The t(3;21) (q26;q22) is associated with chronic myelogenous leukemia in blast crisis, leukemia evolving from therapy-related myelodysplasia, and with leukemia following other hematopoietic proliferative diseases. The t(3;21) is rare secondary aberration in blast crisis of Philadelphia(Ph)-positive chronic myeloid leukemia, which may be restricted to patients entering myeloid blast crisis. We report here in one case of chronic myeloid leukemia in blast crisis which reveals both t(9;22) (q34;q11), and t(3;21) (q26 ;q22). A 62-year-old male was diagnosed as chronic myeloid leukemia 5 years ago, received hydroxyurea therapy, and admitted because of gingival bleeding and fever. On examination, splenomegaly and leukocytosis with proliferated blasts(91%) in peripheral blood were noted. Bone marrow aspirate showed hypercellularity with severe blast proliferation(92.5%) which revealed all negative in peroxidase and PAS stain. Cytogenetic study of bone marrow cells showed the karyotype 46, XY, t(3;21) (q26;q22), t(9;22) (q34;q11), which might be suspected as myeloid blast crisis. Above finding was confirmed by the result of immunophenotyping(CD13 43.6%, CD34 68.2%, HLA-DR 91.6%). He received intensive chemotherapy, but still sustained proliferation of blasts was noted . The follow up cytogenetic study was as follows: 46, XY, 4(3;21) (q26:22), t(9;22) (q34;q11)/46, XY, t(3;21)(q26;q22), del(8) (q22), t(9:22) (q34,q11)/46, XY (16/3/1). He died soon from severe pancytopenia and sepsis.
Blast Crisis* ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Fever ; Follow-Up Studies ; Hemorrhage ; HLA-DR Antigens ; Humans ; Hydroxyurea ; Karyotype ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytosis ; Male ; Middle Aged ; Pancytopenia ; Peroxidase ; Sepsis ; Splenomegaly

No abstract available.

Silicone gel breast implants may induce local(fibrous capsular contracture) or systemic(rheumatoid arthritis, systemic sclerosis, etc) complications. The exact mechanism of fibrous capsular contracture has not been fully understood. In the present study, we tried to find out the effect of silicone gel on the fibroblast proliferation which has been known as a major contributing factor in fibrous capsular contracture formation. In vitro, activated macrophages are known to secrete monokines which affect fibroblast proliferation and collagen synthesis. And tumour necrosis factor-alpha(TNF-alpha) and interleukin-6(IL-6), which were released by macrophages, were reported as potent stimulator of fibroblast proliferation. The goal of this study is to investigate the role of macrophages and tumour necrosis factor-alphaor interleukin-6 in the interaction of fibroblasts and silicone gel. We designed four groups, two experimental and two control, using Institute for Cancer Research(ICR) mouse peritioneal macrophage and silicone gel. For the preparation of the conditioned medium of macrophages, peritoneal macrophages were prepared and cultured for 24 hours on the silicone gel-coated and naked (not coated) surface [silicone gel-macrophage conditioned medium(SCM; experimental group) and normal polystyrene-macrophage conditioned medium(NCM; control group) respectively]. To correct the effect of 10% fetal bovine serum which was included in Rapid Prototyping and Manufacturing Institute (RPMI) 1640 medium and draw the effect only by macrophages, the RPMI 1640 medium with 10% fetal bovine serum was cultured by the same method on the silicone gel-coated and naked surface (silicone gel-macrophage free conditioned medium; SFM and normal polystyrene-macrophage free conditioned medium; NFM respectively). Each conditioned medium was added onto NIH 3T3 fibroblasts culture at a final 25% concentration of total culture medium and followed by the cultivation for 24 hours. For antibody neutralizing experiments, each conditioned medium was preincubated with polyclonal rabbit anti-mouse TNF-alpha antibody or polyclonal rat anti-mouse IL-6 antibody for 1 hour and then, conditioned medium with antibody was added to the culture medium of NIH 3T3 fibroblasts by the same method. After 24 hours cultivation, total number of viable fibroblast(cell growth), DNA synthesis and collagen synthesis of fibroblasts with each medium were measured by sulforhodamine B(SRB) assay, 3H-thymidine and 3H-proline incorporation respectively. The results were as follows: 1. In the experiment about the effect of the conditioned medium on the fibroblast activity, the experimental group(SCM), compared with the control group(NCM), showed a significant increase of the cell growth (p<0.01), a significant decrease of DNA synthesis(p<0.001), but no significant difference in the collagen synthesis. 2. In the experiment about the effect of polyclonal rabbit anti-mouse TNF-alpha antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.01), but no significant difference in the collagen syn thesis. 3. In the experiment about the effect of polyclonal rat anti-mouse IL-6 antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.0001), but no significant difference in the collagen synthesis. In conclusion, culture supernatants (conditioned medium) of peritoneal macrophages, activated by silicone gel, stimulate the NIH 3T3 fibroblast proliferation. TNF-alpha and IL-6, products of macrophage, are involved in the stimulation of NIH 3T3 fibroblast proliferation in an in vitro condition.
Animals ; Arthritis ; Breast Implants ; Collagen ; Contracture ; Culture Media, Conditioned ; DNA ; Fibroblasts* ; Interleukin-6* ; Macrophages ; Macrophages, Peritoneal* ; Mice ; Monokines ; Necrosis ; Rats ; Scleroderma, Systemic ; Silicone Gels* ; Tumor Necrosis Factor-alpha*

