Spindle cell hemangioendothelioma was first described in 1986 by Weiss and Enzinger as a low grade angiosarcoma resr mbling a cavernous hemangioma and kaposis sarcoma. Recently, it is suggested to be non neoplastic lesion or reactive process arising from pre-existing vascular mal- formation. We report a case of spindle cell hemangioendothelioma in a 9-month-old boy. He had multiple, variable sized, colorful, cutaneous or subcutaneous nodules on the forearm and hand. The tumor first appeared on the forearm as erythematous patches at birth and grew rapidly with- in 3 months. Histopatholgical findings showed that the lesion was composed of thin walled cavernous spaces mixed with spindle cells and occasional epithelioid endothelial cells containing intracytoplasmic vacuole. Most af the endothelial cells lining the cavernous spaces and intracytoplasmic lumina, were positive for factor VIII associated antigen. But the spindle cells were negative. Atypical vascular structures resembling arteriovenous shunts were noted around the tumor suggesting a reactive proliferation due to disturbance of local blood flow. Several turnors were excised. No recurrence has been recognized in the one year- follow-up period.
Endothelial Cells ; Factor VIII ; Follow-Up Studies ; Forearm ; Hand ; Hemangioendothelioma* ; Hemangioma, Cavernous ; Hemangiosarcoma ; Humans ; Infant ; Male ; Parturition ; Recurrence ; Sarcoma, Kaposi ; Vacuoles

BACKGROUND: The bcl-2 is an oncogene involved in tumorigenesis by blocking apoptosis, or programmed cell death and over-expression of bcl-2 protein has been reported in several malignant tumors such as lung cancer, basal cell carcinoma, breast cancer and malignant melanoma. However, there have been only a few studies about bcl-2 expression of cutaneous T cell lymphoma. OBJECTIVE: The purpose of this study was to examine whether there is any difference in expression of bcl-2 between mycosis fungoides(MF), angiocentric T cell lymphoma, angioimmunoblastic T cell lymphoma, subcutaneous T cell lymphoma and anaplastic large cell lymphoma. We also evaluated the statistical significance between expression of bcl-2 and the prognosis of the diseases. METHODS: Routine paraffin sections of formalin-fixed 36 tissues (14 MF, 7 angiocentric T cell lymphoma, 5 subcutaneous panniculitic T cell lymphoma, 2 anaplastic large cell lymphoma, 1 angioimmunoblastic T cell lymphoma, 1 unspecified peripheral T cell lymphoma, 2 small plaque parapsoriasis, 2 psoriasis and 2 lichen planus) were labelled with anti-bcl-2 monoclonal antibody using an avidin- biotin-peroxidase complex. Normal skin for bcl-2 served as negative controls. RESULTS: The results were as follows. l. All cases of benign inflammatory diseases, small plaque parapsoriasis and patch stages of MF showed positive staining for bcl-2. Therefore, there were no differences in expression of bcl-2 among these diseases. 2. In the plaque and tumor stages of mycosis fungoides, statistically significancant differences in bcl-2 expression were not found during disease progression. 3. bcl-2 expression in peripheral T cell lymphoma (five in seven cases of angiocentric T cell lymphoma showed positive staining but all other peripheral T cell lymphoma was negative) decreased significantly (p<0.05) than that of MF. 4. No statistical significance was found between bcl-2 expression and prognosis of cutaneous lymphoma (p>0.05). CONCLUSION: These results suggest that the loss of bcl-2 expression may play a significant role in progression of cutaneous T cell lymphoma except in MF and angiocentric T cell lymphoma.
Apoptosis ; Breast Neoplasms ; Carcinogenesis ; Carcinoma, Basal Cell ; Cell Death ; Disease Progression ; Lichens ; Lung Neoplasms ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous* ; Lymphoma, T-Cell, Peripheral ; Melanoma ; Mycosis Fungoides ; Oncogenes ; Paraffin ; Parapsoriasis ; Prognosis ; Psoriasis ; Skin

Clinical characteristics of papular-purpuric gloves and socks syndrome consist of a purpuric erythema affecting the hands and feet in a gloves and stocking distribution. It is sometimes associated with fever and oral lesions. The disease is self-limiting and resolves within 1 to 2 weeks. Serological studies have shown that there is an association with parvovirus B19 infection in most patients affected by this syndrome. We report a case of gloves and socks syndrome in a 21-year-old female. She had a 4-day history of papular-purpuric eruptions of the hands and feet in a gloves-and-socks distribution. She also complained of fever(up to 39C) during the first 2 or 3 days of clinical onset. The oral mucosa was normal and there were no palpable lymph nodes. Laboratory and histopathological findings were non-specific. However, human parvovirus B19 DNA was detected in the serum by a polymerase chain reaction. Systemic manifestations were transient and disappeared within a few days, whereas the skin lesions resolved gradually over a period of 2 weeks.
DNA ; Erythema ; Female ; Fever ; Foot ; Hand ; Humans ; Lymph Nodes ; Mouth Mucosa ; Parvovirus ; Parvovirus B19, Human ; Polymerase Chain Reaction ; Skin ; Young Adult

