A virus-associated hemophagocytic syndrome is characterized by high fever, liver dysfunction, coagulation abnormalities, pancytopenia, and a benign histiocytic proliferation with prominent hemophagocytosis in bone marrow, lymph node, spleen, and liver. Three phases of disease progression can be defined. In the first week, there is mild leukocytosis and myeloid hyperplasia in the marrow and the fever is resistant to antipyretics and antibiotics. In the second phase, usually corresponding to the 2nd to 3rd week of the illness, the fever persists and jaundice and hepatosplenomegaly may develop and the marrow now reveals the presence of atypical or transformed T lymphocytes and a scattering of histiocytes with hemophagocytosis. In the third phase, the disease progresses to a full-blown hemophagocytic syndrome with coagulopathy and lung infiltrates. The marrow in this stage is usually hypoplastic with florid histiocytic proliferation and hemophagocytosis and the patients usually die within 1-2 months. We describe a pregnant woman with fatal hemophagocytic syndrome. Virologic study strongly suggests that Epstein-Barr virus implicated in the pathogenesis of this patient.
Anti-Bacterial Agents ; Antipyretics ; Bone Marrow ; Disease Progression ; Female ; Fever ; Herpesvirus 4, Human* ; Histiocytes ; Humans ; Hyperplasia ; Jaundice ; Leukocytosis ; Liver ; Liver Diseases ; Lung ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Pregnancy* ; Pregnant Women ; Spleen ; T-Lymphocytes

No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

BACKGROUND: This study was conducted to reveal the health effects of air pollution on the residents living near waste treatment plant. METHODS: We sampled 190 residents as the hogh exposed group, 192 residents as the moderate group, and 139 residents as the low exposed group according to the geographical distances from the waste treatment plant. Self-administered questionnaires for prevalence of respiratory disease, irritation symptoms of mucous membrane (eye, nose, thoat, skin, and respiratory tract), gastrointestinal symptoms, other nonspecific symptoms were conducted. We measured the concentrations of total suspened partcles, Zn, Cu, Cr, Ni, Pb, Cd and As in 3 exposed area. RESULT: Airborne concentrations of total suspended particles measured in exposed area were 485, 365, and 332 micro gram/m(3) which excees the limit value. Airborne concentrations of Zn, Cu, Cr, Ni, Pb, Cd and As were not excees the limit value. The prevalence of respiratory disease of high exposed group (16.8%) was significantly higher than that of moderate group (3.6%) and low exposed group (5.0%). The sysptom score of irrtation sysptoms of mucous membrane, gastrointestinal sysptoms, and other nonspecific sysptoms were increased with exposed level. In multiple linear regression, exposure level was related to all sysptom scores significantly. CONCLUSION: These results suggest that the air pollution of waste treatment plant would influence prevalence of respiratory disease, induce irritation of mucous membrane, gastrointestinal symptoms, and other nonspecific sysptoms.
Air Pollution ; Linear Models ; Mucous Membrane ; Nose ; Plants* ; Prevalence ; Skin ; Surveys and Questionnaires

The majority of ptients with ischemic heart disease such as angina pectoris and myocardial infarction have coronary atherosclerosis as a underlying cause. However, in unusual conditions such as variant angina, aortic valvular heart disease, hypertrophic cardiomyopathy, vasculitis, hypercoagulable states, coronary atherosclerosis is not the cause. Polycythemia vesa is a myeloproliferative disease characterized by infrequent thromboembolic complications such as ischemic heart disease. We report a case of polycythemia vera presenting with angina pectoris without coronary artery stenosis with the review of the literature.
Angina Pectoris* ; Cardiomyopathy, Hypertrophic ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Heart Valve Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Polycythemia Vera* ; Polycythemia* ; Vasculitis

No abstract available.
Amniotic Fluid* ; Animals ; Embryonic Structures* ; Female ; Humans* ; Mice*

No abstract available.
Amniotic Fluid* ; Animals ; Embryonic Structures* ; Female ; Humans* ; Mice*

