The term malignant mesenchymoma has been applied to those tumors of the soft tissue of mesenchymal origin which are composed of tumor cells differentiating into two or more unrelated malignant forms in addition to the fibrosarcomatous element. Recently authors experienced a case of malignant mesenchymoma in the right axillary area. Microscopically the sarcoma revealed multiple pattern of differentiation, including liposarcoma, malignant schwannoma, fibrosarcoma, malignant fibrous histiocytoma and rhabdomyoblastoma. The presence of rhabdomyblastic cells were proved by immunochemical study utilizing desmin. This patient was treated with surgical excision and radiation.

The most common etiologic agents of neonatal osteomyelitis in the last decades were Staphylococcus aureus, Group B streptococcus, and E. coli, but Klebsiella pneumoniae as a cause of neonatal osteomyelitis appears to be rare. Klebsiella pneumoniae is one of the most important organisms associated with hospital acquired infections in the neonate and outbreaks with multiresistant strains have been reported from neonatal intensive care units around the world. These multiresistant Klebsiella pneumoniae have been shown to produce tranferable plasmid mediated beta-lactamases that are able to hydrolyze oxyimmino- beta-lactamas and these confer resistance to the third generation cephalosporin and named extended spectrum beta-lactamase producing Klebsiella pneumoniae. We experienced two cases of neonatal osteomyelitis due to extended spectrum lactamase producing Klebsiella pneumoniae in our neonatal intensive care unit during the same period. To our knowledge this represents the first documented neonatal osteomyelitise to extended spectrum beta-lactamase producing Klebsiellae pneumoniae in Korea.
beta-Lactamases* ; Disease Outbreaks ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Osteomyelitis* ; Plasmids ; Pneumonia ; Staphylococcus aureus ; Streptococcus

Intrathecal administration of methotrexate(IT-MTX) has constituted the standard approach to prophylaxis and treatment of central nevous system(CNS) leukemia. We experienced a quadriplegia and motor aphasia in a 14-year-old boy following repeated IT-MTX for the prophylaxis of meningeal leukemia. He was diagnosed as ALL without CNS involvement and treated by CCG- 1882 protocol. IT-MTX was administered for CNS prophylaxis. The patient began complaining of urinary incontinence, motor aphasia and weakness in his right leg from 12 days after the 5th dose of the IT-MTX therapy. Even though the IT-MTX was discontinued, loss of muscle power progressed upward resulting in quadriplegia. The patient showed slow and partial recovery on right extremities over 3 months. We report this case with brief review of literature.
Adolescent ; Aphasia, Broca* ; Extremities ; Humans ; Leg ; Leukemia ; Male ; Methotrexate* ; Quadriplegia* ; Urinary Incontinence

PURPOSE: This study was examined to identify the relationship between mood state, interaction anxiety, and quality of life of cancer patients with chemotherapy-induced alopecia. METHODS: The participants were 115 cancer patients. Data were collected from August to December 2012, and analyzed using descriptive statistics, Pearson's correlation coefficients, t-test, ANOVA and Duncan's multiple test. RESULTS: The mean scores of mood state (119.17+/-35.94), interaction anxiety (45.57+/-11.73), and global health status (38.08+/-22.45), functional scales (45.41+/-20.98), symptom scales (57.96+/-18.28) in quality of life were moderate or below. Negative correlations were found between mood state and quality of life, interaction anxiety and quality of life, but positive correlation were found between mood state and interaction anxiety. CONCLUSION: These findings indicate that mood state and interaction anxiety are important factors to improve quality of life of cancer patients with chemotherapy-induced alopecia, And it is meaningful in that this study prepared basic data for development of nursing intervention programs for effective management of chemotherapy-induced alopecia.
Alopecia* ; Anxiety* ; Drug Therapy ; Humans ; Nursing ; Quality of Life* ; Weights and Measures

Sclerosing hemangioma of the lung is uncommon benign neoplasm of uncertain histogenesis, although their radiological appearance is relatively distinct and well-defined. Recently, we experienced 2 cases of sclerosing hemangiomas of the lungs in 61 and 39 years old women. The light microscopic findings of the tissues are similar to the features reported by Liebow and Hubbell(1956). The basic cellular response is thought to be type II pneumonocytes because of findings of multilamellar-like bodies within stromal cells with electron microscopy in case I in addition to other characteristics generally found in epithelial cells.
Female ; Humans ; Hemangioma