Congenital dislocation of the knee is very rare skeletal deformity and was firstly described by Chatelaine in 1822. Since then there have been a few number of case reports and some series discussing the etiology and treatment. The tibia is displaced anteriorly in relation to the femur. It is generally subdassified as simple hyperextention, subluxation, and dislocation depending on the degree of the joint displacement and the severity of disease. Early gentle manipulation and serial splintage or plaster cast are recommended for treatment and were successful in the majority except the case of quadriceps contrarture or late correction. The authors experienced one case of congenital dislocation of the right knee and brief review of the related literatures was made.
Casts, Surgical ; Congenital Abnormalities ; Dislocations* ; Femur ; Joints ; Knee* ; Tibia

This is a comparative study based on the data of legal autopsies performed at the National Institute of Scientific Investigation, Seoul, during the year of 2000. In South Korea, the pathologists usually do not attend the death scene, and the scene investigation is performed only by the law enforcement agency. The latter collects the information needed for clarifying the cause and manner of death. The authors tried to estimate the efficiency of the death investigation through the discrepancy between the presumed and the most possible cause of death. We presumed the cause of death on the ground of police investigation and external examination by the general physicians, The most possible cause of death means the best diagnosis after autopsy by pathologists, with the consideration of police information. Followings are the summary of the results. The coincidence rate with the most possible death are over 90% in presumed trauma, asphyxia, thermal injuries, electrocution, starvation/neglect, and over 80% in drowning and natural deaths. The rate was low in medical injuries(26.6%) and poisoning(67.2%). 7.3 to 8.2% were natural in presumed blunt trauma, traffic injury and fall down injuries. Among 48 cases of presumed ligature strangulation, 6 were other type of asphyxia or other injuries, and 2 unknown. The coincidence rate was only 30.8% in acute alcohol poisoning. 5.9% of presumed fire death was proved other type of violent injuries. In the field of medical practices, only 6.3% of accused general medical procedures were proved dead due to themselves. But the rate was increased up to 49.0% in presumed surgery/anesthetic deaths. 12.9% were violent death in presumed natural death, and 64.6% were dead due to violent causes in the cases of no presumable cause of death.
Asphyxia ; Autopsy* ; Cause of Death* ; Diagnosis ; Drowning ; Fires ; Humans ; Korea ; Law Enforcement ; Ligation ; Poisoning ; Police ; Seoul

We describe the case of a patient with symptomatic left cervical ICA stenosis and aneurysm of the left distal anterior cerebral artery. She presented with chronic headache and recurrent attack of right hemiparesis, and underwent staged operations. Using the interhemispheric approach, the intracranial aneurysm was clipped, and there was no postoperative neurologic deterioration. Two months later, a carotid endarterectomy was performed. The patient recovered without complications and angiography revealed relief of carotid stenosis and non-visualization of the aneurysm. The coexistence of symptomatic carotid stenosis and an unruptured intracranial aneurysm poses a therapeutic dilemma; correction of significant stenosis of the internal carotid artery may increase the pressure and turbulence to which the aneurysm is subjected, while the intracranial approach to an aneurysm, when blood flow is decreased by carotid stenosis, may also involve increased risk. In view of the theoretical risk of increased blood flow and turbulence after carotid endarterectomy, aneurysm neck clipping followed by this procedure either in a single stage or separate stages seems to be the another safest management strategy.
Aneurysm* ; Angiography ; Anterior Cerebral Artery ; Carotid Artery, Internal ; Carotid Stenosis* ; Constriction, Pathologic ; Endarterectomy, Carotid ; Headache Disorders ; Humans ; Intracranial Aneurysm ; Neck ; Paresis

