PURPOSE: Colorectal surgery, there are many important prognostic factors---depth of invasion, lymph node metastasis and distant metastasis. In there, the involvement of the lymph nodes by metastatic colorectal carcinoma may depends on several factors such as the sex, the age of the patient, tumor site and size, the symptomatic duration of the disease, tumor cell differentiation, and operating methods. In that point of view, we want to know how many lymph nodes are dissected for enough to determine statistically considerated Dukes C stage. METHODS: We had studied 128 operation cases of colorectal adenocarcinoma from our hospital admission during the period of May, 1988 to October, 1997 to determine to provide an accurate assessment of the presence of nodal metastases. Patients status, tumor site and size, symptomatic duration of disease, tumor cell differentiation, and operating methods of 128 cases were analyzed. We calculated the probability to find at least one positive node in Dukes C, by binomial distribution from SPSS (version 7.5). RESULTS: Eighty-three specimens (65%) were classified as Dukes B. Forty-five specimen (35%) had lymph node metastases (Dukes C) with a mean of 4.1+/-4.1 positive lymph nodes per specimen. The mean total number of lymph nodes identified per specimen was 11.6+/-7.4 (range 1~41), Dukes B was 10.9+/-7.1 (range 1~29) and Dukes C was 12.8+/-7.9 (range 3~41). Applying Students t-test to compare two independent average means, the result was the absence of significant differences in the number of nodes for the specimens defined as Dukes B and Dukes C, sex, age, symptom duration, and operationmethods whereas significant differences did exist for the specimen depending on the tumor differentiation, tumor size, and location. Poorly differentiation cancer was more prominent meaning than well or moderately differentiation in Dukes B (p<0.05). In stage Dukes C, if tumor size was below 2cm it was differences in other sizes (p<0.05). In tumor location, if tumor sited ascending colon was more prominent than sigmoid and rectum (p<0.05). According to our result, minimum 6 lymph nodes per specimen were optimal Dukes C staging assessment. CONCLUSION: The minimum 6 lymph nodes provided an accurate assessment of the presence of nodal metastases (95 percent confidence interval) in Dukes C stage.
Adenocarcinoma ; Cell Differentiation ; Colon, Ascending ; Colon, Sigmoid ; Colorectal Neoplasms* ; Colorectal Surgery ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Rectum

Adenoid basal carcinoma of the uterine cervix is a rare neoplasm that accounts for less than 1% of cervical adenocarcinomas. Though it has been confused with adenoid cystic carcinoma, it is now distinctly recognized by better prognosis and different histologic and immunohistochemical findings. We have experienced a case of adenoid basal carcinoma associated with invasive squamous cell carcinoma of the uterine cervix in a 52-year-old woman. The tumor was composed of small, round to oval nests of basaloid cells with peripheral palisading. Some of the nests showed central cystic spaces, or cribriform pattern, and central squamous differentiation with cytological atypia. Invasive squamous cell carcinoma was located adjacent to the adenoid basal carcinoma without any transition between these two lesions. Immunohistochemically, the tumor cells disclosed positive staining for cytokeratin, but negative reaction for CEA, EMA, and S-100 protein.
Female ; Humans

Angioimmunoblastic lymphadenopathy (AILD) is a systemic disease clinically characterized by fever, generalized lymphadenopathy, hepatosplenomegaly, polyclonal gamma-globulinemia and Cooms' positive hemolytic anemia. The lymph node in AILD reveals a polymorphic feature consisting of a proliferation of small vessels, immunoblasts and plasma cells and acidophilic interstitial material. Progression into immunoblastic sarcoma is reported as high 35% of the patient with AILD. Nathwani et al have observed not only malignant transformation of AILD in sequential tissue examination, but also the coexistence of AILD and immunoblastic lymphoma in the same lymph node or at different sites in the same patient. Multiple clusters or islands of compactly arranged large lymphoid cells constitute the initial histologic evidence of immunoblastic sarcoma. Immunoblastic sarcoma is a large cell lymphoma conceptually related to transformed T-and B-lymphocytes of the extrafollicular compartment of the immune system, which proignosis is poor. We have recently experienced a case of immuno blastic sarcoma arising in angioimmunoblastic lymphadenopathy in a 24-year-old woman. She had history of multiple enlarged lymph nodes in the inguinal, axilla and supraclavicular areas. Previous lymph node biopsies revealed reactive change. Six month later, right axillary lymph node biopsy reveled AILD with focal clusters of immunoblasts. Subsequent lymph node biopsy at the same site revealed diffuse immunoblasic sarcoma, B-cell type. A case presentation with histologic findings and a brief review of literature were done.
Female ; Humans ; Biopsy

Congenital lipoid adrenal hyperplasia, the most severe form of congenital adrenal hyperplasia, is caused by mutations in the steroidogenic acute regulatory protien (StAR). It is characterized by failure of synthesis of all three classes of adrenal steroids and massive accumulation of lipids and cholesterol in the adrenal cortex. The computed tomography (CT) unequivocally delineated massively enlarged adrenal glands of fat-tissue attenuation, enabling early diagnosis and replacement therapy. We report a case of congenital lipoid adrenal hyperplasia, in which CT established that lipoid deposition at the adrenal cortex disappeared after the adrenal hormone replacement therapy.
Adrenal Cortex ; Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Cholesterol ; Early Diagnosis* ; Hormone Replacement Therapy ; Hyperplasia* ; Steroids

