Primary malignant lymphoma of the appendix is an unconnnon neoplasm although the gastrointestinal tract is the most common extranodal site of malignant lymphoma. We report a case of primary malignant lymphoma of the appendix in a 54-year-old male, who presented with pain in the right lower abdomen. An appendectomy was performed. The appendix measured 9.5 cm in length and 5.5 cm in diameter. Cut sections showed a solitary circumferential mass in the appendiceal lumen. Light microscopic features were compatible with malignant lymphoma of diffuse large cell type(Working Formulation) and the immunophenotype was B cell type.

We report a case of primary osteosarcoma of the breast which is rare and exhibits poor prognosis. A 52 years-old-woman was admitted with rapidly growing right mammary mass. A huge lobulated dense mass with speckled calcifications, suggesting malignancy, was observed on mammography. She underwent a radical mastectomy. Grossly, the mass measured 16 14 6 cm and showed grayish white hard lobulated tissue with focal hemorrhage and necrosis. Light microscopically, the tumor was confirmed as an osteosarcoma devoid of any epithelial components. In postoperative whole body bone scan, there was no evidence of the other malignancy. To the best of our knowledge, the present case is the first report of primary osteosarcoma of the breast in Korea.
Breast* ; Hemorrhage ; Korea ; Mammography ; Mastectomy, Radical ; Necrosis ; Osteosarcoma* ; Prognosis

The Pill Questionnaire (PillQ) has been proposed as a simple way to evaluate cognitive deficits and their impact on the daily lives of those with Parkinson’s disease (PD) by asking patients or caregivers about whether patients can independently manage their pills. We used the PillQ to investigate the association of ability to manage medication with cognition and activities of daily living (ADLs) in patients with PD. Patients were divided into two groups based on PillQ scores. The no-impact group was able to take their antiparkinsonian medication independently, and the impact group exhibited problems describing their treatment or taking their drugs independently. A total of 208 participants (93 men) were included. 111 patients (53.4%) were included in the no-impact group, and 97 (46.6%) were included in the impact group. The impact group showed significantly lower cognitive functioning, difficulties with the performance of ADLs, and severe motor dysfunction. PillQ scores were significantly correlated with Mini-Mental State Examination and the Montreal Cognitive Assessment, and Clinical Dementia Rating scores. Management of medication by PD patients is associated with cognitive function, and the PillQ is an easy and useful test for detecting cognitive impairment and its impact on daily life.

It has been known that estradial(E2) level is concerned with the quality, number and growing of follicles. Determination of the serum levels of E2 has been used to predict the oocyte maturity. We experienced the rare case who has significantly low serum E2 level(551.26 pg/ml) in spite of multiple ovarian responses by sonographic finding, but from her we obtained 23 oocytes on MCD#16 after COH with ultrashort protocol(HP-FSH 150 IU, daily). The numbers of retrieved oocyte were 23 and fertilization rate was 56.6%, so the result of IVF-ET was successful twin pregnancy. Serum estradiol level and sonographic finding are essential to measure the number and growing of follicles, but E2 levels may be too unreliable to be used as sole parameter for the number and maturity of oocytes.
Estradiol* ; Fertilization ; Humans ; Oocytes ; Pregnancy ; Pregnancy, Twin ; Ultrasonography

PURPOSE : Developmental screening tests are in widespread use, but few reliable and valid tests are available. One of the oldest and best known developmental screening test was recently restandardized and revised as Denver II. Because the Denver II was published without evidence of its accuracy in developmental screening, we evaluate its accuracy in chidren with developmental delay to see whether it can be used on Korean children. METHODS : The Denver II was translated and was administered to 244 children attending the child development clinic in Kangnam St. Mary's Hospital to evaluated motor delay(Group I, n=68), language delay(Group II, n=84) or other problem(Group III, n=92). RESULTS : 1) The ratio of male to female and the mean age of the subject were 2.4:1 and 25.1 months overall, 1.6:1 and 11.8 months in Group I, 4.6:1 and 35.6 months in Group II, and 1.3:1 and 25.4 months in Group III. 2) The distribution of results(abnormal, normal and questionable) were 76%, 13% and 10% in Group I, 76%, 10% and 14% in Group II, and 38%, 53% and 9% in Group III. 3) The neurologic problems were determined 75%(cerebral palsy, central hypotonia, infantile spasm, myopathy etc.) in Group I, 74%(mental retardation, developmental language disorder, epilepsy, cerebral palsy etc.) Group II and 39%(mental retardation, epilepsy, cerebral palsy etc.) in Group III. 4) The sensitivity and the specificity of Denver II were 0.88 and 0.41 in Group 1, 0.90 and 0.27 in Group II, 0.81 and 0.77 in Group III, and 0.85 and 0.59 overall. CONCLUSION: Although the Denver II in identifying children at risk for developmental delay has a excellent sensitivity, it has a poor specificity, especially in identifying children at risk for language delay. These results demonstrate that the Denver fail to reliably identify children in need of developmental delay evaluation. So the Denver II should be standardized and modified to be used on Korean children with developmental delay.
Cerebral Palsy ; Child ; Child Development ; Epilepsy ; Female ; Humans ; Infant ; Infant, Newborn ; Language Development Disorders ; Male ; Mass Screening* ; Muscle Hypotonia ; Muscular Diseases ; Paralysis ; Sensitivity and Specificity ; Spasms, Infantile

