No abstract available.

Desmoplastic small round cell tumor (DSRCT) is a rare neoplasm that develops in the abdominal cavity in young people. Microscopically, nests of small undifferentiated cells within a desmoplastic stroma are observed and immunohistochemical studies show polyphenotypic differentiation with expression of epithelial, neural and muscle markers. A specific chromosomal translocation, t (11;22)(p13;q12) has been documented in DSRCT and is increasingly used to confirm the diagnosis. We had experienced a 59-year-old female with right upper quardrant pain for 1 month. On abdominal computerized tomography, multiple demarcated intrahepatic mass lesions were found, but other organs metastasis or abnormal lymph node enlargement and fluid collection were not found. Fine needle aspiration biopsy of hepatic mass was performed and DSRCT was diagnosed by H and E and immunohistochemical staining. She was treated with cyclophosphamide, etoposide, doxorubicin and cisplatin. After three cycles of chemotherapy, computerized tomography demonstrated distinct shrinkage of tumor. At present, she continues in the state of partial remission for 15months after chemotherapy was started.
Abdominal Cavity ; Biopsy ; Biopsy, Fine-Needle ; Cisplatin ; Cyclophosphamide ; Desmoplastic Small Round Cell Tumor* ; Diagnosis ; Doxorubicin ; Drug Therapy ; Etoposide ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Translocation, Genetic

We report the case of a 47-year-old female who developed idiopathic eosinophilia-myalgia syndrome following complete remission of non-Hodgkin's lymphoma. She had been diagnosed extranodal marginal zone B cell lymphoma of nasal cavity and treated with CHOP chemotherapy and radiotherapy. She complained fever, myalgia and the complete blood count showed markedly elevated eosinophil count. Non-Hodgkin's lymphoma was confirmed in complete remission state by PNS CT, nasal septum biopsy and bone marrow biopsy. The patient showed eosinophilia in peripheral blood, myositis in electromyography and muscle biopsy consistent with eosinophilia-myalgia syndrome. The symptoms were improved and the eosinophilia count was decreased after prednisolone medication. We report a case of idiopathic eosinophilia-myalgia syndrome with a review of the literature.
Biopsy ; Blood Cell Count ; Bone Marrow ; Drug Therapy ; Electromyography ; Eosinophilia ; Eosinophilia-Myalgia Syndrome* ; Eosinophils ; Female ; Fever ; Humans ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Middle Aged ; Myalgia ; Myositis ; Nasal Cavity ; Nasal Septum ; Prednisolone ; Radiotherapy

Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder characterized by fever, pancytopenia, hyperferritinemia, and phagocytosis of hematopoietic cells in bone marrow, liver, or lymph nodes. HLH can occur during the course of systemic lupus erythematosus (SLE), but can also be a presenting manifestation. Because development of pancytopenia occurs in less than 10 percent of SLE cases, investigation for HLH is necessary when otherwise unexplained pancytopenia persists despite adequate treatment. We experienced three cases of secondary HLH associated with SLE. Among the three patients, two patients developed HLH during the clinical course of SLE. The other patient who presented with pancytopenia was first diagnosed with HLH, and later with SLE. In her case, HLH turned out to be a presenting manifestation of SLE. We report on three successfully treated cases, and discuss the prevalence, characteristics, treatments, and prognosis of secondary HLH associated with SLE.
Bone Marrow ; Fever ; Humans ; Liver ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Phagocytosis ; Prevalence ; Prognosis

