Plasma col1 leukemia with motility-related morphological behavior is rarely studied. The plasma cells have variable degrees of cytoplasmic morphologies as dairy Projections, long extensions and pseudopods. These morphological evidences show the papa bility of wide spread and dissemination of disease itself. We present a case of a 38 year old woman who had back pain for 4 months and was diagnosed as a solitary plasmacytoma of the third lumbar vertebra. In spite of resection of the tumor and chemotherapy, the plasmacytoma was disseminated into both breasts and ovaries within less than a year. On her blood examination, we counted 34% of plasma cells in peripheral blood and 91.6% of plasma cells in bone marrow aspiration. Most of them resealed hairy projections and pseudopods of the cytoplasm.
Adult ; Back Pain ; Bone Marrow ; Breast ; Cytoplasm ; Drug Therapy ; Female ; Humans ; Leukemia ; Leukemia, Plasma Cell* ; Ovary ; Plasma Cells* ; Plasma* ; Plasmacytoma ; Spine

PURPOSE: The purpose of this study is to evaluate the normal anatomy of the lymphatic system draining the biliary trees and the prevalence of variable lymphatic spread of primary biliary carcinoma into these extrahepatic planes. MATERIALS AND METHODS: We reviewed 46 pathologically confirmed among 116 cases underwent abdominal CT. RESULTS: Of 17 patients with gallbladder cancer, nodal metastsis was proved in 10(59%) cases, direct organ invasion in 3(18%) cases, and peritoneal spread in 2(12%) cases. After a radicaloperation, nodal invasion was developed in 4 patients and peritoneal spread in 5 patients. Of 11 patients with hilar cholangiocarcinoma, nodal metastasis was proved in 6(55%) patients. Four patients developed paritoneal dissemination later. Of 18 patients with extrahepatic cholangiocarcinoma, however, nodal metastasis was proved in only 6(33%), but 5 among 12 patients who took a radical operation showed recurrence. CONCLUSION: The lymph node of the foramen of Winslow and pancreaticoduodenal lymph node were prevalent sites in the nodal metastasis of biliary carcinoma and CT was helpful in the indentification of this lymphadenopathy and extrabiliary spread on both initial and follow-up studies.
Cholangiocarcinoma ; Follow-Up Studies ; Gallbladder Neoplasms ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphatic System ; Neoplasm Metastasis* ; Prevalence ; Recurrence ; Tomography, X-Ray Computed

No abstract available.
Cervix Uteri* ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Follicular Fluid* ; Humans* ; Spermatozoa* ; Spouses*

False aneurysms (Pseudoaneurysms) and arteriovenous fistulas have only rarely been reported in the facial region. In this region the false aneurysm arises most frequently in the superficial temporal and facial artery, but other branches of the external carotid are sometimes involved, including the maxillary and lingual artery. False aneurysms can be occurred by blunt trauma that either laceration or rupture the full thickness of the arterial wall. The diagnosis of a false arterial aneurysm can be often made solely on the basis of physical examination. Angiography is helpful for conformation, for delineating the lesion and its vascular supply, and for ruling out the presence of associated vascular lesions such as arteriovenous fistulas. Ultrasonography may also be useful in delineating lesions that are not easily accessible for physical examination. Treatment of false aneurysms is excision, ligation, and arterial embolization. This is a case of false aneurysm of the lingual artery after facial trauma caused by traffic accident. The lesion was successfully treated by embolization and ligation of the lingual and facial branches of the external carotid artery.
Accidents, Traffic ; Aneurysm ; Aneurysm, False* ; Angiography ; Arteries* ; Arteriovenous Fistula ; Carotid Artery, External ; Diagnosis ; Lacerations ; Ligation ; Physical Examination ; Rupture ; Ultrasonography

The authors retrospectively reviewed the efficacy of percutaneous catheter drainage in treatment of abdominal abscess associated with fistulas. One hundred sixty four consecutive patients with abdominal abscesses drained percutaneously since 1985 at department of Radiology, Wonkwang University Hospital were studied. Among these, 13 patients were found to have fistulous communications to the biliary duct, the intestinal tract, or the renal calyx. Eleven patients (85%) were successfully treated without surgical intervention while two patients (15%) needed surgical drainage and fistulectomy. The duration of drainage ranged from 7 days to 9 months. Initial drainage of abdominal abscess was performed in the hospital, but 5 of 13 patients were discharged with a tube in place and were followed up as outpatients. In conclusion, percutaneous catheter drainage is an effective and safe means of treating abdominal abscesses with fistulas.
Abdominal Abscess* ; Catheters* ; Drainage* ; Fistula* ; Humans ; Outpatients ; Retrospective Studies

