The fat embolism syndrome is a complication which encounters rarely after fractures of pelvis and long bones of lower extremity of severe injury of soft tissue, and may results in microinfarctions in lungs, brain, heart, kidneys and other important organs when fat globules flow from bone marrow into small vessels. And that is the one of the main cause of death within 72 hours after major trauma of long bones. Diagnosis of fat embolism syndrome was made by clinical criteria by Gurd, but, majority of cases didn't show characteristic clinical symptoms or signs. Recently CT and MRI of the brain are adopted to the diagnosis of FFS as a new method. Authors experiences six cases of fat embolism syndrome from Mar. 1991 to Mar. 1994 and analyzed the brain MRI findings. We concluded that the brain MRI findings such as diffuse brain swelling, petechial hemorrhage and microinfarctions were helpful to diagnose clinically apparent or subclinical fat embolism syndrome.
Bone Marrow ; Bones of Lower Extremity ; Brain Edema ; Brain ; Cause of Death ; Diagnosis ; Embolism, Fat ; Heart ; Hemorrhage ; Kidney ; Lung ; Magnetic Resonance Imaging ; Methods ; Pelvis

No abstract available.
Humans ; Infant, Newborn* ; Mass Screening*

The posterior fossa tumors were reviewed from January 1980 through September 1988. During that time, 72 tumors were diagnosed, with a male: female ratio of 1 : 1.8. The distribution of histopathologic types was; 17 acoustic neuromas(23%), 14 astrocytomas(19%), 8 hemangioblastomas(11%), 8 meningiomas(11%), 7 medulloblastomas(10%), 6 stem gliomas(8%), 4 metastatic tumors(5%), 3 granulomas(4%). The most common presenting symptoms were headache, nausea and vomiting, dizziness, diplopia and hearing diffrculty. Twenty-five patients(37%) showed hydrocephalus on CT scan. For the entire series of 60 patients operated on, results were: 31% excellent, 37% good, 8% fair, 13% poor and 10% Dead. Individuals with meningioma, acoustic neuroma or hemangioma were more favorable prognostically. With survival time should be further investigated for postoperative irradiation and chemotherapy.
Acoustics ; Diplopia ; Dizziness ; Drug Therapy ; Female ; Headache ; Hearing ; Hemangioma ; Humans ; Hydrocephalus ; Infratentorial Neoplasms ; Male ; Meningioma ; Nausea ; Neuroma, Acoustic ; Tomography, X-Ray Computed ; Vomiting

The appearance of a tumor in the chest wall is rare compared to that in any other part of the body. It can be classified into benign and malignant types and can be located in the rib, clavicle, sternum, cartilage and soft tissues. Tumors that are metastatic are commonly located in the lung, breast, bone and pleura. But, the soft tissue mass of anterior chest wall is rarely metastasized from a distant organ that is not confined to the thoracic cavity. This and thus has rarely been described. A 68-year-old man was admitted to our hospital with a chief complaint of resting dyspnea. A huge non-tender mass of about 10*15 cm in size was visible on his left lower anterior chest wall. We pathologically confirmed that the mass was a metastatic renal cell carcinoma of clear cell type by incision biopsy. Through an incision biopsy, the mass was pathologically confirmed as a metastatic renal cell carcinoma of the clear cell type.
Aged ; Biopsy ; Breast ; Carcinoma, Renal Cell* ; Cartilage ; Clavicle ; Dyspnea ; Humans ; Lung ; Neoplasm Metastasis* ; Pleura ; Ribs ; Sternum ; Thoracic Cavity ; Thoracic Wall* ; Thorax*

Septic arthritis of the hip is rarely caused by Mycoplasma hominis. It rarely develops in a patient during the postpartum period. However, delayed treatment of septic arthritis of the hip may lead to serious sequelae; therefore, it is important for clinicians not to overlook patients with the disease. This case illustrates the clinical steps in diagnosis and treatment of M. hominis septic arthritis of the hip.
Arthritis, Infectious* ; Diagnosis ; Hip* ; Humans ; Mycoplasma hominis* ; Postpartum Period*

