Liver abscess in children is rare in developed countries; the incidence is 25 per 100,000 admissions in USA. Common complications are pleural effusion, empyema, pneumonitis, hepatopleural or hepatobronchial fistula, intraperitoneal or intrapericardiac rupture, septic shock, cerebral amebiasis, etc. These complications may lead to death if the management is delayed. However, recent management results in a mortality of less than 15%. We report a case of liver abscess in a child. He manifested with fever and abdominal pain in the right upper quadrant. On computerized tomography scans, multiple cystic lesions were seen in both lobes of the liver and were 5 to 55 mm in size. In laboratory findings, neutrophilic leukocytosis, peripheral eosinophila, elevated values of ESR, C-reactive protein, and elevated serum AST, ALT, ALP and GGT were detected. Furthermore, we determined the organisms in the blood culture and serum. Blood culture was positive for Streptococcus spp., and amebic indirect hemagglutination antibody titer was increased to 1:512.
Abdominal Pain ; Abscess ; Amebiasis ; C-Reactive Protein ; Child ; Empyema ; Fever ; Fistula ; Hemagglutination ; Humans ; Incidence ; Leukocytosis ; Liver ; Liver Abscess ; Neutrophils ; Pleural Effusion ; Pneumonia ; Rupture ; Shock, Septic ; Streptococcus

Breast cancer is one of the leading causes of death attributable to cancer in women. In view of the limitations of conventional predictable factors of the breast cancer, additional second-generation parameters would be valuable in selecting the patients who would be most likely to be beneficial from adjuvant therapy and breast reconstruction. The author investigated the HER2/neu gene amplification and the number of chromosome 17 in 39 cases of paraffin embedded breast cancer tissues, 20 cases without lymph node metastasis and 19 cases with lymph node metastasis, using fluorescent in situ hybridization(FISH) and compared the results with HER2/neu and p 53 protein expression detected by immunohistochemical method. Eleven cases fibroadenoma were used as benign tumor control. Numerical aberrations of chromosome 17 were found in 17 out 39 breast cancer cases (44%)(monosomy in 10 cases, 26%; trisomy in 3 cases, 8%; tetrasomy in 3 cases, 8%; polysomy in 1 case ,3%), and the frequency of each type aberration was not significantly different between the negative and positive groups in lymph node metastasis. Monosomy of chromosome 17 was found in 2 out of 11(12%) fibroadenoma cases. HER2/neu gene amplification was found in 8 out of 39 cases (19%) and other 2 cases revealed HER2/neu gene amplification in lymph node metastatic tumor only, not in original tumor. Fourteen out of 19 cases of breast cancer with lymph metastasis showed HER2/neu protein expression both in original and metastatic tumors. All of the six cases showing HER2/neu gene amplification in original and/or metastatic tumor revealed HER2/neu protein expression. The frequency of HER2/neu gene amplification in the 39 breast cancer cases was not different between metastatic and non-metastatic groups(p= 0.284). However, HER2/neu protein expression was increased significantly in the metastatic group(p=0.028). None of the 11 fibroadenoma cases revealed HER2/neu gene amplification or HER2/ neu protein expression. Nine out of 19 cases of breast cancer with lymph node metastasis showed p 53 protein accumulation in original tumor(47%), but 3 of them revealed p 53 protein accumulation only in original tumor. The frequency of p 53 protein accumulation was not significantly different between metastatic and non-metastatic groups. None of the 11 fibroadenoma cases revealed p 53 protein accumulation. In conclusion, there are no differences between the lymph node metastatic group and non-metastatic groups in numerical aberrations of the chromosome 17 , amplification of the HER2/neu gene expression and accumulation of the p 53 protein in breast cancer. However, the HER2/neu protein expression was increased significantly in lymph node metastatic group, so it could be one of the predictors of the metastasis in breast cancer.
Breast Neoplasms* ; Breast* ; Cause of Death ; Chromosomes, Human, Pair 17* ; Female ; Fibroadenoma ; Gene Amplification* ; Gene Expression ; Humans ; Lymph Nodes ; Mammaplasty ; Monosomy ; Neoplasm Metastasis ; Paraffin ; Tetrasomy ; Trisomy

