No abstract available.
Female ; Methotrexate* ; Pregnancy ; Pregnancy, Tubal*

We report two cases of malignant schwannoma of skin in association with non-familial neurofibromatosis. Case 1, a 47 year old man, had a large subcutaneous tumor on the sacral area and case 2, a 62 year old woman, a painful, ulcerating tumor on the posterior aspect of the left arm. Both cases were histopathologically confirmed as malignant schwannomas and immunohistochemical studies showed 5-100 protein in the tumor cells. After surgical excision of the tumors, case 1 was lost to follow up, while case 2 remained without evidence of disease for more than one and half years.
Arm ; Female ; Humans ; Lost to Follow-Up ; Neurilemmoma* ; Neurofibromatoses* ; Skin ; Ulcer

Gastric cancer is the most prevalent gastrointestinal tract malignancy in Korea. By the time the patient hassymptoms, these tumors are usually advanced in stage. In high risk populations,screening such as double contrastUGI or gastric endoscopy is needed and patient with vague symptoms should be studied. However, these screeningshave high diagnostic accuracy rate, only CT scan can identify accurately abnormal stomach wall thickening andintraabdominal tumor extension. And CT is important for palnning of treatment, assessing surgical resectability,postoperative evaluation and prognostic implications. Author reviewed CT scan of 67 cases of confirmed gastriccancer by double contrast UGI or endoscopic biopsy, for 29 months from March 1983 to August 1985 at Department ofRadiology, Pusan National University Hospital. The results were as follows: 1. The most frequent site ofinvolvement of gastric cancer was gastric antrum in 49.9%(33/67). 2. By CT staging, stage 3 was 40.2%(27/67) andstage 4 was 38.8%(26/67). 3. In CT scan analysis, the structures involved by diect invasion were regional lymphnodes, pancrease, and gastrocolic ligament in order of frequency. The structures involved by distant metastaseswere liver, systemic lymph nodes, and mesentery in order of requency. 4. The diagnostic accuracy of CT staging was73.9%(17/23) by correlation of surgical and pathological findings. 5. In determination of stage by CT, the rate ofin accuracy of stage 2 was highest as 33%(2/6), and that of stage 3 was 29.2%(3/11). 6. Of all misdiagnoses,83.3%(5/6) was owing to failure to differentiate lymph node invasion from reactive hyperplasia of lymph node.
Biopsy ; Busan ; Endoscopy ; Gastrointestinal Tract ; Humans ; Hyperplasia ; Korea ; Ligaments ; Liver ; Lymph Nodes ; Mesentery ; Pancreas ; Pancrelipase ; Pyloric Antrum ; Stomach ; Stomach Neoplasms ; Tomography, X-Ray Computed

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma*

BACKGROUND: Acid-base derangement are commonly encountered in critically ill patients. This study is to investigate underlying mechanisms of acid-base imbalance and also to examine whether they can predict mortality in burn patients. METHODS: We retrospectively reviewed 73 severely burned patients who had admitted to burn intensive care unit, from January to July in 2004. All the patients had inhalation injury, identified by bronchoscopic examination. We analyzed the type and nature of the acid-base imbalances from arterial blood gas analysis, electrolytes and other biological tests between survivors and non-survivors for 30 days after admission. RESULTS: Acidosis was the most common disorder during the early and late hospital periods. Large fractions of those showed decreased strong ion difference (SID), increased anion gap corrected by albumin (AGc) and [Cl-]corrected. Mixed disorder and alkalosis emerged after the 7(th) hospital day. As time went by, albumin, PaO2/FiO2 ratio, pH and SID were more decreased in non-survivors (n=28) than in survivors (n=45) while [Cl-] corrected, alveolar-arterial oxygen tension gradients, peripheral WBC counts and CRP were more increased in non-survivors than in survivors. In the area under the receiver operating characteristic curves for mortality prediction, APACHE II score and % of total body surface area (%TBSA) burn were high: 0.866 (95% CI; 0.785~0.946) for APACHE II score, 0.817 (95% CI; 0.717~0.918) for %TBSA burn. CONCLUSIONS: In burned patients with inhalation injury, various types of acid-base imbalances and electrolytes abnormalities emerged after resuscitation and so, more careful attentions pursued for correcting underlying acid-base derangement.
Acid-Base Equilibrium ; Acid-Base Imbalance* ; Acidosis ; Alkalosis ; APACHE ; Attention ; Blood Gas Analysis ; Body Surface Area ; Burns* ; Critical Illness ; Diagnosis* ; Electrolytes ; Humans ; Hydrogen-Ion Concentration ; Inhalation* ; Intensive Care Units ; Mortality* ; Oxygen ; Resuscitation ; Retrospective Studies ; ROC Curve ; Sudden Infant Death ; Survivors

