Granulocytic sarcoma is an uncommon extramedullary localized tumor composed of granulocytic precursor cells. The majority of cases have been reported in association with acute myeloid leukemia(AML) especially in children, but infrequently may occur in patients with myeloproliferative disorders or myelodysplastic syndromes. Most common sites of involvement were bone, soft tissue, lymph nodes and skin, but gastrointestinal tract, testis, central nervous system are also involved rarely. We present an unusual case of granulocytic sarcoma of the intracranium and the retro-orbital soft tissue occurring in a patient with concurrent myelodysplastic syndrome, diagnosed by brain magnetic resonance images and ultrasound guided needle biopsy.
Biopsy, Needle ; Brain ; Central Nervous System ; Child ; Gastrointestinal Tract ; Granulocyte Precursor Cells ; Humans ; Lymph Nodes ; Myelodysplastic Syndromes* ; Myeloproliferative Disorders ; Sarcoma, Myeloid* ; Skin ; Testis ; Ultrasonography

PURPOSE: Our purpose in this study is to evaluate the effectiveness of bronchial and nonbronchial systemic arteries for the control of hemoptysis. MATERIALS AND METHODS: Seventy patients with massive or recurrent hemoptysis underwent percutaneous transcatheter embolotherapy between 1991 and 1993. Retrospectively we reviewed 77 cases of bronchial artery embotization and 32 cases of nonbronchial systemic artery embolization in the 70 patients. RESULTS: Immdiate control of hemoptysis was achieved in 33 of 39 patients with massive hemoptysis(84.6%) and 20 of 24 patients with recurrent hemopt ysis(83.3%). In 32 cases, nonbronchial systemic arteries contributed significantly to areas of pathologic pulmonary tissue and frequently were the major arterial supply. CONCLUSION: Bronchial artery embolization is an effective and life saving procedure in non-surgical candidates. Recognition and occlusion of nonbronchial systemic arteries that feed to hypervascular pulmonary lesions is essential for successful percutaneous embolotherapy of hemoptysis.
Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis* ; Humans ; Retrospective Studies

Interleukin-6(IL-6) is a multifunctional cytokine, and deregulated IL-6 gene expression has been implicated as being involved in the pathogenesis of a number of diseaaes. So we measured the serum level of IL-6 to find a relationahip between uterine cervical cancer and serum IL-6 level. The serum levels of IL-6 were meesured m 54 patients adrnitted to the Severance hospital, from August, 1992 to February, 1993, of whom 27 patients were diagnosed as invasive cancer of cervix, 17 as CIN, and also utilizing 10 patiente diagnosed as uterine myoma as a control group for matched age and parity. The average serum level of IL-6 in invasive cancer, CIN, and uterine myoma were respectively 30.33pg/ml, 37.27pg/ml, and 12.45pg Jml. In 22% af cervical cancer patients (6 of 27), and 27% of CIN patients (4 of 17) studied blood levels of II-6 were detected whereas only 10% of uterine myoma (1 of 10) shorved the same result. However, the difference does not seem to be statistically significant, There was no statistically significant difference among any of the groups, and age and stage did not show any significant cmrelation, and the results need furt,ber investigations.
Cervix Uteri* ; Female ; Gene Expression ; Humans ; Interleukin-6* ; Leiomyoma ; Parity ; Uterine Cervical Neoplasms

The appearance of a tumor in the chest wall is rare compared to that in any other part of the body. It can be classified into benign and malignant types and can be located in the rib, clavicle, sternum, cartilage and soft tissues. Tumors that are metastatic are commonly located in the lung, breast, bone and pleura. But, the soft tissue mass of anterior chest wall is rarely metastasized from a distant organ that is not confined to the thoracic cavity. This and thus has rarely been described. A 68-year-old man was admitted to our hospital with a chief complaint of resting dyspnea. A huge non-tender mass of about 10*15 cm in size was visible on his left lower anterior chest wall. We pathologically confirmed that the mass was a metastatic renal cell carcinoma of clear cell type by incision biopsy. Through an incision biopsy, the mass was pathologically confirmed as a metastatic renal cell carcinoma of the clear cell type.
Aged ; Biopsy ; Breast ; Carcinoma, Renal Cell* ; Cartilage ; Clavicle ; Dyspnea ; Humans ; Lung ; Neoplasm Metastasis* ; Pleura ; Ribs ; Sternum ; Thoracic Cavity ; Thoracic Wall* ; Thorax*

