Primary pulmonary Hodgkin's lymphoma is a rare but distinct entity to be distinguished from nodal Hodgkin's lymphoma and from lymphomas involving lung secondarily. This lymphoma affects women more frequently than men, and typically involves superior portions of the lung. This case is reported to illustrate the clinical, radiographic and anatomic characteristics of the primary pulmonary Hodgkin's lymphoma. A 34-year-old woman presented for the evaluation of hemoptysis. A chest CT revealed a large poorly defined mass in the medial aspect of the right upper lobe, extending to the right mediastinum and trachea. The microscopic examination of the biopsied lesion revealed fibroblastic stroma infiltrated by a mixture of lymphocytes, histiocytes, and eosinophils. The clinical impression was inflammatory pseudotumor, presumably due to slightly favorable response to corticosteroid therapy. Two months later the patient's symptoms worsened despite the steroid therapy and a lobectomy was done. The specimen showed a soft to firm, pale yellow, ill defined mass, 10.0 8.0 cm, involving the visceral pleura. A few satellite nodules around the main mass were noted. The histologic findings were consistent with Hodgkin's lymphoma, nodular sclerosis type.
Adult ; Eosinophils ; Female ; Fibroblasts ; Granuloma, Plasma Cell ; Hemoptysis ; Histiocytes ; Hodgkin Disease* ; Humans ; Lung ; Lymphocytes ; Lymphoma ; Male ; Mediastinum ; Pleura ; Sclerosis ; Tomography, X-Ray Computed ; Trachea

The endolymphatic secretory epithelium are stria vascularis in cochlear and dark cell in vestibule which are regulated by Na+-K+ ATPase. It is important that we study intracytoplasmic Na+-K+ ATPase for the physiologic research of inner ear. Recently cerium-based method for stain of Na+-K+ ATPase was developed. This study was underkaken to investigate the morphologic changes and Na+-K+ ATPase activity in stria vascularis and vestibular dark cell of mongolian gerbil after systemic intramuscular injection(200mg/kg or 300mg/kg) for 7days or local infiltration of streptomycin through round window. The results are as follows. 1) The strong Na+-K+ ATPase activity was seen at basolateral infoldings of marginal cell in stria vascularis but weak Na+-K+ ATPase activity in dark cell near transitional area. 2) There was no change of Na+-K+ ATPase activity in the stria vascularis and dark cell by systemic injection of streptomycin. The decrease of Na+-K+ ATPase activity in stria vascularis was seen at destruction site of infoldings by local infiltration of streptomycin but no changes in dark cell. 3) The ultrastructural changes of marginal cell by local infiltration of streptomycin were intracytoplasmic vacuole, partial loss of cytoplasmic infoldings, edema, and increase of melanin particle. but, there was no change of ultrastructure in dark cell except increase of melanin particle. The changes of ultrastructure of stria vascularis was variable by systemic streptomycin injection and there was no dark cell change except increased melanin particle. From the above results, the changes of ultrastructure and Na+-K+ ATPase were more severe by local infiltration of streptomycin through round window than systemic injection of streptomycin. The local infiltration of streptomycin through round window may be suitable method for the induction of inner ear damage.
Adenosine Triphosphatases* ; Cytoplasm ; Ear, Inner ; Edema ; Epithelium* ; Gerbillinae ; Melanins ; Streptomycin* ; Stria Vascularis ; Vacuoles

We investigated the vestibulo-ocular reflex which is followed by the change of angular acceleration in sinusoidal harmonic acceleration test. 20 normal volunteers with no evidence of previous otoneurologic disease were tested. The maximal slow phase eye velocity, gain and asymmetry were obtained in five different amplitudes of rotation, 30degrees, 60degrees, 90degrees, 120degrees and 150degrees with properly fixed conditions such as darkness and the frequency of rotation fixed at 0.05Hz. During each test, we asked the examinees to be alert and keep the eyes open. At least 5 minute interval was given between the tests and recalibrations were done before each test. The results of this test were as follows. 1) The maximal slow phase eye velocities were gradually increased according to the increment of the amplitudes of rotation with the statistical significances(p<0.05). 2) The gains were gradually decreased according to the increment of the amplitudes of rotation between the range of 30degrees and 90degrees with the statistical significances(p<0.05). 3) The asymmetries of each amplitude were the highest(13.6%) at 30degrees and the lowest(6.9%) at 120degrees, but there were no statistical significances(p>0.05). Therefore, from the above results, sinusoidal harmonic acceleration test with the frequency fixed at 0.05Hz, gain is higher when the amplitude of rotation is smaller and the pattern of the nystagmus is more evident when the amplitude of rotation is bigger. But The authors conclude that in order to get the results which are statistically significant, the amplitude of rotation should be lower than 90degrees.
Acceleration* ; Darkness ; Healthy Volunteers ; Reflex, Vestibulo-Ocular*