BACKGROUND: Dipeptidyl peptidase 4 (DPP-4, also known as CD26) binds with adenosine deaminase (ADA) to activate T lymphocytes. Here, we investigated whether ADA activity is specifically affected by treatment with DPP-4 inhibitor (DPP4I) compared with other anti-diabetic agents. METHODS: Fasting ADA activity, in addition to various metabolic and biochemical parameters, were measured in 262 type 2 diabetes mellitus (T2DM) patients taking various anti-diabetic agents and in 46 non-diabetic control subjects. RESULTS: ADA activity was increased in T2DM patients compared with that in non-diabetic control subjects (mean+/-standard error, 23.1+/-0.6 U/L vs. 18.6+/-0.8 U/L; P<0.05). ADA activity was correlated with fasting plasma glucose (r=0.258, P<0.05), HbA1c (r=0.208, P<0.05), aspartate aminotransferase (r=0.325, P<0.05), and alanine aminotransferase (r=0.248, P<0.05). Compared with the well-controlled T2DM patients (HbA1c<7%), the poorly controlled group (HbA1c>9%) showed significantly increased ADA activity (21.1+/-0.8 U/L vs. 25.4+/-1.6 U/L; P<0.05). The effect of DPP4I on ADA activity in T2DM patients did not differ from those of other oral anti-diabetic agents or insulin. T2DM patients on metformin monotherapy showed a lower ADA activity (20.9+/-1.0 U/L vs. 28.1+/-2.8 U/L; P<0.05) compared with that of those on sulfonylurea monotherapy. CONCLUSION: Our results show that ADA activity is increased in T2DM patients compared to that in non-diabetic patients, is positively correlated with blood glucose level, and that DPP4I has no additional specific effect on ADA activity, except for a glycemic control- or HbA1c-dependent effect.
Adenosine ; Adenosine Deaminase ; Alanine Transaminase ; Aspartate Aminotransferases ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Dipeptidyl Peptidase 4 ; Fasting ; Glucose ; Humans ; Insulin ; Metformin ; Plasma ; T-Lymphocytes

ESRD patients have higher cardiovascular mortality risk than the general population. Increased QT dispersion has been shown to be a risk factor for cardiac arrhythmia in chronic hemodialysis patients with diabetes or arterial disease. It is known that QT dispersion is significantly prolonged in postdialysis than in predialysis. It is associated with a decrease in serum potassium. During hemodialysis, serum potassium is decreased and QT dispersion increases. Therefore ventricular arrhythmia frequently occurs in the latter half of dialysis. We report 2 cases of ventricular arrhythmia caused by potassium removal during dialysis in chronic hemodialysis patients.
Arrhythmias, Cardiac* ; Dialysis ; Humans ; Hypokalemia ; Kidney Failure, Chronic ; Mortality ; Potassium* ; Renal Dialysis* ; Risk Factors

BACKGROUND: Emphysematous pyelonephritis (EPN) is a rare and potentially life-threatening condition that requires prompt evaluation and management. However, its clinical presentation and outcomes vary widely. This study was conducted to ascertain the clinical features and prognostic factors regarding EPN. METHODS: All patients diagnosed with EPN radiologically and treated at the emergency department in the university-affiliated, tertiary-referral center, from January 1999 to December 2009 were evaluated. The patients' demographic and clinical characteristics, computed tomographic findings, treatment, and outcomes were analyzed retrospectively. RESULTS: Overall 14 patients diagnosed with EPN were admitted. There were 12 females and 2 males. A history of diabetes was found in 12 (85.7%) patients and was the most common comorbidity. The chief complaint among patients was flank pain (42.9%). Severe sepsis or septic shock was noted in 10 (71.4%) patients. Thirteen cases had unilateral involvement and one case had bilateral involvement. More than half of patients had Escherichia.coli in culture. Mean serum levels of HbA1c, creatinine, C-reactive protein (CRP) were 9.4 +/- 2.7, 2.4 +/- 1.4 mg/dl, and 22.4 +/- 13.1 mg/dl. Eight (57.1%) patients received antibiotic treatment alone and four (28.6%) patients received the concurrent percutaneous drainage as well as antibiotics. Hospital mortality was 7.1%. A higher initial serum CRP level (20.3 vs. 49.8 mg/dl, p = 0.02) and HbA1c level (8.7 vs. 16.4, p = 0.01) was associated with hospital mortality. CONCLUSIONS: Antibiotics alone provide a high success rate for the treatment of EPN. Higher serum CRP and HbA1c level was associated with a higher mortality rate in patients with EPN.
Anti-Bacterial Agents ; C-Reactive Protein ; Comorbidity ; Creatinine ; Diabetes Mellitus ; Drainage ; Emergencies ; Female ; Flank Pain ; Hospital Mortality ; Humans ; Male ; Pyelonephritis ; Sepsis ; Shock, Septic