Among various dermatological entities, toxic epidermal necrolysis (TEN) is a rare but potentially fatal delayed hypersensitivity reaction to numerous medications. A 38-year-old male presented with systemic hypersensitivity reaction, such as high fever, pain in the eyes, and diffuse pruritic erythematous maculopapular eruptions with multiple targetoid plaques that became vesicular and bullous. Oral mucosa and conjunctivae were involved. The first sign appeared about 1 week after taking methazolamide (50 mg twice a day) for the management of glaucomatous eyes. Although methazolamide was discontinued, blistering and skin denudation progressed to affect up to 80% of the body surface area and a positive Nikolsky sign was noted. High fever also persisted. Skin lesions started to improve after 2 weeks of management and fever subsided. Cutaneous lesions improved with minimal permanent sequele 2 months later. HLA-B*5901 was found by high-resolution genotyping. The lymphocyte activation test performed 6 months after remission showed a positive response to methazolamide challenge. This is the first case of methazolamide-induced TEN in which methazolamide was confirmed as a culprit drug by the lymphocyte activation test.
Adult ; Blister ; Body Surface Area ; Conjunctiva ; Fever ; Humans ; Hypersensitivity ; Hypersensitivity, Delayed ; Lymphocyte Activation* ; Lymphocytes* ; Male ; Methazolamide ; Mouth Mucosa ; Skin ; Stevens-Johnson Syndrome*

OBJECTIVE: We studied the possibility that addition of Tyrphostin AG 1478 which is selective epidermal growth factor inhibitor, would enhance the effect of radiation on human cervical cancer cell lines, HeLa and CaSki. METHODS: Tyrphostin was added to the cells which were irradiated. The ratio of dead cells was estimated by trypan blue dye examination, and survived cell fractions were estimated by clonogenic assays. The presence and degree of apoptosis were examined by DNA electrophoresis and nuclear dye using propium iodide. RESULTS: The growth was completely inhibited in both cell lines, but the addition of tyrphostin resulted in different effects on the radiation induced cell death and apoptosis in each cell line. However, the percentage of dead cells and apoptotic cells was decreased in HeLa cell line compared with CaSki cell line. The ultimate survived cell fractions determined by clonogenic assays were decreased in both cell lines and the size of colony was also decreased. CONCLUSION: These data suggest that the addition of Tyrphostin is able to increase the radiotherapeutic effects on human cervical cancer cells, and this synergistic effect may result from effective blocking of radiation-induced accelerated repopulation of cancer cells by tyrphostin.
Apoptosis ; Cell Death ; Cell Line* ; DNA ; Electrophoresis ; Epidermal Growth Factor ; HeLa Cells ; Humans* ; Trypan Blue ; Uterine Cervical Neoplasms*

BACKGROUND: Several lymphocytic populations, such as natural killer(NK) cells and lymphokine-activated killer (LAK) cells, are involved in immunosurveillance against tumors. Whereas the biological significance of the regional lymph node as a tumor barrier remains unclear, the clinical prognostic relevance of the neoplastic infiltration of these nodes is accepted. It appears that lymph node metastasis are more frequent in lung cancer than in other cancers because of impaired defensive mechanisms in the regional lymph nodes. However little is known about the immunologic function of regional lymph node lymphocytes in patients with lung cancer. Although there is general agreement that the NK and LAK activities of peripheral blood mononuclear cells(PBMC) decreases in patients with various solid and leukemic tumors, this decrease remains unclear with regard to the NK and LAK activities of their regional lymph node mononuclear cells(LNMC). We performed this study to determine the NK and LAK acti vities of regional lymph node, and to compare with those of peripheral blood in patients with lung cancer. METHODS: We measured the NK and LAK activities of PBMC and LNMC that were extirpated at lung cancer operations in 17 patients with lung cancer by 4 hour 51Cr-release assay using K562, Raji cell and allogenous lung cancer cell line(NCIH1092) as a target cell. E:T ratio were 12.5:1, 25:1, and 50:1. RESULTS: 1. Recombinant interleukin-2 induced strong cytotoxic activities against various target cells in PBMC and LNMC. 2. In patients with lung cancer, NK and LAK activities against K562 and allogenous lung cancer cell line(NCIH 1092) were lower than those of PBMC. 3. Against Raji cell, NK activities were not signifi cantly different between PBMC and LNMC, but LAK activities were significantly lower than those of PBMC. 4. NK activities against K562, Raji, and NCIH1092 cell were not significantly different between in patients with early stage and advanced stage lung cancer. 5. LAK activities of PBMC and LNMC against K562, Raji, and NCIH1092 cell were significantly lower in pa tients with advanced stage than those in patients with early stage lung cancer. CONCLUSION: NK and LAK activities of LNMC in patients with lung cancer were lower than those of PBMC, but the cytotoxicity was markedly increased after culture with rIL-2.
Humans ; Interleukin-2 ; Killer Cells, Natural ; Lung Neoplasms* ; Lung* ; Lymph Nodes* ; Lymphocytes ; Monitoring, Immunologic ; Neoplasm Metastasis