Purpose: The purpose of this pilot study was to assess the feasibility of a proposed study “To investigate the effects of applying a vibration stimulation to the paretic and non-paretic sides on balance and gait in stroke patients” before proceeding with the main study. Methods: A total of 30 patients who had suffered a stroke and who met the selection criteria participated in this study. However, only 14 patients completed the study. The study subjects were randomly assigned to vibration stimulation on either both sides (B group) or the paralyzed side (P group). The interventions were applied for six weeks. The patients were assessed using the Berg balance scale (BBS), Timed up and go (TUG), 10-meter walk (10 MW), and 6-minute walk (6 MW) tests. Results: There was a significant difference before and after the application of vibration stimulation in the BBS, TUG, 10MW, and 6 MW tests in the B group (p < 0.05). Similarly, there was also a significant difference observed in the 10 MW and 6 MW tests in the P group (p < 0.05). The difference between the two groups was not significant in the BBS, TUG, 10 MW, and 6 MW tests (p > 0.05). Conclusion This pilot study suggests that it would be feasible to conduct a large-scale randomized controlled trial (RCT) to examine the effects of applying a vibration stimulation to the paretic and non-paretic sides, on the balance and gait in stroke patients.

Extra-pulmonary tuberculosis usually progresses as a secondary infection from pulmonary tuberculosis, and tuberculosis of the head and neck region. Tuberculosis of ocular and periocular areas, however, is a rare disease. Among ocular tuberculosis involving the adnexal structures, a few lacrimal sac tuberculosis has been reported. We recently experienced a case of lacrimal sac tuberculosis presenting as epiphora. Examination revealed bilateral nasolacrimal duct obstruction and the patient underwent endoscopic endonasal dacryocystorhinostomy. During the operation, a biopsy taken from the unhealthy looking lacrimal sac filled with caseous necrotic tissue was suggestive of tuberculosis. Histopathological features and further systemic evaluation confirmed tuberculosis. She was treated medically with anti-tubercular agents. The new opening of the lacrimal sac was patent and epiphora was resolved successfully at a year follow up. This report highlights the requirement of high suspicion of tuberculosis, even in the nasolacrimal drainage system.

The diagnosis of Hodgkin's disease is based on the morphologic identification of Reed-Sternberg (RS) cells and its variants in paraffin-embedded sections. The origin of RS cells remains a subject of controversy, and cells resembling RS cells are observed in some non-Hodgkin's lymphoma of T-cell lineage. In this study, eighteen cases of Hodgkin's disease (3 nodular sclerosis, 6 diffuse lymphocyte predominance, and 9 mixed cellularity) were studied with peanut agglutinin(PNA), anti-Leu-M1(CD15), LN2(CD74), Ber-H2(CD30) and bauhinia purpurea (BPA) by the avidin-biotin-peroxidase complex(ABC) method in paraffin-embedded sections. RS cells and their variants revealed positive reactions with one or more of the reagents in all examined cases. BPA staining was positive in 17 of 18 cases (94.4%), PNA staining was positive in 9 of 18 cases (50.0%), Leu MI was positive in 7 of 18 cases(38.9%), Ber-H2 was positive in 11 of 18 cases (61.1%), and LN2 was positive in 8 of 18 cases(44.4%). The staining properties of examined markers were recognized as paranuclear, diffuse cytoplasmic and cellular membranous patterns, but LN2 disclosed diffuse cytoplasmic staining in the positive cells. BPA also showed dense cytoplasmic staining reaction with macrophage-histiocytes. BPA reactivity was not affected by fortnalin fixation or paraffm embedding. Thirty six cases of non-Hodgkin's lymphomas(IO T-cell and 26 B-cell type) were also examined. The neoplastic cells of those cases did not stain positive with BPA, PNA, and Leu-Mi, but stained positively with LN2 in 3 cases of T-cell lymphomas and 14 cases of B-cell lymphomas, and BeT-H2 in T-cell lymphomas. In conclusion, to facilitate the detection of RS cells and related variants in paraffm sectionse of Hodgkin's disease, BPA can be used as a useful marker because of its high-detection rate, reproducible staining pattem, and resistance to fixative.