Spindle cell lipoma was first described in 1975 by Enzinger and Harvey as a variant of lipomas. Histopathological findings show the lipomatous tissue to be replaced by a mixture of uniform spindle cells and mature fat cells closely associated with a mucoid matrix and a varying number of collagen fibers. Immunohistochemical staining is reported to give assistance in the differential diagnosis af spindle cell lipoma from other fibrous or neural tumors. Also, it can be used to investigate the origin of the spindle cells. We report a case of spindle cell lipoma in a 41-year-old female. She had a solitary, normal skin colored, bean sized, subcutaneous mass on the forearm. Most of the spindle cells were strongly positive for vimentin, CD34 and NSE, but negative for actin, factor VIII, S-100 protein and neuro- filaments. The tumor was excised. No recurrence was recognized in a 10 month follow up period.
Actins ; Adipocytes ; Adult ; Collagen ; Diagnosis, Differential ; Factor VIII ; Female ; Follow-Up Studies ; Forearm ; Humans ; Lipoma* ; Recurrence ; S100 Proteins ; Skin ; Vimentin

PURPOSE: Persistent pulmonary hypertension (PPHN) is considered an important prognostic factor in meconium aspiration syndrome (MAS). The aim of this study was to determine the comorbid risk factors for PPHN in infants with MAS. METHODS: We retrospectively analyzed 60 infants diagnosed with MAS and admitted to the neonatal intensive care unit of the Sanggye Paik Hospital from January 2007 to April 2013. There were 28 infants (47%) with PPHN and 32 infants (53%) without PPHN. Clinical characteristics, laboratory findings within 24 hours after birth, and initial capillary blood gas analysis results were compared between infants with and without PPHN. RESULTS: Incidence of PPHN was associated with the severity of MAS (P<0.001). The PPHN group had a greater incidence of hypotension and hypoxic-ischemic encephalopathy within 24 hours of birth compared to the non-PPHN group. The PPHN group also had a lower initial pH. However, there was no significant difference for laboratory findings within 24 hours of birth and initial capillary blood gas analysis. In the multivariate analysis, hypotension within 24 hours of birth (P=0.046, odds ratio 11.494, 95% confidence interval 1.048-125.00) was found to be a significant comorbid factor for PPHN in infants with MAS. CONCLUSION: Infants with MAS who develop hypotension within 24 hours of birth should be closely monitored for development of PPHN.
Blood Gas Analysis ; Capillaries ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary* ; Hypotension ; Hypoxia-Ischemia, Brain ; Incidence ; Infant* ; Infant, Newborn* ; Intensive Care, Neonatal ; Meconium Aspiration Syndrome* ; Multivariate Analysis ; Odds Ratio ; Parturition ; Retrospective Studies ; Risk Factors*

BACKGROUND: Although a brachial plexus block can be used to provide anesthesia and analgesia for upper extremity surgery, its effects using MgSO4 on postoperative pain management have not been reported. The aim of this study was to evaluate brachial plexus block using MgSO4 on postoperative analgesia. METHODS: Thirty-eight patients who were scheduled to undergo upper extremity surgery were randomly allocated into two groups: patients receiving axillary brachial plexus block with 0.2% ropivacaine 20 ml and normal saline 2 ml (group S) or 0.2% ropivacaine 20 ml and MgSO4 200 mg (group M). Before extubation, the blocks were done and patient controlled analgesia was started, and then, the patients were transported to a postanesthetic care unit. The postoperative visual analogue scale (VAS), opioid consumption, and side effects were recorded. RESULTS: The two groups were similar regarding the demographic variables and the duration of the surgery. No differences in VAS scores were observed between the two groups. There was no statistically significant difference in opioid consumption between the two groups. Nausea was observed in three patients for each group. CONCLUSIONS: Axillary brachial plexus block using MgSO4 did not reduce the level of postoperative pain and opioid consumption.
Amides ; Analgesia ; Analgesia, Patient-Controlled ; Anesthesia and Analgesia ; Brachial Plexus ; Humans ; Magnesium Sulfate ; Nausea ; Pain, Postoperative ; Upper Extremity