BACKGROUND: Aminophylline is an inhibitor of phosphodiesterase; it increase the cAMP and, in turn, the level of acetylcholine at the neuromuscular junction. In doing so, it has an antifatigue action. It antagonizes nondepolarizing neuromuscular blockade in animals, and has been anecdotally noted to do so in humans, as well. We investigated the interaction of aminophylline and vecuronium on the dose response curve in vitro. METHODS: Institutional approval was obtained. Thirty seven male Spague Dawley rats (150~200 g) were divided into four groups (control, aminophylline 2.5, 5.0 and 7.5 microgram/ml). The animal were anesthetized with 40 mg/kg phentobarbital. The left hemidiaphragm with phrenic nerve was dissected and mounted within 5 minutes in bath containing 100 ml Krebs solution at 32oC. The phrenic nerve was stimulated at supramaximal intensity by a Grass S88 stimulator through an SIU5 isolation unit. The twitch height was measured by precalibrated Grass FT03 force displacement transducer and recorded. After stabilization of twitch response, vecuronium was added to the solution to obtained an initial concentration 1.0 microgram/ml with aminophylline 0, 2.5, 5.0, or 7.5 microgram/ml. When a stable 3~5 twitch was obtained after first dose, additional vecuronium was added to the Krebs solution in increments of 0.5 microgram/ml to achieve a more than 90% neuromuscular block. The data were analyzed by repeated measures of ANOVA and kappa2 test. RESULTS: There was a significant increase in the effective dose of vecuronium needed to depress the twitch response in aminophylline 5.0 and 7.5 microgram/ml added groups compared with control group and aminophylline 2.5 microgram/ml group. CONCLUSIONS: We conclude that aminophylline shows decreased sensitivity to vecuronium in the phrenic nerve diaphragm preparation of rats.
Acetylcholine ; Aminophylline* ; Animals ; Baths ; Diaphragm ; Humans ; Male ; Neuromuscular Blockade ; Neuromuscular Junction ; Phrenic Nerve ; Poaceae ; Rats* ; Transducers ; Vecuronium Bromide*

PURPOSE: To evaluate the ultrasonographic and CT findings of hepatosplenic tuberculosis MATERIALS AND METHODS: We retrospectively reviewed the ultrasonographic and CT findings of confirmed hepatosplenic tuberculosis in 12patients. Six were men and six were women ; their average age was 41, and most were in their twenties. Lesions ofthe liver and spleen, as well as associated findings such as abdominal tuberculosis and other organ involvement oftuberculosis were analyzed. RESULTS: There were three cases of hepatic tuberculosis, seven of splenictuberculosis, and two of hepatosplenic involvement of tuberculosis. On the basis of the ultrasonographic and CTfindings, hepatosplenic tuberculosis was classified as one of two patterns : miliary or micronodular, ormacronodular. The micronodular type was more common (9/12 cases) being characterized by innumerable micronodules,and with easy coalescence in the liver and spleen in five of the nine cases. The macronodular type of low densitymass was noted in the other three patients. Splenomegaly was noted in 12 cases and hepatomegaly in ten. Pulmonarytuberculosis-including the miliary type(n=5)-was noted in eight patients. Associated abdominal tuberculosis suchas lymphadenopathy with central low density and peripheral rim enhancement (n=6), tuberculous peritonitis(n=3),highly attenuated ascites(n=6), adrenal tuberculosis(n=1), renal tuberculosis(n=1), ovarian abscess(n=1), psoasabscess(n=1), and systemic tuberculosis such as central nervous system tuberculoma(n=2), cervicallymphadenopathy(n=4) and tuberculous spondylitis(n=1) were noted. CONCLUSION: Ultrasonography and CT werevaluable in the detection and diagnosis of hepatosplenic tuberculosis
Central Nervous System ; Diagnosis ; Female ; Hepatomegaly ; Humans ; Liver ; Lymphatic Diseases ; Male ; Retrospective Studies ; Spleen ; Splenomegaly ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Hepatic ; Ultrasonography

PURPOSE: Theophylline, an adenosine antagonist commonly used in premature infants to treat apnea, has been shown to decrease erythropoietin levels in adults. We studied the effect of theophylline on serum erythropoietin levels in premature infants with apnea. METHODS: Subject were 12 premature infants with apnea who were admitted to the NICU, Chosun University Hospital. The first dose of theophylline was 5mg/kg, given intravenously, followed by 1 to 2mg/kg per day. Serum levels were maintained between 5 and 12microgram/dl with dosage adjustments. Erythropoietin, hemoglobin, hematocrit, reticulocyte count, erythrocyte indices were obtained on the last day of theophylline treatment and again 1 week later. Erythropoietin levels were determined by radioimmunoassay. Blood transfusions were avoided a week before and during the study period. RESULTS: 1) Hemoglobin and hematocrit levels were decreased at 1 week after the discontinuation of theophylline treatment compared to the last day of theophylline treatment (P<0.05), but reticulocyte count (%) was increased (P<0.05). 2) There was a significant increase in serum erythropoietin levels from 3.31+/-1.53u/l to 6.68+/-2.41u/l (P<0.05). 3) No correlation was found between erythropoietin levels and the number of days on respirator, the number of days of O2 supply, the number of apneic episodes, the number of blood transfusion, the period of theophylline treatment and the theophylline blood levels. CONCLUSIONS: We suggest that prolonged treatment with theophylline might reduce erythropoietin production in premature infants.
Adenosine ; Adult ; Apnea ; Blood Transfusion ; Erythrocyte Indices ; Erythropoietin* ; Hematocrit ; Humans ; Infant, Newborn ; Infant, Premature* ; Radioimmunoassay ; Reticulocyte Count ; Theophylline* ; Ventilators, Mechanical

