Sweets syndrome has 4 cardinal features, that is, fever, neutrophil polymorphonuclear leukocytosis of the blood, raised painful plaques on the limbs, face and neck, histologically a dense dermal infiltration with mature neutrophil polymorphs. Hematologic malignancies are associated with 10-15% of cases, but gastric adenocarcinoma associated case is very rare. A 57-year-old male patient admitted to Korea University affiliated hospital because of fever and painful erythematous plaques of both limbs. No response to antibiotics and antihistamines for 1 week, so we referred to dermatologic department for skin biopsy. After then under the impression of Sweet's syndrome, oral prednisolone 60 mg/day prescribed and skin lesions were progressively regressed. For the purpose of screening of associated disease, we did abdominal CT scan and panendoscopy with biopsy which revealed adenocarcinoma of stomach. We couldn't find out any other etiologic agents.
Adenocarcinoma* ; Anti-Bacterial Agents ; Biopsy ; Extremities ; Fever ; Hematologic Neoplasms ; Histamine Antagonists ; Humans ; Korea ; Leukocytosis ; Male ; Mass Screening ; Middle Aged ; Neck ; Neutrophils ; Prednisolone ; Skin ; Stomach ; Sweet Syndrome* ; Tomography, X-Ray Computed

Experimental allergic encephalomyelitis (EAE) has been a well established animal model of postvaccinatal demyelinating diseases occurring in humans. Therefore elucidation of its pathogenesis would be very critical for the understanding of various human demyelinating diseases including multiple sclerosis. This study was performed to characterize the infiltrating cells in inflammatory sites and analyze the nature of the damage of blood brain barrier in experimental allergic encephalomyelitis. Experimental allergic encephalomyelitis was produced by administering homologous spinal cord homogenate together with complete Freund's adjuvant in guinea pigs. Immunostainings on guinea pig IgG, IgM, IgA and muramidase were performed by peroxidase-antiperoxidase or indirect immunofluorescent methods. The blood-brain barrier change was assessed by administering fluorescent Evans blue. Following results were made. In juvenile animals, both clinical findings and histopathologic changes were first noted by 3 weeks after injection and progressed during the whole experimental period. However, these findings were delayed in onset and low in incidence in adult animals. The clinical and pathologic changes started from the caudal portions and extended rostrally. The blood-brain barrier (BBB) was damaged and progressed starting also from the caudal portion of the spinal cord. The BBB changes were more severe in young animal than adult animals. Those changes preceded th histologic alterations. It is suggested that the BBB susceptibility is responsible for the caudal onset of histologic changes. Although the lesion has been thought to be induced by T-cell mediated hypersensitivity, infiltrating cells consisted mainly of muramidase positive histiocytes. A few immunoglobulin positive B cells or plasma cells could also be demonstrated in the lesion. The former usually infiltrated the parenchyme and the latter remained around the small or medium-sized vessels.
Adult ; Male ; Female ; Humans ; Animals ; Incidence

We report an autopsy of a male fetus that showed multiple congenital anomalies that could best be designated as Meckel-Gruber syndrome. The fetus was born dead at the gestational age of 38 weeks. His parents denied any history of congenital malformation. And the parity of the mother was 0-0-0-0, but she had the past history of receiving herb medication for common cold. The congenital anomalies found in this case consited of occipital meningoencephalocele, midline cleft palate, bifid epiglottis, hepatic fibrosis, choledochal cyst, bilateral polycystic kidneys, postaxial polydactyly of both hands and feet, aplasia of the left testis, secundum type atrial septal defect and patent ductus arterious. This malformation syndrome is rare and lethal. The prenatal diagnosis should be made by ultrasound study or analysis of the amniotic fluid for alpha-feto protein during intrauterine period. The kidneys showed Potter type III cystic change and there was a characteristic hepatic fibrosis.
Male ; Humans

Pulmonary thromboembolism (PTE) is a serious postoperative complication. Prompt diagnosis of PTE is important but it is difficult because clinical manifestations of PTE are not obvious in most cases. A 59 year-old woman received cholecystectomy and choledocholithotomy under general anesthesia. At the 9th postoperative day, syncope, hypoxemia and hypotension were developed suddenly and the patient was transfered to intensive care unit. PTE was suspected with hemodynamic monitoring from pulmonary arterial catheter and echocardiography and diagnosed with lung perfusion scan and venogram of lower extremities. Proper cardiopulmonary support was done and the patient was recovered and discharged in improved condition. In conclusion, if a patient have syncopal attack with shock in postoperative period, PTE must be thought to be an one of possible causes of syncope and thoroughly investigated.
Anesthesia, General ; Anoxia ; Catheters ; Cholecystectomy ; Diagnosis ; Echocardiography ; Female ; Hemodynamics ; Humans ; Hypotension ; Intensive Care Units ; Lower Extremity ; Lung ; Middle Aged ; Perfusion ; Postoperative Complications ; Postoperative Period ; Pulmonary Embolism* ; Shock ; Syncope

Epithelial-myoepithelial carcinoma of intercalated duct(origin) is a recently described tumor characterized by its typical biphasic pattern of central duct like cell and peripheral clear cell. We described a case of epithelial-myoepithelial carcinoma in a 10-year-old boy. Microscopically, the tumor showed typical biphasic pattern, diffuse proliferation of clear cells and linining epithelial cells of tubular structures. Immunohistochemically, the clear cell showed positive reaction to S-100 protein, and the epithelial cells expressed cytokeratin indicating myoepithelial and epithelial differentiation respectively. Biphasic differentiation of the tumor cells could be also proved by electronmicroscopic study.