BACKGROUND: Vancomycin resistance in enterococci is an emerging problem in Korea. It has become a worldwide problem and nosocomial spread of vancomycin-resistant enterococci (VRE) is very difficult to control. METHODS: Twenty-six strains of vancomycin-resistant Enterococcus faecium, which were isolated from clinical specimens at Soonchunhyang Chunan Hospital from September 1997 to July 1998, were evaluated to determine the antimicrobial susceptibility pattern, the vancomycin resistance genotypes, and their clinical characteristics. RESULTS: All strains were resistant to multiple antibiotics and resistant to vancomycin with MICs in excess of 256 g/ml. All isolates proved to have the vanA gene by the polymerase chain reaction. However, most of them were considered to be colonizations rather than infections from the clinical point of view. They were all cultured from patients who were being hospitalized or had been hospitalized in a neonatal intensive care unit or pediatric wards. Fourteen of 24 patients whose cultures were positive for VRE had a previous use of broad spectrum -lactam and/or vancomycin. CONCLUSIONS: Our cases indicate the importance of nosocomial spread of VRE via person-to-person transmission in a limited space. In order to prevent and control infection and colonization with VRE, a comprehensive and strategic plan such as the recommendations of the CDC's Hospital Infection Control Practices Advisory Committee, may be necessary.
Advisory Committees ; Anti-Bacterial Agents ; Chungcheongnam-do ; Colon ; Cross Infection ; Enterococcus faecium* ; Enterococcus* ; Genotype ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Polymerase Chain Reaction ; Vancomycin ; Vancomycin Resistance

PURPOSE: Salmonella species is one of the most common causative organisms of acute gastroenteritis in neonates. There have been some reports of outbreaks of Salmonella species in neonates, but none was caused by Salmonella london. Pulsed-Filed Gel Electrophoresis (PFGE) was used to compare and analyze 6 isolates of S. london from the formula-fed neonates in Chunan city from late June through early July in the year of 2000. METHODS: In June and July 2000, we performed culture from blood and stool of 5 patients who admitted in Soonchunhyang Chunan Hospital. We performed a molecular analysis based on plasmid profile and pulsed-filed gel electrophoresis (PFGE). We reviewed their hospital records retrospectively. The affected babies were isolated during hospitalization and discharged home as soon as possible. In addition, hand washing, cleaning, and disinfection were intensified to prevent the spread to other babies. RESULTS: We isolated 6 strains of S. london from stool or blood samples of five patients, who were 9 to 14 days old and had fever, diarrhea, poor feeding or weight loss. The specimens for culture of Salmonella species were obtained on the admission day of every patient. All Salmonella species showed the same biochemical reactions as slant/ butt on KIA -/+, H2S +, gas +, motility +, indole -, ornitine decarboxylase +, lysine decarboxylase +, and citrate utilization +. They also showed agglutinations by Salmonella serogroup E antisera. They were susceptible to all antimicrobial agents tested by NCCLS disk diffusion method. The clonality of isolates was confirmed by PFGE after digestion with Xba I and revealed the similar band patterns of S. london. CONCLUSION: We have reported the outbreak of S. london of the formula-fed neonates in Chunan city from late June through early July in the year of 2000. Pulsed-Filed Gel Electrophoresis (PFGE) would be essential for the molecular and epidemiologic studies for the outbreaks caused by Salmonella species.
Anti-Infective Agents ; Chungcheongnam-do ; Citric Acid ; Diarrhea ; Diffusion ; Digestion ; Disease Outbreaks ; Disinfection ; Electrophoresis ; Electrophoresis, Gel, Pulsed-Field* ; Fever ; Gastroenteritis ; Hand Disinfection ; Hospital Records ; Hospitalization ; Humans ; Immune Sera ; Infant, Newborn ; Lysine ; Plasmids ; Retrospective Studies ; Salmonella* ; Weight Loss