Hypereosinophilic syndrome comprises several disorders with the common features of prolonged eosinophilia of an undetectable cause and organ system dysfunction. It is likely that organ damage is due to infiltration by eosinophils or to eosinophil-derived products. We report a case of hypereosinophilic syndrome with multiple mononeuropathy verified by EMG, nerve conduction study, and biosy..
Eosinophilia ; Eosinophils ; Hypereosinophilic Syndrome* ; Mononeuropathies* ; Neural Conduction

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation (NISI), requested by every kind of law enforcement agencies during the year of 2005. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,851 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,007 cases (70.4%) and that of female 844 (29.6%). Male was over twice more than female. The forties were 807 cases (28.3%), the thirties 573 (20.1%), and these two decades occupied 48.4%. 2. Unnatural deaths were 1,716 cases (60.2%), natural 1011 (35.5%), and the unknown 124 (4.3%). Among 1,716 unnatural deaths, suicide was 497 (29.0%), homicide 426 (24.9%), accident 510 (29.6%), and the unclear 283 (16.5%). Homicide occupied 42.0% of trauma, 75.6% of blunt force injury excluding traffic and fall-down injury, and 85.5% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 60.1% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 716 cases, occupying 41.7% of 1,716 unnatural deaths, followed by asphyxial deaths(296 cases). Blunt trauma was 205 cases (28.6%) and the leading cause of death in traumatic death. Poisoning was 229 cases, among which the ethanols were dominant (58cases). Thermal injuries were 198 cases, electrocution 20 cases, and starvation/neglect 14 cases. and 18 cases were directly due to medical procedures. 4. Among 1,011 natural deaths, heart diseases were 481 cases (47.6%), and vascular diseases 193 (19.1%), and these two categories were added up to 674 (66.7%). 5. Child deaths under the age of 10 were 129 cases. Homicide was 40 cases (62.5%) out of 64 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 41 cases(31.8%)
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Ethanol ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases

PURPOSE: To describe the pattern of various shoulder abnormalities with an associated superior labrum anterior to posterior (SLAP) lesion type II using magnetic resonance (MR) arthrography, and to assess the clinical significance of the associated abnormalities. MATERIALS AND METHODS: A retrospective review of the MR arthrographic findings of 92 cases of a shoulder with an arthroscopically confirmed SLAP lesion type II was performed. The MR arthrography images were reviewed and analyzed. MR arthrographic analysis noted the presence of a rotator cuff abnormality, acromioclavicular arthritis, adhesive capsulitis, glenohumeral arthritis, a labral abnormality besides the SLAP lesion, and a paralabral cyst. The patients with SLAP lesions were divided into two age groups: those over 40 years of age and those forty years old or younger. Statistical analysis was performed to evaluate the influence of age on the various shoulder abnormalities with associated SLAP lesion. RESULTS: Of the 92 SLAP lesions type II, there were 7 cases (8%) of isolated SLAP lesions without any associated any shoulder abnormality. Eighty-five (92%) SLAP lesions were associated with various shoulder abnormalities including rotator cuff tendinosis (30/92, 33%), partial-thickness tear (36/92, 39%), full-thickness tear (2/92, 2%), acromioclavicular arthritis (46/92, 50%), adhesive capsulitis (7/92, 8%), glenohumeral arthritis (15/92, 16%), labral abnormality (26/92, 28 %) and paralabral cyst (7/92, 8%). The SLAP lesions (60/92, 65%) in patients over forty years of age were accompanied by a significantly high number of rotator cuff abnormalities (p < 0.001), glenohumeral osteoarthritis (p = 0.001), and acromioclavicular osteoarthritis (p < 0.001). In contrast, the SLAP lesions (32/92, 35%) in patients forty years old or younger had a significantly high number of anterior or posterior labral lesions (p < 0.001). CONCLUSION: Isolated SLAP lesions type II without other associated shoulder abnormalities are uncommon, and the age of the patient influences the prevalence of other shoulder abnormalities associated with SLAP lesions. In addition, MR arthrography can help detect shoulder abnormalities accompanying the SLAP lesions.
Arthritis ; Arthrography ; Bursitis ; Humans ; Osteoarthritis ; Prevalence ; Retrospective Studies ; Rotator Cuff ; Shoulder* ; Tendinopathy

No abstract available.
Apoproteins* ; Diabetic Nephropathies* ; Lipoproteins*