BACKGROUND: T lymphocytes that bear CD3 but lack CD4 and CD8 (Double negative T cells, DN T cells) are normally present early in ontogeny in the fetal thymus, but constitute only a small proportion of adult thymocytes and peripheral blood. Since DN T TCR alpha beta+ cells have been found to accumulate in the lymphoid organs of lpr and gld mice and to be expanded in patients with autoimmune diseases, their functional properties are now of considerable interest. METHOD: Sixty four rheumatoid arthritis (RA) patients and 24 healthy volunteers were studied from Jan 1997 to Feb 1998. The whole blood from the patients and controls were analyzed by flow cytometry (Elite ESP, Coulter, USA) and XL-II software after the cells were stained with trifluorochrome monoclonal antibodies (anti-CD4-FITC/anti-CD8-PE/anti-CD3-PE-Cy5, anti-CD3-FITC/anti-CD19-PE/anti-CD45-PE-Cy5, anti-CD3-FITC/ CD16+56-PE) (Immunotech, Coulter, USA). We reviewed patient records to find out the inflammatory parameters and Ritchie index. RESULTS: We confirmed the presence of DN T cells in peripheral blood of healthy volunteers and RA patients. DN T cells were lower in RA patients (mean+/-SD; 6.44%+/-4.46), when compared to healthy volunteers (mean+/-SD; 9.97%+/-4.50) (p=0.001). There was no clinical correlations between DN T cells and inflammatory parameters. CONCLUSION: Our study showed that the DN T cells in normal control were about 10% of CD3 positive T cells and the cells were significantly lower in RA patients. Although we did not identify whether these cells have either TCR alpha beta or TCR gamma delta, we could conclude that these cells are not expanded in RA patients. We would like to continue this study further 1) to identify TCR the DN T cells have and 2) to monitor the changes after treatment.
Adult ; Animals ; Antibodies, Monoclonal ; Arthritis, Rheumatoid* ; Autoimmune Diseases ; Flow Cytometry ; Healthy Volunteers ; Humans ; Mice ; Receptors, Antigen, T-Cell, alpha-beta ; Receptors, Antigen, T-Cell, gamma-delta ; T-Lymphocytes* ; Thymocytes ; Thymus Gland

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

Rhabdomyolysis is defined as skeletal muscle injury with release of muscle cell constituents into the plasma and may lead to acute renal failure secondary to myoglobinuria. The most sensitive marker of muscle cell damage is serum creatine kinase concentration. It was first described by Bywaters and Beall in association with crush injuries during the second world war, and since then it has been recognized as the cause of about 5 % of all cases of acute renal failure. But acute renal failure is extremely rare in diabetic patient with hyperosmolarity irrespective of the frequency of rhabdomyolysis. Since osmotic diuresis, which is provoked by a high renal glucose load, prevents the development of acute tubular necrosis; there have been a few case reports connecting diabetic hyperosmolar state with acute renal failure, secondary to rhabdomyolysis. We reported a case with diabetic hyperosmolar nonketotic coma who developed acute renal failure secondary to rhabdomyolysis and myoglobinuria in a 60 year old patient with review of the literatures.
Acute Kidney Injury* ; Coma* ; Creatine Kinase ; Diuresis ; Glucose ; Humans ; Middle Aged ; Muscle Cells ; Muscle, Skeletal ; Myoglobinuria ; Necrosis ; Plasma ; Rhabdomyolysis* ; World War II

Natural killer (NK) cell neoplasms are a group of rare but highly malignant tumors. We report here one case of NK cell leukemia. A 54-yr-old woman presented with a 2-month history of progressive left neck mass. Based on the positive result of tissue PCR for Mycobacterium tuberculosis, she was at first diagnosed with tuberculous lymphadenopathy. After two weeks, she developed generalized lymphadenopathy, hepatosplenomegaly, fever and anemia. Subsequent evaluation was performed including bone marrow aspiration and biopsy. Peripheral blood smear showed leukoerythroblastic features with 31% blasts. Bone marrow was packed with agranular blastoid cells, which were periodic acid-Schiff (PAS) positive and myeloperoxidase (MPO) negative. Immunophenotyping showed that these cells were positive for CD45 and HLA-DR, whereas negative for CD3, CD5, CD7, CD10, CD13, CD14, CD19, CD20, CD22, CD33, CD34, and CD61. Because of the absence of the markers of T-cell, B-cell, and myeloid lineage-specific antigens, we added CD16/56 for the immunophenotyping and the blasts were positive (94%). The tumor cells of biopsied lymph node were only positive for CD56, consistent with NK cell lymphoma. Epstein-Barr virus (EBV) was not detected by RNA in situ hybridization. Culture for M. tuberculosis was negative. Thus this patient was diagnosed with blastic NK cell lymphoma/leukemia involving bone marrow and lymph node.
Antigens, CD45/metabolism ; Bone Marrow/pathology ; Female ; HLA-DR Antigens/metabolism ; Humans ; Killer Cells, Natural/immunology/*pathology ; Leukemia/*diagnosis/immunology/pathology ; Middle Aged ; Tuberculosis, Lymph Node/diagnosis

OBJECTIVE: Peripheral blood mononuclear cells (PBMC) in culture release a biologically active human chorionic gonadotropin (hCG). This effect is detectable during pregnancy with a maximum between the 16th and 19th week. HCG plays an important role for the corpus luteum rescue during the early gestational age and possibly for the immunotolerance. This study was performed to investigate the relationships between the productivity of cultured PBMC of pregnant women and the ability to maintain early pregnancy, and whether 12-o-tetradecanoyl-phorbol-13-acetate (TPA) increases hCG sectetion by cultured PBMCs. MATERIALS AND METHODS: PBMC were obtained from 20 pregnant women between 16th to 19th week of gestation , and cultured with TPA. Culture cells were harvested and hCG mRNA were extracted and RT-PCR were performed. Culture supernatants were collected and hCG concentration were determined by commercial RIA methods. RESULTS: The mean age was 31.0 years old, 19 of 20 (95%) pregnant women's PBMC secereted hCG and expressed hCG mRNA, but in control group exept male hepatitis B patient, none of them produced hCG. TPA activated expression of hCG in PBMC in linear manner. CONCLUSION: Pregnant women's cultured PBMC secreted hCG, but not in non-pregnant or male. We could confirm the mRNA of hCG in PBMC as well in the placental control. The productivity of hCG in PBMC might be closely related with maintenance of early pregnancy.
Chorionic Gonadotropin ; Corpus Luteum ; Efficiency ; Female ; Gestational Age ; Hepatitis B ; Humans ; Male ; Pregnancy* ; Pregnant Women ; RNA, Messenger