BACKGROUND: Recently, 2.1 persons per day are reported to be HIV infected and totally more than 4,500 HIV infected persons have been officially reported until 2006 in Korea. We started highly active antiretroviral therapy (HAART) for HIV patients from 1997. Data on the efficacy of antiretroviral therapy are limited in Korea. MATERIALS AND METHODS: HIV infected patients treated with HAART for more than 1 year were included. We studied the therapeutic response of antiretroviral therapy in patients with AIDS and without previous antiretroviral therapy who were treated until Dec 2005 in Severance hospital. RESULTS: More than 450 were diagnosed as HIV infected in Severance hospital. Among these HIV infected patients, 141 patients including 14 females were included. 121 of the 141 patients (85.8%) were treated with PI based regimen, and 20(14.2%) were treated with NNRTI based regimen. The initial mean CD4 T cell count was 207/mm3 (IQR 73-299) and the mean HIV RNA level was 70,800 copies/mL. After 6 months of HAART, 103 patients (73%) had fewer than 400 copies of HIV RNA copies/mL. After 12 months of HAART, 90 patients (63.8%) had fewer than 50 copies of HIV RNA copies/mL. The mean increase in the CD4 T cell count from baseline to 12 months was 143 cells/mm3. After 12 months, 96 patients (68.1%) had increased more than 100 cells/mm3. CONCLUSION: This report the therapeutic response of HAART in Korea which the prevalence of HIV infection is now increasing. Overall, the outcomes are similar to those in other developed countries. Further large scale prospective cohort study is needed.
Antiretroviral Therapy, Highly Active* ; Cell Count ; Cohort Studies ; Developed Countries ; Female ; HIV ; HIV Infections ; Humans ; Korea ; Prevalence ; RNA

BACKGROUND: Recently, 2.1 persons per day are reported to be HIV infected and totally more than 4,500 HIV infected persons have been officially reported until 2006 in Korea. We started highly active antiretroviral therapy (HAART) for HIV patients from 1997. Data on the efficacy of antiretroviral therapy are limited in Korea. MATERIALS AND METHODS: HIV infected patients treated with HAART for more than 1 year were included. We studied the therapeutic response of antiretroviral therapy in patients with AIDS and without previous antiretroviral therapy who were treated until Dec 2005 in Severance hospital. RESULTS: More than 450 were diagnosed as HIV infected in Severance hospital. Among these HIV infected patients, 141 patients including 14 females were included. 121 of the 141 patients (85.8%) were treated with PI based regimen, and 20(14.2%) were treated with NNRTI based regimen. The initial mean CD4 T cell count was 207/mm3 (IQR 73-299) and the mean HIV RNA level was 70,800 copies/mL. After 6 months of HAART, 103 patients (73%) had fewer than 400 copies of HIV RNA copies/mL. After 12 months of HAART, 90 patients (63.8%) had fewer than 50 copies of HIV RNA copies/mL. The mean increase in the CD4 T cell count from baseline to 12 months was 143 cells/mm3. After 12 months, 96 patients (68.1%) had increased more than 100 cells/mm3. CONCLUSION: This report the therapeutic response of HAART in Korea which the prevalence of HIV infection is now increasing. Overall, the outcomes are similar to those in other developed countries. Further large scale prospective cohort study is needed.
Antiretroviral Therapy, Highly Active* ; Cell Count ; Cohort Studies ; Developed Countries ; Female ; HIV ; HIV Infections ; Humans ; Korea ; Prevalence ; RNA