BACKGROUND: Angiogenesis is an essential component of tumor growth and metastasis, and the vascular endothelial growth factor (VEGF) is one of the most important angiogenic factors. Several solid tumors produce substantial amounts of VEGF, which stimulates proliferation and the migration of ednothelial cells, therby inducing neovasculization by a paracrine mechanism. To evaluate the prognostic roles of angiogenesis and VEGF expression in patients with non-small cell lung cancer, the relationship between VEGF expression in tumor tissues, the clinicopathologic features and the overall survival rate were analysed. METHODS: Sixty-nine resected primary non-small cell lung cancer specimens were evaluated. The pareffinembedded tumor tissues were stained by anti-VEGF polyclonal antibodies using an immunohistochemical method to assess VEGF expression. RESULTS: In Forty-one patients (59%), the VEGF antigen was expressed weakly in their tumor tissue, whereas in twenty-eight patients (41%) the VEGF antigen was expressed strongly. The median survival time of the weak VEGF expression group was 24 months, and that of the strong VEGF expression group was 19 months. The three year-survival rates were 35%, 33%, respectively. The survival difference between both groups was not statistically significnat. CONCLUSION: Although results were not statistically significant, the strong expression group tended to poorer prognosis than weak expression group.
Angiogenesis Inducing Agents ; Antibodies ; Carcinoma, Non-Small-Cell Lung* ; Humans ; Neoplasm Metastasis ; Prognosis ; Survival Rate ; Vascular Endothelial Growth Factor A

Tuberculosis is a common chronic infectious disease, although the spleen is an uncommon organ to harbor tubercle bacilli. Immunocompromised subjects are primarily prone to miliary tuberculosis and in them the spleen is invaded by Mycobacterium tuberculosis. Spleen tuberculosis is manifested commonly as a miliary form. The basic pathology is granulomatous inflammation. The CT finding of splenic tuberculosis are multiple, well-defined, roung or ovoid, low-density masses. Lymphadenopathy in the abdomen and mediastinum and pleural effusion can be found. We report two cases with tuberculosis of the spleen proved by computed tomography and histologic identification. One paitient did not improve following antituberculous medication, so splenectomy was performed. The other patient has been treated with antituberculous medication.
Abdomen ; Communicable Diseases ; Humans ; Inflammation ; Lymphatic Diseases ; Mediastinum ; Mycobacterium tuberculosis ; Pathology ; Pleural Effusion ; Spleen* ; Splenectomy ; Tuberculosis* ; Tuberculosis, Miliary ; Tuberculosis, Splenic

The t(8;21)(q22;q22) is one of the most frequent structural chromosomal anomaly found in AML, occurring in about 5% of all AML and in 10% of AML with maturation (M2). And approximately 3.4% of AML with t(8;21)(q22;q22) occurs as a complex chromosomal abnormality and occasionally shows discrepancy between cytogenetic and molecular genetic analyses. We report a case of 42 yr old male patient that revealed morphological characteristics of AML-M2 and karyotypic abnormality of 45,X,-Y,t(8;17)(q22;p13) without visible involvement of chromosome 21 by conventional cytogenetic study with masked t(8;21) identified by FISH using RUNX1/RUNX1T1 probes. FISH confirmed nuc ish (RUNX1T1x3),(RUNX1x3), (RUNX1T1 con RUNX1x1). According to the results of conventional cytogenetic and FISH analyses, the karyotype was revised to 45,X,-Y,t(8;17;21)(q22;p13;q22).
Chromosome Aberrations ; Chromosomes, Human, Pair 21 ; Cytogenetics ; Humans ; Karyotype ; Leukemia, Myeloid, Acute ; Male ; Masks ; Molecular Biology

