Epithelioid sarcoma is malignant tumor described by Enzinger, that is likely to be confused with a varety of benign and malignant conditions, especially a granulomatous process, a synovial sarcoma Or an ulerating squamous cell carcinoma. The tumor occurs chiefly in young adult and most commonly affects the soft tissue of the hand, the forearm and the pretibial region. The tumor is characteristically a slowly growing lesion but frequent recurrence is common and metastasis were most frequent in the lung. In this paper, we reported one case which is believed to be epithelioid sarcoma in the forearm.
Carcinoma, Squamous Cell ; Forearm ; Hand ; Humans ; Lung ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Sarcoma, Synovial ; Young Adult

BACKGROUND: The human papillomavirus (HPV) is the most common etiologic factor of cervical cancer. It was reported that the incidence of cervical intraepithelial neoplasia and cervical carcinoma was increased when normal women was infected with HPV. To date, for detection and classification of HPV, it were used by hybridization method using the DNA probe specific for HPV and in situ hybridization method for fixed paraffinized tissue, but reported that these methods were inadequate for detection of HPV DNA because of low sensitivity and complex procedure. Compared with these methods, polymerase chain reaction (PCR) was reported as a highly sensitive molecular biologic technique which could detect the HPV DNA in the cervical epithelial cell of women. Thus we used PCR for the investigation of detection rate of HPV 16 and 18, and its relationship with Pap smear class in normal women. METHODS: In 86 normal women, we had extracted the HPV DNA from cervical swab samples and then detected the presence of HPV DNA by nested PCR. RESULTS: In the cases of 86 normal women, the detection rate for HPV DNA was about 7.0%. In the cases of 26 women with Pap smear class I, the HPV DNA was not detected. And in the cases of 60 women with Pap smear class II, the detection rate for HPV DNA was about 10.0%; HPV subtype 16 about 6.7%; HPV subtype 18 about 1.7%; and the coinfection rate of HPV subtype 16 and 18 about 1.7%. CONCLUSIONS: We think that women who was previously infected with high-risk HPV should be examined for Pap smear test in regular time interval, and if the result of Pap smear was abnormal, then should be examined for the presence of the HPV DNA.
Cervical Intraepithelial Neoplasia ; Classification ; Coinfection ; DNA ; Epithelial Cells ; Female ; Human papillomavirus 16 ; Humans* ; In Situ Hybridization ; Incidence ; Papillomavirus Infections* ; Paraffin ; Polymerase Chain Reaction* ; Uterine Cervical Neoplasms

Practice parameters for non-pharmacological treatment of children and adolescents with pervasive developmental disorders are based on the scientific literature for evidence-based practices. Appropriate educational and behavioral interventions are important in improving the long-term outcome in pervasive developmental disorders. Early and sustained intervention appears to be particularly important. The goal for interventions is to gain pragmatic skills for verbal communication, playing with peers, daily living routines, self-management, and social adaptation. Appropriate involvement and collaboration with parents and family are essential for well-functioning intervention programs. The life-long nature of autism implies that the clinician should maintain an active role in long-term treatment planning and family support. Vocational training and training for more independent living are important for adolescents with autism. Professionals should be knowledgeable about local and national resources and opportunities for family support as well as support of the individual.
Adolescent ; Autistic Disorder ; Child ; Cooperative Behavior ; Humans ; Independent Living ; Parents ; Self Care

The objective of this review is to establish practice parameters for pharmacological treatment of children and adolescents with pervasive developmental disorders. We performed a detailed review of the literature, including a wide range of controlled clinical trials, open trials, case reports, and side-effect profiles of related drugs. Few medications have a treatment indication for pervasive developmental disorders, and few studies with well-controlled methodology are available for evaluating treatment results. Pharmacological treatments focus on associated target symptoms because symptom reduction may improve educational and social ability and enhance quality of life. Well-controlled trials have been conducted for some SSRI(selective serotonin reuptake inhibitor) antidepressants, risperidone, and methylphenidate, and showed reduction of some target symptoms. Since the medications are not specific to autism and do not treat core symptoms of the disorder, their potential side effects should be carefully considered. Family education is necessary to give proper information on target symptoms, limitation of drug treatments, and risks.
Adolescent ; Antidepressive Agents ; Autistic Disorder ; Child ; Education ; Humans ; Methylphenidate ; Quality of Life ; Risperidone ; Serotonin

Multiple areas of development are affected in pervasive developmental disorders(PDD), and assessments of various aspects of behavior and development are essential for diagnosis. The object of this review is to provide the practical guidelines for the assessment of core features of PDD, including abnormalities in communication, social interaction, and repetitive and stereotyped behavior. It covers the issues of differential diagnosis within and outside the PDD category, standardized diagnostic tools, assessment of intellectual and language functions, and the early diagnosis of PDD in infancy. This guideline also stresses the process of medical and neurological evaluation for proper diagnosis of PDD.
Diagnosis* ; Diagnosis, Differential ; Early Diagnosis ; Interpersonal Relations ; Stereotyped Behavior