Ancient schwannoma is a variant of schwannoma characterized by slow progression, degenerative changes, and a higher incidence in older adults. There have been two prior reported cases of ancient schwannoma arising from the distal ulnar nerve at the wrist level, but neither were longstanding or very large. Herein, we report an ancient schwannoma found in the ulnar nerve of the distal forearm that was found to be clinically meaningful in size. A 61-year-old man presented with complaints of tingling sensation of the fourth and fifth fingers and bulging of the ulnar side of the wrist. The patient reported that the mass in his wrist had grown very slowly, starting about 10 years ago, and that he had started experiencing a tingling sensation in his fourth and fifth fingers about 3 years prior, which had become worse in the past year. Based on the results of the preoperative examination, a benign nerve sheath tumor was suspected. As it was thought that the possibility of malignancy was not high, we elected to perform a marginal excision. Pathological examination confirmed ancient schwannoma. At his most recent visit, 3 years after surgery, he reported no recurrence and that he felt better than before surgery, but some tingling sensations remained. As with small ancient schwannoma in the distal wrist, most cases of large ancient schwannoma can be treated without special complications based on an accurate preoperative diagnosis.

BACKGROUND: Exercise can aggravate asthmatic symptoms in many patients with bronchial asthma. It is caused by that inhaled air bypasses nasal cavity and goes directly to the lower airways through open mouth dring exercise. Although the pathogenetic mechanisms of exercise-induced asthma(EIA) have not been clarified yet, there is evidence that chemical mediators, released from the inflammatory cells triggered by airway cooling or drying, might be responsible for induction of bronchoconstriction. However, it has been controversial which chemical mediators or cells are involved in such process. Objectiye . The aim of this study was to evaluate the role of activated mast cells in the pathogenesis of EIA and find out whether or not sulfidopeptide leukotrienes (LTC4/d4/E4) are involved in the exercise-induced bronchoconstriction. MATERIAL AND METHOD: Eleven asthmatics with documented exercise-induced bronchoconstriction and 10 control subjects were studied. Before and 6 hours after free running for 6 minutes, forced expiratory volume in 1 second (FEV,) and the concentrations of N- methylhistamine, LTE4, and creatinine in unine collected for 6 hours after exercise were determined. RESULT: Urinary concentrations of N-methylhistamine(mean+SE, ng/mg creatinine) of EIA patients before and after exercise were 159+40 and 450+75, respectively. Those of control subjects were 208+ 54 and 275+ 62, respectively. Uninary N-methylhistamine levels of EIA group increased significantly after exercise, while those of control group did not change. Urinary concentrations of LTE,(mean+SE, pg/mg creatinine) of EIA patients before and after exercise were 15.6 k2.6 and 22.2+5.8, respectively. Those of control subjects were 10.4+ 4.0, 18.2 +7.0, respectively. The concentrations of LTE4 in the urine samples collected before exerise revealed no difference between EIA and control subjects (p=0.07). There was no change after exercise in both groups. Percent fall of FEV, was 29.1+8.0% (mean+SD) in EIA group and 3.4 + 4.0% in control group, respectively. There was no correlation between reduction of FEV, and change in urinary concentrations of N-methyl-histmine after exercise. CONCLUSTION: Chemical mediators of activated mast cells may be involved in exercise-induced bronchoconstriction, but there is little evidence for enhanced sulfidopeptide leukotriene generation as assessed by urinary LTE4.
Asthma ; Asthma, Exercise-Induced* ; Bronchoconstriction ; Creatinine ; Forced Expiratory Volume ; Humans ; Leukotriene E4 ; Leukotrienes ; Mast Cells ; Mouth ; Nasal Cavity ; Running

Uterine sarcoma is a rare female neoplasm that accounts for about 2-4% of all uterine malignancies. According to the classification of Norris and Taylor, the subgroup of endometrial stromal sarcoma (ESS), comprising approximately 7-15% of all uterine sarcomas, can be divided into low-grade ESS and high-grade ESS and is characterized by proliferations composed of cells with endometrial stromal cell differentiation. We experienced this infrequent malignant tumor in a 52-year old woman and was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adriamycin chemotherapy. We present a case of low-grade ESS with a brief review of the literature.
Classification ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Middle Aged ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Stromal Cells

Uterine sarcoma is a rare female neoplasm that accounts for about 2-4% of all uterine malignancies. According to the classification of Norris and Taylor, the subgroup of endometrial stromal sarcoma (ESS), comprising approximately 7-15% of all uterine sarcomas, can be divided into low-grade ESS and high-grade ESS and is characterized by proliferations composed of cells with endometrial stromal cell differentiation. We experienced this infrequent malignant tumor in a 52-year old woman and was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adriamycin chemotherapy. We present a case of low-grade ESS with a brief review of the literature.
Classification ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Middle Aged ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Stromal Cells