The etiology of spontaneous hemarthrosis of the knee joint in elderly pattents is still unknown. This report discusses seven spontaneous hernarthroses, three that were managed witla conservative measures such as aspiration, rest and knee immobilization because of poor general condition and four in which arthroscopic evaluation and treatment were performed. These patients were elderly indi.viduals without an obvious history of trauma. The roentgenograms of each involved knee demonstrated degenerative osteoarthritic changes of knee joint. Arthroscopic examination revealed denuded articular cartilage and subchondral bone exposure in four operative cases and degenerative meniscal tear in one case of four. These patients underwent mthroscopic debridement and did not experience recurrenees of the hemarthrosis. We think that the origin of the bleeding was most likely from the subchondral cancellous bone which was exposed due to degenerative change of the knee joint and the senile changes of the vessels around the knee joint with aging process may contribute the spontaneous bleeding into the knee joints.
Aged* ; Aging ; Cartilage, Articular ; Debridement ; Hemarthrosis* ; Hemorrhage ; Humans ; Immobilization ; Knee Joint ; Knee*

BACKGROUND :Although clinicopathologic differences have been described between Epstein-Barr virus (EBV)-positive and negative gastric adenocarcinomas, the pathogenetic basis for these differences remains unclear. In this study, efforts were made to confirm that expression of EBV-latent membrane protein (LMP1) and immunohistochemical characteristics of EBVpositive gastric adenocarcinomas. METHODS: We investigated genomic deletion, and RNA & protein expression of the EBV-LMP1, as well as immunohistochemical protein expression of transforming growth factor (TGF)-beta1, TGF-bata RII, p21, p16, E2F1, thymidylate synthase, and NF-kappaB in relation to EBV positive gastric adenocarcinoma. RESULTS: A total of 38 Epstein-Barr Virus Encoded RNA-positive and 80 negative gastric carcinomas were examined. A 30 bp DNA deletion in the EBV-LMP1 gene, initiating at codon 342, was detected in 94.4% of EBVpositive cases. By RT-PCR and western blotting, EBV-LMP1 mRNA and protein expressions were absent in all cases, re-gardless of DNA deletion. No significant differences in TGF-bata1, TGF-betaRII, p21, NF-kappaB, E2F1, or thymidylate synthase expression were identified. However, the decreased expression of p16 was found in 84.2% of EBV-positive carcinomas, relative to only 57.5% of EBV-negative tumors (p=0.024). CONCLUSION: EBV-LMP1 DNA deletion, mRNA and protein losses are highly prevalent in EBV-positive gastric adenocarcinoma among Korean patients, along with decreased p16 expression.
Adenocarcinoma* ; Blotting, Western ; Codon ; DNA ; Herpesvirus 4, Human* ; Humans ; Membrane Proteins* ; Membranes* ; NF-kappa B* ; RNA ; RNA, Messenger ; Stomach Neoplasms ; Thymidylate Synthase* ; Transforming Growth Factors*

No abstract available.
Humans ; Referral and Consultation*

Gefitinib is regarded as a relatively safe agent for the treatment of an advanced non-small cell lung cancer (NSCLC). Pulmonary toxicity such as interstitial lung disease associated with gefitinib is uncommon with an estimated all time incidence around 1% worldwide. Moreover, a case of gefitinib associated with pulmonary cystic changes has not been reported yet. In this report we present a case of progressive multiple air cystic changes in both lungs in a patient with NSCLC and intrapulmonary metastases who underwent a gefitinib therapy.
Antineoplastic Agents/*adverse effects ; Brain Neoplasms/secondary ; Carcinoma, Non-Small-Cell Lung/*drug therapy/secondary ; Cysts/*chemically induced ; Female ; Humans ; Lung/pathology ; Lung Diseases/*chemically induced ; Lung Diseases, Interstitial ; Lung Neoplasms/*drug therapy ; Middle Aged ; Quinazolines/*adverse effects

Although failure of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKI) is generally believed to be associated with cross-resistance to other EGFR TKI, the benefit of administering erlotinib as a second EGFR TKI after resistance of gefitinib as the first TKI has been well known. However, good response to gefitinib after an initial response to erlotinib has been rare. We report that a 45-year-old woman (never smoked), with lung adenocarcinoma and EGFR mutation, showed an initial response to erlotinib, and then responded to gefitinib again.
Adenocarcinoma ; Female ; Humans ; Lung ; Lung Neoplasms ; Middle Aged ; Protein-Tyrosine Kinases ; Quinazolines ; Receptor, Epidermal Growth Factor ; Erlotinib Hydrochloride