The 55 years old male patient, undergoing maintenance hemodialysis, was admitted on our department because of painful swelling on left knee joint. At 19th hospital day, he complained of severe dyspnea. He had a large amount of pleural effusion of the left chest that was shown to be hemothorax by thoracentesis. After closed thoracostomy, about amount of 3,000 mL of blood was drained and bleeding was sustained from pleural cavity, and then emergency thoracotomy was done. We cannot find any bleeding focus in thoracic cavity, but oozing blood was seen on entire inner thoracic cavity. He had no previous invasive procedure or history of trauma before 6 months. We think that hemothorax may be developed because of defected coagulopathy and increased bleeding tendency due to platelet dysfunction in renal failure patient. Immediately thoracotomy and cryoprecipitate were helpful for this patient. We report a rare case of spontaneous hemothorax in a maintenance hemodialysis patient with literature review.
Blood Platelets ; Dyspnea ; Emergencies ; Hemorrhage ; Hemothorax* ; Humans ; Knee Joint ; Male ; Middle Aged ; Pleural Cavity ; Pleural Effusion ; Renal Dialysis* ; Renal Insufficiency ; Thoracic Cavity ; Thoracostomy ; Thoracotomy ; Thorax

For investigation of the species diversity of the Genus Crepidotus in Korea and constructing a key to Korean Crepidotus species, a total of 65 specimens, collected from 18 locations from 1982 to 2002, were observed for morphological characters of carpophores and other features. All the specimens have been preserved in the herbarium of the National Institute of Agricultural Sciences and Technology, R.D.A., Suwon, Korea. The specimens were identified according to the classification systems given by Hesler and Smith(1965), Nordstein(1990), Orton(1960), Pilat(1948), Senn-Irlet(1991, 1992, 1993) and Singer(1951, 1973, 1986). In this study, a total of 10 Crepidotus species were confirmed. Among them, Korean common names were designated to six unrecorded species as follows: C. uber; C. hygrophanus; C. latifolius; C. obscurus; C. subverrucisporus; and C. circinatus. A key to 10 Crepidotus species has been constructed.
Classification ; Gyeonggi-do ; Korea*

BACKGROUND/AIMS: Propofol is widely used for sedation during endoscopy. Because propofol may cause hepatic encephalopathy, hemodynamic compromise, and respiratory depression, cautious use is required in patients with liver cirrhosis. We evaluated the safety and efficacy of propofol in compensated cirrhosis during endoscopic examination. METHODS: Thirty-nine cirrhotic patients (19 and 20 cases of Child Pugh classes A and B, respectively) and 56 control subjects were included. The initial dose of propofol (40 mg) was increased by 20-mg increments until moderate sedation was achieved. The number connection test, flapping tremor test, blood pressure, heart rate, oxygen saturation, liver enzymes, and prothrombin time were evaluated before and after endoscopy. RESULTS: No significant change was observed in any parameter compared to baseline in either group. The mean dose of propofol was significantly lower in cirrhotic versus control subjects (49.7+/-15.8 versus 65.0+/-17.9 mg, respectively; p<0.001). Scores based on a visual analog scale evaluating patient satisfaction did not differ between groups (72+/-27 versus 64+/-26, respectively; p=0.196), nor did mean recovery time (16.4+/-9.8 versus 14.2+/-6.7 min, respectively; p=0.186). CONCLUSION: Propofol is safe and effective for moderate sedation in compensated liver cirrhosis.
Child ; Conscious Sedation ; Endoscopy ; Fibrosis ; Heart Rate ; Hematologic Tests ; Hemodynamics ; Hepatic Encephalopathy ; Humans ; Liver ; Liver Cirrhosis ; Oxygen ; Patient Satisfaction ; Propofol ; Prothrombin Time ; Respiratory Insufficiency ; Tremor