The patient was a 52-year-old female with swelling in both lower legs and peripheral blood eosinophilia. Biopsy specimen revealed the heavy infiltration of eosinophils with sparse small lymphocytes showing mild atypia. The diagnosis was Kimura disease. The symptoms including eosinophilia were relieved by steroid treatment. At 17 months from initial biopsy, the patient developed swelling of the buttock. At 25 months, fever and dyspnea with multiple lung nodules developed. Wedge resection revealed multiple aggregates of CD3(+), CD56(+), Epstein-Barr virus(+) large atypical lymphocytes with necrosis. The patient was finally diagnosed with extranodal NK/T cell lymphoma (NKTL). Epstein-Barr virus in situ hybridization retrospectively performed on the previous biopsies demonstrated Epstein-Barr virus infection in small CD3(+) lymphocytes. The patient expired after 26 months despite chemotherapy. Blood eosinophilia correlated well with disease activity during the clinical course. This case shows not only unusual histologic features, which hampered the correct diagnosis, but also a unique clinical manifestation of NKTL.
Angiolymphoid Hyperplasia with Eosinophilia ; Biopsy ; Buttocks ; Dyspnea ; Eosinophilia ; Eosinophils ; Epstein-Barr Virus Infections ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leg ; Lung ; Lymphocytes ; Lymphoma ; Middle Aged ; Morphinans ; Muscle, Skeletal ; Necrosis ; Retrospective Studies

The patient was a 52-year-old female with swelling in both lower legs and peripheral blood eosinophilia. Biopsy specimen revealed the heavy infiltration of eosinophils with sparse small lymphocytes showing mild atypia. The diagnosis was Kimura disease. The symptoms including eosinophilia were relieved by steroid treatment. At 17 months from initial biopsy, the patient developed swelling of the buttock. At 25 months, fever and dyspnea with multiple lung nodules developed. Wedge resection revealed multiple aggregates of CD3(+), CD56(+), Epstein-Barr virus(+) large atypical lymphocytes with necrosis. The patient was finally diagnosed with extranodal NK/T cell lymphoma (NKTL). Epstein-Barr virus in situ hybridization retrospectively performed on the previous biopsies demonstrated Epstein-Barr virus infection in small CD3(+) lymphocytes. The patient expired after 26 months despite chemotherapy. Blood eosinophilia correlated well with disease activity during the clinical course. This case shows not only unusual histologic features, which hampered the correct diagnosis, but also a unique clinical manifestation of NKTL.
Angiolymphoid Hyperplasia with Eosinophilia ; Biopsy ; Buttocks ; Dyspnea ; Eosinophilia ; Eosinophils ; Epstein-Barr Virus Infections ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leg ; Lung ; Lymphocytes ; Lymphoma ; Middle Aged ; Morphinans ; Muscle, Skeletal ; Necrosis ; Retrospective Studies

Primary cardiac tumors in infancy and childhood are rare, with fibromas being the second most common tumor after rhabdomyomas. Although cardiac fibromas are characteristically benign intramural tumors, they may exhibit exhibit expansile growth resulting in obstruction, valvular dysfunction, as well as other problems so early diagnosis and successful surgical excision are important. We report a case of cardiac fibroma in a 2 month-old male infant. He presented with generalized cyanosis from birth. Echocardiography showed oval round large mass filing the right atrium and ventricle which infiltrated into the lateral wall of the ventricle. Partial excision of the tumor was done after another echocardiogram showed a pericardial effusion and restriction of blood flow to the right ventricle due to the tumor. The resected tumor was ovoid, gray-tan, slightly firm and measuring 5x3x2.5 cm. Histologically, the tumor was composed of spindle-shaped fibroblasts and hyalinized fibrous tissue interdigitating with the surrounding myocardium.
Infant ; Child ; Male ; Female ; Humans

Among the complications of cataract surgery, the reported frequency of posterior capsular opacification was 20~50 percent. We experienced a case of new type of posterior capsular opacification in the seventy-one year old woman patient, who undertook the cataract operation with phacoemulsification six years ago and visited our hospital with the decreased vision. With biomicroscopic examination, posterior capsular opacification, creating a closed chamber between the lens and the posterior capsule in which a liquefied, milky white substance accumulates was detected. The patient was treated with Nd: YAG laser capsulotomy. To our knowledge, there has been no reported case of liquefied posterior capsular opacification in Korea. Therefore we report this case with literature review.
Cataract ; Female ; Humans ; Korea ; Lasers, Solid-State ; Phacoemulsification

OBJECTIVE: To evaluate mouse embryos development in conventional medium IVF-20 versus vero cell coculture. METHODS: Female ICR mice aged 6 to 8 weeks, were stimulated with 5IU PMSG and 48 hours later were injected 5IU of hCG, then female and male mice were mated. At 48 hour post-hCG injection, oviducts were dissected out and 2-cell embryos were flushed. The 2-cell embryos were cultured in IVF-20 media or media containing vero cell (African green monkey kidney epithelial cell lines) for 120 hours. Coculture techniques have been applied in mouse 2-cell embryos culture used vero cell lines. RESULTS: 1. After 48 hours culture, 60.7% and 55.7% of 2 cell embryos developed to 4 cell and morulae stage, respectively, in IVF-20 culture medium, but significantly less embryos developed to 4 cell (47.6%, p<0.05) and momlae (42.9%, p<0.05) in vero cell coculture. 2. After 72 hours culture, 51.6% of 2 cell embryos developed to blastocyst and expanded blastocyst in IVF-20 culture medium, but significantly less embryos developed to blastocyst and expanded blastocyst (25.9%, p<0.01) in vero cell coculture. 3. After 96 hours culture, 37.7% and 32.6% of 2 cell embryos similar developed to expanded blastocyst and hatching in IVF-20 culture medium and vero cell coculture, respectively. 4. After 120 hours culture, 36.9% and 37.4% of 2 cell embryos similar developed to expanded blastocyst and hatching in IVF-20 culture medium and vero cell coculture, respectively. CONCLUSION: There was no difference of embryo development rates between the two culture groups. IVF-20 medium alone gives a benefit to the viability of an embryo compared with a vero cell coculture.
Animals ; Blastocyst ; Cercopithecus aethiops ; Coculture Techniques* ; Embryonic Development ; Embryonic Structures* ; Epithelial Cells ; Female ; Humans ; Kidney ; Male ; Mice* ; Mice, Inbred ICR ; Morula ; Oviducts ; Pregnancy ; Vero Cells*

Sialadenoma papilliferum (SP) is a rare benign neoplasm that normally arises from the minor salivary glands, particularly in the palate. SP is normally encountered in older men with an exophytic papillary surface growth. In the present study, an SP of the hard palate of a 69-year-old woman was examined immunohistochemically. Myoepithelial cell markers, such as S-100, smooth muscle actin and vimentin, were observed in the basal or luminal layer of tumor cells, indicating that myoepithelial cells participate in the pathogenesis of SP. In addition, cytokeratin 7 was also strongly detected in the tumor cells, suggesting that excretory ductal epithelial cells have a role in its histogenesis. A review of the literature of immunohistochemical studies on SP showed that the expression and co-expression of cytokeratins and myoepithelial cell markers have been reported in tumor cells. These results suggested that excretory duct cells and myoepithelial cells participate in the pathogenesis of SP.
Actins ; Aged ; Epithelial Cells ; Female ; Humans ; Immunohistochemistry ; Keratin-7 ; Keratins ; Male ; Muscle, Smooth ; Palate ; Palate, Hard ; Phenobarbital ; Salivary Glands, Minor ; Vimentin

PURPOSE: FK506 (tacrolimus) is a widely used immunosuppressive agent in the treatment of various medical conditions, including autoimmune disease, bone marrow and organ transplantations. Previously FK506 was known to cause apoptotic death of human Jurkat T cells. METHODS: The current study was designed to analyze the gene expression pattern of Jurkat T cells after FK506 application by using cDNA microarray. Treatment of Jurkat T cells with FK506 resulted in a decrease of cell viability in a time- and dose-dependent manner. Next, total RNA of Jurkat T cells was extracted by using TRIzol reagent and used to carry out a confirmation test for the purity and integrity of total RNA. RESULTS: Gene expression levels related to apoptosis and cell cycle process were mainly focused to analyze in FK506-treated Jurkat T cells. According to the inhibition of calcineurin activity, MARCKS in PKC substrates and Sp3 transcription factor was markedly increased in FK506-treated cells. Also, cell cycle control gene Id1 and Id3 were induced in expression from FK506-treated Jurkat T cells. However, FK506 decreased the expression of Src homology 2, G protein, and MEK 2 genes in bioactive peptide induced signaling pathway. It also reduced the expression level of the insulin receptor, DRPLA and Bai1-associated protein 2 genes, which are involved in the regulation of cell motility and morphology control. CONCLUSION: The author will continue to pursue the exact functional roles of genes that are markedly changed in expression by FK506 in human Jurkat T cells in vitro and in vivo experimental models.
Apoptosis ; Autoimmune Diseases ; Bone Marrow ; Calcineurin ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Movement ; Cell Survival ; Gene Expression ; Gene Expression Profiling ; GTP-Binding Proteins ; Guanidines ; Humans ; Jurkat Cells ; Models, Theoretical ; Oligonucleotide Array Sequence Analysis ; Organ Transplantation ; Phenols ; Receptor, Insulin ; RNA ; Sp3 Transcription Factor ; T-Lymphocytes ; Tacrolimus ; Transplants

BACKGROUND: Propofol may decrease myocardial contractility via actions on the beta-adrenoceptor-mediated signal transduction. The aim of this study was to evaluate the effect of propofol via beta-adrenoceptor-mediated signal transduction by measuring the tissue levels of cAMP (cyclic adenosine monophosphate). METHODS: The effects of propofol on beta-adrenoceptor mediated cascades were measured with cAMP concentrations, which were stimulated by agonists (l-isoproterenol, GTPgammaS, and forskolin) of each step of beta-adrenoceptor-mediated cascades. RESULTS: While the production of cAMP stimulated by isoproterenol, GTPgammaS, or forskolin are increased (P < 0.05), application of each concentration of propofol (0.1, 1, 10, 100 micrometer) did not alter the levels of cAMP. CONCLUSIONS: Considering that propofol did not alter the tissue cAMP levels when stimulated by isoproterenol, GTPgammaS, and forskolin, propofol appears to have no effect on the beta-adrenoceptor signaling pathway in guinea pig ventricular myocardium.
Adenosine ; Animals ; Forskolin ; GTP-Binding Proteins ; Guanosine 5'-O-(3-Thiotriphosphate) ; Guinea Pigs ; Isoproterenol ; Myocardium ; Propofol ; Signal Transduction

PURPOSE: This study was performed to determine whether the anion gap, the base excess, the lactate, and the strong ion gap obtained in the emergency department correlate with the prognosis and whether the strong ion gap is the most useful marker compared to the prognostic ability of the anion gap, the base excess, and the lactate. METHODS: We reviewed the records of 106 patients admitted to the intensive care unit via the emergency department. We measured the anion gap, the base excess, and the lactate and we calculated strong anion gap by using a formula. We divided the patients into survivors and nonsurvivors and compared the prognostic abilities of the four variables by using the Student's t-test and receiver operator characteristic curves. RESULTS: The mean age of the patients was 67+/-14, and the numbers of males and females were similar (58 males vs 48 females). The number of survivors was 92 (86.7%), and that of nonsurvivors was 14 (3.2%). The anion gap ( 24.8+/-8.8 vs. 16.4+/-4.8 mmol/L, p value=0.000), the base excess (-11.9+/-8.7 vs. -3.49+/-6.5 mmol/L, p value = 0.001), the lactate (9.1+/-7.7 vs. 4.5+/-3.1 mmol/L, p value = 0.011 ) and the strong ion gap (16.6+/-3.6 vs. 10.9+/-3.7, p value=0.000) of the nonsurvivors were higher. All of the four varibles were associated with the prognosis, but among them, the strong ion gap discriminated most strongly with an area under the receiver operator characteristic curve of 0.866 (95% confidence interval, 0.787 to 0.92). CONCLUSION: The initial emergency-department acid-base variables, the anion gap, the base excess, the lactate and the strong ion gap have prognostic abilities, but the strong ion gap is the variable that most strongly predicts of mortality.
Acid-Base Equilibrium ; Critical Illness* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Intensive Care Units ; Lactic Acid ; Male ; Mortality ; Prognosis ; Survivors

BACKGROUND: Platelets play a key role in many occlusive vascular disorders and anti-platelet agents are the most important therapeutic strategy in preventing the recurrence of cerebral infarction. In order to know the platelet aggregability according to the strategy of anti-platelet agents, we measured platelet aggregability in patients who were taking anti-platelet agents for cerebral infarction. METHODS: Platelet aggregability in response to adenosine diphosphate (ADP) or collagen was measured in whole blood samples from 175 patients (48 females and 137 males). It was analyzed according to the type of cerebral infarction, vascular risk factors, and each anti-platelet agent. RESULTS: Platelet aggregability induced by ADP or collagen was significantly increased in patients with large artery atherosclerotic infarction compared to those with small vessel disease. Among anti-platelet regimens, combined therapy with aspirin and clopidogrel decreased platelet aggregability most effectively. CONCLUSIONS: These findings suggest that anti-platelet treatment should be tailored to the vascular status of each patient, and that combination therapy with aspirin and clopidogrel can effectively modulate platelet aggregability in preventing the recurrence of cerebral infarction.
Adenosine Diphosphate ; Arteries ; Aspirin ; Atherosclerosis ; Blood Platelets* ; Cerebral Arterial Diseases ; Cerebral Infarction* ; Collagen ; Female ; Humans ; Infarction ; Recurrence ; Risk Factors