Changes in microparticles (MP) from red blood cell (RBC) concentrates in the context of irradiation have not been investigated. The aim of this study was to evaluate how irradiation affects the number of MPs within transfusion components. Twenty RBC concentrates, within 14 days after donation, were exposed to gamma rays (dose rate: 25 cGy) from a cesium-137 irradiator. Flow cytometry was used to determine the numbers of MPs derived from RBC concentrates before and 24 hr after irradiation. The mean number of MPs (±standard deviation) in RBC concentrates was 21.9×10(9)/L (±22.7×10(9)/L), and the total number of MPs ranged from 2.6×10(9)/L to 96.9×10(9)/L. The mean number of MPs increased to 22.6×10(9)/L (±31.6×10(9)/L) after irradiation. Before irradiation, the CD41-positive and CD235a-positive MPs constituted 9.5% (1.0×10(9)/L) and 2.2% (263×10(6)/L) of total MPs, respectively. After irradiation, CD41-positive MPs increased to 12.1% (1.5×10(9)/L) (P=0.014), but the CD235a-positive MPs decreased to 2.0% (214×10(6)/L) of the total MPs (P=0.369). Irradiation increases the number of CD41-positive MPs within RBC concentrates, suggesting the irradiation of RBC concentrates could be associated with thrombotic risk of circulating blood through the numerical change.
Cell-Derived Microparticles/chemistry/*metabolism/radiation effects ; Erythrocytes/*cytology/radiation effects ; Flow Cytometry ; Gamma Rays ; Humans ; Membrane Glycoproteins/metabolism ; Metalloendopeptidases/metabolism ; Platelet Membrane Glycoprotein IIb/metabolism

Incidences of blowout fractures have increased due to rapid industrialization and rise in violent crimes. However, there have been few studies on the proper follow-up guidelines or protocol after reduction of the orbital wall for patients working in a high atmospheric pressure environment. We have experienced a pilot with an orbital medial wall fracture who underwent reduction through an endoscopic approach. The patient underwent the Valsalva maneuver and scan of paranasal sinuses 8 weeks after reduction. Emphysema did not occur in the orbit even after the Valsalva maneuver and he was able to return to his workplace without any complications. We report this case with a brief review of the literature.
Atmospheric Pressure ; Crime ; Emphysema ; Follow-Up Studies ; Humans ; Incidence ; Orbit ; Paranasal Sinuses ; Valsalva Maneuver ; Industrial Development

Paranasal sinus mucocele is a slowly expanding benign lesion which can occur as a result of obstruction in the sinus ostium or ostial tract. Frontal sinus mucocele differ from mucoceles of other sinuses in that the frontal outflow tract is usually narrower and less accessible. Since the introduction of endoscopic sinus surgical instrument and techniques, there has been an increasing trend towards the use of endoscopic transnasal technique for managing the paranasal sinus mucoceles. Some studies also recommend the use of intrafrontal stent to reduce the rate of restenosis of frontal sinus outflow tract. We experienced a case of recurrent frontal sinus mucocele complicated by visual disturbance and periorbital swelling. To treat this condition, an intranasal marsupialization was performed and an intrafrontal stent was applied. This paper reports the particulars of this case with a review of related literature.
Frontal Sinus* ; Mucocele* ; Stents* ; Surgical Instruments

BACKGROUND: The aims of our study were to determine the correlation of the strain variation and degree of homogeneity of infecting Helicobacter pylori (H. pylori) with their disease outcomes, and the relevance of duodenal H. pylori expression of cagA and/or vacA gene to the development of duodenal ulcer in Korean patients. METHODS: One hundred and twenty bacterial colonies isolated from different anatomical sites of the stomach and duodenum were used. The study population was consisted of 40 Korean patients, 21 with duodenal ulcer, 7 with gastric ulcer, 3 with combined gastric and duodenal ulcer, and 9 with chronic gastritis. Genomic characteristics of each strain were analyzed by random amplified polymorphic DNA (RAPD) fingerprinting. The cagA and vacA genes were detected by polymerase chain reaction (PCR). RESULTS: PCR-based RAPD was proved to be a reliable method for the discrimination of individual bacterial genomic characteristics. Genomic fingerprinting showed a varying degree of inter- and intra-patient variation. Thirteen patients (32.5%) were colonized by a single strain throughout the corpus, antrum and duodenum, whereas the other 27 (67.5%) harbored multiple H. pylori strains. Thirty-six isolates (90.0%) each from the corpus and antrum, and 34 (85.0%) from the duodenum, expressed the cagA gene. The prevalence of duodenal H. pylori expression of the cagA gene was not different between patients with chronic gastritis and those with duodenal ulcer. All isolates were positive for both genes vacA s1 and vacA s1a. CONCLUSION: These results suggested that many of the H. pylori-infected Korean patients were actually colonized with mixed populations of different H. pylori strains and that the prevalence of duodenal H. pylori expression of the cagA and/or vacA gene was not correlated with the development of duodenal ulcer in Korean patients.
Adolescent ; Adult ; Aged ; Antigens, Bacterial/*analysis/genetics ; Bacterial Proteins/*analysis/genetics ; DNA, Bacterial/*analysis ; Female ; Genome, Bacterial ; Helicobacter Infections/epidemiology/*microbiology ; Helicobacter pylori/*genetics/isolation & purification ; Human ; Korea/epidemiology ; Male ; Middle Aged ; Peptic Ulcer/*microbiology ; Prevalence ; Random Amplified Polymorphic DNA Technique ; Support, Non-U.S. Gov't