The authors performed a study of 32 patients who had undergone anterior lumbar interbody fusion using allograft with posterior pedicular instrumentation. The clinical outcomes were evaluated and the radiographs were analyzed with respect to graft subsidence, interspace collapse, graft collapse, sagittal angle and fusion status. In 71% of the levels there was a loss of disc space height during the follow-up, with 18% of the levels being narrower than their preoperative height at late follow-up. Significant(more than 3mm) subsidence and collapse were noted in three and four levels respectively. Approximately 84% of the 32 patients had satisfactory results and a radiological fusion was obtained in 88.2% of the 34 levels. We consider the pedicle screw fixation improves the retention of interspace distraction and the fusion rate of allograft in anterior lumbar interbody fusion.
Allografts* ; Follow-Up Studies ; Humans ; Spine ; Transplants

Herein we report two cases of leukemia cutis that were responsive to oral all-tratm retinoic acid(ATRA) therapy. The two presented patients, who had been diagnosed with acute pmmyelocytic leukemia, disclosed specific lesions of leukemia cutis through histopathological examinations. Leukemia cutis due to acute promyelocytic leukemia is characterized by PML/RAR-a chimeric fusion proteins which arise from chromosomal trmslocation. This PML/RAR-a transcript can be a valuable molecular therapeutic target to systemic retinoid therapy in that ATRA induces terminal differentiation of leukemic clones and PML/RAR-a transcript preserves the ATRA-responsive signal transduction pathway. We concluded that leukemia cutis might be treated by tretinoin therapy without notifi.able adverse effects.
Clone Cells ; Humans ; Leukemia* ; Leukemia, Promyelocytic, Acute ; Signal Transduction ; Tretinoin

We herein present a rare case of a 42-year-old man with primary cutaneous marginal zone lymphoma(MZL) of the B-cell type on his shin. MZL is known to be the cutaneous counterpart of MALT(mucosa-associated lymphatic tissue) lymphoma. Histopathologically, MZL is characterized by multi-nodular infiltrates of centrocyte-like and centroblast-like marginal cells with bottom-heavy patterns, lymphoplasmacytoid differentiation, typical distribution of tumor cells in the marginal zone and follicular colonization by tumor cells. This B-cell lymphoma of a benign grade should be differentiated from mantle cell lymphoma and follicular center cell lymphoma.
Adult ; B-Lymphocytes ; Colon ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Mantle-Cell

We herein report a case of Richters syndrome(RS) that was discovered following an investigation of a skin lesion. RS represents an acute transformation of chronic lymphocytic leukemia(CLL) to highly malignant large cell lymphoma such as diffuse large B-cell lymphoma(DLBCL). RS is characterixed by abrupt B-symptoms, rapidly progressive lymphadenopathy, hepatosplenomegaly, frequent extranodal involvement, hypercalcemia and an unfavorable clinical course. The patient is a 31-year-old male with skin lesions on his face. He had been previously diagnosed with CLL. At his presentation, CLL and DLBCL manifestly co-existed. Our multistage analysis suggested that DLBCL and CLL might arise from a different B-cell clone. He showed a poor clinical response to systemic chemotherapy.
Adult ; B-Lymphocytes ; Clone Cells ; Drug Therapy ; Humans ; Hypercalcemia ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Lymphatic Diseases ; Lymphoma* ; Male ; Skin

