A 21-year-old man presented with a 7 days history of fever. Careful clinical examination led to the discovery of left supraclavicular lymphadenopathy without hepatosplenomegaly. Serologic tests for Ebstein-Barr virus, HIV, hepatitis type B & C, syphilis and typhoid fever were negative. Blood, urine, and stool cultures yielded no growth. Histologically, the process mainly involved the connective tissue framework of the lymph node, sharing the features of inflammatory pseudotmor(IPT) of other organs: a storiform growth pattern, increased vascularity with associated vascular lesions, and a polymorphous inflammatory infiltrate in a collagen-rich stroma. Immunohistochemical study for spindle cells showed positive reaction for actin and vimentin but not for desmin, and lymphoid cells revealed polyclonality. Characteristics of mass formation, and the inflammatory nautre of the process enabled us adopt the term IPT which should be differentiated from hematolymphoid proliferative disorder or mesenchymal neoplasia.
Male ; Humans

PURPOSE: The aim of the present study was to assess the clinical, endoscopic and histologic findings of the Helicobacter pylori(Hp)-associated gastritis in children. METHODS: We have assessed 91 patient(age range 3-15 years) referred for upper intestinal endoscopy during 17 months. At least two antral biopsies were taken during endoscopy. The histological analysis and CLO test were done. The histologic changes were scored and semiquantitative assessment of the degree of Hp colonization was performed using Giemsa' stain. RESULTS: 1) Helicobacter pylori(Hp) was detected by CLO test and/or histologic analysis in 35 patients(38.5%). The CLO test was positive in 25 cases and H. pylori was colonized histologically in 10 patients. 2) The clinical symptoms were not significantly different between Hp positive and Hp negative patients(p>0.01). 3) Nodular antritis(37.1%) was a frequent endoscopic finding in Hp-infected patients, particularly in the subgroup with active chronic gastritis(93.8%). All patient with nodular antritis had Hp infection. 4) Helicobacter pylori has been associated both with active chronic gastritis(42.9%) and with nonactive chronic gastritis(40.0%). The common abnormal histologic finding was active chronic gastritis(42.9%) in Hp positive patients and nonactive chronic gastritis(66%) in HP negative patients. A significant correlation was found between Hp colonization score and the histologic categories(p<0.01). 5) The frequency of Hp infection(positiveness) as related to histologic categories was: active chronic gastritis 93.8 %; duodenal ulcer 66.7%; gastric ulcer 33.3 %; nonactive chronic gastritis 27.5%; normal 16.7%. 6) The histolgical colonization by Hp was assessed semiquantitatively, and a significantly greater Hp colonization score was observed in patients with signs of histological activity(p<0.01). CONCLUSIONS: This study suggests that Hp infection was significantly associated with endoscopic nodular antritis and the presence of gastroduodenal pathology.
Biopsy ; Child* ; Colon ; Duodenal Ulcer ; Endoscopy ; Gastritis* ; Helicobacter pylori ; Helicobacter* ; Humans ; Pathology ; Stomach Ulcer

It is well documented that cardiac myxomas are associated with immunologic features that can simulate systemic autoimmune diseases. Recently, it was reported that cardiac myxomas produce IL-6 constitutively, which could partly explain the immunologic features observed in these patients. However, only a few investigators have studied cytokines in regards to symptoms they may cause in patients with cardiac myxoma. Also there is very little information in the literature on the immunohistochmical localization of IL-6. We performed immunobistochemical stains for IL-4, TNF, and IL-6 on paraffm embbeded tissue of cardiac myxoma tissue. A bioassay of IL-6 activity in patient's serum and in cultured cells from fresh myxoma tissue was performed to ascertain the role of these cytokines in myxomas. In this study, we demonstrated inununohistochemically that there was a local overproduction of IL-4, TNF, and IL-6 in cytoplasm of the tumor cells in about half cases. Bioassays of the serum and cultured tumor cells revealed elevated IL-6 activities. Also these findings correlate to production of patient's constitutional symptoms with statistical significance (P<0.05). In conclusion, these results are of considerable importance in understanding the role of IL-4, TNF, and IL-6 in cardiac myxoma patient with constitutional symptoms, and have an impact on strategies for diagnosis and therapy of cardiac myxoma.

PURPOSE: The aim of the present study is to detect cagA and vacA genes of Helicobacter pylori(H. pylori) strain in gastric biopsy specimens and to evaluate its association with gastric inflammation in children. METHODS: The cagA and vacA genes were detected by a direct polymerase chain reaction(PCR) assay of gastric biopsy specimens in 22 patients who were found to be H. pylori positive by histological detection with modified Giemsa stain, rapid urease test(CLO; Delta West Pty Ltd, Australia) and PCR using ureC primer in gastric biopsy specimens. RESULTS: The cagA gene was detected in 16(72.7%) of 22 patients. Eleven patients(50%) had both the cagA and vacA gene. Five patients had only the vacA gene. Twenty one patients(95.5%) had the cagA or vacA gene. The cagA gene was detected in 66.7% of gastritis and in 87.5% of peptic ulcer patients. The association of the cagA gene with peptic ulcer or the higher degree of inflammation did not reach statistical significance. The histological H. pylori density of antrum was significantly correlated with gastric inflammation(P<0.05). CONCLUSION: These findings suggest that the antral density of H. pylori was associated with the gastric inflammation. The association of the cagA gene with peptic ulcer or the higher degree of imflammation was not significant.
Azure Stains ; Biopsy* ; Child* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Inflammation* ; Peptic Ulcer ; Polymerase Chain Reaction* ; Urease