The Clinical observation of a microphthalmic eye with primary congenital aphakia and another eye with congenital cataract in a 19-year-old girl is reported.
Aphakia* ; Cataract ; Female ; Humans ; Young Adult

PURPOSE: The aim of this study was to identify clinical predictive factors for tumor response after preoperative chemoradiotherapy (CRT) in rectal cancer. MATERIALS AND METHODS: The study involved 51 patients who underwent preoperative CRT followed by surgery between January 2005 and February 2012. Radiotherapy was delivered to the whole pelvis at a dose of 45 Gy in 25 fractions, followed by a boost of 5.4 Gy in 3 fractions to the primary tumor with 5 fractions per week. Three different chemotherapy regimens were used (5-fluorouracil and leucovorin, capecitabine, or tegafur/uracil). Tumor responses to preoperative CRT were assessed in terms of tumor downstaging and pathologic complete response (ypCR). Statistical analyses were performed to identify clinical factors associated with pathologic tumor response. RESULTS: Tumor downstaging was observed in 28 patients (54.9%), whereas ypCR was observed in 6 patients (11.8%). Multivariate analysis found that predictors of downstaging was pretreatment relative lymphocyte count (p = 0.023) and that none of clinical factors was significantly associated with ypCR. CONCLUSION: Pretreatment relative lymphocyte count (%) has a significant impact on the pathologic tumor response (tumor downstaging) after preoperative CRT for locally advanced rectal cancer. Enhancement of lymphocyte-mediated immune reactions may improve the effect of preoperative CRT for rectal cancer.
Chemoradiotherapy ; Deoxycytidine ; Fluorouracil ; Humans ; Leucovorin ; Lymphocyte Count ; Multivariate Analysis ; Pelvis ; Rectal Neoplasms ; Capecitabine

Syphilitic aneurysm is a rare type aneurysm followed by syphilitic aortitis. Authors present a case ofsyphilitic aneurysm of the ascending aorta and describe radiological findings on chest roentgenogram, aortogramand computed tomogram.
Aneurysm ; Aorta ; Syphilis, Cardiovascular ; Thorax

A clinical study was done for 103 cases of the trochanteric fractures which were admitted and treated at the department of orthopedic surgery, Kyungpook National University Hospital during the period of 9 yeras from January 1972 to December 1980. Following results were obtained: 1. Of the 103 cases of the trochanteric fractures, 73 cases were in man, with peak age at 6th decade and 21 out of 30 in woman were over 50 years of age. 2. Causes of the fracture were ear accidents in 67 cases and “slip or fall down” in 36 cases. 3. According to the classification of the trochanteric fractures by Boyd and Griffin, most common type was type 11 in 40 cases and followed by type 111 in 27, type 1 in 24 and type 1V in 12. 4. Upon the treatment, 53 out of 103 cases were conservatively treated with Thomas splint and skeletal tractior. Those cases were mostly combined injury on other organs. Open reduction and internal fixation was done on 50 cases with Jewett nail in 48, Zickel nail in 1 and Judet plate with screw in 1. Most of unstable fractures were reduced by Dimon-Hughston method and fixed with Jewett nail. 3. Union of thef ractures ranged from 10 to 16 weeks, average 13 weeks, by open reduction with internal fixation and from 12 to 24 weeks, average 17. 5 weeks, by conservative treatment. 6. Complications were encountered 31% of those cases with conservative treatment and 16% of those cases with operative treatment. Major complicationss after the conservative treatment were decubitus ulcer in 14 cases (27%), coxa vara deformity in 8(16%) and urinary tract infections in 5(10%).
Classification ; Clinical Study ; Congenital Abnormalities ; Coxa Vara ; Ear ; Female ; Femur ; Gyeongsangbuk-do ; Hip Fractures ; Humans ; Methods ; Orthopedics ; Pressure Ulcer ; Splints ; Urinary Tract Infections

The gross tissue specimens are a valuable aid to the teaching of pathology and anatomy. However, traditional methods for storage and handling of them are discouragingly difficult and, recently, minimal surgical resections as well as preoperative interventions make it more difficult to have instructive gross specimens. Plastination is a process of tissue preservation by impregnation with silicone polymers or epoxy resins. The process in our study involves dehydration by cryosubstitution in aceton, defatting, forced impregnation of silicon polymer in a vacuum, curing and finishing. We submitted 40 surgically resected specimens to plastination. The resulting specimens are odorless, relatively dry, durable, life-like, non-hazardous, maintenance-free, and do not deteriorate with time. Plastinated specimens are a useful adjunct to the teaching of pathology, particularly suited for use in small groups, and appropriate method of tissue preservation. They are much preferred to wet preparation and conventional pots by both students and teachers owing to their accessibility, superior illustrative powers, and comparative ease of interpretation.
Dehydration ; Epoxy Resins ; Humans ; Pathology* ; Polymers ; Silicones ; Tissue Preservation ; Vacuum