The uterine cervix is an uncommon site of primary non-Hodgkin's lymphoma (NHL). Although the cytologic findings of NHLs are well known, most cervicovaginal smear of uterine NHLs give lower diagnostic yield than common epithelial malignancy because abnormal cells do not appear in the sample in the absence of surface ulceration. Herein, we describe cytologic findings of a case of uterine cervical NHL which was initially diagnosed by cervicovaginal smear. The tumor cells were relatively uniform, isolated, large-sized with scanty cytoplasm and round or indented nuclei. The nuclei had stippled chromatin and small nucleoli. Histologically and immunohistochemically the tumor was proven to be large cell lymphoma of T-cell lineage.
Buttocks ; Cervix Uteri ; Chromatin ; Cytoplasm ; Epidermal Cyst ; Female ; Lymphoma ; Lymphoma, Non-Hodgkin ; Nephrotic Syndrome* ; T-Lymphocytes ; Ulcer

The renin-angiotensin system plays an important role in renal growth and development. Exposure of the fetus or neonate to angiotensin converting enzyme (ACE) inhibitors increases mortality, growth retardation, and results in renal anomalies. This study was designed to investigate the effects of ACE inhibition in the neonatal rat on the expression of genes known to modulate renal cellular proliferation, cell interactions, and extracellular matrix. Newborn rat pups were treated with enalapril (30mg/ kg/day) or vehicle for 14 days, and kidneys were removed for determination of mRNA for transforming growth factor-beta 1 (TGF- B1) and prepro epidermal growth factor (EGF). Enalapril treatment resulted in 40Yo mortality by day 14 as well as reduced body and kidney weight (P<0.05 vs vehicle group). Also enalapril decreased renal TGF-Bl and EGF mRNA expression (P<0.05). These results indicate that ACE inhibition in the developing kidney reduces the renal expression of critical growth factors, which may account for renal growth impairment.
Angiotensins* ; Animals ; Cell Communication ; Cell Proliferation ; Enalapril ; Epidermal Growth Factor ; Extracellular Matrix ; Fetus ; Growth and Development ; Humans ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Kidney* ; Mortality ; Peptidyl-Dipeptidase A* ; Rats* ; Renin-Angiotensin System ; RNA, Messenger ; Transforming Growth Factor beta1

We experienced a case of vitamin B12 unresponsive methlymalonic acidemia in a 4 day old female, who had poor feeding, dehydration with metabolic acidosis, and hyperammonernia and died at 7 days of age. Diagnosis was made by gas chromatography and mass spectrometry, and this case is probably a methylmalonyl CoA mutase apoenzyme deficiency type.
Acidosis ; Apoenzymes ; Chromatography, Gas ; Dehydration ; Diagnosis ; Female ; Humans ; Mass Spectrometry ; Methylmalonyl-CoA Mutase ; Vitamin B 12

OBJECTIVE: Dopamine transporter is a key regulator of dopamine neurotransmission and is also the primary target of methylphenidate. This study tested the hypothesis that dopamine transporter (DAT) density in basal ganglia is a predictor of favorable methylphenidate (MP) treatment response. METHODS: 15 drug-naive boys with ADHD were included in this study (8 children: treatment responder, 7 children: treatment non responder). They were assessed with psychiatric interview, KEDI-WISC, K-ARS, ADS and CBCL. After then, they were performed [123 I]IPT SPECT. They were evaluated about treatment response after treatment with methylphenidate during 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between treatment responders and nonresponders. RESULTS: There were not significant differences in dopamine transporter density in basal ganglia between the two groups. CONCLUSION: This finding suggests that dopamine transporter density does not mediate the MP treatment response in a direct way.
Basal Ganglia* ; Child* ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Methylphenidate* ; Synaptic Transmission ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: Oral UFT is known to be a safe and effective antineoplastic regimen for adjuvant chemotherapy of colorectal cancer. As it sometimes produces upper gastrointestinal symptoms such as anorexia, nausea, vomiting and abdominal pain, medication should be stopped transiently or dosage reduced. UFT-E, an enteric coated granule of UFT was introduced to reduce UGI toxicity. We analyzed the toxicity of UFT and UFT-E prospectively for the purpose of comparison between the two types. METHODS: The toxicity of UFT and UFT-E were evaluated in 83 patients (UFT; 45, UFT-E; 38) with colorectal cancer who underwent curative surgery according to the WHO toxicity criteria. All patients were selected consecutively with patients' approval and by the "Institutional Review Board, Asan Medical Center". RESULTS: The toxicity incidence in UFT-E group was slightly less than that in UFT group without statistical significance. The severity of toxicity seemed to be mild within grade 1 or 2 and most of them toxicity self-limiting. The regimen was completely interrupted in 9 patients (20%) in the UFT group, 3 patients (7.9%) in the UFT-E group due to severe UGI symptoms, prolonged leukopenia, derrangement of liver function and skin rash. CONCLUSIONS: Toxicity rate of UFT-E was not higher than that of UFT. But we cannot prove superiority of UFT-E on UGI toxicity. Oral UFT-E can be administered safely on an outpatient basis without lethal toxicity requiring hospitalization.
Abdominal Pain ; Anorexia ; Chemotherapy, Adjuvant ; Chungcheongnam-do ; Colorectal Neoplasms* ; Exanthema ; Hospitalization ; Humans ; Incidence ; Leukopenia ; Liver ; Nausea ; Outpatients ; Prospective Studies ; Vomiting