We examined C3H pregnant mice at 15 days (70% gestation) after treatment of lipopolysaccaride (LPS) to observe the changes of IL-6 concentration in maternal serum and amniotic fluid and expression of IL-6, IL-13 & TIMP-3 in placenta, fetus and endometrium, and to investigate the correlation among IL-6, IL-13 and TIMP-3. The results were as follows: 1) IL-6 in serum and amniotic fluid after treatment of LPS was significantly elevated; peaked at 1, 2, 4, 5 hours and decreased to control level at 8 hours (P<0.05). IL-6 in placental disc, chorioamnionic membrane, fetus, decidua and endometrial epithelium was overexpressed significantly at 1, 2, 4 hours after treatment of LPS (P<0.05). IL-6 overexpression was more significantly increased in maternal tissue than fetal tissue (P<0.05). 2) Increased concentration of amniotic fluid IL-6 was equally originated from transplacental crossage of maternal serum IL-6, and direct local production of IL-6 from placenta, fetus and endometrium (P<0.05). 3) IL-13 in placental disc, chorioamnionic membrane, fetus, decidua and endometrial epithelium was overexpressed after treatment of LPS, but not significant statistically. 4) TIMP-3 was overexpressed in placental disc, chorioamnionic membrane, fetus and decidua. TIMP-3 overexpression was more significant in placental disc than other tissues (P<0.05). 5) Overexpressions in IL-13 and IL-6 revealed direct proportional correlation coefficient (Spearman correlation coefficient, 0.5212 ; P<0.05). IL-6 expression was a head of overexpression of TIMP-3, but not significant. In conclusion, all of IL-6, IL-13 and TIMP-3 relate with inflammatory response, especially IL-6 in maternal serum, amniotic fluid and tissue of placenta, fetus and endometrium was so sensitive that it can be an indicator for antenatal diagnosis of chorioamnonitis, and amniotic fluid IL-6 is equally originated from maternal serum and from tissue of placenta, fetus and endometrium. IL-13 and TIMP-3 may have parallel correlation to the IL-6 in fetal and maternal tissue after treatment of LPS.
Amniotic Fluid ; Animals ; Decidua ; Endometrium* ; Epithelium ; Female ; Fetus* ; Head ; Interleukin-13* ; Interleukin-6* ; Membranes ; Mice* ; Placenta* ; Prenatal Diagnosis ; Tissue Inhibitor of Metalloproteinase-3*

PURPOSE: Dysregulation of gastric epithelial cell proliferation and apoptosis are important in development of ulcer, atrophy and neoplasia in Helicobacter pylori (H. pylori) infection. The aim of this study was to investigate the effect of infection of H. pylori on gastric epithelial cell proliferation and apoptosis in children. METHODS: Histological grading by updated Sydney system, PCNA immunostaining and TUNEL method were performed in H. pylori positive (N=58) and negative (N=40) gastric biopsy specimens. RESULTS: In H. pylori positive children, there were significantly higher grade of polymorphonuclear neutrophil activity (P=0.000), chronic inflammation (P=0.000), epithelial damage (P=0.000) and lymphoid follicles (P=0.000) than in H. pylori negative children. Intestinal metaplasia was not seen in H. pylori positive children. PCNA index was significantly different between H. pylori positive children (67.8+/-18.13) and H. pylori negative children (54.8+/-14.46, P=0.000). There was positive correlation between PCNA index and H. pylori density (r=0.277, P=0.007), polymorphonuclear neutrophil activity (r=0.280, P=0.007) and chronic inflammation (r=0.284, P=0.006). Apoptosis index of H. pylori positive children (0.44+/-0.447) was significantly higher than of H. pylori negative children (0.14+/-0.196, P=0.000). There was positive correlation between apoptosis index and H. pylori density (r=0.472, P=0.000), polymorphonuclear neutrophil activity (r=0.370, P=0.001) and chronic inflammation (r=0.483, P=0.000). There was positive correlation between PCNA index and apoptosis index (r=0.353, P=0.003). CONCLUSION: The PCNA and apoptosis index in H. pylori positive children were significantly higher than in H. pylori negative children. This study suggested that gastric epithelial cell proliferation and apoptosis are important to pathogenesis of H. pylori infection in children.
Apoptosis* ; Atrophy ; Biopsy ; Child* ; Epithelial Cells* ; Helicobacter pylori* ; Helicobacter* ; Humans ; In Situ Nick-End Labeling ; Inflammation ; Metaplasia ; Neutrophils ; Proliferating Cell Nuclear Antigen ; Ulcer

