A 45-year-old man presented with muscle pain, skin nodules and persistent hypereosinophilia over a period of 4 months. Laboratory data excluded the diagnosis of trichinosis or any other parasite infection. The patient's course of the disease over the 9 months was compatible with idiopathic hypereosinophilic syndrome. In a muscle biopsy, eosinophilic and lymphoplasma cells are predominantly infiltrated. Authors report a case of rhabdomyolysis due to eosinophilic polymyositis in idiopathic hypereosinophilic syndrome.
Male ; Humans ; Biopsy

Colorectal cancer is the second most frequent malignant tumor in the United States and fourth most frequent tumor in Korea. Surgery has been used as a primary treatment modality but reported overall survivals after curative resection were from 20% to 50%. Local recurrence is the most common failure in the treatment of locally advanced colorectal cancer. Once recurrence has developed, surgery has rarely the role and the five year survival of locally advanced rectal cancer is less than 5%, this indicated that significant improvement of local conrol could be achieved. We performed 6 cases of IORT for locally advanced colorectal cancer which is he first experience in Korea. Patient's eligibility, treatment applicator, electron energy, dose distribution on the surface and depth within the treatment field and detailed skills are discussed. We hope that our IORT protocol can reduce local failure and increase the long term survival significantly.
Colorectal Neoplasms* ; Hope ; Korea ; Radiotherapy* ; Rectal Neoplasms ; Recurrence ; United States

Purpose: . The purpose of this study was to evaluate the performance efficiency of two different drill combinations according to the heat generated and drilling time. Materials and methods: . In this study, cow ribs were used as research materials. To test the specimen, cow bones were rid of fascia and muscles, and a temperature sensor was mounted around the drilling area. The experimental group was divided into a group using a guide drill and a group using a Lindmann drill according to the drill used before the initial drilling. The drilling sequence of the guide drilling group is as follows; guide drill (ø 2.25), initial drill (ø 2.25), twist drill (ø 2.80), and twist drill (ø 3.20). The drilling sequence of the Lindmann drilling group is as follows; Lindmann drill (ø 2.10), initial drill (ø 2.25), twist drill (ø 2.80), and twist drill (ø 3.20). The temperature was measured after drilling. For statistical analysis, the difference between the groups was analyzed using the Mann-Whitney U test and the Friedman test was used (α = .05). Results: . The average performance efficiency for each specimen of guide drilling group ranged from 0.3861 to 1.1385 mm3/s and that of Lindmann drilling group ranged from 0.1700 to 0.4199 mm3/s. The two drill combinations contained a guide drill and Lindmann drill as their first drills. The combination using the guide drill demonstrated excellent performance efficiency when calculated using the drilling time (P < .001). Conclusion . Since the guide drill group showed better performance efficiency than the Lindmann drill group, the use of the guide drill was more suitable for the primary drilling process.

Non-Hodgkin's lymphoma presented as a malignancy of the uterine cervix is exceedingly rare disease and accounts for approximately only 0.12-0.6% of extranodal lymphomas. There is no consensus on the management and prognosis of the disease because of its extreme rarity. Previously, treatment of this disease has been radiation therapy, surgery or chemotherapy either alone or in combination. We present the case of a 45-year-old woman diagnosed with diffuse, large B-cell non-Hodgkin's lymphoma of the uterine cervix. We administered neoadjuvant chemotherapy according to CHOP protocol (cyclophosphamide, adriamycin, vincristine, and prednisone) followed by hysterectomy and bilateral salpingo-oophorectomy. The patient is alive 20 months after the initial diagnosis. We report the case with a brief review of literature.
B-Lymphocytes ; Cervix Uteri* ; Consensus ; Diagnosis ; Doxorubicin ; Drug Therapy* ; Female ; Humans ; Hysterectomy ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Prognosis ; Rare Diseases ; Vincristine