PURPOSE: Incorrect positioning of umbilical artery catheter (UAC) results in an increased incidence of complications and erroneous pressure measurements. We radiologically localized major aortic branches and calculated the length of catheter from umbilicus to celiac artery, renal artery and aortic bifurcation for optimal positioning of UAC. To determine the neonatal body measurement that best predicts optimal UAC lengths, we studied three commonly used parameters-birth weight (BW), total body length (TBL) and shoulder-umbilicus length (SUL). METHODS: Fifty one high type of UAC were routinely identified by sonographic scanning from the epigastrium in longitudinal projection and 42 low type of UAC from the flank in coronal projection. The distances from the catheter tip to the celiac artery, the renal artery and to the aortic bifurcation were measured by electronic calipers and were compared with the length of the catheter from umbilicus to the tip on the chest anteroposterior radiograph. RESULTS: The celiac arteries originated from T10-T12, renal arteries Ll-L2, and aortic bifurcations L3-L5. There was positive correlation between BW, TBL or SUL and the length of catheter to the celiac artery (r2=0.476, 0.749 or 0.753), to the renal artery (r2= 0.785, 0.847 or 0.720), and to the aortic bifurcation (r2=0.714, 0.809 or 0.747). CONCLUSION: Although any one of the three parameters can be used clinically, we prefer the TBL and SUL parameters for its reliability and usefulness in emergency settings. The use of a new distribution plot of origins of major branches and regression equations for calculation of the lengths may help deciding the optimal position of UAC.
Catheters* ; Celiac Artery ; Emergencies ; Humans ; Incidence ; Infant, Newborn* ; Renal Artery ; Thorax ; Ultrasonography* ; Umbilical Arteries* ; Umbilicus

PURPOSE: Atrial natriuretic peptide(ANP) is a hormone with strong vasodilating, diu-retic and natriuretic properties. The aim of this study was to clarify the interrelationship of ANP secretion and hemodynamic changes of patent ductus arteriosus(PDA) in healthy preterm and fullterm infants without clinical evidence of PDA. METHODS: Thirteen preterm infants and six full term infants who did not develop clinical evidence of PDA were studied at 6 hr, 12 hr, 24 hr, 3rd day and 4th day after birth, until their PDAs closed spontaneously. Plasma ANP concentrations and the hemodynamic changes of PDA were rneasured. RESULTS: The ANP concentrations of all infants increased from 34.1+/-10.9 pg/ml at 6 hr to 120.5+/-18.8 pg/ml at 12 hr, and declined thereafter gradually to 74.2+/-12.7 pg/ml at 4th day. The ANP concentrations, LA/Ao ratio and LAV decreased after ductal closure. The pulmonary flow velocity(PFV) of PDA correlated with ANP concentration in preterm infants(r=0.23, P<0.05). LA/Ao ratio correlated with ANP contration in all infants (r=0.28, P<0.05), especially in preterm infants(r=0.46, P<0.01 during 12 hr and 4th day after birth. LAV correlated with the ANP concentrations in preterm infants during 12 hr and 4th day after birth(r=0.34, P<0.05). CONCLUSION: The changes of ANP concentrations are probably due to the changes of the left-to-right shunt of PDA with left atrial stretch. Reduction of the ANP concentrations may serve as an indicator of spontaneous closure of PDA. Therefore ANP measurement may be useful in deciding the need and the timing of medical and surgical managernent of newbom infants without clinical evidence of PDA.
Atrial Natriuretic Factor ; Ductus Arteriosus, Patent* ; Hemodynamics* ; Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Premature ; Parturition ; Plasma*