Background: To report the long-term clinical and radiologic results of impaction bone grafting and standard cemented polished stem for femoral revision arthroplasty in patients with extensive bone deficiency. Methods: We retrospectively reviewed 47 hips that underwent femoral revision hip arthroplasty using an impaction-morselized allograft with a standard cemented polished stem. The average age at the time of revision hip arthroplasty was 55 years (range, 39–75 years). The modified Harris hip score (HHS) was used for clinical evaluation. The radiologic evaluation focused on stem subsidence, stem position, progressive radiolucent lines, bone remodeling, and the incorporation of allografts. Results: The modified HHS improved from an average of 55.04 (range, 25–79.5) preoperatively to 90.1 (range, 81–93.2) at the last follow-up. The mean follow-up duration was 13.5 years (10.9–17.8 years). The radiographic analysis revealed stable stems.Femoral stems showed an average subsidence of 3.2 mm (range, 2–8 mm) in the cement mantle. However, there was no mechanical failure or subsidence of the cement mantle in the femurs. The stem position was neutral or varus less than 5°. No progressive radiolucent line or osteolysis was observed. Evidence of cortical and trabecular remodeling was observed in all cases. There were four cases of intraoperative cracks and four cases of distal femur splitting. Conclusions Initial stem stability using impaction bone grafting and a standard cemented polished stem in femoral revision arthroplasty resulted in good outcome. Delicate impaction grafting techniques and intraoperative crack and splitting fixation are the points that need attention for successful long-term results.

Neurofibromatosis also referred to as von Recklinghausen`s disease, is an autosomal dominant disease, which is characterized by cutaneous neurofibromas, cafe-au-lait spot, and axillary freckles. Although neruofibromatosis is a congenital disorder, the pulmonary manifestation become evident in adulthood. Approximately 15percent of patients with cutaneous lesions have intrathoracic neurofibromas. In some patients with neurofibromatosis, the lungs are the seat of interstitial fibrosis, leiomyoma, and bullous lesion, meningocele or less commonly lung cancer. The association of neurofibromatosis and lung cancer is rare, A 47-year-old man, who was a heavy smoker, was admitted to our hospital because of hemoptysis. Since cafe-au-lait sopts, diffuse pigmentation and multiple neurofibromatosis were observed on the skin, he was considered to have von Recklinghausen`s disease. Chest X-ray film showd extensive hazy density affecting all of his lung field, and minimal peribronchial infiltratin in his left lower lung field. Chest CT showed that near total consolidative lesions were present of right middle lobe. Also, some patchy infiltration were present in his right lower lobe and some of left lower lobe. Histoathological examination of the percutaneous lung biopsy specimen demonstrated that he had undifferentiated large cell carcinoma. The Authors have experienced a case of neurofibromatosis combined with undifferntiated large cell carcinoma. A brief review of related literature was conducted.
Biopsy ; Blister ; Cafe-au-Lait Spots ; Carcinoma, Large Cell* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Fibrosis ; Hemoptysis ; Humans ; Leiomyoma ; Lung Neoplasms ; Lung* ; Melanosis ; Meningocele ; Middle Aged ; Neurofibroma ; Neurofibromatoses* ; Pigmentation ; Skin ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

Granular cell tumor is characterized by large eosinophilic cells with granular appearances. These are mostly benign. Approximately 1~2% are malignant, and establishment of reliable criteria for diagnosing malignant granular cell tumor has been difficult to establish because of the rarity. Reports on the cytologic features of this neoplasm are hardly found in Korea. We report a case of rarely-occurring granular cell tumor in the lower leg of a 40-year-old male, diagnosed on fine needle aspiration cytology, together with a review of the literature regarding significant adverse histology and prognostic factors. The aspirates revealed cellular smears of isolated cells, syncytial clusters, and occasionally stripped nuclei in a fine, bluish-purple, granular background. Tumor cells were polygonal, rounded, or slightly spindled, and showed ill-defined granular cytoplasm. Nuclei were small and round or oval, with inconspicuous or small, prominent nucleoli. The nuclei showed rare intranuclear cytoplasmic invagination. Occasionally, there were mild to moderate nuclear pleomorphisms with vesicular nuclei, with large, prominent nucleoi, but no mitosis. The immunocytochemical stain for S-100 was strongly positive in the cytoplasm of tumor cells with occasional nuclei.
Adult ; Biopsy, Fine-Needle* ; Cytoplasm ; Eosinophils ; Granular Cell Tumor* ; Humans ; Korea ; Leg* ; Male ; Mitosis