Epstein-Barr virus (EBV)-associated disease is known to be one of the major complication after transplantation. Early identification and diagnosis is crucial. The objectives of this study are to evaluate the incidence and to analyze the risk factors of EBV-associated disease. Twenty-five children with liver transplantation from Oct. 1994 to Oct. 1997 had been surveyed. Laboratory data of EBV infection such as anti-viral capsid antigen (VCA) IgM and IgG, EBV PCR, EBV encoded small RNA (EBER) in situ hybridization had been obtained at pre op, and post op 1, 2, 3, 4, 12, 24 weeks, then annually or when EBV infection was suspected. We classified these cases as asymptomatic infection, EBV syndrome, posttransplant lymphoproliferative disease (PTLD). And we analyzed the incidence of EBV infection according to age, type of immunosuppression, and CMV disease. Incidence of EBV infection in this study was 48% (12 out of 25), among them, 5 children were symptomatic and PTLD developed in 2 children. The significant risk factors were age at transplantation and CMV infection. One of PTLD cases resulting from EBV infection showed fatal outcome, the other was improved. We suggested that physicians especially in the care of the children after the liver transplantation should recognize the risk factors of the development of the EBV infection to avoid the progression into the potentially fatal PTLD.
Asymptomatic Infections ; Capsid ; Child ; Diagnosis ; Epstein-Barr Virus Infections ; Fatal Outcome ; Herpesvirus 4, Human* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunosuppression ; In Situ Hybridization ; Incidence* ; Liver Transplantation* ; Liver* ; Polymerase Chain Reaction ; Risk Factors ; RNA

A 34-year-old male who has recieved regular hemodialysis three times a week for 2years due to chronic renal failure was admitted due to chest pain. Chest x-ray and computed tomography showed large sized anterior mediastinal mass compressing heart and great vessels posteriorly. Open lung biopsy was performed and the result was spindle cell type thymoma. We recommanded surgical resection but he refused and discharged. After 8 months, we observed marked regression of the thymoma without any other treatment. We report a case of spontaneous regression of thymoma in patient with chronic renal failure during regular hemodialysis.
Adult ; Biopsy ; Chest Pain ; Heart ; Humans ; Kidney Failure, Chronic ; Lung ; Male ; Renal Dialysis* ; Thorax ; Thymoma*

Distal renal tubular acidosis is classified into primary and secondary. Sjogren Syndrome is the most common cause of secondary distal RTA. We experienced a 51 year-old female patient who had many manifestations of primary Sjogren syndrome which showes Distal renal tubular acidosis, acute pancreatitis, acute renal failure, possibly nephrogenic diabetes insipidus, but We found other atypical findings including ANA negative serology, high anion gap metabo1ic acidosis.
Acid-Base Equilibrium ; Acidosis ; Acidosis, Renal Tubular* ; Acute Kidney Injury ; Diabetes Insipidus, Nephrogenic ; Female ; Humans ; Middle Aged ; Pancreatitis* ; Sjogren's Syndrome*

PURPOSE : To evaluate the compliance of patients who underwent complete resection of non-small cell lung cancer (NSCLC) with adjuvant chemotherapy. MATERIALS AND METHODS : Between January 2004 and May 2006, patients who underwent a complete resection for NSCLC were referred to oncologists for adjuvant chemotherapy. Three or 4 cycles of platinum-based adjuvant chemotherapy was then performed according to the protocol or the preference of the oncologists. RESULTS : Two hundred and thirty-two patients were enrolled in this study. The median age of the study group was 60.9 years and 76.7 % of the patients enrolled were male. 34.9%, 28.8% and 36.2% of the patients were in stage IB, II and III respectively. In addition, 142 of the patients (61.2%) completed all planned cycles, whereas 65 patients (28%) received no therapy. The causes of start failure for adjuvant chemotherapy consisted of decreased postoperative performance status (n=39), refusal (n=13) and distant metastasis at the initial follow-up (n=2). The causes of cessation during adjuvant chemotherapy included the occurrence of severe adverse effects (n=12), aggravation of the disease with newly developed metastasis (n=4) and others (n=6). The mortality related to the adjuvant chemotherapy was 1.3 % (n=3), all of the fatalities were due to pneumonia and sepsis. Univariate analysis showed that age, postoperative complications and pathologic staging were the significant factors that determined whether the adjuvant chemotherapy was completed. Multivariate analysis demonstrated statistically significant differences in compliance when age and pathologic staging were considered. CONCLUSION : Adjuvant chemotherapy for completely resected NSCLC was performed with satisfactory compliance in approximately 60% of the patients included in this study, and age plays an important role in the compliance of adjuvant chemotherapy. Elderly subsets will be examined to help determine the effect of age on compliance and outcome. In addition, the medical oncologist tended to complete the adjuvant chemotherapy for more advanced cases of lung cancer than for stage IB lung cancer
Aged ; Carcinoma, Non-Small-Cell Lung* ; Chemotherapy, Adjuvant* ; Compliance* ; Disulfiram ; Drug Therapy ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Male ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Pneumonia ; Postoperative Complications ; Sepsis