BACKGROUND: High plasma levels of coagulation factor VII (FVII) are associated with a risk of coronary artery disease (CAD). Plasma FVII levels are influenced by environmental and genetic factors. We investigated whether the risk of CAD is associated with R353Q polymorphism and whether this polymorphism is associated with factor VII activity METHODS: We analysed plasma levels of FVII:C and FVII genotype for R353Q polymorphism in 85 CAD patients, 63 healthy controls, and 27 patient controls. And total cholesterol, HDL-cholesterol and triglyceride were measured in the same study populations. RESULTS: There was no difference among CAD patients, healthy controls, and patient controls in plasma levels of FVII:C. Allele Q of the R353Q polymorphism was less frequent in CAD patients (11.8%) than healthy controls (17.5%), although the difference was not statistically significant. Patients with the RQ genotype had a decreased risk of CAD (odds ratio, 0.29). There was no association between R353Q polymorphism and plasma levels of FVII:C. Plasma levels of FVII:C were positively correlated with total cholesterol and triglyceride. CONCLUSIONS: Our findings suggest that R353Q polymorphism may confer significant protection from CAD and that plasma levels of FVII:C may influenced by total cholesterol and triglyceride.
Alleles ; Blood Coagulation Factors* ; Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; Factor VII* ; Genotype ; Humans ; Plasma ; Triglycerides

The clinicopathological manifestations of gastric mucormycosis range from colonization of ulcer disease to infiltration of tissue with or without vascular involvement. The prognosis of this disease is extremely poor when blood vessel invasion is observed. Herein, we report on a rare case of ischemic gastric perforation that was associated with vascular invasive mucormycosis in a renal recipients 7 years after transplantation.
Blood Vessels ; Colon ; Kidney Transplantation ; Mucormycosis* ; Prognosis ; Transplantation* ; Ulcer

PURPOSE: To investigate the role of 3D imaging in the sinonasal mass. MATERIALS AND METHODS: Twenty patients with sinonasal mass(squamous cell carcinoma[n=6], spindle cell carcinoma[n=1}, angiomatous polyp[n=1}, giant cell reparative granuloma[n=1}, non-Hodgkin's lymphoma[n=1}, melanoma[n=1}, angiofibroma[n=1}, pyocele[n=1}, inverted papilloma[n=1}) were studied with spiral CT. Reconstruction of surface rendered 3D images and segmentations were performed and compared with the 2D image. RESULTS: The 3D images enabled easy understanding of the characteristics of the mass in 12 casese. The 3D images displayed pathway of tumor extension in 5 cases and werehelpful in assessing the primary site of the mass in 3 cases. In two cases with encasement of ICA by the mass, assesment of relationship between the mass and vessels were possible through the segmentation. CONCLUSION: The 3D image, as an adjunct to the 2D image, can help to evaluate the virtual appearance of bony change, the degree of extension of mass, the spreading route, the evaluation of origin site. It also provides valuable 3-dimensional conception of the mass, especially for the surgeon.
Imaging, Three-Dimensional* ; Tomography, Spiral Computed

We report the case of a 4 year-old boy with Menetrier's disease, who was presented with edema and hypoalbuminemia. Gastroduodenal endoscopy showed the characteristic features of giant hypertrophy of the gastric rugae and large quantities of adherent gelatinous material. Histologic findings revealed foveolar hyperplasia. The presence of CMV infection was identified by serology. His symptoms resolved spontaneously, and he has fared well.
Child, Preschool ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Edema ; Endoscopy ; Gastritis, Hypertrophic* ; Gelatin ; Humans ; Hyperplasia ; Hypertrophy ; Hypoalbuminemia ; Male

The new onset of acanthosis nigricans in an adult-especially when the lesions appear on mucosal membranes such as the lips, periocular areas, and anus-may be indicative of an underlying tumor. Adenocarcinoma of the gastrointestinal tract is the most common malignancy-most often cancer of the stomach. A 72 years old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 12 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy. The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.
Acanthosis Nigricans* ; Adenocarcinoma* ; Aged ; Female ; Gastrointestinal Tract ; Humans ; Hypertrophy ; Lip ; Membranes ; Pigmentation ; Stomach Neoplasms