1.Graft-Versus-Host Disease of the Lung after Allogeneic Hematopoietic Stem Cell Transplantation: A Report of Two Cases.
Ji Hyeon ROH ; Joungho HAN ; Keon Hee YOO ; Kang Mo AHN ; Jihye KIM
Korean Journal of Pathology 2009;43(4):378-381
Herein, we describe cases of pulmonary acute graft-versus-host disease (aGVHD) in two patients occurring after allogeneic hematopoietic stem cell transplantation (HSCT) due to precursor B-cell acute lymphoblastic leukemia in a 6-year-old patient and in acute myeloid leukemia in a 14-year-old boy. In both cases, chest CT revealed confluent ground-glass attenuation along the bronchovascular bundles, as well as some bronchial dilatation. Microscopically, in both cases we noted a characteristic bronchiolocentric pattern and bronchiolar epithelial changes, which included denudation of the bronchiolar epithelium, regenerating atypical cells, and wall thickening with subepithelial or transmural fibroblast proliferation, along with some lymphocytic infiltration. One patient died on day 86 after allogeneic HSCT due to sudden acute respiratory distress syndrome, and the other patient currently remains alive without active aGVHD. The authors' experiences in these two cases demonstrate that intense awareness of the pathologic findings of GVHD is mandatory after allogeneic HSCT.
Adolescent
;
Child
;
Dilatation
;
Epithelium
;
Fibroblasts
;
Graft vs Host Disease
;
Hematopoietic Stem Cell Transplantation
;
Hematopoietic Stem Cells
;
Humans
;
Leukemia
;
Leukemia, Myeloid, Acute
;
Lung
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma
;
Precursor Cells, B-Lymphoid
;
Respiratory Distress Syndrome, Adult
;
Thorax
2.A Case of Methanol Intoxication with Multifocal Enhancing Lesions in Brain Magnetic Resonance Imaging.
Chang Bon YUN ; Myung Kwon KIM ; Sung Soo KANG ; Hyeon Mi PARK ; Hwan Mo JEONG ; Dong Jin SHIN
Journal of the Korean Neurological Association 2000;18(3):330-332
In accidental or suicidal methanol ingestion, bilateral necrosis of the putamen and hemispheric white matter lesions are the most common findings on CT and MRI. There are a few reports that have demonstrated abnormal CT findings in methanol intoxication, however, to our knowledge, contrast enhancement of these lesions have not been reported in Korea. We report the case of a 36-year-old male who had a brain MRI performed 3 weeks after accidental methanol intoxication. T2 weighted MRI showed bilateral symmetrical high signal lesions in the frontal lobe and basal ganglia with hemorrhaegic necrosis. A postcontrast MRI demonstrated multifocal enhancing lesions in both frontal lobes, right temporal lobe, both basal ganglias and both cerebellar hemispheres. We suggest that the characteristic brain MRI finding and careful history taking are helpful in diagnosis of methanol intoxication.
Adult
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Basal Ganglia
;
Brain*
;
Diagnosis
;
Eating
;
Frontal Lobe
;
Humans
;
Korea
;
Magnetic Resonance Imaging*
;
Male
;
Methanol*
;
Necrosis
;
Putamen
;
Temporal Lobe
3.Twelve-year Incidence of Hypertension and Its Risk Factors in a Lean Population: the Kangwha Study.
Hyeon Chang KIM ; Il SUH ; Kang Hee LEE ; Sun Ha JEE ; Chang Soo KIM ; Chung Mo NAM
Korean Journal of Preventive Medicine 1999;32(4):435-442
OBJECTIVES: The purpose of this study was to examine the twelve-year incidence of hypertension, and to find risk factors for the incidence in adult population in Kangwha County, Korea. METHODS: In 1986, 413 males(mean age 37 years) and 434 females(mean age 33 years) were examined in the Kangwha Study. Among 764 non-hypertensive participants, 164 males and 214 females were reexamined in 1998. Blood pressure(BP) was measured with standard mercury sphygmomanometers. Multiple logistic regression analysis was used to estimate the relative risk of risk factors on the incidence of hypertension. RESULTS: During the 12-year period, 68 of 164 males and 53 of 214 females developed hypertension. In a multiple logistic model adjusted for age and pulse rate, baseline BP, baseline body mass index(BMI) and BMI change during the follow-up period were significantly related to the incidence of hypertension. Adjusted relative risk(RR)s of baseline high-normal BP were 3.90(95% CI: 1.81-7.84) in males, and 12.72(95% CI: 3.70-30.73) in females. Compared with lower baseline BMI group, adjusted RRs of middle baseline BMI group were 2.66(95% CI: 1.19-5.70) in males, and 2.33(95% CI: 0.95-5.55) in females. Adjusted RRs of upper baseline BMI group were 3.52(95% CI: 1.53-7.67)in males and 3.63(95% CI: 1.50-8.43) in females. Increase of BMI was positively related to the incidence in males(adjusted RR=2.71, 95% CI: 1.00-6.71) and females(adjusted RR=3.05, 95% CI: 1.29-6.88). CONCLUSIONS: The twelve-year incidence of hypertension was 41.5% in males, and 25.8% in females. Baseline BP, baseline BMI, and BMI change were strongly related to the incidence of hypertension.