Selective introduction of genes conferring chemosensitivity into proliferating tumor cells may be used to treat cancer. We investigated the bystander effect of retrovirusmediated gene transfer of herpes simplex virus thymidine kinase (HSV-TK) gene to murine neuroblastoma cell line (neuro-2a) in vitro and in vivo, and we examined whether the mechanism of bystander effect in neuroblastoma would also depend on connexin-dependent gap junction and/or immune response. A strong bystander effect was observed in vitro, whereby nontransduced tumor cells in proximity to transduced cells acquired susceptibility to ganciclovir (GCV) killing. Implanted mixtures of wildtype cells and HSV-TK transduced cells showed a potent bystander effect upon administration of GCV in A/J mice. HSV-TK/GCV system in murine neuroblastoma induced systemic immunity. Immunohistochemical staining showed many CD4+ and CD8+ cell infiltration but did not show anti-connexin 43+ cells. In conclusion, a strong bystander effect was observed in vitro and in vivo. The bystander effect in murine neuroblastoma might be dependent on immune response and/or on other mechanism such as protein phosphorylation or transfer of apoptotic vesicle, rather than connexin-dependent gap junction.
Animals ; Apoptosis ; Bystander Effect ; CD4-Positive T-Lymphocytes/metabolism ; CD8-Positive T-Lymphocytes/metabolism ; Cell Line, Tumor ; Connexin 43/biosynthesis ; Gap Junctions ; Gene Therapy/*methods ; *Gene Transfer Techniques ; Human ; Immunohistochemistry ; Mice ; Neoplasm Transplantation ; Neuroblastoma/*therapy ; Phosphorylation ; Retroviridae/genetics ; Simplexvirus/*enzymology ; Support, Non-U.S. Gov't ; Thymidine Kinase/*genetics ; Time Factors

BACKGROUND: The prevalence of metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD) and their associated risk factors are not well-established in young children with obesity. The purpose of this study was to evaluate the prevalence of early onset NAFLD and identify its biochemical predictors in obese children aged less than 10 years. METHODS: Anthropometric measurements, blood pressure, laboratory tests, and abdominal ultrasonography (USG) were performed in all subjects. National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria for MS diagnosis and liver enzymes and USG for NAFLD diagnosis were assessed. RESULTS: A total of 356 children with obesity (233 boys, 123 girls) were included, with 172 children age ≤ 10 years and 184 adolescents. The prevalence of MS was 23.3% in young children and 35.3% in adolescents (P = 0.020); while the prevalence of NAFLD was 36.0% and 70.7%, respectively (P = 0.001). In obese children aged 10 years or less, there were significant differences in levels of serum γ-glutamyltranspeptidase (γGT) (P < 0.001), triglycerides (P = 0.042), and homeostatic model assessment of insulin resistance (P < 0.001) between the non-NAFLD and the NAFLD group. Multivariate logistic regression analysis revealed significant increase in serum γGT and uric acid levels in young children. CONCLUSION: Although MS and NAFLD were more prevalent in adolescents, young children also demonstrated MS and NAFLD as obesity-related complications. Elevated serum γGT and uric acid levels may serve as biochemical predictors in detecting NAFLD in young children with obesity before investigation with abdominal USG.
Adolescent ; Blood Pressure ; Child* ; Cholesterol ; Diagnosis ; Education ; Humans ; Insulin Resistance ; Liver ; Logistic Models ; Non-alcoholic Fatty Liver Disease* ; Obesity* ; Prevalence ; Risk Factors ; Triglycerides ; Ultrasonography ; Uric Acid

PURPOSE: Clostridium difficile colonization and infection are commonly associated with poor outcomes in patients with pediatric inflammatory bowel disease (PIBD). We aimed to investigate the prevalence of C. difficile colonization and infection at the time of diagnosis and to evaluate risk factors associated with the development of C. difficile infection during the course of PIBD treatment. METHODS: We retrospectively enrolled a total of 59 children who were newly diagnosed with PIBD at the tertiary medical center. All patients underwent C. difficile toxin assays and cultures initially and at every follow-up during the disease course. Kaplan-Meier survival analysis and Cox regression test were used for statistical analysis. RESULTS: Initial cultures for C. difficile were positive in 13 (22.0%) of 59 PIBD patients, whereas initial toxin assays were positive in 3 patients (5.1%). During treatment, C. difficile cultures converted to positive in 28 (47.5%) in addition to 13 patients who were initially culture-positive, and C. difficile toxins converted to positive in 13 (22.0%) in addition to 3 originally toxin-positive patients. Antibiotic usage alone was significantly associated with the development of C. difficile colonization (p=0.011), and the length of hospitalization was associated with the development of C. difficile infection (p=0.032). CONCLUSION: C. difficile colonization and infection occur frequently during the disease course of PIBD. Antibiotic usage and longer hospital stay were significant risks factors for the conversion of C. difficile status in PIBD patients undergoing treatment.
Child ; Clostridium difficile ; Clostridium ; Colon ; Diagnosis ; Follow-Up Studies ; Hospitalization ; Humans ; Inflammatory Bowel Diseases ; Length of Stay ; Prevalence ; Retrospective Studies ; Risk Factors