In several pathologic conditions of the joints, it is rather frequent to find a swollen joint. The authors performed an analysis of the joint fluid proteins from 20 cases of rheumatoid arthrit is and 20 normal Kore an adults with the object of evaluating the significance of it s clinical application. The study was done with Beckman Model R System, Durrum type cell, and scanned with Model RB Analytrol. Scheicher and Schuell 2043-A paper was used with diethyl barbituric acid-sodium diethyl barbituratebuffer, pH 8.6, ionic strenght 0.075 and stianed with 0.1% bromphenol blue. The results obtained were as follows: 1) The amount of total protein was significantly increased with average of 4.80 + 1.249gm% in comparison with 2.34 + 0.553gm% in normal group. 2) Albumin fraction showed the average of 41.86 + 6.219% in comparison with 64.85 + 5.288% in normal group. 3) Alpha 2 globulin fraction disclosed the average of 10.19 + 3.379% in comparison with 4.24 + 1.158% in normal group, which was significantly increased one. 4) Gammaglobulin fraction was also significantly elevated with the average of 21.51 + 8.942% in comparison with 11.70 + 1.923% in normal group. 5) There was noted a decreased A/G ratio, the average of 0.74 + 0.196, in comparison with 1.911 + 0.430 in normal group.
Adult ; Arthritis, Rheumatoid ; Bromphenol Blue ; Humans ; Hydrogen-Ion Concentration ; Joints

Fibroblast growth factor-4 (FGF-4) has various functions, affecting many signaling pathways, and leading to cellular proliferation and differentiation and to the regulation of cell migration, invasion, and angiogenesis. However, there are few reports of the relationship between TS cells and FGF-4 even if FGF-4 is located in inner cell mass of embryo and Fibroblast growth factor receptor (FGFR) is located in TS cells. Therefore the physiologic effects of FGF-4 on TS cells were investigated for identifying the effects of FGF-4 on TS ell differentiation. FGF-4 was involved in early stage development of the trophoblast via upregulation of eomesodermin mRNA expression. In addition, FGF-4 suppressed the differentiation of TS cells through activation of extracellular-signal regulated kinase (Erk) and suppression of focal adhesion kinase (FAK) activation, which in TS cells is an important indicator of early trophoblast cell differentiation, migration and invasion. FGF-4 was involved in angiogenesis in the trophoblast through the activation of p38 and the induction of Dlx-3 mRNA expression in TS cells. In addition, TS cells cultured with FGF-4 for 4 days in a thrombinfibrinogen gel culture system, a specific culture system for endothelial cells, showed a healthy appearance, while TS cells cultured without FGF-4 were severely damaged. Taken together, these data suggest that FGF-4 is closely involved in differentiation of TS cells for development of placenta.
Cell Differentiation ; Cell Movement ; Cell Proliferation ; Embryonic Structures ; Endothelial Cells ; Fibroblasts ; Focal Adhesion Protein-Tyrosine Kinases ; Phosphotransferases ; Placenta ; Receptors, Fibroblast Growth Factor ; RNA, Messenger ; Trophoblasts* ; Up-Regulation

Leiomyosarcoma of the rectum is a extremely rare disease without well documented report on its management and prognosis. The most complicated problem lies on the correct diagnosis. Many pathologic and histologic criteria have been proposed to make it clear. The treatment of rectal leiomyosarcoma is controversial. Some authors recommand wide local excison for low-grade tumors as much as 2 cm in diameter. However, radical abdominoperineal resection is the procedure of choice. Leiomyosarcoma of the rectum is resistant to radiotherapy, and no single effective chemotherapeutic drug has been found yet, although adriamycin is effective in one third of all cases. The local recurrence rate was much higher in patients receiving wide local excision and the overall 5-year or 10-year survival rate is similar. We report a case of rectal leiomyosarcoma and review the literature.
Diagnosis ; Doxorubicin ; Humans ; Leiomyosarcoma* ; Prognosis ; Radiotherapy ; Rare Diseases ; Rectum* ; Recurrence ; Survival Rate

