Lymphomatoid papulosis is a chronic disease of cutaneous atypical lymphoid infiltration characterized clinically by involuting and recurring papules, plaques, and sometimes nodules. A 51-year-old man presented with a single, coin sized, nontender, erythematous nodule on the left thigh of a 2-week duration. There was a history of recurrence and spontaneous healing of similar asymptomatic eruptions five to six times over 20 years. A biopsy specimen showed a dense, wedge-shaped dermal infiltrate that was patchy and perivascular. The cellular infiltrate was polymorphous and consisted of large atypical cells, small lymphocytes, eosinophils and neutrophils. The large atypical cells were strongly CD30(Ki-1) positive. We report a case of lymphomatoid papulosis unusually presenting as a single nodular eruption, in which the differential diagnosis between lymphomatoid papulosis and CD30(Ki-1)positive large cell lymphoma is exceedingly difficult.
Biopsy ; Chronic Disease ; Diagnosis, Differential ; Eosinophils ; Humans ; Lymphocytes ; Lymphoma ; Lymphomatoid Papulosis* ; Middle Aged ; Neutrophils ; Numismatics ; Recurrence ; Thigh

A case of metastatic adenoid cystic carcinoma of the lung, originated from the trachea, was diagnosed by fine needle aspiration. Although the cytologic features of adenoid cystic carcinoma have been well described, it is easy to confuse adenoid cystic carcinoma with more common primary small cell neoplasms of the lung, i.e., small cell carcinoma, well differentiated adenocarcinoma, and carcinoid tumor of the lung. The features distinguishing adenoid cystic carcinoma from these neoplasms include 1) tight, globular, honeycomb pattern of cells, 2) acelluair basement membrane material in the lumen, and 3) cells lacking true nuclear molding and having bland chromatin pattern. The mcrphologic feature of metastatic adenoid cystic carcinoma in this case was so distinctive as to permit a definite diagnosis by aspiration cytology.
Adenocarcinoma ; Basement Membrane ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Carcinoma, Adenoid Cystic ; Carcinoma, Small Cell ; Chromatin ; Diagnosis ; Fungi ; Kidney* ; Lung ; Trachea

PURPOSE: The incidence of clinical nephritis is much higher especially in younger ages and in about one half of the cases, it also shows nephrotic syndrome. Thus, we examine the clinical and pathologic consideration of children with lupus nephritis and their treatment modality to improve the prognosis. MATERIAL AND METHOD: Among 67 cases of children under eighteen who were diagnosed SLE, 50 patients with hematuria and proteinuria from Jan. 1980 to Dec. 1996 were selected for the review. RESULTS: The ratio of the male to female patient was 1:3.5 and the average age at the diagnosis was 11.85+/-3.2 years old. Most common clinical manifestations at the time of the diagnosis were fever and skin rashes and the common laboratory results were proteinuria, hematuria, Out of 50 cases, 33 cases had renal biopsy. The results were 17 cases of Class IV, 7 cases of Class lll, 5 cases of Class lll, 3 cases of Class V and 1 case of Class l. Different treatment modalities were carried out; Corticosteroid only 21 cases, Corticosteroid+Azathioprine 25 cases, Corticosteroid+Cyclophosphamide 3 cases, and Corticosteroid+Cyclosporine A 1 case. However, there were no significant difference in the recurrence and complete remission rate of lupus nephritis in between each treatment groups. Average follow-up period was 37+/-23 months. Of all the follow-ups, 7 patients were dead. CONCLUSION: Early diagnosis should be carried out with renal biopsy, and should be considered for vigorous therapy, which currently includes high doses of corticosteroids and immunosuppressive drugs. Among these immunosuppressive agents, azathioprine has a lower incidence of long-term complications and low costs might be recommended. In addition, regular check-up for anti-DNA antibody, serum complement concentration and appropriate moniroting and management for the adverse effects of the treatment should enable to reach the continuous remission.
Adrenal Cortex Hormones ; Azathioprine* ; Biopsy ; Child* ; Complement System Proteins ; Diagnosis ; Early Diagnosis ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Lupus Nephritis* ; Male ; Nephritis ; Nephrotic Syndrome ; Prognosis ; Proteinuria ; Recurrence

OBJECTIVE AND METHODS: To determine correlations among ambulatory renin activity, ambulatory blood pressure and microalbumin excretion rate, 66 Korean essential hypertensives were studied after 4 week wash-out period. The ambulatory blood pressure was monitored every 30 minutes and mean BP were calculated automatically. Urinary microalbumin excretion rate(UAER) and ambulatory plasma renin activity(aPRA) collected at mid-day were measured by radioimmunoassays. Subjectives were divided into 2 groups by aPRA value(2ng/ml/hr). RESULT: 14 cases were high renin group and 52 cases low renin group. The mean BP were 148.83/94.69mmHg in low renin group, and 146.57/98.07mmHg in high-renin group without difference. UAER were not different also between both groups. 23.07%(4/14) of non-dippers were included in high renin group and 25.58%(12/52) in low renin group without statistical difference. The aPRA was significantly related to UAER and systolic and diastolic mean blood pressure. Also UAER was related significantly to day mean blood pressures. CONCLUSION: Thus aPRA is thought to be a meaningful indicator to predict hypertensive renal target organ damage as well as blood pressure measured with 24-hr ABPM.
Blood Pressure* ; Hypertension* ; Plasma* ; Radioimmunoassay ; Renin*