BACKGROUND AND OBJECTIVE: It is well known that compensation begins after acute unilateral peripheral vestibular function loss. The change of vestibulo-ocular reflex (VOR) is variable and affected by many factors. But there is no studies reported on the changes of individuals with the lapse of time. Using the rotation chair test and caloric test, we wanted to know the individual compensatory process of VOR as time progresses following an acute unilateral peripheral vestibular loss. MATERIALS AND METHODS: Subjects were patients of acute peripheral vestibular neuritis (n=19) whose nystagmus showed more than 24 hours. The follow up period was 10 weeks until the head shake nystagmus (HSN) disappeared. We measured the duration of each spontaneous nystagmus (SN) and HSN. Sinusoidal harmonic acceleration (SHA) was tested at 0.04 and at 0.08 Hz level, with the step velocity of 100 degrees per second. We also performed caloric test after HSN disappeared. RESULTS: SN and HSN each lasted 25 days and 50 days. VOR changes had an irregular pattern among individuals with gain increasing after decrement and phase lead decreasing after increment. Furthermore, the gain asymmetry was more irregular and lasted longer as well at the step velocity. Even though compensation has been reached, the caloric test revealed continuous abnormal values, which is quite different from the recovery of VOR in the rotatory test. CONCLUSION: During the early compensation period, we could recognize that the individual VOR changes recovered with a irregular pattern. On the other hand, the caloric test was not altered even after compensation.
Acceleration ; Caloric Tests ; Compensation and Redress ; Follow-Up Studies ; Hand ; Head ; Humans ; Reflex, Vestibulo-Ocular* ; Vestibular Neuronitis

5-Lipoxygenase (5-LO) plays a pivotal role in the progression of atherosclerosis. Therefore, this study investigated the molecular mechanisms involved in 5-LO expression on monocytes induced by LPS. Stimulation of THP-1 monocytes with LPS (0~3 microg/ml) increased 5-LO promoter activity and 5-LO protein expression in a concentration-dependent manner. LPS-induced 5-LO expression was blocked by pharmacological inhibition of the Akt pathway, but not by inhibitors of MAPK pathways including the ERK, JNK, and p38 MAPK pathways. In line with these results, LPS increased the phosphorylation of Akt, suggesting a role for the Akt pathway in LPS-induced 5-LO expression. In a promoter activity assay conducted to identify transcription factors, both Sp1 and NF-kappaB were found to play central roles in 5-LO expression in LPS-treated monocytes. The LPS-enhanced activities of Sp1 and NF-kappaB were attenuated by an Akt inhibitor. Moreover, the LPS-enhanced phosphorylation of Akt was significantly attenuated in cells pretreated with an anti-TLR4 antibody. Taken together, 5-LO expression in LPS-stimulated monocytes is regulated at the transcriptional level via TLR4/Akt-mediated activations of Sp1 and NF-kappaB pathways in monocytes.
Arachidonate 5-Lipoxygenase ; Atherosclerosis ; Monocytes* ; NF-kappa B ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; Transcription Factors

BACKGROUND AND OBJECTIVES: We previously reported that the more eosinophils infiltrate in the mucosa, the poorer the prognosis gets after an endoscopic sinus surgery for the chronic sinusitis patients. But, there have not been any reports until now about correlation between serum eosinophils and tissue eosinophil infiltrations. The aim of this study is to investigate the relevance of serum and tissue eosinophils, and significance of serum eosinophils in chronic sinusitis. MATERIALS AND METHOD: A retrospective review of medical records was carried out on 158 patients who had undergone endoscopic sinus surgery from January, 1995 through July, 2001 at our institution. We divided them into two groups: good and poor outcome groups, then reviewed serum eosinophil counts and tissue eosinophil infiltrations, and investigated their relationship. RESULTS: There were significant statistical differences of serum eosinophils between the two groups, and significant correlation between serum eosinophil counts and tissue eosinophil infiltrations. CONCLUSION: We assume that the serum eosinophil counts is a one of the prognostic factors after endoscopic sinus surgery.
Endoscopy ; Eosinophils* ; Humans ; Medical Records ; Mucous Membrane ; Prognosis ; Retrospective Studies ; Sinusitis*