OBJECTIVE: Fibromyalgia (FM) is a rheumatic disorder characterized by widespread bodily pain, tenderness at multiple sites, and fatigue. It has a major impact on the quality of life. However, there has been no report regarding the health-related quality of life (HRQOL) in Korean patients with FM. The objective of this study was to assess the HRQOL and the correlation among each measurement and to identify the predictors for HRQOL in Korean patients with FM. METHODS: The HRQOL and clinical parameters were assessed by Short Form Health Survey-36 (SF-36), EuroQol 5 Dimensions (EQ-5D), time trade off (TTO), standard gamble (SG), Centers for Epidemiologic StudiesDepression (CES-D), social support, self-efficacy scale, Fibromyalgia Impact Questionnaire (FIQ), and tender points, respectively, from 104 outpatients with FM. RESULTS: Of the 104 subjects, 99 (95.2 %) were women with mean (+/-SD) age of 49.2 years (+/-11.1). The mean (+/-SD) years of disease onset was 8.06 (+/-7.38). The mean (+/-SD) scores of SF-36 global, mental component summary (MCS) and physical component summary (PCS) were 41.6 (+/-19.8), 47.4 (+/-25.0), and 43.5 (+/-23.7), respectively. The SF-36 GH, PCS, MCS scores of FM patients were lower than that of healthy controls (p<0.001). The mean (+/-SD) EQ-5D utility and visual analog scale (VAS) were 0.52 (+/-0.32) and 55.6 (+/-19.4). The mean (+/-SD) scores of the TTO and SG were 0.49 (+/-0.44) and 0.47 (+/-0.42). The mean (+/-SD) scores of CES-D, self-efficacy scale, social support and social network were 16.0 (+/-10.2), 55.9 (+/-19.4), 2.37 (+/-0.27), and 2.07 (+/-0.58), respectively. The mean (+/-SD) scores of FIQ was 46.4 (+/-17.7). The FIQ total score was negatively correlated with the scores of SF-36 GH, MCS, PCS, EQ-5D utility and VAS, TTO, SG, social support, social network, and self-efficacy scale (r=-0.63, r=-0.60, r=-0.48, r=-0.59, r=-0.56, r=-0.32, r=-0.27, r=-0.25, r=-0.31, r=-0.54, respectively. all p's<0.001), and positively correlated with the CES-D (r=0.67, p<0.001). In multivariate models, the predicting variables of SF-36 GH and PCS were age, FIQ, and self-efficacy and the predicting variables of SF-36 MCS were income, FIQ, and social support. CONCLUSION: These results suggest that the HRQOL in Korean patients with FM is lower than healthy subjects. In a simple correlation analysis, FIQ, CES-D, social support, and self-efficacy were meaningful variables correlated with HRQOL. In multivariate model, age, FIQ, and self-efficacy were independent variables correlated with HRQOL. Therefore, the efforts to improve HRQOL in Korean patients with FM should be designed to improve the self-efficacy and depression in addition to conventional approach.
Depression ; Fatigue ; Female ; Fibromyalgia* ; Humans ; Outpatients ; Quality of Life* ; Surveys and Questionnaires ; Visual Analog Scale

The congenital cataracts are lens opacity which are present at birth or within 3 months after birth. The pathogenesis of congenital cataract is no less varied and complex than that of adult-onset or senile lens opacification, but most of etiology is unknown. Inheritance can play a major role in their etiology and the most mode of inheritance is autosomal dominant. However, the possibility of preventing the disease in future generation through genetic counseling give the ophthalmologist responsibility in the recognition and classification of congenital lens opacities. We experienced hereditary congenital cataract, and so we reported these patients with review of literatures.
Cataract* ; Classification ; Genetic Counseling ; Humans ; Parturition ; Social Responsibility ; Wills

No abstract available.
Sturge-Weber Syndrome*

Osteoma is relatively rare benign tumor of non-inflammatory origin having a circumscribed form, a definite periosteal covering forming a line of cleavage from adjacent structures and showing active participation of osteoblasts. The tumor commonly originates in a nasal accessory sinus or calvaria and may invade the orbit relatively early in its growth, causing ocular disability prior to localizing signs in the smus. We have reported a giant osteoma in an adult having right eye protrusion, pain and interference of eyeball movements. The mass was totally removed by transcranial route successfully with no development of significant complications. The mass was extremely hard, well circumscribed and extended into right frontal, ethmoidal sinuses and orbital cavity.
Adult ; Ethmoid Sinus* ; Humans ; Orbit* ; Osteoblasts ; Osteoma* ; Skull

Eosinophilic folliculitis (EF) is regarded as a variant of eosinophilic pustular folliculitis (EPF), because it has a few distinctive clinical features different from those of EPF. EF is generally associated with systemic disorders, such as acquired immunodeficiency syndrome (AIDS) and hematologic malignancies. We have recently experienced a case of EF occurring in a 40 year-old male patient treated with allogenic bone marrow transplantation (BMT) for acute myelogenous leukemia(AML) and achieved a good clinical outcome after a short course of systemic corticosteroid therapy. The immunologic aberration resulting from systemic diseases may play a role in the development of EF.
Acquired Immunodeficiency Syndrome ; Bone Marrow Transplantation ; Bone Marrow* ; Eosinophils* ; Folliculitis* ; Hematologic Neoplasms ; Humans ; Leukemia, Myeloid, Acute* ; Male