No abstract available.
Lymph Nodes* ; Lymphocytes* ; Lymphocytes, Tumor-Infiltrating* ; Stomach Neoplasms* ; Stomach*

PURPOSE: Peripheral T-cell lymphoma (PTCL) derived from mature T cells forms morphologically diverse group of non-Hodgkin's lymphomas and the clinicopathologic features remain to be debated. In order to elucidate the specific characteristics of PTCL, comparison with a group of diffuse B-cell lymphomas (DBCL) was done. MATERIALS AND METHODS: Between Dec. 1989 and Feb. 1993, clinical data of 67 cases of intermediate or high grade NHL identified as T-cell or B-cell origin by immunophenotyping was reviewed. RESULTS: There were 30 cases of PTCL and 37 cases of DBCL. PTCL had more advanced stage and B symptoms at diagnosis. Frequent sites of extranodal involvement were bone marrow, nasal cavity/paranasal sinus, and skin in PTCL and gastrointestinal tract in DBCL. Based on NCI Working Formulation, 40% of PTCL and 14% of DBCL were high grade. Patients with DBCL had a better 3-year overall survival rate (67% vs 47%), however, there was no difference in complete remission rate and disease-free survival rate between two groups with intensive treatment. A subgroup of PTCL patients who had died earlier was found to have more advanced stage and poor performance status. CONCLUSION: Although patients with PTCL had worse survival in advanced stage, the outcome of patients with PTCL who received intensive treatment was comparable to that of DBCL.
B-Lymphocytes* ; Bone Marrow ; Diagnosis ; Disease-Free Survival ; Gastrointestinal Tract ; Humans ; Immunophenotyping ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell, Peripheral* ; Skin ; Survival Rate ; T-Lymphocytes

Isolated dissecting aneurysm of the superior mesenteric artery (SMA) is a rare condition. Although aneurysms of the SMA are frequently classified with other splanchnic aneurysms, dissecting SMA aneurysms are quite different in terms of their etiology and natural history. Therefore, independent consideration is warranted during their treatment. In this case report, a dissecting aneurysm was accompanied by burst fractures of the first and third lumbar spines at the same height. We treated the patient, who was suffering from chronic post-prandial intermittent abdominal pain after falling down. The patient stopped displaying repeated episodes of abdominal pain did not recur after the false lumen entry was closed by a short exclusion stent graft, and there were no procedural complications. The stent graft remained patent, and the patient has remained free of symptoms during the 16 months follow-up period. We present here the case of a traumatic isolated SMA dissecting aneurysm that was successfully managed by endovascular treatment.
Abdominal Pain ; Aneurysm ; Aneurysm, Dissecting* ; Blood Vessel Prosthesis ; Follow-Up Studies ; Humans ; Mesenteric Artery, Superior ; Natural History ; Spine*

Isolated dissecting aneurysm of the superior mesenteric artery (SMA) is a rare condition. Although aneurysms of the SMA are frequently classified with other splanchnic aneurysms, dissecting SMA aneurysms are quite different in terms of their etiology and natural history. Therefore, independent consideration is warranted during their treatment. In this case report, a dissecting aneurysm was accompanied by burst fractures of the first and third lumbar spines at the same height. We treated the patient, who was suffering from chronic post-prandial intermittent abdominal pain after falling down. The patient stopped displaying repeated episodes of abdominal pain did not recur after the false lumen entry was closed by a short exclusion stent graft, and there were no procedural complications. The stent graft remained patent, and the patient has remained free of symptoms during the 16 months follow-up period. We present here the case of a traumatic isolated SMA dissecting aneurysm that was successfully managed by endovascular treatment.
Abdominal Pain ; Aneurysm ; Aneurysm, Dissecting* ; Blood Vessel Prosthesis ; Follow-Up Studies ; Humans ; Mesenteric Artery, Superior ; Natural History ; Spine*

