BACKGROUND: Recent reports suggest that Epstein-Barr virus (EBV) may play an important role in such a wide spectrum of human neoplasia. Recently, peripheral T cell lymphomas and particularly, angiocentric lymphomas (ACL), increasingly are reported to be associated with EBV.Nasal-type and nasal T/NK cell lymphoma (TNKL) have recently been reported to comprise most of ACLs. The prognosis of these tumors has been extremely poor. OBJECTIVE: The purpose of this study was to investigate EBV association in primary or secondary cutaneous T-cell lymphoproliferative disorders and to identify any prognostic association. METHODS: Thirty six patients with primary or secondary cutaneous T-cell lymphoproliferative (CTCL) disorders were examined to evaluate the presence of Epstein-Barr virus using in situ hybridization for EBV-encoded RNA (EBER). RESULTS: EBER was detected in tumor cells in one third of the total cases (13/36); 4/4 secondary skin lymphoma from nasal TNKL, 8/8 primary cutaneous nasal type TNKLs and 1/5 mycosis fungoides (MF).EBER was not detected in the following disease: 6 cases of anaplastic large cell lymphomas (ALCL) including 2 cases of probable NK-like T cell lineage, 3 lymphomatoid papulosis, 2 CD56 (-) T cell ACLs and 7 subcutaneous panniculitic T-cell lymphomas (SPTL) by Revised European-American Lymphoma (REAL) classification and recent concept of further classification into NK-cell lineage. One case of T-cell pseudolymphoma as a negative control was also negative in EBER. CONCLUSION: High incidence of EBV was observed in primary or secondary CTCLs in Koreans, with predilection for nasal and nasal type TNKL. In MFs, an erythrodermic MF with fatal outcome was associated with EBV and the EBV detection might reflect worse prognosis in MFs as seen in an aggressive course of nasal and nasal type TNKLs.
Cell Lineage ; Classification ; Fatal Outcome ; Herpesvirus 4, Human* ; Humans ; In Situ Hybridization ; Incidence ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders* ; Mycosis Fungoides ; Prognosis ; Pseudolymphoma ; RNA* ; Skin ; T-Lymphocytes*

Insulinoma is rare functioning islet cell tumor of pancreas and its main feature is frequent attacks of hypoglycemia. Because of frequent seizure, the disease is occasionally mistook as epilepy. We experienced a case of insulinoma with dilantin toxicity in a 45 year old patient who had been treated with dilantin for 7 years. Selective splenic arteriogram showed 0.8cm mass in the tail of pancreas which was proven insulin secreting tumor on histiopathological examination. After operation no more seizure attack was detected and her blood sugar level was well maintained within normal range. This case might provide an insight that the possibility of insulinoma should be considered in patient with episodic neurobehavioral dysfunction such as epilepsy.
Adenoma, Islet Cell ; Blood Glucose ; Epilepsy ; Humans ; Hypoglycemia ; Insulin ; Insulinoma ; Pancreas ; Phenytoin ; Reference Values ; Seizures ; Tail

Struma ovarii consists of thyroid tissue which is derived from germ cells in a mature teratoma. Five percent of struma ovarii are malignant, and of these only five percent metastasize. The rarity of this disease has resulted in difficulty in agreeing on treatment regimens and in limited imaging and monitoring difficulties encountered in their management. We have experienced two cases of malignant struma ovarii with brief review of the literature.
Germ Cells ; Neoplasms, Germ Cell and Embryonal ; Struma Ovarii* ; Teratoma ; Thyroid Gland

Arthroscopic shoulder surgery has become a common and routine procedure because it provides several advantages for the diagnosis and therapy of shoulder injuries. However, shoulder arthroscopy is not a technique that's void of complications. We describe here a unique case of a patient who experienced pleural effusion caused by extravasation of irrigation fluid during arthroscopic shoulder surgery, and this surgery was done under general anesthesia.
Anesthesia, General ; Arthroscopy ; Humans ; Pleural Effusion ; Shoulder