Adult
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Body Mass Index
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Female
;
Follow-Up Studies
;
Heart Rate
;
Humans
;
Hypertension*
;
Incidence*
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Korea
;
Logistic Models
;
Male
;
Risk Factors*
;
Sphygmomanometers
4.Comparison of Femoral Morphology and Bone Mineral Density between Femoral Neck Fractures and Trochanteric Fractures in 65+ Females.
Sung Soo KIM ; Myung Jin LEE ; Hyeon Jun KIM ; Jung Mo KANG
Hip & Pelvis 2012;24(2):102-108
PURPOSE: To analyze, by radiograph, the difference in bone mineral density (BMD) and the proximal femoral morphology of females who are over 65 years old and have had either an intertrochanteric fracture or a femoral neck fracture. MATERIALS AND METHODS: One hundred twenty-five females over 65 years of age with femoral neck fractures or intertrochanteric fractures were examined for bone mineral density using computed tomography from April 2008 to March 2011. The bone mineral density was measured by dual-energy x-ray absorptiometry (DEXA). The morphology of the proximal femur was also measured by computed tomography in the unaffected hip. RESULTS: In the femoral neck fracture group, the mean BMD value was 0.563 g/cm2 in the femoral neck region and 0.753 g/cm2 in the intertrochanteric region. In the intertrochanteric fracture group, the mean BMD value was 0.457 g/cm2 in the femoral neck region and 0.656 g/cm2 in the intertrochanteric region. There are statistically significant differences between the femoral neck fracture and intertrochanteric fracture groups (P=0.029, 0.030). The mean cortical index was 0.59 in the femoral neck fracture group and 0.51 in the intertrochanteric fracture group. There are statistical differences between the femoral neck fracture and intertrochanteric fracture groups (P=0.001). CONCLUSION: The BMD of the proximal femoral neck and intertrochanteric regions of the intertrochanteric fracture group were significantly lower than that of the femoral neck fracture group. The cortical index was also significantly lower in the intertrochanteric fracture group than the femoral neck fracture group. BMD and computed tomography seem useful to check in women older than 65 who have fractures of the proximal femur.
Absorptiometry, Photon
;
Bone Density
;
Female
;
Femoral Neck Fractures
;
Femur
;
Femur Neck
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Hip Fractures
;
Humans
5.Pathologic Factors Associated with Prognosis after Adjuvant Chemotherapy in Stage II/III Microsatellite-Unstable Colorectal Cancers.
Jung Ho KIM ; Jeong Mo BAE ; Hyeon Jeong OH ; Hye Seung LEE ; Gyeong Hoon KANG
Journal of Pathology and Translational Medicine 2015;49(2):118-128
BACKGROUND: Although there are controversies regarding the benefit of fluoropyrimidine-based adjuvant chemotherapy in patients with microsatellite instability-high (MSI-H) colorectal cancer (CRC), the pathologic features affecting postchemotherapeutic prognosis in these patients have not been fully identified yet. METHODS: A total of 26 histopathologic and immunohistochemical factors were comprehensively evaluated in 125 stage II or III MSI-H CRC patients who underwent curative resection followed by fluoropyrimidine-based adjuvant chemotherapy. We statistically analyzed the associations of these factors with disease-free survival (DFS). RESULTS: Using a Kaplan- Meier analysis with log-rank test, we determined that ulceroinfiltrative gross type (p=.003), pT4 (p<.001), pN2 (p=.002), perineural invasion (p=.001), absence of peritumoral lymphoid reaction (p=.041), signet ring cell component (p=.006), and cribriform comedo component (p=.004) were significantly associated with worse DFS in patients receiving oxaliplatin-based adjuvant chemotherapy (n=45). By contrast, pT4 (p<.001) and tumor budding-positivity (p=.032) were significant predictors of poor survival in patients receiving non-oxaliplatin-based adjuvant chemotherapy (n=80). In Cox proportional hazards regression model-based univariate and multivariate analyses, pT category (pT1-3 vs pT4) was the only significant prognostic factor in patients receiving non-oxaliplatin-based adjuvant chemotherapy, whereas pT category, signet ring cell histology and cribriform comedo histology remained independent prognostic factors in patients receiving oxaliplatin-based adjuvant chemotherapy. CONCLUSIONS: pT4 status is the most significant pathologic determinant of poor outcome after fluoropyrimidine-based adjuvant chemotherapy in patients with stage II/III MSI-H CRC.