PURPOSE: Dukes' A & B colorectal cancer patients are often excluded from adjuvant chemotherapy following potentially curative surgery because they are expected to have good long-term survival. However, actually 20 ~ 30% of these patients suffer from recurrent disease, so it would be helpful for these patients of recurrent disease to be able to select a high risk group. METHODS: In 78 Dukes' A & B colorectal cancers, we investigated by immunohistochemistry the role of molecular markers, such as p27(kip1), p53, Ki-67, and Skp2, in identifying high-risk patients. RESULTS: Patients with low p27(kip1) expression showed poor overall survival compared to those with high p27(kip1) expressions (55.3 versus 66.7 months, P=0.018). The only significant factor associated with p27(kip1) expression was p53 expression. The low p27(kip1) expression and positive p53 expression group had poor overall survival (54.3 months, P=0.036). CONCLISIONS: In a node-negative colorectal carcinoma, the molecular marker p27(kip1) does not play an independent prognostic role, but it may have prognostic significance in correlation with other markers such as p53, Ki-67, and Skp2. The assessment of molecular alterations may be useful to node-negative colorectal patients in identifying the high risk group that may benefit from adjuvant chemotherapy.
Chemotherapy, Adjuvant ; Colorectal Neoplasms* ; Humans ; Immunohistochemistry ; Prognosis

PURPOSE: Non-Hodgkins lymphoma (NHL) is recognized as not a single disease but a group of diseases heterogeneous in biology and clinical characteristics. Recently, a new pathologic classification system, the REAL classification, has been introduced into the clinic. Although REAL classification has tried to define the subtypes biologically more correctly, its clinical usefulness has not been established yet. A retrospective study was performed to define the clinical characteristics of Korean NHLs according to the REAL classification and to determine its clinical usefulness. MATERIALS AND METHODS: Pathologies of NHLs managed at 3 major hospitals in Korea between 1989 and 1995 were reviewed with immunophenotyping to determine the pathologic subtypes according to REAL classification. Clinical characteristics at the presentation and treatment outcomes of the eligible patients were analyzed. To determine the differences from the NHLs in the western countries, data of Non-Hodgkins Lymphoma Classification Project (NHLCP) were also compared. RESULTS: Total 802 cases were eligible for this study. Although it was similar to NHLCP study that B-cell subtypes were the majority and diffuse large B-cell lymphoma was the most common subtype, the proportion of T-cell subtypes were much higher in our patient population than in the western population. It was because peripheral T-cell lymphomas, angiocentric lymphoma in particular, were more common and follicular lymphomas were less common in our patients. Eleven common pathologic subtypes could be classified into 3 prognostic groups. Marginal zone B-cell lymphoma and lymphoplasmacytoid lymphoma of which 5-year overall survival rate (5-yOSR) were > 80% were classified in the good prognostic group. Precursor T-lymphoblastic lymphoma was classified in the poor prognostic group because its 5-yOSR was less than 30%. The other 9 subtypes were classified in the intermediate prognostic group with S-yOSR of 30-79%. CONCLUSION: The clinical. character' tics and prognoses of Korean NHLs could be defined according to REAL classification. These information would be helpful for the clinicians in formulating treatment strategies of Korean NHLs according to REAL classification.
B-Lymphocytes ; Biology ; Classification* ; Hodgkin Disease* ; Humans ; Immunophenotyping ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Follicular ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell, Peripheral ; Pathology ; Prognosis ; Retrospective Studies ; Survival Rate ; T-Lymphocytes ; Tics ; Waldenstrom Macroglobulinemia

RPGN is a catastrophic form of acute glomerulonephritis characterized by an abrupt onset and rapid deterioration of renal function resulting in oliguria within weeks or months. RPGN is seen in a variety of systemic disorders, including systemic lupus erythematosus, poly arteritis nodosa, Wegener's granulomatosis and subacute bacterial endocarditis. In addition, RPGN is seen in association with a variety of primary renal diseases such as poststreptococcal glomerulonephritis, membranoproliferative glomerulonephritis, and IgA nephropathy, Goodpasture's syndrome. Toxic epidermal necrolysis(TEN) is a drug induced life threatening disease characterized by extensive epidermal detachment, necrosis, and mucosal erosion. TEN may involve liver, lung, intestine, and kidney. But renal involvement has seldom been reported. We report on a 63-year-old patient who developed a RPGN with a TEN. Renal biopsy showed pauci-immune crescentric glomerulonephritis and skin biopsy showed edematous change with extravasated erythrocytes in upper dermis and several individually necrotic keratinocytes. ANCA and FANA test was negative. Our patient recovered renal function with steroid pulse therapy. The pathophysiology of TEN is unresolved but abnormal cytokine release(e.g., tumor necrosis factor) has been implicated in pathogenesis of TEN. Because various cytokines have direct toxic effect on kidney structure, the tubular and glomerular damage may be related to the cytokines involved in TEN. To our knowledge, this is the first case documenting the presence of RPGN in patients with TEN. And there maybe some relations between PRGN and TEN which require further study.
Anti-Glomerular Basement Membrane Disease ; Antibodies, Antineutrophil Cytoplasmic ; Arteritis ; Biopsy ; Cytokines ; Dermis ; Endocarditis, Subacute Bacterial ; Erythrocytes ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Humans ; Intestines ; Keratinocytes ; Kidney ; Liver ; Lung ; Lupus Erythematosus, Systemic ; Middle Aged ; Necrosis ; Oliguria ; Skin ; Stevens-Johnson Syndrome* ; Wegener Granulomatosis