Isolated extramedullary relapse of acute lymphoblastic leukemia (ALL) with sparing of the marrow after allogeneic stem cell transplantation is not common. We report a 32-year-old female patient with isolated ovarian relapse of T-cell ALL 18 months after allogeneic stem cell transplantation. She had no evidence of concomitant relapse in the bone marrow.
Adult ; Bone Marrow* ; Female ; Hematopoietic Stem Cell Transplantation* ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Stem Cell Transplantation ; T-Lymphocytes

BACKGROUND: Chimerism analysis used to be one of the most valuable methods for monitoring patients after allogeneic hematopoietic stem cell transplantation (SCT). The relationship between the mixed chimerism status and the risk of relapse has been controversial. We analysed the clinical significance of mixed chimerism for the prediction of relapse after SCT. METHODS: Between October 2000 and January 2002, 16 patients with haematologic malignancies treated with SCT were included in this study. The median follow-up periods were 11.5 months (range 5-32 months) after SCT. For chimerism analysis, STR (D13S317, D5S818, D7S820) and VNTR (D1S80, D17S30) loci were amplified by PCR. Patients who exhibited complete donor hematopoiesis at all times during the follow-up period were defined as CCG (complete chimerism group) and those who showed mixed chimerism at least once at any time were definded as the MCG (mixed chimerism group). Relapse was considered based on clinical, hematologic and cytogenetic findings. RESULTS: MCG was 63% (10/16). Relapse was observed in 80% (8/10) of MCG and none of CCG (P>0.05). Among 8 relapsed patients, two patients showed MC 1 month prior to relapse and 4 patients changed to MC from CC at relapse status. The remaining 1 patient continued to show CC. CONCLUSIONS: Mixed chimerism seems to be associated with a high risk of relapse. For early detection of relapse, chimerism analysis may need to be performed at shorter time intervals than once a month.
Chimerism* ; Cytogenetics ; Follow-Up Studies ; Hematopoiesis ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Polymerase Chain Reaction ; Recurrence ; Tissue Donors

Background: Non-HLA antibodies, anti-angiotensin II type 1 receptor antibodies (anti-AT1R) and anti-endothelial cell antibodies (AECA), are known to play a role in allograft rejection. We evaluated the role of both antibodies in predicting post-transplant outcomes in low-risk living donor kidney transplantation (LDKT) recipients. Methods: In 94 consecutive LDKT recipients who were ABO compatible and negative for pre-transplant HLA donor-specific antibodies, we determined the levels of anti-AT1Rs using an enzyme-linked immunosorbent assay and the presence of AECAs using a flow cytometric endothelial cell crossmatch (ECXM) assay with pre-transplant sera. Hazard ratio (HR) was calculated to predict post-transplant outcomes. Results: Pre-transplant anti-AT1Rs (≥11.5 U/mL) and AECAs were observed in 36 (38.3%) and 22 recipients (23.4%), respectively; 11 recipients had both. Pre-transplant anti-AT1Rs were a significant risk factor for the development of acute rejection (AR) (HR 2.09; P=0.018), while a positive AECA status was associated with AR or microvascular inflammation only (HR 2.47; P=0.004) throughout the follow-up period. In particular, AECA (+) recipients with ≥11.5 U/mL anti-AT1Rs exhibited a significant effect on creatinine and estimated glomerular filtration rate (P<0.001; P=0.028), although the risk of AR was not significant. Conclusions Pre-transplant anti-AT1Rs and AECAs have independent negative effects on post-transplant outcomes in low-risk LDKT recipients. Assessment of both antibodies would be helpful in stratifying the pre-transplant immunological risk, even in low-risk LDKT recipients.