PURPOSE: The renin-angiotensin system plays an important role in renal growth and development. Exposuring the neonate to angiotensin converting enzyme(ACE) inhibitor increases mortality and results in growth retardation and abnormal renal development. ACE inhibition in the developing kidney reduces the renal expression of TGF-beta1 and EGF, which may account for renal growth impairment. This study was designed to investigate the relationship between this growth impairment, and apoptosis, cell proliferation, bcl-2 and clusterin expression. METHODS: Newborn rat pups were treated with enalapril(30mg/kg/d) or vehicle for 7 days and kidneys were removed for RT-PCR and Western blotting of bcl-2 and clusterin. Distribution of apoptosis was determined by modified TUNEL technique and PCNA for cell proliferation was stained by immunohistochemistry. RESULTS: Enalapril treatment resulted in 24% mortality by day 7 and reduced body weight(P< 0.05 versus vehicle group). Enalapril increased renal apoptosis and decreased PCNA positive proliferating cells especially in cortical tubular epithelial cells(P<0.05). Renal bcl-2 and clusterin mRNA expression was increased(P<0.05), but bcl-2 and clusterin protein expression was decreased by enalapril treatment. CONCLUSION: These results indicate that ACE inhibition in the developing kidney increases apoptosis and decreases cell proliferation, which may account for renal growth impairment. Bcl-2 and clusterin mRNA expression may increase as a secondary response to increased apoptosis and decreased their protein expression.
Angiotensins* ; Animals ; Apoptosis* ; Blotting, Western ; Cell Proliferation ; Clusterin ; Enalapril ; Epidermal Growth Factor ; Growth and Development ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Infant, Newborn ; Kidney* ; Mortality ; Peptidyl-Dipeptidase A* ; Proliferating Cell Nuclear Antigen ; Rats* ; Renin-Angiotensin System ; RNA, Messenger ; Transforming Growth Factor beta1

Sigmoid colon cancer occasionally attaches to the adjacent viscera. It is estimated that such attachment occurs in 6% to 12% of all patients with colon carcinoma without distant metastases. This study was performed to identify the parameters to distinguish direct tumor invasion to adjacent organs from simple inflammatory adhesion in sigmoid colon cancer and to clarify the difference of survival and recurrence pattern between two groups. METHODS: Between 1989 and 1998, 415 patients underwent resection of sigmoid colon cancer in our clinic. Of these, 46 had tumors adherent to adjacent organs and confirmed as tumor direct invasion or simple inflammatory adhesion by pathologic examination. The mean age of 46 cases was 54.2+/-12.8 (mean+/-SD) years and median follow up was 21 (3~53) months. RESULTS: Among the clinical and pathologic parameters such as symptoms and laboratory findings presenting bowel obstruction, serum CEA levels, preoperative radiological findings, tumor size, differentiation, and stage, there was no specific one that was correlated with direct tumor invasion or inflammatory adhesion. Almost all cases with adhesion to adjacent organ were treated by an en bloc resection including mutivisceral resection. The group with direct invasion had inferior disease free survival rate and overall survival rate comparing with simple inflammatory adhesion group. CONCLUSIONS: In the situation that there was no valuable parameter suggesting direct tumor invasion, en bloc resection or multivisceral resection involving one tumor-free plane may be beneficial to the patients with sigmoid colon cancer adherent to adjacent organ.
Colon ; Colon, Sigmoid* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Sigmoid Neoplasms* ; Survival Rate ; Viscera

PURPOSE: The anatomic and physiologic changes after rectal cancer surgery was suggested to be a cause of inguinal hernia. But, there are only few reported cases about the inguinal hernia following rectal cancer surgery. The aim of this study is to verify risk factors and surgical techniques to prevent inguinal hernia following rectal cancer surgery. METHODS: Out of 1226 patients who underwent operations at the Department of Surgery, Asan Medical Center, between the period from June 1989 to July 1999, 12 patients who had developed inguinal hernia and their medical records were reviewed retrospectively regarding the clinical characteristics. RESULTS: The median duration of hernia following rectal cancer surgery was 12 (3-36) months. The median age was 63 (36-74) years with eight of them more than seventh decades of their life. All patients had male sex. Three of them were overweighted. Five cases had hernias on the left side, six on the right, and one case on both side. All patients had indirect inguinal hernia. Three cases had preoperative symptoms of bowel obstruction. The operations for rectal cancer were low anterior resection in eight cases, ultralow anterior resection in three cases, and abdominoperineal resection in one case. The complications in rectal cancer surgery were found in six cases. Six cases had the advanced stage. A postoperative radiation therapy was applied in five cases. Five cases had the coexisting diseases. CONCLUSIONS: Male sex and old age would be related with occuring inguinal hernia after rectal cancer surgery and, it would be necessary to give a special attention to the patients who have these factors, although the present study could not show the definite correlation between inguinal hernia and rectal cancer surgery due to a small number of cases.
Chungcheongnam-do ; Hernia ; Hernia, Inguinal* ; Humans ; Male ; Medical Records ; Overweight ; Rectal Neoplasms* ; Retrospective Studies ; Risk Factors