PURPOSE: Most cystic tumors of the pancreas are composed of serous cystic tumor, mucinous cystic tumor, solid pseudo- papillary epithelial neoplasm (SPEN) and intraductal papillary mucinous tumor (IPMT). With advancements in diagnostic imaging, cystic lesions of the pancreas are being detected with increasing frequency; however, there is still difficulty determining the appropriate diagnostic and therapeutic plan. METHODS: A retrospective review was performed of 15 cases that underwent surgery for pancreatic cystic tumors in our department between July 1995 and August 2005. All 15 cases identified had their records and radiological images reviewed. Radiological findings were characterized and analyzed by one radiologist. RESULTS: The median age was 55.9 years. Six cases were male and nine were female. Common symptoms included: epigastirc pain 6/14 (43%) and palpable mass 2/14 (14%). The accuracy of the preop radiological diagnosis including abdominal CT and US was 12/15 (80%). One case of serous cystic tumor, one of chronic pancreatitis and one SPEN were misdiagnosed; the preoperative diagnosis for these cases was mucinous cystic tumor. Serous cystic tumors were seen with central calcification 2/3 (67%), external lobulation 3/3 (100%); however, the mucinous cystic tumors were seen with peripheral calcification 4/5 (80%), no external lobulation 5/5 (100%) by radiological evaluation. There was no calcification, but external lobulation was common in the IPMT. The SPEN had no specific radiological findings except for peripheral calcification. CONCLUSION: Future multicenter studies with endoscopic sonography and aspiration cytology is needed for improved accuracy of diagnosis.
Diagnosis ; Diagnostic Imaging ; Female ; Humans ; Male ; Mucins ; Neoplasms, Glandular and Epithelial ; Pancreas* ; Pancreatic Cyst ; Pancreatitis, Chronic ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: IMVP-16 (Ifosfamide/Methotrexate/VP-16) regimen consists of drugs that are not commonly used as the first-line therapy of non-Hodgkin's lymphoma. This study was performed to determine the efficacy of this relatively non-cross resistant regimen, with the addition of prednisone, in patients with primary refractory or relapsed non-Hodgkin's lymphoma. MATERIALS AND METHODS: Patients with primary refractory or relpased intermediate to high grade non-Hodgkin's lymphoma were treated with ifosfamide (1000 mg/m2 iv, D1-5 with mesna), methotrexate (30 mg/m2 iv, D 3 & 10), VP-16 (100 mg/m2 iv, D 1-3), and prednisone (120 mg devided by 3 doses, D1-5). The treatment was repeated every 3 weeks. RESULTS: Between Jan. 1988 and Aug. 1993, thirty eight patients were included. In 33 evaluable patients (4 loss-to follow up and 1 ineligibility) the median age was 49 years. The common histologic types were diffuse large cell type (52%) and immunoblastic type (18%). The proportion of patients with relapsed and refractory NHL was 39% and 61%, respectively. The rate of complete remission was 21% (7/33) and overall response rate was 48% (16/33). The median-response duration was 8 months (1.5~45+). Hematologic toxicities were tolerable. Non-hematologic side effects were also tolerable including stomatitis, peripheral neuropathy, and toxic hepatitis. Three treatment-related deaths were associated with sepsis, ARDS (adult respiratory distress syndrome) and acute gastrointestinal bleeding. CONCLUSION: Based on these results, IMVP-16/Pd combination chemotherapy seems to have a moderate efficacy for the relapsed or refractory non-Hodgkin's lymphoma with tolerable toxicities.
Drug Therapy, Combination* ; Drug-Induced Liver Injury ; Etoposide ; Follow-Up Studies ; Hemorrhage ; Humans ; Ifosfamide ; Lymphoma, Non-Hodgkin* ; Methotrexate ; Peripheral Nervous System Diseases ; Prednisone ; Sepsis ; Stomatitis