Large bowel metastasis from a primary lung cancer is rare and is hard to be asymptomatic. We report a case of intussusception without any symptoms caused by cecal metastasis of primary small cell lung cancer. A 70-year-old woman was admitted to hospital with cough and sputum of 3 weeks' duration. She was diagnosed with small cell lung cancer based on percutaneous needle biopsy of a lung mass identified by chest CT. In abdominal CT, multiple metastatic lesions were detected in the left adrenal gland and cecum with intussusception. After further colonoscopy and biopsy evaluations, the pathology results showed metastatic cancer originating from small cell cancer of the lung.
Adrenal Glands ; Biopsy ; Biopsy, Needle ; Cecum ; Colonoscopy ; Cough ; Female ; Humans ; Intussusception ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Small Cell Lung Carcinoma ; Sputum ; Thorax

Lung cancer metastatic to the small intestine is uncommon. Despite the widespread nature of metastases that characterize this carcinoma, symptomatic intestinal metastases are extremely rare, but have been reported as a cause of intestinal obstruction, hemorrhage, malabsorption, and perforation. We have recently encountered two cases with squamous cell lung cancer who underwent endoscopic retrograde cholangiopancreatography for obstructive jaundice. Biopsies obtained from concentric ulcerative mass in the duodenum showed metastatic squamous cell carcinoma in the lymphatics. Histologically, the pulmonary and duodenal lesions were identical and this suggests a lymphatic route of dissemination. This is the report of two cases with obstructive jaundice secondary to duodenal metastasis from primary lung cancer. Metastatic squamous cell carcinoma of the lung to the duodenum should be considered in the differential diagnosis of patients harboring such a malignancy who have obstructive jaundice.
Biopsy ; Carcinoma, Squamous Cell ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis, Differential ; Duodenum ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intestine, Small ; Jaundice ; Jaundice, Obstructive* ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Ulcer

The transdermal administration of narcotics is one of the alternative ways of providing adequate pain relief for the patients with chronic cancer pain. A Phase 4 trial was conducted to evaluate the efficacy and safety of Fentanyl-TTS in adult patients with cancer-related pain in Korea. METHODS: Patients with histologically confirmed malignancy, who have pain related to the cancer and/or therapy, pain necessitating the use of opoid analgesics, age of 18 yr or older, ability to communicate effectively with study personnel, and signed on informed consent were included. The patients were titrated with a short-acting narcotic to control their cancer pain before they are converted to a fentanyl-transdermal therapeutic system(TTS). Short acting parenteral morphine and MS contin were used as rescue medications. All patients were evaluated initially and were followed up with a pain visual analogue scale(VAS), quality of life(QOL)-VAS. Patients were asked to keep the daily record for 21 days about pain VAS, QOL-VAS, amount of rescue morphine used, and side effects. RESULTS: Twenth two patients were enrolled from January 1996 to October 1997. The dose of fentanyl-TTS required, ranged between 25 and 75 ug/hr (25 microgram/hr in 13, 50 microgram/hr in 4, and 75 microgram/hr in 2). The mean dose of morphine required before the use of the fentanyl-TTS was 135.3 mg (20-285 mg/day), but it was decreased after the use of the fentanyl-TTS. Pain VAS and QOL-VAS were in adquate level during the fentanyl- TTS treatment. Patients favored continuous use of fentanyl after the study was finished. Side effect of fentanyl-TTS was minimal. CONCLUSION: Transdermal fentanyl seems to be a convenient and effective analgesic for the control of cancer related pain in Korean. A controlled trial comparing fentanyl-TTS to morphine needs to be followed.
Administration, Cutaneous ; Adult* ; Analgesics ; Fentanyl ; Humans ; Informed Consent ; Korea ; Morphine ; Narcotics

No abstract available.
Eosinophilia* ; Respiratory Insufficiency*