A case of xanthoma of the liver in a 61-year-old Korean woman with multiple myeloma, hyperlipidemia and xanthoma of the skin is described. Microscopically, the liver showed a multiple xanthomatous collection of foamy histiocytes as well as diffuse sinusoidal infiltration of the foam cells. This hepatic accumulation of foam cells seems to be related to hyperlipidemia of the patient. The mechanism of hyperlipidemia in multiple myeloma is discussed.
Case Report ; Female ; Human ; Hyperlipidemia/blood/*complications ; Liver Diseases/blood/*complications ; Middle Age ; Multiple Myeloma/blood/*complications ; Xanthomatosis/blood/*complications

No abstract available.
Colitis* ; Dasatinib* ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

Perfusion scintigraphy has proved to be an essential part for the diagnosis of pulmonary thromboembolism. The wedge shaped perfusion defect extending to lung base is a highly probable finding of pulmonary embolism. Occasionally, great perfusion defects could be presented as a false positive finding under the circumstance of nonthromboembolic origin, such as neoplastic compression or invasion of pulmonary artery. We report an unusual case of massive perfusion defect resulting from pulmonary arterial compression by bronchogenic carcinoma. A 71-year-old man visited our hospital because of productive cough and was diagnosed as bronchogenic carcinoma. The perfusion scintigraphy showed unilateral total defect of lung, not accompanied by any clinical evidence of thromboembolism. A contrast enhanced computed tomogram showed heterogeneous mass shadow in left hilum, abutting to the descending aorta and compressing left main pulmonary artery. These findings suggested a nonembolic mechanism of perfusion defects which were produced by the neoplastic compression of pulmonary artery.
Aged ; Aorta, Thoracic ; Carcinoma, Bronchogenic* ; Cough ; Diagnosis ; Humans ; Lung* ; Perfusion Imaging ; Perfusion* ; Pulmonary Artery ; Pulmonary Embolism ; Thromboembolism

Necrotizing pneumonia is a complication of severe, sometimes fatal, lobar pneumonia that leads to extensive necrosis of lung parenchyme. The plain chest X-ray shows many small lucencies and pneumatoceles while the chest CT demonstrates cavities, that do not show contrast enhancement. Major bacteriae that cause necrotizing pneumonia are anaerobes in immune deficient patients and nosocomial infections, and Streptococcus pneumoniae and Mycoplasma pneumoniae in children of healthy environments. Cases of necrotizing pneumonia in children, unlike those observed in adults, show less need for invasive surgery and lead to a favorable outcome once an early diagnosis is made and a course of appropriate antibiotics is initiated. Empirical antibiotic treatment is important because the specific causative agent may not be found. We report two cases of successful treatment of healthy children who had lung abscesses combined with extensive necrotizing pneumonia.
Adult ; Anti-Bacterial Agents ; Bacteria ; Child* ; Cross Infection ; Early Diagnosis ; Humans ; Lung ; Lung Abscess ; Mycoplasma pneumoniae ; Necrosis ; Pneumonia* ; Pneumonia, Mycoplasma ; Streptococcus pneumoniae ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: Pleural effusion is a common disease in clinical practice but its effect on pulmonary function and altered pulmonary mechanics after removal of effusion are not still largely understood. Previous studies have shown that there is little or a relatively small improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracentesis. The present study was designed to assess the effect on pulmonary function of pleural effusion and to test whether there was a significant improvement in pulmonary function and arterial oxygenation after thoracentesis and to observe long term effect after thoracentesis. METHOD: We examined flow-volume curve, body box and arterial blood gas analysis according to severity of effusion, present symptom, and symptom duration. Then, we measured changes of pulmonary function after thoracentesis and observed longterm effect after thoracentesis. RESULT: 1) Pleural effusion cause restrictive pulmonary insufficiency. Not only functional impairment of small airway but also large airway is provoked. 2) MMFR, FEV1, Raw, PO2 are earlier improved than FVC and TLC after thoracentesis and patients without complication have mild restrictive pulmonary insufficiency after longterm observation 3) FVC, FEV1, & TLC are similarly restricted as severity of pleural effusion and PO2 is relatively decreased. 4) Cases with symptom duration 1 week or less and cases with dyspnea have more severe pulmonary insufficiency than others. 5) The flow volume curves show a relatively greater improvement in flow rates at large lung volumes than small airway. 6) Significant relationship is shown between first thoracentesis amount and changes of FEV1, FVC, TLC. CONCUSION: Pleural effusion cause restrictive pulmonary insufficiency and not only functional impairment of small airway impairment but also large airway is provoked. Then, Pulmonary function is progressively improved after thoracentesis and remained mild restrictive pulmonary insufficiency after recovery
Blood Gas Analysis ; Dyspnea ; Humans ; Lung ; Maximal Midexpiratory Flow Rate ; Mechanics ; Oxygen ; Pleural Effusion* ; Tuberculosis, Pleural*