Cellular Structures
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Chemotherapy, Adjuvant*
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Colorectal Neoplasms*
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Disease-Free Survival
;
Humans
;
Microsatellite Instability
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Microsatellite Repeats
;
Multivariate Analysis
;
Pathology
;
Prognosis*
6.Correlation between Cross-sectional Areas of Paraspinal Muscles and Isometric Lumbar Extension Strength.
Jeong Yi KWON ; Kang Woo LEE ; Hyeon Sook KIM ; Jong Moon KIM ; Joong Mo AHN
Journal of the Korean Academy of Rehabilitation Medicine 2000;24(2):275-280
OBJECTIVE: To evaluate the correlation of the cross-sectional areas (CSA) of paraspinal muscles (back extensors and psoas muscles) and full range-of-motion isometric lumbar extension strength in the individuals with low back pain. METHOD: Twenty four subjects (14 men and 10 women) with low back pain completed a maximum isometric lumbar extension strength test at seven angles through a 72degrees range of motion (0, 12, 24, 36, 48, 60, 72 degrees of lumbar flexion). CSA of back extensors and psoas muscles were measured from standardized transaxial view by CT scanner. RESULTS: CSA of lumbar extensor and psoas were correlated with isometric lumbar extension strength from full flexion to extension in the low back pain patients. The greater the lumbar flexion angle, the greater the coefficient of determination (R2). The correlation coefficients of psoas muscles were greater than those of lumbar extensors. CONCLUSION: Both back extensors and psoas muscles do their important role during isometric lumbar extension. Isometric lumbar extension strength of full lumbar flexion is well correlated with CSA of paraspinal muscles.
Humans
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Low Back Pain
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Male
;
Paraspinal Muscles*
;
Psoas Muscles
;
Range of Motion, Articular
7.Overexpression of POSTN in Tumor Stroma Is a Poor Prognostic Indicator of Colorectal Cancer.
Hyeon Jeong OH ; Jeong Mo BAE ; Xian Yu WEN ; Nam Yun CHO ; Jung Ho KIM ; Gyeong Hoon KANG
Journal of Pathology and Translational Medicine 2017;51(3):306-313
BACKGROUND: Tumor microenvironment has recently drawn attention in that it is related with tumor prognosis. Cancer-associated fibroblast also plays a critical role in cancer invasiveness and progression in colorectal cancers. Periostin (POSTN), originally identified to be expressed in osteoblasts and osteoblast-derived cells, is expressed in cancer-associated fibroblasts in several tissue types of cancer. Recent studies suggest an association between stromal overexpression of POSTN and poor prognosis of cancer patients. METHODS: We analyzed colorectal cancer cases for their expression status of POSTN in tumor stroma using immunohistochemistry and correlated the expression status with clinicopathological and molecular features. RESULTS: High level of POSTN expression in tumor stroma was closely associated with tumor location in proximal colon, infiltrative growth pattern, undifferentiated histology, tumor budding, luminal necrosis, and higher TNM stage. High expression status of POSTN in tumor stroma was found to be an independent prognostic parameter implicating poor 5-year cancer-specific survival and 5-year progression-free survival. CONCLUSIONS: Our findings suggest that POSTN overexpression in tumor stroma of colorectal cancers could be a possible candidate marker for predicting poor prognosis in patients with colorectal cancers.
Colon
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Colorectal Neoplasms*
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Disease-Free Survival
;
Fibroblasts
;
Humans
;
Immunohistochemistry
;
Necrosis
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Osteoblasts
;
Phenobarbital
;
Prognosis
;
Tumor Microenvironment
8.Analysis of the Risk Factors and Clinical Outcomes of Femoral Intertrochanteric Fractures in Patients over 65 Years Old.