Pervasive developmental disorders are characterized by lifelong impairments in fundamental social and/or communication skills and by the presence of seemingly purposeless and repetitive behaviors, interests, or activities. A number of possible biological etiologies, including genetic, structural and functional brain abnormalities, have been identified in patients with pervasive developmental disorders. In addition, clinicians should take the possibility of comorbid psychiatric conditions into consideration when making the differential diagnosis of pervasive developmental disorders.
Brain ; Comorbidity* ; Diagnosis, Differential ; Epidemiology* ; Humans

The new research data and rapid development of psychotropic drugs over the past few years have warranted the development of clinical practice guidelines for managing pervasive developmental disorder(PDD). These guidelines are urgently needed due to the recent changes in social circumstances and clinical situations in Korea. Despite the many limitations and problems surrounding the development of these guidelines, the Korean Academy of Child and Adolescent Psychiatry(KACAP) has decided to develop the Korean Practice Parameters for the Treatment of PDD. The goal, basic principles, organization, and implications of this development project are introduced in this special paper. We expect these practice parameters to be a useful reference not only for child psychiatrists and other healthcare professionals in clinical practice, but also for the autistic patients themselves and their caregivers. The practice parameters shall be revised and improved in the near future.
Adolescent ; Caregivers ; Child ; Delivery of Health Care ; Humans ; Korea ; Psychiatry ; Psychotropic Drugs

Immunotherapy with regulatory T lymphocytes is considered to be an attractive new therapeutic modality to prevent allograft rejection. The success of this new therapy is critically dependent on the preparation of highly effective and enough number of regulatory T cells. Here, we tried to establish a proper strategy for the ex vivo expansion of regulatory T cells and evaluated their characteristics. CD4+CD25h+CD62L+ T cells were isolated from the recipient mice and weekly stimulated with various stimuli in the presence of IL-2. The most efficient protocol for the expansion of regulatory T cells maintaining Foxp3 expression and regulatory activity was the three cycles stimulation with donor bone marrow-derived dendritic cells (BM-DCs) which yielded around 400 fold expansion of regulatory T cells. The in vitro-expanded regulatory T cells expressing lymph node homing receptors on their cell surface, were composed of polyclonal population, and did not acquire the ability to produce effector cytokines. Importantly, these expanded regulatory T cells induced a modest prolongation of skin allograft survival when combined with transient T cell depletion in recipient mice. These data indicate that our protocol could be used to obtain an effective population of natural regulatory T cells available for the regulatory T cell therapy to prevent allograft rejection.
Animals ; Cytokines ; Dendritic Cells ; Humans ; Immunotherapy ; Interleukin-2 ; Mice ; Receptors, Lymphocyte Homing ; Rejection (Psychology) ; Skin ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Tissue Donors ; Tissue Therapy ; Transplantation, Homologous

BACKGROUND: This scientific statement is intended to provide a systematic review of new evidences in dyslipidemia and inflammation for primary stroke prevention. METHODS: Using a structured literature search, we identified major observational studies, clinical trials, meta-analyses, and updated major guidelines published between July 2007 and November 2010. In addition to the brief summary of earlier evidences employed in the first edition of Korean clinical practice guideline for primary prevention of stroke, we summarized the newly identified evidences. RESULTS: For dyslipidemia, observational studies further support a strong association between ischemic stroke and high total and low-density lipoprotein cholesterol and low high-density lipoprotein cholesterol. Two clinical trials and 6 meta-analyses confirm statin efficacy for primary prevention of stroke in high risk patients. Efficacy of other lipid-lowering agents is not established. For inflammation, inflammatory markers might help to identify patients having high risk for stroke or cardiovascular event and to decide whether statin therapy is indicated, but its usefulness for broad population needs to be confirmed. CONCLUSIONS: Writing committee will continue to keep an eye on upcoming evidences to timely update the guideline for primary stroke prevention in dyslipidemia and inflammation.
Cholesterol ; Dyslipidemias ; Eye ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Inflammation ; Lipoproteins ; Meta-Analysis as Topic ; Practice Guidelines as Topic ; Primary Prevention ; Stroke ; Writing

Pivotal clinical trials testing the efficacy of new antithrombotics for the prevention of stroke and systemic embolism in patients with atrial fibrillation have been published since the release of the first edition of Korean clinical practice guidelines for primary stroke prevention. From July 2007 to August 2012, 5 clinical studies and update of guidelines in Europe and North America were identified through systematic search. In patients with atrial fibrillation who were unsuitable for warfarin, the combination of clopidogrel and aspirin reduced the risk of stroke at the cost of increased major bleedings as compared to aspirin. In patients with nonvalvular atrial fibrillation and risk factors for stroke, new oral anticoagulants, dabigatran, rivaroxaban and apixaban, were as effective as or more effective than warfarin in preventing stroke or systemic embolism. The risks of major bleeding with novel anticoagulants were similar to or lower than that of warfarin. Particularly, the risk of intracranial bleeding was significantly lower with novel anticoagulants than with warfarin. In this report, we summarized the new evidences and updated our recommendations for primary stroke prevention in patients with atrial fibrillation.
Anticoagulants ; Aspirin ; Atrial Fibrillation ; Benzimidazoles ; beta-Alanine ; Embolism ; Europe ; Hemorrhage ; Humans ; Morpholines ; North America ; Primary Prevention ; Pyrazoles ; Pyridones ; Risk Factors ; Stroke ; Thiophenes ; Ticlopidine ; Warfarin ; Dabigatran ; Rivaroxaban