BACKGROUND: Several kinds of stents have shown their safety and efficacy to treat acute or subacute closure after balloon angioplasty as well as to reduce restenosis rate. However, one of the limitations of stents is difficult to deploy especially in tortuos vessels, lesions at a bend, and distal to previously deployed stents. The Micro stent II, which was one of the most recently developed stents, ia a rapid-exchage balloon expandable stainless steel stent with a zigzag design connected with a continuous single weld in each 3mm segments. It scores over excellent trackability and optimum radio-opacity. Therefore, it is easy to operate and feasible in tortuous, distal lesions and variety of lesion lengths. We report our experiences with Micro-II stent implanatation in the first 76 patients at Tonsei cardiovascular center to assess its safety and efficacy in patients with complex coronary anatomy and clinical results in the first months. METHODS: Between January 1996 and July 1996, eighty-six Micro-II stent were implanted in the coronary arteries of 76 patients(male 65.8%, age 59+/-10 year). Forty-five patients had unstable angina, the others had stable angina(17pts), acute myocardial infarction(14pts). RESULTS: 1) Indication of stenting was de novo 51(59.3%), suboptimal result 25(29.1%), restenosis 1(1.2%) and 9(10.4%) of lesions were stented in bail out situation. 2) Single stent were implanted in 76(88.4%)lesions, overlapping stent in 10(11.6%)lesions. Among overlapping stents, the second stent with Micro-II stent and with another kind of stent were 4.6%, 7.0%, respectively. 3) Procedure related complication including a subacute closure was occurred in 1(1.2%) patient who had distal dissection and 45% residual stenosis. In 12(14%) lesions, preistent dissection has been noticed after stent impantation. 4) Angiographic success(defined as a residual stenosis of <30% without major dissection) was achieved in 82 of 86 attempts(95.3%). The procedual success rate(defined as a residual stenosis of <30% without occurrence of major clinical events within 4 weeks after procesure) was 96.1%(73/76 patients). Angiographic success and procedural success rate in calcified lesion were 100% and 100%, respectively. Angiographic success and procedural success rate in more than 45` angulated lesion were 97% and 100%, respectively. 5) The mean minimal luminal diameter of the target lesions was increased from 0.42+/-0.40mm before stent implantation to 2.93+/-0.50mm(p<0.001). The percentage of diameter stenosis was reduced from 86.49+/-13.04% to 1.40+/-7.11%(p<0.001) after stent implantation. CONCLUSION: Coronary stenting with AVE Micro-II stent can be safety performed and is particularly beneficial in tortuous and calcified arteries. There was a high tendency for peristent dissection which need to special consideration to avoid. Follow-up data is needed to assess mid and term patency. Coronary artery disease . AVE Micro-II stent . Immediate results.
Angina, Unstable ; Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Follow-Up Studies ; Humans ; Phenobarbital ; Stainless Steel ; Stents*

PURPOSE: To determine whether intracellular localization of intravenously injected infection specific MoAb can be localized in the infected cells, immunohistochemical staining was obtained in animals infected with Mycobacterium tuberculosis. MATERIALS AND METHODS: One mg of intact mouse MoAb against mwobacteria (group I, n=10) and F(ab')2 (group II, n=6) were intravenously injected to the rabbits of each groups infected with M. tuberculosis H37RV. Immunohistochemical staining using an anti-mouse antibody was obtained at the 1,3, 5, 7 and 8th days in Group I and at the 1, 2, 3rd days in group II by streptavidin biotin method. For the control study, I mg of non specific polyclonal human IgG (group III, n=10) and 100 microgram of normal rabbit IgG F(ab')2 (group IV, n=6) were injected to the rabbits and guinea pigs respectively. RESULTS: Both groups (group I & II) showed a positive Ag-Ab reaction within the cytoplasm of monocytes. A weak but positive reaction was observed intracellularly in group III, however no positive reaction in group IV. CONCLUSION: Our results suggest intracellular Ag-Ab reaction plays an important role in the localization of infection by immunoscintigraphy using a specific MoAb fragments.
Animals ; Biotin ; Cytoplasm ; Guinea Pigs ; Humans ; Immunoglobulin G ; Mice ; Monocytes ; Mycobacterium tuberculosis ; Rabbits ; Streptavidin ; Tuberculosis ; Tuberculosis, Pulmonary*