Aspergillosis refers to an infection with any species from the genus Aspergillus. Pleural aspergillosis is an uncommon disease with less than 30 cases having been reported in the literature since 1958. The etiologic factors for this aspergillosis are preexisting pulmonary tuberculosis, bronchopleural fistula, pleural drainage, and a lung resection. Surgical removal of the aspergillus-infected pleura is the main treatment for managing this disease. We have experienced two cases of pleural aspergillosis as a complication of a preexisting chronic empyema. The chest radiographs showed a pyopneumothorax with cavitation and the chest computed tomographic scans revealed a loculated pyopneumothorax with cavity formation suggesting a bronchopleural fistula. A grossly purulent fluid was extracted by thoracentesis, and Aspergillus fumigatus was grown from a fungus culture of the fluid. A decortication, wedge resection with a pleurectomy and a pleuropneumonectomy were performed. The postoperative course was satisfactory and the patients have been in good condition up to now. Pleural aspergillosis is a very rare and potentially life-threatening disease. However, good result without significant complication were obtained by treatment with systemic antifungal agents and surgical removal.
Antifungal Agents ; Aspergillosis* ; Aspergillus ; Aspergillus fumigatus ; Drainage ; Empyema ; Fistula ; Fungi ; Humans ; Lung ; Pleura ; Radiography, Thoracic ; Thorax ; Tuberculosis, Pulmonary

We present a patient with type 2 diabetes mellitus and metastatic renal cell carcinoma who developed severe hypoglycemia and metabolic encephalopathy after sunitinib treatment. Sunitinib, a multi-target tyrosine kinase inhibitor, is used to treat metastatic renal cell carcinoma. Sunitinib-induced hypoglycemia has been reported and there are rare case reports of severe hypoglycemia due to sunitinib. Therefore, glycemic control should be monitored closely in diabetic patients treated with sunitinib.
Brain Diseases, Metabolic ; Carcinoma, Renal Cell* ; Coma* ; Diabetes Mellitus, Type 2 ; Humans ; Hypoglycemia ; Protein-Tyrosine Kinases

The antinuclear antbody (ANA) test have been used to screen the patients with systemic lupus erythematosus (SLE) and other autoimmune diseases. We had retrospectively reviewed the 263 records of pediatric patients with doing ANA tests who admitted at Department of Pediatrics, Kyung Hee University Hospital, from January 1988 to May 1993. The following results were obtained. 1) The positive rate of ANA test in patients with connective tissue diseases is 16 out of 40(40%).In patients with SLE, the positive rate of ANA test is 9 out of 11 (82%). 2) The positive predictivity for SLE is 9 out 36 (25%). 3) The positive predictivity for connective tissue disease and possible immune disease is 28 out of 36 (78%). 4) The false positive rate is 8 0ut of 36 (22%), Thus, the pediatric patients with positive ANA test should be applicable for diagnosis with prudence. 5) The positive anti-dsDNA in patients with the positive ANA is shown in 4 cases and these patients are all SLE. In conclusion, the patients who had repeated positive ANA should be tested Anti-dsDNA antibody, and further clinical and diagnostic evaluation of other ANA associated diseases.
Autoimmune Diseases ; Connective Tissue Diseases ; Diagnosis ; Humans ; Immune System Diseases ; Lupus Erythematosus, Systemic ; Pediatrics ; Retrospective Studies

Thrombotic thrombocytopenic purpura (TTP) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, and variable abnormalities in renal function and mental status. The pathogenesis of TTP is related to an inhibitor or deficiency of the von Willebrand factor (vWF)-cleaving protease (a disintegrin and metalloprotease with thrombospondin type 1 repeats; ADAMTS-13) that cleaves the large vWF multimers. Uncleaved, large vWF molecules are present in TTP and induce thrombosis in small vessels. Even though plasma exchange was proven effective in TTP, 20-40% of the cases showed refractory to plasma exchange. We describe a 41 years old female with plasma exchange refractory TTP who was completely recovered from anemia, thrombocytopenia, and accompanying symptoms following splenectomy.
Adult ; Anemia ; Anemia, Hemolytic ; Female ; Fever ; Humans ; Plasma Exchange* ; Plasma* ; Purpura* ; Purpura, Thrombotic Thrombocytopenic ; Splenectomy* ; Thrombocytopenia* ; Thrombosis ; Thrombospondins ; von Willebrand Factor