It is known that antithrombin III is a potent vasodilator and plasmin is a vasoconstrictor, and some patients with a subarachnoid hemorrhage(SAH) develop clinical vasospasm and some patients do not. Under the hypothesis that the development of clinical vasospasm might depend on the difference of the blood level of antithrombin III in each patient with SAH and that the plasmin might have a role in the development of clinical vasospasm, we repeatedly checked the levels of blood antithombin III with a single radial immunodiffusion method and CSF fibrinogen degradation products(FDP : indirect indicator of plasmin activity) with a latex-test(Thrombo-Wellcotest(R)) during the period between 1-4, 5-11 and 12-24 days after a SAH in 29 patients. 10 patients with diseases except those with a SAH were selected as a control group. First, we analyzed the difference of the average of blood antithrombin III and CSF FDP between aneurysmal SAH patients and control patients and then, between patients with clinical vasospasm(8 cases) and patients without clinical vasospasm(21 cases). Secondly, we also analyzed the difference of these data between patients with clinical vasospasm and patients without clinical vasospasm according to the sampling day after a SAH. As a result, there was no statistical difference between the average blood level of antithrombin III in control and in SAH patients(29.06+/-3.04 vs. 25.61+/-6.95, respectively), and in patients with clinical vasospasm and in patients without clinical vasospasm(26.59+/-7.65 vs. 23.67+/-7.40, respectively). The average CSF levels of FDP is higher in SAH patients than in control patients(18.16+/-14.36 vs. 1.00+/-3.16, respectively : p<0.01). It is also higher in patients with clinical vasospasm than in patients without clinical vasospasm. However, there is no statistical significance(28.75+/-9.91 vs. 21.75+/-12.07, respectively : p>0.05). In the analysis of the average CSF levels of the FDP according to the sampling day after a SAH, even though the average levels is higher in patients with clinical vasospasm than in patients without clinical vasospasm(1-4 days : 31.43+/-14.64 vs. 27.33+/-16.24, 5-11 days : 23.75+/-17.68 vs. 18.10+/-16.32, 12-24 days : 32.50+/-13.89 vs. 18.82+/-16.54, respectively), a statistical significant difference was noticed only in levels which were checked between 12 and 24 days after a SAH(p<0.05). This study concludes that the blood level of antithrombin III shows no difference between the control and SAH patients, and patients with clinical vasospasm and patients without clinical vasospasm. Although it suggests a causal relationship between the FDP itself or plasmin in CSF and the development of clinical vasospasm, it does not justify any valid conclusion.
Aneurysm* ; Antithrombin III* ; Cerebrospinal Fluid* ; Fibrinogen ; Fibrinolysin ; Humans ; Immunodiffusion ; Subarachnoid Hemorrhage* ; Vasospasm, Intracranial

No abstract available.
Genes, ras* ; Humans

PURPOSE: Effective management of pediatric hand burn is a considerable challenge for clinicians. Traditional dressings may result in significant pain, wound dryness, weak adhesive strength, and increase necessity for dressing change. Versiva(R)XC is combined dressing materials of hydrocolloid, hydrofiber, a polyurethane foam. Authors have used Versiva(R)XC in treatment of pediatric hand burns, and we experienced that maintenance of dressing is comfortable and decrease patient's discomfort. METHODS: Study enrolled 9 patients of mean age 3.6 years with second degree pediatric hand burn, Versiva(R)XC dressing initially applied after bullae aspiration and saline gauze dressing. After admission, we daily changed the dressing in first two or three days and had an interval of two or three days depending on the degree of exudate from the wound. RESULTS: The mean day of application was 6.3 days. None of patients required surgery and healed with no other complication of scar contracture and hypertrophic scar formation. CONCLUSION: The dressing with Versiva(R)XC was effective method because of decreased pain, easy dressing change, more comfort, and decreased hospital day.
Adhesives ; Bandages ; Blister ; Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Colloids ; Contracture ; Exudates and Transudates ; Hand ; Humans ; Polyurethanes