Pyriform sinus fistula (PSF) is a persistent embryologic third or fourth pharyngeal pouch, which typically presents as a congenital sinus tract that originates from the pyriform sinus. PSF is among the most uncommon congenital malformation of the neck. The usual clinical manifestations are either acute thyroiditis or abscess, usually on the left side of the neck. We report a case of PSF in a 9-year old female with a left cervical abscess who had been diagnosed by barium esophagogram and treated endoscopically by injection of histoacryl.
Abscess ; Barium ; Child ; Enbucrilate* ; Female ; Fistula* ; Humans ; Neck ; Pyriform Sinus* ; Thyroid Gland ; Thyroiditis

A casts of Barrett's esophagus complicated with stricture is reported. A 82 years old male was undergone distal esophagectomy and esophagogastrostomy on suspicion of malignancy. The microscopic examination of specimen taken from the lesion revealed the "tall columnar cells" which were indicative of Barrett's esophagus, hence the diagnosis. Barrett's esophagus is a rare disease in Korea. Because of the malignant potential of the disease, surgery involving esophagectomy is often required.
Aged, 80 and over ; Barrett Esophagus* ; Constriction, Pathologic ; Diagnosis ; Esophageal Stenosis* ; Esophagectomy ; Humans ; Korea ; Male ; Rare Diseases

OBJECTIVES: Idiopathic REM sleep behavior disorder (RBD) is by far the strongest clinical predictor of neurodegenerative disease available. Several potential early diagnostic markers of neurodegenerative disease including autonomic symptoms have been proposed, but they have generally not been tested in presymptomatic neurodegenerative disease. So the authors investigated autonomic symptoms and their associated factors in idiopathic RBD patients. METHODS: 52 idiopathic RBD patients and 52 controls participated in the study. Autonomic symptoms were evaluated by applying the unified multiple system atrophy rating scale (UMSARS) and measuring orthostatic systolic blood pressure drop. RESULTS: Idiopathic RBD patients showed significantly higher UMSARS subscale scores and sharper drop of orthostatic systolic blood pressure than controls. In multiple linear regression analysis, all autonomic symptoms and measured orthostatic systolic blood pressure drop were associated with RBD. In addition, orthostatic symptoms were associated with medication and age, urinary function was associated with benign prostatic hyperplasia, and measured orthostatic systolic blood pressure drop was associated with hypertension. CONCLUSION: In this study, idiopathic RBD patients showed more autonomic symptoms than controls. However, other autonomic symptoms-related factors also influenced some autonomic symptoms. Prospective studies should be performed to evaluate autonomic symptoms as a potential predictor of neurodegenerative diseases.
Aged* ; Blood Pressure ; Humans ; Hypertension ; Linear Models ; Multiple System Atrophy ; Neurodegenerative Diseases ; Prostatic Hyperplasia ; REM Sleep Behavior Disorder* ; Sleep, REM*

OBJECTIVE: To find out the optimal conditions of human chromosomal analysis protocol in peripheral blood sample. METHODS: The experiments were made with the variations of phytohaemagglutinin, colcemid, ethidium bromide concentration and the variations of hypotonic solution exposure time. RESULTS: In the experiment on the optimal phytohaemagglutinin concentration, the highest mitotic index in the overall collected cells was obtained in phytohaemagglutinin concentration 15microL/ml. In the experiment on the concentration of mitotic arrestant colcemid, the proper chromosomal state that is meta phase stage and doesn't have many chromosomal crossings or tangles was obtained in colcemid concentration 0.05microg/ml. In the experiment on the optimal exposure time of hypotonic solution(0.075M KCl) treatment, the most suitable intervals between chromosomes were subtained in 20 minutes. In the experiment on the optimal concentration of ethidium bromide to obtain minute chromosomal bands, the best result was when ethidium bromide concentration 5microg/ml or 7.5microg/ml was addition to colcemid concentration 0.02microg/ml. CONCLUSION: The combination of phytohaemagglutinin 15microL/ml, colcemid 0.05microg/ml, hypotonic solution exposure time for 20 minutes is important to the collection of appropriate chromosome state in human chromosomal analysis using peripheral blood. In the case that needs to obtain minute bands, the elongated chromosomes are obtained when ethidium bromide 5microg/ml or 7.5microg/ml in addition to colcemid concentration 0.02microg/ml with the same conditions of phytohaemagglutinin and hypotonic solution.
Demecolcine ; Ethidium ; Humans ; Mitotic Index