PURPOSE: The purpose of this study is to assess the effect of Transcatheter Arterial Embolization(TAE) according to anglographic findings in hepatocellular carcinoma. MATERIALS AND METHOD: We retrospectively reviewed 50 cases who received TAE for unresectable hepatocellular carcinoma. We analyzed the anglographic findings which were correlated with the effect of TAE. The common anglographic findings of the hepatocellular carcinoma were tumor staining, neovascularity and enlargement of feeding artery. These anglographic findings were classified into grade 0, +1, +2. Effect of TAE were classified into five patterns;good response, partial response, minimal response, no response and more aggravation. RESULT:In grading of tumor staining, among 50 cases, the grade 0, +1, +2 were seen in 1 case(2%), 14 cases(28%), 35 cases(70%) each. In grading of enlargement of feeding artery, the grade 0, +1, +2 were seen in 7 cases(14%), 19 cases(38%), 24 cases(48%) each. In grading of neovascularity, the grade 0, +1, +2 were seen in 6 cases(12%), 15 cases(30%), 29 cases(58%) each. This study showed that the higher grade of anglographic finding, the better effect of TAE. A statistically significant differance was found (p<0.005). But the TAE was not effective in some cases (the maximum diameter of mass is over 10cm, portal vein thrombosis or ateriovenous shunt) in spite of high grade. CONCLUSION: We believe that these angiogr. aphic findings (tumor staining, enlargement of feeding artery, neovascularity) are one of important indices for anticipating the effect of TAE in patients with unresectable hepatocellular carcinoma.
Arteries ; Carcinoma, Hepatocellular* ; Humans ; Retrospective Studies ; Venous Thrombosis

BACKGROUND: Traditionally, herpes zoster (HZ) has been known to be a recrudescence of a latent viral infection of sensory ganglia, with the spread of the virus along sensory nerves and a dermatomal cutaneous eruption. However, clinically detectable muscular wenkness often occurs in patients with HZ. Accordingly, segmental or non-segmental motor neuron involvement by HZ may occur in addition to the involvement of sensory ganglion. OBJECTIVE: This study was conducted to estimate the frequency of motor neuron involvement in patients with HZ in Korea. METHODS: Fifty six subjects with HZ were enrolled in this study which used a conventional needle EMG (electromyography) and motor nerve conduction velocity test. Studies were conducted a minimum of 2 weeks after the onset of the rash. EMG was performed on the ipsilateral paravertebral muscles at the dermatomial levels of the eruption and controlateral sides. RESULTS: 1. One or more abnormal EMG findings(fibrillation potential, positive waves, bursts of high frequency discharge, polyphasia, fasciculation) were found in 51.8% of HZ patients. 2. Among the subjects with motor involvement, thoracic dermatome was most frequently involved (58.6%). 3. Ipsilateral motor involvement was more common(72.5%) than controlateral involvement(27.5%) among the patients with abnormal EMG findings. 55.2% of patients showed non-segmental motor involvement and that the altered EMG findings were not confined to the segment invaded by the eruption. 4, There was no association between the presence of postherpetic neuralgia or severity of pain or initial allodynia and EMG changes. CONCLUSION: Segmental or non-segmental motor neuron involvement by HZ may not be uncommon in Korea. HZ seems to cause widespread motor nerve changes, albeit usually subclinical alterations in the motor system, easily identifiable on EMG.
Exanthema ; Ganglia, Sensory ; Herpes Zoster* ; Humans ; Hyperalgesia ; Korea ; Motor Neurons* ; Muscles ; Needles ; Neural Conduction ; Neuralgia, Postherpetic ; Recurrence

We herein present two cases of generalized pustular psoriasis(GPP) followed by acquired bullous diseases during antipsoriatic management. Although there were several reports de-scribing the coexistence of psoriasis vulgaris and autoimmune bullous diseases such as bullous pemphigoid or pemphigus vulgaris(PV), a coexistence of GPP and bullous disease was sparcely reported. In one patient, we could define atypical autoantigen which was distinct from the other known antigens in documented cases of bullous diseases. The other case was compatible with PV. The psoriatic lesions and bullous eruptions of the two patients cleared in several weeks after administration of cyclosporine.
Cyclosporine ; Humans ; Pemphigoid, Bullous ; Pemphigus ; Psoriasis*