BACKGROUND: Ota's nevus, characterized by the presence of melanocytes in the dermis, has been familiar among dermatologists, but the etiology, the pathophysiology, the clinical and histological classification are not entirely clear. To understand and elucidate them, more clinical studies and researches are necessary. OBJECT: The aim of this study was to document the clinical and histopathological features of Ota's nevus. METHODS: We examined 299 patients with Ota's nevus who visited the dermatology clinic in Korea from February 1993 to August 2003. Among them, 188 patients were biopsied. All the specimens were stained with hematoxylin and eosin. We examined the age & sex distribution, age of onset, seasonal variation, associated skin diseases, aggravating factors and color. We clinically classified Ota's nevus into 4 types according to Tanino's classification and histologically into 5 types based on the pattern of pigmentation. RESULTS: 1. The ratio of male and female was 1: 3. 2. The peak age of onset was at birth (28.4%) and puberty (24.8%). 3. Seasonal variation was observed with distinct aggravation in the summer (60%). 4. The associated diseases were 9 cases of persistent mongolian spot, 6 cases of nevus flameus, 4 cases of blue nevus, 3 cases of vitiligo, 3 cases of nevus of Ito, 2 cases of atopic dermatitis, 2 cases of psoriasis, 2 cases of cafe au late macules and 2 cases of contact dermatitis. 5. The aggravating factors were sunlight (35.8%), emotional stress (21.0%), menstruation (12.6%), cold exposure (9.5%), pregnancy (9.5%), fatigue (9.5%) and chemical agents (2.1%). 6. The color of lesions were blue black (36.8%), brown (34.8%), dark brown (16.1%) and slate (11.0%). 7. All cases were classified according to Tanino's METHODS: type Ia (23.1%), type Ib (20.1%), type II (26.7%), type III (9.4%), type IV (20.7%). 8. The histological subtypes of Ota's nevus were classified as: the superficial type (35.6%); the middermis type (5.9%), the superficial-middermis type (18.6%); the mid-lower dermis type (2.7%); the diffuse type was composed of the superficial dominant type (19.7%), the middermis dominant type (4.8%), the dispersed (true diffuse) type (12.2%) and the deep dominant type (0.5%). 9. In the relation between histological types and the color of the lesion: the superficial type had 31 cases of brown color, 15 cases of blue black color, 11 cases of dark brown color and 9 cases of slate color; the middermis type had 6 cases of blue black color and 2 cases of dark brown color, query number of cases of slate color; the superficial-middermis type had 12 cases of blue black color, 10 cases of dark brown color, 7 cases of brown color and 6 cases of slate color: the mid-lower dermis type had 3 cases of blue black color; for the diffuse type, the superficial dominant type had 13 cases of brown color, query number of cases of blue black color and 7 cases of dark brown color; the mid-dermis dominant type had 4 cases of brown color, query number of cases of dark brown color, the dispersed type had 14 cases of blue black color and 5 cases of brown color; the deep dominant type had 1 case of blue black color. CONCLUSION: The histological reclassification of Ota's nevus may be very useful in making a therapeutic prognosis of the disease.
Adolescent ; Age of Onset ; Classification ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatology ; Dermis ; Eosine Yellowish-(YS) ; Fatigue ; Female ; Hematoxylin ; Humans ; Korea ; Male ; Melanocytes ; Menstruation ; Mongolian Spot ; Nevus ; Nevus of Ota* ; Nevus, Blue ; Parturition ; Pigmentation ; Pregnancy ; Prognosis ; Psoriasis ; Puberty ; Seasons ; Sex Distribution ; Skin Diseases ; Stress, Psychological ; Sunlight ; Vitiligo