To assess the value of routine chest roentgenographic examinations at the time of admission, we analysed chest roentgenogram of 1,283 patients under the age of 15 who were admitted to St. Paul's Hospital from 1975 to 1977. A bonormal radiographic findings were detected in 111out of 1,283 Patients(8.7%). In 108 patients with abnormal findings, no medical or surgical therapy was required except three nowborn infants who had medical therapy as a result of pneumonic infiltration. In view of clinical analysis of 1,283 patients, it is considered that routine chest roentgenographic examinations were not warranted in patients under the age of 15 but justifiable in newborn infants.
Child* ; Humans ; Infant ; Infant, Newborn ; Radiography* ; Thorax*

Mycosis fungoides palmaris et plantaris is an uncommon expression of mycosis fungoides that manifests primarily on the palms and the soles. The lesions may be quite hyperkeratotic and mimic various inflammatory palmoplantar dermatoses. A biopsy is recommended in the evaluation of recalcitrant palmoplantar dermatoses. We report a case of mycosis fungoides palmaris et plantaris in a 36-year-old woman presented with hyperkeratotic plaque on her palms and soles.
Adult ; Biopsy ; Female ; Humans ; Mycosis Fungoides* ; Skin Diseases

No abstract available.
Blood Glucose ; Diabetes Mellitus, Type 2 ; Humans

BACKGROUND: A point mutation in the RET proto-oncogene, in medullary thyroid carcinoma (MTC) is well known, but no other genetic causes of MTC have been found. This study was performed to identify the most common DNA copy number changes in MTC by comparative genomic hybridization (CGH). METHODS: Twenty-nine surgically resected MTC specimens were retrospectively selected from patients operated on between 1996 and 2004 at the Asan Medical Center. A review of the clinical data and pathological findings was performed. Congored staining and immunohistochemical stains (calcitonin, chromogranin A and CEA) were processed by tissue microarray. CGH analysis was performed. RESULTS: The Congo-red stain was positive in only 12 cases. The immunohistochemical results were positive in 29 cases for chromogranin A, 26 cases for CEA and 25 cases for calcitonin. DNA copy number changes were found in 23 cases (79.3%). The most frequent change was a gain of 19q (65.5%); less frequent changes were gain of 22 (55.2%), 19p (51.7%), 16p (27.58%), 17q (17.24%), and loss of 4q (27.6%) and 3p (17.24%). CONCLUSIONS: DNA copy number changes of MTC were more common (79.3%) than reported in previous studies. The most frequent changes were gains in 19q, 22 and 19p.

BACKGROUND: In some instances, thyroid cancer may be diagnosed only after resection of a putative or suspected benign nodule. In these cases a complete thyroidectomy is usually recommended to prevent recurrence. We analyzed the frequency of malignancy in the contralateral lobe after a complete thyroidectomy, and assessed the factors that may predict the presence of a malignancy, which might necessitate a complete thyroidectomy. METHODS: Between 1995 and 2001, 65 patients, who initially underwent a lobectomy and isthmectomy, but were finally diagnosed with differentiated thyroid carcinoma, underwent complete thyroidectomies. Their mean age was 39.8 +/- 12.4 years, ranging, 14 to 71 years. After initial surgery, 45 proved to have follicular carcinomas, 18 papillary carcinomas, 1 medullary and 1 insular carcinoma. The mean tumor size was 4.0 +/- 1.8 cm, ranging from 0.3 to 8.5 cm. After a complete thyroidectomy, the presence of a tumor the at contralateral lobe was assessed according to clinical parameters and the pathological findings in the ipsilateral lobe. RESULTS: The first surgeries revealed tumor multifocality in 27 cases, perithyroidal tumor extension in 4 and lymph node metastasis in 1. On completion of the thyroidectomy, 22 of the 65 patients had a malignancy in the contralateral lobe. Age, sex, size or the pathological primary tumor type, were not associated with the presence of additional tumors at the contralateral lobe. Tumor multifocality at the first surgery was the only significant variable to predict the presence of a tumor in the contralateral lobe. CONCLUSION: When thyroid cancer is diagnosed after ipsilateral surgery, the only predictive factor for the presence of a contralateral tumor was multifocality. We believe that a complete thyroidectomy is mandatory in these cases.
Carcinoma, Papillary ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy*