T cell lymphoblastic lymphoma is characterized by immature lymphoid cells that are indistinguishable from the lymphoblasts and prolymphocytes of acute lymphoblastic leukemia. Several characteristic clinical features of lymphoblastic lymphoma, with include a high male-to-female ratio, a relatively high incidence in older children and young adults, the frequent presence of mediastinal involvement at the time of diagnosis. Also, this disease is rapidly progressive, and early dissemination to the bone marrow, blood, and central nervous system leads to the evolution of a picture resembling a acute lymphoblastic leukemia. We have experienced a rare case of congenital T-cell lymphoblastic lymphoma in which 1/365 year old female newborn had generalized multiple irregular protruding mass on her body. On bone marrow biopsy, CSF analysis, ultrasonogram and whole body MRI studies. We found metastasized tumor mass to, orbit, abdominal cavity, bulva, skin, and lower extremities. Histopathologically, specimen from mass on the right thigh showed diffuse infiltration of poorly differentiated and immature lymphoid cells in the skelectal muscle and subcutaneous soft tissue. By immunophenotyping studies using anti T cell and B cell monoclonal antibody, these cells were reactive with UCHL-1, MB2, but unreactive with MB1, L26. Based on these findings, the lesion was diagnosed as lymphoblastic lymphoma of the T-cell type, which occurred congenitally. Most T cell lymphoblastic lymphoma are noted, but congenital case was not reported. So we report it with a brief review of literature.
Abdominal Cavity ; Biopsy ; Bone Marrow ; Central Nervous System ; Child ; Diagnosis ; Female ; Humans ; Immunophenotyping ; Incidence ; Infant, Newborn ; Lower Extremity ; Lymphocytes ; Magnetic Resonance Imaging ; Orbit ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Skin ; T-Lymphocytes ; Thigh ; Ultrasonography ; Young Adult

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Abscess* ; Myocardium*

The authors present a retrospective analysis of 100 consecutive patients who between February 1993 and June 1996 underwent computed tomography(CT)-guided stereotactic biopsy using the Riechert-Mundinger system. The patients were aged between ten and 70(mean 41) years and the male-to-female ratio was 58 : 42. All were suffering from intracranial lesion(s) which had not been correctly diagnosed by CT and/or magnetic resonance(MR) imaging. Among these 100 patients, 102 stereotactic biopsy procedures were carried out ; in two cases, the procedure was repeated, due to initial failure. Diagnostic yield was 92%(94 procedures) and the accuracy by image was 100%. After biopsy, eleven glioma cases underwent craniotomy ; in ten of these(92%), the diagnosis was the same on craniotomy and on biopsy. The exception had on biopsy been diagnosed as anaplastic astrocytoma, but on craniotomy was diagnosed as anaplastic oligoastrocytoma. The treatment plan for 27 of 85 patients(31%) was changed after biopsy. The mortality rate was 1%(one case) ; after biopsy, a patient with brain abscess and impending herniation died due to progressive brain edema. The morbidity rate was 7%(seven cases) ; one patient showed transient symptoms of increased intracranial pressure, five showed transient weakness, and one, transient speech disturbance. In conclusion, our system for CT-guided stereotactic biopsy is highly diagnostic, accurate, effective for treatment planning, and in diagnosing brain lesions, does not damage tissue. The possible causes and the solutions for non-specific diagnoses are also discussed.
Astrocytoma ; Biopsy* ; Brain Abscess ; Brain Edema ; Brain* ; Craniotomy ; Diagnosis ; Glioma ; Humans ; Intracranial Pressure ; Mortality ; Retrospective Studies

Pretibial myxedema is a condition in which there is loeal thickening of the skin by a mucin-like deposit; it is nearly always asosciated with ophthalmopathy and thyrotoxicosis, not infrequently becomes more pronounced after treatrnent of thyrotoxicosis. The precise cause of pretibial myxedema is not known, but it appears that IgG LATS represents an autoantibody against a thyroid antigen, retroorbital tiesue and tbe skin, so, pretibial myxedema is presumed to be the result of a local antigen-antibody tissue reaction. A 57-year-old man had the history of diabetes since 1964 and Graves disease since May 1980, he was treated with metimazole for 1 month, with improving thyrotoxicosis but developed the pretibial myxedema. The histologic findings showed considerable amount of mucin, especially hyaluronic acid with toluidin blue stain at PH 3.0. The lesions were improved by local application of 0.01 x fluocinolone acetonide ointment with occlusive dressing technique.
Fluocinolone Acetonide ; Graves Disease ; Humans ; Hyaluronic Acid ; Hydrogen-Ion Concentration ; Immunoglobulin G ; Long-Acting Thyroid Stimulator ; Middle Aged ; Mucins ; Myxedema* ; Occlusive Dressings ; Skin ; Thyroid Gland ; Thyrotoxicosis

The healthcare for elite athletes has the potential to create many ethical issues for sports practitioners. And the relationship between a sports practitioner and an athlete differs significantly from the traditional doctor-patient relationship. However, there has been little discussion of them to date. To investigate the ethical awareness and concerns in sports medicine field, we surveyed the responses of Korean medical team to a questionnaire during the Summer Olympic Games 2012. The questionnaire was developed to access a wide-range of common ethical issues in sports medicine; conflict of interests, confidentiality, pediatric athletes, performance-enhancing substances, infectious disease, innovative therapies, medical advertising. Twenty-nine out of 32 sports practitioners responded to the questionnaire (90.6%). Respondents identified many ethical matters concerning the unique characteristics of athletes-as-patients in sports medicine. This study has started the process of identifying contemporary ethical problems with regard to the sports medicine, and there should be further studies dealing with these problems.
Athletes ; Communicable Diseases ; Confidentiality ; Conflict of Interest ; Delivery of Health Care ; Humans ; Performance-Enhancing Substances ; Surveys and Questionnaires ; Sports ; Sports Medicine ; Therapies, Investigational

For effective prevention of doping, individual and situational factors that make an elite athlete more susceptible to doping than others should be investigated. The aim of this study was to quantitatively measure doping related attitudes and dispositions of adolescent competitive athletes at elite level. Data were collected by questionnaires among athletes (n=123) who were participating in the 2nd Asian Youth Games. Outcome measures included doping knowledge, behavior and attitude (performance enhancement attitude scale, PEAS). One athlete admitted the past use of doping and 2 athletes reported that they knew others who had doped. Athletes were mainly provided with anti-doping information from anti-doping agency (16.3%), coaches (11.4%) or medical staffs (10.6%). The average PEAS score was 38.39+/-11.36. High school (elder) athletes showed higher PEAS score (39.63+/-11.35) than middle school (younger) athletes (34.53+/-10.67) and team sport athletes showed lower PEAS score (35.11+/-9.80) than athletes in endurance (45.08+/-15.49) or motor skill sports (43.25+/-9.08). This study suggests that many factors play an important role in athlete's decisions regarding the use of doping. Further research should incorporate these factors to understand the complexity of doping and to identify points for effective anti-doping program.
Adolescent* ; Asian Continental Ancestry Group ; Athletes* ; Humans ; Medical Staff ; Motor Skills ; Outcome Assessment (Health Care) ; Peas ; Surveys and Questionnaires ; Sports

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a syndrome with complex genetics and diverse manifestations. Diffuse alveolar hemorrhage is caused by alveolar microcirculation injury associated with lung illness or systemic disorders. To date, the relationship between diffuse alveolar hemorrhage and MELAS has not been reported. We report a MELAS patient who presented complications with diffuse alveolar hemorrhage.

BACKGROUND: The Cobas(R) Integra is a new automated chemistry analyzer with continuous and random-access features for routine chemistries, specific proteins, electrolytes, therapeutic drugs and drugs of abuse. The system maintains 68 test-specific reagent cassettes on board and have test principles of absorbance photometry, immunoturbidometry, fluorescence polarization and ISE measurements. We evaluated the usefulness of Cobas(R) Integra in the aspect of accuracy, precision, linearity, comparison study, test speed and general performance. METHODS: We evaluated the analytical performance of the Cobas(R) Integra for T. bilirubin, CRP, BUN, creatinine, sodium, potassium, chloride, valproic acid, phenytoin and carbamazepine according to NCCLS guidelines (EP5-T2, EP6-P, EP9-T and GP10-T). RESULTS: In accuracy study, error ranges(%) of most test items, except sodium and chloride, were within analytic goals. In within-run and between-run precision study, Coefficient of variation (CV, %) of most items, except sodium, were lower than limits suggested by College of American Pathologists Survey 1991. The linearities were maintained well in the range of medically significant levels and were statistically acceptable (p<0.001). The comparison study for most items, except sodium and chloride, indicated good correlation with Hitachi 747 and TDx FLx(TM) and correlation coefficients (r) were above 0.98. Throughput was about 450 tests/hr. CONCLUSIONS: Cobas(R) Integra showed satisfactory accuracy, precision, linearity, good correlation with other analyzers and high throughput. So, we concluded that Cobas(R) integra is highly suitable for not only routine use but also emergency tests in medium to large-sized hospitals because of its high productivity and reliability.
Bilirubin ; Carbamazepine ; Chemistry* ; Creatinine ; Efficiency ; Electrolytes ; Emergencies ; Fluorescence Polarization ; Phenytoin ; Photometry ; Potassium ; Sodium ; Street Drugs ; Valproic Acid

BACKGROUND: The Cobas(R) Integra is a new automated chemistry analyzer with continuous and random-access features for routine chemistries, specific proteins, electrolytes, therapeutic drugs and drugs of abuse. The system maintains 68 test-specific reagent cassettes on board and have test principles of absorbance photometry, immunoturbidometry, fluorescence polarization and ISE measurements. We evaluated the usefulness of Cobas(R) Integra in the aspect of accuracy, precision, linearity, comparison study, test speed and general performance. METHODS: We evaluated the analytical performance of the Cobas(R) Integra for T. bilirubin, CRP, BUN, creatinine, sodium, potassium, chloride, valproic acid, phenytoin and carbamazepine according to NCCLS guidelines (EP5-T2, EP6-P, EP9-T and GP10-T). RESULTS: In accuracy study, error ranges(%) of most test items, except sodium and chloride, were within analytic goals. In within-run and between-run precision study, Coefficient of variation (CV, %) of most items, except sodium, were lower than limits suggested by College of American Pathologists Survey 1991. The linearities were maintained well in the range of medically significant levels and were statistically acceptable (p<0.001). The comparison study for most items, except sodium and chloride, indicated good correlation with Hitachi 747 and TDx FLx(TM) and correlation coefficients (r) were above 0.98. Throughput was about 450 tests/hr. CONCLUSIONS: Cobas(R) Integra showed satisfactory accuracy, precision, linearity, good correlation with other analyzers and high throughput. So, we concluded that Cobas(R) integra is highly suitable for not only routine use but also emergency tests in medium to large-sized hospitals because of its high productivity and reliability.
Bilirubin ; Carbamazepine ; Chemistry* ; Creatinine ; Efficiency ; Electrolytes ; Emergencies ; Fluorescence Polarization ; Phenytoin ; Photometry ; Potassium ; Sodium ; Street Drugs ; Valproic Acid