Non-nasal T/NK-cell lymphoma(TNKCL) without nasal cavity invasion is a subtype of angiocentric T-cell lymphomas showing the biphenotype of the T-cell and NK-cell. This tumor is characterized by the absence of clonal rearrangement of the T-cell receptor gene, frequent association with Epstein- Barr virus(EBV), poor clinical course, and common extranodal invasion. Antiphospholipid syndrome (APS) is characterized by repetitive spontaneaus abortion, thrombocytopenia, thrombotic symptoms and the positivity to the antiphospholipid antibody. Our patient was a 35-year-old woman with skin lesion on her face. Previously, she had been diagnosed of APS. Histopathological, immunohistochemical and serologic studies could disclose EBV-associated non-nasal TNKCL.
Adult ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Female ; Genes, T-Cell Receptor ; Humans ; Lymphoma* ; Lymphoma, T-Cell ; Nasal Cavity ; Skin ; T-Lymphocytes ; Thrombocytopenia

BACKGROUND: A pathogenesis of skin-homing lymphoid cells in primary cutaneous T-eell lymphoma(CTCL) has not been elucidated, CLA(cutaneous lymphocyte-associated antigen) defined by HECA-452 monoclonal anfibody has been proposed as the novel skin-homing receptors of infiltrative lymphocytes in atopic dermatitis and graft-versus-host disease. Accordingly, CLA may be a determinant explaining about the skin-homing properties of lymphoid tumor cells in CTCL. OBJECTIVE: This study was conducted to investigate the immunohistochemical expression of CLA in the lesional tissue specimens of cutaneous lymphomas. METHODS: Immunohistochemicslly, we examined the expression of CLA, E-selectin, ICAM-1 and LFA-1 antigens in the tissue specimens taken from the skin lesions and lymph nodes of the 22 patients with cutaneous lymphomas and the 20 control subjects with non-cutaneous lymphomas. Results : 1. The expression rate of CLA was 40.9% in the skin specimens of cutaneous lymphomas. We could not fad any expression of CLA in non-cutaneous lymphomas. 2. CTCL showed a more frequent expression of CLA(80%) than cutaneous B-cell lymphomas (CBCL)(8.3%). We found more frequently CLA+ high endothelial venules in non-cutaneous lymphomas(40%) than in cutaneous lymphomas(9.1%). 3. CLA and E-selectin were more frequently expressed in primary CTCL(100%, 83.3%) than in secondary CTCL(50%, 0%). 4. The positivity to ICAM-1 and LFA-1 antigens was higher in primary cutaneous lymphomas (72.7%, 81.8%) than in secondary forms(9.1%, 9.1%). Conclusion : CLA and E-selectin may represent the pivotal skin-homing receptor of infiltrative tumor cells and vascular counter-receptor in primary CTCL, respectively. Also, ICAM-1 and LFA-1 may have a role in the primary cutaneous infiltration of lymphoma cells as the additional cofactors.
Dermatitis, Atopic ; E-Selectin ; Flavin-Adenine Dinucleotide ; Graft vs Host Disease ; Humans ; Intercellular Adhesion Molecule-1 ; Lymph Nodes ; Lymphocyte Function-Associated Antigen-1 ; Lymphocytes ; Lymphoma* ; Lymphoma, B-Cell ; Skin ; Venules

Uterine artery ligation was performed to control postpartum hemorrhage in 17 cases at Han-Il hospital from July, 1994 to June, 1996. In 14 cases among them, postpartum hemorrhage was controlled successfully(82.4%) and there were no significant complications such as ureteral injury. Twelve cases could be followed up for 6 months to 2 years after uterine artery ligation. Menstruation occurred in all cases(12 cases) and it was normal in rhythm, duration and amount of bleeding. This procedure had significantly saved operation time, estimated blood loss and transfused packed RBC volume than the hysterectomy. It can be concluded that uterine artery ligation is an effective and safe alternative to hysterectomy for management of uncontrollable postpartum hemorrhage.
Female ; Hemorrhage ; Hysterectomy ; Ligation* ; Menstruation ; Methods ; Postpartum Hemorrhage* ; Postpartum Period* ; Ureter ; Uterine Artery*