneously. Data were analyzed using a Pearson correlation and a linear regression. RESULTS: Four hundred ninety-six patients were entered into the study. The potassium concentrations measured using two blood gas analyzers and two automated chemical analyzers were relatively highly correlated (coefficient=0.871), with an average difference between two methods of 0.449 mmol/L. There was also a high level of agreement between the methods with the 95% limits of agreement being -0.2 to 1.2 mmol/L. CONCLUSION: Compared with data from other previous test, our data were unsatisfactory. However our trial makes it possible in our ED to obtain serum potassium level from the plasma level. In addition, hypokalemia obtained by blood gas analyzer should be made an exception in treating it.
Blood Gas Analysis ; Chemistry ; Critical Illness ; Emergency Service, Hospital ; Humans ; Hypokalemia ; Linear Models ; Plasma ; Potassium* ; Prospective Studies

BACKGROUND: Hepatocellular carcinoma(HCC) has characteristic differences in both viral profiles and the most frequently occurring age in each country. It also has clinically distinct features between adult patients of the age under 65 and senile patients over 65 years. Herein we investigate differences in clinical features of the patients with HCC of the three different age groups : young patients (group 1) below 45 years of age; most frequently occurring age (45 - 65 year) (group 2); and elderly patients (group 3) above 65 years of age. METHODS: The 371 HCC patients hospitalized and followed-up from 1986 to February 1997 have been analyzed. At the time of diagnosis there was no significant difference among the three groups in alcohol intake, cigarette smoking, sex, family history of liver disease, mean values of aminotransferases, Child-Pugh class, tumor location, TNM stage, tumor size, varix grade, metastasis, abdominal pain, ascites, encephalopathy, fever, or jaundice. RESULTS: In the younger group HCC showed (1) a high incidence of HBsAg positivity (group 1, 95.3%; group 2, 78.6%; group 3, 25%; p<0.001) ; (2) a low positive rate of anti-HCV (group 1, 0%; group 2, 7.7%; group 3, 44.4; p<0.001); (3) a low incidence of NBNC(group 1, 4.9%; group 2, 14.1%; group 3, 30.4%; p<0.01); (4) a high incidence of diffuse type (group 1, 40.5%; group 2, 29.5%; group 3, 11.9%; p<0.05); (5) a higher levels of serum AFP (group 1, 4,180 ng/mL; group 2, 3,224 ng/mL; group 3, 2,025 ng/mL; between group 1 and group 3, p<0.05). But three different levels of AFP (<20 ng/mL, 20-400 ng/mL, >400 ng/mL) showed no differences among the three age groups (p=0.23766). (6) The overall survival rates did not differ statistically among the three groups (mean survival: group 1, 12 months; group 2, 18 months; group 3, 15 months; p=0.4635, log rank test). CONCLUSION: These data support the younger patients with HCC are the most frequently associated with HBV contrarily to the elderly patients the more frequently associated with HCV or NBNC rather than HBV. This suggests, in turn, that the onset of HCC occurs one or two decades later in those with adult-acquired HCV than it does in lifelong HBV patients after neonatal vertical infection.
Abdominal Pain ; Adult ; Aged ; Ascites ; Carcinoma, Hepatocellular* ; Clonorchis sinensis ; Diagnosis ; Eosinophilia ; Fever ; Hepatitis B Surface Antigens ; Humans ; Incidence ; Jaundice ; Liver Diseases ; Neoplasm Metastasis ; Smoking ; Survival Rate ; Transaminases ; Varicose Veins

Streptococcal myositis is an extremely uncommon infectious disease caused by Group A streptococcus (GAS). GAS infection spreads rapidly and diffusely through the muscle, resulting in edema and necrosis. Consequently, it results in streptococcal toxic shock syndrome having extremely high mortality. We report a 42 year-old female patient with systemic lupus erythematosus accompanying with streptococcal myositis who initially presented with fever, severe pain, and tenderness on the calf. Her systemic toxic symptoms were aggravated and finally she died of the disease in spite of aggressive management.
Adult ; Communicable Diseases ; Edema ; Female ; Fever ; Humans ; Lupus Erythematosus, Systemic* ; Mortality ; Myositis* ; Necrosis ; Shock, Septic ; Streptococcus