Angiogenesis is an essential process in tumor growth and metastasis. VEGF has been considered a leading candidate inducing tumor angiogenesis. VEGF expression was significantly correlated with clinical stage, lymph node matastasis, and prognosis of cancers of various parts of body. However, little has been known about the correlation between VEGF expression and clinicopathologic parameters in oral squamous cell carcinoma. The aim of this study was to correlate VEGF expression with the clinicopathological parameters and microvessel density. Forty six oral squamous cell carcinomas were analyzed using immunohistochemical method with primary antibodies to VEGF and CD31. VEGF expression was detected in 33 (71.7%) of the 46 cases. The microvessel density was significantly correlated with VEGF expression (P=0.002). There was no correlation between microvessel density and tumour size, clinical stage, and lymph node metastasis, respectively. VEGF expression did not correlate with the histological grade of tumour differentiation, tumour size, and clinical stages. The VEGF-positive rate seemed to be higher in patients with cervical lymph nodal metastasis than in those without it, but it was not statistically significant. In conclusion, the overexpression of VEGF in the oral squamous cell carcinoma seemed to be associated with a more aggressive course of the disease. Further study is necessary to define the role of VEGF in oral squamous cell carcinoma.
Antibodies ; Carcinoma, Squamous Cell* ; Humans ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Prognosis ; Vascular Endothelial Growth Factor A*

Background: Studies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine. Methods: We reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings. Results: We reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine.Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients. Conclusion Considering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.

Background: Studies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine. Methods: We reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings. Results: We reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine.Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients. Conclusion Considering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.

The erector spinae plane block (ESPB) is minimally invasive, safer, and technically easy procedure. Although the ESPB is considered an easier technique compared to the neuraxial block, its efficacy in patients with cervical radicular pain is uncertain. This study aimed to identify pain relief in patients with cervical radicular pain and spread level in the craniocaudal direction using fluoroscopic guidance. A total of 157 patients experiencing neck or arm pain caused by cervical spine disease or muscle related issues who underwent T2 ESPBs were included. The patients were injected with 10 mL (ESPB 10 mL group) or 20 mL (ESPB 20 mL group) of local anesthetic mixture containing a contrast medium. The degree of pain relief and disability was assessed using an 11-point numerical rating scale (NRS) and the neck disability index (NDI), respectively. Moreover, the spread level of ESPB in the craniocaudal direction was assessed. The number of patients who demonstrated excellent pain relief (NRS reduction > 50%) was 49 (62.8%) and 52 (65.8%) in the ESPB 10 mL and 20 mL groups, respectively. The total number of vertebral segments in the craniocaudal direction was significantly higher in the ESPB 20 mL group than in the ESPB 10 mL group (4.69 ± 1.31 vs. 5.96 ± 1.03, p < 0.001). Both groups of ESPB demonstrated a significant reduction in NRS and NDI. The distribution of the contrast medium in the ESPB 20 mL group was more extensive than that in the ESPB 10 mL group.

The erector spinae plane block (ESPB) is minimally invasive, safer, and technically easy procedure. Although the ESPB is considered an easier technique compared to the neuraxial block, its efficacy in patients with cervical radicular pain is uncertain. This study aimed to identify pain relief in patients with cervical radicular pain and spread level in the craniocaudal direction using fluoroscopic guidance. A total of 157 patients experiencing neck or arm pain caused by cervical spine disease or muscle related issues who underwent T2 ESPBs were included. The patients were injected with 10 mL (ESPB 10 mL group) or 20 mL (ESPB 20 mL group) of local anesthetic mixture containing a contrast medium. The degree of pain relief and disability was assessed using an 11-point numerical rating scale (NRS) and the neck disability index (NDI), respectively. Moreover, the spread level of ESPB in the craniocaudal direction was assessed. The number of patients who demonstrated excellent pain relief (NRS reduction > 50%) was 49 (62.8%) and 52 (65.8%) in the ESPB 10 mL and 20 mL groups, respectively. The total number of vertebral segments in the craniocaudal direction was significantly higher in the ESPB 20 mL group than in the ESPB 10 mL group (4.69 ± 1.31 vs. 5.96 ± 1.03, p < 0.001). Both groups of ESPB demonstrated a significant reduction in NRS and NDI. The distribution of the contrast medium in the ESPB 20 mL group was more extensive than that in the ESPB 10 mL group.

The erector spinae plane block (ESPB) is minimally invasive, safer, and technically easy procedure. Although the ESPB is considered an easier technique compared to the neuraxial block, its efficacy in patients with cervical radicular pain is uncertain. This study aimed to identify pain relief in patients with cervical radicular pain and spread level in the craniocaudal direction using fluoroscopic guidance. A total of 157 patients experiencing neck or arm pain caused by cervical spine disease or muscle related issues who underwent T2 ESPBs were included. The patients were injected with 10 mL (ESPB 10 mL group) or 20 mL (ESPB 20 mL group) of local anesthetic mixture containing a contrast medium. The degree of pain relief and disability was assessed using an 11-point numerical rating scale (NRS) and the neck disability index (NDI), respectively. Moreover, the spread level of ESPB in the craniocaudal direction was assessed. The number of patients who demonstrated excellent pain relief (NRS reduction > 50%) was 49 (62.8%) and 52 (65.8%) in the ESPB 10 mL and 20 mL groups, respectively. The total number of vertebral segments in the craniocaudal direction was significantly higher in the ESPB 20 mL group than in the ESPB 10 mL group (4.69 ± 1.31 vs. 5.96 ± 1.03, p < 0.001). Both groups of ESPB demonstrated a significant reduction in NRS and NDI. The distribution of the contrast medium in the ESPB 20 mL group was more extensive than that in the ESPB 10 mL group.