PURPOSE: To evaluate functional MR imaging of the motor speech area with and without motor stimulation duringthe rest period. MATERIALS AND METHODS: Nine healthy, right-handed volunteers(M:F=7:2, age:21-40years) wereincluded in this study. Brain activity was mapped using a multislice, gradient echo single shot EPI on a 1.5T MRscanner. The paradigm consisted on a series of alternating rest and activation tasks, performed six times. Each volunteer in the first study(group A) was given examples of motor stimulation during the rest period, while eachin the second study(group B) was not given examples of a rest period. Motor stimulation in group A was achieved bycontinuously flexing five fingers of the right hand. In both groups, maximum internal word generation was achievedduring the activation period. Using fMRI analysis software(Stimulate 5.0) and a cross-correlationmethod(background threshold, 200; correlation threshold, 0.3; ceiling, 1.0; floor, 0.3; minimal count, 3),functional images were analysed. After correlating the activated foci and a time-signal intensity curve, theactivated brain cortex and number of pixels were analysed and compared between the two tasks. The t-test was usedfor statistical analysis. RESULT: In all nine subjects in group A and B, activation was observed in and adjacentto the left Broca's area. The mean number of activated pixels was 31.6 in group A and 27.8 in group B, adifference which was not statistically significant(P>0.1). Activities in and adjacent to the right Broca 's areawere seen in seven of group A and four of group B. The mean number of activated pixels was 14.9 in group A and 18in group B. Eight of nine volunteers in group A showed activity in the left primary motor area with negativecorrelation to the time-signal intensity curve. The mean number of activated pixels for this group was 17.5. Inthree volonteers, activation in the right primary motor area was also observed, the mean number of activatedpixels in these cases was 10.0. CONCLUSION: During the rest period, functional MR imaging of the motor speechcenter combined with motor stimulation was more effective than that without stimulation, and simultaneouslyprovided mapping of the primary motor area.
Brain ; Fingers ; Hand ; Magnetic Resonance Imaging* ; Volunteers

Although dysphagia in patients with acute leukemia is usually related to reflux esophagitis, infectious esophagitis, chemotherapy1) and leukemic infiltration2), acute esophageal stricture resulting from chemotherapy in the patient with leukemia is very rare. A 40-year-old man with acute myelogenous leukemia was admitted for operation of esophageal stricture which was developed within 1 month of chemotherapy. An esophagectomy and esophagogastrostomy with pyloroplasty was carried out. Histology showed mucosal infiltration of mononuclear cells and transmural fibrosis involving submucosa and the muscle layer.
Adult ; Deglutition Disorders ; Drug Therapy ; Esophageal Stenosis* ; Esophagectomy ; Esophagitis ; Esophagitis, Peptic ; Fibrosis ; Humans ; Induction Chemotherapy* ; Leukemia ; Leukemia, Myeloid, Acute

No abstract available.
Female ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy Trimester, Second*

Ki-1 positive anaplastic large cell lymphoma is a newly described high-grade lymphoma and is defined by histopathological and immunologic criteria. We experienced a case of systemically involving Ki-1 positive anaplastic large cell lymphoma in a 44 year- old female which initially manifested as pleural effusion. Abdominopelvic CT scan showed the evidence of marked lymphadenopathy in retroperitoneal and both external and inguinal lymph nodes. On cytologic examination of pleural fluid, tumor cells revealed pleomorphic large isolated cells with prominent nucleoli and abundant cytoplasms. The nuclei were large with irregular profiles including some deep invaginations. Also, occasional multilobed/ multinucleated and binucleated nuclei were seen. Immunohistochemical examination was performed to differentiate from the undifferentiated adenocarcinoma, Hodgkin's disease, non-Hodgkin's lymphoma and malignant histiocytosis. The neoplastic cells were positive for leukocyte common antigen, CD3, CD30(Ki-1) but negative for cytokeratin, epithelial membrane antigen, and CD15. A histologic diagnosis of Ki-1 positive anaplastic lymphoma was made by biopsies of the inguinal lymph node, polypoid lesions of the stomach and cecum.
Adenocarcinoma ; Amyloid ; Antigens, CD45 ; Biopsy ; Cecum ; Child* ; Cytoplasm ; Diagnosis ; Female ; Histiocytic Sarcoma ; Hodgkin Disease ; Humans ; Keratins ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Mucin-1 ; Multiple Myeloma ; Pleural Effusion ; Stomach ; Tomography, X-Ray Computed

Castleman's disease is a relatively rate disorder of lymphoid tissue and poorly understood etiology. The disease may occur anywhere along the lymphatic chain, but is most commonly found as a solitary mass in the mediastinum. The hyaline vascular type represents 91% of Castlemen's disease, and these are most often discovered in the asymptomatic patient on routine chest film. Patients with the plasma cell type often exhibit systemic symptoms, including fever, night sweats, anemia, and hypergammaglobulinemia. Surgical excision effects cure, although resection of the hyaline vascular type may be associated with significant hemprrage owing to extreme vascularity. We recently experienced a case of hyaline vascular type Castleman's disease which was treated by surgical resection through the anterior mini-thoracotomy, and report with its review.
Anemia ; Fever ; Giant Lymph Node Hyperplasia ; Humans ; Hyalin ; Hypergammaglobulinemia ; Lymphoid Tissue ; Mediastinal Neoplasms ; Mediastinum* ; Plasma Cells ; Sweat ; Thorax

The CT findings of pulmonary paragonimiasis are well known. However, the pathologic findings of nodular opacity have not been studied sufficiently. To clarify the nature of nodular opacity on CT in patient with paragominiasis, we reviewed CT scans of 9 patients retrospectively. Five of them were compared with pathologic findings of the resected specimen. Other four patients were confirmed by needle aspiration biopsy. CT scans showed nodular opacities of 5 to 30mm in diameter which were accompanied with perinodular air-space consolidations in all patients. The usual location of nodular opacities were peripheral zone of the lung. Correlation with pathologic findings demonstrated That the nodular opacity on CT scans corresponded to the parasitic granuloma with central ova and intracystic worm. The most frequent CT finding of pulmonary paragonimiasis was nodular opacities with perinodular airspace consolidations caused by parasitic granuloma or intracystic worm.
Biopsy, Needle ; Granuloma ; Humans ; Lung ; Needles ; Ovum ; Paragonimiasis ; Retrospective Studies ; Tomography, X-Ray Computed