A 44-year-old male presented with a month history of exertional dyspnea and dizziness. A peripheral blood smear revealed a pancytopenia with 3% of blasts. We were not able to obtain a bone marrow aspirate, but a biopsy specimen showed hypercellularity, proliferation of trilineage cell lines (panmyelosis) with extensive myelofibrosis, and clusters of immature cells at the paratrabecular area. After remission induction therapy with idarubicin 12mg/m2 (D1-3) and cytosine arabinoside 100mg/m2 (D1-7), the bone marrow blast count was decreased, but the marrow fibrosis and pancytopenia persisted. Peripheral blood stem cell transplantation from his HLA-matched brother was performed after administering fludarabine 30mg/m2 for 5 days and busulfan 3.2mg/kg for 2 days. Early engraftment occurred and the bone marrow reticulin fibrosis disappeared. Full-donor chimerism was demonstrated at day 22 by performing short tandem repeats analysis and this was maintained for 1 year. The patient has survived 20 months after transplantation without any complication.
Adult ; Biopsy ; Bone Marrow ; Busulfan ; Cell Line ; Chimerism ; Cytarabine ; Dizziness ; Dyspnea ; Fibrosis ; Humans ; Idarubicin ; Male ; Microsatellite Repeats ; Pancytopenia ; Peripheral Blood Stem Cell Transplantation* ; Primary Myelofibrosis* ; Remission Induction ; Reticulin ; Siblings

BACKGROUND: Medical decisions concerning the prolongation of life, the right to die and euthanasia are among the most extensively discussed issues within medicine and law today. The purpose of this study was to evaluate the attitudes of medical students and housestaff toward euthanasia. METHODS: From July 15 to September 15 of the 1998, the responses of 180 medical students and 132 housestaff to a self-administered questionnaire were analyzed to identify attitudes toward euthanasia. Over 312 respondents about attitudes toward euthanasia, the analysis of differences between proportions was made by the Chi-square test. RESULTS: About 69.9% of the respondents thought euthanasia should be legalized. The findings suggest that Buddhists (77.5%) and non-religious groups (88.1%) tend to support euthanasia more than Christians. Futhermore, medical students (74.4%) support euthanasia more than housestaffs(63.6%), male(75.1%) more often than female(57.9%). About 73.1% of the respondents said that active euthanasia is not justifiable, and 79.2% said that they do not like performing active euthanasia. In respect to passive euthanasia, 69.0% said that it is not ethically justifiable, but 63.0% would perform this as if it were legal. Housestaffs of internal medicine (76.9%) were more willing to do euthanasia than pediatrics (70.0%), surgery (63.6%), family practice (53.8%) and Ob/Gyn (33.3%). CONCLUSION: Respondents have positive attitudes toward legalization of euthanasia.. Most considered that passive euthanasia is not morally justifiable. But if it were legalized, they would be willing to do euthanasia, while they would still be disturbed by active euthanasia. The opinions of physician and medical students directly affect patient care and their attitudes must be considered if clear policies are to be developed concerning euthanasia.
Surveys and Questionnaires ; Euthanasia* ; Euthanasia, Active ; Euthanasia, Passive ; Family Practice ; Humans ; Internal Medicine ; Jurisprudence ; Life Support Care ; Patient Care ; Pediatrics ; Right to Die ; Students, Medical*

PURPOSE: An adequate vitamin D level is important for normal growth, cancer prevention, controlling hormones, and immune regulation. However, no study has investigated vitamin D status in patients with serious illnesses, such as malignancies, malabsorption diseases, or prematurity in Korean children. Thus, we analyzed the results of 25-hydroxyvitamin D3 (25-D) levels in children in a single tertiary medical center. METHODS: Children who had their vitamin D level evaluated at Keimyung University Dongsan Medical Center from January 2004 to December 2014 were included. We reviewed the medical records and laboratory test results. RESULTS: Ninety-three children (male:female = 48:45) who had their vitamin D levels measured were included. The most common reason for measuring vitamin D level was hypocalcemia with or without neurological signs. Among the subjects, 61 children had hypovitaminosis D (25-D < 30 ng/mL). A positive correlation was detected between 25-D and total calcium levels (p = 0.001). Negative correlations were found between 25-D and immunoreactive parathyroid hormone (iPTH) levels (p = 0.002) and between 25-D and alkaline phosphatase (ALP) levels (p = 0.021). Twenty-three subjects (37.7%) had a critical underlying condition, including a hemato-oncologic issue (18.0%), gastrointestinal or nutritional problem (11.5%), and prematurity or low birth weight (8.2%). CONCLUSION: The levels of total calcium, ALP, and iPTH were correlated with 25-D level. An underlying malignancy, malabsorption issues, or prematurity may be risk factors for hypovitaminosis D in children.
Alkaline Phosphatase ; Calcifediol ; Calcium ; Child* ; Humans ; Hypocalcemia ; Infant, Low Birth Weight ; Infant, Newborn ; Medical Records ; Parathyroid Hormone ; Risk Factors* ; Vitamin D