Chul Hong KIM ; Kyu Yeol LEE ; Sung Soo KIM ; Myung Jin LEE ; Lih WANG ; Hyeon Jun KIM ; Jung Mo KANG
Hip & Pelvis 2013;25(2):127-134
PURPOSE: This study examined therelationship between the clinical outcome and risk factors of intertrochanteric femoral fractures in patients over 65 years old. MATERIALS AND METHODS: From January 2000 to March 2012, three hundred and twenty one patients older than 65 years, who underwent surgeryfor intertrochanteric femoral fractures, were evaluated. The following parameters wereanalyzed: the patient risk factors, such as age, sex, smoking, drinking history, cardiovascular disease, cerebrovascular disease and delayed days to surgery; admission day of the week; anesthetic method; operation time by perioperative care related to clinical outcome including postoperative mortality; and complications. RESULTS: An analysis of the risk factors revealedfemale patients to have a 13% higher mortality (P=0.043). Aduration of surgerylonger than 3 hours was associated with a 29.1% and 20.8% higher mortality and complication rate, respectively (P<0.001, P=0.027). Asurgical delay of four days or more after admission wasassociated with a 20.1% and 18.8% higher mortality risk and complication rate, respectively (P<0.001, P<0.001). Smoking, drinking history, underlying disease, anesthetic method, and operation time had no significant effect on the outcome. CONCLUSION: In addition to recognizing the importance of patient-related risk factors, modifying the operative factors, such as reducing surgical delays and method of anesthesia, can reduce the mortality and postoperative complications of intertrochanteric femoral fractures.
Anesthesia
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Cardiovascular Diseases
;
Drinking
;
Femoral Fractures
;
Hip Fractures
;
Humans
;
Perioperative Care
;
Postoperative Complications
;
Risk Factors
;
Smoke
;
Smoking
9.A case of Good's syndrome.
Gun Woo KIM ; Ji Hyeon PARK ; Eon Jeong NAM ; Shin Woo KIM ; Young Mo KANG ; Jong Myung LEE ; Nung Soo KIM
Journal of Asthma, Allergy and Clinical Immunology 2002;22(1):142-147
A 52-year-old woman suffering from recurrent orogenital ulcerations with superficial candidiasis and chronic mucocutaneous herpes simplex infection was admitted for headache and productive cough. She had undergone a thymectomy due to thymoma of an epithelial cell type several years ago. Radiologic and immunologic examinations revealed bronchiectasis in the left lower lobe, severe deficiency in all isotypes of immunoglobulin and an abnormal delayed hypersensitivity to ubiquitous antigens on skin test. Analysis of lymphocyte subsets in peripheral blood and bone marrow showed marked decreases in the proportion of cells bearing B cell markers. Her symptoms and signs were improved with antibiotics, antifungal and antiviral agents, and monthly administration of high dose intravenous immunoglobulin (IVIG, 400mg/kg). This is a rare case of Good's syndrome presenting, a humoral and cellular immune deficiency syndrome related with thymoma. The pathogenic mechanism of hypogammaglobulinemia in this case might be caused by a block in the early stage of B cell differentiation.
Agammaglobulinemia
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Antifungal Agents
;
Antiviral Agents
;
Bone Marrow
;
Bronchiectasis
;
Candidiasis
;
Cell Differentiation
;
Cough
;
Epithelial Cells
;
Female
;
Headache
;
Herpes Simplex
;
Humans
;
Hypersensitivity, Delayed
;
Immunoglobulins
;
Lymphocyte Subsets
;
Middle Aged
;
Skin Tests
;
Thymectomy
;
Thymoma
;
Ulcer
10.Oral food challenges in children.
Hye Yung YUM ; Hyeon Jong YANG ; Kyung Won KIM ; Tae Won SONG ; Woo Kyung KIM ; Jung Hee KIM ; Kang Mo AHN ; Hyun Hee KIM ; Soo Young LEE ; Bok Yang PYUN
Korean Journal of Pediatrics 2011;54(1):6-10
Many patients assume that allergic reactions against foods are responsible for triggering or worsening their allergic symptoms. Therefore, it is important to identify patients who would benefit from an elimination diet, while avoiding unnecessary dietary restrictions. The diagnosis of food allergy depends on the thorough review of the patients's medical history, results of supplemented trials of dietary elimination, and in vivo and in vitro tests for measuring specific IgE levels. However, in some cases the reliability of such procedures is suboptimal. Oral food challenges are procedures employed for making an accurate diagnosis of immediate and occasionally delayed adverse reactions to foods. The timing and type of the challenge, preparation of patients, foods to be tested, and dosing schedule should be determined on the basis of the patient's history, age, and experience. Although double-blind, placebo-controlled food challenges(DBPCFC) are used to establish definitively if a food is the cause of adverse reactions, they are time-consuming, expensive and troublesome for physician and patients. In practice, An open challenge controlled by trained personnel is sufficient especially in infants and young children. The interpretation of the results and follow-up after a challenge are also important. Since theses challenges are relatively safe and informative, controlled oral food challenges could become the measure of choice in children.
Appointments and Schedules
;
Child
;
Diet
;
Follow-Up Studies
;
Food Hypersensitivity
;
Humans
;
Hypersensitivity
;
Immunoglobulin E
;
Infant