PURPOSE: We aimed to analyze the clinical results and investigate the factors that affect the range of motion (ROM) after revision total knee arthroplasty. MATERIALS AND METHODS: We measured the range of motion from 61 knees of 55 patients who underwent revision total knee arthroplasty using the Nexgen(R) LCCK and we investigated the factors affecting the postoperative ROM, including age, the body mass index (BMI), the preoperative ROM, deformity, causes of revision (septic vs. aseptic) and the type of polyethylene inserts (constrained vs. posterior-stabilized). The clinical results and radiographic findings were assessed using the American Knee Society Score and the roentgenographic method of the American Knee Society. RESULTS: The mean range of motion was improved from 113.7degrees to 127.2degrees. The preoperative ROM (p=0.000) and diagnosis (p=0.006) significantly influenced the postoperative ROM, yet age (p=0.386), BMI (p=0.054), deformity (p=0.218) and the type of polyethylene insert (p=0.195) were not related to the postoperative knee ROM. The American Knee Society Knee Score and Function Score on average was improved from 31.7 and 27.9 points to 86.7 and 64.7 points, respectively. CONCLUSION: The range of motion and clinical results were satisfactory after revision total knee arthroplasty using the Nexgen(R) LCCK, and the important factors affecting the range of motion after operation were the preoperative ROM and the causes of revision. The range of motion after arthroplasty using the constrained type polyethylene insert was not inferior to that using the posterior-stabilized insert.
Arthroplasty ; Body Mass Index ; Congenital Abnormalities ; Humans ; Knee ; Knee Joint ; Polyethylene ; Range of Motion, Articular

PURPOSE: This study was conducted to measure the length of the patellar tendon in normal adults and to analyze the effect of several anthropological variables on the patellar tendon length. MATERIALS AND METHODS: The study included 316 knees (278 males, 38 females) that were undergoing anterior cruciate ligament reconstruction with a bone-patellar-bone autograft. The patellar tendon length was measured on the middle 1/3 of the ipsilateral patellar tendon taken during the operation and we analyzed the relationships between the tendon length and age, weight, height and gender using simple correlation tests and linear regression analysis. RESULTS: The mean tendon length was 42.6 mm (range: 30~60 mm) and the mean age, mean weight and mean height was 32.7 years, 72.8 kg and 170.2 cm, respectively. There was weak negative correlation between the tendon length and age (Pearson correlation r=-0.187) and weak positive correlation between the tendon length and weight (r=0.288) but there was no significant correlation between tendon length and the body mass index (p=0.282) There was a positive correlation between tendon length and height (r=0.434). There was a significant difference between the males and females for the length of tendon (p<0.001), yet after removing the variance of height, the difference was statistically insignificant (beta=-0.041, p=0.491). The linear regression equation for the patellar tendon length (y, in centimeters) as a function of height (x, in centimeter) can be expressed as y=0.032x1.183. CONCLUSION: The length of the patellar tendon is correlated with height, and a patient's height can predict the length of the patellar tendon.
Adult ; Anterior Cruciate Ligament Reconstruction ; Body Mass Index ; Female ; Humans ; Knee ; Linear Models ; Male ; Patellar Ligament ; Tendons

Carbonic anhydrase catalizes the reversible hydration of carbonic dioxide and participate in various biological processes. There are several isozymes and differ in their kinetic properties, tissue distribution and subcellular localization. The expression of carbonic anhydrase isozymes in digestive tract vary according to animal species and region of the tract. The distribution of carbonic anhydrase (CA) isozymes I, II, IV and IX was investigated in various portions of the rat small intestine using Western blotting analysis and immunohistochemical staining. Western blotting analysis of rat small intestine revealed that CAI was found to be abundantly expressed throughout the small intestine. Expression of CAII in duodenum was much higher than that in jejunum and ileum. Expression of CAIV and IX was found to be weak throughout the small intestine. Immunohistochemical reaction revealed no staining of CAI in all parts of small intestine except blood vessels. CAII was detected at the supranuclear cytoplasm of surface epithelium, but not in intestinal gland. Staining intensity was most strong in the proximal duodenum. CAIV was detected at the apical surface of epithelial cells of villi, and showed most strong staining intensity in the terminal ileum. CAIX was detected at the surfcae epithelium, cells of intestinal gland and Brunner's gland, and the positive reaction was confined to the supranuclear cytoplasm. CAIX differed from CAII in tissue distribution, but subcellular localization of CAIX and II were the same. These results indicate that the surface epithelium of small intestine express CAII, IV and IX, intestinal gland and Brunner's gland express CAIX, and suggest that CAIX may somewhat contribute the control of acid-base balance in the small intestine.
Acid-Base Equilibrium ; Animals ; Biological Processes ; Blood Vessels ; Blotting, Western ; Carbon* ; Carbonic Anhydrases* ; Cytoplasm ; Duodenum ; Epithelial Cells ; Epithelium ; Gastrointestinal Tract ; Ileum ; Immunohistochemistry ; Intestinal Mucosa ; Intestine, Small* ; Isoenzymes* ; Jejunum ; Rats* ; Tissue Distribution