OBJECTIVES: Schizophrenia patients are known to be more prone to metabolic disease than normal people. This study aimed to identify the changes in metabolic parameters of schizophrenia patients using atypical antipsychotic drugs for 1 year. METHODS: A total of 200 schizophrenia patients were recruited and categorized into the aripiprazole-treatment group and control group taking 5 atypical antipsychotic drugs. Comparative analysis were between groups. The prescriptions of psychotropic drugs were collected by a review of medical records. Blood was collected after fasting for 12 hours at the starting point of treatment and the 12th month, and patient medical records were evaluated for basici nformation and treatment history. Physical measurement, the prevalence of metabolic syndrome and metabolic parameters were studied using ATP-III diagnostic criteria. RESULTS: From the study, the aripiprazole-treatment group had a mean weight increase of 0.6 kg and the control group had a mean weight increase of 6.5 kg at the 1 year follow-up, showing a significant difference between the two groups. There were also significant differences between the two groups in waist size, systolic and diastolic blood pressure, fasting blood sugar, total cholesterol, triglyceride, HDL-choleseterol and prolactin level. Along with meaningful improvement of the symptoms, aripiprazole-treatment group showed less effect on in abdominal obesity, diabetes, blood pressure, cholesterol and prolactin than other atypical antipsychotic drugs. CONCLUSION: Therapeutic intervention such as diagnosis, treatment, weight management and diet improvement is necessary for schizophrenia patients. Psychiatric symptoms as well as internal meicine-related problems such as metabolic disease need to be addressed in case management.
Antipsychotic Agents ; Blood Glucose ; Blood Pressure ; Case Management ; Cholesterol ; Diagnosis ; Diet ; Fasting ; Follow-Up Studies ; Humans ; Medical Records ; Metabolic Diseases ; Obesity, Abdominal ; Prescriptions ; Prevalence ; Prolactin ; Prospective Studies* ; Psychotropic Drugs ; Schizophrenia ; Triglycerides

Primary extrapulmonary small cell carcinoma(SCC) is appearing with increased frequency in the literature. These tumors have been described in the esophagus, stomach, pancreas, larynx, hypopharynx, salivary gland, nasal cavity & paranasal sinus, thymus, small & large bowel, uterine cervix, endometrium, breast, prostate, urinary bladder and skin. Small cell carcinoma of the stomach is extremely rare and a total 9 cases have been reported in the English literature. Like SCC in the lung, SCC in the alimentary tract has a aggresive behavior and prognosis of the patient is poor. We are reported a case of advanced gastric cancer diagnosed as small cell type by endoscopic biopsy. Grossly, the lesion of small cell carcinoma of the stomach, located in the upper body and gastric angle, is ulcerated with irregular margin and dirty surface covered with blodd clots and exudates.
Biopsy ; Breast ; Carcinoma, Small Cell* ; Cervix Uteri ; Endometrium ; Endoscopy ; Esophagus ; Exudates and Transudates ; Female ; Humans ; Hypopharynx ; Larynx ; Lung ; Nasal Cavity ; Pancreas ; Prognosis ; Prostate ; Salivary Glands ; Skin ; Stomach Neoplasms ; Stomach* ; Thymus Gland ; Ulcer ; Urinary Bladder

Cytologic findings from five cases with variable types of Hodgkin's disease were reviewed with special emphasis on the Reed-Sternberg (R-S) cells and their variants, Typical R-S and Hodgkin's cells were mono- or binucleated, and nuclei had rounded smooth con- tour. Acidophilic prominent nucleoli with perinucleolar halo were conspicuous. In comparison to typical Reed-Sternberg cells, L & H (lymphocytic and histiocytic) cells in the lymphocyte predominant type tended to show pop-corn like irregular nuclear contour and to lack the prominent nucleoli. Lacunar cells in the nodular sclerosis type had multilobated nuclei with prominent acidophilic nucleoli. There was no prominent perinucleolar halo in L & H and lacunar cells. In conjuction with the number of Reed-Sternberg cells and back ground findings observed on the smears, the characteristic features of R-S cells and their variants allowed to make typing of Hodgkin's disease.
Epidemiologic Studies* ; Hodgkin Disease ; Lymphocytes ; Multiple Myeloma ; Nephrotic Syndrome* ; Reed-Sternberg Cells ; Sclerosis

Epidermal cysts slowly growing, intradermal or subcutaneous tumors that usually cease growing after having reached 1 to 5 cm in diameter. We report a case of giant epidermal cyst on the scapular region with the appearance of well delineated huge mass measured 19×17×14cm in size. Its clinical and surgical management are illustrated.
Epidermal Cyst

OBJECTIVE: With improvement in the social and economic states of Korea, most of the pregnancies have been appropriately examined but there are a few mothers and newborns who have not received proper prenatal care. The aim of this study was to investigate obstetrical and neonatal complications resulting from inadequate prenatal care. METHODS: The medical records of 107 neonates who had received prenatal care lesser than 3 visits and admitted to the neonatal intensive care units of Korea University Ansan Hospital from January 2004 to December 2009 were retrospectively reviewed. Obstetrical complications, neonatal gestational age, birth weight, neonatal complications were analyzed. We compared neonatal complications of the inadequate prenatal care group and those of the adequate prenatal care group lesser than 34 weeks' gestational age neonates. RESULTS: In obstetrical complications, there were twenty women with anemia, fifteen cases with premature rupture of membranes, and fourteen chorioamnionitis. In neonatal complications, there were forth-four premature infants, and forty-four low birth weight infants. Respiratory distress syndrome, small for gestational age, severe intraventricular hemorrhage were more common in the inadequate prenatal care group than the adequate prenatal care group. Thirty-seven infants (34.5%) were sent to the adoption agency. Fifty infants (46.6%) received medical expense support by the social service. CONCLUSIONS: Obstetrical and neonatal complications and social burden were increasing when the pregnancies had not received adequate prenatal care. To reduce perinatal complications of mothers and neonates in low socioeconomic classes, practical nation's policies and social supports for adequate prenatal care should be provided.
Adoption ; Anemia ; Birth Weight ; Chorioamnionitis ; Female ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Korea ; Medical Records ; Membranes ; Mothers ; Pregnancy ; Prenatal Care ; Retrospective Studies ; Rupture