PURPOSE: The aim of this study was to evaluate the usefulness of PCR using ureC primer in the gastric biopsy specimens for the diagnosis of Helicobacter pylori (H. pylori) infection in children. METHODS: We have assessed prospectively 82 patients (age range 1-15 years) who underwent esophagogastroduodenoscopy (Olympus EVIS XQ 200 or p230, Japan) for 15 months. At least three biopsy specimens were taken from the antral mucosa within 2cm of the pylorus. We performed histological detection with modified Giemsa stain, CLO test (Delta West Pty Ltd, Australia) for rapid urease test and PCR using ureC primer. H. pylori positivity was defined as the concordance of two tests. The patients with only one positive test were defined as undetermined cases. RESULTS: Seventeen of the 82 patients were H. pylori positive and 52 patients were H. pylori negative by definition. Of the 17 patients, 15 were found to be positive by all three tests, 2 were found to be positive by two tests. Abnormal endoscopic findings in H. pylori positive patients (82.4%) was significantly higher than H. pylori negative patients (50.0%) (P<0.05). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and efficiency of PCR in gastric biopsy specimens were 94.1%, 100%, 100%, 98.1%, 98.7% and same as CLO test, respectively. Those of endoscopic nodularity was 58.8%, 100%, 100%, 88.1% 89.9%. CONCLUSION: These findings suggest the PCR assay using the ureC gene in gastric biopsy specimens is sensitive and rapid for the diagnosis of H. pylori infection in children. But, in this study diagnostic sensitivity and specificity of PCR assay were the same as the CLO test.
Azure Stains ; Biopsy* ; Child* ; Diagnosis* ; Endoscopy, Digestive System ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mucous Membrane ; Polymerase Chain Reaction* ; Prospective Studies ; Pylorus ; Sensitivity and Specificity ; Urease

PURPOSE: The aim of this study was to evaluate the usefulness of PCR using ureC primer in the gastric biopsy specimens for the diagnosis of Helicobacter pylori (H. pylori) infection in children. METHODS: We have assessed prospectively 82 patients (age range 1-15 years) who underwent esophagogastroduodenoscopy (Olympus EVIS XQ 200 or p230, Japan) for 15 months. At least three biopsy specimens were taken from the antral mucosa within 2cm of the pylorus. We performed histological detection with modified Giemsa stain, CLO test (Delta West Pty Ltd, Australia) for rapid urease test and PCR using ureC primer. H. pylori positivity was defined as the concordance of two tests. The patients with only one positive test were defined as undetermined cases. RESULTS: Seventeen of the 82 patients were H. pylori positive and 52 patients were H. pylori negative by definition. Of the 17 patients, 15 were found to be positive by all three tests, 2 were found to be positive by two tests. Abnormal endoscopic findings in H. pylori positive patients (82.4%) was significantly higher than H. pylori negative patients (50.0%) (P<0.05). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and efficiency of PCR in gastric biopsy specimens were 94.1%, 100%, 100%, 98.1%, 98.7% and same as CLO test, respectively. Those of endoscopic nodularity was 58.8%, 100%, 100%, 88.1% 89.9%. CONCLUSION: These findings suggest the PCR assay using the ureC gene in gastric biopsy specimens is sensitive and rapid for the diagnosis of H. pylori infection in children. But, in this study diagnostic sensitivity and specificity of PCR assay were the same as the CLO test.
Azure Stains ; Biopsy* ; Child* ; Diagnosis* ; Endoscopy, Digestive System ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mucous Membrane ; Polymerase Chain Reaction* ; Prospective Studies ; Pylorus ; Sensitivity and Specificity ; Urease

OBJECTIVE: To assess the reliability of triple marker screening test in midtrimester pregnancy for fetal Down syndrome. METHODS: From October 1, 1996 to May 31, 1998 at Nowon Eulji Hospital, 3700 Pregnant women underwent serum tiple marker screening for Down syndrome during 15-20weeks of gestational age. The results of serum triple marker screenig tests for Down syndrome and the outcomes of pregnancies were retrospectively assesed. RESULTS: Sixty seven of 3700 cases(1.81%) were positive in screening test, and 3633(98.18%) cases were negative. Among 67 cases of positive screening test, 1 case(1.49%) was diagnosed as Down syndrome. Among 3633 cases of negative screening test, 4 cases(0.1%) were diagnosed as chromosomal abnormalies postnatally. Two of these 4 cases of chromosomal abnormalies were Down syndrome. CONCLUSION: With this results, sensitivity of triple marker screeing test for Down syndrome is very low as 33.3%. In order to increase the sensitivity, some compensatory adjustment is required in triple marker screening test.
Down Syndrome* ; Equidae ; Female ; Gestational Age ; Humans ; Mass Screening* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second* ; Pregnant Women ; Retrospective Studies

No abstract available.
Humans ; Intracranial Aneurysm* ; Tomography, Emission-Computed, Single-Photon*