No abstract available.
Recurrence* ; Thyroid Gland* ; Thyroid Neoplasms*

Kimura's disease is a benign, uncommon, chronic inflammatory condition that usually presents with painless subcutaneous nodules or plaques. Head and neck are the most frequently involved sites in Kimura's disease. Mandible is the most commonly involved, followed by neck, cheek, scalp and forehead. Other possible sites are oral cavity, inguinal area and extremities, but there have been no reports involving the nose, especially the one that looks like a rhinophyma. We describe a case of Kimura's disease presenting like a rhinophyma.
Cheek ; Extremities ; Forehead ; Head ; Mandible ; Mouth ; Neck ; Nose ; Rhinophyma ; Scalp

BACKGROUND: Although the main features of psoriasis consist of abnormal epidermal proliferation and T cell infiltration, which of these is the initial abnormality has been a longstanding unresolved question. Recently there has been definite evidence that activated T cells produce the cytokines that induce keratinocyte abnormalities. OBJECTIVE: We investigated the distributions and relative numbers of T lymphocyte subpopulations, that is, CD4+ and CD8+ T cells, to verify the more important T cell subtype and its infiltrating site in the formation of psoriatic lesions. METHODS: Paired psoriatic lesional and non-lesional skin tissues were obtained from eight typical psoriatic patients. Immunohistochemical staining was done on the frozen sections using a labelled streptavidin-biotin peroxidase complex method with DAKO LSAB kit. The primary antibodies used in this study were monoclonal or polyclonal antibodies against CD3, CD4, CD8, HLA-DR, and ICAM-1. RESULTS: In lesional psoriatic skin, the epidermis was mainly infiltrated by CD8+ T cells. There were little or no T cells in non-lesional epidermis. In both lesional and non-lesional dermis, CD4+ T cells were the main ones. In lesional skin, anti-ICAM-1 antibody positively stained diffusely in the endothelial cells of papillary and subpapillary plexuses and focally in epidermal keratinocytes, but in non-lesional skin only the endothelial cells in the subpapillary plexus were stained. There were many HLA-DR+T lymphocytes in lesional and non-lesional dermis. In the epidermis, HLA DR was detected only in lesional keratinocytes and T lymphocytes. CONCLUSION: These results suggest (1) participation of activated epidermal CD8+ T lymphocytes in the formation of psoriatic plaques, and (2) a pathogenetic role of ICAM-1 expression on papillary microvessels.
Antibodies ; Cytokines ; Dermis ; Endothelial Cells ; Epidermis ; Frozen Sections ; HLA-DR Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Subsets* ; Lymphocytes* ; Microvessels ; Peroxidase ; Psoriasis ; Skin* ; T-Lymphocytes

To our knowledge, MR findings of neuroshistosomiasis has not been reported in Korea. A case of neuroshistosomiasis involving cerebellum and presumably spinal cord is reported. A 40 year old man who had lived in Middle East complained of low back pain and progressive paraparesis for 6 months, and subsequently developed headache, dizziness and diplopia. On cervical spine MRI, there was diffuse enlargement of cervical cord with increased signal intensity on T2 weighted image and nodular heterogenous enhancement after Gd-DTP^ administration. Brain MR imaging obtained 4 months later showed ill-defined, irregularly enhancing heterogenous mass in cerebellar vermis which was proved to be a granulomatous lesion containing shistosomiasis mansoni ova.
Adult ; Brain ; Cerebellum ; Diplopia ; Dizziness ; Granuloma* ; Headache ; Humans ; Korea ; Low Back Pain ; Magnetic Resonance Imaging* ; Middle East ; Myelitis, Transverse* ; Neuroschistosomiasis* ; Ovum ; Paraparesis ; Spinal Cord ; Spine

PURPOSE: To investigate renal toxicity of high-dose intravenous immunoglobulin(IVIG) in children with Kawasaki disease and idiopathic thrombocytopenic purpura. METHODS: 23 children with Kawasaki disease and 7 children with idiopathic thrombocytopenic purpura who were treated with high-dose IVIG(2 g/kg) were evaluated for the change of urine output, blood urea nitrogen(BUN), serum creatinine(Scr), creatinine clearance(Ccr), tubular reabsorption of phosphorus(TRP), fractional excretion of sodium(FENa), 24hour urine b2-microg1obuin/creatinine(b2MG/cr) ratio and urine microalbumin/creatinine(MA/cr) ratio at post-IVIG 1 and 3 day. RESULTS: There was no significant change of urine output, BUN, Scr, Ccr, TRP, 24hour urine b2MG/cr and MA/cr ratio after high-dose IVIG treatment. Transient increase of FENa at post-IVIG 1 day was the only significant change. CONCLUSION: There was no significant renal toxicity of high-dose IVIG in children with Kawasaki disease and idiopathic thrombocytopenic purpura who had normal renal function.
Biopsy, Fine-Needle* ; Child ; Creatinine ; Humans ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome ; Purpura, Thrombocytopenic, Idiopathic ; Salivary Ducts* ; Urea

The authors wish to retract this article due to duplicate publication.